A Neutron Star Binary Merger Model for GW170817/GRB170817a/SSS17a

The merging neutron star gravitational wave event GW170817 has been observed throughout the entire electromagnetic spectrum from radio waves to $\gamma$-rays. The resulting energetics, variability, and light curves are shown to be consistent with GW170817 originating from the merger of two neutron stars, in all likelihood followed by the prompt gravitational collapse of the massive remnant. The available $\gamma$-ray, X-ray and radio data provide a clear probe for the nature of the relativistic ejecta and the non-thermal processes occurring within, while the ultraviolet, optical and infrared emission are shown to probe material torn during the merger and subsequently heated by the decay of freshly synthesized $r$-process material. The simplest hypothesis that the non-thermal emission is due to a low-luminosity short $\gamma$-ray burst (sGRB) seems to agree with the present data. While low luminosity sGRBs might be common, we show here that the collective prompt and multi-wavelength observations are also consistent with a typical, powerful sGRB seen off-axis. Detailed follow-up observations are thus essential before we can place stringent constraints on the nature of the relativistic ejecta in GW170817.Comment: 9 pages, 5 figures, accepted to ApJ Letter

Beneficiary Survey-Based Feedback on New Medicare Informational Materials

In response to the Balanced Budget Act (BBA) of 1997, the Center for Medicare & Medicaid Services (CMS) initiated a massive information and education campaign to promote effective health plan decisionmaking. Early results suggest that the pilot version of the Medicare & You handbook and other new Medicare informational materials were viewed favorably overall. Despite their limitations, most beneficiaries found the information useful. The longer, more comprehensive materials were not perceived to be more useful than the shorter, less complicated version. Additional research is needed to determine which subgroups of beneficiaries may need more and, possibly less, information

Abuse‐Related Post‐Traumatic Stress, Coping, and Tobacco Use in Pregnancy

Objective: To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. Design: Secondary analysis from a prospective study on PTSD and pregnancy outcomes. Setting: Maternity clinics at three health systems in the midwestern United States. Participants: Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. Methods: Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. Results: Smokers differed from nonsmokers on all demographic risk factors (being African American, being pregnant as a teen, having lower income and less education, and living in high‐crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as “extremely troubling,” and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking “to cope with emotions and problems” doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors. Conclusion: Smoking behavior in pregnancy may be influenced by the need to cope with abuse‐related PTSD symptoms. Clinicians should consider using trauma‐informed interventions when working with tobacco‐using pregnant women.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86982/1/j.1552-6909.2011.01261.x.pd

Surface Phenotype and Functionality of WNV Specific T Cells Differ with Age and Disease Severity

West Nile virus (WNV) infection can result in severe neuroinvasive disease, particularly in persons with advanced age. As rodent models demonstrate that T cells play an important role in limiting WNV infection, and strong T cell responses to WNV have been observed in humans, we postulated that inadequate antiviral T cell immunity was involved in neurologic sequelae and the more severe outcomes associated with age. We previously reported the discovery of six HLA-A*0201 restricted WNV peptide epitopes, with the dominant T cell targets in naturally infected individuals being SVG9 (Env) and SLF9 (NS4b). Here, memory phenotype and polyfunctional CD8+ T cell responses to these dominant epitopes were assessed in 40 WNV seropositive patients displaying diverse clinical symptoms. The patients' PBMC were stained with HLA-I multimers loaded with the SVG9 and SLF9 epitopes and analyzed by multicolor flow cytometry. WNV-specific CD8+ T cells were found in peripheral blood several months post infection. The number of WNV-specific T cells in older individuals was the same, if not greater, than in younger members of the cohort. WNV-specific T cells were predominantly monofunctional for CD107a, MIP-1β, TNFα, IL-2, or IFNγ. When CD8+ T cell responses were stratified by disease severity, an increased number of terminally differentiated, memory phenotype (CD45RA+ CD27− CCR7− CD57+) T cells were detected in patients suffering from viral neuroinvasion. In conclusion, T cells of a terminally differentiated/cytolytic profile are associated with neuroinvasion and, regardless of age, monofunctional T cells persist following infection. These data provide the first indication that particular CD8+ T cell phenotypes are associated with disease outcome following WNV infection

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis.

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis

Stress sensitization and adolescent depressive severity as a function of childhood adversity: A link to anxiety disorders

The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth's life and from the youths themselves at age 15, and included information on the mother's relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals

Phylogeographic Study of Apodemus ilex (Rodentia: Muridae) in Southwest China

BACKGROUND: The Mountains of southwest China have complex river systems and a profoundly complex topography and are among the most important biodiversity hotspots in the world. However, only a few studies have shed light on how the mountains and river valleys promote genetic diversity. Apodemus ilex is a fine model for investigating this subject. METHODOLOGY/PRINCIPAL FINDINGS: To assess the genetic diversity and biogeographic patterns of Apodemus ilex, the complete cytochrome b gene sequences (1,140 bp) were determined from 203 samples of A. draco/ilex that were collected from southwest China. The results obtained suggested that A. ilex and A. draco are sistergroups and diverged from each other approximately 2.25 million years ago. A. ilex could be divided into Eastern and Western phylogroups, each containing two sub-groups and being widespread in different geographical regions of the southern Hengduan Mountains and the western Yunnan - Guizhou Plateau. The population expansions of A. ilex were roughly from 0.089 Mya to 0.023 Mya. CONCLUSIONS: Our result suggested that A. ilex is a valid species rather than synonym of A. draco. As a middle-high elevation inhabitant, the phylogenetic pattern of A. ilex was strongly related to the complex geographical structures in southwest China, particularly the existence of deep river valley systems, such as the Mekong and Salween rivers. Also, it appears that the evolutionary history of A. ilex, such as lineage divergences and population expansions were strongly affected by climate fluctuation in the Late Pleistocene