Does Screening in the Emergency Department Hurt or Help Victims of Intimate Partner Violence?

Study objective: Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the ED visit and whether computer kiosk identification and referral of intimate partner violence in the ED setting resulted in safety behaviors or contact with referrals. Methods: We conducted a prospective, observational study in which a convenience sample of male and female ED patients triaged to the waiting room who screened positive (on a computer kiosk-based questionnaire) for intimate partner violence in the past year were provided with resources and information and invited to participate in a series of follow-up interviews. At 1-week and 3-month follow-up visits, we assessed intimate partner violence, safety issues, and use of resources. In addition, to obtain an objective measure of safety, we assessed the number of violence-related 911 calls to participant addresses within a call district 6 months before and 6 months after the index ED visit. Results: Of the 2,134 participants in a relationship in the last year, 548 (25.7%) screened positive for intimate partner violence. No safety issues, such as calling security or a partner’s interference with the screening, occurred during the ED visit for any patient who disclosed intimate partner violence. Of the 216 intimate partner violence victims interviewed in person and 65 contacted by telephone 1 week later, no intimate partner violence victims reported any injuries or increased intimate partner violence resulting from participating in the study. For the sample in the local police district, there was no increase in the number of intimate partner violence victims who called 911 in the 6 months after the ED visit. Finally, 35% (n131) reported they had contacted community resources during the 3-month follow-up period. Conclusion: Among patients screening positive for intimate partner violence, there were no identified adverse events related to screening, and many had contacted community resources

The distance of M33 and the stellar population in its outskirts

We present deep V,I photometry of two $9.4' x 9.4' field in the outer regions of the M33 galaxy. We obtain a robust detection of the luminosity of the Red Giant Branch Tip (I{TRGB}=20.72 +- 0.08) from which we derived a new estimate of the distance modulus of M33, (m-M)_0=24.64 +- 0.15, corresponding to a distance D=847 +- 60 Kpc. By comparison of the color and magnitude of the observed Red Giant Branch stars with ridge lines of template globular clusters we obtained the photometric metallicity distribution of the considered fields in three different metallicity scales. The derived metallicity distributions are very similar over a range of distances from the galactic center 10' <= R <= 33', and are characterized by a well defined peak at [M/H] ~ -0.7 ([Fe/H] ~ -1.0, in the Zinn & West scale) and a weak metal-poor tail reaching [M/H] ~ -2.0. Our observations demonstrate that Red Giant Branch and Asymptotic Giant Branch stars have a radial distribution that is much more extended than the young MS stars associated with the star-forming disc.Comment: 10 pages,10 figures,accepted for publication in Astronomy & Astrophysic

Na-O Anticorrelation and HB. IV. Detection of He-rich and He-poor stellar populations in the globular cluster NGC 6218

We used the multifiber spectrograph FLAMES on the ESO Very Large Telescope UT2 to derive atmospheric parameters, metallicities and abundances of O and Na for 79 red giant stars in the Galactic globular cluster NGC 6218 (M 12). We analyzed stars in the magnitude range from about 1 mag below the bump to the tip of the Red Giant Branch. The average metallicity we derive is [Fe/H]=-1.31+/-0.004+/-0.028 dex (random and systematic errors, respectively), with a very small star-to-star scatter (rms=0.033 dex), from moderately high-resolution Giraffe spectra. This is the first extensive spectroscopic abundance analysis in this cluster. Our results indicate that NGC 6218 is very homogeneous as far as heavy elements are concerned. On the other hand, light elements involved in the well known proton-capture reactions of H-burning at high temperature, such as O and Na, show large variations, anticorrelated with each other, at all luminosities along the red giant branch. The conclusion is that the Na-O anticorrelation must be established in early times at the cluster formation. We interpret the variation of Na found near the RGB-bump as the effect of two distinct populations having different bump luminosities, as predicted for different He content. To our knowledge, NGC 6218 is the first GC where such a signature has been spectroscopically detected, when combined with consistent and homogeneous data obtained for NGC 6752 to gain in statistical significance.Comment: 15 pages, 10 figures; fig.5 degraded in resolution; tables 2,3,5 available at CDS. Accepted for publication on A&

Globular cluster system and Milky Way properties revisited

Updated data of the 153 Galactic globular clusters are used to readdress fundamental parameters of the Milky Way. We build a reduced sample, decontaminated of the clusters younger than 10Gyr, those with retrograde orbits and/or evidence of relation to dwarf galaxies. The 33 metal-rich globular clusters of the reduced sample extend basically to the Solar circle and distribute over a region with projected axial-ratios typical of an oblate spheroidal, $\rm\Delta x:\Delta y:\Delta z\approx1.0:0.9:0.4$. The 81 metal-poor globular clusters span a nearly spherical region of axial-ratios $\approx1.0:1.0:0.8$ extending from the central parts to the outer halo. A new estimate of the Sun's distance to the Galactic center is provided, $\rm R_O=7.2\pm0.3 kpc$. The metal-rich and metal-poor radial-density distributions flatten for $\rm R_{GC}\leq2 kpc$ and are well represented both by a power-law with a core-like term and S\'ersic's law; at large distances they fall off as $\rm\sim R^{-3.9}$. Both metallicity components appear to have a common origin, which is different from that of the dark matter halo. Structural similarities of the metal-rich and metal-poor radial distributions with the stellar halo are consistent with a scenario where part of the reduced sample was formed in the primordial collapse, and part was accreted in an early period of merging. This applies to the bulge as well, suggesting an early merger affecting the central parts of the Galaxy. We estimate that the present globular cluster population corresponds to $\rm\leq23\pm6$ of the original one. The fact that the volume-density radial distributions of the metal-rich and metal-poor globular clusters of the reduced sample follow both a core-like power-law and S\'ersic's law indicates that we are dealing with spheroidal subsystems in all scales.Comment: 14 pages and 6 figures. Astronomy & Astrophysics, accepted on NOv. 2

Common HLA Alleles Associated with Health, but Not with Facial Attractiveness

Three adaptive hypotheses have been proposed to explain the link between the human leucocyte antigen (HLA) genes, health measures and facial attractiveness: inbreeding avoidance, heterozygote advantage and frequency-dependent selection. This paper reports findings that support a new hypothesis relating HLA to health. We suggest a new method to quantify the level of heterozygosity. HLA heterozygosity did not significantly predict health measures in women, but allele frequency did. Women with more common HLA alleles reported fewer cold and flu bouts per year, fewer illnesses in the previous year and rated themselves healthier than women with rare alleles. To our knowledge, this is the first study to show a positive correlation between HLA allele frequency and general health measures. We propose that certain common HLA alleles confer resistance to prevalent pathogens. Nevertheless, neither HLA heterozygosity nor allele frequency significantly predicted how healthy or attractive men rated the female volunteers. Three non-mutually exclusive explanations are put forward to explain this finding

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Participant and spectator scaling of spectator fragments in Au + Au and Cu + Cu collisions at √sNN = 19.6 and 22.4 GeV

Spectator fragments resulting from relativistic heavy ion collisions, consisting of single protons and neutrons along with groups of stable nuclear fragments up to nitrogen (Z=7), are measured in PHOBOS. These fragments are observed in Au+Au (√sNN =19.6GeV) and Cu+Cu (22.4 GeV) collisions at high pseudorapidity (η). The dominant multiply-charged fragment is the tightly bound helium (α), with lithium, beryllium, and boron all clearly seen as a function of collision centrality and pseudorapidity. We observe that in Cu+Cu collisions, it becomes much more favorable for the α fragments to be released than lithium. The yields of fragments approximately scale with the number of spectator nucleons, independent of the colliding ion. The shapes of the pseudorapidity distributions of fragments indicate that the average deflection of the fragments away from the beam direction increases for more central collisions. A detailed comparison of the shapes for α and lithium fragments indicates that the centrality dependence of the deflections favors a scaling with the number of participants in the collision.United States. Department of Energy (Grant DE-AC02-98CH10886)United States. Department of Energy (Grant DE-FG02-93ER40802)United States. Department of Energy (Grant DE-FG02-94ER40818)United States. Department of Energy (Grant DE-FG02-94ER40865)United States. Department of Energy (Grant DE-FG02- 99ER41099)United States. Department of Energy (Grant DE-AC02-06CH11357)National Science Foundation (U.S.) (Grant 9603486)National Science Foundation (U.S.) (Grant 0072204)National Science Foundation (U.S.) (Grant 0245011

NYESO-1/LAGE-1s and PRAME Are Targets for Antigen Specific T Cells in Chondrosarcoma following Treatment with 5-Aza-2-Deoxycitabine

Chondrosarcoma has no proven systemic option in the metastatic setting. The development of a non-cross-resistant strategy, such as cellular immunotherapy using antigen-specific T cells would be highly desirable. NY-ESO-1 and PRAME are members of the Cancer Testis Antigen (CTA) family that have been identified as promising targets for T cell therapy. LAGE-1 is a cancer testis antigen 90% homologous to NY-ESO-1, sharing the 157-165 A*0201 NY-ESO-1 epitope with its transcript variant, LAGE-1s. A number of CTA's have been induced using 5-Aza-2-Deoxycitabine (5-Aza-dC) in other cancers. We sought to evaluate the feasibility of targeting chondrosarcoma tumors using NY-ESO-1/LAGE-1s and PRAME specific T cells using 5-Aza-dC to induce antigen expression.We used 11 flash frozen tumors from the University of Washington tumor bank to test for the expression of NY-ESO-1, PRAME, LAGE-1s and LAGE-1L in chondrosarcoma tumors. Using four chondrosarcoma cell lines we tested the expression of these CTA's with and without 5-Aza-dC treatments. Finally, using NY-ESO-1/LAGE-1s and PRAME specific effectors that we generated from sarcoma patients, we evaluated the ability of these T cells to lyse A*0201 expressing chondrosarcoma cell lines in vitro both with and without 5-Aza-dC treatment.A minority (36%) of chondrosarcoma tumors expressed either NY-ESO-1 or LAGE-1s at >10% of our reference value and none expressed PRAME at that level. However, in all four of the chondrosarcoma cell lines tested, NY-ESO-1 and PRAME expression could be induced following treatment with 5-Aza-dC including in cell lines where expression was absent or barely detectable. Furthermore, NY-ESO-1/LAGE-1s and PRAME specific CD8+ effector T cells were able to specifically recognize and lyse A*0201 expressing chondrosarcoma cell lines following 5-Aza-dC treatment.These data suggest that adoptive immunotherapy in combination with 5-Aza-dC may be a potential strategy to treat unresectable or metastatic chondrosarcoma patients where no proven systemic therapies exist