Participant Blinding and Gastrointestinal Illness in a Randomized, Controlled Trial of an In-Home Drinking Water Intervention

We conducted a randomized, triple-blinded home drinking water intervention trial to determine if a large study could be undertaken while successfully blinding participants. Households were randomized 50:50 to use externally identical active or sham treatment devices. We measured the effectiveness of blinding of participants by using a published blinding index in which values >0.5 indicate successful blinding. The principal health outcome measured was “highly credible gastrointestinal illness” (HCGI). Participants (n=236) from 77 households were successfully blinded to their treatment assignment. At the end of the study, the blinding index was 0.64 (95% confidence interval 0.51-0.78). There were 103 episodes of HCGI during 10,790 person-days at risk in the sham group and 82 episodes during 11,380 person-days at risk in the active treatment group. The incidence rate ratio of disease (adjusted for the clustered sampling) was 1.32 (95% CI 0.75, 2.33) and the attributable risk was 0.24 (95% CI -0.33, 0.57). These data confirm that participants can be successfully blinded to treatment group assignment during a randomized trial of an in-home drinking water intervention

Desert Research and Technology Studies (DRATS) 2010 Science Operations: Operational Approaches and Lessons Learned for Managing Science during Human Planetary Surface Missions

Desert Research and Technology Studies (Desert RATS) is a multi-year series of hardware and operations tests carried out annually in the high desert of Arizona on the San Francisco Volcanic Field. These activities are designed to exercise planetary surface hardware and operations in conditions where long-distance, multi-day roving is achievable, and they allow NASA to evaluate different mission concepts and approaches in an environment less costly and more forgiving than space.The results from the RATS tests allows election of potential operational approaches to planetary surface exploration prior to making commitments to specific flight and mission hardware development. In previous RATS operations, the Science Support Room has operated largely in an advisory role, an approach that was driven by the need to provide a loose science mission framework that would underpin the engineering tests. However, the extensive nature of the traverse operations for 2010 expanded the role of the science operations and tested specific operational approaches. Science mission operations approaches from the Apollo and Mars-Phoenix missions were merged to become the baseline for this test. Six days of traverse operations were conducted during each week of the 2-week test, with three traverse days each week conducted with voice and data communications continuously available, and three traverse days conducted with only two 1-hour communications periods per day. Within this framework, the team evaluated integrated science operations management using real-time, tactical science operations to oversee daily crew activities, and strategic level evaluations of science data and daily traverse results during a post-traverse planning shift. During continuous communications, both tactical and strategic teams were employed. On days when communications were reduced to only two communications periods per day, only a strategic team was employed. The Science Operations Team found that, if communications are good and down-linking of science data is ensured, high quality science returns is possible regardless of communications. What is absent from reduced communications is the scientific interaction between the crew on the planet and the scientists on the ground. These scientific interactions were a critical part of the science process and significantly improved mission science return over reduced communications conditions. The test also showed that the quality of science return is not measurable by simple numerical quantities but is, in fact, based on strongly non-quantifiable factors, such as the interactions between the crew and the Science Operations Teams. Although the metric evaluation data suggested some trends, there was not sufficient granularity in the data or specificity in the metrics to allow those trends to be understood on numerical data alone

Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children

Desert Research and Technology Studies (DRATS) 2010 science operations: Operational approaches and lessons learned for managing science during human planetary surface missions

Desert Research and Technology Studies (Desert RATS) is a multi-year series of hardware and operations tests carried out annually in the high desert of Arizona on the San Francisco Volcanic Field. These activities are designed to exercise planetary surface hardware and operations in conditions where long-distance, multi-day roving is achievable, and they allow NASA to evaluate different mission concepts and approaches in an environment less costly and more forgiving than space. The results from the RATS tests allow selection of potential operational approaches to planetary surface exploration prior to making commitments to specific flight and mission hardware development. In previous RATS operations, the Science Support Room has operated largely in an advisory role, an approach that was driven by the need to provide a loose science mission framework that would underpin the engineering tests. However, the extensive nature of the traverse operations for 2010 expanded the role of the science operations and tested specific operational approaches. Science mission operations approaches from the Apollo and Mars-Phoenix missions were merged to become the baseline for this test. Six days of traverse operations were conducted during each week of the 2-week test, with three traverse days each week conducted with voice and data communications continuously available, and three traverse days conducted with only two 1-hour communications periods per day. Within this framework, the team evaluated integrated science operations management using real-time, tactical science operations to oversee daily crew activities, and strategic level evaluations of science data and daily traverse results during a post-traverse planning shift. During continuous communications, both tactical and strategic teams were employed. On days when communications were reduced to only two communications periods per day, only a strategic team was employed. The Science Operations Team found that, if communications are good and down-linking of science data is ensured, high quality science returns is possible regardless of communications. What is absent from reduced communications is the scientific interaction between the crew on the planet and the scientists on the ground. These scientific interactions were a critical part of the science process and significantly improved mission science return over reduced communications conditions. The test also showed that the quality of science return is not measurable by simple numerical quantities but is, in fact, based on strongly non-quantifiable factors, such as the interactions between the crew and the Science Operations Teams. Although themetric evaluation data suggested some trends, there was not sufficient granularity in the data or specificity in the metrics to allow those trends to be understood on numerical data alone

Surface Ocean CO2 Atlas (SOCAT) V4

The Surface Ocean CO2 Atlas (SOCAT) is a synthesis activity by the international marine carbon research community (>100 contributors). SOCAT version 4 has 18.5 million quality-controlled, surface ocean fCO2 (fugacity of carbon dioxide) observations with an accuracy of better than 5 µatm from 1957 to 2015 for the global oceans and coastal seas. Automation of data upload and initial data checks speeds up data submission and allows annual releases of SOCAT from version 4 onwards. SOCAT enables quantification of the ocean carbon sink and ocean acidification and evaluation of ocean biogeochemical models. SOCAT represents a milestone in research coordination, data access, biogeochemical and climate research and in informing policy

Guidelines for preventing opportunistic infections among HIV-infected persons - 2002

In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) developed guidelines for preventing opportunistic infections (OIs) among persons infected with human immunodeficiency virus (HIV); these guidelines were updated in 1997 and 1999. This fourth edition of the guidelines, made available on the Internet in 2001, is intended for clinicians and other health-care providers who care for HIV-infected persons. The goal of these guidelines is to provide evidence-based guidelines for preventing OIs among HIV-infected adults and adolescents, including pregnant women, and HIV-exposed or infected children. Nineteen OIs, or groups of OIs, are addressed, and recommendations are included for preventing exposure to opportunistic pathogens, preventing first episodes of disease by chemoprophylaxis or vaccination (primary prophylaxis), and preventing disease recurrence (secondary prophylaxis). Major changes since the last edition of the guidelines include 1) updated recommendations for discontinuing primary and secondary OI prophylaxis among persons whose CD4+ T lymphocyte counts have increased in response to antiretroviral therapy; 2) emphasis on screening all HIV-infected persons for infection with hepatitis C virus; 3) new information regarding transmission of human herpesvirus 8 infection; 4) new information regarding drug interactions, chiefly related to rifamycins and antiretroviral drugs; and 5) revised recommendations for immunizing HIV-infected adults and adolescents and HIV-exposed or infected children.Link_to_subscribed_fulltex