Integrating tuberculosis and HIV care in the primary care setting in South Africa.

BACKGROUND: In many countries including South Africa, the increasing human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have impacted significantly on already weakened public health services. This paper reviews the scope, process and performance of the HIV and TB services in a primary care setting where antiretroviral therapy is provided, in Khayelitsha, South Africa, in order to assess whether there is a need for some form of integration. METHODS: The scope and process of both services were assessed through observations of the service and individual and group interviews with key persons. The performance was assessed by examining the 2001-2002 reports from the health information system and clinical data. RESULTS: The TB service is programme oriented to the attainment of an 85% cure rate amongst smear-positive patients while the HIV service has a more holistic approach to the patient with HIV. The TB service is part of a well-established programme that is highly standardized. The HIV service is in the pilot phase. There is a heavy load at both services and there is large degree of cross-referral between the two services. There are lessons that can be learnt from each service. There is an overlap of activities, duplication of services and under-utilization of staff. There are missed opportunities for TB and HIV prevention, diagnosis and management. CONCLUSIONS: The study suggests that there may be benefits to integrating HIV and TB services. Constraints to this process are discussed

Stabilizing the Complex Structure in Heterotic Calabi-Yau Vacua

In this paper, we show that the presence of gauge fields in heterotic Calabi-Yau compacitifications causes the stabilisation of some, or all, of the complex structure moduli of the Calabi-Yau manifold while maintaining a Minkowski vacuum. Certain deformations of the Calabi-Yau complex structure, with all other moduli held fixed, can lead to the gauge bundle becoming non-holomorphic and, hence, non-supersymmetric. This leads to an F-term potential which stabilizes the corresponding complex structure moduli. We use 10- and 4-dimensional field theory arguments as well as a derivation based purely on algebraic geometry to show that this picture is indeed correct. An explicit example is presented in which a large subset of complex structure moduli is fixed. We demonstrate that this type of theory can serve as the hidden sector in heterotic vacua and can co-exist with realistic particle physics.Comment: 17 pages, Late

On Free Quotients of Complete Intersection Calabi-Yau Manifolds

In order to find novel examples of non-simply connected Calabi-Yau threefolds, free quotients of complete intersections in products of projective spaces are classified by means of a computer search. More precisely, all automorphisms of the product of projective spaces that descend to a free action on the Calabi-Yau manifold are identified.Comment: 39 pages, 3 tables, LaTe

New distinguished classes of spectral spaces: a survey

In the present survey paper, we present several new classes of Hochster's spectral spaces "occurring in nature", actually in multiplicative ideal theory, and not linked to or realized in an explicit way by prime spectra of rings. The general setting is the space of the semistar operations (of finite type), endowed with a Zariski-like topology, which turns out to be a natural topological extension of the space of the overrings of an integral domain, endowed with a topology introduced by Zariski. One of the key tool is a recent characterization of spectral spaces, based on the ultrafilter topology, given in a paper by C. Finocchiaro in Comm. Algebra 2014. Several applications are also discussed

Quadrotor multibody modelling by vehiclesim: adaptive technique for oscillations in a PVA control system

The work presented here covers the detailed modelling and trajectory control for an elastic bladed quadrotor vehicle. The benefits of using VehicleSim modelling software are also discussed. The authors present a full elastic structural and dynamical model as well as two different aerodynamic models. These two aerodynamic models differ from each other on their level of complexity and therefore, accuracy. The control methodology employed to stabilize and guide the vehicle is PVA (ProportionalVelocity-Acceleration), derived and implemented by using Simulink. As it will be shown, it stabilises and provides satisfactory quadrotor trajectory tracking. Since the control methodology feeds back the acceleration of the vehicle, and this acceleration has an oscillating nature, an adaptive process has been designed and introduced into the vehicle’s model in order to avoid the oscillations’ transmission to the control system, showing how it reduces the amplitude of the control actions oscillations. Results of simulations and discussion on them are also provided at the end of this article

Damage to the prefrontal cortex increases utilitarian moral judgements

The psychological and neurobiological processes underlying moral judgement have been the focus of many recent empirical studies1–11. Of central interest is whether emotions play a causal role in moral judgement, and, in parallel, how emotion-related areas of the brain contribute to moral judgement. Here we show that six patients with focal bilateral damage to the ventromedial prefrontal cortex (VMPC), a brain region necessary for the normal generation of emotions and, in particular, social emotions12–14, produce an abnor- mally ‘utilitarian’ pattern of judgements on moral dilemmas that pit compelling considerations of aggregate welfare against highly emotionally aversive behaviours (for example, having to sacrifice one person’s life to save a number of other lives)7,8. In contrast, the VMPC patients’ judgements were normal in other classes of moral dilemmas. These findings indicate that, for a selective set of moral dilemmas, the VMPC is critical for normal judgements of right and wrong. The findings support a necessary role for emotion in the generation of those judgements

An Assessment of Computer Use, Knowledge, and Attitudes of Diabetes Educators

A questionnaire to survey attitudes, use, and knowledge of computers was sent to 816 randomly selected members of AADE to determine the degree to which currently available computer resources are used in diabetes education and to investigate the need for future computing resources designed to support diabetes education. Analysis of the data showed that even diabetes educators who use computers infrequently have a generally favorable attitude toward them. Highest use of computers is in noneducational applications, mostly for word processing and record keeping. Most respondents believe that computers have yet to make a major contribution to the teaching and learning process in diabetes education, and few felt adequately prepared for creative use or development of computer applications. Increasing the role of computers in support of patient education will require encouragement and demonstrations of computer efficacy from health care institutions and professional organizations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68469/2/10.1177_014572179201800107.pd

Well-mixed plasma and tissue viral populations in RT-SHIV-infected macaques implies a lack of viral replication in the tissues during antiretroviral therapy

Background: Determining the anatomic compartments that contribute to plasma HIV-1 is critical to understanding the sources of residual viremia during combination antiretroviral therapy (ART). We analyzed viral DNA and RNA populations in the plasma and tissues from macaques infected with SIV containing HIV-1 RT (RT-SHIV) to identify possible sources of persistent viremia and to investigate the effect of ART on viral replication in tissues. Tissues were collected at necropsy from four pigtailed macaques infected for 30 weeks with a diverse population of RT-SHIV. Two animals (6760 and 8232) were untreated and two animals (8030 and 8272) were treated with efavirenz, tenofovir, and emtricitabine for 20 weeks. Results: A total of 1800 single-genome RT-SHIV pol and env DNA and RNA sequences were analyzed from the plasma, PBMCs, axillary and mesenteric lymph nodes, spleen, thymus, small intestine, bone marrow, lung, and brain. Analyses of intracellular DNA and RNA populations revealed that the majority of proviruses in tissues from untreated animal 8232 were not expressed, whereas a greater proportion of proviruses in tissues were expressed from 6760. Few intracellular RNA sequences were detected in treated animals and most contained inactivating mutations, such as frame shifts or large deletions. Phylogenetics showed that RT-SHIV DNA populations in tissues were not different from virus in contemporary plasma samples in the treated or untreated animals, demonstrating a lack of anatomic compartmentalization and suggesting that plasma viremia is derived from multiple tissue sources. No sequence divergence was detected in the plasma or between tissues in the treated animals after 20 weeks of ART indicating a lack of ongoing replication in tissues during treatment. Conclusions: Virus populations in plasma and tissues did not differ significantly in either treated or untreated macaques, suggesting frequent exchange of virus or infected cells between tissues and plasma, consistent with non-compartmentalized and widely disseminated infection. There was no genetic evidence of ongoing replication in tissues during suppressive ART

Evaluating Acquisition Time of rfMRI in the Human Connectome Project for Early Psychosis. How Much Is Enough?

Resting-state functional MRI (rfMRI) correlates activity across brain regions to identify functional connectivity networks. The Human Connectome Project (HCP) for Early Psychosis has adopted the protocol of the HCP Lifespan Project, which collects 20 min of rfMRI data. However, because it is difficult for psychotic patients to remain in the scanner for long durations, we investigate here the reliability of collecting less than 20 min of rfMRI data. Varying durations of data were taken from the full datasets of 11 subjects. Correlation matrices derived from varying amounts of data were compared using the Bhattacharyya distance, and the reliability of functional network ranks was assessed using the Friedman test. We found that correlation matrix reliability improves steeply with longer windows of data up to 11–12 min, and ≥14 min of data produces correlation matrices within the variability of those produced by 18 min of data. The reliability of network connectivity rank increases with increasing durations of data, and qualitatively similar connectivity ranks for ≥10 min of data indicates that 10 min of data can still capture robust information about network connectivities

Contribution of non-extensor muscles of the leg to maximal-effort countermovement jumping

BACKGROUND: The purpose of this study was to determine the effects of non-extensor muscles of the leg (i.e., muscles whose primary function is not leg extension) on the kinematics and kinetics of human maximal-effort countermovement jumping. Although it is difficult to address this type of question through experimental procedures, the methodology of computer simulation can be a powerful tool. METHODS: A skeletal model that has nine rigid body segments and twenty degrees of freedom was developed. Two sets of muscle models were attached to this skeletal model: all (most of) major muscles in the leg ("All Muscles" model) and major extensor muscles in the leg (i.e., muscles whose primary function is leg extension; "Extensors Only" model). Neural activation input signal was represented by a series of step functions with a step duration of 0.05 s. Simulations were started from an identical upright standing posture. The optimal pattern of the activation input signal was searched through extensive random-search numerical optimization with a goal of maximizing the height reached by the mass centre of the body after jumping up. RESULTS: The simulated kinematics was almost two-dimensional, suggesting the validity of two-dimensional analyses when evaluating net mechanical outputs around the joints using inverse dynamics. A greater jumping height was obtained for the "All Muscles" model (0.386 m) than for the "Extensors Only" model (0.301 m). For the "All Muscles" model, flexor muscles developed force in the beginning of the countermovement. For the "All Muscles" model, the sum of the work outputs from non-extensor muscles was 47.0 J, which was 13% of the total amount (359.9 J). The quantitative distribution of the work outputs from individual muscles was markedly different between these two models. CONCLUSION: It was suggested that the contribution of non-extensor muscles in maximal-effort countermovement jumping is substantial. The use of a computer simulation model that includes non-extensor muscles seems to be more desirable for the assessment of muscular outputs during jumping