An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK

Objectives Partner notification (PN) is a key public health intervention in the control of STIs. Data regarding its clinical effectiveness in the context of HIV are lacking. We sought to audit HIV PN outcomes across the UK. Methods All UK sexual health and HIV services were invited to participate. Clinical audit consisted of retrospective case-note review for up to 40 individuals diagnosed with HIV per site during 2011 (index cases) and a review of PN outcomes for up to five contacts elicited by PN per index case. Results 169/221 (76%) clinical services participated (93% sexual health/HIV services, 7% infectious diseases/HIV units). Most (97%) delivered PN for HIV. Data were received regarding 2964 index cases (67% male; 50% heterosexual, 52% white). PN was attempted for 88% of index cases, and outcomes for 3211 contacts were audited (from an estimated total of 6400): 519 (16%) were found not to be at risk of undiagnosed HIV infection, 1399 (44%) were informed of their risk and had an HIV test, 310 (10%) were informed of the risk but not known to have tested and 983 (30%) were not informed of their risk of HIV infection. Of 1399 contacts tested through PN, 293 (21%) were newly diagnosed with HIV infection. Regular partners were most likely to test positive (p<0.001). Conclusions HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection

ATTORNEYS -TAXATION - UNAUTHORIZED PRACTICE OF INCOME TAX LAW BY CERTIFIED PUBLIC ACCOUNTANTS

The accepted law in the United States is that laymen may not engage in the practice of law. However, the enigma of what constitutes the practice of law has plagued laymen, lawyers and the courts for many years. Attempts to find the answer have engendered intense friction between various professional groups, each arguing that its jurisdiction extends further than the other admits. The greatest animosity has developed between lawyers and certified public accountants in the dispute as to their respective functions in the income tax field

From Relations to Rules: A Theoretical Explanation and Empirical Evidence

(First Paragraph) There is a general perception that people in the East rely more on guanxi (relations, or informal social networks) to govern economic transactions and manage business activities than people in the West. A large quantity of literature on the difference has been produced. One of the dominant views argues that the difference is due to culture, which is treated as an exogenous variable.1 These studies on culture as the determinant of different management and governance style have helped us gain insight on how businesses are conducted in different regions of the world and on how cultures differ through-out the world. However, attributing the differences in management style and in the mode of business governance primarily to culture does not add to our knowledge on why certain culture prevails in a particular country or region in the first place to shape the management style and the mode of governance, how management styles evolve, and how different management styles and modes of governance interface

Acute kidney disease and renal recovery : consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of > 90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process. For patients in whom pathophysiologic processes are ongoing, the term acute kidney disease (AKD) has been proposed to define the course of disease after AKI; however, definitions of AKD and strategies for the management of patients with AKD are not currently available. In this consensus statement, the Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients. We also make recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD

Habitat structure: a fundamental concept and framework for urban soil ecology

Habitat structure is defined as the composition and arrangement of physical matter at a location. Although habitat structure is the physical template underlying ecological patterns and processes, the concept is relatively unappreciated and underdeveloped in ecology. However, it provides a fundamental concept for urban ecology because human activities in urban ecosystems are often targeted toward management of habitat structure. In addition, the concept emphasizes the fine-scale, on-the-ground perspective needed in the study of urban soil ecology. To illustrate this, urban soil ecology research is summarized from the perspective of habitat structure effects. Among the key conclusions emerging from the literature review are: (1) habitat structure provides a unifying theme for multivariate research about urban soil ecology; (2) heterogeneous urban habitat structures influence soil ecological variables in different ways; (3) more research is needed to understand relationships among sociological variables, habitat structure patterns and urban soil ecology. To stimulate urban soil ecology research, a conceptual framework is presented to show the direct and indirect relationships among habitat structure and ecological variables. Because habitat structure serves as a physical link between sociocultural and ecological systems, it can be used as a focus for interdisciplinary and applied research (e.g., pest management) about the multiple, interactive effects of urbanization on the ecology of soils

The Hubble Constant

I review the current state of determinations of the Hubble constant, which gives the length scale of the Universe by relating the expansion velocity of objects to their distance. There are two broad categories of measurements. The first uses individual astrophysical objects which have some property that allows their intrinsic luminosity or size to be determined, or allows the determination of their distance by geometric means. The second category comprises the use of all-sky cosmic microwave background, or correlations between large samples of galaxies, to determine information about the geometry of the Universe and hence the Hubble constant, typically in a combination with other cosmological parameters. Many, but not all, object-based measurements give $H_0$ values of around 72-74km/s/Mpc , with typical errors of 2-3km/s/Mpc. This is in mild discrepancy with CMB-based measurements, in particular those from the Planck satellite, which give values of 67-68km/s/Mpc and typical errors of 1-2km/s/Mpc. The size of the remaining systematics indicate that accuracy rather than precision is the remaining problem in a good determination of the Hubble constant. Whether a discrepancy exists, and whether new physics is needed to resolve it, depends on details of the systematics of the object-based methods, and also on the assumptions about other cosmological parameters and which datasets are combined in the case of the all-sky methods.Comment: Extensively revised and updated since the 2007 version: accepted by Living Reviews in Relativity as a major (2014) update of LRR 10, 4, 200

A new rhynchocephalian from the late jurassic of Germany with a dentition that is unique amongst tetrapods.

Rhynchocephalians, the sister group of squamates (lizards and snakes), are only represented by the single genus Sphenodon today. This taxon is often considered to represent a very conservative lineage. However, rhynchocephalians were common during the late Triassic to latest Jurassic periods, but rapidly declined afterwards, which is generally attributed to their supposedly adaptive inferiority to squamates and/or Mesozoic mammals, which radiated at that time. New finds of Mesozoic rhynchocephalians can thus provide important new information on the evolutionary history of the group. A new fossil relative of Sphenodon from the latest Jurassic of southern Germany, Oenosaurus muehlheimensis gen. et sp. nov., presents a dentition that is unique amongst tetrapods. The dentition of this taxon consists of massive, continuously growing tooth plates, probably indicating a crushing dentition, thus representing a previously unknown trophic adaptation in rhynchocephalians. The evolution of the extraordinary dentition of Oenosaurus from the already highly specialized Zahnanlage generally present in derived rhynchocephalians demonstrates an unexpected evolutionary plasticity of these animals. Together with other lines of evidence, this seriously casts doubts on the assumption that rhynchocephalians are a conservative and adaptively inferior lineage. Furthermore, the new taxon underlines the high morphological and ecological diversity of rhynchocephalians in the latest Jurassic of Europe, just before the decline of this lineage on this continent. Thus, selection pressure by radiating squamates or Mesozoic mammals alone might not be sufficient to explain the demise of the clade in the Late Mesozoic, and climate change in the course of the fragmentation of the supercontinent of Pangaea might have played a major role

Quantum entanglement for systems of identical bosons: I. General features

These two accompanying papers are concerned with two mode entanglement for systems of identical massive bosons and the relationship to spin squeezing and other quantum correlation effects. Entanglement is a key quantum feature of composite systems in which the probabilities for joint measurements on the composite sub-systems are no longer determined from measurement probabilities on the separate sub-systems. There are many aspects of entanglement that can be studied. This two-part review focuses on the meaning of entanglement, the quantum paradoxes associated with entangled states, and the important tests that allow an experimentalist to determine whether a quantum state—in particular, one for massive bosons is entangled. An overall outcome of the review is to distinguish criteria (and hence experiments) for entanglement that fully utilize the symmetrization principle and the super-selection rules that can be applied to bosonic massive particles. In the first paper (I), the background is given for the meaning of entanglement in the context of systems of identical particles. For such systems, the requirement is that the relevant quantum density operators must satisfy the symmetrization principle and that global and local super-selection rules prohibit states in which there are coherences between differing particle numbers. The justification for these requirements is fully discussed. In the second quantization approach that is used, both the system and the sub-systems are modes (or sets of modes) rather than particles, particles being associated with different occupancies of the modes. The definition of entangled states is based on first defining the non-entangled states—after specifying which modes constitute the sub-systems. This work mainly focuses on the two mode entanglement for massive bosons, but is put in the context of tests of local hidden variable theories, where one may not be able to make the above restrictions. The review provides the detailed arguments necessary for the conclusions of a recent paper, where the question of how to rigorously demonstrate the entanglement of a two-mode Bose–Einstein condensate (BEC) has been examined. In the accompanying review paper (II), we consider spin squeezing and other tests for entanglement that have been proposed for two-mode bosonic systems. We apply the approach of review (I) to determine which tests, and which modifications of the tests, are useful for detecting entanglement in massive bosonic (BEC), as opposed to photonic, systems. Several new inequalities are derived, a theory for the required two-mode interferometry is presented, and key experiments to date are analyzed