Field evaluation of rK39 test and direct agglutination test for diagnosis of visceral leishmaniasis in a population with high prevalence of human immunodeficiency virus in Ethiopia

Accuracy of an rK39 rapid diagnostic test (DiaMed-IT-Leish ) for visceral leishmaniasis (VL) was compared with splenic aspiration and the direct agglutination test (DAT) in a population with a high prevalence of infection with human immunodeficiency virus (HIV) in Ethiopia. There were 699 patients clinically suspected of having VL (153 parasitologically confirmed, 482 DAT confirmed, and 130 DAT negative), and 97 DAT-negative controls. A total of 84% were tested for HIV and 34% were HIV positive. Sensitivity of the rK39 test in parasitologically confirmed VL patients was 84% (77% in HIV positive and 87% in HIV negative; P = 0.25). Sensitivity of the DAT was higher (94%; P = 0.01), 89% in HIV-positive patients and 95% in HIV-negative patients; P = 0.27). Specificity of the rK39 test was 99% in DAT-negative controls and 92% in DAT-negative patients clinically suspected of having VL. A diagnostic algorithm combining DAT and the rK39 test had a sensitivity of 98% in HIV-positive VL patients and 99% in HIV-negative VL patients. Despite the lower sensitivity in a population with a high prevalence of HIV, the DiaMed-IT-Leish rK39 test enables decentralization of diagnosis. Patients clinically suspected of having VL who show negative results on the rK39 antigen test should undergo follow-up DAT testing, especially if they are HIV positive

Limited effectiveness of high-dose liposomal amphotericin B (AmBisome) for treatment of visceral leishmaniasis in an Ethiopian population with high HIV prevalence.

Due to unacceptably high mortality with pentavalent antimonials, Médecins Sans Frontières in 2006 began using liposomal amphotericin B (AmBisome) for visceral leishmaniasis (VL) patients in Ethiopia who were severely ill or positive for human immunodeficiency virus (HIV)

Bose-Fermi mixtures in 1D optical superlattices

The zero temperature phase diagram of binary boson-fermion mixtures in two-colour superlattices is investigated. The eigenvalue problem associated with the Bose-Fermi-Hubbard Hamiltonian is solved using an exact numerical diagonalization technique, supplemented by an adaptive basis truncation scheme. The physically motivated basis truncation allows to access larger systems in a fully controlled and very flexible framework. Several experimentally relevant observables, such as the matter-wave interference pattern and the condensatefraction, are investigated in order to explore the rich phase diagram. At symmetric half filling a phase similar to the Mott-insulating phase in a commensurate purely bosonic system is identified and an analogy to recent experiments is pointed out. Furthermore a phase of complete localization of the bosonic species generated by the repulsive boson-fermion interaction is identified. These localized condensates are of a different nature than the genuine Bose-Einstein condensates in optical lattices.Comment: 18 pages, 9 figure

A Comparison of Miltefosine and Sodium Stibogluconate for Treatment of Visceral Leishmaniasis in an Ethiopian Population with High Prevalence of HIV Infection.

BACKGROUND: Antimonials are the mainstay of visceral leishmaniasis (VL) treatment in Africa. The increasing incidence of human immunodeficiency virus (HIV) coinfection requires alternative safe and effective drug regimens. Oral miltefosine has been proven to be safe and effective in the treatment of Indian VL but has not been studied in Africa or in persons with HIV and VL coinfection. METHODS: We compared the efficacy of miltefosine and sodium stibogluconate (SSG) in the treatment of VL in persons in Ethiopia. A total of 580 men with parasitologically and/or serologically confirmed VL were randomized to receive either oral miltefosine (100 mg per day for 28 days) or intramuscular SSG (20 mg/kg per day for 30 days). RESULTS: The initial cure rate was 88% in both treatment groups. Mortality during treatment was 2% in the miltefosine group, compared with 10% in the SSG group. Initial treatment failure was 8% in the miltefosine group, compared with 1% in the SSG group. Among the 375 patients (65%) who agreed to HIV testing, HIV seroprevalence was 29%. Among patients not infected with HIV, initial cure, mortality, and initial treatment failure rates were not significantly different (94% vs. 95%, 1% vs. 3%, and 5% vs. 1% for the miltefosine and SSG groups, respectively). Initial treatment failure with miltefosine occurred in 18% of HIV-coinfected patients, compared with treatment failure in 5% of non-HIV-infected patients. At 6 months after treatment, 174 (60%) of the 290 miltefosine recipients and 189 (65%) of the 290 SSG recipients experienced cure; 30 (10%) of 290 in the miltefosine group and 7 (2%) of 290 in the SSG group experienced relapse, and the mortality rate was 6% in the miltefosine group, compared with 12% in the SSG group. HIV-infected patients had higher rates of relapse (16 [25%] of 63 patients), compared with non-HIV-infected patients (5 [5%] of 131). CONCLUSIONS: Treatment with miltefosine is equally effective as standard SSG treatment in non-HIV-infected men with VL. Among HIV-coinfected patients, miltefosine is safer but less effective than SSG

Metalliferous sediments and the scavenging residence time of Nd near hydrothermal vents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94674/1/grl5993.pd

Spitzer Space Telescope Infrared Imaging and Spectroscopy of the Crab Nebula

We present 3.6, 4.5, 5.8, 8.0, 24, and 70 micron images of the Crab Nebula obtained with the Spitzer Space Telescope IRAC and MIPS cameras, Low- and High-resolution Spitzer IRS spectra of selected positions within the nebula, and a near-infrared ground-based image made in the light of [Fe II]1.644 micron. The 8.0 micron image, made with a bandpass that includes [Ar II]7.0 micron, resembles the general morphology of visible H-alpha and near-IR [Fe II] line emission, while the 3.6 and 4.5 micron images are dominated by continuum synchrotron emission. The 24 micron and 70 micron images show enhanced emission that may be due to line emission or the presence of a small amount of warm dust in the nebula on the order of less than 1% of a solar mass. The ratio of the 3.6 and 4.5 micron images reveals a spatial variation in the synchrotron power law index ranging from approximately 0.3 to 0.8 across the nebula. Combining this information with optical and X-ray synchrotron images, we derive a broadband spectrum that reflects the superposition of the flatter spectrum jet and torus with the steeper diffuse nebula, and suggestions of the expected pileup of relativistic electrons just before the exponential cutoff in the X-ray. The pulsar, and the associated equatorial toroid and polar jet structures seen in Chandra and HST images (Hester et al. 2002) can be identified in all of the IRAC images. We present the IR photometry of the pulsar. The forbidden lines identified in the high resolution IR spectra are all double due to Doppler shifts from the front and back of the expanding nebula and give an expansion velocity of approximately 1264 km/s.Comment: 21 pages, 4 tables, 16 figure

Software for Spatial Statistics

We give an overview of the papers published in this special issue on spatial statistics, of the Journal of Statistical Software. 21 papers address issues covering visualization (micromaps, links to Google Maps or Google Earth), point pattern analysis, geostatistics, analysis of areal aggregated or lattice data, spatio-temporal statistics, Bayesian spatial statistics, and Laplace approximations. We also point to earlier publications in this journal on the same topic