Integration of family planning services into HIV care clinics: Results one year after a cluster randomized controlled trial in Kenya.

OBJECTIVES:To determine if integration of family planning (FP) and HIV services led to increased use of more effective contraception (i.e. hormonal and permanent methods, and intrauterine devices) and decreased pregnancy rates. DESIGN:Cohort analysis following cluster randomized trial, when the Kenya Ministry of Health led integration of the remaining control (delayed integration) sites and oversaw integrated services at the original intervention (early integration) sites. SETTING:Eighteen health facilities in Kenya. SUBJECTS:Women aged 18-45 receiving care: 5682 encounters at baseline, and 11628 encounters during the fourth quarter of year 2. INTERVENTION:"One-stop shop" approach to integrating FP and HIV services. MAIN OUTCOME MEASURES:Use of more effective contraceptive methods and incident pregnancy across two years of follow-up. RESULTS:Following integration of FP and HIV services at the six delayed integration clinics, use of more effective contraception increased from 31.7% to 44.2% of encounters (+12.5%; Prevalence ratio (PR) = 1.39 (1.19-1.63). Among the twelve early integration sites, the proportion of encounters at which women used more effective contraceptive methods was sustained from the end of the first to the second year of follow-up (37.5% vs. 37.0%). Pregnancy incidence including all 18 integrated sites in year two declined in comparison to the control arm in year one (rate ratio: 0.72; 95% CI 0.60-0.87). CONCLUSIONS:Integration of FP services into HIV clinics led to a sustained increase in the use of more effective contraceptives and decrease in pregnancy incidence 24 months following implementation of the integrated service model. TRIAL REGISTRATION:ClinicalTrials.gov NCT01001507

Response of deep-sea deposit-feeders to detrital inputs: A comparison of two abyssal time-series sites

Biological communities on the abyssal plain are largely dependent on detritus from the surface ocean as their main source of energy. Seasonal fluctuations in the deposition of that detritus cause temporal variations in the quantity and quality of food available to these communities, altering their structure and the activity of the taxa present. However, direct observations of energy acquisition in relation to detritus availability across megafaunal taxa in abyssal communities are few. We used time-lapse photography and coincident measurement of organic matter flux from water column sediment traps to examine the impact of seasonal detrital inputs on resource acquisition by the deposit feeding megafauna assemblages at two sites: Station M (Northeast Pacific, 4000 m water depth) and the Porcupine Abyssal Plain Sustained Observatory (PAP-SO, Northeast Atlantic 4850 m water depth). At Station M, studied over 18-months, the seasonal particle flux was followed by a salp deposition event. At that site, diversity in types of deposit feeding was related to seabed cover by detritus. At PAP-SO, studied over 30 months, the seasonal particle flux consisted of two peaks annually. While the two study sites were similar in mean flux (~8.0 mgC m−2 d−1), the seasonality in the flux was greater at PAP-SO. The mean overall tracking at PAP-SO was five times that of Station M (1.9 and 0.4 cm2 h−1, respectively); both are likely underestimated because tracking by some common taxa at both sites could not be quantified. At both sites, responses of deposit-feeding megafauna to the input of detritus were not consistent across the taxa studied. The numerically-dominant megafauna (e.g. echinoids, large holothurians and asteroids) did not alter their deposit feeding in relation to the seasonality in detrital supply. Taxa for which deposit feeding occurrence or rate were correlated to seasonality in particle flux were relatively uncommon (e.g. enteropneusta), known to cache food (e.g. echiurans), or to be highly selective for fresh detritus (e.g. the holothurian Oneirophanta mutabilis). Thus, the degree of seasonality in deposit feeding appeared to be taxon-specific and related to natural history characteristics such as feeding and foraging modes

Inter-annual species-level variations in an abyssal polychaete assemblage (Sta. M, NE Pacific, 4000 m)

Understanding the dynamics of abyssal community structure and function has become increasingly important as deep-sea resource exploitation and climate change pressures are expected to ramp up. This time-series study investigates macrofaunal polychaete dynamics at a station in the North East Pacific (Sta. M; 35˚ N 123˚ W, 4000 m, 1991-2011). Infaunal polychaete species were identified and their proxy biomass and proxy energy use rate estimated. The assemblage comprised 167 species, having a composition consistent with other abyssal areas globally. Significant changes in univariate and multivariate parameters (rank abundance distribution, Simpson’s diversity index, and species and functional group composition) were detected across 1991-2011. However, no change in biomass or energy use rate was apparent through the time-series. The largest changes in the polychaete assemblage coincided with both an increase in sinking particulate organic carbon flux to the seafloor in 2007, and a 40 km relocation of the sampling location to a site 100 m shallower, preventing a conclusive assessment of which might drive the observed variation. Analyses prior to the change of sampling location showed that the polychaete assemblage composition dynamics were primary driven by food supply variation. Changes in several species were also lagged to changes in POC flux by 4 to 10 months. The polychaete fauna exhibited a significant positive relationship between total density and total energy use rate, suggesting population-level tracking of a common resource (e.g. POC flux food supply). Neither compensatory nor energetic zero-sum dynamics were detected among the polychaete assemblage, but the results suggest that the latter occur in the macrofaunal community as a whole. The results do indicate (a) potential control of species composition, and the density of individual key species, by food supply, when the time-series prior to the sampling location was analysed separately, and (b) generally sensitive detection of environmental change by species-level analysis of the abyssal polychaete assemblage

An MCMC Fitting Method for Triaxial Dark Matter Haloes

Measuring the 3D distribution of mass on galaxy cluster scales is a crucial test of the LCDM model, providing constraints on the behaviour of dark matter. Recent work investigating mass distributions of individual galaxy clusters (e.g. Abell 1689) using weak and strong gravitational lensing has revealed potential inconsistencies between the predictions of structure formation models relating halo mass to concentration and those relationships as measured in massive clusters. However, such analyses employ simple spherical halo models while a growing body of work indicates that triaxial 3D halo structure is both common and important in parameter estimates. The very strong assumptions about the symmetry of the lensing halo implied with circular or perturbative elliptical NFW models are not physically motivated and lead to incorrect parameter estimates with significantly underestimated error bars. We here introduce a Markov Chain Monte Carlo (MCMC) method to fit fully triaxial models to weak lensing data that gives parameter and error estimates that fully incorporate the true uncertainty present in nature. Applying the MCMC triaxial fitting method to a population of NFW triaxial lenses drawn from the shape distribution of structure formation simulations, we find that including triaxiality cannot explain a population of massive, highly concentrated clusters within the framework of LCDM, but easily explains rare cases of apparently massive, highly concentrated, very efficient lensing clusters. Our MCMC triaxial NFW fitting method is easily expandable to include constraints from additional data types, and its application returns model parameters and errors that more accurately capture the true (and limited) extent of our knowledge of the structure of galaxy cluster lenses. (abridged)Comment: 18 pages, 15 figures. Updated to match published versio

Performance analysis of AlGaAs/GaAs tunnel junctions for ultra-high concentration photovoltaics

An n(++)-GaAs/p(++)-AlGaAs tunnel junction with a peak current density of 10 100Acm(-2) is developed. This device is a tunnel junction for multijunction solar cells, grown lattice-matched on standard GaAs or Ge substrates, with the highest peak current density ever reported. The voltage drop for a current density equivalent to the operation of the multijunction solar cell up to 10 000 suns is below 5 mV. Trap-assisted tunnelling is proposed to be behind this performance, which cannot be justified by simple band-to-band tunnelling. The metal-organic vapour-phase epitaxy growth conditions, which are in the limits of the transport-limited regime, and the heavy tellurium doping levels are the proposed origins of the defects enabling trap-assisted tunnelling. The hypothesis of trap-assisted tunnelling is supported by the observed annealing behaviour of the tunnel junctions, which cannot be explained in terms of dopant diffusion or passivation. For the integration of these tunnel junctions into a triple-junction solar cell, AlGaAs barrier layers are introduced to suppress the formation of parasitic junctions, but this is found to significantly degrade the performance of the tunnel junctions. However, the annealed tunnel junctions with barrier layers still exhibit a peak current density higher than 2500Acm(-2) and a voltage drop at 10 000 suns of around 20 mV, which are excellent properties for tunnel junctions and mean they can serve as low-loss interconnections in multijunction solar cells working at ultra-high concentrations

A simulation study of the reaction of human heart to biphasic electrical shocks

BACKGROUND: This article presents a study, which examines the effects of biphasic electrical shocks on human ventricular tissue. The effects of this type of shock are not yet fully understood. Animal experiments showed the superiority of biphasic shocks over monophasic ones in defibrillation. A mathematical computer simulation can increase the knowledge of human heart behavior. METHODS: The research presented in this article was done with different models representing a three-dimensional wedge of ventricular myocardium. The electrophysiology was described with Priebe-Beuckelmann model. The realistic fiber twist, which is specific to human myocardium was included. Planar electrodes were placed at the ends of the longest side of the virtual cardiac wedge, in a bath medium. They were sources of electrical shocks, which varied in magnitude from 0.1 to 5 V. In a second arrangement ring electrodes were placed directly on myocardium for getting a better view on secondary electrical sources. The electrical reaction of the tissue was generated with a bidomain model. RESULTS: The reaction of the tissue to the electrical shock was specific to the initial imposed characteristics. Depolarization appeared in the first 5 ms in different locations. A further study of the cardiac tissue behavior revealed, which features influence the response of the considered muscle. It was shown that the time needed by the tissue to be totally depolarized is much shorter when a biphasic shock is applied. Each simulation ended only after complete repolarization was achieved. This created the possibility of gathering information from all states corresponding to one cycle of the cardiac rhythm. CONCLUSIONS: The differences between the reaction of the homogeneous tissue and a tissue, which contains cleavage planes, reveals important aspects of superiority of biphasic pulses. ..

Climate change hotspots and implications for the global subsea telecommunications network

A global network of subsea telecommunications cables underpins our daily digital lives, enabling >95% of global digital data transfer, $trillions/day in financial trading, and providing critical communications links, particularly to remote, low-income countries. Despite their importance, subsea cables and their landing stations are vulnerable to damage by natural hazards, including storm surges, waves, cyclones, earthquakes, floods, volcanic eruptions, submarine landslides and ice scour. However, the likelihood or recurrence interval of these types of events will likely change under future projected climate change scenarios, compounded by sea-level rise, potentially increasing hazard severity, creating previously unanticipated hazards, or hazards may shift to new locations during the 20–30-year operational life of cable systems. To date, no study has assessed the wide-reaching impacts of future climate change on subsea cables and landing stations on a global scale. Here, for the first time we synthesize the current evidence base, based on published peer-reviewed datasets, to fill this crucial knowledge gap, specifically to assess how and where future climate change is likely to impact subsea cables and their shore-based infrastructure. We find that ocean conditions are highly likely to change on a global basis as a result of climate change, but the feedbacks and links between climate change, natural processes and human activities are often complicated, resulting in a high degree of geographic variability. We identify climate change ‘hotspots’ (regions and locations likely to experience the greatest impacts) but find that not all areas will be affected in the same manner, nor synchronously by the same processes. We conclude that cable routes should carefully consider locally-variable drivers of hazard frequency and magnitude. Consideration should be given both to instantaneous events (e.g. landslides, tropical cyclones) as well as longer-term, sustained impacts (e.g. seabed currents that circulate even in deep water). Multiple factors can combine to increase the risk posed to subsea cables, hence a holistic approach is essential to assess the compounded effects of both natural processes and human activities in the future

The Ubiquitin-Proteasome Reporter GFPu Does Not Accumulate in Neurons of the R6/2 Transgenic Mouse Model of Huntington's Disease

Impairment of the ubiquitin-proteasome system (UPS) has long been considered an attractive hypothesis to explain the selective dysfunction and death of neurons in polyglutamine disorders such as Huntington's disease (HD). The fact that inclusion bodies in HD mouse models and patient brains are rich in ubiquitin and proteasome components suggests that the UPS may be hindered directly or indirectly by inclusion bodies or their misfolded monomeric or oligomeric precursors. However, studies into UPS function in various polyglutamine disease models have yielded conflicting results, suggesting mutant polyglutamine tracts may exert different effects on the UPS depending on protein context, expression level, subcellular localisation and cell-type. To investigate UPS function in a well-characterised mouse model of HD, we have crossed R6/2 HD mice with transgenic UPS reporter mice expressing the GFPu construct. The GFPu construct comprises GFP fused to a constitutive degradation signal (CL-1) that promotes its rapid degradation under conditions of a healthy UPS. Using a combination of immunoblot analysis, fluorescence and immunofluorescence microscopy studies, we found that steady-state GFPu levels were not detectably different between R6/2 and non-R6/2 brain. We observed no correlation between inclusion body formation and GFPu accumulation, suggesting no direct relationship between protein aggregation and global UPS inhibition in R6/2 mice. These findings suggest that while certain branches of the UPS can be impaired by mutant polyglutamine proteins, such proteins do not necessarily cause total blockade of UPS-dependent degradation. It is therefore likely that the relationship between mutant polyglutamine proteins and the UPS is more complex than originally anticipated

A New Look at Massive Clusters: weak lensing constraints on the triaxial dark matter halos of Abell 1689, Abell 1835, & Abell 2204

Measuring the 3D distribution of mass on galaxy cluster scales is a crucial test of the LCDM model, providing constraints on the nature of dark matter. Recent work investigating mass distributions of individual galaxy clusters (e.g. Abell 1689) using weak and strong gravitational lensing has revealed potential inconsistencies between the predictions of structure formation models relating halo mass to concentration and those relationships as measured in massive clusters. However, such analyses employ simple spherical halo models while a growing body of work indicates that triaxial 3D halo structure is both common and important in parameter estimates. We recently introduced a Markov Chain Monte Carlo (MCMC) method to fit fully triaxial models to weak lensing data that gives parameter and error estimates that fully incorporate the true shape uncertainty present in nature. In this paper we apply that method to weak lensing data obtained with the ESO/MPG Wide-Field Imager for galaxy clusters A1689, A1835, and A2204, under a range of Bayesian priors derived from theory and from independent X-ray and strong lensing observations. For Abell 1689, using a simple strong lensing prior we find marginalized mean parameter values M_200 = (0.83 +- 0.16)x10^15 M_solar/h and C=12.2 +- 6.7, which are marginally consistent with the mass-concentration relation predicted in LCDM. The large error contours that accompany our triaxial parameter estimates more accurately represent the true extent of our limited knowledge of the structure of galaxy cluster lenses, and make clear the importance of combining many constraints from other theoretical, lensing (strong, flexion), or other observational (X-ray, SZ, dynamical) data to confidently measure cluster mass profiles. (Abridged)Comment: 21 pages, 10 figures, accepted for publication in MNRA