Mathematical modeling and forecasting of COVID-19: experience in Santiago de Cuba province

In the province of Santiago de Cuba, Cuba, the COVID-19 epidemic has a limited progression that shows an early small-number peak of infections. Most published mathematical models fit data with high numbers of confirmed cases. In contrast, small numbers of cases make it difficult to predict the course of the epidemic. We present two known models adapted to capture the noisy dynamics of COVID-19 in the Santiago de Cuba province. Parameters of both models were estimated using the approximate-Bayesian-computation framework with dedicated error laws. One parameter of each model was updated on key dates of travel restrictions. Both models approximately predicted the infection peak and the end of the COVID-19 epidemic in Santiago de Cuba. The first model predicted 57 reported cases and 16 unreported cases. Additionally, it estimated six initially exposed persons. The second model forecasted 51 confirmed cases at the end of the epidemic. In conclusion, an opportune epidemiological investigation, along with the low number of initially exposed individuals, might partly explain the favorable evolution of the COVID-19 epidemic in Santiago de Cuba. With the available data, the simplest model predicted the epidemic evolution with greater precision, and the more complex model helped to explain the epidemic phenomenology

What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh

Responsiveness entails the social actions by health providers to meet the legitimate expectations of patients. It plays a critical role in ensuring continuity and effectiveness of care within people centered health systems. Given the lack of contextualized research on responsiveness, we qualitatively explored the perceptions of outpatient users and providers regarding what constitute responsiveness in rural Bangladesh. An exploratory study was undertaken in Chuadanga, a southwestern Bangladeshi District, involving in-depth interviews of physicians (n = 17) and users (n = 7), focus group discussions with users (n = 4), and observations of patient provider interactions (three weeks). Analysis was guided by a conceptual framework of responsiveness, which includes friendliness, respecting, informing and guiding, gaining trust and optimizing benefits. In terms of friendliness, patients expected physicians to greet them before starting consultations; even though physicians considered this unusual. Patients also expected physicians to hold social talks during consultations, which was uncommon. With regards to respect patients expected physicians to refrain from disrespecting them in various ways; but also by showing respect explicitly. Patients also had expectations related to informing and guiding: they desired explanation on at least the diagnosis, seriousness of illness, treatment and preventive steps. In gaining trust, patients expected that physicians would refrain from illegal or unethical activities related to patients, e.g., demanding money against free services, bringing patients in own private clinics by brokers (dalals), colluding with diagnostic centers, accepting gifts from pharmaceutical representatives. In terms of optimizing benefits: patients expected that physicians should be financially sensitive and consider individual need of patients. There were multiple dimensions of responsiveness- for some, stakeholders had a consensus; context was an important factor to understand them. This being an exploratory study, further research is recommended to validate the nuances of the findings. It can be a guideline for responsiveness practices, and a tipping point for future research

First demonstration of O(1 ns)\mathcal{O}(1\,\text{ns}) timing resolution in the MicroBooNE liquid argon time projection chamber

MicroBooNE is a neutrino experiment located in the Booster Neutrino Beamline (BNB) at Fermilab, which collected data from 2015 to 2021. MicroBooNE's liquid argon time projection chamber (LArTPC) is accompanied by a photon detection system consisting of 32 photomultiplier tubes used to measure the argon scintillation light and determine the timing of neutrino interactions. Analysis techniques combining light signals and reconstructed tracks are applied to achieve a neutrino interaction time resolution of $\mathcal{O}(1\,\text{ns})$. The result obtained allows MicroBooNE to access the ns neutrino pulse structure of the BNB for the first time. The timing resolution achieved will enable significant enhancement of cosmic background rejection for all neutrino analyses. Furthermore, the ns timing resolution opens new avenues to search for long-lived-particles such as heavy neutral leptons in MicroBooNE, as well as in future large LArTPC experiments, namely the SBN program and DUNE

Measurement of triple-differential inclusive muon-neutrino charged-current cross section on argon with the MicroBooNE detector

We report the first measurement of the differential cross section $d^{2}\sigma (E_{\nu})/ d\cos(\theta_{\mu}) dP_{\mu}$ for inclusive muon-neutrino charged-current scattering on argon. This measurement utilizes data from 6.4$\times10^{20}$ protons on target of exposure collected using the MicroBooNE liquid argon time projection chamber located along the Fermilab Booster Neutrino Beam with a mean neutrino energy of approximately 0.8~GeV. The mapping from reconstructed kinematics to truth quantities, particularly from reconstructed to true neutrino energy, is validated by comparing the distribution of reconstructed hadronic energy in data to that of the model prediction in different muon scattering angle bins after conditional constraint from the muon momentum distribution in data. The success of this validation gives confidence that the missing energy in the MicroBooNE detector is well-modeled in simulation, enabling the unfolding to a triple-differential measurement over muon momentum, muon scattering angle, and neutrino energy. The unfolded measurement covers an extensive phase space, providing a wealth of information useful for future liquid argon time projection chamber experiments measuring neutrino oscillations. Comparisons against a number of commonly used model predictions are included and their performance in different parts of the available phase-space is discussed

First measurement of quasi-elastic Λ\Lambda baryon production in muon anti-neutrino interactions in the MicroBooNE detector

We present the first measurement of the cross section of Cabibbo-suppressed $\Lambda$ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the Main Injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to $2.2 \times 10^{20}$ protons on target of neutrino mode running and $4.9 \times 10^{20}$ protons on target of anti-neutrino mode running. An automated selection is combined with hand scanning, with the former identifying five candidate $\Lambda$ production events when the signal was unblinded, consistent with the GENIE prediction of $5.3 \pm 1.1$ events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of $3.7 \pm 1.0$ events. Restricting the phase space to only include $\Lambda$ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of $2.0^{+2.2}_{-1.7} \times 10^{-40}$ cm$^2/$Ar, where statistical and systematic uncertainties are combined

First Measurement of Differential Cross Sections for Muon Neutrino Charged Current Interactions on Argon with a Two-proton Final State in the MicroBooNE Detector

We present the first measurement of differential cross sections for charged-current muon neutrino interactions on argon with one muon, two protons, and no pions in the final state. Such interactions leave the target nucleus in a two-particle two-hole state; these states are of great interest, but currently there is limited information about their production in neutrino-nucleus interactions. Detailed investigations of the production of two-particle two-hole states are vital to support upcoming experiments exploring the nature of the neutrino, and the development of the liquid-argon time-projection-chamber has made possible the isolation of such final states. The opening angle between the two protons, the angle between the total proton momentum and the muon, and the total transverse momentum of the final state system are sensitive to the underlying physics processes as embodied in a variety of models. Realistic initial-state momentum distributions are shown to be important in reproducing the data.Comment: To be submitted to PR

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- A nd middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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First constraints on light sterile neutrino oscillations from combined appearance and disappearance searches with the MicroBooNE detector

We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses