Lessons learned in extended-extended Spitzer Space Telescope operations

The Spitzer Space Telescope is executing the ninth year of extended operations beyond its 5.5-year prime mission. The project anticipated a maximum extended mission of about four years when the first mission extension was proposed. The robustness of the observatory hardware and the creativity of the project engineers and scientists in overcoming hurdles to operations has enabled a substantially longer mission lifetime. This has led to more challenges with an aging groundsystem due to resource reductions and decisions made early in the extended mission based on a shorter planned lifetime. We provide an overview of the extended mission phases, challenges met in maintaining and enhancing the science productivity, and what we would have done differently if the extended mission was planned from the start to be nearly twice as long as the prime mission

Control of Vancomycin-Resistant Enterococcus in Health Care Facilities in a Region

Background In late 1996, vancomycin-resistant enterococci were first detected in the Siouxland region of Iowa, Nebraska, and South Dakota. A task force was created, and in 1997 the assistance of the Centers for Disease Control and Prevention was sought in assessing the prevalence of vancomycin-resistant enterococci in the region’s facilities and implementing recommendations for screening, infection control, and education at all 32 health care facilities in the region. Methods The infection-control intervention was evaluated in October 1998 and October 1999. We performed point-prevalence surveys, conducted a case– control study of gastrointestinal colonization with vancomycin-resistant enterococci, and compared infection-control practices and screening policies for vancomycin-resistant enterococci at the acute care and long-term care facilities in the Siouxland region. Results Perianal-swab samples were obtained from 1954 of 2196 eligible patients (89 percent) in 1998 and 1820 of 2049 eligible patients (89 percent) in 1999. The overall prevalence of vancomycin-resistant enterococci at 30 facilities that participated in all three years of the study decreased from 2.2 percent in 1997 to 1.4 percent in 1998 and to 0.5 percent in 1999 (P Conclusions An active infection-control intervention, which includes the obtaining of surveillance cultures and the isolation of infected patients, can reduce or eliminate the transmission of vancomycinresistant enterococci in the health care facilities of a region. (N Engl J Med 2001;344:1427-33.

In Vivo Efficacy of a Cocktail of Human Monoclonal Antibodies (CL184) Against Diverse North American Bat Rabies Virus Variants

Following rabies virus (RABV) exposure, a combination of thorough wound washing, multiple-dose vaccine administration and the local infiltration of rabies immune globulin (RIG) are essential components of modern post-exposure prophylaxis (PEP). Although modern cell-culture-based rabies vaccines are increasingly used in many countries, RIG is much less available. The prohibitive cost of polyclonal serum RIG products has prompted a search for alternatives and design of anti-RABV monoclonal antibodies (MAbs) that can be manufactured on a large scale with a consistent potency and lower production costs. Robust in vitro neutralization activity has been demonstrated for the CL184 MAb cocktail, a 1:1 protein mixture of two human anti-RABV MAbs (CR57/CR4098), against a large panel of RABV isolates. In this study, we used a hamster model to evaluate the efficacy of experimental PEP against a lethal challenge. Various doses of CL184 and commercial rabies vaccine were assessed for the ability to protect against lethal infection with representatives of four distinct bat RABV lineages of public health relevance: silver-haired bat (Ln RABV); western canyon bat (Ph RABV); big brown bat (Ef-w1 RABV) and Mexican free-tailed bat RABV (Tb RABV). 42–100% of animals survived bat RABV infection when CL184 (in combination with the vaccine) was administered. A dose-response relationship was observed with decreasing doses of CL184 resulting in increasing mortality. Importantly, CL184 was highly effective in neutralizing and clearing Ph RABV in vivo, even though CR4098 does not neutralize this virus in vitro. By comparison, 19–95% survivorship was observed if human RIG (20 IU/kg) and vaccine were used following challenge with different bat viruses. Based on our results, CL184 represents an efficacious alternative for RIG. Both large-scale and lower cost production could ensure better availability and affordability of this critical life-saving biologic in rabies enzootic countries and as such, significantly contribute to the reduction of human rabies deaths globally

Observations of Radar Backscatter at Ku and C Bands in the Presence of Large Waves during the Surface Wave Dynamics Experiment

Ocean radar backscatter in the presence of large waves is investigated using data acquired with the Jet Propulsion Laboratory NUSCAT radar at Ku band for horizontal and vertical polarizations and the University of Massachusetts CSCAT radar at C band for vertical polarization during the Surface Wave Dynamics Experiment. Off-nadir backscatter data of ocean surfaces were obtained in the presence of large waves with significant wave height up to 5.6 m. In moderate-wind cases, effects of large waves are not detectable within the measurement uncertainty and no noticeable correlation between backscatter coefficients and wave height is found. Under high-wave light-wind conditions, backscatter is enhanced significantly at large incidence angles with a weaker effect at small incidence angles. Backscatter coefficients in the wind speed range under consideration are compared with SASS-2 (Ku band), CMOD3-H1 (C band), and Plant's model results which confirm the experimental observations. Variations of the friction velocity, which can give rise to the observed backscatter behaviors in the presence of large waves, are presented

Ex^2Box: Interdependent Modes of Binding in a Two-Nanometer-Long Synthetic Receptor

Incorporation of two biphenylene-bridged 4,4′-bipyridinium extended viologen units into a para-phenylene-based cyclophane results in a synthetic receptor that is 2 nm long and adopts a box-like geometry. This cyclophane, Ex^2Box^4+, possesses the ability to form binary and ternary complexes with a myriad of guest molecules ranging from long π-electron-rich polycyclic aromatic hydrocarbons, such as tetracene, tetraphene, and chrysene, to π-electron-poor 2,6-dinitrotoluene, 1,2,4-trichlorobenzene, and both the 9,10- and 1,4-anthraquinone molecules. Moreover, Ex^2Box^4+ is capable of forming one-to-one complexes with polyether macrocycles that consist of two π-electron-rich dioxynaphthalene units, namely, 1,5-dinaphtho[38]crown-10. This type of broad molecular recognition is possible because the electronic constitution of Ex^2Box^4+ is such that the pyridinium rings located at the “ends” of the cyclophane are electron-poor and prefer to enter into donor–acceptor interactions with π-electron-rich guests, while the “middle” of the cyclophane, consisting of the biphenylene spacer, is more electron-rich and can interact with π-electron-poor guests. In some cases, these different modes of binding can act in concert to generate one-to-one complexes which possess high stability constants in organic media. The binding affinity of Ex^2Box^4+ was investigated in the solid state by way of single-crystal X-ray diffraction and in solution by using UV–vis and NMR spectroscopy for 12 inclusion complexes consisting of the tetracationic cyclophane and the corresponding guests of different sizes, shapes, and electronic compositions. Additionally, density functional theory was carried out to elucidate the relative energetic differences between the different modes of binding of Ex^2Box^4+ with anthracene, 9,10-anthraquinone, and 1,4-anthraquinone in order to understand the degree with which each mode of binding contributes to the overall encapsulation of each guest

Identifying existing Choosing Wisely recommendations of high relevance and importance to hematology

Choosing Wisely (CW) is a medical stewardship initiative led by the American Board of Internal Medicine Foundation in collaboration with professional medical societies in the United States. In an effort to learn from and leverage the work of others, the American Society of Hematology CW Task Force developed a method to identify and prioritize CW recommendations from other medical societies of high relevance and importance to patients with blood disorders and their physicians. All 380 CW recommendations were reviewed and assessed for relevance and importance. Relevance was assessed using the MORE TM relevance scale. Importance was assessed with regard to six guiding principles: harm avoidance, evidence, aggregate cost, relevance, frequency and impact. Harm avoidance was considered the most important principle. Ten highly relevant and important recommendations were identified from a variety of professional societies. Recommendations focused on decreasing unnecessary imaging, blood work, treatments and transfusions, as well as on increasing collaboration across disciplines and considering value when recommending treatments. Many CW recommendations have relevance beyond the society of origin. The methods developed by the ASH CW Task Force could be easily adapted by other Societies to identify additional CW recommendations of relevance and importance to their fields. Am. J. Hematol. 91:787–792, 2016. © 2016 Wiley Periodicals, Inc

Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome

Background The polycystic ovary syndrome is a common cause of infertility. Clomiphene and insulin sensitizers are used alone and in combination to induce ovulation, but it is unknown whether one approach is superior. Methods We randomly assigned 626 infertile women with the polycystic ovary syndrome to receive clomiphene citrate plus placebo, extended-release metformin plus placebo, or a combination of metformin and clomiphene for up to 6 months. Medication was discontinued when pregnancy was confirmed, and subjects were followed until delivery. Results The live-birth rate was 22.5% (47 of 209 subjects) in the clomiphene group, 7.2% (15 of 208) in the metformin group, and 26.8% (56 of 209) in the combinationtherapy group (P\u3c0.001 for metformin vs. both clomiphene and combination therapy; P=0.31 for clomiphene vs. combination therapy). Among pregnancies, the rate of multiple pregnancy was 6.0% in the clomiphene group, 0% in the metformin group, and 3.1% in the combination-therapy group. The rates of first-trimester pregnancy loss did not differ significantly among the groups. However, the conception rate among subjects who ovulated was significantly lower in the metformin group (21.7%) than in either the clomiphene group (39.5%, P=0.002) or the combinationtherapy group (46.0%, P\u3c0.001). With the exception of pregnancy complications, adverse-event rates were similar in all groups, though gastrointestinal side effects were more frequent, and vasomotor and ovulatory symptoms less frequent, in the metformin group than in the clomiphene group. Conclusions Clomiphene is superior to metformin in achieving live birth in infertile women with the polycystic ovary syndrome, although multiple birth is a complication. (ClinicalTrials.gov number, NCT00068861.

Seismic imaging in Long Valley, California, by surface and borehole techniques: An investigation of active tectonics

The search for silicic magma in the upper crust is converging on the Long Valley Caldera of eastern California, where several lines of geophysical evidence show that an active magma chamber exists at mid‐to lower‐crustal depths. There are also other strong indications that magma may be present at depths no greater than about 5 km below the surface. In this paper, we review the history of the search for magma at Long Valley. We also present the preliminary results from a coordinated suite of seismic experiments, conducted by a consortium of institutions in the summer and fall of 1984, that were designed to refine our knowledge of the upper extent of the magma chamber. Major funding for the experiments was provided by the Geothermal Research Program of the U.S. Geological Survey (USGS) and by the Magma Energy Technology Program of the U.S. Department of Energy (DOE), a program to develop the technology necessary to extract energy directly from crustal magma. Additional funding came from DOE's Office of Basic Energy Sciences and the National Science Foundation (NSF). Also, because extensive use was made of a 0.9‐km‐deep well lent to us by Santa Fe Geothermal, Inc., the project was conducted partly under the auspices of the Continental Scientific Drilling Program (CSDP). As an integrated seismic study of the crust within the caldera that involved the close cooperation of a large number of institutions, the project was moreover viewed as a prototype for future scientific experiments to be conducted under the Program for Array Seismic Studies of the Continental Lithosphere (PASSCAL). The experiment thus represented a unique blend of CSDP and PASSCAL methods, and achieved goals consistent with both programs