Hip and Knee Replacement in the HIV positive patient

Arthroplasty is used to relieve pain associated with degenerative or inflammatory joint disease, some post-traumatic joint problems, and avascular necrosis. Avascular necrosis, inflammatory and post-traumatic problems are seen on a regular basis in areas of high HIV seroprevalence. Degenerative arthritis is rare in younger HIV patients, however. Historically the only group of HIV patients in which arthroplasty has been common is that which received contaminated factor VIII transfusions in the 1980’s. Haemophiliacs get a haemophilic arthropathy from repeated bleeds into joints and so is an additional complication.Much of the previous literature on this topic has focused on haemophiliac patients. This review examines the success of arthroplasty in HIV positive patients, with an emphasis on non-haemophiliac patients. We conclude that arthroplasty can be a safe procedure for HIV positive individuals if the surgery is carried out in good conditions, and early results are encouraging

Irrigation Laws of the West

Thesis for Degree of LL.B

Magnetars as Highly Magnetized Quark Stars: an analytical treatment

We present an analytical model of a magnetar as a high density magnetized quark bag. The effect of strong magnetic fields (B > 5 x 10^{16} G) in the equation of state is considered. An analytic expression for the Mass-Radius relationship is found from the energy variational principle in general relativity. Our results are compared with observational evidences of possible quark and/or hybrid stars.Comment: 15 pages, 1 figure/Comments added and two references removed. Accepted for publication in Astrophysical Journa

Quality evaluation of health libraries in England: a new framework

Purpose: The purpose of this paper is to give the details of the development of the health libraries standards in England during the last decade; to identify and analyse the main features and innovations of the new accreditation framework published last year to assess the quality of that type of library, comparing it with the previous accreditation programme, and to present its first results. Design/methodology/approach: This study is based on a comparative analysis between the two main health libraries’ accreditation programmes developed in England (the Helicon checklist and the LQAF framework), reviewing the goals they intend to achieve, the methodology they propose and the structure and content of their standards. This analysis is built on a wide literature review, including mostly grey resources: technical standards and reports, newsletters, minutes of meetings, and briefings Findings: In the study, the main changes incorporated in the LQAF framework have been identified both at strategic, tactical and operational levels, delimiting the scope of the “360 degrees review” of the health libraries situation it aims. Besides, the main achievements since the LQAF appeared have been stated: the undertaken of the first National Baseline Assessments against the standards, whose results show the good fitness of English health libraries’ services quality, and the creation of the Innovation Reward. The near future, however, raises some uncertainties prompted by a new revision of the standards. Originality/value: This is the first study about the new LQAF framework and it also provides the first comparison in the literature and a unique view of the main health libraries’ national accreditation programmes in England

The Accreting White Dwarf in SS Cygni Revealed

We have carried out a combined Hubble Space Telescope (HST/GHRS) and Far Ultraviolet Spectroscopic Explorer FUSE) analysis of the prototype dwarf nova SS Cygni during quiescence. The FUSE and HST spectra were obtained at comparable times after outburst and have matching flux levels where the two spectra overlap. In our synthetic spectral analysis, we have used SS Cygni's accurate HST FGS parallax giving d = 166pc, a newly determined mass for the accreting white dwarf (Bitner et al. 2007) of Mwd=0.81Msun (lower than the previous, widely used 1.2 Msun) and the reddening E_{B-V} values 0.04 (Verbunt 1987; La Dous 1991) and 0.07 (Bruch and Engel 1994) derived from the 2175A absorption feature in the IUE LWP spectra. From the best-fit model solutions to the combined HST + FUSE spectral energy distribution, we find that the white dwarf is reaching a temperature Teff of 45-55,000K in quiescence, assuming Log(g)= 8.3 with a solar composition accreted atmosphere. The exact temperature of the WD depends on the reddening assumed and on the inclusion of a quiescent low mass accretion rate accretion disk. Accretion disk models alone fit badly in the FUSE range while, and if we take the distance to be a free parameter, the only accretion disk model which fits well is for a discordant distance of at least several hundred pc and an accretion rate (1.E-8 Msun/yr which is unacceptably high for a dwarf nova in quiescence. We discuss the implications of the white dwarf's temperature on the time-averaged accretion rate and long term compressional heating models.Comment: ApJ, accepte

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs

Parallax and Distance Estimates for Twelve Cataclysmic Variable Stars

We report parallax and distance estimates for twelve more cataclysmic binaries and related objects observed with the 2.4m Hiltner telescope at MDM Observatory. The final parallax accuracy is typically about 1 mas. For only one of the twelve objects, IR Gem, do we fail to detect a significant parallax. Notable results include distances for V396 Hya (CE 315), a helium double degenerate with a relatively long orbital period, and for MQ Dra (SDSSJ155331+551615), a magnetic system with a very low accretion rate. We find that the Z Cam star KT Persei is physically paired with a K main-sequence star lying 15 arcsec away. Several of the targets have distance estimates in the literature that are based on the white dwarf's effective temperature and flux; our measurements broadly corroborate these estimates, but tend to put the stars a bit closer, indicating that the white dwarfs may have rather larger masses than assumed. As a side note, we briefly describe radial velocity spectroscopy that refines the orbital period of V396 Hya to 65.07 +- 0.08 min.Comment: Accepted for Astronomical Journal. 19 pages, no figure

Variación de las propiedades estructurales, térmicas y mecánicas del Poli (ácido láctico) por medio del empleo de aditivos derivados de la resina de pino

[ES] El principal objetivo del presente trabajo ha sido la utilización de resinas de pino y algunos de sus derivados en la modificación del ácido poliláctico (PLA), en específico se ha utilizado como modificadores gum rosin y unik tack en diferentes proporciones, 5, 10 y 15 phr en mezclas con PLA, las mezclas fueron realizadas con procesos convencionales de conformado de polímeros. Posteriormente se caracterizaron los materiales obtenidos mediante las principales técnicas de caracterización de polímeros, cuyos resultados cuantitativos y cualitativos permitieron determinar los cambios ocurrido en la propiedades mecánicas, térmicas y microestructurales del material. Además, se incluyeron ensayos de color, ángulo de contacto e índice de fluidez con el objetivo de tener información adicional acerca del material estudiado, así como el estudio de forma exhaustiva de las principales características, propiedades y aplicaciones del PLA y de las resinas empleadas, para tomarlas como punto de referencia al momento de obtener los resultados de la caracterización de los materiales mezclados en sus distintas proporciones.The use of pine resin and some of its derivatives in the modification of Poly (lactic acid) PLA, arises from the interest of knowing how it affects the incorporation of resins in the structure of the PLA, either in increase or decrease of its properties. For them they consider the realization of mixtures of PLA and resins in different proportions. Later, analyze the materials obtained by means of polymer characterization techniques. As well as the exhaustive study of the main characteristics, properties and applications of the PLA and the residences used. To take them as a point of reference when obtaining the results of the characterization of the materials obtained in their various proportions.[CA] El principal objectiu del present treball ha sigut la utilització de resines de pi i alguns dels seus derivats en la modificació de l'àcid poliláctic (PLA). En concret, s'ha utilitzat com a modificadors gum rosin i unik tuck en diferents proporcions, 5, 10 i 15 phr en mescles amb PLA, les mescles van ser realitzades amb processos convencionals de conformat de polímers. Posteriorment es van caracteritzar els materials obtinguts per mitjà de les principals tècniques de caracterització de polímers, els resultats quantitatius i qualitatius dels quals van permetre determinar els canvis ocorregut en la propietats mecàniques, tèrmiques i microestructurals del material. A més, es van incloure assajos de color, angle de contacte i índex de fluïdesa amb l'objectiu de tindre informació addicional sobre el material estudiat, així com l'estudi de forma exhaustiva de les principals característiques, propietats i aplicacions del PLA i de les resines empleades, per a prendre-les com a punt de referència al moment d'obtindre els resultats de la caracterització dels materials mesclats en les seues distintes proporcions.Rosa Ramírez, HDL. (2018). Variación de las propiedades estructurales, térmicas y mecánicas del Poli (ácido láctico) por medio del empleo de aditivos derivados de la resina de pino. http://hdl.handle.net/10251/115399TFG

Oligomerization of amyloid Abeta peptides using hydrogen bonds and hydrophobicity forces

The 16-22 amino acid fragment of the beta-amyloid peptide associated with the Alzheimer's disease, Abeta, is capable of forming amyloid fibrils. Here we study the aggregation mechanism of Abeta(16-22) peptides by unbiased thermodynamic simulations at the atomic level for systems of one, three and six Abeta(16-22) peptides. We find that the isolated Abeta(16-22) peptide is mainly a random coil in the sense that both the alpha-helix and beta-strand contents are low, whereas the three- and six-chain systems form aggregated structures with a high beta-sheet content. Furthermore, in agreement with experiments on Abeta(16-22) fibrils, we find that large parallel beta-sheets are unlikely to form. For the six-chain system, the aggregated structures can have many different shapes, but certain particularly stable shapes can be identified.Comment: 19 pages, 7 figures (to appear in Biophys. J.

The White Dwarf in EM Cygni: Beyond The Veil

We present a spectral analysis of the FUSE spectra of EM Cygni, a Z Cam DN system. The FUSE spectrum, obtained in quiescence, consists of 4 individual exposures (orbits): two exposures, at orbital phases phi ~ 0.65 and phi ~ 0.90, have a lower flux; and two exposures, at orbital phases phi =0.15 and 0.45, have a relatively higher flux. The change of flux level as a function of the orbital phase is consistent with the stream material (flowing over and below the disk from the hot spot region to smaller radii) partially masking the white dwarf. We carry out a spectral analysis of the FUSE data, obtained at phase 0.45 (when the flux is maximual, using the codes TLUSTY and SYNSPEC. Using a single white dwarf spectral component, we obtain a white dwarf temperature of 40,000K, rotating at 100km/s. The white dwarf, or conceivably, the material overflowing the disk rim, shows suprasolar abundances of silicon, sulphur and possibly nitrogen. Using a white dwarf+disk composite model, we obtain that the white dwarf temperature could be even as high as 50,000K, contributing more than 90% of the FUV flux, and the disk contributing less than 10% must have a mass accretion rate reaching 1.E-10 Msun/yr.In both cases, however, we obtain that the white dwarf temperature is much higher than previously estimated.Comment: accepted for publication in ApJ, 3 Tables, 12 Figures (including color figures), 33 pages in present format (possibly 10 pages in ApJ format