Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

E-cadherin Gene (CDH1) Expression in Low Grade Astrocytoma

Astrocytoma is the commonest primary brain tumor. These are feared due to their invasiveness in brain parenchyma so are less amenable to surgical removal and current chemotherapy regimens with a high mortality rate. Cell adhesion molecule (CAM) E-cadherin (CDH1) downregulation has been associated with tumors of different system and organs featuring invasion and metastasis. Therefore, the aim of the study was to find out the level of E-cadherin gene expression in low grade astrocytoma. In this cross-sectional study, 22 formalin fixed paraffin embedded tissue were taken as cases. Three non tumorous brain tissue and 1fresh post-mortem brain tissue were taken as control. Histological features were studied under light microscope with Haematoxylin and Eosin (H&E stain). Expression of CDH1 gene was analyzed by real time - polymerase chain reaction (RT-PCR) by comparative cyclic threshold (Ct) value method. The change in E-cadherin expression was measured by fold change in comparison with the control brain tissue. The data was tabulated and statistical analysis was performed. Among the 22 study cases 8(36.36%) were World Health Organization (WHO) Grade I and 14(63.63%) were WHO Grade II. All tumors showed downregulation of CDH1 gene in comparison with non-tumorous control tissue. The result is statistically significant (p=0.019). So, the study data revealed that downregulation of E-cadherin gene occurs in low grade astrocytoma and tumors of WHO Grade II showed more downregulation than Grade I tumors.

Detection of Antimicrobial Resistance Pattern and ESBL Production among Clinical Isolates of Salmonella Species in Mymensingh, Bangladesh

The occurrence of antimicrobial resistance in Salmonella enterica serovars (both typhoidal and non-typhoidal Salmonellae) is a major public health problem especially in developing countries, which have been associated with treatment failures. Therefore, the study was undertaken to determine the current antimicrobial resistance pattern and extended spectrum β-lactamase (ESBL) production among clinical isolates of Salmonella spp. during 2019-2020 in Mymensingh, Bangladesh. In this cross sectional study, 36 Salmonella enterica isolates were obtained from blood and stool culture of suspected 200 enteric fever and 100 gastroenteritis patients attending at Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Isolated Salmonella species were identified by biochemical tests and Polymerase Chain Reaction (PCR). Disk diffusion test was performed by modified Kirby Bauer method. Minimum Inhibitory Concentration (MIC) of ceftriaxone was detected by agar dilution method. Double disk synergy test was used as a screening test for ESBL production. PCR was done for detection of blaTEM, blaSHV and blaCTX-MU genes. The isolates showed 25% resistance to Ceftriaxone and 58.3% to Azithromycin. The highest sensitivity rates were 88.9% to Meropenem and 83.3% to Amikacin. Whereas 6(16.7%) isolates were Multi Drug Resistant (MDR). Eight (8) isolates were confirmed as ESBL producer by DDST. The marked increase in MIC was observed between 8->512μg/ml to ceftriaxone. blaTEM, blaSHV and blaCTX-MU genes were detected in 3, 5 and 8 isolates respectively. In conclusion, the current study observed, higher level of resistance to ceftriaxone and azithromycin. At the same times 22.2% isolates showed ESBL production, which is a cause for concern as it may lead to treatment failure. On the other hand the study also showed the re-emergence of chloramphenicol and Sulfamethoxazole-Trimethoprim sensitivity.

Diseasome and comorbidities complexities of SARS-CoV-2 infection with common malignant diseases

With the increasing number of immunoinflammatory complexities, cancer patients have a higher risk of serious disease outcomes and mortality with SARS-CoV-2 infection which is still not clear. In this study, we aimed to identify infectome, diseasome and comorbidities between COVID-19 and cancer via comprehensive bioinformatics analysis to identify the synergistic severity of the cancer patient for SARS-CoV-2 infection. We utilized transcriptomic datasets of SARS-CoV-2 and different cancers from Gene Expression Omnibus and Array Express Database to develop a bioinformatics pipeline and software tools to analyze a large set of transcriptomic data and identify the pathobiological relationships between the disease conditions. Our bioinformatics approach revealed commonly dysregulated genes (MARCO, VCAN, ACTB, LGALS1, HMOX1, TIMP1, OAS2, GAPDH, MSH3, FN1, NPC2, JUND, CHI3L1, GPNMB, SYTL2, CASP1, S100A8, MYO10, IGFBP3, APCDD1, COL6A3, FABP5, PRDX3, CLEC1B, DDIT4, CXCL10 and CXCL8), common gene ontology (GO), molecular pathways between SARS-CoV-2 infections and cancers. This work also shows the synergistic complexities of SARS-CoV-2 infections for cancer patients through the gene set enrichment and semantic similarity. These results highlighted the immune systems, cell activation and cytokine production GO pathways that were observed in SARS-CoV-2 infections as well as breast, lungs, colon, kidney and thyroid cancers. This work also revealed ribosome biogenesis, wnt signaling pathway, ribosome, chemokine and cytokine pathways that are commonly deregulated in cancers and COVID-19. Thus, our bioinformatics approach and tools revealed interconnections in terms of significant genes, GO, pathways between SARS-CoV-2 infections and malignant tumors.

Predominance of Leptospira wolffii in north-central Bangladesh, 2019

Leptospira was detected in 48.9% of blood samples from 182 febrile patients in north-central Bangladesh in 2019. Most Leptospira were classified as L. wolffii (93%) on the basis of phylogenetic analysis of 16S ribosomal RNA genes, while others were assigned to L. borgpetersenii and L. meyeri.

Impact of Concomitant Medications on Biochemical Outcome in Localised Prostate Cancer Treated with Radiotherapy and Androgen Deprivation Therapy

AIMS

Several classes of concomitant medications have been shown to affect oncological outcomes in patients with prostate cancer (PCa). We assessed the association between the use of commonly prescribed concomitant medications and biochemical relapse-free survival (bRFS) in patients with localised PCa treated with radiotherapy and androgen deprivation therapy (ADT).

MATERIALS AND METHODS

A secondary pooled analysis of two phase III randomised trials was carried out. In the first trial, patients with localised PCa with clinical stage T1b-T3, prostate-specific antigen <30 ng/ml and Gleason score ≤7 were treated with radical radiotherapy and 6 months of ADT starting 4 months before or concomitantly with radiotherapy. In the second trial, patients with high-risk PCa were treated with radical radiotherapy and 36 months of ADT with randomisation to three-dimensional conformal or intensity-modulated radiotherapy. Information on concomitant medications was collected from the medical record. Univariable and multivariable Cox regression was used to identify factors associated with bRFS.

RESULTS

Overall, 486 patients were evaluable. The median follow-up was 125 months; 10-year bRFS was 83.7%. On univariable analysis, receipt of metformin was significantly associated with worse bRFS. Ten-year bRFS was 73% and 85% for patients with and without concomitant metformin (adjusted hazard ratio 2.11, 95% confidence interval 1.03-4.33). Similar evidence of an association was observed with sulfonamide-based α1-receptor blockers (adjusted hazard ratio 2.72, 95% confidence interval 1.31-5.66). However, no such association was seen with receipt of quinazoline-based α1-receptor blockers (adjusted hazard ratio 1.09, 95% confidence interval 0.42-2.82). There was no significant association between bRFS and receipt of all other medication classes considered.

CONCLUSIONS

In this population of patients with localised PCa treated with radiotherapy and ADT, receipt of concomitant metformin and sulfonamide-based α1-receptor blockers was associated with inferior biochemical outcome. Randomised trials are required to assess the true effect of these medications on oncological outcomes in localised PCa.

Molecular Detection of Human Brucellosis among Patients with Pyrexia of Unknown Origin

This study describes the molecular detection of human brucellosis among patients with pyrexia of unknown origin. It was a cross-sectional descriptive study and was carried out in the Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Non-probability purposive type of sampling technique was used. Blood samples were collected from 400 pyretic patients from September 2018 to August 2019. BCSP31 Brucella genus-specific TaqMan real-time PCR and SYBR Green real-time PCR were undertaken for molecular detection. Out of 400 samples, 22 (5.5%) samples found BCSP31 Brucella genus-specific real-time PCR positive. The study revealed that a considerable number of brucellosis is present in rural areas among risk as well as non-risk group study population having definite male predominancy, most prone to develop among >40-80 years age group. Brucella genus and species-specific real-time PCR might be performed for confirmation and also to avoid unjustified costs, drug toxicity, and un-masking of other potentially dangerous diseases.

Comparison of Cardiac Outcome of Continuous Ambulatory Peritoneal Dialysis & Hemodialysis in CKD5 Patients with Heart Failure

Prevalence of heart failure (HF) among end stage renal disease (ESRD) patients is high and HF remains the main cardiovascular co-morbidity at dialysis initiation. There is paucity of data comparing change of NYHA class, improvement of ejection fraction (EF) and major cardiac events in ESRD patients with concomitant heart failure on haemodialysis to those on peritoneal dialysis. The objective of the study was to compare the cardiac outcome of continuous ambulatory peritoneal dialysis (CAPD) & hemodialysis (HD) in chronic kidney disease 5 (CKD5) patients with HF. This prospective observational study was carried out from March 2018 to February 2019 in seventy CKD 5 patients with HF who opted for CAPD or HD. Seven patients dropped out during the follow-up & sixty three patients (CAPD=31; HD=32) were followed up for symptomatic assessment of cardiac status in terms of NYHA class as well as echocardiography and serum haemoglobin at baseline and at 3rd & 6th month. Major cardiovascular events like non fatal MI, non fatal stroke & death duo to cardiovascular diseases and co-morbidities were recorded during the study period. Statistical analysis was done using SPSS 22.0. Mean age was 53.33±6.38 and 54.23±10.15 years & male to female ratio was 1.81:1 and 1.46:1 in CAPD and HD groups respectively. Both NYHA class & left ventricular ejection fraction (EF) were significantly increased after six months compared to baseline in each group and significantly more increased in the CAPD group than the HD group. Left ventricular internal diameter in diastole (LVIDd) was reduced significantly after six months compared to baseline in both groups and there was no significant difference in LVIDd reduction between the CAPD and HD groups. Major cardiovascular events were found to occur more frequently in the HD group. According to NYHA functional class, echocardiographic findings and major cardiovascular events during six months, improvement of cardiac function in CKD 5 patients with HF was better on CAPD in comparison to HD.

Who manages health workforce in the States of India: Profile, knowledge and perceptions of the team

Problem

Human resources in the public health sector is of prime importance in a limited resource setting country, who at times work in a high-pressure, limited resource environment and where skilled staff continue to remain in short supply. The role of Human Resource for Health (HRH) team responsible for managing this health workforce is crucial. They play an important role in improving the human resource practices and creating an enabling organizational culture for optimal resource utilization. The paper explores the profile of the HRH teams of the states of India, their knowledge levels, and perceptions of their role.

Methods

The participants were HR Managers from 29 states of India who look after HRH in National Health Mission and State Health Departments. Cross-sectional survey tool was used for data collection. Quantitative data analysis included univariate and bivariate analysis. One Way ANOVA test of significance and post-hoc tests using Tukey's method was used to ascertain the groups with significant difference.

Results

Most of the HRH team members are postgraduates or have management background. Their experience varies from &lt;1year to &gt; 25 years. Mostly of them perceive their role to be limited to implementing bare essential HRM practices, mostly administrative. The educational qualification of the members did not have any significant bearing on their technical knowledge related to HRM practices; but their experience in public health sector showed a significant association.

Lessons

This study lends evidence to the principle that professionals who have been in the system for long, know about HRH and the associated policies better, and hence may be better equipped to handle HRH and establish good HR Management (HRM) systems. Better role clarity among the HRH teams, expansion of their current scope of work to include advanced practices of HRM and continuous capacity building mechanisms are needed to help strengthen the development and management of HRH.

Key messages

This study, a first of its kind in the country, lend evidence related to the principle for deciding the profile of team who should be entrusted with managing and development of HRH. The Study gives evidence to focus on the role clarity of HRH to zero down their knowledge and skills gaps and enhance their competencies through better capacity building.

Child drowning mortality in the Sundarbans, India: Applying the Community Knowledge Approach

Background

The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region due to its remoteness and poor coverage of health and police systems. Household methodology was found to be resource and time intensive, and so a Community Knowledge Approach was used and applied to calculate injury mortality for the first time.

Methods

A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for 1-4 and 5-9 year old children. A Community Knowledge Approach was applied. Meetings were held with law community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child's household through a structured survey, inquiring on the circumstances around the drowning death.

Results

The drowning mortality rate for children aged 1-4 years old was 243.8 per 100,000 children and 38.8 per 100,000 children for 5-9-year olds. 58.0% of deaths were of 1-2-year-old children. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. Only one third of deaths were reported to hospitals or civil registration systems. Of deaths listed by community members, 63.0% were identified by both residents and by at least one key informant, 25.6% by key informants only, and 11.4% (n = 79) by community residents only.

Conclusions

Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1-4 years old. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based in rural low-and middle-income country contexts.

Key messages

Drowning is likely the largest killer of 1-9 year old children in the Sundarbans region, emphasising the need to better understanding drowning epidemiology in similar rural LMICs contexts. The Community Knowledge Approach provides a low-resource, valid method for capturing injury mortality data.