Antiretroviral therapy initiated soon after HIV diagnosis as standard care: potential to save lives?

In 2008, an estimated 33.4 million people were infected with human immunodeficiency virus (HIV) and ~4 million people were receiving antiretroviral therapy (ART). However, in 2007, an estimated 6.7 million people were in need of ART under the current World Health Organization guidelines, and 2.7 million more people became infected with HIV. Most of those not currently eligible for ART will become eligible within the next decade, making the current treatment strategy unsustainable. The development of cheaper, less toxic, and more potent antiretrovirals over the past decade has made it possible to consider novel strategies of arresting the HIV/AIDS epidemic. Evidence is growing that ART can be used to prevent HIV transmission and that earlier initiation of treatment is beneficial for those infected with HIV. A mathematical model predicts that by testing whole communities annually and treating all who are infected immediately, up to 7.2 million AIDS-related deaths could be prevented in the next 40 years, long-term funding required to fight the HIV epidemic could be reduced, and, most importantly, control of the HIV/ AIDS epidemic could be regained within 1–2 years of full-scale implementation of the strategy. We discuss the development of the concept of ART for the prevention of HIV transmission and the modeled impact that a test-and-treat strategy could have on the HIV epidemic, and consequently argue that a field trial should be carried out to confirm model parameters, highlight any practical problems, and test the model’s predictions

Large Area Mapping at 850 Microns. V. Analysis of the Clump Distribution in the Orion A South Molecular Cloud

We present results from a 2300 arcmin^2 survey of the Orion A molecular cloud at 450 and 850 micron using the Submillimetre Common-User Bolometer Array (SCUBA) on the James Clerk Maxwell Telescope. The region mapped lies directly south of the OMC1 cloud core and includes OMC4, OMC5, HH1/2, HH34, and L1641N. We identify 71 independent clumps in the 850 micron map and compute size, flux, and degree of central concentration in each. Comparison with isothermal, pressure-confined, self-gravitating Bonnor-Ebert spheres implies that the clumps have internal temperatures T_d ~ 22 +/- K and surface pressures log (k^-1 P cm^-3 K) = 6.0 +/- 0.2. The clump masses span the range 0.3 - 22 Msun assuming a dust temperature T_d ~ 20 K and a dust emissivity kappa_850 = 0.02 cm^2 g^-1. The distribution of clump masses is well characterized by a power-law N(M) propto M^-alpha with alpha = 2.0 +/- 0.5 for M > 3.0 Msun, indicating a clump mass function steeper than the stellar Initial Mass Function. Significant incompleteness makes determination of the slope at lower masses difficult. A comparison of the submillimeter emission map with an H_2 2.122 micron survey of the same region is performed. Several new Class 0 sources are revealed and a correlation is found between both the column density and degree of concentration of the submillimeter sources and the likelihood of coincident H_2 shock emission.Comment: 44 pages, 17 figures, accepted by Ap

Multi-Generational Star Formation in L1551

The L1551 molecular cloud contains two small clusters of Class 0 and I protostars, as well as a halo of more evolved Class II and III YSOs, indicating a current and at least one past burst of star formation. We present here new, sensitive maps of 850 and 450 um dust emission covering most of the L1551 cloud, new CO J=2-1 data of the molecular cloud, and a new, deep, optical image of [SII] emission. No new Class 0/I YSOs were detected. Compact sub-millimetre emitters are concentrated in two sub-clusters: IRS5 and L1551NE, and the HL~Tauri group. Both stellar groups show significant extended emission and outflow/jet activity. A jet, terminating at HH 265 and with a very weak associated molecular outflow, may originate from LkHa 358, or from a binary companion to another member of the HL Tauri group. Several Herbig Haro objects associated with IRS5/NE were clearly detected in the sub-mm, as were faint ridges of emission tracing outflow cavity walls. We confirm a large-scale molecular outflow originating from NE parallel to that from IRS5, and suggest that the "hollow shell" morphology is more likely due to two interacting outflows. We confirm the presence of a prestellar core (L1551-MC) of mass 2-3 Mo north-west of IRS5. The next generation cluster may be forming in this core. The L1551 cloud appears cometary in morphology, and appears to be illuminated and eroded from the direction of Orion, perhaps explaining the multiple episodes of star formation in this cloud. The full paper (including figures) can be downloaded at http://www.jach.hawaii.edu/~gms/l1551/l1551-apj641.pdf, or viewed at http://www.jach.hawaii.edu/~gms/l1551/.Comment: Accepted for publication in The Astrophysical Journal, April 2006 (vol. 641). 27 pages, 17 figure

Characterising encapsulated nuclear waste using cosmic-ray muon tomography

Tomographic imaging techniques using the Coulomb scattering of cosmic-ray muons have been shown previously to successfully identify and characterise low- and high-Z materials within an air matrix using a prototype scintillating-fibre tracker system. Those studies were performed as the first in a series to assess the feasibility of this technology and image reconstruction techniques in characterising the potential high-Z contents of legacy nuclear waste containers for the UK Nuclear Industry. The present work continues the feasibility study and presents the first images reconstructed from experimental data collected using this small-scale prototype system of low- and high-Z materials encapsulated within a concrete-filled stainless-steel container. Clear discrimination is observed between the thick steel casing, the concrete matrix and the sample materials assayed. These reconstructed objects are presented and discussed in detail alongside the implications for future industrial scenarios.Comment: 6 pages, 4 figure

An ALMA Search for Substructure, Fragmentation, and Hidden Protostars in Starless Cores in Chamaeleon I

We present an Atacama Large Millimeter/submillimeter Array (ALMA) 106 GHz (Band 3) continuum survey of the complete population of dense cores in the Chamaeleon I molecular cloud. We detect a total of 24 continuum sources in 19 different target fields. All previously known Class 0 and Class I protostars in Chamaeleon I are detected, whereas all of the 56 starless cores in our sample are undetected. We show that the Spitzer+Herschel census of protostars in Chamaeleon I is complete, with the rate at which protostellar cores have been misclassified as starless cores calculated as <1/56, or < 2%. We use synthetic observations to show that starless cores collapsing following the turbulent fragmentation scenario are detectable by our ALMA observations when their central densities exceed ~10^8 cm^-3, with the exact density dependent on the viewing geometry. Bonnor-Ebert spheres, on the other hand, remain undetected to central densities at least as high as 10^10 cm^-3. Our starless core non-detections are used to infer that either the star formation rate is declining in Chamaeleon I and most of the starless cores are not collapsing, matching the findings of previous studies, or that the evolution of starless cores are more accurately described by models that develop less substructure than predicted by the turbulent fragmentation scenario, such as Bonnor-Ebert spheres. We outline future work necessary to distinguish between these two possibilities.Comment: Accepted by Ap

WFPC2 Observations of the Cooling Flow Elliptical in Abell 1795

We present WFPC2 images of the core of the cooling flow cD galaxy in Abell 1795. An irregular, asymmetric dust lane extends 7 \h75 kpc in projection to the north-northwest. The dust shares the morphology observed in the H$\alpha$ and excess UV emission. We see both diffuse and knotty blue emission around the dust lane, especially at the ends. The dust and emission features lie on the edge of the radio lobes, suggesting star formation induced by the radio source or the deflection of the radio jets off of pre-existing dust and gas. We measure an apparent R$_V$ significantly less than 3.1, implying that the extinction law is not Galactic in the dust lane, or the presence of line emission which is proportional to the extinction. The dust mass is at least 2$\times10^{5} h_{75}^{-2}$ M\solar\ and is more likely to be 6.5$\times10^{5} h_{75}^{-2}$ M\solar.Comment: 14 pages, LaTeX, Figure 4 included, Postscript Figs. 1-3 available at ftp://astro.nmsu.edu/pub/JASON/A1795/, accepted for publication in ApJ Letter

The Bolocam Galactic Plane Survey: Survey Description and Data Reduction

We present the Bolocam Galactic Plane Survey (BGPS), a 1.1 mm continuum survey at 33" effective resolution of 170 square degrees of the Galactic Plane visible from the northern hemisphere. The survey is contiguous over the range -10.5 < l < 90.5, |b| < 0.5 and encompasses 133 square degrees, including some extended regions |b| < 1.5. In addition to the contiguous region, four targeted regions in the outer Galaxy were observed: IC1396, a region towards the Perseus Arm, W3/4/5, and Gem OB1. The BGPS has detected approximately 8400 clumps over the entire area to a limiting non-uniform 1-sigma noise level in the range 11 to 53 mJy/beam in the inner Galaxy. The BGPS source catalog is presented in a companion paper (Rosolowsky et al. 2010). This paper details the survey observations and data reduction methods for the images. We discuss in detail the determination of astrometric and flux density calibration uncertainties and compare our results to the literature. Data processing algorithms that separate astronomical signals from time-variable atmospheric fluctuations in the data time-stream are presented. These algorithms reproduce the structure of the astronomical sky over a limited range of angular scales and produce artifacts in the vicinity of bright sources. Based on simulations, we find that extended emission on scales larger than about 5.9' is nearly completely attenuated (> 90%) and the linear scale at which the attenuation reaches 50% is 3.8'. Comparison with other millimeter-wave data sets implies a possible systematic offset in flux calibration, for which no cause has been discovered. This presentation serves as a companion and guide to the public data release through NASA's Infrared Processing and Analysis Center (IPAC) Infrared Science Archive (IRSA). New data releases will be provided through IPAC IRSA with any future improvements in the reduction.Comment: Accepted for publication in Astrophysical Journal Supplemen

Comparative neurohormonal responses in patients with preserved and impaired left ventricular ejection fraction: Results of the studies of left ventricular dysfunctions (SOLVD) registry

AbstractObjectives. The aim of this study was to determine the differences in neurohumoral responses between patients with pulmonary congestion with and without impaired left ventricular ejection fraction.Background. Previous studies have established the presence of neurohumoral activation in patients with congestive heart failure. It is not known whether the activation of these neurohumoral mechanisms is related to the impairment in systolic contractility.Methods. The 898 patients recruited into the Studies of Left Ventricular Dysfunction (SOLVD) Registry substudy were examined to identify those patients with pulmonary congestion on chest X-ray film who had either unpaired (<- 45%, group I) or preserved (> 45%, group II) left ventricular ejection fraction. Plasma norepinephrine, plasma renin activity, arginine vasopressin and atrial natriuretic peptide levels were measured in these two groups of patients and compared with values in matched control subjects,Results. Distribution of the New York Heart Association symptom classification was the same in the two groups of patients. Compared with control subjects, patients in group II with pulmonary congestion and preserved ejection fraction had no activation of the neurohumoral mechanisms, except for a small but statistically significant increase in arginine vasopressin and plasma renin activity. Compared with patients in group II, those in group I with pulmonary congestion and unpaired ejection fraction had significant increases in plasma norepinephrine (p < 0.002), plasma renin activity (p < 0.02) and atrial natriuretic peptide levels (p < 0.0007). When we controlled for baseline differences between groups I and II, the between-group differences in plasma norepinephrine (p < 0.02) and atrial natriuretic peptide (p < 0.002) remained significant. However, plasma renin activity was not significantly different between groups I and II. When the effects of diuretic agents and angiotensinconverting enzyme inhibitors were adjusted, patients with lower ejection fraction were found to have significantly higher plasma norepinephrine and atrial natriuretic peptide levels.Conclusions. The results point to the importance of the decrease in left ventricular ejection fraction as one of the mechanisms for activation of neurohormones in patients with heart failure