On the path to rabies elimination: The need for risk assessments to improve administration of post-exposure prophylaxis.

Costs of rabies post-exposure prophylaxis (PEP) often remain high in regions where rabies has been controlled in dogs, presenting a challenge for sustaining rabies elimination programmes. We investigated the potential for bite patient risk assessments to improve PEP provision and surveillance in settings approaching elimination of dog-mediated rabies. We conducted a longitudinal study of patients presenting to animal bite treatment centres (ABTCs) on the island province of Bohol in the Philippines to investigate the health status of biting dogs and to quantify current expenditure on PEP. Incidence of bite patients presenting to ABTCs was high (>300/100,000 persons/year) and increasing, resulting in substantial health provider costs. Over $142,000 was spent on PEP in 2013 for a population of 1.3 million. From follow up of 3820 bite patients we found that  >92% were bitten by healthy dogs (alive 14 days after the bite) and just 1.4% were bitten by probable or confirmed rabid dogs. The status of dogs that bit 6% of patients could not be determined. During the course of investigations of bites by suspect dogs, we were able to obtain samples for case confirmation, identify exposed persons who had not sought PEP as well as in-contact dogs at risk of developing rabies. We calculate that expenditure on PEP could at least be halved through more judicious approaches to provision of PEP, based on the histories of biting animals determined through risk assessments with bite patients. We conclude that a One Health approach to surveillance based on Integrated Bite Case Management could improve the sustainability and effectiveness of rabies elimination programmes while also improving patient care by identifying those genuinely in need of lifesaving PEP

Factorization in a torus and Riemann-Hilbert problems

A new concept of meromorphic $\Sigma$-factorization, for H\"{o}lder continuous functions defined on a contour $\Gamma$ that is the pullback of $\dot{\mathbb{R}}$ (or the unit circle) in a Riemann surface $\Sigma$ of genus 1, is introduced and studied, and its relations with holomorphic $\Sigma$-factorization are discussed. It is applied to study and solve some scalar Riemann-Hilbert problems in $\Sigma$ and vectorial Riemann-Hilbert problems in $\mathbb{C}$, including Wiener-Hopf matrix factorization, as well as to study some properties of a class of Toeplitz operators with $2 \times 2$ matrix symbols.Comment: accepted for publication in Journal of Mathematical Analysis and Application

Interstitial Hyperthermia Device

According to one aspect, an interstitial hyperthermia device has an electrode structure to be coupled to an electric power source for providing an alternating electric field for heating up a patients tissue. The device is provided with a hollow source guide for conducting a radiation source capsule to be moved by a guidewire. The hollow source guide has an inner wall for guiding the source capsule and an outer wall to be contacted with the patients tissue. The outer wall is provided with the electrode structure arranged on a circumference of the outer wall of the hollow source guide and having a dielectric layer shielding the electrode structure from the patients tissue

End-Stage Renal Disease in Familial Amyloidosis ATTR Val30Met: A

Transplant Proc. 2003 May;35(3):1116-20. End-stage renal disease in familial amyloidosis ATTR Val30Met: a definitive indication to combined liver-kidney transplantation. Lobato L, Ventura A, Beirão I, Miranda HP, Seca R, Henriques AC, Teixeira M, Sarmento AM, Pereira MC. Department of Nephrology, and Liver Transplantation Program, Hospital Geral de Santo António, Largo Professor Abel Salazar, 4050, Porto, Portugal. [email protected] PMID: 12947881 [PubMed - indexed for MEDLINE

Probing neutrino non-standard interactions with atmospheric neutrino data

We have reconsidered the atmospheric neutrino anomaly in light of the laetst data from Super-Kamiokande contained events and from Super-Kamiokande and MACRO up-going muons. We have reanalysed the proposed solution to the atmospheric neutrino anomaly in terms of non-standard neutrino-matter interactions (NSI) as well as the standard nu_mu -> nu_tau oscillations (OSC). Our statistical analysis shows that a pure NSI mechanism is now ruled out at 99%, while the standard nu_mu -> nu_tau OSC mechanism provides a quite remarkably good description of the anomaly. We therefore study an extended mechanism of neutrino propagation which combines both oscillation and non-standard neutrino-matter interactions, in order to derive limits on flavour-changing (FC) and non-universal (NU) neutrino interactions. We obtain that the off-diagonal flavour-changing neutrino parameter epsilon and the diagonal non-universality neutrino parameter epsilon' are confined to -0.03 < epsilon < 0.02 and |epsilon'| < 0.05 at 99.73% CL. These limits are model independent and they are obtained from pure neutrino-physics processes. The stability of the neutrino oscillation solution to the atmospheric neutrino anomaly against the presence of non-standard neutrino interactions establishes the robustness of the near-maximal atmospheric mixing and massive-neutrino hypothesis. The best agreement with the data is obtained for Delta_m^2 = 2.3*10^{-3} eV^2, sin^2(2*theta) = 1, epsilon = 6.7*10^{-3} and epsilon' = 1.1*10^{-3}, although the chi^2 function is quite flat in the epsilon and epsilon' directions for epsilon, epsilon' -> 0.Comment: 26 pages, LaTeX file using REVTeX4, 1 table and 12 figures included. Added a revised analysis which takes into account the new 1489-day Super-Kamiokande and final MACRO data. The bound on NSI parameters is considerably improve

Constraining neutrino oscillation parameters with current solar and atmospheric data

We analyze the impact of recent solar, atmospheric and reactor data in the determination of the neutrino oscillation parameters, taking into account that both the solar nu_e and the atmospheric nu_mu may convert to a mixture of active and sterile neutrinos. We use the most recent global solar neutrino data, including the 1496-day Super-K neutrino data sample, and we investigate in detail the impact of the SNO neutral current, spectral and day/night data by performing also an analysis using only the charged current rate from SNO. The implications of the first 145.1 days of KamLAND data on the determination of the solar neutrino parameters are also discussed in detail. We confirm the clear preference of solar+reactor data for the pure active LMA-MSW solution of the solar neutrino problem, and obtain that the LOW, VAC, SMA and Just-So^2 solutions are disfavored with a Delta_chi^2 = 22, 22, 36, 44, respectively. Furthermore, we find that the global solar data constrains the admixture of a sterile neutrino to be less than 43% at 99% CL. By performing an improved fit of the atmospheric data, we also update the corresponding regions of oscillation parameters. We find that the recent atmospheric Super-K (1489-day) and MACRO data have a strong impact on constraining a sterile component in atmospheric oscillations: if the nu_mu is restricted to the atmospheric mass states only a sterile admixture of 16% is allowed at 99% CL, while a bound of 35% is obtained in the unconstrained case. Pure sterile oscillations are disfavored with a Delta_chi^2 = 34.6 compared to the pure active case.Comment: 28 pages, LaTeX file using RevTEX4, 12 figures and 3 tables included. Improved version including the new KamLAND dat