The Geometry of Cold, Metal-Enriched Gas Around Galaxies at z∼1.2z\sim1.2

We present the first results from a Hubble Space Telescope WFC3/IR program, which obtained direct imaging and grism observations of galaxies near quasar sightlines with a high frequency of uncorrelated foreground Mg II absorption. These highly efficient observations targeted 54 Mg II absorbers along the line of sight to nine quasars at $z_{qso}\sim2$. We find that 89% of the absorbers in the range $0.64< z < 1.6$ can be spectroscopically matched to at least one galaxy with an impact parameter less than 200 kpc and $|\Delta z|/(1+z)<0.006$. We have estimated the star formation rates and measured structural parameters for all detected galaxies with impact parameters in the range 7-200 kpc and star formation rates greater than 1.3 M$_{\odot}$ yr$^{-1}$. We find that galaxies associated with Mg II absorption have significantly higher mean star formation rates and marginally higher mean star formation rate surface densities compared to galaxies with no detected Mg II. Nearly half of the Mg II absorbers match to more than one galaxy, and the mean equivalent width of the Mg II absorption is found to be greater for groups, compared to isolated galaxies. Additionally, we observe a significant redshift evolution in the physical extent of Mg II-absorbing gas around galaxies and evidence of an enhancement of Mg II within 50 degrees of the minor axis, characteristic of outflows, which persists to 80 kpc around the galaxies, in agreement with recent predictions from simulations.Comment: 21 pages, 20 figures, Submitted to Ap

Antarctic climate, Southern Ocean circulation patterns, and deep water formation during the Eocene

We assess early-to-middle Eocene seawater neodymium (Nd) isotope records from seven Southern Ocean deep-sea drill sites to evaluate the role of Southern Ocean circulation in long-term Cenozoic climate change. Our study sites are strategically located on either side of the Tasman Gateway and are positioned at a range of shallow (Nd(t) = −9.3 ± 1.5). IODP Site U1356 off the coast of Adélie Land, a locus of modern-day Antarctic Bottom Water production, is identified as a site of persistent deep water formation from the early Eocene to the Oligocene. East of the Tasman Gateway an additional local source of intermediate/deep water formation is inferred at ODP Site 277 in the SW Pacific Ocean (εNd(t) = −8.7 ± 1.5). Antarctic-proximal shelf sites (ODP Site 1171 and Site U1356) reveal a pronounced erosional event between 49 and 48 Ma, manifested by ~2 εNd unit negative excursions in seawater chemistry toward the composition of bulk sediments at these sites. This erosional event coincides with the termination of peak global warmth following the Early Eocene Climatic Optimum and is associated with documented cooling across the study region and increased export of Antarctic deep waters, highlighting the complexity and importance of Southern Ocean circulation in the greenhouse climate of the Eocene

Clindamycin versus Trimethoprim–Sulfamethoxazole for Uncomplicated Skin Infections

BackgroundSkin and skin-structure infections are common in ambulatory settings. However, the efficacy of various antibiotic regimens in the era of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is unclear.MethodsWe enrolled outpatients with uncomplicated skin infections who had cellulitis, abscesses larger than 5 cm in diameter (smaller for younger children), or both. Patients were enrolled at four study sites. All abscesses underwent incision and drainage. Patients were randomly assigned in a 1:1 ratio to receive either clindamycin or trimethoprim-sulfamethoxazole (TMP-SMX) for 10 days. Patients and investigators were unaware of the treatment assignments and microbiologic test results. The primary outcome was clinical cure 7 to 10 days after the end of treatment.ResultsA total of 524 patients were enrolled (264 in the clindamycin group and 260 in the TMP-SMX group), including 155 children (29.6%). One hundred sixty patients (30.5%) had an abscess, 280 (53.4%) had cellulitis, and 82 (15.6%) had mixed infection, defined as at least one abscess lesion and one cellulitis lesion. S. aureus was isolated from the lesions of 217 patients (41.4%); the isolates in 167 (77.0%) of these patients were MRSA. The proportion of patients cured was similar in the two treatment groups in the intention-to-treat population (80.3% in the clindamycin group and 77.7% in the TMP-SMX group; difference, -2.6 percentage points; 95% confidence interval [CI], -10.2 to 4.9; P=0.52) and in the populations of patients who could be evaluated (466 patients; 89.5% in the clindamycin group and 88.2% in the TMP-SMX group; difference, -1.2 percentage points; 95% CI, -7.6 to 5.1; P=0.77). Cure rates did not differ significantly between the two treatments in the subgroups of children, adults, and patients with abscess versus cellulitis. The proportion of patients with adverse events was similar in the two groups.ConclusionsWe found no significant difference between clindamycin and TMP-SMX, with respect to either efficacy or side-effect profile, for the treatment of uncomplicated skin infections, including both cellulitis and abscesses. (Funded by the National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences, National Institutes of Health; ClinicalTrials.gov number, NCT00730028.)

Clindamycin versus Trimethoprim–Sulfamethoxazole for Uncomplicated Skin Infections

BACKGROUND: Skin and skin-structure infections are common in ambulatory settings. However, the efficacy of various antibiotic regimens in the era of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is unclear. METHODS: We enrolled outpatients with uncomplicated skin infections who had cellulitis, abscesses larger than 5 cm in diameter (smaller for younger children), or both. Patients were enrolled at four study sites. All abscesses underwent incision and drainage. Patients were randomly assigned in a 1:1 ratio to receive either clindamycin or trimethoprim–sulfamethoxazole (TMP-SMX) for 10 days. Patients and investigators were unaware of the treatment assignments and microbiologic test results. The primary outcome was clinical cure 7 to 10 days after the end of treatment. RESULTS: A total of 524 patients were enrolled (264 in the clindamycin group and 260 in the TMP-SMX group), including 155 children (29.6%). One hundred sixty patients (30.5%) had an abscess, 280 (53.4%) had cellulitis, and 82 (15.6%) had mixed infection, defined as at least one abscess lesion and one cellulitis lesion. S. aureus was isolated from the lesions of 217 patients (41.4%); the isolates in 167 (77.0%) of these patients were MRSA. The proportion of patients cured was similar in the two treatment groups in the intention-to-treat population (80.3% in the clindamycin group and 77.7% in the TMP-SMX group; difference, −2.6 percentage points; 95% confidence interval [CI], −10.2 to 4.9; P = 0.52) and in the populations of patients who could be evaluated (466 patients; 89.5% in the clindamycin group and 88.2% in the TMP-SMX group; difference, −1.2 percentage points; 95% CI, −7.6 to 5.1; P = 0.77). Cure rates did not differ significantly between the two treatments in the subgroups of children, adults, and patients with abscess versus cellulitis. The proportion of patients with adverse events was similar in the two groups. CONCLUSIONS: We found no significant difference between clindamycin and TMP-SMX, with respect to either efficacy or side-effect profile, for the treatment of uncomplicated skin infections, including both cellulitis and abscesses. (Funded by the National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences, National Institutes of Health; ClinicalTrials.gov number, NCT00730028.

Tropical sea temperatures in the high-latitude South Pacific during the Eocene

Sea-surface temperature (SST) estimates of ~30 °C from planktic foraminifera and archaeal membrane lipids in bathyal sediments in the Canterbury Basin, New Zealand, support paleontological evidence for a warm subtropical to tropical climate in the early Eocene high-latitude (55°S) southwest Pacific. Such warm SSTs call into question previous estimates based on oxygen isotopes and present a major challenge to climate modelers. Even under hypergreenhouse conditions (2240 ppm CO2), modeled summer SSTs for the New Zealand region do not exceed 20 °C

A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses

BackgroundUncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear.MethodsWe conducted a multicenter, prospective, double-blind trial involving outpatient adults and children. Patients were stratified according to the presence of a surgically drainable abscess, abscess size, the number of sites of skin infection, and the presence of nonpurulent cellulitis. Participants with a skin abscess 5 cm or smaller in diameter were enrolled. After abscess incision and drainage, participants were randomly assigned to receive clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), or placebo for 10 days. The primary outcome was clinical cure 7 to 10 days after the end of treatment.ResultsWe enrolled 786 participants: 505 (64.2%) were adults and 281 (35.8%) were children. A total of 448 (57.0%) of the participants were male. S. aureus was isolated from 527 participants (67.0%), and MRSA was isolated from 388 (49.4%). Ten days after therapy in the intention-to-treat population, the cure rate among participants in the clindamycin group was similar to that in the TMP-SMX group (221 of 266 participants [83.1%] and 215 of 263 participants [81.7%], respectively; P=0.73), and the cure rate in each active-treatment group was higher than that in the placebo group (177 of 257 participants [68.9%], P&lt;0.001 for both comparisons). The results in the population of patients who could be evaluated were similar. This beneficial effect was restricted to participants with S. aureus infection. Among the participants who were initially cured, new infections at 1 month of follow-up were less common in the clindamycin group (15 of 221, 6.8%) than in the TMP-SMX group (29 of 215 [13.5%], P=0.03) or the placebo group (22 of 177 [12.4%], P=0.06). Adverse events were more frequent with clindamycin (58 of 265 [21.9%]) than with TMP-SMX (29 of 261 [11.1%]) or placebo (32 of 255 [12.5%]); all adverse events resolved without sequelae. One participant who received TMP-SMX had a hypersensitivity reaction.ConclusionsAs compared with incision and drainage alone, clindamycin or TMP-SMX in conjunction with incision and drainage improves short-term outcomes in patients who have a simple abscess. This benefit must be weighed against the known side-effect profile of these antimicrobials. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT00730028 .)

Kids Run the World SHP

The Boys &amp; Girls Club services children ages 6 to 18 with programs and activities that emphasize development strategies (BGCA, n.d.). It provides role models, a safe environment, and constructive activities that focus on overall health. The club depends heavily on community engagement in the form of donors, partnerships, and volunteers (BGCA, n.d.). Our local club provided programs focusing on financial responsibility, leadership, and mental health, but lacked development of physical health practices. Kids Run the World comprised various activities to promote physical health in adolescents. This program is led by college level volunteers that worked with elementary and middle school-aged children to show them fun and safe ways to exercise. Before implementation of the program, research was completed to understand the dynamics of the local Boys &amp; Girls Club. This research included how to be an effective role model and successes of similar programs. This is when “Kid Run the World” was established and put into action. After volunteering at the Boys &amp; Girls Club throughout the duration of our project, we have observed increased physical activity levels and overall morale when group members and athletes are there leading activities. This was successful because of consistent attendance and positive interactions with the children. We learned we needed to have a youthful perspective and engage the kids with exercises they found familiar. Despite COVID-19, our group continues to make efforts to engage youth through our organization on campus, Kids Run the World. The Boys &amp; Girls Club has many underserved children, and this has provided our group with a unique platform that has benefited both us and the children through increased physical activity levels and community involvement

Early Paleogene temperature history of the Southwest Pacific Ocean: Reconciling proxies and models

We present a new multiproxy (TEX86, ?18O and Mg/Ca), marine temperature history for Canterbury Basin, eastern New Zealand, that extends from middle Paleocene to middle Eocene, including the Paleocene–Eocene thermal maximum (PETM) and early Eocene climatic optimum (EECO). In light of concerns that proxy-based sea surface temperature (SST) estimates are untenably warm for the southwest Pacific during the Eocene, we review the assumptions that underlie the proxies and develop a preliminary paleo-calibration for TEX86 that is based on four multiproxy Eocene records that represent an SST range of 15–34 °C. For the southwest Pacific Paleogene, we show that TEX86L exhibits the best fit with the Eocene paleo-calibration. SSTs derived from related proxies (TEX86H, 1/TEX86) exhibit a systematic warm bias that increases as TEX86 values decrease (a warm bias of 4–7 °C where TEX86&lt;0.7). The TEX86L proxy indicates that southwest Pacific SST increased by ?10 °C from middle Paleocene to early Eocene, with SST maxima of 26–28 °C (tropical) during the PETM and EECO and an SST minimum of 13–16 °C (cool–warm temperate) at the middle/late Paleocene transition (58.7 Ma). The base of the EECO is poorly defined in these records but the top is well-defined in Canterbury Basin by a 2–5 °C decrease in SST and bottom water temperature (BWT) in the latest early Eocene (49.3 Ma); BWT falls from a maximum of 18–20 °C in the EECO to 12–14 °C in the middle Eocene. Overall, cooler temperatures are recorded in the mid-Waipara section, which may reflect a deeper (?500 m water depth) and less neritic depositional setting compared with Hampden and ODP 1172 (?200 m water depth). The high SSTs and BWTs inferred for the PETM and EECO can be reconciled with Eocene coupled climate model results if the proxies are biased towards seasonal maxima and the likely effect of a proto-East Australian Current is taken into account

A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease

OBJECTIVE: To evaluate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) and a serotonin and norepinephrine reuptake inhibitor (SNRI) in the treatment of depression in Parkinson disease (PD). METHODS: A total of 115 subjects with PD were enrolled at 20 sites. Subjects were randomized to receive an SSRI (paroxetine; n = 42), an SNRI (venlafaxine extended release [XR]; n = 34), or placebo (n = 39). Subjects met DSM-IV criteria for a depressive disorder, or operationally defined subsyndromal depression, and scored >12 on the first 17 items of the Hamilton Rating Scale for Depression (HAM-D). Subjects were followed for 12 weeks (6-week dosage adjustment, 6-week maintenance). Maximum daily dosages were 40 mg for paroxetine and 225 mg for venlafaxine XR. The primary outcome measure was change in the HAM-D score from baseline to week 12. RESULTS: Treatment effects (relative to placebo), expressed as mean 12-week reductions in HAM-D score, were 6.2 points (97.5% confidence interval [CI] 2.2 to 10.3, p = 0.0007) in the paroxetine group and 4.2 points (97.5% CI 0.1 to 8.4, p = 0.02) in the venlafaxine XR group. No treatment effects were seen on motor function. CONCLUSIONS: Both paroxetine and venlafaxine XR significantly improved depression in subjects with PD. Both medications were generally safe and well tolerated and did not worsen motor function. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that paroxetine and venlafaxine XR are effective in treating depression in patients with PD

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health