Voluntary Counselling, HIV Testing and Adjunctive Cotrimoxazole Reduces Mortality in Tuberculosis Patients in Thyolo, Malawi.

OBJECTIVES: To assess the feasibility and effectiveness of voluntary counselling, HIV testing and adjunctive cotrimoxazole in reducing mortality in a cohort of tuberculosis (TB) patients registered under routine programme conditions in a rural district of Malawi. DESIGN: 'Before' and 'after' cohort study using historical controls. METHODS: Between 1 July 1999 and 30 June 2000 all TB patients were started on standardized anti-TB treatment, and offered voluntary counselling and HIV testing (VCT). Those found to be HIV-positive were offered cotrimoxazole at a dose of 480 mg twice daily, provided there were no contraindications. Side-effects were monitored clinically. End-of-treatment outcomes in this cohort (intervention group) were compared with a cohort registered between 1 July 1998 and 30 June 1999 in whom VCT and cotrimoxazole was not offered (control group). FINDINGS: A total of 1986 patients was registered in the study: 1061 in the intervention group and 925 in the control cohort. In the intervention group, 1019 (96%) patients were counselled pre-test, 964 (91%) underwent HIV testing and 938 (88%) were counselled post-test. The overall HIV-seroprevalence rate was 77%. A total of 693 patients were given cotrimoxazole of whom 14 (2%) manifested minor dermatological reactions. The adjusted relative risk of death in the intervention group compared with the control group was 0.81 (P < 0.001). The number needed to treat with VCT and adjunctive cotrimoxazole to prevent one death during anti-TB treatment was 12.5. INTERPRETATION: This study shows that VCT and adjunctive cotrimoxazole is feasible, safe and reduces mortality rates in TB patients under routine programme conditions

Determination of the Far-Infrared Cosmic Background Using COBE/DIRBE and WHAM Data

Determination of the cosmic infrared background (CIB) at far infrared wavelengths using COBE/DIRBE data is limited by the accuracy to which foreground interplanetary and Galactic dust emission can be modeled and subtracted. Previous determinations of the far infrared CIB (e.g., Hauser et al. 1998) were based on the detection of residual isotropic emission in skymaps from which the emission from interplanetary dust and the neutral interstellar medium were removed. In this paper we use the Wisconsin H-alpha Mapper (WHAM) Northern Sky Survey as a tracer of the ionized medium to examine the effect of this foreground component on determination of the CIB. We decompose the DIRBE far infrared data for five high Galactic latitude regions into H I and H-alpha correlated components and a residual component. We find the H-alpha correlated component to be consistent with zero for each region, and we find that addition of an H-alpha correlated component in modeling the foreground emission has negligible effect on derived CIB results. Our CIB detections and 2 sigma upper limits are essentially the same as those derived by Hauser et al. and are given by nu I_nu (nW m-2 sr-1) < 75, < 32, 25 +- 8, and 13 +- 3 at 60, 100, 140, and 240 microns, respectively. Our residuals have not been subjected to a detailed anisotropy test, so our CIB results do not supersede those of Hauser et al. We derive upper limits on the 100 micron emissivity of the ionized medium that are typically about 40% of the 100 micron emissivity of the neutral atomic medium. This low value may be caused in part by a lower dust-to-gas mass ratio in the ionized medium than in the neutral medium, and in part by a shortcoming of using H-alpha intensity as a tracer of far infrared emission.Comment: 38 pages, 8 figures. Accepted for publication in Ap

The discrete fragmentation equations : semigroups, compactness and asynchronous exponential growth

In this paper we present a class of fragmentation semigroups which are compact in a scale of spaces defined in terms of finite higher moments. We use this compactness result to analyse the long time behaviour of such semigroups and, in particular, to prove that they have the asynchronous growth property. We note that, despite compactness, this growth property is not automatic as the fragmentation semigroups are not irreducible

Evolution of vertebrate retinal photoreception

Recent findings shed light on the steps underlying the evolution of vertebrate photoreceptors and retina. Vertebrate ciliary photoreceptors are not as wholly distinct from invertebrate rhabdomeric photoreceptors as is sometimes thought. Recent information on the phylogenies of ciliary and rhabdomeric opsins has helped in constructing the likely routes followed during evolution. Clues to the factors that led the early vertebrate retina to become invaginated can be obtained by combining recent knowledge about the origin of the pathway for dark re-isomerization of retinoids with knowledge of the inability of ciliary opsins to undergo photoreversal, along with consideration of the constraints imposed under the very low light levels in the deep ocean. Investigation of the origin of cell classes in the vertebrate retina provides support for the notion that cones, rods and bipolar cells all originated from a primordial ciliary photoreceptor, whereas ganglion cells, amacrine cells and horizontal cells all originated from rhabdomeric photoreceptors. Knowledge of the molecular differences between cones and rods, together with knowledge of the scotopic signalling pathway, provides an understanding of the evolution of rods and of the rods' retinal circuitry. Accordingly, it has been possible to propose a plausible scenario for the sequence of evolutionary steps that led to the emergence of vertebrate photoreceptors and retina

Reply to Jensen, O.K. On the Use of Quantitative Sensory Testing to Estimate Central Sensitization in Humans. Comment on "Schuttert et al. The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review. J. Clin. Med. 2021, 10, 5931":A Systematic Review. J. Clin. Med. 2021, 10, 5931"

We thank Dr. Jensen for his interest [...]

The Berry-Keating operator on L^2(\rz_>, x) and on compact quantum graphs with general self-adjoint realizations

The Berry-Keating operator H_{\mathrm{BK}}:= -\ui\hbar(x\frac{ \phantom{x}}{ x}+{1/2}) [M. V. Berry and J. P. Keating, SIAM Rev. 41 (1999) 236] governing the Schr\"odinger dynamics is discussed in the Hilbert space L^2(\rz_>, x) and on compact quantum graphs. It is proved that the spectrum of $H_{\mathrm{BK}}$ defined on L^2(\rz_>, x) is purely continuous and thus this quantization of $H_{\mathrm{BK}}$ cannot yield the hypothetical Hilbert-Polya operator possessing as eigenvalues the nontrivial zeros of the Riemann zeta function. A complete classification of all self-adjoint extensions of $H_{\mathrm{BK}}$ acting on compact quantum graphs is given together with the corresponding secular equation in form of a determinant whose zeros determine the discrete spectrum of $H_{\mathrm{BK}}$. In addition, an exact trace formula and the Weyl asymptotics of the eigenvalue counting function are derived. Furthermore, we introduce the "squared" Berry-Keating operator $H_{\mathrm{BK}}^2:= -x^2\frac{ ^2\phantom{x}}{ x^2}-2x\frac{ \phantom{x}}{ x}-{1/4}$ which is a special case of the Black-Scholes operator used in financial theory of option pricing. Again, all self-adjoint extensions, the corresponding secular equation, the trace formula and the Weyl asymptotics are derived for $H_{\mathrm{BK}}^2$ on compact quantum graphs. While the spectra of both $H_{\mathrm{BK}}$ and $H_{\mathrm{BK}}^2$ on any compact quantum graph are discrete, their Weyl asymptotics demonstrate that neither $H_{\mathrm{BK}}$ nor $H_{\mathrm{BK}}^2$ can yield as eigenvalues the nontrivial Riemann zeros. Some simple examples are worked out in detail.Comment: 33p

The Mid-Infrared Colors of the ISM and Extended Sources at the Galactic Center

A mid-infrared (3.6-8 um) survey of the Galactic Center has been carried out with the IRAC instrument on the Spitzer Space Telescope. This survey covers the central 2x1.4 degree (~280x200 pc) of the Galaxy. At 3.6 and 4.5 um the emission is dominated by stellar sources, the fainter ones merging into an unresolved background. At 5.8 and 8 um the stellar sources are fainter, and large-scale diffuse emission from the ISM of the Galaxy's central molecular zone becomes prominent. The survey reveals that the 8 to 5.8 um color of the ISM emission is highly uniform across the surveyed region. This uniform color is consistent with a flat extinction law and emission from polycyclic aromatic hydrocarbons (PAHs). Models indicate that this broadband color should not be expected to change if the incident radiation field heating the dust and PAHs is <10^4 times that of the solar neighborhood. The few regions with unusually red emission are areas where the PAHs are underabundant and the radiation field is locally strong enough to heat large dust grains to produce significant 8 um emission. These red regions include compact H II regions, Sgr B1, and wider regions around the Arches and Quintuplet Clusters. In these regions the radiation field is >10^4 times that of the solar neighborhood. Other regions of very red emission indicate cases where thick dust clouds obscure deeply embedded objects or very early stages of star formation.Comment: 37 pages, 15 Postscript figures (low resolution). Accepted for publication in the Ap

Steady states in a structured epidemic model with Wentzell boundary condition

We introduce a nonlinear structured population model with diffusion in the state space. Individuals are structured with respect to a continuous variable which represents a pathogen load. The class of uninfected individuals constitutes a special compartment that carries mass, hence the model is equipped with generalized Wentzell (or dynamic) boundary conditions. Our model is intended to describe the spread of infection of a vertically transmitted disease, for example Wolbachia in a mosquito population. Therefore the (infinite dimensional) nonlinearity arises in the recruitment term. First we establish global existence of solutions and the Principle of Linearised Stability for our model. Then, in our main result, we formulate simple conditions, which guarantee the existence of non-trivial steady states of the model. Our method utilizes an operator theoretic framework combined with a fixed point approach. Finally, in the last section we establish a sufficient condition for the local asymptotic stability of the positive steady state