First Simultaneous Measurement of Differential Muon-Neutrino Charged-Current Cross Sections on Argon for Final States with and without Protons Using MicroBooNE Data

We report the first double-differential neutrino-argon cross section measurement made simultaneously for final states with and without protons for the inclusive muon neutrino charged-current interaction channel. The proton kinematics of this channel are further explored with a differential cross section measurement as a function of the leading proton's kinetic energy that extends across the detection threshold. These measurements use data collected with the MicroBooNE detector from 6.4×10^{20} protons on target from the Fermilab booster neutrino beam with a mean neutrino energy of ∼0.8  GeV. Extensive data-driven model validation utilizing the conditional constraint formalism is employed. This motivates enlarging the uncertainties with an empirical reweighting approach to minimize the possibility of extracting biased cross section results. The extracted nominal flux-averaged cross sections are compared to widely used event generator predictions revealing severe mismodeling of final states without protons for muon neutrino charged-current interactions, possibly from insufficient treatment of final state interactions. These measurements provide a wealth of new information useful for improving event generators which will enhance the sensitivity of precision measurements in neutrino experiments.

First Search for Dark-Trident Processes Using the MicroBooNE Detector

We present a first search for dark-trident scattering in a neutrino beam using a dataset corresponding to 7.2×10^{20} protons on target taken with the MicroBooNE detector at Fermilab. Proton interactions in the neutrino target at the main injector produce π^{0} and η mesons, which could decay into dark-matter (DM) particles mediated via a dark photon A^{'}. A convolutional neural network is trained to identify interactions of the DM particles in the liquid-argon time projection chamber (LArTPC) exploiting its imagelike reconstruction capability. In the absence of a DM signal, we provide limits at the 90% confidence level on the squared kinematic mixing parameter ϵ^{2} as a function of the dark-photon mass in the range 10≤M_{A^{'}}≤400  MeV. The limits cover previously unconstrained parameter space for the production of fermion or scalar DM particles χ for two benchmark models with mass ratios M_{χ}/M_{A^{'}}=0.6 and 2 and for dark fine-structure constants 0.1≤α_{D}≤1.

Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

Search for Heavy Neutral Leptons in Electron-Positron and Neutral-Pion Final States with the MicroBooNE Detector

We present the first search for heavy neutral leptons (HNLs) decaying into νe^{+}e^{-} or νπ^{0} final states in a liquid-argon time projection chamber using data collected with the MicroBooNE detector. The data were recorded synchronously with the NuMI neutrino beam from Fermilab's main injector corresponding to a total exposure of 7.01×10^{20} protons on target. We set upper limits at the 90% confidence level on the mixing parameter |U_{μ4}|^{2} in the mass ranges 10≤m_{HNL}≤150  MeV for the νe^{+}e^{-} channel and 150≤m_{HNL}≤245  MeV for the νπ^{0} channel, assuming |U_{e4}|^{2}=|U_{τ4}|^{2}=0. These limits represent the most stringent constraints in the mass range 35 Collapse

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Cannabis for the treatment of amyotrophic lateral sclerosis: What is the patients' view?

Cannabis may have therapeutic benefits to relieve symptoms of amyotrophic lateral sclerosis (ALS) thanks to its pleiotropic pharmacological activity. This study is the first to present a large questionnaire-based survey about the "real-life" situation regarding cannabis use in the medical context in ALS patients in France. There were 129 respondents and 28 reported the use of cannabis (21.7%) to relieve symptoms of ALS. Participants mostly reported the use of cannabidiol (CBD) oil and cannabis weed and declared benefits both on motor (rigidity, cramps, fasciculations) and non-motor (sleep quality, pain, emotional state, quality of life, depression) symptoms and only eight reported minor adverse reactions (drowsiness, euphoria and dry mouth). Even if cannabis is mostly used outside medical pathways and could expose patients to complications (street and uncontrolled drugs, drug-drug interactions, adverse effects…), most of the participants reported "rational" consumption (legal cannabinoids, with only few combustion and adverse reactions). Despite some limitations, this study highlights the need for further research on the potential benefits of cannabis use for the management of ALS motor and non-motor symptoms. Indeed, there is an urgent need and call for and from patients to know more about cannabis and secure its use in a medical context.

Increase in hospitalisation-associated methadone intoxication in France following first COVID-19 lockdown

OBJECTIVES

At the beginning of the COVID-19 pandemic, the French Addictovigilance Network drew attention to the need to facilitate access to methadone while ensuring its safe use, in order to avoid the occurrence of overdoses and deaths. The objectives of the study were to assess the impact of the lockdowns on the incidence of methadone-use-related hospitalisations (MUHs) and describe the characteristics of patients and hospitalisations.

STUDY DESIGN

An interrupted time series using the unobserved components model was performed to predict the monthly incidence of MUHs in 2020 on the basis of previous years' data and compared with MUHs observed. Data were presented with prediction intervals (PI95%).

METHODS

This retrospective study was conducted on patients hospitalised in France for methadone between 2014 and 2020, using the French national database hospital discharge database. Patients' characteristics and hospitalisations were described over four periods: before lockdown, first lockdown, after first lockdown, and second lockdown.

RESULTS

Compared to the predictions, a higher incidence of MUH was found during the first lockdown, especially in March 2020 (66 cases vs. 51.3; PI95%: 34-65), and there was a large increase during the month following the end of the first lockdown (79 cases vs. 61; PI95%: 46-75). Coconsumptions (alcohol, cannabis, cocaine) were more frequent during the first lockdown, whereas patients aged over 30 years were more concerned thereafter. The second lockdown did not present any particularity.

CONCLUSIONS

The first lockdown had a significant impact on the incidence of MUHs. These results confirm the data from the reinforced national monitoring during first lockdown published in 2020, where methadone was the primary substance involved in overdoses and deaths.

Observation of high-energy neutrinos from the Galactic plane

The origin of high-energy cosmic rays, atomic nuclei that continuously impact Earth's atmosphere, is unknown. Because of deflection by interstellar magnetic fields, cosmic rays produced within the Milky Way arrive at Earth from random directions. However, cosmic rays interact with matter near their sources and during propagation, which produces high-energy neutrinos. We searched for neutrino emission using machine learning techniques applied to 10 years of data from the IceCube Neutrino Observatory. By comparing diffuse emission models to a background-only hypothesis, we identified neutrino emission from the Galactic plane at the 4.5σ level of significance. The signal is consistent with diffuse emission of neutrinos from the Milky Way but could also arise from a population of unresolved point sources.

Patient involvement in pharmacovigilance: determinants and evolution of reporting from 2011 to 2020 in France

INTRODUCTION

Because patients and patient organizations want to strengthen their role in the care pathway and drug evaluation and in order to improve pharmacovigilance activities, European competent authorities implemented regulations to allow direct reporting of adverse drug reactions related to medicinal products by patients in 2012.

OBJECTIVES

To describe evolution and analyze determinants of patient reporting activity in France in order to assess patient involvement in pharmacovigilance.

METHOD

Using the French national pharmacovigilance database, univariate and multivariate analyses were performed to compare the characteristics of adverse drug reaction (ADR) reports from patients and healthcare professionals (HCP) between 2011 and 2020. The relationship between regional patient ADR report activity and regional care provision and socio-professional characteristics was analyzed using the principal component analysis.

RESULTS

A significant and higher increase in ADR reports over time from patients (r = 0.89, p < 0.001) compared to HCP (r = 0.27, p = 0.002) has been observed. Patient ADR report activities compared to HCP concerned more women (80% vs. 55%, p < 0.001), younger age classes (p < 0.001), reporting through web portal (83% vs. 17%, p < 0.001), and less serious events (26% vs. 63%, p < 0.001). In the principal component analysis, regional patient reporting activity was related to socio-professional categories, age classes, and densities of hospital beds and physicians.

CONCLUSION

Our results confirm an increasing involvement of patients in ADR report activities. The determinants of patient reporting activities are not only related to drug and medical factors but also to social factors. Digital tools may also play a role in health democracy in pharmacovigilance.

A, Barbano A, Barwick SW, Bastian B, Basu V, Baur S, Bay R, Beatty JJ, Becker KH, Becker Tjus J, Bellenghi C, BenZvi S, Berley D, Bernardini E, Besson DZ, Binder G, Bindig D, Blaufuss E, Blot S, Boddenberg M, Bontempo F, Borowka J, Böser S, Botner O, Böttcher J, Bourbeau E, Bradascio F, Braun J, Brinson B, Bron S, Brostean-Kaiser J, Browne S, Burgman A, Burley RT, Busse RS, Campana MA, Carnie-Bronca EG, Chen C, Chen Z, Chirkin D, Choi K, Clark BA, Clark K, Classen L, Coleman A, Collin GH, Conrad JM, Coppin P, Correa P, Cowen DF, Cross R, Dappen C, Dave P, De Clercq C, DeLaunay JJ, Delgado López D, Dembinski H, Deoskar K, Desai A, Desiati P, de Vries KD, de Wasseige G, de With M, DeYoung T, Diaz A, Díaz-Vélez JC, Dittmer M, Dujmovic H, Dunkman M, DuVernois MA, Dvorak E, Ehrhardt T, Eller P, Engel R, Erpenbeck H, Evans J, Evenson PA, Fan KL, Fazely AR, Fedynitch A, Feigl N, Fiedlschuster S, Fienberg AT, Filimonov K, Finley C, Fischer L, Fox D, Franckowiak A, Friedman E, Fritz A, Fürst P, Gaisser TK, Gallagher J, Ganster E, Garcia A, Garrappa S, Gerhardt L, Ghadimi A, Glaser C, Glauch T, Glüsenkamp T, Goldschmidt A, Gonzalez JG, Goswami S, Grant D, Grégoire T, Griswold S, Günther C, Gutjahr P, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Ha Minh M, Hanson K, Hardin J, Harnisch AA, Haungs A, Hebecker D, Helbing K, Henningsen F, Hettinger EC, Hickford S, Hignight J, Hill C, Hill GC, Hoffman KD, Hoffmann R, Hokanson-Fasig B, Hoshina K, Huang F, Huber M, Huber T, Hultqvist K, Hünnefeld M, Hussain R, Hymon K, In S, Iovine N, Ishihara A, Jansson M, Japaridze GS, Jeong M, Jin M, Jones BJP, Kang D, Kang W, Kang X, Kappes A, Kappesser D, Kardum L, Karg T, Karl M, Karle A, Katz U, Kauer M, Kellermann M, Kelley JL, Kheirandish A, Kin K, Kintscher T, Kiryluk J, Klein SR, Koirala R, Kolanoski H, Kontrimas T, Köpke L, Kopper C, Kopper S, Koskinen DJ, Koundal P, Kovacevich M, Kowalski M, Kozynets T, Kun E, Kurahashi N, Lad N, Lagunas Gualda C, Lanfranchi JL, Larson MJ, Lauber F, Lazar JP, Lee JW, Leonard K, Leszczyńska A, Li Y, Lincetto M, Liu QR, Liubarska M, Lohfink E, Lozano Mariscal CJ, Lu L, Lucarelli F, Ludwig A, Luszczak W, Lyu Y, Ma WY, Madsen J, Mahn KBM, Makino Y, Mancina S, Mariş IC, Martinez-Soler I, Maruyama R, Mase K, McElroy T, McNally F, Mead JV, Meagher K, Mechbal S, Medina A, Meier M, Meighen-Berger S, Micallef J, Mockler D, Montaruli T, Moore RW, Morse R, Moulai M, Naab R, Nagai R, Nahnhauer R, Naumann U, Necker J, Nguyen LV, Niederhausen H, Nisa MU, Nowicki SC, Nygren D, Obertacke Pollmann A, Oehler M, Oeyen B, Olivas A, O’Sullivan E, Pandya H, Pankova DV, Park N, Parker GK, Paudel EN, Paul L, Pérez de los Heros C, Peters L, Peterson J, Philippen S, Pieper S, Pittermann M, Pizzuto A, Plum M, Popovych Y, Porcelli A, Prado Rodriguez M, Price PB, Pries B, Przybylski GT, Raab C, Rack-Helleis J, Raissi A, Rameez M, Rawlins K, Rea IC, Rehman A, Reichherzer P, Reimann R, Renzi G, Resconi E, Reusch S, Rhode W, Richman M, Riedel B, Roberts EJ, Robertson S, Roellinghoff G, Rongen M, Rott C, Ruhe T, Ryckbosch D, Rysewyk Cantu D, Safa I, Saffer J, Sanchez Herrera SE, Sandrock A, Sandroos J, Santander M, Sarkar S, Sarkar S, Satalecka K, Schaufel M, Schieler H, Schindler S, Schmidt T, Schneider A, Schneider J, Schröder FG, Schumacher L, Schwefer G, Sclafani S, Seckel D, Seunarine S, Sharma A, Shefali S, Silva M, Skrzypek B, Smithers B, Snihur R, Soedingrekso J, Soldin D, Spannfellner C, Spiczak GM, Spiering C, Stachurska J, Stamatikos M, Stanev T, Stein R, Stettner J, Steuer A, Stezelberger T, Stokstad R, Stürwald T, Stuttard T, Sullivan GW, Taboada I, Ter-Antonyan S, Tilav S, Tischbein F, Tollefson K, Tönnis C, Toscano S, Tosi D, Trettin A, Tselengidou M, Tung CF, Turcati A, Turcotte R, Turley CF, Twagirayezu JP, Ty B, Unland Elorrieta MA, Valtonen-Mattila N, Vandenbroucke J, van Eijndhoven N, Vannerom D, van Santen J, Verpoest S, Walck C, Watson TB, Weaver C, Weigel P, Weindl A, Weiss MJ, Weldert J, Wendt C, Werthebach J, Weyrauch M, Whitehorn N, Wiebusch CH, Williams DR, Wolf M, Woschnagg K, Wrede G, Wulff J, Xu XW, Yanez JP, Yoshida S, Yu S, Yuan T, Zhang Z, Zhelnin P. Evidence for neutrino emission from the nearby active galaxy NGC 1068

A supermassive black hole, obscured by cosmic dust, powers the nearby active galaxy NGC 1068. Neutrinos, which rarely interact with matter, could provide information on the galaxy’s active core. We searched for neutrino emission from astrophysical objects using data recorded with the IceCube neutrino detector between 2011 and 2020. The positions of 110 known gamma-ray sources were individually searched for neutrino detections above atmospheric and cosmic backgrounds. We found that NGC 1068 has an excess of 79 − 20 + 22 neutrinos at tera–electron volt energies, with a global significance of 4.2σ, which we interpret as associated with the active galaxy. The flux of high-energy neutrinos that we measured from NGC 1068 is more than an order of magnitude higher than the upper limit on emissions of tera–electron volt gamma rays from this source.

Search for Unstable Sterile Neutrinos with the IceCube Neutrino Observatory

We present a search for an unstable sterile neutrino by looking for a resonant signal in eight years of atmospheric ν_{μ} data collected from 2011 to 2019 at the IceCube Neutrino Observatory. Both the (stable) three-neutrino and the 3+1 sterile neutrino models are disfavored relative to the unstable sterile neutrino model, though with p values of 2.8% and 0.81%, respectively, we do not observe evidence for 3+1 neutrinos with neutrino decay. The best-fit parameters for the sterile neutrino with decay model from this study are Δm_{41}^{2}=6.7_{-2.5}^{+3.9}  eV^{2}, sin^{2}2θ_{24}=0.33_{-0.17}^{+0.20}, and g^{2}=2.5π±1.5π, where g is the decay-mediating coupling. The preferred regions of the 3+1+decay model from short-baseline oscillation searches are excluded at 90% C.L.

Six Action Steps to Address Global Disparities in Parkinson Disease: A World Health Organization Priority

Importance

The Global Burden of Disease study conducted between 1990 and 2016, based on a global study of 195 countries and territories, identified Parkinson disease (PD) as the fastest growing neurological disorder when measured using death and disability. Most people affected by PD live in low- and middle-income countries (LMICs) and experience large inequalities in access to neurological care and essential medicines. This Special Communication describes 6 actions steps that are urgently needed to address global disparities in PD.

Observations

The adoption by the 73rd World Health Assembly (WHA) of resolution 73.10 to develop an intersectoral global action plan on epilepsy and other neurological disorders in consultation with member states was the stimulus to coordinate efforts and leverage momentum to advance the agenda of neurological conditions, such as PD. In April 2021, the Brain Health Unit at the World Health Organization convened a multidisciplinary, sex-balanced, international consultation workshop, which identified 6 workable avenues for action within the domains of disease burden; advocacy and awareness; prevention and risk reduction; diagnosis, treatment, and care; caregiver support; and research.

Conclusions and Relevance

The dramatic increase of PD cases in many world regions and the potential costs of PD-associated treatment will need to be addressed to prevent possible health service strain. Across the board, governments, multilateral agencies, donors, public health organizations, and health care professionals constitute potential stakeholders who are urged to make this a priority.

Strong Constraints on Neutrino Nonstandard Interactions from TeV-Scale ν_{μ} Disappearance at IceCube

We report a search for nonstandard neutrino interactions (NSI) using eight years of TeV-scale atmospheric muon neutrino data from the IceCube Neutrino Observatory. By reconstructing incident energies and zenith angles for atmospheric neutrino events, this analysis presents unified confidence intervals for the NSI parameter ε_{μτ}. The best-fit value is consistent with no NSI at a p value of 25.2%. With a 90% confidence interval of -0.0041≤ε_{μτ}≤0.0031 along the real axis and similar strength in the complex plane, this result is the strongest constraint on any NSI parameter from any oscillation channel to date.

P-308 Spontaneous reports of menstrual cycle disorders after mRNA Covid-19 vaccine

Study question

Does the mRNA Covid-19 vaccine have an influence on the ovulatory process and menstrual disorders?

Summary answer

Menstrual disorders were more frequently reported in women aged 25 to 45 years, mainly amenorrhea and increased cycle length, and were often not severe.

What is known already

Menstrual disorders can be due to several factors, including stress, especially during a pandemic or sometimes during a vaccination. However, the SARS-CoV-2 spike protein is able to interact with the human ACE2 receptor, which is widely expressed in the ovaries, uterus, vagina, and hypothalamic pituitary axis. Accumulating evidence now suggests that 2019-nCoV/ACE2 may interfere with the female reproductive functions, leading to menstrual disorder. The role of this spike protein is also to trigger an immune response, used in particular for mRNA vaccines. The aim of this study is to describe the side effects on menstrual cycles after mRNA Covid-19 vaccine.

Study design, size, duration

This is a descriptive analysis of adverse events affecting the menstrual cycle reported to a regional pharmacovigilance center between May 2021 and January 2022. A case-by-case review was performed to collect variables characterizing the patient and the reactions.

Participants/materials, setting, methods

Patients upper 11 years and under 60 years with mRNA Covid-19 vaccine suspected, were enrolled. Medical Dictionary for Drug Regulatory Activities (MedDRA) was used to identify cases of menstrual disorders. Reactions related to the following System Organ Classes from MedDRA were extracted: amenorrhea, disorder of menstrual cycle, dysmenorrhea, long menstrual cycle, menorrhea, menometrorrhagia, metrorrhagia. Seriousness was defined, according to the WHO, as the occurrence of death, lifethreatening, hospitalisation, requirement of consultation.

Main results and the role of chance

Side effects with mRNA Covid-19 vaccine concerned women in 67.8% (N = 1306) of cases, between 12 and 59 years old.5.1% (N = 67) were related to the menstrual cycle. Serious cases 53.7% (N = 36) were no more frequent than in the whole women 50.1% (N = 654). Menstrual disorders were more represented in the 25-45 age group 64.2% (N = 43) vs 12-24 age group 14.9% (N = 10) and over 45 age group 20.9% (N = 14) p = 0.001. Menstrual disorders not recovered at the time of reporting accounted for 38.9% (N = 26). For the all studied population, amenorrhea or increased cycle length were more frequent 53.8% (n = 36) vs increased duration of menstruation or menorrhagia 26.8 % (N = 18) or increased frequency of menstruation metrorrhagia/menometrorrhagia 22.4% (N = 13) p < 0.001. Long cycles or amenorrhea were most represented in the 12-24 age group 90% (N = 9) p < 0.0001 and 25-45 age group 62.7% (N = 27) p < 0.1 vs dysmenorrhea , menorrhea, metrorrhagia, menometrorrhagia. The difference was not significative in women over 45 years old 35.7% (N = 5). Finally amenorrhea and long cycles were less often reported with severity 22.2% (N = 8) than other menstrual side effect (dysmenorrhea , menorrhea, menometrorrhagia, metrorrhagia) 45.2% (N = 14), p < 0.1.

Limitations, reasons for caution

The most important limitation relies on the spontaneous reporting. Underreporting is estimated to about 90%. It was probably not the case for side effect due to the Covid-19 vaccination. Furthermore, serious cases are more likely to be reported than mild or minor cases resulting in a possible reporting bias.

Wider implications of the findings

The cases reported reflect the experience of clinicians who were asked about cycle disturbances after covid-19 vaccination (V. Male BMJ 2021).We observed more frequent changes in cycle length but not in menstrual length, as reported by A. Edelman (Obstet Gynecol 2022). Fertility may be punctually affected by Covid-19 vaccination.

Trial registration number

Analyzing anonymous data, being retrospective and non-interventional, the approval of an Ethics committee was not necessary according to the Good Clinical Practice in pharmacovigilance.

Search for Relativistic Magnetic Monopoles with Eight Years of IceCube Data

We present an all-sky 90% confidence level upper limit on the cosmic flux of relativistic magnetic monopoles using 2886 days of IceCube data. The analysis was optimized for monopole speeds between 0.750c and 0.995c, without any explicit restriction on the monopole mass. We constrain the flux of relativistic cosmic magnetic monopoles to a level below 2.0×10^{-19}  cm^{-2} s^{-1} sr^{-1} over the majority of the targeted speed range. This result constitutes the most strict upper limit to date for magnetic monopoles with β≳0.8 and up to β∼0.995 and fills the gap between existing limits on the cosmic flux of nonrelativistic and ultrarelativistic magnetic monopoles.

First use of the Adolescent Depression Rating Scale (ADRS) in the management of young people with severe acne treated with isotretinoin: a pilot study of an active monitoring of depressive disorders by dermatologists

BACKGROUND

During isotretinoin treatment, special attention is required to detect any symptom or change in the mental health of patients. The monitoring is complex for adolescents because of confounding factors such as mood changes associated with adolescence and puberty and the higher psychosocial impairment due to the acne itself.

AIM

To determine the utility of the Adolescent Depression Rating Scale (ADRS) for monitoring symptoms in adolescents before and during isotretinoin treatment in dermatology real-life practice.

METHODS

This was a national, multicentre prospective study that enrolled a random sample of dermatologists treating adolescents. An algorithm including ADRS score and its changes between consecutive visits was used. At each visit, dermatologists rated their satisfaction with ADRS and its ease of use, while patients rated the acceptability of the ADRS.

RESULTS

In total, 70 dermatologists used the algorithm for 1227 visits of 283 adolescents receiving isotretinoin. Of these 70 dermatologists, 80.8% were satisfied/very satisfied with the ADRS, 82.7% considered the use of the ADRS in clinical practice to be easy/very easy and 75% considered that the ADRS enabled them to discuss more easily the risk of depression with their patients. For the patients, acceptability of the ADRS was considered good by 93.8%.

CONCLUSIONS

The implementation of the ADRS could be valuable in dermatology practice, optimizing the monitoring of patients and the good use of isotretinoin.

eV-Scale Sterile Neutrino Search Using Eight Years of Atmospheric Muon Neutrino Data from the IceCube Neutrino Observatory

The results of a 3+1 sterile neutrino search using eight years of data from the IceCube Neutrino Observatory are presented. A total of 305 735 muon neutrino events are analyzed in reconstructed energy-zenith space to test for signatures of a matter-enhanced oscillation that would occur given a sterile neutrino state with a mass-squared differences between 0.01 and 100  eV^{2}. The best-fit point is found to be at sin^{2}(2θ_{24})=0.10 and Δm_{41}^{2}=4.5  eV^{2}, which is consistent with the no sterile neutrino hypothesis with a p value of 8.0%.

Characteristics of the Diffuse Astrophysical Electron and Tau Neutrino Flux with Six Years of IceCube High Energy Cascade Data

We report on the first measurement of the astrophysical neutrino flux using particle showers (cascades) in IceCube data from 2010-2015. Assuming standard oscillations, the astrophysical neutrinos in this dedicated cascade sample are dominated (∼90%) by electron and tau flavors. The flux, observed in the sensitive energy range from 16 TeV to 2.6 PeV, is consistent with a single power-law model as expected from Fermi-type acceleration of high energy particles at astrophysical sources. We find the flux spectral index to be γ=2.53±0.07 and a flux normalization for each neutrino flavor of ϕ_{astro}=1.66_{-0.27}^{+0.25} at E_{0}=100  TeV, in agreement with IceCube's complementary muon neutrino results and with all-neutrino flavor fit results. In the measured energy range we reject spectral indices γ≤2.28 at ≥3σ significance level. Because of high neutrino energy resolution and low atmospheric neutrino backgrounds, this analysis provides the most detailed characterization of the neutrino flux at energies below ∼100  TeV compared to previous IceCube results. Results from fits assuming more complex neutrino flux models suggest a flux softening at high energies and a flux hardening at low energies (p value ≥0.06). The sizable and smooth flux measured below ∼100  TeV remains a puzzle. In order to not violate the isotropic diffuse gamma-ray background as measured by the Fermi Large Area Telescope, it suggests the existence of astrophysical neutrino sources characterized by dense environments which are opaque to gamma rays.

Recurrent Dystonic Crisis and Rhabdomyolysis Treated with Dantrolene in Two Patients with Aromatic L-Amino Acid Decarboxylase Deficiency

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare, autosomal recessive inborn error of metabolism in which several neurotransmitters including serotonin, dopamine, norepinephrine and epinephrine are deficient. Symptoms typically appear in the first year of life and include oculogyric crises and dystonia, hypotonia, and global developmental delay. Dystonia is of particular concern as a dystonic storm can ensue leading to rhabdomyolysis. Rhabdomyolysis can become life-threating and therefore its recognition and prompt management is of significant importance. Here we present two cases of patients with AADC deficiency and a history of dystonic crisis causing rhabdomyolysis. We hypothesize that in addition to the hypodopaminergic, a hypercholinergic state is contributing to the pathophysiology of dystonia in AADC deficiency, as well as to the associated rhabdomyolysis. We were able to prevent rhabdomyolysis in both patients with using Dantrolene and we suggest using a trial of this medication in cases of sustained dystonic crisis in AADC deficiency patients.

Time-Integrated Neutrino Source Searches with 10 Years of IceCube Data

This Letter presents the results from pointlike neutrino source searches using ten years of IceCube data collected between April 6, 2008 and July 10, 2018. We evaluate the significance of an astrophysical signal from a pointlike source looking for an excess of clustered neutrino events with energies typically above ∼1  TeV among the background of atmospheric muons and neutrinos. We perform a full-sky scan, a search within a selected source catalog, a catalog population study, and three stacked Galactic catalog searches. The most significant point in the northern hemisphere from scanning the sky is coincident with the Seyfert II galaxy NGC 1068, which was included in the source catalog search. The excess at the coordinates of NGC 1068 is inconsistent with background expectations at the level of 2.9σ after accounting for statistical trials from the entire catalog. The combination of this result along with excesses observed at the coordinates of three other sources, including TXS 0506+056, suggests that, collectively, correlations with sources in the northern catalog are inconsistent with background at 3.3σ significance. The southern catalog is consistent with background. These results, all based on searches for a cumulative neutrino signal integrated over the 10 years of available data, motivate further study of these and similar sources, including time-dependent analyses, multimessenger correlations, and the possibility of stronger evidence with coming upgrades to the detector.

Quantitative System Pharmacology (QSP): An Integrative Framework for paradigm change in the treatment of the first-episode schizophrenia

Despite the lack of progress in the curative treatment of mental illness, especially schizophrenia, the accumulation of neuroscience data over the past decade suggests the re-conceptualization of schizophrenia. With the advent of new biomarkers and cognitive tools, new neuroscience technologies such as functional dynamic connectivity and the identification of subtle clinical features; it is now possible to detect early stages at risk or prodromes of a first psychotic episode. Current concepts reconceptualizes schizophrenia as a neurodevelopmental disorder at early onset, with polygenic risk and only symptomatic treatment for positive symptoms at this time. The use of such technologies in the future suggests new diagnostic and therapeutic options. Next steps include new pharmacological perspectives and potential contributions of new technologies such as quantitative system pharmacology brain computational modeling approach.