Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Diffuse supernova neutrino background search at Super-Kamiokande

A new search for the diffuse supernova neutrino background (DSNB) flux has been conducted at Super-Kamiokande (SK), with a $22.5\times2970$-kton$\cdot$day exposure from its fourth operational phase IV. The new analysis improves on the existing background reduction techniques and systematic uncertainties and takes advantage of an improved neutron tagging algorithm to lower the energy threshold compared to the previous phases of SK. This allows for setting the world's most stringent upper limit on the extraterrestrial $\bar{\nu}_e$ flux, for neutrino energies below 31.3 MeV. The SK-IV results are combined with the ones from the first three phases of SK to perform a joint analysis using $22.5\times5823$ kton$\cdot$days of data. This analysis has the world's best sensitivity to the DSNB $\bar{\nu}_e$ flux, comparable to the predictions from various models. For neutrino energies larger than 17.3 MeV, the new combined $90\%$ C.L. upper limits on the DSNB $\bar{\nu}_e$ flux lie around $2.7$ cm$^{-2}$$\cdot$$\text{sec}^{-1}$, strongly disfavoring the most optimistic predictions. Finally, potentialities of the gadolinium phase of SK and the future Hyper-Kamiokande experiment are discussed.Comment: 42 pages, 37 figures, 14 table

Searching for supernova bursts in Super-Kamiokande IV

Super-Kamiokande has been searching for neutrino bursts characteristic of core-collapse supernovae continuously, in real time, since the start of operations in 1996. The present work focuses on detecting more distant supernovae whose event rate may be too small to trigger in real time, but may be identified using an offline approach. The analysis of data collected from 2008 to 2018 found no evidence of distant supernovae bursts. This establishes an upper limit of 0.29 yr−1 on the rate of core-collapse supernovae out to 100 kpc at 90% C.L. For supernovae that fail to explode and collapse directly to black holes the limit reaches to 300 kpc

Indirect search for dark matter from the Galactic Center and halo with the Super-Kamiokande detector

We present a search for an excess of neutrino interactions due to dark matter in the form of weakly interacting massive particles (WIMPs) annihilating in the Galactic center or halo based on the data set of Super-Kamiokande-I, -II, -III and -IV taken from 1996 to 2016. We model the neutrino flux, energy, and flavor distributions assuming WIMP self-annihilation is dominant to ν ¯ ν , μ + μ − , b ¯ b , or W + W − . The excess is in comparison to atmospheric neutrino interactions which are modeled in detail and fit to data. Limits on the self-annihilation cross section ⟨ σ A V ⟩ are derived for WIMP masses in the range 1 GeV to 10 TeV, reaching as low as 9.6 × 10 − 23     cm 3   s − 1 for 5 GeV WIMPs in b ¯ b mode and 1.2 × 10 − 24     cm 3   s − 1 for 1 GeV WIMPs in ν ¯ ν mode. The obtained sensitivity of the Super-Kamiokande detector to WIMP masses below several tens of GeV is the best among similar indirect searches to date

Search for neutrinos in coincidence with gravitational wave events from the LIGO–Virgo O3a observing run with the Super-Kamiokande detector

The Super-Kamiokande detector can be used to search for neutrinos in time coincidence with gravitational waves detected by the LIGO–Virgo Collaboration (LVC). Both low-energy (7–100 MeV) and high-energy (0.1–105 GeV) samples were analyzed in order to cover a very wide neutrino spectrum. Follow-ups of 36 (out of 39) gravitational waves reported in the GWTC-2 catalog were examined; no significant excess above the background was observed, with 10 (24) observed neutrinos compared with 4.8 (25.0) expected events in the high-energy (low-energy) samples. A statistical approach was used to compute the significance of potential coincidences. For each observation, p-values were estimated using neutrino direction and LVC sky map; the most significant event (GW190602_175927) is associated with a post-trial p-value of 7.8% (1.4σ). Additionally, flux limits were computed independently for each sample and by combining the samples. The energy emitted as neutrinos by the identified gravitational wave sources was constrained, both for given flavors and for all flavors assuming equipartition between the different flavors, independently for each trigger and by combining sources of the same nature

A SHORT-TERM EVALUATIVE STUDY OF DIABETIC NEPHROPATHY PATIENT

Background: Rising diabetes incidence globally and consequently diabetic nephropathy is a major concern. Being chronic disease patients are continuously monitored. Clinical improvement of major sign/symptoms in short course of therapy may lead to satisfaction of the patient’s that will increase better compliance to the treatment. Objective: To evaluate signs/symptoms and GFR status of diabetic nephropathy patient in short course of treatment therapy and nutritional management Material & Methods: All 170 incident cases of diabetic nephropathy (DN) based on glomerular filtration rate and creatinine level registered on pre-fixed dates during May 2007 to May 2010, but 127 followed inclusion criteria. Patients were recorded for demographic, biological & biochemical characteristics and presenting major sign/symptoms at registration time; further, evaluated for presenting sign/symptoms after six months of medicine and dietary intervention. Statistical Analysis: Statistical significance for association was tested by c2 (unrelated samples) and McNemar (related samples) and for the differences of number of signs/symptoms by Mann Whitney (unrelated samples) and Wilcoxon Signed Rank tests (related samples). Results: No statistical association was seen between GFR status and presence of edema/swelling in any part of the body. After six months of treatment and dietary management, the edema/swelling presenting in 69.6% of the cases was found only in 33.3%. Pedal edema was found in 43.1%; while either eye lid or facial swelling was in 12.9% of the cases but after six months of drug treatment and dietary care these were present only in 18.6% and 3.9% cases respectively. GFR status of one third cases also improved after 6 months, while 57.8% were unchanged; very few (9.8%) deteriorated. The GFR improvement was more in cases reporting with GFR 60 and above. Conclusion: Though, for the drug compliance and dietary intake patient’s statement was believed, after six months of treatment and dietary care, edema/swelling, the major signs/symptoms of diabetic nephropathy that reduced significantly and moreover on an average one third reduction of all signs/symptoms among the cases may satisfy the cases resulting to better compliance to drug and dietary management. Better improvement in cases with higher GFR indicated that early detection of diabetic nephropathy cases is essential