University Leadership for Innovation in Global Health and HIV/AIDS Diagnostics

Medical products used in the developed world often fail to adequately serve resource-limited settings where electricity, transportation and health care workers are not readily available. We suggest that the problem is not only a lack of coordinated financial resources to purchase existing medical products, but also a lack of products that are specifically designed for resource-limited settings. While donor organisations with a focus on global health are increasingly willing to bear the additional financial risk for the research and development of such high-impact medical products, corporations are still reluctant to take their best scientists and engineers away from more commercially attractive projects. Universities, on the other hand, given their teaching and research missions, are well positioned to engage in such high-risk development projects. A group of biomedical, engineering, business and social science researchers at Northwestern University (NU) propose a creative model to address significant social and health needs. The team's initial product focus is a rapid test for diagnosing infants with HIV. The NU model aligns the incentives and expertise of industry, donors and academia to innovate medical products, such as the infant HIV diagnostic test, for resource-limited settings

The X-ray Position and Optical Counterpart of the Accretion-Powered Millisecond Pulsar XTE J1814-338

We report the precise optical and X-ray localization of the 3.2 ms accretion-powered X-ray pulsar XTE J1814-338 with data from the Chandra X-Ray Observatory as well as optical observations conducted during the 2003 June discovery outburst. Optical imaging of the field during the outburst of this soft X-ray transient reveals an R = 18 star at the X-ray position. This star is absent (R > 20) from an archival 1989 image of the field and brightened during the 2003 outburst, and we therefore identify it as the optical counterpart of XTE J1814-338. The best source position derived from optical astrometry is R.A. = 18h13m39.s04, Dec.= -33d46m22.3s (J2000). The featureless X-ray spectrum of the pulsar in outburst is best fit by an absorbed power-law (with photon index = 1.41 +- 0.06) plus blackbody (with kT = 0.95 +- 0.13 keV) model, where the blackbody component contributes approximately 10% of the source flux. The optical broad-band spectrum shows evidence for an excess of infrared emission with respect to an X-ray heated accretion disk model, suggesting a significant contribution from the secondary or from a synchrotron-emitting region. A follow-up observation performed when XTE J1814-338 was in quiescence reveals no counterpart to a limiting magnitude of R = 23.3. This suggests that the secondary is an M3 V or later-type star, and therefore very unlikely to be responsible for the soft excess, making synchroton emission a more reasonable candidate.Comment: Accepted for publication in ApJ. 6 pages; 3 figure

Presyncope Is Associated with Intensive Care Unit Admission in Emergency Department Patients with Acute Pulmonary Embolism

Introduction: Syncope is common among emergency department (ED) patients with acute pulmonary embolism (PE) and indicates a higher acuity and worse prognosis than in patients without syncope. Whether presyncope carries the same prognostic implications has not been established. We compared incidence of intensive care unit (ICU) admission in three groups of ED PE patients: those with presyncope; syncope; and neither.Methods: This retrospective cohort study included all adults with acute, objectively confirmed PE in 21 community EDs from January 2013–April 2015. We combined electronic health record extraction with manual chart abstraction. We used chi-square test for univariate comparisons and performed multivariate analysis to evaluate associations between presyncope or syncope and ICU admission from the ED, reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI).Results: Among 2996 PE patients, 82 (2.7%) had presyncope and 109 (3.6%) had syncope. ICU admission was similar between groups (presyncope 18.3% vs syncope 25.7%) and different than their non-syncope counterparts (either 22.5% vs neither 4.7%; p<0.0001). On multivariate analysis, both presyncope and syncope were independently associated with ICU admission, controlling for demographics, higher-risk PE Severity Index (PESI) class, ventilatory support, proximal clot location, and submassive and massive PE classification: presyncope, aOR 2.79 (95% CI, 1.40, 5.56); syncope, aOR 4.44 (95% CI 2.52, 7.80). These associations were only minimally affected when excluding massive PE from the model. There was no significant interaction between either syncope or presyncope and PESI, submassive or massive classification in predicting ICU admission.Conclusion: Presyncope appears to carry similar strength of association with ICU admission as syncope in ED patients with acute PE. If this is confirmed, clinicians evaluating patients with acute PE may benefit from including presyncope in their calculus of risk assessment and site-of-care decision-making

On Perturbations in Warm Inflation

Warm inflation is an interesting possibility of describing the early universe, whose basic feature is the absence, at least in principle, of a preheating or reheating phase. Here we analyze the dynamics of warm inflation generalizing the usual slow-roll parameters that are useful for characterizing the inflationary phase. We study the evolution of entropy and adiabatic perturbations, where the main result is that for a very small amount of dissipation the entropy perturbations can be neglected and the purely adiabatic perturbations will be responsible for the primordial spectrum of inhomogeneities. Taking into account the COBE-DMR data of the cosmic microwave background anisotropy as well as the fact that the interval of inflation for which the scales of astrophysical interest cross outside the Hubble radius is about 50 e-folds before the end of inflation, we could estimate the magnitude of the dissipation term. It was also possible to show that at the end of inflation the universe is hot enough to provide a smooth transition to the radiation era.Comment: 12 pages, no figures, requires revtex4. Further explanation on the origin of the entropy perturbation, reference added and minor notation change. Version accepted for publication in Phys. Rev.

The Imprint of Gravitational Waves in Models Dominated by a Dynamical Cosmic Scalar Field

An alternative to the standard cold dark matter model has been recently proposed in which a significant fraction of the energy density of the universe is due to a dynamical scalar field ($Q$) whose effective equation-of-state differs from that of matter, radiation or cosmological constant ($\Lambda$). In this paper, we determine how the Q-component modifies the primordial inflation gravitational wave (tensor metric) contribution to the cosmic microwave background anisotropy and, thereby, one of the key tests of inflation.Comment: 15 pages, 14 figures, revtex, submitted to Phys. Rev.

Model Independent Predictions of Big Bang Nucleosynthesis from \he4 and \li7: Consistency and Implications

We examine in detail how BBN theory is constrained, and what predictions it can make, when using only the most model-independent observational constraints. We avoid the uncertainties and model-dependencies that necessarily arise when solar neighborhood D and \he3 abundances are used to infer primordial D and \he3 via chemical and stellar evolution models. Instead, we use \he4 and \li7, thoroughly examining the effects of possible systematic errors in each. Via a likelihood analysis, we find near perfect agreement between BBN theory and the most model-independent data. Given this agreement, we then {\it assume} the correctness of BBN to set limits on the single parameter of standard BBN, the baryon-to-photon ratio, and to predict the primordial D and \he3 abundances. We also repeat our analysis including recent measurements of D/H from quasar absorption systems and find that the near perfect agreement between theory and observation of the three isotopes, D, \he4 and \li7 is maintained. These results have strong implications for the chemical and stellar evolution of the light elements, in particular for \he3. In addition, our results (especially if the D/H measurements are confirmed) have implications for the stellar depletion of \li7. Finally, we set limits on the number \nnu\ of neutrino flavors, using an analysis which carefully and systematically includes all available experimental constraints. The value \nnu = 3.0 fits best with BBN and a 95\% CL upper limit of \nnu \la 4 is established.Comment: 28 pages, latex, 10 ps figure

Inelastic Dark Matter

Many observations suggest that much of the matter of the universe is non-baryonic. Recently, the DAMA NaI dark matter direct detection experiment reported an annual modulation in their event rate consistent with a WIMP relic. However, the Cryogenic Dark Matter Search (CDMS) Ge experiment excludes most of the region preferred by DAMA. We demonstrate that if the dark matter can only scatter by making a transition to a slightly heavier state (Delta m ~ 100kev), the experiments are no longer in conflict. Moreover, differences in the energy spectrum of nuclear recoil events could distinguish such a scenario from the standard WIMP scenario. Finally, we discuss the sneutrino as a candidate for inelastic dark matter in supersymmetric theories.Comment: 20 pages, 6 figure

Quantum strategies

We consider game theory from the perspective of quantum algorithms. Strategies in classical game theory are either pure (deterministic) or mixed (probabilistic). We introduce these basic ideas in the context of a simple example, closely related to the traditional Matching Pennies game. While not every two-person zero-sum finite game has an equilibrium in the set of pure strategies, von Neumann showed that there is always an equilibrium at which each player follows a mixed strategy. A mixed strategy deviating from the equilibrium strategy cannot increase a player's expected payoff. We show, however, that in our example a player who implements a quantum strategy can increase his expected payoff, and explain the relation to efficient quantum algorithms. We prove that in general a quantum strategy is always at least as good as a classical one, and furthermore that when both players use quantum strategies there need not be any equilibrium, but if both are allowed mixed quantum strategies there must be.Comment: 8 pages, plain TeX, 1 figur