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At least 145 records · Page 8

Extended Field Intensity Modulated Radiation Therapy With Concomitant Boost for Lymph Node–Positive Cervical Cancer: Analysis of Regional Control and Recurrence Patterns in the Positron Emission Tomography/Computed Tomography Era

Purpose: Positron emission tomography/computed tomography (PET/CT) is commonly used for nodal staging in locally advanced cervical cancer; however the false negative rate for para-aortic disease are 20% to 25% in PET-positive pelvic nodal disease. Unless surgically staged, pelvis-only treatment may undertreat para-aortic disease. We have treated patients with PET-positive nodes with extended field intensity modulated radiation therapy (IMRT) to address the para-aortic region prophylactically with concomitant boost to involved nodes. The purpose of this study was to assess regional control rates and recurrence patterns. Methods and Materials: Sixty-one patients with cervical cancer (stage IBI-IVA) diagnosed from 2003 to 2012 with PET-avid pelvic nodes treated with extended field IMRT (45 Gy in 25 fractions with concomitant boost to involved nodes to a median of 55 Gy in 25 fractions) with concurrent cisplatin and brachytherapy were retrospectively analyzed. The nodal location was pelvis-only in 41 patients (67%) and pelvis + para-aortic in 20 patients (33%). There were a total of 179 nodes, with a median number of positive nodes of 2 (range, 1-16 nodes) per patient and a median nodal size of 1.8 cm (range, 0.7-4.5 cm). Response was assessed by PET/CT at 12 to 16 weeks. Results: Complete clinical and imaging response at the first follow-up visit was seen in 77% of patients. At a mean follow-up time of 29 months (range, 3-116 months), 8 patients experienced recurrence. The sites of persistent/recurrent disease were as follows: cervix 10 (16.3%), regional nodes 3 (4.9%), and distant 14 (23%). The rate of para-aortic failure in patients with pelvic-only nodes was 2.5%. There were no significant differences in recurrence patterns by the number/location of nodes, largest node size, or maximum node standardized uptake value. The rate of late grade 3+ adverse events was 4%. Conclusions: Extended field IMRT was well tolerated and resulted in low regional recurrence in node-positive cervical cancer. The dose of 55 Gy in 25 fractions was effective in eradicating disease in involved nodes, with acceptable late adverse events. Distant metastasis is the predominant mode of failure, and the OUTBACK trial may challenge the presented paradigms.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Patterns of Local-Regional Management Following Neoadjuvant Chemotherapy in Breast Cancer: Results From ACOSOG Z1071 (Alliance)

Purpose: American College of Surgeons Oncology Group Z1071 was a prospective trial evaluating the false negative rate of sentinel lymph node (SLN) surgery after neoadjuvant chemotherapy (NAC) in breast cancer patients with initial node-positive disease. Radiation therapy (RT) decisions were made at the discretion of treating physicians, providing an opportunity to evaluate variability in practice patterns following NAC. Methods and Materials: Of 756 patients enrolled from July 2009 to June 2011, 685 met all eligibility requirements. Surgical approach, RT, and radiation field design were analyzed based on presenting clinical and pathologic factors. Results: Of 401 node-positive patients, mastectomy was performed in 148 (36.9%), mastectomy with immediate reconstruction in 107 (26.7%), and breast-conserving surgery (BCS) in 146 patients (36.4%). Of the 284 pathologically node-negative patients, mastectomy was performed in 84 (29.6%), mastectomy with immediate reconstruction in 69 (24.3%), and BCS in 131 patients (46.1%). Bilateral mastectomy rates were higher in women undergoing reconstruction than in those without (66.5% vs 32.2%, respectively, P<.0001). Use of internal mammary RT was low (7.8%-11.2%) and did not differ between surgical approaches. Supraclavicular RT rate ranged from 46.6% to 52.2% and did not differ between surgical approaches but was omitted in 193 or 408 node-positive patients (47.3%). Rate of axillary RT was more frequent in patients who remained node-positive (P=.002). However, 22% of patients who converted to node-negative still received axillary RT. Post-mastectomy RT was more frequently omitted after reconstruction than mastectomy (23.9% vs 12.1%, respectively, P=.002) and was omitted in 19 of 107 patients (17.8%) with residual node-positive disease in the reconstruction group. Conclusions: Most clinically node-positive patients treated with NAC undergoing mastectomy receive RT. RT is less common in patients undergoing reconstruction. There is wide variability in RT fields. These practice patterns conflict with expert recommendations and ongoing trial guidelines. There is a significant need for greater uniformity and guidelines regarding RT following NAC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Detection of Local Cancer Recurrence After Stereotactic Ablative Radiation Therapy for Lung Cancer: Physician Performance Versus Radiomic Assessment

Purpose: Stereotactic ablative radiation therapy (SABR) is a guideline-specified treatment option for early-stage lung cancer. However, significant posttreatment fibrosis can occur and obfuscate the detection of local recurrence. The goal of this study was to assess physician ability to detect timely local recurrence and to compare physician performance with a radiomics tool. Methods and Materials: Posttreatment computed tomography (CT) scans (n=182) from 45 patients treated with SABR (15 with local recurrence matched to 30 with no local recurrence) were used to measure physician and radiomic performance in assessing response. Scans were individually scored by 3 thoracic radiation oncologists and 3 thoracic radiologists, all of whom were blinded to clinical outcomes. Radiomic features were extracted from the same images. Performances of the physician assessors and the radiomics signature were compared. Results: When taking into account all CT scans during the whole follow-up period, median sensitivity for physician assessment of local recurrence was 83% (range, 67%-100%), and specificity was 75% (range, 67%-87%), with only moderate interobserver agreement (κ = 0.54) and a median time to detection of recurrence of 15.5 months. When determining the early prediction of recurrence within <6 months after SABR, physicians assessed the majority of images as benign injury/no recurrence, with a mean error of 35%, false positive rate (FPR) of 1%, and false negative rate (FNR) of 99%. At the same time point, a radiomic signature consisting of 5 image-appearance features demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.85, classification error of 24%, FPR of 24%, and FNR of 23%. Conclusions: These results suggest that radiomics can detect early changes associated with local recurrence that are not typically considered by physicians. This decision support system could potentially allow for early salvage therapy of patients with local recurrence after SABR.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Evaluation of Preoperative and Intraoperative Mobile Gamma Camera Imaging in Sentinel Lymph Node Biopsy for Melanoma Independent of Preoperative Lymphoscintigraphy

Sentinel lymph node biopsy (SLNB) is standard practice for staging cutaneous melanoma. High false negative rates have increased interest in adjunctive techniques for localizing SLNs. Mobile gamma cameras (MGCs) represent potential tools to enhance SLNB performance. Twenty eligible melanoma patients underwent 99mTc sulfur colloid injection and standard lymphoscintigraphy with a fixed gamma camera (FGC). A survey using a 20 cm square MGC, performed immediately preoperatively by the study surgeon, was used to establish an operative plan while blinded to the FGC results. Subsequently, SLNB was performed using a gamma probe and a novel 6 cm diameter handheld MGC. A total of 24 SLN basins were detected by FGC. Prior to unblinding, all 24 basins were identified with the preoperative MGC, and the operative plan established by preoperative MGC imaging was confirmed accurate by review of the FGC images. All individual SLNs were identified during intraoperative MGC imaging, and in 5/24 (21%) cases, additional clinical information was obtained from the MGC. Preoperative MGC images provide information consistent with FGC images for planning SLNB and in some cases provides additional information that aided in surgical decision-making.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Radial feature descriptors for cell classification and recommendation

This paper introduces computational tools for cell classification into normal and abnormal, as well as content-based-image-retrieval (CBIR) for cell recommendation. It also proposes the radial feature descriptors (RFD), which define evenly interspaced segments around the nucleus, and proportional to the convexity of the nuclear boundary. Experiments consider Herlev and CRIC image databases as input to classification via Random Forest and bootstrap; we compare 14 different feature sets by means of False Negative Rate (FNR) and Kappa (κ), obtaining FNR =0.02 and κ=0.89 for Herlev, and FNR =0.14 and κ=0.78 for CRIC. Next, we sort and rank cell images using convolutional neural networks and evaluate performance with the Mean Average Precision (MAP), achieving MAP =0.84 and MAP =0.82 for Herlev and CRIC, respectively. Finally, cell classification show encouraging results regarding RFD, including its sensitivity to intensity variation around the nuclear membrane as it bypasses cytoplasm segmentation.

47 OTHER INSTRUMENTATION↗

Initial experience of ArcCHECK and 3DVH software for RapidArc treatment plan verification

The purpose of this study was to perform delivery quality assurance with ArcCHECK and 3DVH system (Sun Nuclear, FL) and to evaluate the suitability of this system for volumetric-modulated arc therapy (VMAT) (RapidArc [RA]) verification. This software calculates the delivered dose distributions in patients by perturbing the calculated dose using errors detected in fluence or planar dose measurements. The device is tested to correlate the gamma passing rate (%GP) and the composite dose predicted by 3DVH software. A total of 28 patients with prostate cancer who were treated with RA were analyzed. RA treatments were delivered to a diode array phantom (ArcCHECK), which was used to create a planned dose perturbation (PDP) file. The 3DVH analysis used the dose differences derived from comparing the measured dose with the treatment planning system (TPS)-calculated doses to perturb the initial TPS-calculated dose. The 3DVH then overlays the resultant dose on the patient's structures using the resultant “PDP” beams. Measured dose distributions were compared with the calculated ones using the gamma index (GI) method by applying the global (Van Dyk) normalization and acceptance criteria, i.e., 3%/3 mm. Paired differences tests were used to estimate statistical significance of the differences between the composite dose calculated using 3DVH and %GP. Also, statistical correlation by means of logistic regression analysis has been analyzed. Dose-volume histogram (DVH) analysis for patient plans revealed small differences between treatment plan calculations and 3DVH results for organ at risk (OAR), whereas planning target volume (PTV) of the measured plan was systematically higher than that predicted by the TPS. The t-test results between the planned and the estimated DVH values showed that mean values were incomparable (p < 0.05). The quality assurance (QA) gamma analysis 3%/3 mm showed that in all cases there were only weak-to-moderate correlations (Pearson r: 0.12 to 0.74). Moreover, clinically relevant differences increased with increasing QA passing rate, indicating that some of the largest dose differences occurred in the cases of high QA passing rates, which may be called “false negatives.” The clinical importance of any disagreement between the measured and the calculated dose is often difficult to interpret; however, beam errors (either in delivery or in TPS calculation) can affect the effectiveness of the patient dose. Further research is needed to determinate the role of a PDP-type algorithm to accurately estimate patient dose effect.

61 RADIATION PROTECTION AND DOSIMETRY↗

Jensen–Shannon divergence based novel loss functions for Bayesian neural networks

Bayesian neural networks (BNNs) are state-of-the-art machine learning methods that can naturally regularize and systematically quantify uncertainties using their stochastic parameters. Kullback–Leibler (KL) divergence-based variational inference used in BNNs suffer from unstable optimization and challenges in approximating light-tailed posteriors due to the unbounded nature of the KL divergence. To resolve these issues, we formulate a novel loss function for BNNs based on a new modification to the generalized Jensen–Shannon (JS) divergence, which is bounded. In addition, we propose a Geometric JS divergence-based loss, which is computationally efficient since it can be evaluated analytically. We found that the JS divergence-based variational inference is intractable, and hence employed a constrained optimization framework to formulate these losses. Our theoretical analysis and empirical experiments on multiple regression and classification data sets suggest that the proposed losses perform better than the KL divergence-based loss, especially when the data sets are noisy or biased. Specifically, there are approximately 5% and 8% improvements in accuracy for a noise-added CIFAR-10 dataset and a regression dataset, respectively. There is about 13% reduction in false negative predictions of a biased histopathology dataset. Additionally, we quantify and compare the uncertainty metrics for the regression and classification tasks.

97 MATHEMATICS AND COMPUTING↗

Limits of special material detectability fundamental to idealized dual-energy radiographic systems

Analysis of dual-energy radiographic approaches to the detection of “special” material, i.e. contraband, in otherwise innocuous scenes, such as maritime cargo containers encountered at ports of entry, reveals fundamental limitations of data obtained along a single line-of-sight. The basic equations that describe idealized systems are presented and analyzed so as to identify challenges that are only exacerbated by scatter, noise, and measurement uncertainty. In the mono-energetic limit, the instrumentation and measurement methods reduce to a system of linear equations that are simple to treat: it is observed that there exists a threshold for the minimum amount of high-Z material that can be detected unambiguously (without the risk of false positive or false negative indications), even when the background materials are of finite and of well-known variety. The threshold depends on the quality of prior information about the cargo and the selection of probing energies, and can therefore be minimized by good system design practices and measurement procedures, but persists as a general challenge to security operations. In discussion of this result, it is noted that techniques incorporating other prior information, such as the geometry of cargo and potential contraband, along with data from 2D imaging, have far greater potential. For instance, a simple data analysis method capable of differentiating high-Z spheres from those of more common material is presented. This simple example demonstrates that, although simple line-of-sight transmission radiography may suffer fundamental limitations, there remains good cause to be optimistic about the potential for image analysis in radiographic material identification.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

A novel experimental system for the KDK measurement of the 40 K decay scheme relevant for rare event searches

Potassium-40 ( 40 K) is a long-lived, naturally occurring radioactive isotope. The decay products are prominent backgrounds for many rare event searches, including those involving NaI-based scintillators. 40 K also plays a role in geochronological dating techniques. The branching ratio of the electron capture directly to the ground state of argon-40 has never been measured, which can cause difficulty in interpretingcertain results or can lead to lack of precision depending on the field and analysis technique. Additionally, the KDK (Potassium (K) Decay (DK)) collaboration is measuring this decay. A composite method has a silicon drift detector with an enriched, thermally deposited 40 K source inside the Modular Total Absorption Spectrometer. This setup has been characterized in terms of energy calibration, gamma tagging efficiency, live time and false negatives and positives. A complementary, homogeneous, method is also discussed; it employs a KSr 2 I 5 :Eu scintillator as source and detector.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Validating genome-wide CRISPR-Cas9 function improves screening in the oleaginous yeast Yarrowia lipolytica

Genome-wide mutational screens are central to understanding the genetic underpinnings of evolved and engineered phenotypes. The widespread adoption of CRISPR-Cas9 genome editing has enabled such screens in many organisms, but identifying functional sgRNAs still remains a challenge. Here, we developed a methodology to quantify the cutting efficiency of each sgRNA in a genome-scale library, and in doing so improve screens in the biotechnologically important yeast Yarrowia lipolytica. Screening in the presence and absence of native DNA repair enabled high-throughput quantification of sgRNA function leading to the identification of high efficiency sgRNAs that cover 94% of genes. Library validation enhanced the classification of essential genes by identifying inactive guides that create false negatives and mask the effects of successful disruptions. Quantification of guide effectiveness also creates a dataset from which determinants of CRISPR-Cas9 can be identified. Finally, application of the library identified novel mutations for metabolic engineering of high lipid accumulation.

59 BASIC BIOLOGICAL SCIENCES↗

A Two-Step Absorber Deposition Approach To Overcome Shunt Losses in Thin-Film Solar Cells: Using Tin Sulfide as a Proof-of-Concept Material System

As novel absorber materials are developed and screened for their photovoltaic (PV) properties, the challenge remains to reproducibly test promising candidates for high-performing PV devices. Many early-stage devices are prone to device shunting due to pinholes in the absorber layer, producing “false-negative” results. We demonstrate a device engineering solution toward a robust device architecture, using a two-step absorber deposition approach. We use tin sulfide (SnS) as a test absorber material. The SnS bulk is processed at high temperature (400 °C) to stimulate grain growth, followed by a much thinner, low-temperature (200 °C) absorber deposition. At a lower process temperature, the thin absorber overlayer contains significantly smaller, densely packed grains, which are likely to provide a continuous coating and fill pinholes in the underlying absorber bulk. We compare this two-step approach to the more standard approach of using a semi-insulating buffer layer directly on top of the annealed absorber bulk, and we demonstrate a more than 3.5× superior shunt resistance R sh with smaller standard error σ Rsh . Electron-beam-induced current (EBIC) measurements indicate a lower density of pinholes in the SnS absorber bulk when using the two-step absorber deposition approach. We correlate those findings to improvements in the device performance and device performance reproducibility.

14 SOLAR ENERGY↗

Cric searchable image database as a public platform for conventional pap smear cytology data

Amidst the current health crisis and social distancing, telemedicine has become an important part of mainstream of healthcare, and building and deploying computational tools to support screening more efficiently is an increasing medical priority. The early identification of cervical cancer precursor lesions by Pap smear test can identify candidates for subsequent treatment. However, one of the main challenges is the accuracy of the conventional method, often subject to high rates of false negative. While machine learning has been highlighted to reduce the limitations of the test, the absence of high-quality curated datasets has prevented strategies development to improve cervical cancer screening. The Center for Recognition and Inspection of Cells (CRIC) platform enables the creation of CRIC Cervix collection, currently with 400 images (1,376 × 1,020 pixels) curated from conventional Pap smears, with manual classification of 11,534 cells. This collection has the potential to advance current efforts in training and testing machine learning algorithms for the automation of tasks as part of the cytopathological analysis in the routine work of laboratories.

59 BASIC BIOLOGICAL SCIENCES↗

A comparison of machine learning methods to classify radioactive elements using prompt-gamma-ray neutron activation data

The detection of illicit radiological materials is critical to establishing a robust second line of defence in nuclear security. Neutron-capture prompt-gamma activation analysis (PGAA) can be used to detect multiple radioactive materials across the entire Periodic Table. However, long detection times and a high rate of false positives pose a significant hindrance in the deployment of PGAA-based systems to identify the presence of illicit substances in nuclear forensics. In the present work, six different machine-learning algorithms were developed to classify radioactive elements based on the PGAA energy spectra. The model performance was evaluated using standard classification metrics and trend curves with an emphasis on comparing the effectiveness of algorithms that are best suited for classifying imbalanced datasets. We analyse the classification performance based on Precision, Recall, F1-score, Specificity, Confusion matrix, ROC-AUC curves, and Geometric Mean Score (GMS) measures. The tree-based algorithms (Decision Trees, Random Forest and AdaBoost) have consistently outperformed Support Vector Machine and K-Nearest Neighbours. Based on the results presented, AdaBoost is the preferred classifier to analyse data containing PGAA spectral information due to the high recall and minimal false negatives reported in the minority class.

97 MATHEMATICS AND COMPUTING↗

Random forest models accurately classify synthetic opioids using high-dimensionality mass spectrometry datasets

Detection of novel threat agents presents several challenges, a principle one being the development of untargeted methods to screen an increasing number of threat chemicals whose exact structures are unknown. With the use of Machine Learning (ML) tools, we can guide the development of analytical methods for broad-spectrum detection of unbounded threat chemical families in complex mixtures. Toward this goal, we used nominal mass and high-resolution mass spectrometry data for hundreds of synthetic opioids and non-opioid compounds. We tested two ML techniques, logistic regression and random forest, to develop models towards a practical, implementable method for opioid detection. We found that of these tested ML methods, random forest models resulted in the highest validation accuracy (95+%) for both nominal mass and high-resolution classification of opioids versus non-opioids, with low false positive and false negative rates. The RF models were then used to successfully predict the classification of 10 compounds—five opioids and five non-opioids not part of the training and validation analysis. This application of ML is a critical step towards the development of field-deployable nominal mass spectrometers with ML-driven analyses for classification of emergent threats.

Chemistry↗

Prevalence of Self-Reported Voice Concerns and Associated Risk Markers in a Nonclinical Sample of Military Service Members

Introduction: Difficult communication environments are common in military settings, and effective voice use can be critical to mission success. This study aimed to estimate the prevalence of self-reported voice disorders among U.S. military service members and to identify factors that contribute to their voice concerns. Method: A nonclinical sample of 4,123 active-duty service members was recruited across Department of Defense hearing conservation clinics. During their required annual hearing evaluation, volunteers provided responses to voice-related questions including a slightly adapted version of the Voice Handicap Index-10 (VHI-10) as part of a larger survey about communication issues. Changepoint detection was applied to age and years of service to explore cohort effects in the reporting of voice concerns. Logistic regression analyses examined multiple available factors related to communication to identify factors associated with abnormal results on the VHI-10. Results: Among the respondents, 41% reported experiencing vocal hoarseness or fatigue at least several times per year, and 8.2% ( n = 336) scored above the recommended abnormal cut-point value of 11 on the VHI-10. Factors independently associated with the greatest risk for self-reported voice concerns were sex (female), cadmium exposure, vocal demands (the need for a strong, clear voice), and auditory health measures (frequency of experiencing temporary threshold shifts; self-reported hearing difficulties). Conclusions: Based on self-reported voice concerns and false negative rates reported in the literature, the prevalence of dysphonia in a large sample of active-duty service members is estimated to be 11.7%, which is higher than that in the general population. Certain predictors for voice concerns were expected based on previous literature, like female sex and voice use, but frequency of temporary threshold shifts and exposure to cadmium were surprising. The strong link between voice and auditory problems has particular implications regarding the need for effective communication in high-noise military and other occupational environments.

Audiology & Speech-Language Pathology↗

Sensing small changes in a wave chaotic scattering system

Classical analogs of the quantum mechanical concepts of the Loschmidt Echo and quantum fidelity are developed with the goal of detecting small perturbations in a closed wave chaotic region. Sensing techniques that employ a one-recording-channel time-reversal-mirror, which in turn relies on time reversal invariance and spatial reciprocity of the classical wave equation, are introduced. In analogy with quantum fidelity, we employ scattering fidelity techniques which work by comparing response signals of the scattering region, by means of cross correlation and mutual information of signals. The performance of the sensing techniques is compared for various perturbations induced experimentally in an acoustic resonant cavity. The acoustic signals are parametrically processed to mitigate the effect of dissipation and to vary the spatial diversity of the sensing schemes. In addition to static boundary condition perturbations at specified locations, perturbations to the medium of wave propagation are shown to be detectable, opening up various real world sensing applications in which a false negative cannot be tolerated.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Numerical characterization of support recovery in sparse regression with correlated design

Sparse regression is employed in diverse scientific settings as a feature selection method. A pervasive aspect of scientific data is the presence of correlations between predictive features. These correlations hamper both feature selection and estimation and jeopardize conclusions drawn from estimated models. On the other hand, theoretical results on sparsity-inducing regularized regression have largely addressed conditions for selection consistency via asymptotics, and disregard the problem of model selection, whereby regularization parameters are chosen. In this numerical study, we address these issues through exhaustive characterization of the performance of several regression estimators, coupled with a range of model selection strategies. These estimators and selection criteria were examined across correlated regression problems with varying degrees of signal to noise, distributions of non-zero model coefficients, and model sparsity. Our results reveal a fundamental tradeoff between false positive and false negative control in all regression estimators and model selection criteria examined. Additionally, we numerically explore a transition point modulated by the signal-to-noise ratio and spectral properties of the design covariance matrix at which the selection accuracy of all considered algorithms degrades. Overall, we find that SCAD coupled with BIC or empirical Bayes model selection performs the best feature selection across the regression problems considered.

97 MATHEMATICS AND COMPUTING↗

Identifying high-redshift gamma-ray bursts with RATIR

We present a template-fitting algorithm for determining photometric redshifts, z {sub phot}, of candidate high-redshift gamma-ray bursts (GRBs). Using afterglow photometry, obtained by the Reionization and Transients InfraRed (RATIR) camera, this algorithm accounts for the intrinsic GRB afterglow spectral energy distribution, host dust extinction, and the effect of neutral hydrogen (local and cosmological) along the line of sight. We present the results obtained by this algorithm and the RATIR photometry of GRB 130606A, finding a range of best-fit solutions, 5.6 < z {sub phot} < 6.0, for models of several host dust extinction laws (none, the Milky Way, Large Magellanic Clouds, and Small Magellanic Clouds), consistent with spectroscopic measurements of the redshift of this GRB. Using simulated RATIR photometry, we find that our algorithm provides precise measures of z {sub phot} in the ranges of 4 < z {sub phot} ≲ 8 and 9 < z {sub phot} < 10 and can robustly determine when z {sub phot} > 4. Further testing highlights the required caution in cases of highly dust-extincted host galaxies. These tests also show that our algorithm does not erroneously find z {sub phot} < 4 when z {sub sim} > 4, thereby minimizing false negatives and allowing us to rapidly identify all potential high-redshift events.

79 ASTRONOMY AND ASTROPHYSICS↗