Tenofovir disoproxil fumarate for prevention of HIV infection in women: a phase 2, double-blind, randomized, placebo-controlled trial.

ObjectivesThe objective of this trial was to investigate the safety and preliminary effectiveness of a daily dose of 300 mg of tenofovir disoproxil fumarate (TDF) versus placebo in preventing HIV infection in women.DesignThis was a phase 2, randomized, double-blind, placebo-controlled trial.SettingThe study was conducted between June 2004 and March 2006 in Tema, Ghana; Douala, Cameroon; and Ibadan, Nigeria.ParticipantsWe enrolled 936 HIV-negative women at high risk of HIV infection into this study.InterventionParticipants were randomized 1:1 to once daily use of 300 mg of TDF or placebo.Outcome measuresThe primary safety endpoints were grade 2 or higher serum creatinine elevations (>2.0 mg/dl) for renal function, grade 3 or 4 aspartate aminotransferase or alanine aminotransferase elevations (>170 U/l) for hepatic function, and grade 3 or 4 phosphorus abnormalities (<1.5 mg/dl). The effectiveness endpoint was infection with HIV-1 or HIV-2.ResultsStudy participants contributed 428 person-years of laboratory testing to the primary safety analysis. No significant differences emerged between treatment groups in clinical or laboratory safety outcomes. Study participants contributed 476 person-years of HIV testing to the primary effectiveness analysis, during which time eight seroconversions occurred. Two were diagnosed in participants randomized to TDF (0.86 per 100 person-years) and six in participants receiving placebo (2.48 per 100 person-years), yielding a rate ratio of 0.35 (95% confidence interval = 0.03-1.93), which did not achieve statistical significance. Owing to premature closures of the Cameroon and Nigeria study sites, the planned person-years of follow-up and study power could not be achieved.ConclusionDaily oral use of TDF in HIV-uninfected women was not associated with increased clinical or laboratory adverse events. Effectiveness could not be conclusively evaluated because of the small number of HIV infections observed during the study

Ultra High Energy Cosmology with POLARBEAR

Observations of the temperature anisotropy of the Cosmic Microwave Background (CMB) lend support to an inflationary origin of the universe, yet no direct evidence verifying inflation exists. Many current experiments are focussing on the CMB's polarization anisotropy, specifically its curl component (called "B-mode" polarization), which remains undetected. The inflationary paradigm predicts the existence of a primordial gravitational wave background that imprints a unique B-mode signature on the CMB's polarization at large angular scales. The CMB B-mode signal also encodes gravitational lensing information at smaller angular scales, bearing the imprint of cosmological large scale structures (LSS) which in turn may elucidate the properties of cosmological neutrinos. The quest for detection of these signals; each of which is orders of magnitude smaller than the CMB temperature anisotropy signal, has motivated the development of background-limited detectors with precise control of systematic effects. The POLARBEAR experiment is designed to perform a deep search for the signature of gravitational waves from inflation and to characterize lensing of the CMB by LSS. POLARBEAR is a 3.5 meter ground-based telescope with 3.8 arcminute angular resolution at 150 GHz. At the heart of the POLARBEAR receiver is an array featuring 1274 antenna-coupled superconducting transition edge sensor (TES) bolometers cooled to 0.25 Kelvin. POLARBEAR is designed to reach a tensor-to-scalar ratio of 0.025 after two years of observation -- more than an order of magnitude improvement over the current best results, which would test physics at energies near the GUT scale. POLARBEAR had an engineering run in the Inyo Mountains of Eastern California in 2010 and will begin observations in the Atacama Desert in Chile in 2011.Comment: 8 pages, 6 figures, DPF 2011 conference proceeding

The bolometric focal plane array of the Polarbear CMB experiment

The Polarbear Cosmic Microwave Background (CMB) polarization experiment is currently observing from the Atacama Desert in Northern Chile. It will characterize the expected B-mode polarization due to gravitational lensing of the CMB, and search for the possible B-mode signature of inflationary gravitational waves. Its 250 mK focal plane detector array consists of 1,274 polarization-sensitive antenna-coupled bolometers, each with an associated lithographed band-defining filter. Each detector's planar antenna structure is coupled to the telescope's optical system through a contacting dielectric lenslet, an architecture unique in current CMB experiments. We present the initial characterization of this focal plane

Neutralino Dark Matter in Minimal Supergravity: Direct Detection vs. Collider Searches

We calculate expected event rates for direct detection of relic neutralinos as a function of parameter space of the minimal supergravity model. Numerical results are presented for the specific case of a $^{73}$Ge detector. We find significant detection rates ($R> 0.01$ events/kg/day) in regions of parameter space most favored by constraints from $B\to X_s\gamma$ and the cosmological relic density of neutralinos. The detection rates are especially large in regions of large $\tan\beta$, where many conventional signals for supersymmetry at collider experiments are difficult to detect. If the parameter $\tan\beta$ is large, then there is a significant probability that the first direct evidence for supersymmetry could come from direct detection experiments, rather than from collider searches for sparticles.Comment: 25 page REVTEX file including 9 PS figure

Resolved 24.5 micron emission from massive young stellar objects

Massive young stellar objects (MYSO) are surrounded by massive dusty envelopes. Our aim is to establish their density structure on scales of ~1000 AU, i.e. a factor 10 increase in angular resolution compared to similar studies performed in the (sub)mm. We have obtained diffraction-limited (0.6") 24.5 micron images of 14 well-known massive star formation regions with Subaru/COMICS. The images reveal the presence of discrete MYSO sources which are resolved on arcsecond scales. For many sources, radiative transfer models are capable of satisfactorily reproducing the observations. They are described by density powerlaw distributions (n(r) ~ r^(-p)) with p = 1.0 +/-0.25. Such distributions are shallower than those found on larger scales probed with single-dish (sub)mm studies. Other sources have density laws that are shallower/steeper than p = 1.0 and there is evidence that these MYSOs are viewed near edge-on or near face-on, respectively. The images also reveal a diffuse component tracing somewhat larger scale structures, particularly visible in the regions S140, AFGL 2136, IRAS 20126+4104, Mon R2, and Cep A. We thus find a flattening of the MYSO envelope density law going from ~10 000 AU down to scales of ~1000 AU. We propose that this may be evidence of rotational support of the envelope (abridged).Comment: 21 pages, accepted for A&

Long-Baseline Neutrino Facility (LBNF) and Deep Underground Neutrino Experiment (DUNE) Conceptual Design Report Volume 2: The Physics Program for DUNE at LBNF

The Physics Program for the Deep Underground Neutrino Experiment (DUNE) at the Fermilab Long-Baseline Neutrino Facility (LBNF) is described

Pediatric patient asthma-related emergency department visits and admissions in Washington, DC, from 2001–2004, and associations with air quality, socio-economic status and age group

BACKGROUND: The District of Columbia (DC) Department of Health, under a grant from the US Centers for Disease Control and Prevention, established an Environmental Public Health Tracking Program. As part of this program, the goals of this contextual pilot study are to quantify short-term associations between daily pediatric emergency department (ED) visits and admissions for asthma exacerbations with ozone and particulate concentrations, and broader associations with socio-economic status and age group. METHODS: Data included daily counts of de-identified asthma-related pediatric ED visits for DC residents and daily ozone and particulate concentrations during 2001–2004. Daily temperature, mold, and pollen measurements were also obtained. After a cubic spline was applied to control for long-term seasonal trends in the ED data, a Poisson regression analysis was applied to the time series of daily counts for selected age groups. RESULTS: Associations between pediatric asthma ED visits and outdoor ozone concentrations were significant and strongest for the 5–12 year-old age group, for which a 0.01-ppm increase in ozone concentration indicated a mean 3.2% increase in daily ED visits and a mean 8.3% increase in daily ED admissions. However, the 1–4 yr old age group had the highest rate of asthma-related ED visits. For 1–17 yr olds, the rates of both asthma-related ED visits and admissions increased logarithmically with the percentage of children living below the poverty threshold, slowing when this percentage exceeded 30%. CONCLUSION: Significant associations were found between ozone concentrations and asthma-related ED visits, especially for 5–12 year olds. The result that the most significant ozone associations were not seen in the age group (1–4 yrs) with the highest rate of asthma-related ED visits may be related to the clinical difficulty in accurately diagnosing asthma among this age group. We observed real increases in relative risk of asthma ED visits for children living in higher poverty zip codes versus other zip codes, as well as similar logarithmic relationships for visits and admissions, which implies ED over-utilization may not be a factor. These results could suggest designs for future epidemiological studies that include more information on individual exposures and other risk factors

Validity of a novel computerized cognitive battery for mild cognitive impairment

BACKGROUND: The NeuroTrax Mindstreams computerized cognitive assessment system was designed for widespread clinical and research use in detecting mild cognitive impairment (MCI). However, the capability of Mindstreams tests to discriminate elderly with MCI from those who are cognitively healthy has yet to be evaluated. Moreover, the comparability between these tests and traditional neuropsychological tests in detecting MCI has not been examined. METHODS: A 2-center study was designed to assess discriminant validity of tests in the Mindstreams Mild Impairment Battery. Participants were 30 individuals diagnosed with MCI, 29 with mild Alzheimer's disease (AD), and 39 healthy elderly. Testing was with the Mindstreams battery and traditional neuropsychological tests. Receiver operating characteristic (ROC) analysis was used to examine the ability of Mindstreams and traditional measures to discriminate those with MCI from cognitively healthy elderly. Between-group comparisons were made (Mann-Whitney U test) between MCI and healthy elderly and between MCI and mild AD groups. RESULTS: Mindstreams outcome parameters across multiple cognitive domains significantly discriminated among MCI and healthy elderly with considerable effect sizes (p < 0.05). Measures of memory, executive function, visual spatial skills, and verbal fluency discriminated best, and discriminability was at least comparable to that of traditional neuropsychological tests in these domains. CONCLUSIONS: Mindstreams tests are effective in detecting MCI, providing a comprehensive profile of cognitive function. Further, the enhanced precision and ease of use of these computerized tests make the NeuroTrax system a valuable clinical tool in the identification of elderly at high risk for dementia

Geomorphic and stratigraphic evidence for an unusual tsunami or storm a few centuries ago at Anegada, British Virgin Islands

© The Author(s), 2010. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Natural Hazards 63 (2012): 51-84, doi:10.1007/s11069-010-9622-6.Waters from the Atlantic Ocean washed southward across parts of Anegada, east-northeast of Puerto Rico, during a singular event a few centuries ago. The overwash, after crossing a fringing coral reef and 1.5 km of shallow subtidal flats, cut dozens of breaches through sandy beach ridges, deposited a sheet of sand and shell capped with lime mud, and created inland fields of cobbles and boulders. Most of the breaches extend tens to hundreds of meters perpendicular to a 2-km stretch of Anegada’s windward shore. Remnants of the breached ridges stand 3 m above modern sea level, and ridges seaward of the breaches rise 2.2–3.0 m high. The overwash probably exceeded those heights when cutting the breaches by overtopping and incision of the beach ridges. Much of the sand-and-shell sheet contains pink bioclastic sand that resembles, in grain size and composition, the sand of the breached ridges. This sand extends as much as 1.5 km to the south of the breached ridges. It tapers southward from a maximum thickness of 40 cm, decreases in estimated mean grain size from medium sand to very fine sand, and contains mud laminae in the south. The sand-and-shell sheet also contains mollusks—cerithid gastropods and the bivalve Anomalocardia—and angular limestone granules and pebbles. The mollusk shells and the lime-mud cap were probably derived from a marine pond that occupied much of Anegada’s interior at the time of overwash. The boulders and cobbles, nearly all composed of limestone, form fields that extend many tens of meters generally southward from limestone outcrops as much as 0.8 km from the nearest shore. Soon after the inferred overwash, the marine pond was replaced by hypersaline ponds that produce microbial mats and evaporite crusts. This environmental change, which has yet to be reversed, required restriction of a former inlet or inlets, the location of which was probably on the island’s south (lee) side. The inferred overwash may have caused restriction directly by washing sand into former inlets, or indirectly by reducing the tidal prism or supplying sand to post-overwash currents and waves. The overwash happened after A.D. 1650 if coeval with radiocarbon-dated leaves in the mud cap, and it probably happened before human settlement in the last decades of the 1700s. A prior overwash event is implied by an inland set of breaches. Hypothetically, the overwash in 1650–1800 resulted from the Antilles tsunami of 1690, the transatlantic Lisbon tsunami of 1755, a local tsunami not previously documented, or a storm whose effects exceeded those of Hurricane Donna, which was probably at category 3 as its eye passed 15 km to Anegada’s south in 1960.The work was supported in part by the Nuclear Regulatory Commission under its project N6480, a tsunami-hazard assessment for the eastern United States

Genome-wide regional heritability mapping identifies a locus within the<i> TOX2</i> gene associated with Major Depressive Disorder

Background: Major depressive disorder (MDD) is the second largest cause of global disease burden. It has an estimated heritability of 37%, but published genome-wide association studies have so far identified few risk loci. Haplotype-block-based regional heritability mapping (HRHM) estimates the localized genetic variance explained by common variants within haplotype blocks, integrating the effects of multiple variants, and may be more powerful for identifying MDD-associated genomic regions. Methods: We applied HRHM to Generation Scotland: The Scottish Family Health Study, a large family- and population-based Scottish cohort (N = 19,896). Single-single nucleotide polymorphism (SNP) and haplotype-based association tests were used to localize the association signal within the regions identified by HRHM. Functional prediction was used to investigate the effect of MDD-associated SNPs within the regions. Results: A haplotype block across a 24-kb region within the TOX2 gene reached genome-wide significance in HRHM. Single-SNP- and haplotype-based association tests demonstrated that five of nine genotyped SNPs and two haplotypes within this block were significantly associated with MDD. The expression of TOX2 and a brain-specific long noncoding RNA RP1-269M15.3 in frontal cortex and nucleus accumbens basal ganglia, respectively, were significantly regulated by MDD-associated SNPs within this region. Both the regional heritability and single-SNP associations within this block were replicated in the UK–Ireland group of the most recent release of the Psychiatric Genomics Consortium (PGC), the PGC2–MDD (Major Depression Dataset). The SNP association was also replicated in a depressive symptom sample that shares some individuals with the PGC2–MDD. Conclusions: This study highlights the value of HRHM for MDD and provides an important target within TOX2 for further functional studies