Determinants of incident vulvovaginal candidiasis in human immunodeficiency virus-positive women.

OBJECTIVE: Mucosal infections including vulvovaginal candidiasis are a common problem for women with human immunodeficiency virus (HIV) infection. Our objective was to determine which factors predict the development of symptomatic disease among HIV-infected women. MATERIALS AND METHODS: In a prospective study from 1991 to 1995, 205 HIV-positive women were evaluated every 6 months for occurrences of vulvovaginal candidiasis. Included in the study were all initially asymptomatic women, whether they were fungal-culture-positive or -negative at baseline. Excluded from the study were all women with symptomatic vulvovaginal candidiasis at the initial visit, those who developed trichomonas vaginitis at any visit, and those who used any antifungal agents. RESULTS: The risk of the development of vulvovaginal candidiasis did not differ between women who were asymptomatically colonized at baseline and those who were fungal-culture-negative. However, the risk of developing vulvovaginal candidiasis was increased 6.8 times for women with CD4 counts less than 200 cells/mm3 at baseline. CONCLUSIONS: Fungal culture is not predictive of the development of symptomatic vulvovaginal candidiasis. Women infected with HIV who have CD4 counts below 200 cells/mm3 should be monitored more carefully for vulvovaginal candidiasis

Modeling flow in a pressure-sensitive, heterogeneous medium

Using an asymptotic methodology, including an expansion in inverse powers of {radical}{omega}, where {omega} is the frequency, we derive a solution for flow in a medium with pressure dependent properties. The solution is valid for a heterogeneous medium with smoothly varying properties. That is, the scale length of the heterogeneity must be significantly larger then the scale length over which the pressure increases from it initial value to its peak value. The resulting asymptotic expression is similar in form to the solution for pressure in a medium in which the flow properties are not functions of pressure. Both the expression for pseudo-phase, which is related to the 'travel time' of the transient pressure disturbance, and the expression for pressure amplitude contain modifications due to the pressure dependence of the medium. We apply the method to synthetic and observed pressure variations in a deforming medium. In the synthetic test we model one-dimensional propagation in a pressure-dependent medium. Comparisons with both an analytic self-similar solution and the results of a numerical simulation indicate general agreement. Furthermore, we are able to match pressure variations observed during a pulse test at the Coaraze Laboratory site in France

A Generalized Multiscale Finite Element Method for poroelasticity problems II: nonlinear coupling

In this paper, we consider the numerical solution of some nonlinear poroelasticity problems that are of Biot type and develop a general algorithm for solving nonlinear coupled systems. We discuss the difficulties associated with flow and mechanics in heterogenous media with nonlinear coupling. The central issue being how to handle the nonlinearities and the multiscale scale nature of the media. To compute an efficient numerical solution we develop and implement a Generalized Multiscale Finite Element Method (GMsFEM) that solves nonlinear problems on a coarse grid by constructing local multiscale basis functions and treating part of the nonlinearity locally as a parametric value. After linearization with a Picard Iteration, the procedure begins with construction of multiscale bases for both displacement and pressure in each coarse block by treating the staggered nonlinearity as a parametric value. Using a snapshot space and local spectral problems, we construct an offline basis of reduced dimension. From here an online, parametric dependent, space is constructed. Finally, after multiplying by a multiscale partitions of unity, the multiscale basis is constructed and the coarse grid problem then can be solved for arbitrary forcing and boundary conditions. We implement this algorithm on a geometry with a linear and nonlinear pressure dependent permeability field and compute error between the multiscale solution with the fine-scale solutions

Erosive processes due to physical-biological interactions based in a cellular automata model

The Bahía Blanca Estuary (38° 50' S, 62° 30' W) presents salt marshes where interactions between the local main plant and the dominant crab generate some very characteristics salt pans. These pans alter the normal water circulation and condition its trajectory generating an erosive process. The removed sediment is then exported to the main estuary through the creeks that evolve from those biological-physical interactions. To study it, a conceptual model is proposed, based on the laws deduced from observation of these phenomena in the field, and then verified with measurable data within macroscale time units. The objective of this article is to model how the interaction between the crab C. granulata and the plant S. perennis modifies the landscape of the salt marsh and influences the loss of sediment with a Cellular Automata Model. Originally developed to study the effect of the interaction plant - crab in the formation of tidal creeks, the model copies the basic laws that dominate the problem based on purely biological factors. Finally, the volume of sediment that is removed and how it varies in time are evaluated. The model results a very good tool to integrate a large quantity of data collected recently and to be able to extract conclusions on processes that have a very slow dynamics. Additionally, it could reproduce faithfully the salt marsh landscape product of the plants - crab interaction

Simulación de la formación de canales de mareas por medio de autómatas celulares y fractales

El objetivo de este trabajo es estudiar y simular la interacción entre los agentes biológicos responsables de modificar el paisaje de las marismas e influir en la formación de canales de marea, en particular el cangrejo Chasmagnatus granulatus y la planta Sarcocornia perennis. La interacción entre la planta y el cangrejo se basa en leyes simples, pero cuyo resultado es un complejo mecanismo biológico que desemboca en un proceso erosivo sobre la marisma y favorece la formación de canales de marea (Escapa et. al. 2003). Estos tipos de problemas basados en leyes simples han sido modelados con buena precisión por modelos de Autómatas Celulares (Dunkerley 1997, Matsinos y Troumbis 2002, Aassine y El Jai 2002, Bandini y Pavesi, 2002 ). En particular se desea recrear las leyes observadas y medidas, para obtener una forma automática de reproducir las perturbaciones biológicas en el terreno y estudiar su efecto en la generación de canales de marea en base al estudio de un modelo digital de terreno resultante. Una simulación exitosa permitiría, entre otras cosas, predecir la formación de canales en lugares en donde sería peligroso o problemático (cercanía de rutas o poblaciones).Eje: Visualización y Computación gráficaRed de Universidades con Carreras en Informática (RedUNCI

Trends of and factors associated with live-birth and abortion rates among HIV-positive and HIV-negative women

Little is known about fertility choices and pregnancy outcome rates among HIV-infected women in the current combination ART era

Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa

Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes

Beyond belief: Strategic taboos and organizational identity in strategic agenda setting

A comprehensive strategic agenda matters for fundamental strategic change. Our study seeks to explore and theorize how organizational identity beliefs influence the judgment of strategic actors when setting an organization’s strategic agenda. We offer the notion of “strategic taboo” as those strategic options initially disqualified and deemed inconsistent with the organizational identity beliefs of strategic actors. Our study is concerned with how strategic actors confront strategic taboos in the process of setting an organization’s strategic agenda. Based on a revelatory inductive case study, we find that strategic actors engage in assessing the concordance of the strategic taboos with organizational identity beliefs and, more specifically, that they focus on key identity elements (philosophy; priorities; practices) when doing so. We develop a typology of three reinterpretation practices that are each concerned with a key identity element. While contextualizing assesses the potential concordance of a strategic taboo with an organization’s overall philosophy and purpose, instrumentalizing assesses such concordance with respect to what actors deem an organization’s priorities to be. Finally, normalizing explores concordance with respect to compatibility and fit with the organization’s practices. We suggest that assessing concordance of a strategic taboo with identity elements consists in reinterpreting collective identity beliefs in ways that make them consistent with what organizational actors deem the right course of action. This article discusses the implications for theory and research on strategic agenda setting, strategic change, a practice-based perspective on strategy, and on organizational identity. © The Author(s) 2014

Complementary hydro-mechanical coupled finite/discrete element and microseismic modelling to predict hydraulic fracture propagation in tight shale reservoirs

This paper presents a novel approach to predict the propagation of hydraulic fractures in tight shale reservoirs. Many hydraulic fracture modelling schemes assume that the fracture direction is pre-seeded in the problem domain discretization. This is a severe limitation as the reservoir often contains large numbers of pre-existing fractures that strongly influence the direction of the propagating fracture. To circumvent these shortcomings a new fracture modelling treatment is proposed where the introduction of discrete fracture surfaces is based on new and dynamically updated geometrical entities rather than the topology of the underlying spatial discretization. Hydraulic fracturing is an inherently coupled engineering problem with interactions between fluid flow and fracturing when the stress state of the reservoir rock attains a failure criterion. This work follows a staggered hydro-mechanical coupled finite/discrete element approach to capture the key interplay between fluid pressure and fracture growth. In field practice the fracture growth is hidden from the design engineer and microseismicity is often used to infer hydraulic fracture lengths and directions. Microsesimic output can also be computed from changes of the effective stress in the geomechanical model and compared against field microseismicity. A number of hydraulic fracture numerical examples are presented to illustrate the new technology