Vital Access: How Policymakers Can Streamline the Cancer Care Journey

Patients' odds of surviving blood cancer often hinge on their ability to access specialists who can evaluate, diagnose, and treat them with optimal treatments as quickly as possible. But too often, patients encounter roadblocks that prevent them from accessing the best care and, in some cases, benefiting from incredible advancements. Recent data reveal continued disparities in outcomes for minority populations in particular.Accessing medically necessary and high-quality blood cancer care in the United States is a process that remains overly complex and contingent on factors that are steeped in systemic, socioeconomic, and racial disparities. Numerous factors impact access, but a fragmented insurance system and similarly fragmented federal and state policies that set the rules for that insurance system are major contributors. Studies have noted the impact of narrow networks, which can restrict access to some specialty care providers such as hospitals designated as "cancer centers" or "comprehensive cancer centers" by the National Cancer Institute (NCI). Narrow networks are increasingly common in commercial insurance plans in the individual and group markets and in Medicaid-managed care organizations (MCOs). Studies have also shown that cancer patients with certain types of insurance, such as Medicaid–which covers low-income people, a disproportionate share of whom are people of color–are more likely to experience worse mortality rates. These disparities in coverage and access contribute to significant inequities by income, race, ethnicity, and other factors.In the past three-plus decades, we have seen an explosion of new therapies, including immunotherapy (such as CAR T-cell) and other personalized medicine approaches that target therapies to an individual based on a range of phenotypic and genomic factors.The policy frameworks that govern insurance have not kept pace with advances in cancer treatment, and they continue to contribute to systemic inequities that prevent access to high-quality blood cancer care. Recent efforts by federal regulators to update access-related standards still fall short of ensuring equitable access to quality blood cancer care for all. And some elements of these frameworks have remained largely unchanged for decades. Meaning consumers still struggle to navigate their options when purchasing a plan and access medically appropriate treatment when a diagnosis is received.This report offers nine recommendations in five reform pathways for state and federal policymakers to consider, as they work toward developing insurance regulations that advance a more equitable system of care–one that enables patients with blood cancer to access appropriate treatment and that maximizes the potential for long-term survival. Each of these reform pathways addresses specific deficiencies in the current insurance policy frameworks, and each is critical to pursue in order to ensure a more equitable coverage landscape for patients and familie

World Federation of Hemophilia Gene Therapy Registry

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156126/2/hae14015_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156126/1/hae14015.pd

Galactic Core-Collapse Supernovae at IceCube: “Fire Drill” Data Challenges and follow-up

The next Galactic core-collapse supernova (CCSN) presents a once-in-a-lifetime opportunity to make astrophysical measurements using neutrinos, gravitational waves, and electromagnetic radiation. CCSNe local to the Milky Way are extremely rare, so it is paramount that detectors are prepared to observe the signal when it arrives. The IceCube Neutrino Observatory, a gigaton water Cherenkov detector below the South Pole, is sensitive to the burst of neutrinos released by a Galactic CCSN at a level >10σ. This burst of neutrinos precedes optical emission by hours to days, enabling neutrinos to serve as an early warning for follow-up observation. IceCube\u27s detection capabilities make it a cornerstone of the global network of neutrino detectors monitoring for Galactic CCSNe, the SuperNova Early Warning System (SNEWS 2.0). In this contribution, we describe IceCube\u27s sensitivity to Galactic CCSNe and strategies for operational readiness, including "fire drill" data challenges. We also discuss coordination with SNEWS 2.0

All-Energy Search for Solar Atmospheric Neutrinos with IceCube

The interaction of cosmic rays with the solar atmosphere generates a secondary flux of mesons that decay into photons and neutrinos – the so-called solar atmospheric flux. Although the gamma-ray component of this flux has been observed in Fermi-LAT and HAWC Observatory data, the neutrino component remains undetected. The energy distribution of those neutrinos follows a soft spectrum that extends from the GeV to the multi-TeV range, making large Cherenkov neutrino telescopes a suitable for probing this flux. In this contribution, we will discuss current progress of a search for the solar neutrino flux by the IceCube Neutrino Observatory using all available data since 2011. Compared to the previous analysis which considered only high-energy muon neutrino tracks, we will additionally consider events produced by all flavors of neutrinos down to GeV-scale energies. These new events should improve our analysis sensitivity since the flux falls quickly with energy. Determining the magnitude of the neutrino flux is essential, since it is an irreducible background to indirect solar dark matter searches

TXS 0506+056 with Updated IceCube Data

Past results from the IceCube Collaboration have suggested that the blazar TXS 0506+056 is a potential source of astrophysical neutrinos. However, in the years since there have been numerous updates to event processing and reconstruction, as well as improvements to the statistical methods used to search for astrophysical neutrino sources. These improvements in combination with additional years of data have resulted in the identification of NGC 1068 as a second neutrino source candidate. This talk will re-examine time-dependent neutrino emission from TXS 0506+056 using the most recent northern-sky data sample that was used in the analysis of NGC 1068. The results of using this updated data sample to obtain a significance and flux fit for the 2014 TXS 0506+056 "untriggered" neutrino flare are reported

Recent neutrino oscillation results with the IceCube experiment

The IceCube South Pole Neutrino Observatory is a Cherenkov detector instrumented in a cubic kilometer of ice at the South Pole. IceCube’s primary scientific goal is the detection of TeV neutrino emissions from astrophysical sources. At the lower center of the IceCube array, there is a subdetector called DeepCore, which has a denser configuration that makes it possible to lower the energy threshold of IceCube and observe GeV-scale neutrinos, opening the window to atmospheric neutrino oscillations studies. Advances in physics sensitivity have recently been achieved by employing Convolutional Neural Networks to reconstruct neutrino interactions in the DeepCore detector. In this contribution, the recent IceCube result from the atmospheric muon neutrino disappearance analysis using the CNN-reconstructed neutrino sample are presented and compared to the existing worldwide measurements

Angular dependence of the atmospheric neutrino flux with IceCube data

IceCube Neutrino Observatory, the cubic kilometer detector embedded in ice of the geographic South Pole, is capable of detecting particles from several GeV up to PeV energies enabling precise neutrino spectrum measurement. The diffuse neutrino flux can be subdivided into three components: astrophysical, from extraterrestrial sources; conventional, from pion and kaon decays in atmospheric Cosmic Ray cascades; and the yet undetected prompt component from the decay of charmed hadrons. A particular focus of this work is to test the predicted angular dependence of the atmospheric neutrino flux using an unfolding method. Unfolding is a set of methods aimed at determining a value from related quantities in a model-independent way, eliminating the influence of several assumptions made in the process. In this work, we unfold the muon neutrino energy spectrum and employ a novel technique for rebinning the observable space to ensure sufficient event numbers within the low statistic region at the highest energies. We present the unfolded energy and zenith angle spectrum reconstructed from IceCube data and compare the result with model expectations and previous measurements