Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements

We studied a community cohort of 193 individuals exposed to endemic Schistosoma japonicum infection in the Dongting Lake region of China to assess subclinical morbidity and the 2-year benefit of curative therapy (praziquantel) administered in 1996. Prevalence and intensity of S. japonicum infection before treatment were 28% and 192 eggs per gram faeces (epg), respectively. Two years after cure, 22% of the cohort were reinfected, but with a lighter intensity (67 epg). Sixty-four subjects (37%) showed significant improvement in ultrasound parenchyma images after treatment and 51 subjects (54%) showed significant improvement of periportal fibrosis. Left-lobe enlargement also reversed (P 0·05). The serum levels of laminin and collagen IV associated with reinfection and intensity and hyaluronic acid levels correlated with ultrasound findings (P < 0·01). Overall, treatment induced a marked decrease in subclinical hepatosplenic morbidity attributable to S. japonicum although low-intensity re-infection after treatment remained relatively frequent. Stratified analysis and logistic models evaluated potential confounding factors for assessment of treatment effects on hepatic fibrosis. S. japonicum infection and moderate-heavy alcohol intake interacted: improvement in parenchymal morbidity was impeded among drinkers (P < 0·05). Chemotherapy focused on at-risk residents controls prevalent subclinical hepatic fibrosis but re-infection indicates the need for complementary control strategie

Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia.

OBJECTIVE: Hyperandrogenism in congenital adrenal hyperplasia (CAH) provides an in vivo model for exploring the effect of androgens on erythropoiesis in women. We investigated the association of androgens with haemoglobin (Hb) and haematocrit (Hct) in women with CAH. DESIGN: Cross-validation study PATIENTS: Women with CAH from Sheffield Teaching Hospitals, UK (cohort 1, the training set: n=23) and National Institutes of Health, USA (cohort 2, the validation set: n=53). MEASUREMENTS: Androgens, full blood count and basic biochemistry, all measured on the same day. Demographic and anthropometric data. RESULTS: Significant age-adjusted correlations (P<0.001) were observed for Ln testosterone with Hb and Hct in cohorts 1 and 2 (Hb r=0.712 & 0.524 and Hct r=0.705 & 0.466), which remained significant after adjustments for CAH status, glucocorticoid treatment dose and serum creatinine. In the combined cohorts Hb correlated with androstenedione (P=0.002) and 17-hydroxyprogesterone (P=0.008). Hb and Hct were significantly higher in cohort 1 than those in cohort 2, while there were no group differences in androgen levels, glucocorticoid treatment dose or body mass index. In both cohorts, women with Hb and Hct in the highest tertile had significantly higher testosterone levels than women with Hb and Hct in the lowest tertile. CONCLUSIONS: In women with CAH, erythropoiesis may be driven by androgens and could be considered a biomarker for disease control

Hormonal circadian rhythms in patients with congenital adrenal hyperplasia: identifying optimal monitoring times and novel disease biomarkers

Objectives: The treatment goal in congenital adrenal hyperplasia (CAH) is to replace glucocorticoids while avoiding androgen excess and iatrogenic Cushing's syndrome. However, there is no consensus on how to monitor disease control. Our main objectives were to evaluate hormonal circadian rhythms and use these profiles to identify optimal monitoring times and novel disease biomarkers in CAH adults on intermediate- and long-acting glucocorticoids. Design: This was an observational, cross-sectional study at the National Institutes of Health Clinical Center in 16 patients with classic CAH. Methods: Twenty-four-hour serum sampling for ACTH, 17-hydroxyprogesterone (17OHP), androstenedione (A4), androsterone, DHEA, testosterone, progesterone and 24-h urinary pdiol and 5β-pdiol was carried out. Bayesian spectral analysis and cosinor analysis were performed to detect circadian rhythmicity. The number of hours to minimal (TminAC) and maximal (TmaxAC) adrenocortical hormone levels after dose administration was calculated. Results: A significant rhythm was confirmed for ACTH (r2, 0.95; P<0.001), 17OHP (r2, 0.70; P=0.003), androstenedione (r2, 0.47; P=0.043), androsterone (r2, 0.80; P<0.001), testosterone (r2, 0.47; P=0.042) and progesterone (r2, 0.64; P=0.006). The mean (S.D.) TminAC and TmaxAC for 17OHP and A4 were: morning prednisone (4.3 (2.3) and 9.7 (3.5) h), evening prednisone (4.5 (2.0) and 10.3 (2.4) h), and daily dexamethasone (9.2 (3.5) and 16.4 (7.2) h). AUC0–24 h progesterone, androsterone and 24-h urine pdiol were significantly related to 17OHP. Conclusion: In CAH patients, adrenal androgens exhibit circadian rhythms influenced by glucocorticoid replacement. Measurement of adrenocortical hormones and interpretation of results should take into account the type of glucocorticoid and time of dose administration. Progesterone and backdoor metabolites may provide alternative disease biomarkers

A comprehensive strategy to tackle arsenic contamination of drinking water in Uttar Pradesh in India

Exposure to naturally occurring arsenic through consumption of contaminated groundwater, food and soil is now widely recognized as a new threat to public health in several countries in South and South-East Asia, including parts of India. The realization that arsenic not only occurs in groundwater used for drinking in the Ganges-Brahmaputra delta of West Bengal in India, but also further upstream in Bihar and Uttar Pradesh in the middle and upper Gangetic plains, has necessitated the need to develop arsenic testing and mitigation strategies in these states. This paper outlines the strategy evolved by the state government of Uttar Pradesh, with the support of UNICEF, to tackle the problem of arsenic in groundwater used for drinking. The comprehensive approach includes testing, communication, mitigation and health aspects, and novel strategies used to overcome technological issues are detailed. A similar approach has been used in the neighbouring state of Bihar

Transport properties of dense fluid argon

We calculate using molecular dynamics simulations the transport properties of realistically modeled fluid argon at pressures up to $\simeq 50GPa$ and temperatures up to $3000K$. In this context we provide a critique of some newer theoretical predictions for the diffusion coefficients of liquids and a discussion of the Enskog theory relevance under two different adaptations: modified Enskog theory (MET) and effective diameter Enskog theory. We also analyze a number of experimental data for the thermal conductivity of monoatomic and small diatomic dense fluids.Comment: 8 pages, 6 figure

Second-harmonic generation in a direct-bonded periodically-poled-LiNbO₃ buried waveguide

We report the fabrication of a 12µm-thick periodically poled LiNbO3 planar waveguide buried in LiTaO3 by direct bonding of precision-polished surfaces. Frequency doubling of the 1064nm output of a cw diode-pumped Nd:YAG laser was performed in a 5.5mm-long device with a 6.50µm-period grating at an elevated temperature of 174°C. The resultant green second-harmonic output exhibited fundamental-spatial-mode characteristics at a 4.3% /W conversion efficiency

Like Sign Dilepton Signature for R-Parity Violating SUSY Search at the Tevatron Collider

The like sign dileptons provide the most promising signature for superparticle search in a large category of $R$-parity violating SUSY models. We estimate the like sign dilepton signals at the Tevatron collider, predicted by these models, over a wide region of the MSSM parameter space. One expects an unambiguous signal upto a gluino mass of $200 - 300$ GeV ($\geq 500$ GeV) with the present (proposed) accumulated luminosity of $\sim 0.1~(1)~{\rm fb}^{-1}$.Comment: 12 page LaTeX file; 5 figures available upon request from the autho

Continuity theorems for the M/M/1/nM/M/1/n queueing system

In this paper continuity theorems are established for the number of losses during a busy period of the $M/M/1/n$ queue. We consider an $M/GI/1/n$ queueing system where the service time probability distribution, slightly different in a certain sense from the exponential distribution, is approximated by that exponential distribution. Continuity theorems are obtained in the form of one or two-sided stochastic inequalities. The paper shows how the bounds of these inequalities are changed if further assumptions, associated with specific properties of the service time distribution (precisely described in the paper), are made. Specifically, some parametric families of service time distributions are discussed, and the paper establishes uniform estimates (given for all possible values of the parameter) and local estimates (where the parameter is fixed and takes only the given value). The analysis of the paper is based on the level crossing approach and some characterization properties of the exponential distribution.Comment: Final revision; will be published as i

Broken-Symmetry States in Quantum Hall Superlattices

We argue that broken-symmetry states with either spatially diagonal or spatially off-diagonal order are likely in the quantum Hall regime, for clean multiple quantum well (MQW) systems with small layer separations. We find that for MQW systems, unlike bilayers, charge order tends to be favored over spontaneous interlayer coherence. We estimate the size of the interlayer tunneling amplitude needed to stabilize superlattice Bloch minibands by comparing the variational energies of interlayer-coherent superlattice miniband states with those of states with charge order and states with no broken symmetries. We predict that when coherent miniband ground states are stable, strong interlayer electronic correlations will strongly enhance the growth-direction tunneling conductance and promote the possibility of Bloch oscillations.Comment: 9 pages LaTeX, 4 figures EPS, to be published in PR