Antibiotic Prophylaxis for Leptospirosis

BACKGROUND: Leptospira infection is a global zoonosis with significant health impact for agricultural workers and those persons whose work or recreation takes them into endemic areas. OBJECTIVES: This systematic review assessed the current literature for evidence for or against use of antibiotic prophylaxis against Leptospira infection (leptospirosis). SEARCH STRATEGY: The authors searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and SCI-Expanded as well as relevant professional society meeting abstracts until January 2009. SELECTION CRITERIA: Prospective, randomised clinical trials studying antibiotic prophylaxis against leptospirosis were selected. DATA COLLECTION AND ANALYSIS: Data collection abstracted participant demographics and outcomes as well as features of trial design and quality. Trial results were analysed to independently determine outcomes, while multiple trial data was pooled when relevant. MAIN RESULTS: Three trials were included, all of which evaluated doxycyline use. Trial quality suffered from a lack of intention-to-treat analysis and variability across trials in methodology and targeted outcomes. One trial assessed post-exposure prophylaxis in an indigenous population after a flood without apparent efficacy in reduction of clinical or laboratory identified Leptospira infection. Two trials assessed pre-exposure prophylaxis, one among deployed soldiers and another in an indigenous population. Despite an odds ratio of 0.05 (95% CI 0.01 to 0.36) for laboratory-identified infection among deployed soldiers on doxycyline in one of these two trials, pooled data showed no statistically significant reduction in Leptospira infection among participants (Odds ratio 0.28 (95% CI 0.01 to 7.48). Minor adverse events (predominantly nausea and vomiting) were more common among those on doxycycline with an odds ratio of 11 (95% CI 2.1 to 60). AUTHORS\u27 CONCLUSIONS: Regular use of weekly oral doxycycline 200 mg increases the odds for nausea and vomiting with unclear benefit in reducing Leptospira seroconversion or clinical consequences of infection

Green-pumped, picosecond MgO:PPLN optical parametric oscillator

We investigate the performance of a magnesium-oxide-doped periodically poled lithium niobate crystal (MgO:PPLN) in an optical parametric oscillator (OPO) synchronously-pumped by 530nm, 20ps, 230MHz pulses with an average power of up to 2W from a frequency-doubled, gain-switched laser diode seed and a multi-stage Yb:fiber amplifier system. The OPO produces ~165mW (signal, 845nm) and ~107mW (idler, 1421nm) of average power for ~1W of pump power and can be tuned from ~800nm to 900nm (signal) and 1.28µm to 1.54µm (idler). Observations of photo-refraction and green-induced infrared absorption (GRIIRA) in different operational regimes of the MgO:PPLN OPO are described and the role of peak intensity and average power are investigated, both with the aim to find the optimal operating regime for pulsed systems

Creating an Effective Regional Alignment Strategy for the U.S. Army

View the Executive SummaryAs the war in Afghanistan draws to a close, the Army increasingly is focused upon “regionally aligning” its forces. To do so effectively, however, it must undertake several initiatives. First, the Army must acknowledge and liberate the unique productive capabilities (talents) of each individual. Second, it must shift from process-oriented, industrial age personnel management to productivity-focused, information age talent management. Third, the Army must foster enduring human relationships between its organizations and the governments, militaries, and populations to which they are regionally aligned. Hand in hand with this, it must redesign its Force Generation Model to create regional expertise at both individual and organizational levels. Finally, the Army must ensure that regional alignment does not degrade the worldwide “flex” capabilities of its forces.https://press.armywarcollege.edu/monographs/1474/thumbnail.jp

Fielding Vaccines-Challenges and Opportunities in Outbreaks, Complex Emergencies, and Mass Gatherings

With the recent COVID-19 pandemic, the importance of vaccine development, distribution, and uptake has come to the forefront of the public eye. Effectively fielding vaccines during an emergency-whether that emergency is a result of an infectious disease or not-requires an understanding of usual vaccine-related processes; the impact of outbreak, complex emergencies, mass gatherings, and other events on patients, communities, and health systems; and ways in which diverse resources can be applied to successfully achieve needed vaccine uptake. In this review, both the emergency setting and briefly vaccine product design are discussed in these contexts in order to provide a concise source of general knowledge from experts in fielding vaccines that can aid in future vaccine ventures and increase general awareness of the process and barriers in various settings

Spatial Hypersurfaces in Causal Set Cosmology

Within the causal set approach to quantum gravity, a discrete analog of a spacelike region is a set of unrelated elements, or an antichain. In the continuum approximation of the theory, a moment-of-time hypersurface is well represented by an inextendible antichain. We construct a richer structure corresponding to a thickening of this antichain containing non-trivial geometric and topological information. We find that covariant observables can be associated with such thickened antichains and transitions between them, in classical stochastic growth models of causal sets. This construction highlights the difference between the covariant measure on causal set cosmology and the standard sum-over-histories approach: the measure is assigned to completed histories rather than to histories on a restricted spacetime region. The resulting re-phrasing of the sum-over-histories may be fruitful in other approaches to quantum gravity.Comment: Revtex, 12 pages, 2 figure

A Pilot Online Survey Assessing Risk Factors for HIV Acquisition in the Navy and Marine Corps, 2005-2010

The Department of Defense policy Don\u27t Ask, Don\u27t Tell (DADT) ended in September, 2011. The Navy Bloodborne Infection Management Center conducted a post-DADT pilot survey of HIV seroconverters identified when the DADT policy was in effect. Sailors and Marines newly diagnosed as HIV positive from 2005 to 2010 were invited to participate in an online survey. A structured questionnaire elicited risk information about the 3-year period before HIV diagnosis. Respondents reported engaging commonly in same sex sexual activity, having concurrent partners, and poor condom use for anal sex. In this first post-DADT repeal report of self-reported behaviors, male-to-male sexual contact was a much more common mode of infection than previously reported. Several opportunities for primary prevention messaging now possible after DADT repeal are evident

Hypoxic induction of interleukin-8 gene expression in human endothelial cells.

This is the published version. Copyright 1994 American Society for Clinical Investigation.Because leukocyte-mediated tissue damage is an important component of the pathologic picture in ischemia/reperfusion, we have sought mechanisms by which PMNs are directed into hypoxic tissue. Incubation of human endothelial cells (ECs) in hypoxia, PO2 approximately 14-18 Torr, led to time-dependent release of IL-8 antigen into the conditioned medium; this was accompanied by increased chemotactic activity for PMNs, blocked by antibody to IL-8. Production of IL-8 by hypoxic ECs occurred concomitantly with both increased levels of IL-8 mRNA, based on polymerase chain reaction analysis, and increased IL-8 transcription, based on nuclear run-on assays. Northern analysis of mRNA from hypoxic ECs also demonstrated increased levels of mRNA for macrophage chemotactic protein-1, another member of the chemokine superfamily of proinflammatory cytokines. IL-8 gene induction was associated with the presence of increased binding activity in nuclear extracts from hypoxic ECs for the NF-kB site. Studies with human umbilical vein segments exposed to hypoxia also demonstrated increased elaboration of IL-8 antigen compared with normoxic controls. In mice exposed to hypoxia (PO2 approximately 30-40 Torr), there was increased pulmonary leukostasis, as evidenced by increased myeloperoxidase activity in tissue homogenates. In parallel, increased levels of transcripts for IP-10, a murine homologue in the chemokine family related to IL-8, were observed in hypoxic lung tissue. Taken together, these data suggest that hypoxia constitutes a stimulus for leukocyte chemotaxis and tissue leukostasis

A Bell Inequality Analog in Quantum Measure Theory

One obtains Bell's inequalities if one posits a hypothetical joint probability distribution, or {\it measure}, whose marginals yield the probabilities produced by the spin measurements in question. The existence of a joint measure is in turn equivalent to a certain causality condition known as ``screening off''. We show that if one assumes, more generally, a joint {\it quantal measure}, or ``decoherence functional'', one obtains instead an analogous inequality weaker by a factor of $\sqrt{2}$. The proof of this ``Tsirel'son inequality'' is geometrical and rests on the possibility of associating a Hilbert space to any strongly positive quantal measure. These results lead both to a {\it question}: ``Does a joint measure follow from some quantal analog of `screening off'?'', and to the {\it observation} that non-contextual hidden variables are viable in histories-based quantum mechanics, even if they are excluded classically.Comment: 38 pages, TeX. Several changes and added comments to bring out the meaning more clearly. Minor rewording and extra acknowledgements, now closer to published versio

Use of Remote-Sensing Imagery to Estimate Corn Grain Yield

Remote sensing—the process of acquiring information about objects from remote platforms such as ground-based booms, aircraft, or satellites—is a potentially important source of data for site-specific crop management, providing both spatial and temporal information. Our objective was to use remotely sensed imagery to compare different vegetation indices as a means of assessing canopy variation and its resultant impact on corn (Zea mays L.) grain yield. Treatments consisted of five N rates and four hybrids, which were grown under irrigation near Shelton, NE on a Hord silt loam in 1997 and 1998. Imagery data with 0.5-m spatial resolution were collected from aircraft on several dates during both seasons using a multispectral, four-band [blue, green, red, and near-infrared reflectance] digital camera system. Imagery was imported into a geographical information system (GIS) and then geo-registered, converted into reflectance, and used to compute three vegetation indices. Grain yield for each plot was determined at maturity. Results showed that green normalized difference vegetation index (GNDVI) values derived from images acquired during midgrain filling were the most highly correlated with grain yield; maximum correlations were 0.7 and 0.92 in 1997 and 1998, respectively. Normalizing GNDVI and grain yield variability within hybrids improved the correlations in both years, but more dramatic increases were observed in 1997 (0.7 to 0.82) than in 1998 (0.92 to 0.95). This suggested GNDVI acquired during midgrain filling could be used to produce relative yield maps depicting spatial variability in fields, offering a potentially attractive alternative to use of a combine yield monitor