Nevirapine- and efavirenz-associated hepatotoxicity under programmatic conditions in Kenya and Mozambique.

To describe the frequency, risk factors, and clinical signs and symptoms associated with hepatotoxicity (HT) in patients on nevirapine- or efavirenz-based antiretroviral therapy (ART), we conducted a retrospective cohort analysis of patients attending the ART clinic in Kibera, Kenya, from April 2003 to December 2006 and in Mavalane, Mozambique, from December 2002 to March 2007. Data were collected on 5832 HIV-positive individuals who had initiated nevirapine- or efavirenz-based ART. Median baseline CD4+ count was 125 cells/μL (interquartile range [IQR] 55-196). Over a median follow-up time of 426 (IQR 147-693) days, 124 (2.4%) patients developed HT. Forty-one (54.7%) of 75 patients with grade 3 HT compared with 21 (80.8%) of 26 with grade 4 had associated clinical signs or symptoms (P = 0.018). Four (5.7%) of 124 patients with HT died in the first six months compared with 271 (5.3%) of 5159 patients who did not develop HT (P = 0.315). The proportion of patients developing HT was low and HT was not associated with increased mortality. Clinical signs and symptoms identified 50% of grade 3 HT and most cases of grade 4 HT. This suggests that in settings where alanine aminotransferase measurement is not feasible, nevirapine- and efavirenz-based ART may be given safely without laboratory monitoring

Low level of virological failure and drug resistance among patients receiving antiretroviral treatment under programme conditions in Maputo, Mozambique

Mexico AIDS Conference 200

The Biot-Savart operator and electrodynamics on subdomains of the three-sphere

We study steady-state magnetic fields in the geometric setting of positive curvature on subdomains of the three-dimensional sphere. By generalizing the Biot-Savart law to an integral operator BS acting on all vector fields, we show that electrodynamics in such a setting behaves rather similarly to Euclidean electrodynamics. For instance, for current J and magnetic field BS(J), we show that Maxwell's equations naturally hold. In all instances, the formulas we give are geometrically meaningful: they are preserved by orientation-preserving isometries of the three-sphere. This article describes several properties of BS: we show it is self-adjoint, bounded, and extends to a compact operator on a Hilbert space. For vector fields that act like currents, we prove the curl operator is a left inverse to BS; thus the Biot-Savart operator is important in the study of curl eigenvalues, with applications to energy-minimization problems in geometry and physics. We conclude with two examples, which indicate our bounds are typically within an order of magnitude of being sharp.Comment: 24 pages (was 28 pages) Revised to include a new introduction, a detailed example, and results about helicity; other changes for readabilit

Compression and fracture of ordered and disordered droplet rafts

We simulate a two-dimensional array of droplets being compressed between two walls. The droplets are adhesive due to an attractive depletion force. As one wall moves toward the other, the droplet array is compressed and eventually induced to rearrange. The rearrangement occurs via a fracture, where depletion bonds are quickly broken between a subset of droplets. For monodisperse, hexagonally ordered droplet arrays, this fracture is preceded by a maximum force exerted on the walls, which drops rapidly after the fracture occurs. In small droplet arrays a fracture is a single well-defined event, but for larger droplet arrays, competing fractures can be observed. These are fractures nucleated nearly simultaneously in different locations. Finally, we also study the compression of bidisperse droplet arrays. The addition of a second droplet size further disrupts fracture events, showing differences between ideal crystalline arrays, crystalline arrays with a small number of defects, and fully amorphous arrays. These results are in good agreement with previously published experiments.Comment: 14 pages, 14 figure

Analysis of coupled heat and moisture transfer in masonry structures

Evaluation of effective or macroscopic coefficients of thermal conductivity under coupled heat and moisture transfer is presented. The paper first gives a detailed summary on the solution of a simple steady state heat conduction problem with an emphasis on various types of boundary conditions applied to the representative volume element -- a periodic unit cell. Since the results essentially suggest no superiority of any type of boundary conditions, the paper proceeds with the coupled nonlinear heat and moisture problem subjecting the selected representative volume element to the prescribed macroscopically uniform heat flux. This allows for a direct use of the academic or commercially available codes. Here, the presented results are derived with the help of the SIFEL (SIimple Finite Elements) system.Comment: 23 pages, 11 figure

A method for determining gas-hydrate or free-gas saturation of porous media from seismic measurements

The occurrence of gas hydrate or free gas in a porous medium changes the medium’s elastic properties. Explicit formulas for gas-hydrate or free-gas saturation of pore space on the basis of the Frenkel-Gassmann equations describe the elastic moduli and seismic velocities of a porous medium for low frequencies. A key assumption of the model is that either gas hydrate or free gas is present in the pore space in addition to water. Under this assumption, the method uses measured P- and S-wave velocities and bulk density along with estimates of the moduli and densities of the solid and fluid phases present to determine whether gas or hydrate is present. The method then determines the saturation level of either the gas or the hydrate. I apply the method to published velocity and density data from seismic studies at the antarctic Shetland margin and at the Storegga slide, offshore Norway, and to borehole log and core data from Ocean Drilling Program (ODP) Leg 164 at Blake Ridge, offshore South Carolina. A sensitivity analysis reveals that the standard deviations of the gas-hydrate and free-gas saturations reach 30%–70% of the saturations if the standard deviations of the P- and S-wave velocities and of the bulk density are 50m∕s ..

Thermoelastic Damping in Micro- and Nano-Mechanical Systems

The importance of thermoelastic damping as a fundamental dissipation mechanism for small-scale mechanical resonators is evaluated in light of recent efforts to design high-Q micrometer- and nanometer-scale electro-mechanical systems (MEMS and NEMS). The equations of linear thermoelasticity are used to give a simple derivation for thermoelastic damping of small flexural vibrations in thin beams. It is shown that Zener's well-known approximation by a Lorentzian with a single thermal relaxation time slightly deviates from the exact expression.Comment: 10 pages. Submitted to Phys. Rev.