Tuberculosis treatment delays and associated factors within the Zimbabwe national tuberculosis programme.

BACKGROUND: Delayed presentation of pulmonary TB (PTB) patients for treatment from onset of symptoms remains a threat to controlling individual disease progression and TB transmission in the community. Currently, there is insufficient information about treatment delays in Zimbabwe, and we therefore determined the extent of patient and health systems delays and their associated factors in patients with microbiologically confirmed PTB. METHODS: A structured questionnaire was administered at 47 randomly selected health facilities in Zimbabwe by trained health workers to all patients aged ≥18 years with microbiologically confirmed PTB who were started on TB treatment and entered in the health facility TB registers between 01 January and 31 March 2013. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for associations between patient/health system characteristics and patient delay >30 days or health system delay >4 days. RESULTS: Of the 383 recruited patients, 211(55%) were male with an overall median age of 34 years (IQR, 28-43). There was a median of 28 days (IQR, 21-63) for patient delays and 2 days (IQR, 1-5) for health system delays with 184 (48%) and 118 (31%) TB patients experiencing health system delays >30 days and health system delays >4 days respectively. Starting TB treatment at rural primary healthcare vs district/mission facilities [aOR 2.70, 95% CI 1.27-5.75, p = 0.01] and taking self-medication [aOR 2.33, 95% CI 1.23-4.43, p = 0.01] were associated with encountering patient delays. Associated with health system delays were accessing treatment from lower level facilities [aOR 2.67, 95% CI 1.18-6.07, p = 0.019], having a Gene Xpert TB diagnosis [aOR 0.21, 95% CI 0.07-0.66, p = 0.008] and >4 health facility visits prior to TB diagnosis [(aOR) 3.34, 95% CI 1.11-10.03, p = 0.045]. CONCLUSION: Patient delays were longer and more prevalent, suggesting the need for strategies aimed at promoting timely seeking of appropriate medical consultation among presumptive TB patients. Health system delays were uncommon, suggesting a fairly efficient response to microbiologically confirmed PTB cases. Identified risk factors should be explored further and specific strategies aimed at addressing these factors should be identified in order to lessen patient and health system delays

Elliptic Curves over Real Quadratic Fields are Modular

We prove that all elliptic curves defined over real quadratic fields are modular.Comment: 38 pages. Magma scripts available as ancillary files with this arXiv versio

Generally Deformed Oscillator, Isospectral Oscillator System and Hermitian Phase Operator

The generally deformed oscillator (GDO) and its multiphoton realization as well as the coherent and squeezed vacuum states are studied. We discuss, in particular, the GDO depending on a complex parameter q (therefore we call it q-GDO) together with the finite dimensional cyclic representations. As a realistic physical system of GDO the isospectral oscillator system is studied and it is found that its coherent and squeezed vacuum states are closely related to those of the oscillator. It is pointed out that starting from the q-GDO with q root of unity one can define the hermitian phase operators in quantum optics consistently and algebraically. The new creation and annihilation operators of the Pegg-Barnett type phase operator theory are defined by using the cyclic representations and these operators degenerate to those of the ordinary oscillator in the classical limit q->1.Comment: 21 pages, latex, no figure

Stiff monatomic gold wires with a spinning zigzag geometry

Using first principles density functional calculations, gold monatomic wires are found to exhibit a zigzag shape which remains under tension, becoming linear just before breaking. At room temperature they are found to spin, what explains the extremely long apparent interatomic distances shown by electron microscopy.The zigzag structure is stable if the tension is relieved, the wire holding its chainlike shape even as a free-standing cluster. This unexpected metallic-wire stiffness stems from the transverse quantization in the wire, as shown in a simple free electron model.Comment: 4 pages, latex, 5 figures, submitted to PR

Cloud type comparisons of AIRS, CloudSat, and CALIPSO cloud height and amount

The precision of the two-layer cloud height fields derived from the Atmospheric Infrared Sounder (AIRS) is explored and quantified for a five-day set of observations. Coincident profiles of vertical cloud structure by CloudSat, a 94 GHz profiling radar, and the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO), are compared to AIRS for a wide range of cloud types. Bias and variability in cloud height differences are shown to have dependence on cloud type, height, and amount, as well as whether CloudSat or CALIPSO is used as the comparison standard. The CloudSat-AIRS biases and variability range from −4.3 to 0.5±1.2–3.6 km for all cloud types. Likewise, the CALIPSO-AIRS biases range from 0.6–3.0±1.2–3.6 km (−5.8 to −0.2±0.5–2.7 km) for clouds ≥7 km (<7 km). The upper layer of AIRS has the greatest sensitivity to Altocumulus, Altostratus, Cirrus, Cumulonimbus, and Nimbostratus, whereas the lower layer has the greatest sensitivity to Cumulus and Stratocumulus. Although the bias and variability generally decrease with increasing cloud amount, the ability of AIRS to constrain cloud occurrence, height, and amount is demonstrated across all cloud types for many geophysical conditions. In particular, skill is demonstrated for thin Cirrus, as well as some Cumulus and Stratocumulus, cloud types infrared sounders typically struggle to quantify. Furthermore, some improvements in the AIRS Version 5 operational retrieval algorithm are demonstrated. However, limitations in AIRS cloud retrievals are also revealed, including the existence of spurious Cirrus near the tropopause and low cloud layers within Cumulonimbus and Nimbostratus clouds. Likely causes of spurious clouds are identified and the potential for further improvement is discussed

Water Vapor Measurements by Howard University Raman Lidar during the WAVES 2006 Campaign

Retrieval of water vapor mixing ratio using the Howard University Raman Lidar is presented with emphasis on three aspects: i) performance of the lidar against collocated radiosondes and Raman lidar, ii) investigation of the atmospheric state variables when poor agreement between lidar and radiosondes values occurred and iii) a comparison with satellite-based measurements. The measurements were acquired during the Water Vapor Validation Experiment Sondes/Satellites 2006 field campaign. Ensemble averaging of water vapor mixing ratio data from ten night-time comparisons with Vaisala RS92 radiosondes shows on average an agreement within 10 % up to approx. 8 km. A similar analysis of lidar-to-lidar data of over 700 profiles revealed an agreement to within 20 % over the first 7 km (10 % below 4 km). A grid analysis, defined in the temperature - relative humidity space, was developed to characterize the lidar - radiosonde agreement and quantitatively localizes regions of strong and weak correlations as a function of altitude, temperature or relative humidity. Three main regions of weak correlation emerge: i) regions of low relative humidity and low temperature, ii) moderate relative humidity at low temperatures and iii) low relative humidity at moderate temperatures. Comparison of Atmospheric InfraRed Sounder and Tropospheric Emission Sounder satellites retrievals of moisture with that of Howard University Raman Lidar showed a general agreement in the trend but the formers miss a lot of the details in atmospheric structure due to their low resolution. A relative difference of about 20 % is usually found between lidar and satellites measurements

Competitiveness and communication for effective inoculation byRhizobium, Bradyrhizobium and vesicular-arbuscular mycorrhiza fungi

After a short summary on the ecology and rhizosphere biology of symbiotic bacteria and vesicular-arbuscular (VA) mycorrhiza fungi and their application as microbial inocula, results on competitiveness and communication are summarized. Stress factors such as high temperature, low soil pH, aluminium concentrations and phytoalexins produced by the host plants were studied withRhizobium leguminosarum bv.phaseoli andRhizobium tropici onPhaseolus beans. Quantitative data for competitiveness were obtained by usinggus + (glucoronidase) labelled strains, which produce blue-coloured nodules. ForPhaseolus-nodulating rhizobia, a group specific DNA probe was also developed, which did not hybridize with more than 20 other common soil and rhizosphere bacteria. Results from several laboratories contributing to knowledge of signal exchange and communication in theRhizobium/Bradyrhizobium legume system are summarized in a new scheme, including also defense reactions at the early stages of legume nodule initiation. Stimulating effects of flavonoids on germination and growth of VA mycorrhiza fungi were also found. A constitutive antifungal compound in pea roots, -isoxazolinonyl-alanine, was characterized

Which Kubo formula gives the exact conductance of a mesoscopic disordered system?

In both research and textbook literature one often finds two ``different'' Kubo formulas for the zero-temperature conductance of a non-interacting Fermi system. They contain a trace of the product of velocity operators and single-particle (retarded and advanced) Green operators: $\text{Tr} (\hat{v}_x \hat{G}^r \hat{v}_x \hat{G}^a)$ or $\text{Tr} (\hat{v}_x \text{Im} \hat{G} \hat{v}_x \text{Im} \hat{G})$. The study investigates the relationship between these expressions, as well as the requirements of current conservation, through exact evaluation of such quantum-mechanical traces for a nanoscale (containing 1000 atoms) mesoscopic disordered conductor. The traces are computed in the semiclassical regime (where disorder is weak) and, more importantly, in the nonperturbative transport regime (including the region around localization-delocalization transition) where concept of mean free path ceases to exist. Since quantum interference effects for such strong disorder are not amenable to diagrammatic or nonlinear $\sigma$-model techniques, the evolution of different Green function terms with disorder strength provides novel insight into the development of an Anderson localized phase.Comment: 7 pages, 5 embedded EPS figures, final published version (note: PRB article has different title due to editorial censorship

The IceCube Neutrino Observatory: Instrumentation and Online Systems

The IceCube Neutrino Observatory is a cubic-kilometer-scale high-energy neutrino detector built into the ice at the South Pole. Construction of IceCube, the largest neutrino detector built to date, was completed in 2011 and enabled the discovery of high-energy astrophysical neutrinos. We describe here the design, production, and calibration of the IceCube digital optical module (DOM), the cable systems, computing hardware, and our methodology for drilling and deployment. We also describe the online triggering and data filtering systems that select candidate neutrino and cosmic ray events for analysis. Due to a rigorous pre-deployment protocol, 98.4% of the DOMs in the deep ice are operating and collecting data. IceCube routinely achieves a detector uptime of 99% by emphasizing software stability and monitoring. Detector operations have been stable since construction was completed, and the detector is expected to operate at least until the end of the next decade.Comment: 83 pages, 50 figures; updated with minor changes from journal review and proofin

Planet Hunters Tess I: TOI 813, a subgiant hosting a transiting Saturn-sized planet on an 84-day orbit

We report on the discovery and validation of TOI 813 b (TIC55525572b), a transiting exoplanet identified by citizen scientists in data from NASA\u27s Transiting Exoplanet Survey Satellite (TESS) and the first planet discovered by the Planet Hunters TESS project. The host star is a bright (V = 10.3 mag) subgiant (R* = 1.94 R☉, M☉ = 1.32 M☉). It was observed almost continuously by TESS during its first year of operations, during which time four individual transit events were detected. The candidate passed all the standard light curve-based vetting checks, and ground-based follow-up spectroscopy and speckle imaging enabled us to place an upper limit of 2 MJup (99 per cent confidence) on the mass of the companion, and to statistically validate its planetary nature. Detailed modelling of the transits yields a period of 83.8911+0.0027-0.0031 d, a planet radius of 6.71 ± 0.38 R⊕ and a semimajor axis of 0.423+0031-0.037 AU. The planet\u27s orbital period combined with the evolved nature of the host star places this object in a relatively underexplored region of parameter space. We estimate that TOI 813 b induces a reflex motion in its host star with a semi-amplitude of ∼6 m s−1, making this a promising system to measure the mass of a relatively long-period transiting planet