209 research outputs found

    Front Matter and Editors\u27 Notes

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    Cover page, table of contents, editors\u27 notes

    A Systems Approach and Notional Response Model for Preserving the Health System during the COVID-19 Pandemic

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    During any pandemic, it has long been known that local jurisdictions would need to be self-sufficient with little or no outside assistance, particularly from the federal government. While all eyes have been on California, New York, and Massachusetts, the capacities of health systems in other states have yet to be put to the test. If there are subsequent waves of COVID-19 and other jurisdictions see significant increases in disease spread, the systems used to respond will become critical.Using a review and synthesis approach, this article explores our collective experience and knowledge as it pertains to use of alternate care sites for dealing with the patient surge created by a disease outbreak. Probing the concept of alternate care site (ACS) systems reveals various types of alternate care sites that may be employed during an outbreak. The historical value of ACS models used during outbreak response are discussed. This culminates in the development of a notional response model and list of actions that should be taken by all jurisdictions as we prepare for additional waves of disease

    Bromotryptophans and their incorporation in cyclic and bicyclic privileged peptides

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    While revisiting biologically active natural peptides, the importance of the tryptophan residue became clear. In this article, the incorporation of this amino acid, brominated at different positions of the indole ring, into cyclic peptides was successfully achieved. These products demonstrated improved properties in terms of passive diffusion, permeability across membranes, biostability in human serum and cytotoxicity. Moreover, these brominated tryptophans at positions 5, 6, or 7 proved to be compatible as building blocks to prepare bicyclic stapled peptides by performing on‐resin Suzuki‐Miyaura cross‐coupling reactions

    Is manganese-doped diamond a ferromagnetic semiconductor?

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    We use density-functional theoretical methods to examine the recent prediction, based on a mean-field solution of the Zener model, that diamond doped by Mn (with spin S=5/2) would be a dilute magnetic semiconductor that remains ferromagnetic well above room temperature. Our findings suggest this to be unlikely, for four reasons: (1) substitutional Mn in diamond has a low-spin S=1/2 ground state; (2) the substitutional site is energetically unfavorable relative to the much larger "divacancy" site; 3) Mn in the divacancy site is an acceptor, but with only hyperdeep levels, and hence the holes are likely to remain localized; (4) the calculated Heisenberg couplings between Mn in nearby divacancy sites are two orders of magnitude smaller than for substitutional Mn in germanium.Comment: 5 pages, 5 figure

    A Chandra Observation of the Obscured Star-Forming Complex W40

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    The young stellar cluster illuminating the W40 H II region, one of the nearest massive star forming regions, has been observed with the ACIS detector on board the Chandra X-ray Observatory. Due to its high obscuration, this is a poorly-studied stellar cluster with only a handful of bright stars visible in the optical band, including three OB stars identified as primary excitation sources. We detect 225 X-ray sources, of which 85% are confidently identified as young stellar members of the region. Two potential distances of the cluster, 260 pc and 600 pc, are used in the paper. Supposing the X-ray luminosity function to be universal, it supports a 600 pc distance as a lower limit for W40 and a total population of at least 600 stars down to 0.1 Mo under the assumption of a coeval population with a uniform obscuration. In fact, there is strong spatial variation in Ks-band-excess disk fraction and non-uniform obscuration due to a dust lane that is identified in absorption in optical, infrared and X-ray. The dust lane is likely part of a ring of material which includes the molecular core within W40. In contrast to the likely ongoing star formation in the dust lane, the molecular core is inactive. The star cluster has a spherical morphology, an isothermal sphere density profile, and mass segregation down to 1.5 Mo. However, other cluster properties, including a \leq{1} Myr age estimate and ongoing star formation, indicate that the cluster is not dynamically relaxed. X-ray diffuse emission and a powerful flare from a young stellar object are also reported.Comment: Accepted for publication in The Astrophysical Journal. 60 pages, 16 figure

    Safety and efficacy of mass drug administration with a single-dose triple-drug regimen of albendazole + diethylcarbamazine + ivermectin for lymphatic filariasis in Papua New Guinea: An open-label, cluster-randomised trial

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    Background Papua New Guinea (PNG) has a high burden of lymphatic filariasis (LF) caused by Wucher-eria bancrofti, with an estimated 4.2 million people at risk of infection. A single co-adminis-tered dose of ivermectin, diethylcarbamazine and albendazole (IDA) has been shown to have superior efficacy in sustained clearance of microfilariae compared to diethylcarbama-zine and albendazole (DA) in small clinical trials. A community-based cluster-randomised trial of DA versus IDA was conducted to compare the safety and efficacy of IDA and DA for LF in a moderately endemic, treatment-naive area in PNG. Methodology All consenting, eligible residents of 24 villages in Bogia district, Madang Province, PNG were enrolled, screened for W. bancrofti antigenemia and microfilaria (Mf) and randomised to receive IDA (N = 2382) or DA (N = 2181) according to their village of residence. Adverse events (AE) were assessed by active follow-up for 2 days and passive follow-up for an addi-tional 5 days. Antigen-positive participants were re-tested one year after MDA to assess treatment efficacy. Principal findings Of the 4,563 participants enrolled, 96% were assessed for AEs within 2 days after treat-ment. The overall frequency of AEs were similar after either DA (18%) or IDA (20%) treat-ment. For those individuals with AEs, 87% were mild (Grade 1), 13% were moderate (Grade 2) and there were no Grade 3, Grade 4, or serious AEs (SAEs). The frequency of AEs was greater in Mf-positive than Mf-negative individuals receiving IDA (39% vs 20% p<0.001) and in Mf-positive participants treated with IDA (39%), compared to those treated with DA (24%, p = 0.023). One year after treatment, 64% (645/1013) of participants who were antigen-positive at baseline were re-screened and 74% of these participants (475/ 645) remained antigen positive. Clearance of Mf was achieved in 96% (52/54) of infected individuals in the IDA arm versus 84% (56/67) of infected individuals in the DA arm (rela-tive risk (RR) 1.15; 95% CI, 1.02 to 1.30; p = 0.019). Participants receiving DA treatment had a 4-fold higher likelihood of failing to clear Mf (RR 4.67 (95% CI: 1.05 to 20.67; p = 0.043). In the DA arm, a significant predictor of failure to clear was baseline Mf density (RR 1.54; 95% CI, 1.09 to 2.88; p = 0.007). Conclusion IDA was well tolerated and more effective than DA for clearing Mf. Widespread use of this regimen could accelerate LF elimination in PNG
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