Comparison of Lives Saved Tool model child mortality estimates against measured data from vector control studies in sub-Saharan Africa

<p>Abstract</p> <p>Background</p> <p>Insecticide-treated mosquito nets (ITNs) and indoor-residual spraying have been scaled-up across sub-Saharan Africa as part of international efforts to control malaria. These interventions have the potential to significantly impact child survival. The Lives Saved Tool (LiST) was developed to provide national and regional estimates of cause-specific mortality based on the extent of intervention coverage scale-up. We compared the percent reduction in all-cause child mortality estimated by LiST against measured reductions in all-cause child mortality from studies assessing the impact of vector control interventions in Africa.</p> <p>Methods</p> <p>We performed a literature search for appropriate studies and compared reductions in all-cause child mortality estimated by LiST to 4 studies that estimated changes in all-cause child mortality following the scale-up of vector control interventions. The following key parameters measured by each study were applied to available country projections: baseline all-cause child mortality rate, proportion of mortality due to malaria, and population coverage of vector control interventions at baseline and follow-up years.</p> <p>Results</p> <p>The percent reduction in all-cause child mortality estimated by the LiST model fell within the confidence intervals around the measured mortality reductions for all 4 studies. Two of the LiST estimates overestimated the mortality reductions by 6.1 and 4.2 percentage points (33% and 35% relative to the measured estimates), while two underestimated the mortality reductions by 4.7 and 6.2 percentage points (22% and 25% relative to the measured estimates).</p> <p>Conclusions</p> <p>The LiST model did not systematically under- or overestimate the impact of ITNs on all-cause child mortality. These results show the LiST model to perform reasonably well at estimating the effect of vector control scale-up on child mortality when compared against measured data from studies across a range of malaria transmission settings. The LiST model appears to be a useful tool in estimating the potential mortality reduction achieved from scaling-up malaria control interventions.</p

IRC+10216's Innermost Envelope -- The eSMA's View

We used the Extended Submillimeter Array (eSMA) in its most extended configuration to investigate the innermost (within a radius of 290 R* from the star) circumstellar envelope (CSE) of IRC+10216. We imaged the CSE using HCN and other molecular lines with a beam size of 0."22 x 0."46, deeply into the very inner edge (15 R*) of the envelope where the expansion velocity is only 3 km/s. The excitation mechanism of hot HCN and KCl maser lines is discussed. HCN maser components are spatially resolved for the first time on an astronomical object. We identified two discrete regions in the envelope: a region with a radius of . 15 R*, where molecular species have just formed and the gas has begun to be accelerated (region I) and a shell region (region II) with a radius of 23 R* and a thickness of 15 R*, whose expansion velocity has reached up to 13 km/s, nearly the terminal velocity of 15 km/s. The Si$^{34}$S line detected in region I shows a large expansion velocity of 16 km/s due to strong wing components, indicating that the emission may arise from a shock region in the innermost envelope. In region II, the P.A. of the most copious mass loss direction was found to be 120 +/- 10 degrees, which may correspond to the equatorial direction of the star. Region II contains a torus-like feature. These two regions may have emerged due to significant differences in the size distributions of the dust particles in the two regions.Comment: 26 pages, 8 figures, accepted for publication in The Astrophysical Journal. Please find the pdf at http://www.submm.caltech.edu/~hs/astroph/0904.0280.pdf and the ps file at http://www.submm.caltech.edu/~hs/astroph/0904.0280.p

Biocompatible Reverse Thermal Gel Sustains the Release of Intravitreal Bevacizumab In Vivo

PURPOSE. We assessed the in vivo release profile of bevacizumab from and biocompatibility of poly(ethylene glycol)-poly-(serinol hexamethylene urethane), or ESHU, a thermoresponsive hydrogel administered intravitreally for drug delivery. METHODS. The technical feasibility of injection was assessed quantitatively via mechanical testing. For in vivo studies, New Zealand White rabbit eyes were injected intravitreally with 0.05 mL of either: ESHU dissolved in 25 mg/mL bevacizumab, ESHU dissolved in PBS, or 25 mg/mL bevacizumab. Clinical examination included IOP measurements and examination with indirect ophthalmoscopy for signs of inflammation. Additionally, eyes were examined histologically following euthanasia. To quantify bevacizumab release, aqueous humor samples were obtained via anterior chamber paracentesis and ELISA was used to determine the concentration of drug weekly. In vitro cytotoxicity testing also was performed using bovine corneal endothelial cells. RESULTS. The ESHU was injected easily through a 31-gauge needle, was well tolerated in vivo, and caused minimal cell death in vitro when compared to other common materials, such as silicone oil. The long-term presence of the gel did not affect IOP, and there was no evidence of inflammation histologically or through indirect observation. The ESHU sustained the release of bevacizumab for over 9 weeks and maintained a drug concentration that averaged 4.7 times higher than eyes receiving bolus bevacizumab injections. CONCLUSIONS. To our knowledge, this is the first report demonstrating sustained bevacizumab release in vivo from an intravitreally injected hydrogel formulation, suggesting that this delivery system may be a promising candidate for ocular drug delivery. Keywords: thermally responsive hydrogel, ocular drug delivery, sustained release, biocompatibility, injectable gel C horoidal neovascularization (CNV) is the hallmark of many blinding disorders, most notably wet age-related macular degeneration (AMD) and diabetic retinopathy. It is characterized by pathologic blood vessel growth, which originates in the choroid and progresses through the Bruch&apos;s membrane into the subretinal space. 1 These vessels are fragile and permeable, causing hemorrhage, retinal detachment, scarring, and ultimately, loss of central vision. Elevated levels of VEGF is a central cause of CNV. 2-4 Thus, intravitreal injection of anti-VEGF medications, such as bevacizumab (Avastin) or ranibizumab (Lucentis), has emerged as a leading treatment strategy. 10-13 Therefore, a delivery system that extends the presence of intravitreal drugs in the eye is highly desirable for reducing injection frequency and adverse effects, while maximizing therapeutic outcomes. A number of polymeric delivery systems have been considered by researchers for intravitreal drug delivery, including microparticles, which are well tolerated in the eye and are capable of delivering drugs over a longer period of time. 14,15 For example, microparticle-encapsulated or PEGylated bevacizumab is more effective than bevacizumab alone in treating CNV in rats

A new era of wide-field submillimetre imaging: on-sky performance of SCUBA-2

SCUBA-2 is the largest submillimetre wide-field bolometric camera ever built. This 43 square arc-minute field-of-view instrument operates at two wavelengths (850 and 450 microns) and has been installed on the James Clerk Maxwell Telescope on Mauna Kea, Hawaii. SCUBA-2 has been successfully commissioned and operational for general science since October 2011. This paper presents an overview of the on-sky performance of the instrument during and since commissioning in mid-2011. The on-sky noise characteristics and NEPs of the 450 and 850 micron arrays, with average yields of approximately 3400 bolometers at each wavelength, will be shown. The observing modes of the instrument and the on-sky calibration techniques are described. The culmination of these efforts has resulted in a scientifically powerful mapping camera with sensitivities that allow a square degree of sky to be mapped to 10 mJy/beam rms at 850 micron in 2 hours and 60 mJy/beam rms at 450 micron in 5 hours in the best weather.Comment: 18 pages, 15 figures.SPIE Conference series 8452, Millimetre, Submillimetre and Far-infrared Detectors and Instrumentation for Astronomy VI 201

Social Media and Emergency Services?: Interview Study on Current and Potential Use in 7 European Countries

Social media is much just used for private as well as business purposes, obviously, also during emergencies. Emergency services are often confronted with the amount of information from social media and might consider using them – or not using them. This article highlights the perception of emergency services on social media during emergencies. Within their European research project EMERGENT, the authors therefore conducted an interview study with emergency service staff (N=11) from seven European countries and eight different cities. Their results highlight the current and potential use of social media, the emergency service's participation in research on social media as well as current challenges, benefits and future plans

Comparison of four clinical risk scores in comatose patients after out-of-hospital cardiac arrest.

BACKGROUND AND AIMS Several different scoring systems for early risk stratification after out-of-hospital cardiac arrest have been developed, but few have been validated in large datasets. The aim of the present study was to compare the well-validated Out-of-hospital Cardiac Arrest (OHCA) and Cardiac Arrest Hospital Prognosis (CAHP)-scores to the less complex MIRACLE2- and Target Temperature Management (TTM)-scores. METHODS This was a post-hoc analysis of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Missing data were handled by multiple imputation. The primary outcome was discriminatory performance assessed as the area under the receiver operating characteristics-curve (AUROC), with the outcome of interest being poor functional outcome or death (modified Rankin Scale 4-6) at 6 months after OHCA. RESULTS Data on functional outcome at 6 months were available for 1829 cases, which constituted the study population. The pooled AUROC for the MIRACLE2-score was 0.810 (95% CI 0.790 - 0.828), 0.835 (95% CI 0.816 - 0.852) for the TTM-score, 0.820 (95% CI 0.800 - 0.839) for the CAHP-score and 0.770 (95% CI 0.748 - 0.791) for the OHCA-score. At the cut-offs needed to achieve specificities >95%, sensitivities were <40 % for all four scoring systems. CONCLUSIONS The TTM-, MIRACLE2- and CAHP-scores are all capable of providing objective risk estimates accurate enough to be used as part of a holistic patient assessment after OHCA of a suspected cardiac origin. Due to its simplicity, the MIRACLE2-score could be a practical solution for both clinical application and risk stratification within trials

Resolving the inner jet structure of 1924-292 with the EVENT HORIZON TELESCOPE

We present the first 1.3 mm (230 GHz) very long baseline interferometry model image of an AGN jet using closure phase techniques with a four-element array. The model image of the quasar 1924-292 was obtained with four telescopes at three observatories: the James Clerk Maxwell Telescope (JCMT) on Mauna Kea in Hawaii, the Arizona Radio Observatory's Submillimeter Telescope (SMT) in Arizona, and two telescopes of the Combined Array for Research in Millimeterwave Astronomy (CARMA) in California in April 2009. With the greatly improved resolution compared with previous observations and robust closure phase measurement, the inner jet structure of 1924-292 was spatially resolved. The inner jet extends to the northwest along a position angle of $-53^\circ$ at a distance of 0.38\,mas from the tentatively identified core, in agreement with the inner jet structure inferred from lower frequencies, and making a position angle difference of $\sim 80^{\circ}$ with respect to the cm-jet. The size of the compact core is 0.15\,pc with a brightness temperature of $1.2\times10^{11}$\,K. Compared with those measured at lower frequencies, the low brightness temperature may argue in favor of the decelerating jet model or particle-cascade models. The successful measurement of closure phase paves the way for imaging and time resolving Sgr A* and nearby AGN with the Event Horizon Telescope.Comment: 6 pages, 4 figures, accepted for publication in ApJ

Monomeric IgA Antagonizes IgG-Mediated Enhancement of DENV Infection

Dengue virus (DENV) is a prevalent human pathogen, infecting approximately 400 million individuals per year and causing symptomatic disease in approximately 100 million. A distinct feature of dengue is the increased risk for severe disease in some individuals with preexisting DENV-specific immunity. One proposed mechanism for this phenomenon is antibody-dependent enhancement (ADE), in which poorly-neutralizing IgG antibodies from a prior infection opsonize DENV to increase infection of Fc gamma receptor-bearing cells. While IgM and IgG are the most commonly studied DENV-reactive antibody isotypes, our group and others have described the induction of DENV-specific serum IgA responses during dengue. We hypothesized that monomeric IgA would be able to neutralize DENV without the possibility of ADE. To test this, we synthesized IgG and IgA versions of two different DENV-reactive monoclonal antibodies. We demonstrate that isotype-switching does not affect the antigen binding and neutralization properties of the two mAbs. We show that DENV-reactive IgG, but not IgA, mediates ADE in Fc gamma receptor-positive K562 cells. Furthermore, we show that IgA potently antagonizes the ADE activity of IgG. These results suggest that levels of DENV-reactive IgA induced by DENV infection might regulate the overall IgG mediated ADE activity of DENV-immune plasma in vivo, and may serve as a predictor of disease risk