Pre-clinical development of a combination microbicide vaginal ring containing dapivirine and darunavir

Objectives: Combination microbicide vaginal rings may be more effective than single microbicide rings at reducing/preventing sexual transmission of HIV. Here, we report the preclinical development and macaque pharmacokinetics of matrix-type silicone elastomer vaginal rings containing dapivirine and darunavir.

Methods: Macaque rings containing 25 mg dapivirine, 300 mg darunavir and 100 mg dapivirine, and 300 mg darunavir were manufactured and characterised by differential scanning calorimetry. In vitro release was assessed into isopropanol/water and simulated vaginal fluid. Macaque vaginal fluid and blood serum concentrations for both antiretrovirals were measured during 28-day ring use. Tissue levels were measured on day 28. Ex vivo challenge studies were performed on vaginal fluid samples and IC50 values calculated.

Results: Darunavir caused a concentration-dependent reduction in the dapivirine melting temperature in both solid drug mixes and in the combination ring. In vitro release from rings was dependent on drug loading, the number of drugs present, and the release medium. In macaques, serum concentrations of both microbicides were maintained between 101–102 pg/mL. Vaginal fluid levels ranged between 103–104 ng/g and 104–105 ng/g for dapivirine and darunavir, respectively. Tissue concentrations ranges for each drug were: vagina (1.8×103–3.8×103 ng/g) > cervix (9.4×101–3.9×102 ng/g) > uterus (0–108 ng/g) > rectum (0–40 ng/g). Measured IC50 values were > 2 ng/mL for both compounds.

Conclusions: Based on these results, and in light of recent clinical progress of the 25mg dapivirine ring, a combination vaginal ring containing dapivirine and darunavir is a viable second-generation HIV microbicide candidate.

The role of adiposity in cardiometabolic traits:a Mendelian randomization analysis

The association between adiposity and cardiometabolic traits is well known from epidemiological studies. Whilst the causal relationship is clear for some of these traits, for others it is not. We aimed to determine whether adiposity is causally related to various cardiometabolic traits using the Mendelian randomization approach.

Molecular basis of non-mutational derepression of ramA in Klebsiella pneumoniae

Objectives: The ram locus, consisting of the romA–ramA genes, is repressed by the tetracycline-type regulator RamR, where regulation is abolished due to loss-of-function mutations within the protein or ligand interactions. The aim of this study was to determine whether the phenothiazines (chlorpromazine and thioridazine) directly interact with RamR to derepress ramA expression.

Methods: Quantitative real-time PCR analyses were performed to determine expression levels of the romA–ramA genes after exposure to the phenothiazines. Electrophoretic mobility shift assays (EMSAs) and in vitro transcription experiments were performed to show direct binding to and repression by RamR. Direct binding of the RamR protein to the phenothiazines was measured by fluorescence spectroscopy experiments and molecular docking models were generated using the RamR crystal structure.

Results: Exposure to either chlorpromazine or thioridazine resulted in the up-regulation of the romA–ramA genes. EMSAs and in vitro transcription experiments demonstrated that both agents reduce/abolish binding and enhance transcription of the target PI promoter upstream of the ramR–romA genes in Klebsiella pneumoniae compared with RamR alone. Fluorescence spectroscopy measurements demonstrated that RamR directly binds both chlorpromazine and thioridazine with micromolar affinity. Molecular docking analyses using the RamR crystal structure demonstrated that the phenothiazines interact with RamR protein through contacts described for other ligands, in addition to forming unique strong polar interactions at positions D152 and K63.

Conclusions: These data demonstrate that phenothiazines can modulate loci linked to the microbe–drug response where RamR is an intracellular target for the phenothiazines, thus resulting in a transient non-mutational derepression of ramA concentrations.

Deficiency of the ferrous iron transporter FeoAB is linked with metronidazole resistance in Bacteroides fragilis

Background Metronidazole is the most commonly used antimicrobial for Bacteroides fragilis infections and is recommended for prophylaxis of colorectal surgery. Metronidazole resistance is increasing and the mechanisms of resistance are not clear.

Methods A transposon mutant library was generated in B. fragilis 638R (BF638R) to identify the genetic loci associated with resistance to metronidazole.

Results Thirty-two independently isolated metronidazole-resistant mutants had a transposon insertion in BF638R_1421 that encodes the ferrous transport fusion protein (feoAB). Deletion of feoAB resulted in a 10-fold increased MIC of metronidazole for the strain. The metronidazole MIC for the feoAB mutant was similar to that for the parent strain when grown on media supplemented with excess iron, suggesting that the increase seen in the MIC of metronidazole was due to reduced cellular iron transport in the feoAB mutant. The furA gene repressed feoAB transcription in an iron-dependent manner and disruption of furA resulted in constitutive transcription of feoAB, regardless of whether or not iron was present. However, disruption of feoAB also diminished the capacity of BF638R to grow in a mouse intraperitoneal abscess model, suggesting that inorganic ferrous iron assimilation is essential for B. fragilis survival in vivo.

Conclusions Selection for feoAB mutations as a result of metronidazole treatment will disable the pathogenic potential of B. fragilis and could contribute to the clinical efficacy of metronidazole. While mutations in feoAB are probably not a direct cause of clinical resistance, this study provides a key insight into intracellular metronidazole activity and the link with intracellular iron homeostasis.

Mechanisms of reduced susceptibility and genotypic prediction of antibiotic resistance in Prevotella isolated from cystic fibrosis (CF) and non-CF patients

OBJECTIVES: To investigate mechanisms of reduced susceptibility to commonly used antibiotics in Prevotella cultured from patients with cystic fibrosis (CF), patients with invasive infection and healthy control subjects and to determine whether genotype can be used to predict phenotypic resistance.

METHODS: The susceptibility of 157 Prevotella isolates to seven antibiotics was compared, with detection of resistance genes (cfxA-type gene, ermF and tetQ), mutations within the CfxA-type β-lactamase and expression of efflux pumps.

RESULTS: Prevotella isolates positive for a cfxA-type gene had higher MICs of amoxicillin and ceftazidime compared with isolates negative for this gene (P < 0.001). A mutation within the CfxA-type β-lactamase (Y239D) was associated with ceftazidime resistance (P = 0.011). The UK CF isolates were 5.3-fold, 2.7-fold and 5.7-fold more likely to harbour ermF compared with the US CF, UK invasive and UK healthy control isolates, respectively. Higher concentrations of azithromycin (P < 0.001) and clindamycin (P < 0.001) were also required to inhibit the growth of the ermF-positive isolates compared with ermF-negative isolates. Furthermore, tetQ-positive Prevotella isolates had higher MICs of tetracycline (P = 0.001) and doxycycline (P < 0.001) compared with tetQ-negative isolates. Prevotella spp. were also shown, for the first time, to express resistance nodulation division (RND)-type efflux pumps.

CONCLUSIONS: This study has demonstrated that Prevotella isolated from various sources harbour a common pool of resistance genes and possess RND-type efflux pumps, which may contribute to tetracycline resistance. The findings indicate that antibiotic resistance is common in Prevotella spp., but the genotypic traits investigated do not reflect phenotypic antibiotic resistance in every instance.

MarcoPolo-R near earth asteroid sample return mission

MarcoPolo-R is a sample return mission to a primitive Near-Earth Asteroid (NEA) proposed in collaboration with NASA. It will rendezvous with a primitive NEA, scientifically characterize it at multiple scales,and return a unique sample to Earth unaltered by the atmospheric entry process or terrestrial weathering. MarcoPolo-R will return bulk samples (up to 2 kg) from an organic-rich binary asteroid to Earth for laboratory analyses, allowing us to: explore the origin of planetary materials and initial stages of habitable planet formation; identify and characterize the organics and volatiles in a primitive asteroid; understand the unique geomorphology, dynamics and evolution of a binaryNEA. This project is based on the previous Marco Polo mission study,which was selected for the Assessment Phase of the first round of Cosmic Vision. Its scientific rationale was highly ranked by ESA committees andit was not selected only because the estimated cost was higher than theallotted amount for an M class mission. The cost of Marco Polo-R will be reduced to within the ESA medium mission budget by collaboration withAPL (John Hopkins University) and JPL in the NASA program for coordination with ESA's Cosmic Vision Call. The baseline target is a binary asteroid (175706) 1996 FG3, which offers a very efficient operational and technical mission profile. A binary target also providesenhanced science return. The choice of this target will allow newinvestigations to be performed more easily than at a single object, andalso enables investigations of the fascinating geology and geophysics ofasteroids that are impossible at a single object. Several launch windows have been identified in the time-span 2020-2024. A number of otherpossible primitive single targets of high scientific interest have beenidentified covering a wide range of possible launch dates. The baselinemission scenario of Marco Polo-R to 1996 FG3 is as follows: a singleprimary spacecraft provided by ESA, carrying the Earth Re-entry Capsule, sample acquisition and transfer system provided by NASA, will be launched by a Soyuz-Fregat rocket from Kourou into GTO and using two space segment stages. Two similar missions with two launch windows, in 2021 and 2022 and for both sample return in 2029 (with mission durationof 7 and 8 years), have been defined. Earlier or later launches, in 2020 or 2024, also offer good opportunities. All manoeuvres are carried out by a chemical propulsion system. MarcoPolo-R takes advantage of three industrial studies completed as part of the previous Marco Polo mission (see ESA/SRE (2009)3, Marco Polo Yellow Book) and of the expertise of the consortium led by Dr. A.F. Cheng (PI of the NASA NEAR Shoemaker mission) of the JHU-APL, including JPL, NASA ARC, NASA LaRC, and MIT.

The P/2010 A2 Asteroid Collision Confirmed by Rosetta/OSIRIS Observation

The discovery of P/2010 A2 by the LINEAR survey in January 2010 revealed an object displaying a large trail of material similar in shape to a cometary tail although no central condensation or coma could be detected. The appearance of this object in an asteroidal orbit in the inner main belt attracted attention as a potential new member of the Main Belt Comets class (MBCs) but the discovery of a nucleus, with an estimated diameter of 120 m, around 1500 km away from the trail implied that the extended object we were seeing could be the debris trail from a recent collision rather than the tail of a comet. Due to the low inclination of its orbit, it is difficult to conclude about the nature of P/2010 A2 from Earth-based data only, as different scenarios lead to the same appearance in the orbital configuration at the times of observations. We present here another set of images, acquired from the unique viewing geometry provided by ESA's Rosetta spacecraft en route to comet 67P/Churyumov-Gerasimenko. Albeit faint (22 magnitude), the object could be observed by the high-resolution camera OSIRIS. We used a Finson-Probstein model to simulate the shape of the trail, and estimate the time of emission and β parameter (ratio between solar radiation pressure and gravity) for the dust grains. Simulations were compared to the OSIRIS images and ground based observations acquired at NTT and Palomar telescopes. Thanks to the different phase angle provided by Rosetta, we could reduce the number of solutions to a unique model, leading to the conclusive demonstration that the trail is due to a single event rather than a period of cometary activity.

Spitzer observations of the asteroid-comet transition object and potential spacecraft target 107P (4015) Wilson-Harrington

Context: Near-Earth asteroid-comet transition object 107P/ (4015) Wilson-Harrington is a possible target of the joint European Space Agency (ESA) and Japanese Aerospace Exploration Agency (JAXA) Marco Polo sample return mission. Physical studies of this object are relevant to this mission, and also to understanding its asteroidal or cometary nature. Aims: Our aim is to obtain significant new constraints on the surface thermal properties of this object. Methods: We present mid-infrared photometry in two filters (16 and 22 μm) obtained with NASA's Spitzer Space Telescope on February 12, 2007, and results from the application of the Near Earth Asteroid Thermal Model (NEATM). We obtained high S/N in two mid-IR bands allowing accurate measurements of its thermal emission. Results: We obtain a well constrained beaming parameter (η = 1.39±0.26) and obtain a diameter and geometric albedo of D = 3.46±0.32 km, and pV = 0.059±0.011. We also obtain similar results when we apply this best-fitting thermal model to single-band mid-IR photometry reported by Campins et al. (1995, P&SS, 43, 733), Kraemer et al. (2005, AJ, 130, 2363) and Reach et al. (2007, Icarus, 191, 298). Conclusions: The albedo of 4015 Wilson-Harrington is low, consistent with those of comet nuclei and primitive C-, P-, D-type asteorids. We establish a rough lower limit for the thermal inertia of W-H of 60 Jm-2s-0.5 K-1 when it is at r = 1 AU, which is slightly over the limit of 30 Jm-2 s-0.5 K-1 derived by Groussin et al. (2009, Icarus, 199, 568) for the thermal inertia of the nucleus of comet 22P/Kopff.

ESO observations of the Nucleus of Rosetta Target 67P/C-G

Rosetta is ESA's new comet orbiter mission, launched in March 2004 and currently en route to Jupiter-family comet 67P/Churyumov-Gerasimenko. The probe will rendezvous with the comet in 2014 and remain in orbit around the nucleus for on-going detailed physical and compositional analysis. Pre-encounter observations of the target are important for characterization of the heliocentric light-curve behaviour and the physical properties of the nucleus, information that is critical for mission planning. The nucleus was first characterized using HST observations in 2003 (Lamy et al. 2006) and observed directly in May 2005 by ground based telescopes (Lowry et al. 2006) when it was at 5.6 AU from the Sun. An extensive database of nucleus observations have since been acquired, not only from large ground-based telescopes like the ESO VLT (Tubiana et al. 2008 & 2011), but also from Spitzer (Kelley et al. 2006 & 2009; Lamy et al. 2008).

A modified method for measuring antibiotic use in healthcare settings: implications for antibiotic stewardship and benchmarking

Objectives: To determine whether adjusting the denominator of the common hospital antibiotic use measurement unit (defined daily doses/100 bed-days) by including age-adjusted comorbidity score (100 bed-days/age-adjusted comorbidity score) would result in more accurate and meaningful assessment of hospital antibiotic use. 

Methods: The association between the monthly sum of age-adjusted comorbidity and monthly antibiotic use was measured using time-series analysis (January 2008 to June 2012). For the purposes of conducting internal benchmarking, two antibiotic usage datasets were constructed, i.e. 2004-07 (first study period) and 2008-11 (second study period). Monthly antibiotic use was normalized per 100 bed-days and per 100 bed-days/age-adjusted comorbidity score. 

Results: Results showed that antibiotic use had significant positive relationships with the sum of age-adjusted comorbidity score (P = 0.0004). The results also showed that there was a negative relationship between antibiotic use and (i) alcohol-based hand rub use (P = 0.0370) and (ii) clinical pharmacist activity (P = 0.0031). Normalizing antibiotic use per 100 bed-days contributed to a comparative usage rate of 1.31, i.e. the average antibiotic use during the second period was 31% higher than during the first period. However, normalizing antibiotic use per 100 bed-days per age-adjusted comorbidity score resulted in a comparative usage rate of 0.98, i.e. the average antibiotic use was 2% lower in the second study period. Importantly, the latter comparative usage rate is independent of differences in patient density and case mix characteristics between the two studied populations. 

Conclusions: The proposed modified antibiotic measure provides an innovative approach to compare variations in antibiotic prescribing while taking account of patient case mix effects. 

Millimeter Wave Amplitude Comparison Monopulse Using a Waveguide Rotman Lens

A 94 GHz waveguide Rotman lens is described which can be used to implement an amplitude comparison monopulse RADAR. In transmit mode, adjacent dual beam ports are excited with equal amplitude and phase to form a sum radiation pattern, and in receive mode, the outputs of the beam port pairs are combined using magic tees to provide a sum and a difference signal which can be used to calculate an angular error estimate for target acquisition and tracking. This approach provides an amplitude comparison monopulse system which can be scanned in azimuth and which has a low component count, with no requirement for phase shift circuitry in the array feed lines, making it suitable for mm-wave frequencies. A 12 input (beam ports), 12 output (array ports) lens is designed using CST Microwave Studio, and the predicted results are presented.

Investigations on the Analysis and Design of Aperiodic Frequency Selective Surfaces for Space Applications

An investigation on the design of aperiodic FSS is presented. First, an accurate yet efficient method which allows the analysis of finite sized aperiodic FSS has been developed. Subsequently, an optimisation method is implemented which optimises all the FSS elements to obtain an FSS design with an aperiodic element layout. Preliminary designs of aperiodic FSS are presented and the numerical results are discussed.

Multilayer Dielectric Stack Parameter Modelling for FSS Design

This paper discusses modelling multilayer dielectric stacks for use as substrate support for frequency selective surface. A method of a fast simulation of multilayer dielectric stack as a complementary tool for FSS design is proposed. Using the method analysis of effect of different parts of the multilayer stack has been performed. The tool has also been used for extraction of material parameters from the measured results. Measured transmission and reflection of a sample manufactured material stack show good agreement with the simulated results obtained for extracted material parameters.

SN2014J gamma rays from the 56Ni decay chain

Context. The detection and measurement of gamma-ray lines from the decaychain of 56Ni provides unique information about the explosionin supernovae. SN2014J at 3.3 Mpc is a sufficiently-nearby supernova oftype Ia so that such measurements have been feasible with the gamma-rayspectrometer SPI on ESA's INTEGRAL gamma-ray observatory.

Aims:The 56Ni freshly produced in the supernova is understood topower the optical light curve, because it emits gamma rays upon itsradioactive decay first to 56Co and then to 56Fe.Gamma-ray lines from 56Co decay are expected to becomedirectly visible through the white dwarf material several weeks afterthe explosion, as they progressively penetrate the overlying material ofthe supernova envelope, which is diluted as it expands. The lines areexpected to be Doppler-shifted or broadened from the kinematics of the56Ni ejecta. We aim to exploit high-resolution gamma-rayspectroscopy with the SPI spectrometer on INTEGRAL toward constrainingthe 56Ni distribution and kinematics in this supernova.

Methods: We use the observations with the SPI spectrometer onINTEGRAL, together with an improved instrumental background method.

Results: We detect the two main lines from 56Co decay at847 and 1238 keV, which are significantly Doppler-broadened, and atintensities (3.65 ± 1.21) × 10-4 and (2.27± 0.69) × 10-4 ph cm-2s-1, respectively, at their brightness maximum. We measuretheir rise toward a maximum after about 60-100 days and a declinethereafter. The intensity ratio of the two lines is found to beconsistent with expectations from 56Co decay (0.62 ±0.28 at brightness maximum, the expected ratio is 0.68). We find thatthe broad lines seen in the late, gamma-ray transparent phase are notrepresentative of the early gamma-ray emission, and notice instead thatthe emission spectrum is complex and irregular until the supernova isfully transparent to gamma rays, with progressive uncovering of the bulkof 56Ni. We infer that the explosion morphology is notspherically symmetric, both in the distribution of 56Ni andin the unburnt material which occults the 56Co emission.After we compare light curves from different plausible models, theresulting 56Ni mass is determined to be 0.49 ± 0.09M⊙.