Timing and Determinants of Tuberculosis Treatment Interruption in Nairobi County, Kenya

Tuberculosis (TB) treatment is a key pillar in the management and control of TB. Service delivery within the treatment facilities plays an important role in ensuring treatment adherence by TB patients. A prospective cohort study involving 25 health facilities, 25 facility in-charge officers and 291 patients diagnosed as new sputum smear positive (SM+) between December 2014 and July 2015 was undertaken. The aim of the study was to estimate the median time to treatment interruption, associated factors and overall predictors of non-adherence to TB treatment. A total of 19 (6.5%) treatment interruptions were observed. The median time to default was 56 [95% CI, 36-105] days. Treatment in a non-public facility [AOR=0.210, 95% CI (0.046-0.952)] and facilities perceived to have adequate number of health care workers to offer Directly Observed Therapy (DOT) [AOR=0.195, 95% CI (0.068-0.56)] showed a lower odds of treatment interruption whereas attainment of secondary level education [AOR=5.28, 95% CI (1.18-23.59)] indicated a higher odds of treatment interruption. Non-clinical aspects of health care service delivery influence patient adherence to TB treatment. Health seeking behavior of groups considered to be high risk for treatment interruption should be incorporated into the design and delivery of TB treatment

Searching for Machos (and other Dark Matter Candidates) in a Simulated Galaxy

We conduct gravitational microlensing experiments in a galaxy taken from a cosmological N-body simulation. Hypothetical observers measure the optical depth and event rate toward hypothetical LMCs and compare their results with model predictions. Since we control the accuracy and sophistication of the model, we can determine how good it has to be for statistical errors to dominate over systematic ones. Several thousand independent microlensing experiments are performed. When the ``best-fit'' triaxial model for the mass distribution of the halo is used, the agreement between the measured and predicted optical depths is quite good: by and large the discrepancies are consistent with statistical fluctuations. If, on the other hand, a spherical model is used, systematic errors dominate. Even with our ``best-fit'' model, there are a few rare experiments where the deviation between the measured and predicted optical depths cannot be understood in terms of statistical fluctuations. In these experiments there is typically a clump of particles crossing the line of sight to the hypothetical LMC. These clumps can be either gravitationally bound systems or transient phenomena in a galaxy that is still undergoing phase mixing. Substructure of this type, if present in the Galactic distribution of Machos, can lead to large systematic errors in the analysis of microlensing experiments. We also describe how hypothetical WIMP and axion detection experiments might be conducted in a simulated N-body galaxy.Comment: 18 pages of text (LaTeX, AASTeX) with 12 figures. submitted to the Astrophysical Journa

IGNITE4 : Results of a phase 3, randomized, multicenter, prospective trial of eravacycline vs meropenem in the treatment of complicated intraabdominal infections

Funding Information: Financial support. This work was supported by Tetraphase Pharmaceuticals Inc. Funding Information: Potential conflicts of interest. J. S. S. has received support from Tetraphase Pharmaceuticals Inc. during the production of this manuscript and has served as a consultant to Merck, Pfizer, GlaxoSmithKline, and Melinta outside of the submitted work. A. S received support from Tetraphase Pharmaceuticals Inc. during the production of this manuscript. J. G. received research funding from Tetraphase Pharmaceuticals Inc. for his role as principal investigator of this study. K. L. and L. T. are employed by Tetraphase Pharmaceuticals Inc. D. E. reports grants from Tetraphase Pharmaceuticals Inc. during the conduct of the study and grants from Merck outside of the submitted work. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Publisher Copyright: © 2018 The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.Background: Increasing antimicrobial resistance among pathogens that cause complicated intraabdominal infections (cIAIs) supports the development of new antimicrobials. Eravacycline, a novel member of the fluorocycline family, is active against multidrug-resistant bacteria including extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae. Methods: IGNITE4 was a prospective, randomized, double-blind trial. Hospitalized patients with cIAI received either eravacycline 1 mg/kg every 12 hours or meropenem 1 g every 8 hours intravenously for 4-14 days. The primary objective was to demonstrate statistical noninferiority (NI) in clinical cure rates at the test-of-cure visit (25-31 days from start of therapy) in the microbiological intent-to-treat population using a NI margin of 12.5%. Microbiological outcomes and safety were also evaluated. Results: Eravacycline was noninferior to meropenem in the primary endpoint (177/195 [90.8%] vs 187/205 [91.2%]; difference, -0.5%; 95% confidence interval [CI], -6.3 to 5.3), exceeding the prespecified margin. Secondary endpoints included clinical cure rates in the modified ITT population (231/250 [92.4%] vs 228/249 [91.6%]; difference, 0.8; 95% CI, -4.1, 5.8) and the clinically evaluable population (218/225 [96.9%] vs 222/231 [96.1%]; (difference, 0.8; 95% CI -2.9, 4.5). In patients with ESBL-producing Enterobacteriaceae, clinical cure rates were 87.5% (14/16) and 84.6% (11/13) in the eravacycline and meropenem groups, respectively. Eravacycline had relatively low rates of adverse events for a drug of this class, with less than 5%, 4%, and 3% of patients experiencing nausea, vomiting, and diarrhea, respectively. Conclusions: Treatment with eravacycline was noninferior to meropenem in adult patients with cIAI, including infections caused by resistant pathogens. Clinical Trials Registration: NCT01844856.publishersversionPeer reviewe

Identification of Vehicle Health Assurance Related Trends

Trend analysis in aviation as related to vehicle health management (VHM) was performed by reviewing the most current statistical and prognostics data available from the National Transportation Safety Board (NTSB) accident, the Federal Aviation Administration (FAA) incident, and the NASA Aviation Safety Reporting System (ASRS) incident datasets. In addition, future directions in aviation technology related to VHM research areas were assessed through the Commercial Aviation Safety Team (CAST) Safety Enhancements Reserved for Future Implementations (SERFIs), the National Transportation Safety Board (NTSB) Most-Wanted List and recent open safety recommendations, the National Research Council (NRC) Decadal Survey of Civil Aeronautics, and the Future Aviation Safety Team (FAST) areas of change. Future research direction in the VHM research areas is evidently strong as seen from recent research solicitations from the Naval Air Systems Command (NAVAIR), and VHM-related technologies actively being developed by aviation industry leaders, including GE, Boeing, Airbus, and UTC Aerospace Systems. Given the highly complex VHM systems, modifications can be made in the future so that the Vehicle Systems Safety Technology Project (VSST) technical challenges address inadequate maintenance crew's trainings and skills, and the certification methods of such systems as recommended by the NTSB, NRC, and FAST areas of change

The Arecibo Arp 220 Spectral Census I: Discovery of the Pre-Biotic Molecule Methanimine and New Cm-wavelength Transitions of Other Molecules

An on-going Arecibo line search between 1.1 and 10 GHz of the prototypical starburst/megamaser galaxy, Arp 220, has revealed a spectrum rich in molecular transitions. These include the ``pre-biotic'' molecules: methanimine (CH$_{2}$NH) in emission, three $v_{2}=1$ direct l-type absorption lines of HCN, and an absorption feature likely to be from either $^{18}$OH or formic acid (HCOOH). In addition, we report the detection of two, possibly three, transitions of $\lambda$4-cm excited OH not previously detected in Arp~220 which are seen in absorption, and a possible absorption feature from the 6.668-GHz line of methanol. This marks the first distant extragalactic detection of methanimine, a pre-biotic molecule. Also, if confirmed, the possible methanol absorption line presented here would represent the first extragalactic detection of methanol at a distance further than 10 Mpc. In addition, the strong, previously undetected, cm-wave HCN $v_{2}=1$ direct l-type lines will aid the study of dense molecular gas and active star-forming regions in this starburst galaxy.Comment: 25 pages, 10 figures. Accepted for publication in A

Duality of Non-Supersymmetric Large N Gauge Theories

Starting from Seiberg's electric-magnetic duality for supersymmetric QCD, we construct dual pairs of non-supersymmetric gauge theories. This is accomplished by first taking the large N limit of supersymmetric QCD and its dual partner and then performing a special ``orbifold projection'' recently introduced by Kachru and Silverstein. We argue that in the large N limit the two projected theories remain dual. The non-supersymmetric gauge theories which can be studied in this fashion have non-supersymmetric field content, chiral fermions and exactly massless scalar matter.Comment: 27 pages, 4 figure

New Near-Infrared Spectroscopy of the High Redshift Quasar B 1422+231 at z=3.62

We present new near-infrared (rest-frame UV-to-optical) spectra of the high redshift, gravitationally lensed quasar B 1422+231 (z=3.62). Diagnostic emission lines of FeII, [OIII]5007, and Hb, commonly used to determine the excitation, ionization, and chemical abundances of radio-quiet and radio-loud quasars, were detected. Our new data show that the ratio FeII(UV)/Hb=18.1+-4.6 and FeII(optical)/Hb=2.3+-0.6 are higher than those reported by Kawara et al. (1996) by factors of 1.6 and 3.3, respectively, although the ration [OIII]5007/Hb=0.19+-0.02 is nearly the same between the two measurements. The discrepancy of the line flux ratios between the measurements is likely due to improved data and fitting procedures rather that to intrinsic variability. While approximately half of the high-z quasars observed to date have much more extreme FeII(optical)/Hb ratios, the line ratio measured for B 422+231 are consistent with the observed range of FeII(optical) ratios of low-z quasars.Comment: 5 pages, 1 table, 4 figures. To appear in The Astronomical Journa

Identification of Crew-Systems Interactions and Decision Related Trends

NASA Vehicle System Safety Technology (VSST) project management uses systems analysis to identify key issues and maintain a portfolio of research leading to potential solutions to its three identified technical challenges. Statistical data and published safety priority lists from academic, industry and other government agencies were reviewed and analyzed by NASA Aviation Safety Program (AvSP) systems analysis personnel to identify issues and future research needs related to one of VSST's technical challenges, Crew Decision Making (CDM). The data examined in the study were obtained from the National Transportation Safety Board (NTSB) Aviation Accident and Incident Data System, Federal Aviation Administration (FAA) Accident/Incident Data System and the NASA Aviation Safety Reporting System (ASRS). In addition, this report contains the results of a review of safety priority lists, information databases and other documented references pertaining to aviation crew systems issues and future research needs. The specific sources examined were: Commercial Aviation Safety Team (CAST) Safety Enhancements Reserved for Future Implementation (SERFIs), Flight Deck Automation Issues (FDAI) and NTSB Most Wanted List and Open Recommendations. Various automation issues taxonomies and priority lists pertaining to human factors, automation and flight design were combined to create a list of automation issues related to CDM