Lyme Disease Neuroretinitis: A Case Report and Review of Immunologic Workup

Background: Lyme disease is an infection caused by a bacterial spirochete of the borrelia genus. The human vector is from a tick bite by an infected tick of the ixodes genus, commonly referred to as the deer tick or black legged tick. The incidence of Lyme disease is increasing in the United States. Once infected, Lyme disease manifestations usually depend on the stage of infection with late stage infection often causing debilitating illness.1 Case Report: Neuroborreliosis refers to borrelia, causing neurological infection and can occur as acute or late manifestation of Lyme disease. Neuroretinitis is a rare but reported manifestation of neuroborreliosis. Lyme diagnosis requires a two-step serologic test to meet CDC guidelines for Lyme confirmation.1 Testing may be negative early in disease but may turn positive as the disease progresses. Conclusion: Presented is a case where treatment decisions were made based on equivocal Lyme testing results

Changes in Georgia Restaurant and Bar Smoking Policies From 2006 to 2012

Introduction The purpose of this study is to examine the change in smoking policy status among Georgia restaurants and bars from 2006 to 2012 and to identify restaurant and bar characteristics that are as- sociated with allowing smoking. Methods Data were obtained from similar cross-sectional indoor air sur- veys conducted in 2006 and 2012 in Georgia. Both surveys were designed to gather information about restaurant and bar smoking policies. Weighted χ2 analyses were performed to identify changes in smoking policy status and other variables from 2006 to 2012. Weighted logistic regression analysis was used to test for signific- ant associations between an establishment’s smoking policy and other characteristics. Results The percentage of restaurants and bars in Georgia that allowed smoking nearly doubled, from 9.1% in 2006 to 17.6% in 2012. The analyses also showed a significant increase in the percentage of establishments that allow smoking when minors are present. Having a liquor license was a significant predictor of allowing smoking. Conclusion The Smokefree Air Act was enacted in 2005 to protect the health and welfare of Georgia citizens, but study results suggest that policy makers should reevaluate the law and consider strengthening it to make restaurants and bars 100% smokefree without exemptions

A Survey of Ligand Effects Upon the Reaction Entropies of Some Transition Metal Redox Couples

The reaction entropies ∆S°_rc of a number of transition metal redox couples of the form M(III)/(II) in aqueous solution have been determined using nonisothermal electrochemical cells in order to explore the effect of varying the ligand structure upon the nature of the ion-solvent interactions. Examinations of six aquo couples of the form M(OH_2)_n&3+/2+ with varying metal M yielded ∆S°_rc values in the range 36-49 eu. In order to scrutinize the effect of replacing aquo with ammine and simple anionic ligands, Ru(III)/(II) couples were employed since the relative substituion inertness of both oxidation states allowed ∆S°_rc to be determined using cyclic voltammetry. The stepwise replacement of aquo by ammine ligands results in substantial reductions in ∆S°_rc which are attributed to the smaller extent of ligand-solvent hydrogen bonding for ammine compared with aquo ligands. Substitution of both aquo and ammine by anionic ligands also results in substantial reductions in ∆S°_rc. A number of M(III)/(II) couples containing chelating ligands were also examined. Sizable differences in ∆S°_rc were found between Co(III)/(II) couples and the corresponding Ru(III)/(II) and Fe(III)/(II) couples. Suggested explanations are differences in ligand conformation and electron delocalization effects. The possible contribution of outer-sphere solvent structuring effects to the large reorganization energies observed for electron exchange of aquo complexes is noted. The validity of the assumptions required for the estimation of ∆S°_rc from nonisothermal cell measurements is discussed

Efficacy of a T Cell-Biased Adenovirus Vector as a Zika Virus Vaccine

Zika virus (ZIKV) is a major public health concern due to the risk of congenital Zika syndrome in developing fetuses and Guillain-Barre syndrome in adults. Currently, there are no approved vaccines available to protect against infection. Adenoviruses are safe and highly immunogenic vaccine vectors capable of inducing lasting humoral and cellular immune responses. Here, we developed two Adenovirus (Ad) vectored Zika virus vaccines by inserting a ZIKV prM-E gene expression cassette into human Ad types 4 (Ad4-prM-E) and 5 (Ad5-prM-E). Immune correlates indicate that Ad5-prM-E vaccination induces both an anti-ZIKV antibody and T-cell responses whereas Ad4-prM-E vaccination only induces a T-cell response. In a highly lethal challenge in an interferon α/β receptor knockout mice, 80% of Ad5 vaccinated animals and 33% of Ad4 vaccinated animals survived a lethal ZIKV challenge, whereas no animals in the sham vaccinated group survived. In an infection model utilizing immunocompetent C57BL/6 mice that were immunized and then treated with a blocking anti-IFNAR-1 antibody immediately before ZIKV challenge, 100% of Ad4-prM-E and Ad5-prM-E vaccinated mice survived. This indicates that Ad4-prM-E vaccination is protective without the development of detectable anti-ZIKV antibodies. The protection seen in these highly lethal mouse models demonstrate the efficacy of Ad vectored vaccines for use against ZIKV

Characterization of Species C Human Adenovirus Serotype 6 (Ad6)

Adenovirus serotype (Ad5) is the most studied Ad. Ad1, 2, and 6 are also members of species C Ad and are presumed to have biologies similar to Ad5. In this work, we have compared the ability of Ad1, 2, 5, and 6 to infect liver and muscle after intravenous and intramuscular injection. We found that Ad6 was surprisingly the most potent at liver gene delivery and that Ad1 and Ad2 were markedly weaker than Ad5 and 6. To understand these differences, we sequenced the Ad6 genome. This revealed that the Ad6 fiber protein is surprisingly three shaft repeats shorter than the others which may explain differences in virus infectivity in vitro, but not in the liver. Comparison of hexon hypervariable regions (HVRs) suggests that the higher transduction by Ad5 and 6 as compared to Ad1 and 2 may be related to differences in charge and length

Preliminary efficacy of a brief family intervention to prevent declining quality of life secondary to parental bone marrow transplantation

The primary purpose of this research was to develop and evaluate the efficacy and feasibility of a brief, cost-effective family-focused intervention to promote adaptive coping and quality of life throughout a parent's bone marrow transplantation (BMT). Targeted outcomes were cohesion, decreased use of avoidance coping, open communication and effective management of emotional distress. Participants included an intervention group of 31 families and 29 families in a control group who received usual care. Each family included the BMT recipient, a partner/caregiver and children 10-18 years old. The intervention included two dyadic sessions for the BMT recipient and the partner/caregiver, one individual session for the caregiver and two digital video discs (DVDs) for children. Statistical analyses indicated that the intervention had a positive impact on at least one aspect of the adaptation of each family member. Caregivers reported the most distress but benefitted least from the intervention, whereas recipients and children reported improvement in distress. Ratings of satisfaction/acceptability were high, with 97% responding that they would recommend the intervention to others. Plans for future research include increased intervention intensity for the caregiver, a larger more diverse sample and implementation over an extended period post BMT

Massively parallel simulation with DOE's ASCI supercomputers : an overview of the Los Alamos Crestone project

The Los Alamos Crestone Project is part of the Department of Energy's (DOE) Accelerated Strategic Computing Initiative, or ASCI Program. The main goal of this software development project is to investigate the use of continuous adaptive mesh refinement (CAMR) techniques for application to problems of interest to the Laboratory. There are many code development efforts in the Crestone Project, both unclassified and classified codes. In this overview I will discuss the unclassified SAGE and the RAGE codes. The SAGE (SAIC adaptive grid Eulerian) code is a one-, two-, and three-dimensional multimaterial Eulerian massively parallel hydrodynamics code for use in solving a variety of high-deformation flow problems. The RAGE CAMR code is built from the SAGE code by adding various radiation packages, improved setup utilities and graphics packages and is used for problems in which radiation transport of energy is important. The goal of these massively-parallel versions of the codes is to run extremely large problems in a reasonable amount of calendar time. Our target is scalable performance to {approx}10,000 processors on a 1 billion CAMR computational cell problem that requires hundreds of variables per cell, multiple physics packages (e.g. radiation and hydrodynamics), and implicit matrix solves for each cycle. A general description of the RAGE code has been published in [l],[ 2], [3] and [4]. Currently, the largest simulations we do are three-dimensional, using around 500 million computation cells and running for literally months of calendar time using {approx}2000 processors. Current ASCI platforms range from several 3-teraOPS supercomputers to one 12-teraOPS machine at Lawrence Livermore National Laboratory, the White machine, and one 20-teraOPS machine installed at Los Alamos, the Q machine. Each machine is a system comprised of many component parts that must perform in unity for the successful run of these simulations. Key features of any massively parallel system include the processors, the disks, the interconnection between processors, the operating system, libraries for message passing and parallel 1/0 and other fundamental units of the system. We will give an overview of the current status of the Crestone Project codes SAGE and RAGE. These codes are intended for general applications without tuning of algorithms or parameters. We have run a wide variety of physical applications from millimeter-scale laboratory laser experiments to the multikilometer-scale asteroid impacts into the Pacific Ocean to parsec-scale galaxy formation. Examples of these simulations will be shown. The goal of our effort is to avoid ad hoc models and attempt to rely on first-principles physics. In addition to the large effort on developing parallel code physics packages, a substantial effort in the project is devoted to improving the computer science and software quality engineering (SQE) of the Project codes as well as a sizable effort on the verification and validation (V&V) of the resulting codes. Examples of these efforts for our project will be discussed

An X-ray Mini-survey of Nearby Edge-on Starburst Galaxies II. The Question of Metal Abundance

(abbreviated) We have undertaken an X-ray survey of a far-infrared flux limited sample of seven nearby edge-on starburst galaxies. Here, we examine the two X-ray-brightest sample members NGC 253 and M 82 in a self-consistent manner, taking account of the spatial distribution of the X-ray emission in choosing our spectral models. There is significant X-ray absorption in the disk of NGC 253. When this is accounted for we find that multi-temperature thermal plasma models with significant underlying soft X-ray absorption are more consistent with the imaging data than single-temperature models with highly subsolar abundances or models with minimal absorption and non-equilibrium thermal ionization conditions. Our models do not require absolute abundances that are inconsistent with solar values or unusually supersolar ratios of the alpha-burning elements with respect to Fe (as claimed previously). We conclude that with current data, the technique of measuring abundances in starburst galaxies via X-ray spectral modeling is highly uncertain. Based on the point-like nature of much of the X-ray emission in the PSPC hard-band image of NGC 253, we suggest that a significant fraction of the ``extended'' X-ray emission in the 3-10 keV band seen along the disk of the galaxy with ASCA and BeppoSAX (Cappi et al.) is comprised of discrete sources in the disk, as opposed to purely diffuse, hot gas. This could explain the low Fe abundances of ~1/4 solar derived for pure thermal models.Comment: (accepted for publication in the Astrophysical Journal

Chandra observations of NGC 253: New insights into the nature of starburst-driven superwinds

Arcsecond-resolution X-ray imaging of the nucleus of the nearby starburst galaxy NGC 253 with Chandra reveals a well-collimated, strongly limb-brightened, kiloparsec-scale conical outflow from the central starburst region. The outflow is very similar in morphology to the known H-alpha outflow cone, on scales down to <= 20 pc. This provides, for the first time, robust evidence that both X-ray and H-alpha emission come from low volume filling factor regions of interaction between the fast energetic wind of SN-ejecta and the denser ambient interstellar medium (ISM), and not from the wind fluid itself. We provide estimates of the (observationally and theoretically important) filling factor of the X-ray emitting gas, of between 4 and 40 per cent, consistent with an upper limit of ~40 per cent based directly on the observed limb-brightened morphology of the outflow. Only <= 20 per cent of the observed X-ray emission can come from the volume-filling, metal-enriched, wind fluid itself. Spatially-resolved spectroscopy of the soft diffuse thermal X-ray emission reveals that the predominant source of spectral variation along the outflow cones is due to strong variation in the absorption, on scales of < 60 pc, there being little change in the characteristic temperature of the emission. We show that these observations are easily explained by, and fully consistent with, the standard model of a superwind driven by a starburst of NGC 253's observed power. If these results are typical of all starburst-driven winds, then we do not directly see all the energy and gas (in particular the hot metal-enriched gas) transported out of galaxies by superwinds, even in X-ray emission.Comment: Accepted by the Astronomical Journal. 10 pages, 6 figure

First Year Physical Activity Findings From Turn up the Heat (Healthy Eating and Activity Time) in Summer Day Camps

Background Summer day camps (SDCs) serve 14 million children yearly in the U.S. and aim to provide participating children with 60 minutes of moderate-to-vigorous physical activity (MVPA). This study evaluated an intervention designed to increase the percent of children meeting this MVPA guideline. Design Two-group, pre-post quasi-experimental. Setting/Participants Twenty SDCs serving 1,830 children aged 5–12 years were assigned to MVPA intervention (n = 10) or healthy eating attention control (n = 10). Intervention The STEPs (Strategies to Enhance Practice) intervention is a capacity-building approach grounded in the Theory of Expanded, Extended and Enhanced Opportunities. Camp leaders and staff receive training to expand (e.g., introduction of activity breaks/active field trips), extend (e.g., schedule minimum of 3 hours/day for PA opportunities), and enhance (e.g., maximize MVPA children accumulate during schedule activity) activity opportunities. Camps in the comparison condition received support for improving the types of foods/beverages served. Main outcome measures Percent of children accumulating the 60min/d MVPA guideline at baseline (summer 2015) and post-test (summer 2016) measured via wrist-accelerometry. Results Multilevel logistic regression conducted fall 2016 indicated boys and girls attending intervention SDCs were 2.04 (95CI = 1.10,3.78) and 3.84 (95CI = 2.02,7.33) times more likely to meet the 60min/d guideline compared to boys and girls attending control SDCs, respectively. This corresponded to increases of +10.6% (78–89%) and +12.6% (69–82%) in the percentage of boys and girls meeting the guideline in intervention SDCs, respectively. Boys in comparison SDCs increased by +1.6% (81–83%) and girls decreased by -5.5% (76–71%). Process data indicated intervention SDCs successfully extended and enhanced PA opportunities, but were unable to expand PA opportunities, compared to control SDCs. Conclusions Although substantial proportions of children met the MVPA guideline at baseline, no SDCs ensured all children met the guideline. This intervention demonstrated that, with support, SDCs can help all children in attendance to accumulate their daily recommended 60min MVPA. Trial registration ClinicalTrials.gov NCT0216180