Improved Constraints on Primordial Gravitational Waves using Planck, WMAP, and BICEP/Keck Observations through the 2018 Observing Season.

We present results from an analysis of all data taken by the BICEP2, Keck Array, and BICEP3 CMB polarization experiments up to and including the 2018 observing season. We add additional Keck Array observations at 220 GHz and BICEP3 observations at 95 GHz to the previous 95/150/220 GHz dataset. The Q/U maps now reach depths of 2.8, 2.8, and 8.8 µK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈600 square degrees at 95 GHz and ≈400 square degrees at 150 and 220 GHz. The 220 GHz maps now achieve a signal-to-noise ratio on polarized dust emission exceeding that of Planck at 353 GHz. We take auto- and cross-spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz and evaluate the joint likelihood of the spectra versus a multicomponent model of lensed ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and no longer requires a prior on the frequency spectral index of the dust emission taken from measurements on other regions of the sky. This model is an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.036 at 95% confidence. Running maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.009. These are the strongest constraints to date on primordial gravitational waves.

Constraints on Primordial Gravitational Waves Using Planck, WMAP, and New BICEP2/Keck Observations through the 2015 Season.

We present results from an analysis of all data taken by the bicep2/Keck CMB polarization experiments up to and including the 2015 observing season. This includes the first Keck Array observations at 220 GHz and additional observations at 95 and 150 GHz. The Q and U maps reach depths of 5.2, 2.9, and 26 µK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈400 square degrees. The 220 GHz maps achieve a signal to noise on polarized dust emission approximately equal to that of Planck at 353 GHz. We take auto and cross spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz. We evaluate the joint likelihood of the spectra versus a multicomponent model of lensed-ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and we impose priors on some of these using external information from Planck and WMAP derived from larger regions of sky. The model is shown to be an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.07 at 95% confidence, which tightens to r_{0.05}<0.06 in conjunction with Planck temperature measurements and other data. The lensing signal is detected at 8.8σ significance. Running a maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.020. These are the strongest constraints to date on primordial gravitational waves.

Prevention of complications in glycogen storage disease type Ia with optimization of metabolic control.

Prior to 1971, type Ia glycogen storage disease was marked by life-threatening hypoglycemia, lactic acidosis, severe failure to thrive, and developmental delay. With the introduction of continuous feeds in the 1970s and cornstarch in the 1980s, the prognosis improved, but complications almost universally developed. Changes in the management of type Ia glycogen storage disease have resulted in improved metabolic control, and this manuscript reviews the increasing evidence that complications can be delayed or prevented with optimal metabolic control as previously was seen in diabetes.

Improved Constraints on Cosmology and Foregrounds from BICEP2 and Keck Array Cosmic Microwave Background Data with Inclusion of 95 GHz Band.

We present results from an analysis of all data taken by the BICEP2 and Keck Array cosmic microwave background (CMB) polarization experiments up to and including the 2014 observing season. This includes the first Keck Array observations at 95 GHz. The maps reach a depth of 50 nK deg in Stokes Q and U in the 150 GHz band and 127 nK deg in the 95 GHz band. We take auto- and cross-spectra between these maps and publicly available maps from WMAP and Planck at frequencies from 23 to 353 GHz. An excess over lensed ΛCDM is detected at modest significance in the 95×150 BB spectrum, and is consistent with the dust contribution expected from our previous work. No significant evidence for synchrotron emission is found in spectra such as 23×95, or for correlation between the dust and synchrotron sky patterns in spectra such as 23×353. We take the likelihood of all the spectra for a multicomponent model including lensed ΛCDM, dust, synchrotron, and a possible contribution from inflationary gravitational waves (as parametrized by the tensor-to-scalar ratio r) using priors on the frequency spectral behaviors of dust and synchrotron emission from previous analyses of WMAP and Planck data in other regions of the sky. This analysis yields an upper limit r_{0.05}<0.09 at 95% confidence, which is robust to variations explored in analysis and priors. Combining these B-mode results with the (more model-dependent) constraints from Planck analysis of CMB temperature plus baryon acoustic oscillations and other data yields a combined limit r_{0.05}<0.07 at 95% confidence. These are the strongest constraints to date on inflationary gravitational waves.

Birth month and risk of atopic dermatitis: a nationwide population-based study.

BACKGROUND: An individual's birth month has been associated with allergic diseases, but little is known about the association between birth month and atopic dermatitis (AD). OBJECTIVE: The aim of this study was to investigate the risk of AD in children born in various months. METHODS: Using Taiwan's National Health Insurance Research Database, we conducted a case-control study that included 31 237 AD cases and 124 948 age- and gender-matched controls without AD. Data regarding sociodemographic factors and coexisting medical conditions were collected and controlled in the multivariate logistic regression to determine the adjusted odds ratios and 95% confidence intervals for AD associated with the participant's birth month. RESULTS: Compared with people born in May, people born in December had the highest risk of AD (OR 1.17, 95% CI 1.10-1.25), followed by people born in October (OR 1.15, 95% CI 1.08-1.22) and November (OR 1.13, 95% CI 1.06-1.20). Low income (OR 1.28), asthma (OR 1.88), allergic rhinitis (OR 1.70), psoriasis (OR 2.36), vitiligo (OR 1.99), urticaria (OR 2.14), and systemic lupus erythematosus (OR 1.91) were significant coexisting medical conditions associated with AD. CONCLUSION: Being born in December, October, or November may be associated with an increased risk of AD. Future investigations are needed to evaluate the possible mechanism behind the association between birth month and AD.

Detection of B-mode polarization at degree angular scales by BICEP2.

We report results from the BICEP2 experiment, a cosmic microwave background (CMB) polarimeter specifically designed to search for the signal of inflationary gravitational waves in the B-mode power spectrum around ℓ∼80. The telescope comprised a 26 cm aperture all-cold refracting optical system equipped with a focal plane of 512 antenna coupled transition edge sensor 150 GHz bolometers each with temperature sensitivity of ≈300 µK(CMB)√s. BICEP2 observed from the South Pole for three seasons from 2010 to 2012. A low-foreground region of sky with an effective area of 380 square deg was observed to a depth of 87 nK deg in Stokes Q and U. In this paper we describe the observations, data reduction, maps, simulations, and results. We find an excess of B-mode power over the base lensed-ΛCDM expectation in the range 30 < ℓ < 150, inconsistent with the null hypothesis at a significance of >5σ. Through jackknife tests and simulations based on detailed calibration measurements we show that systematic contamination is much smaller than the observed excess. Cross correlating against WMAP 23 GHz maps we find that Galactic synchrotron makes a negligible contribution to the observed signal. We also examine a number of available models of polarized dust emission and find that at their default parameter values they predict power ∼(5-10)× smaller than the observed excess signal (with no significant cross-correlation with our maps). However, these models are not sufficiently constrained by external public data to exclude the possibility of dust emission bright enough to explain the entire excess signal. Cross correlating BICEP2 against 100 GHz maps from the BICEP1 experiment, the excess signal is confirmed with 3σ significance and its spectral index is found to be consistent with that of the CMB, disfavoring dust at 1.7σ. The observed B-mode power spectrum is well fit by a lensed-ΛCDM+tensor theoretical model with tensor-to-scalar ratio r = 0.20_(-0.05)(+0.07), with r = 0 disfavored at 7.0σ. Accounting for the contribution of foreground, dust will shift this value downward by an amount which will be better constrained with upcoming data sets.

Outcomes of an early childhood obesity prevention program in a low-income community: a pilot, randomized trial.

BACKGROUND: Obesity is a major and worldwide health problem in children. OBJECTIVES: The Early Childhood Obesity Prevention Program is a multi-component, randomized, controlled trial of a pilot community-focused obesity prevention program for mother/newborn dyads. METHODS: Underserved, mother/newborn dyads were recruited to receive a standard home visitation program (Nurturing Families Network, NFN) or an enhanced program (NFN+) that incorporated behavioural change strategies (e.g., goal-setting, problem-solving) and focused on six obesity-associated behaviours (breastfeeding, juice/sugar-sweetened beverages, solids, infant sleep, TV/screen time and soothability) with linkages to community resources. Weight-for-length (WFL) z-score and maternal diet were secondary outcomes. RESULTS: Fifty-seven dyads were recruited and 47 fully eligible dyads were enrolled (NFN = 21, NFN+ = 26). Forty-one (87.2%) were assessed at 6 months and 34 (72.3%) at 12 months. Retention at 12 months was higher for NFN+ dyads (84.6% vs. 56.1%, p = 0.04). NFN+ mothers were more likely to continue breastfeeding at 6 and 12 months vs. NFN mothers (p = 0.03 and 0.003, respectively), and at 12 months, NFN+ infants had fewer nocturnal awakenings (p = 0.04). There were no differences in other primary outcome measures or in WFL z-score at 6 or 12 months. CONCLUSIONS: A multi-component behavioural intervention increased breastfeeding duration and decreased nocturnal awakenings in infants of low-income families.

Cloning of Saccharomyces cerevisiae DNA replication genes: isolation of the CDC8 gene and two genes that compensate for the cdc8-1 mutation.

The CDC8 gene, whose product is required for DNA replication in Saccharomyces cerevisiae, has been isolated on recombinant plasmids. The yeast vector YCp50 bearing the yeast ARS1, CEN4, and URA3 sequences, to provide for replication, stability, and selection, respectively, was used to prepare a recombinant plasmid pool containing the entire yeast genome. Plasmids capable of complementing the temperature-sensitive cdc8-1 mutation were isolated by transformation of a cdc8-1 mutant and selection for clones able to grow at the nonpermissive temperature. The entire complementing activity is carried on a 0.75-kilobase fragment, as revealed by deletion mapping. This fragment lies 1 kilobase downstream from the well-characterized sup4 gene, a gene known to be genetically linked to CDC8, thus confirming that the cloned gene corresponds to the chromosomal CDC8 gene. Two additional recombinant plasmids that complement the cdc8-1 mutation but that do not contain the 0.75-kilobase fragment or any flanking DNA were also identified in this study. These plasmids may contain genes that compensate for the lack of CDC8 gene product.

B-group vitamins, MTHFR C677T polymorphism and carotid intima-media thickness in clinically healthy subjects.

OBJECTIVE: Plasma B-group vitamins and age may affect the carotid intima-media thickness (IMT) in subjects with different 677TT genotype of the methylenetetrahydrofolate reductase (MTHFR) gene. DESIGN: A hospital-based cross-study. SETTING: Genomic and Vascular Center, Changhua Christian Hospital, Changhua, Taiwan. SUBJECTS: Five hundred and forty-one clinically healthy subjects. INTERVENTION: Fasting plasma, homocysteine (Hcy), vitamin B(6), vitamin B(12), folate and B-mode carotid ultrasound. RESULTS: MTHFR genotype, plasma concentrations of folate, vitamin B(6) and vitamin B(12) and age were significantly correlated to the plasma Hcy concentration. MTHFR 677TT carriers had higher concentrations of Hcy than did subjects with the CC and CT genotypes. Age, sex, body mass index and plasma Hcy were independent contributors to increase carotid IMT. However, with stratification by mean value of age and B-group vitamins concentrations, we found that at advanced age, lower plasma folate and vitamin B(12) were three risk factors involved in the enhancing effect of the MTHFR 677TT genotype on the increase of plasma Hcy and carotid IMT. CONCLUSION: MTHFR 677TT-related carotid atherosclerosis was only identified in healthy elderly subjects with lower level of plasma folate and vitamin B(12). SPONSORSHIP: Changhua Christian Hospital.

Development of separation techniques for analysis of Nb-94 in radwaste samples.

A chemical separation technique for removing interfering gamma-ray radionuclides by combined precipitation of Nb pentoxide and anion exchange was proposed, thereby allowing detection of trace 94Nb in low-level radwastes. The detection limit for 94Nb was improved by a factor of 10-103, and the scaling factor (94Nb/60Co) of the radwastes was estimated to be less than 10-5. This technique can be used for low-level radwaste classification and power reactor decommissioning.

Modified alar base cinch suture fixation at the bilateral lower border of the piriform rim after a maxillary Le Fort I osteotomy.

Classic cinch suture narrowing of the nasal alar base by medially suturing the bilateral nasolabial soft tissue with one long suture has a limited effect. The modified cinch method described in the present study anchors non-absorbable sutures to the bilateral lower border of the piriform rim and provides optimal direction, position, and stability. The sutures can be shortened and the strength kept stable while the surgical wounds heal. Separate bilateral sutures can also reduce interference and distortion from nasotracheal intubation and make the nasolabial profile more symmetrical. Seventeen consecutive cases of maxillary Le Fort I osteotomy were analyzed. The nasal and alar base width changes were 0.4±1.2mm and 0.1±1.1mm, respectively, and the widening rate was only 1.1%. Compared with the results of other studies, postoperative nasal flaring was well controlled using the modified cinch suture anchored to the bilateral lower border of the piriform rim described in this study.

In vitro and in vivo killing of ocular Demodex by tea tree oil.

AIMS: To compare the in vitro killing effect of different agents on Demodex and to report the in vivo killing effect of tea tree oil (TTO) on ocular Demodex. METHODS: Survival time of Demodex was measured under the microscope. Sampling and counting of Demodex was performed by a modified method. RESULTS: Demodex folliculorum survived for more than 150 minutes in 10% povidone-iodine, 75% alcohol, 50% baby shampoo, and 4% pilocarpine. However, the survival time was significantly shortened to within 15 minutes in 100% alcohol, 100% TTO, 100% caraway oil, or 100% dill weed oil. TTO's in vitro killing effect was dose dependent. Lid scrub with 50% TTO, but not with 50% baby shampoo, can further stimulate Demodex to move out to the skin. The Demodex count did not reach zero in any of the seven patients receiving daily lid scrub with baby shampoo for 40-350 days. In contrast, the Demodex count dropped to zero in seven of nine patients receiving TTO scrub in 4 weeks without recurrence. CONCLUSIONS: Demodex is resistant to a wide range of antiseptic solutions. Weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo is effective in eradicating ocular Demodex.

Risk of decline and chance of improvement in olfaction among patients with post-traumatic olfactory loss.

OBJECTIVE: To evaluate the chance of improvement and risk of decline in olfaction among patients with post-traumatic olfactory loss. METHODS: This study comprised 80 patients. Changes in olfaction were determined using a visual analogue scale and the 'Sniffin' Sticks' test. Logistic regression was used to identify predictors for olfactory changes. RESULTS: Olfactory changes were observed in 9-35 per cent of patients. The rates of improvement and decline according to visual analogue scale scores were 35 per cent and 10 per cent respectively, whereas those in the Sniffin' Sticks test were 9 per cent and 11 per cent respectively. There was a predictive link between non-anosmia and decline in Sniffin' Sticks test scores (odds ratio = 16.61, p = 0.003). A positive correlation was observed between the scores in the first and last examinations (rho = 0.532, p < 0.001). CONCLUSION: Patients should be informed that they may experience an improvement or decline in olfaction following post-traumatic olfactory dysfunction. This study provides evidence to support comprehensive counselling regarding prognosis as an integral part of management strategies.

Berberine complexes with DNA in the berberine-induced apoptosis in human leukemic HL-60 cells.

Berberine, an alkaloid initially isolated from Chinese herbal medicine exhibited the ability to induce morphological changes and internucleosomal DNA fragmentation, characteristic of apoptosis in promyelocytic leukemia HL-60 cells. Cell cycle studies showed that only about 20% of the cells underwent apoptosis at the early time (6 h) of berberine (25 micrograms/ml) treatment; these appeared to be cells in S phase at the time of berberine treatment. At extended time (6-48 h), cells were cell cycle arrested, the number of cells of each phase, particularly the cells of S phase decreased and much more (> 50%) of the cells appeared with DNA content less than G1. Attempts were also made to isolate possible berberine-DNA complexes from cell cultures treated with berberine (25 micrograms/ml; 2-24 h). Shifts of absorption maxima of berberine in the direction of longer wavelengths were observed in the isolated berberine-DNA complexes. Palmatine, an analog of berberine, which was not able to induce apoptosis, also complexed with DNA in cells treated with palmatine (25 micrograms/ml; 2-24 h). Our results suggest that some important cellular processes other than the intracellular DNA-interacting action of berberine may be involved in the berberine-induced apoptosis in HL-60 cells.

Studies on human serum paraoxonase/arylesterase.

The complete amino acid sequence of human serum paraoxonase/arylesterase and the DNA sequence coding for that protein have recently been determined in two independent laboratories. There is now considerable evidence that the esterase exists in two genetically determined allozymic forms, and these A and B allozymes possess both paraoxonase and arylesterase activities. The B-type esterase has relatively higher paraoxonase activity and is stimulated to a greater degree by 1 M NaCl than the A allozyme. The structural basis for the distinctive isozymic properties is a single nucleotide base at position 572. Codon 191 is CAA (for glutamine) in the A-type esterase, and CGA (for arginine) in the B-type enzyme. There is a second polymorphic site which affects amino acid 54; this can be either methionine or leucine, but these alternatives have not been found to affect either the level or the quality of the allozymes. Purified A or B-type esterases are stimulated by the addition of phosphatidylcholine. The latter addition increases the maximum velocity rate, but does not alter the Km of the reaction with either paraoxon or phenylacetate. In serum, the esterase is tightly bound to the high density lipoproteins, particularly apo A-1, but the importance of this association as far as the stability and catalytic properties of the esterase is not clear, and still under study. No physiological role of the esterase has been established, but its ability to hydrolyze several potent organophosphates may be of some significance in protecting against organophosphate toxicity.

Epidural catheter placement in the rabbit--a novel approach.

BACKGROUND: Using a pediatric epidural set and through caudal approach, we studied a relatively non-invasive technique for epidural percutaneous cannulation in rabbit for chronic laboratory investigations. METHODS: Ten rabbits weighing over 3 kg were chosen and anesthetized with intravenous pentothal. A #19 pediatric Touhy needle and 23-gauge catheter were used for cannulation. Via the caudal approach, the epidural space could be located either by a "give" or with a technique of loss of resistance. Under fluoroscopy the catheter was tested with the injection of contrast medium for the confirmation of the proper position. The catheter was then tunneled under the skin and secured. The rabbits were kept in standard care for 4 weeks and then sacrificed by intraperitoneal pentothal overdose. A pathologist blinded to the study carefully examined the whole spine by laminectomy from cervical to coccyx and the findings were recorded. RESULTS: With the injection of contrast medium, the final position of the catheter was validated by fluoroscopy in all rabbits. Two rabbits sustained immediate complications from the contrast medium and/or technique, of which one died shortly after the contrast medium injection and the other had weakness of the hind legs for a week. At sacrifice, all the catheters were found in good position. Two had hematoma associated with signs of trauma. One developed subcutaneous abscess. One had stitch infection of skin. CONCLUSIONS: Percutaneous cannulation of epidural catheter is possible in the rabbit. Complications could be ameliorated by prudent approach in a skillful hand. It can be a reasonable model for the study of centrally administered medicines and their neurotoxicity.

Unusual coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis: a diagnostic dilemma.

OBJECTIVE: We report a rare case of concurrent myeloid sarcoma and acute fulminant invasive fungal sinusitis in a patient with relapsed acute myeloid leukaemia. CASE REPORT: A 73-year-old man was diagnosed with acute myeloid leukaemia and developed relapse one year later. After two courses of azacytidine, he began suffering from a dull pain in the left temporal and orbital regions. Sinus computed tomography showed a localised lesion in the left ethmoid sinus, which rapidly progressed to an extensive intracranial mass within one month. Surgical debridement was performed, and histopathological analysis revealed the coexistence of myeloid sarcoma and acute fulminant invasive fungal sinusitis. The patient responded well to prompt surgical debridement, antifungal medication and radiotherapy. CONCLUSION: Coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis poses an urgent diagnostic and management challenge to clinicians. Timely recognition of this rare comorbid condition is warranted as application of appropriate treatment can save lives.

Chinese perspectives on culture and mental health.

Central to providing culturally appropriate nursing care is sensitivity to and knowledge about the group being cared for. Although "mental health" and "mental illness" are artificial concepts among people who do not differentiate and treat mind, body, and spirit separately, and who may not differentiate illness from other problems of living, many individuals ethnically rooted in one or more Asian cultures enter Western mental health care systems. Quality nursing care requires understanding and respect for traditional values, beliefs, and practices that may differ significantly from those typical of Western European-based societies. Whether clients are traditional in orientation or highly acculturated to Western ways, nurses are responsible for providing culturally appropriate care. This article discusses mental health and nursing care from various perspectives of Asian and Asian-American clients, and in particular those of Chinese descent.

Antigen/major histocompatibility complex-specific activation of murine T cells transfected with functionally rearranged T-cell receptor genes.

The genes encoding the alpha and beta chains of the T-cell antigen receptor isolated from a cytochrome c-specific, major histocompatibility complex (MHC)-restricted murine T-cell hybridoma were introduced into a mouse T-cell line of helper lineage by electroporation. In order to examine the contributions of those gene products to antigen and/or MHC specificity, the resultant transfectants were tested for functional antigen and/or MHC recognition. Only those transfectants that express both the introduced genes (alpha and beta) contributed by the normal T cell can respond specifically to the appropriate antigen/MHC pair. None of the transfectants that express only one of the introduced genes (alpha or beta) of the normal T cell, or paired hybrid genes (i.e., one gene from the normal T cell and the other from the fusion partner), can respond to the same combination of antigen and MHC product recognized by the donor T cell. However, one clone expressing the transfected genes that encode the alpha and beta chains of the fusion partner shows reactivity to the antigen-presenting cells even in the absence of the antigens. These data suggest that the alpha beta heterodimer of the T-cell receptor is required to define the fine specificity of a T cell.