Evaluation of Noninvasive Respiratory Volume Monitoring in the PACU of a Low Resource Kenyan Hospital

This research aims to evaluate the use of the noninvasive respiratory volume monitor (RVM) compared to the standard of care (SOC) in the Post-Anesthesia Care Unit (PACU) of Kijabe Hospital, Kenya. The RVM provides real-time measurements for quantitative monitoring of non-intubated patients. Our evaluation was focused on the incidence of postoperative opioid-induced respiratory depression (OIRD). The RVM cohort (N = 50) received quantitative OIRD assessment via the RVM, which included respiratory rate, minute ventilation, and tidal volume. The SOC cohort (N = 46) received qualitative OIRD assessment via patient monitoring with oxygenation measurements (SpO2) and physical examination. All diagnosed cases of OIRD were in the RVM cohort (9/50). In the RVM cohort, participants stayed longer in the PACU and required more frequent airway maneuvers and supplemental oxygen, compared to SOC (all p \u3c 0.05). The SOC cohort may have had fewer diagnoses of OIRD due to the challenging task of distinguishing hypoventilation versus OIRD in the absence of quantitative data. To account for the higher OIRD risk with general anesthesia (GA), a subgroup analysis was performed for only participants who underwent GA, which showed similar results. The use of RVM for respiratory monitoring of OIRD may allow for more proactive care

Intensified and protective CD4+ T cell immunity in mice with anti–dendritic cell HIV gag fusion antibody vaccine

Current human immunodeficiency virus (HIV) vaccine approaches emphasize prime boost strategies comprising multiple doses of DNA vaccine and recombinant viral vectors. We are developing a protein-based approach that directly harnesses principles for generating T cell immunity. Vaccine is delivered to maturing dendritic cells in lymphoid tissue by engineering protein antigen into an antibody to DEC-205, a receptor for antigen presentation. Here we characterize the CD4+ T cell immune response to HIV gag and compare efficacy with other vaccine strategies in a single dose. DEC-205–targeted HIV gag p24 or p41 induces stronger CD4+ T cell immunity relative to high doses of gag protein, HIV gag plasmid DNA, or recombinant adenovirus-gag. High frequencies of interferon (IFN)-γ– and interleukin 2–producing CD4+ T cells are elicited, including double cytokine-producing cells. In addition, the response is broad because the primed mice respond to an array of peptides in different major histocompatibility complex haplotypes. Long-lived T cell memory is observed. After subcutaneous vaccination, CD4+ and IFN-γ–dependent protection develops to a challenge with recombinant vaccinia-gag virus at a mucosal surface, the airway. We suggest that a DEC-targeted vaccine, in part because of an unusually strong and protective CD4+ T cell response, will improve vaccine efficacy as a stand-alone approach or with other modalities

Thermohaline forcing and interannual variability of northwestern inflows into the northern North Sea

A long-established, 127 km-long hydrographic section in the northern North Sea at 59.28°N that runs from the eastern coast of Orkney (2.23°W) to the central North Sea (0°) crosses the path of the main inflows of Atlantic water. Data from 122 occupations between 1989 and 2015 are examined to determine the annual cycle and long-term trends of temperature, salinity and depth-varying geostrophic flow across the section. In an average year, the geostrophic flow referenced to the seafloor is at its narrowest (40 km) in winter, during which time it is driven by the strong horizontal salinity gradient; the horizontal temperature gradient is very weak. Velocity exceeds 4 cm s−1, but transport is at a minimum (0.11 Sv). In the deeper water in the east of the section, thermal stratification develops throughout summer and persists until October, whereas the west is tidally mixed all year. The bottom temperature gradient becomes the primary driver of the geostrophic flow, which is fastest (9 cm s−1) in September and broadest (100 km) in October. Maximum transport (0.36 Sv) occurs in October. Throughout the summer, the horizontal salinity gradient weakens, as does its contribution to the flow. However, it nevertheless acts to broaden the flow west of the location of the strongest horizontal temperature gradient. Section-mean de-seasoned temperature is found to be positively correlated to the Atlantic Multidecadal Oscillation and negatively correlated to the North Atlantic Oscillation. These results refine our understanding of the thermohaline forcing of Atlantic inflow into the northern North Sea, particularly in relation to the salinity distribution. Understanding the variability of this inflow is important for understanding the dynamics of the North Sea ecosystem

Using PCR-Based Detection and Genotyping to Trace Streptococcus salivarius Meningitis Outbreak Strain to Oral Flora of Radiology Physician Assistant

We recently investigated three cases of bacterial meningitis that were reported from a midwestern radiology clinic where facemasks were not worn during spinal injection of contrast agent during myelography procedures. Using pulsed field gel electrophoresis we linked a case strain of S. salivarius to an oral specimen of a radiology physician assistant (RPA). We also used a real-time PCR assay to detect S. salivarius DNA within a culture-negative cerebrospinal fluid (CSF) specimen. Here we extend this investigation through using a nested PCR/sequencing strategy to link the culture-negative CSF specimen to the case strain. We also provide validation of the real-time PCR assay used, demonstrating that it is not solely specific for Streptococcus salivarius, but is also highly sensitive for detection of the closely related oral species Streptococcus vestibularis. Through using multilocus sequence typing and 16S rDNA sequencing we further strengthen the link between the CSF case isolate and the RPA carriage isolate. We also demonstrate that the newly characterized strains from this study are distinct from previously characterized S. salivarius strains associated with carriage and meningitis

Dendritic cells induce antigen-specific regulatory T cells that prevent graft versus host disease and persist in mice

Regulatory T cells generated by allostimulation with dendritic cells, transforming growth factor β, and retinoic acid stably express Foxp3 and can suppress even ongoing GVHD in mice

Phase 1 Safety and Immunogenicity Evaluation of ADMVA, a Multigenic, Modified Vaccinia Ankara-HIV-1 B'/C Candidate Vaccine

in a modified vaccinia Ankara viral vector. Sequences were derived from a prevalent circulating HIV-1 recombinant form in Yunnan, China, an area of high HIV incidence. The objective was to evaluate the safety and immunogenicity of ADMVA in human volunteers.. Two volunteers mounted antibodies that were able to neutralize clade-matched viruses.ADMVA was well-tolerated and elicited durable humoral and cellular immune responses

The GALAH survey: Milky Way disc metallicity and alpha-abundance trends in combined APOGEE-GALAH catalogues

GALAH and APOGEE are two high resolution multi object spectroscopic surveys that provide fundamental stellar parameters and multiple elemental abundance estimates for $>$ 400,000 stars in the Milky Way. They are complimentary in both sky coverage and wavelength regime. Thus combining the two surveys will provide us a large sample to investigate the disc metallicity and alpha abundance trends. We use the Cannon data-driven approach selecting training sets from among $\sim$20,000 stars in common for the two surveys to predict the GALAH scaled stellar parameters from APOGEE spectra as well as APOGEE scaled stellar parameters from GALAH spectra. We provide two combined catalogues with GALAH scaled and APOGEE scaled stellar parameters each having $\sim$500,000 stars after quality cuts. With $\sim$470,000 stars that are common in both these catalogues, we compare the GALAH scaled and APOGEE scaled metallicity distribution functions (MDF), radial and vertical metallicity gradients as well as the variation of [$\alpha$/Fe] vs [Fe/H] trends along and away from the Galactic mid plane. We find mean metallicities of APOGEE scaled sample to be higher compared to that for the GALAH scaled sample. We find similar [$\alpha$/Fe] vs [Fe/H] trends using both samples consistent with previous observational as well as simulation based studies. Radial and vertical metallicity gradients derived using the two survey scaled samples are consistent except in the inner and outer Galactocentric radius bins. Our gradient estimates in the solar neighborhood are also consistent with previous studies and are backed by larger sample size compared to previous works.Comment: 21 pages, 19 figures, submitted to MNRA

The Ninth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the SDSS-III Baryon Oscillation Spectroscopic Survey

The Sloan Digital Sky Survey III (SDSS-III) presents the first spectroscopic data from the Baryon Oscillation Spectroscopic Survey (BOSS). This ninth data release (DR9) of the SDSS project includes 535,995 new galaxy spectra (median z=0.52), 102,100 new quasar spectra (median z=2.32), and 90,897 new stellar spectra, along with the data presented in previous data releases. These spectra were obtained with the new BOSS spectrograph and were taken between 2009 December and 2011 July. In addition, the stellar parameters pipeline, which determines radial velocities, surface temperatures, surface gravities, and metallicities of stars, has been updated and refined with improvements in temperature estimates for stars with T_eff<5000 K and in metallicity estimates for stars with [Fe/H]>-0.5. DR9 includes new stellar parameters for all stars presented in DR8, including stars from SDSS-I and II, as well as those observed as part of the SDSS-III Sloan Extension for Galactic Understanding and Exploration-2 (SEGUE-2). The astrometry error introduced in the DR8 imaging catalogs has been corrected in the DR9 data products. The next data release for SDSS-III will be in Summer 2013, which will present the first data from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) along with another year of data from BOSS, followed by the final SDSS-III data release in December 2014.Comment: 9 figures; 2 tables. Submitted to ApJS. DR9 is available at http://www.sdss3.org/dr

The Eighth Data Release of the Sloan Digital Sky Survey: First Data from SDSS-III

The Sloan Digital Sky Survey (SDSS) started a new phase in August 2008, with new instrumentation and new surveys focused on Galactic structure and chemical evolution, measurements of the baryon oscillation feature in the clustering of galaxies and the quasar Ly alpha forest, and a radial velocity search for planets around ~8000 stars. This paper describes the first data release of SDSS-III (and the eighth counting from the beginning of the SDSS). The release includes five-band imaging of roughly 5200 deg^2 in the Southern Galactic Cap, bringing the total footprint of the SDSS imaging to 14,555 deg^2, or over a third of the Celestial Sphere. All the imaging data have been reprocessed with an improved sky-subtraction algorithm and a final, self-consistent photometric recalibration and flat-field determination. This release also includes all data from the second phase of the Sloan Extension for Galactic Understanding and Evolution (SEGUE-2), consisting of spectroscopy of approximately 118,000 stars at both high and low Galactic latitudes. All the more than half a million stellar spectra obtained with the SDSS spectrograph have been reprocessed through an improved stellar parameters pipeline, which has better determination of metallicity for high metallicity stars.Comment: Astrophysical Journal Supplements, in press (minor updates from submitted version