Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin

Background: Kikuchi-Fujimoto disease, a benign self-limited lymphadenopathy is an uncommon cause of pyrexia of unknown origin (PUO). Methods: We retrospectively studied the case-records of 13 patients presenting with PUO who were diagnosed to have Kikuchi-Fujimoto disease on peripheral lymph node excision biopsy and report the salient clinical manifestations and histopathological findings in them. All of them received symptomatic treatment. Results: Their median age was 28 [interquartile range (IQR) 18.5-38.0] years. Women (11/13, 84.6%) were more frequently affected. All of them were human immunodeficiency virus (HIV) seronegative. Prior to presenting to us, two were being treated for lymph node tuberculosis with DOTS. Cervical lymph nodes were predominantly involved, the distribution being: right cervical (n=10, 76.9%); left cervical (n=4); and bilateral cervical (n=2). Axillary and generalized lymphadenopathy were rare being seen in 2 and 1 patient respectively. The median (IQR) erythrocyte sedimentation rate (n=11) was 53 (35-89) mm at the end of first hour. Salient histopathological features were paracortical patchy zones of eosinophilic fibrinoid necrosis with karyorrhectic debris, large numbers of histiocytes, including histiocytes with peripherally placed “crescentic” nuclei. Spontaneous regression of fever and lymphadenopathy was observed over a median (IQR) period of 8 (6.75-10.25) months in all of them. Conclusions: Kikuchi-Fujimoto disease is a rare but important cause of PUO presenting with peripheral lymphadenopathy. Women are most often affected and cervical lymph nodes are the most frequently involved site. Clinical suspicion and thoughtful collaboration between clinicians and pathologists are essential for accurate diagnosis, and to minimize unnecessary investigations and inappropriate aggressive treatment

Livelihood gains and ecological costs of NTFP dependence: assessing the roles of dependence, ecological knowledge and market structure in three contrasting human and ecological settings in south India

Non-timber forest products (NTFPs) constitute the single largest determinant of livelihoods for scores of forest fringe communities and poor people in the tropics. In India over 50 million people are believed to be directly dependent upon NTFPs for their subsistence. However, such human dependence on NTFPs for livelihood gains (win) has most frequently been at a certain ecological cost (lose). If livelihoods are to be maintained, the existing ‘win-lose’ settings have to be steered to a ‘win-win’ mode, otherwise, there could be severe erosion of the biological resources and loss of livelihoods (‘lose-lose’). Examining the dependence of forest fringe communities on NTFPs at three sites in south India with contrasting human and ecological settings, three key factors (extent of dependence on NTFPs, indigenous ecological knowledge and market organization) are likely to constrain reaching the win-win situation. How these factors shape the ecological cost of harvesting NTFPs at the three sites is examined. Within the parameter space of these factors, it is possible to predict outcomes and associations that will conform to win-win or win-lose situations. Empirical data derived from the three study sites demonstrate the causality of the observed associations. The key for long-term livelihood gains lies in reducing the ecological cost. Certain interventions and recommendations that could optimize the balance between livelihood gains and ecological cost are proposed

Relation between sedimentary layer thickness and fundamental frequency of the H/V spectra for Bangalore city

Soil amplification and topographical effects play a major role in earthquake damage to civil structures. Study of sedimentary layer thickness and behaviour under stress cycles is crucial for earthquake hazard analysis. Borehole logs for Bangalore are used to benchmark the relation between sedimentary thickness and resonant frequency of the soil layer for this region. Microtremor measurements are carried out at the locations where borehole drilling was done and the frequencies corresponding to spectral peaks of the H/V ratio are estimated, where H and V denote the horizontal and vertical spectral component of the microtremor displacement respectively. The thicknesses of the soil layer (D), obtained from borehole logs and the soil layer resonant frequencies (fr) determined from the H/V spectral peaks are used to obtain a regression relation between them. The regression relation obtained is given by D = (58.29 ± 8.8) � fr -(0.95±0.1)·Using the data from the work of Divya et al., a similar regression relation is plotted. The results obtained arein agreement with the field data. This relation can be used for computing the depth to the bedrock for Bangalore using microtremor survey at a location where borehole data is not available

Proximity effect at superconducting Sn-Bi2Se3 interface

We have investigated the conductance spectra of Sn-Bi2Se3 interface junctions down to 250 mK and in different magnetic fields. A number of conductance anomalies were observed below the superconducting transition temperature of Sn, including a small gap different from that of Sn, and a zero-bias conductance peak growing up at lower temperatures. We discussed the possible origins of the smaller gap and the zero-bias conductance peak. These phenomena support that a proximity-effect-induced chiral superconducting phase is formed at the interface between the superconducting Sn and the strong spin-orbit coupling material Bi2Se3.Comment: 7 pages, 8 figure

Centrality Dependence of the High p_T Charged Hadron Suppression in Au+Au collisions at sqrt(s_NN) = 130 GeV

PHENIX has measured the centrality dependence of charged hadron p_T spectra from central Au+Au collisions at sqrt(s_NN)=130 GeV. The truncated mean p_T decreases with centrality for p_T > 2 GeV/c, indicating an apparent reduction of the contribution from hard scattering to high p_T hadron production. For central collisions the yield at high p_T is shown to be suppressed compared to binary nucleon-nucleon collision scaling of p+p data. This suppression is monotonically increasing with centrality, but most of the change occurs below 30% centrality, i.e. for collisions with less than about 140 participating nucleons. The observed p_T and centrality dependence is consistent with the particle production predicted by models including hard scattering and subsequent energy loss of the scattered partons in the dense matter created in the collisions.Comment: 7 pages text, LaTeX, 6 figures, 2 tables, 307 authors, resubmitted to Phys. Lett. B. Revised to address referee concerns. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are publicly available at http://www.phenix.bnl.gov/phenix/WWW/run/phenix/papers.htm

Formation of dense partonic matter in relativistic nucleus-nucleus collisions at RHIC: Experimental evaluation by the PHENIX collaboration

Extensive experimental data from high-energy nucleus-nucleus collisions were recorded using the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). The comprehensive set of measurements from the first three years of RHIC operation includes charged particle multiplicities, transverse energy, yield ratios and spectra of identified hadrons in a wide range of transverse momenta (p_T), elliptic flow, two-particle correlations, non-statistical fluctuations, and suppression of particle production at high p_T. The results are examined with an emphasis on implications for the formation of a new state of dense matter. We find that the state of matter created at RHIC cannot be described in terms of ordinary color neutral hadrons.Comment: 510 authors, 127 pages text, 56 figures, 1 tables, LaTeX. Submitted to Nuclear Physics A as a regular article; v3 has minor changes in response to referee comments. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

The PHENIX Experiment at RHIC

The physics emphases of the PHENIX collaboration and the design and current status of the PHENIX detector are discussed. The plan of the collaboration for making the most effective use of the available luminosity in the first years of RHIC operation is also presented.Comment: 5 pages, 1 figure. Further details of the PHENIX physics program available at http://www.rhic.bnl.gov/phenix

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials