244 research outputs found
Incidence and Predictors of Tuberculosis Among Adult PLWHA at Public Health Facilities of Hawassa City
Tuberculosis (TB) is the most frequently diagnosed opportunistic infection (OI) and disease in people living with HIV/AIDS (PLWHA), world-wide. This study aimed at determining the incidence and predictors of tuberculosis among people living with HIV.A Six year retrospective follow up study was conducted among adult PLHIV. The Cox proportional hazards model was used to identify predictors.A total of 554 patients were followed and produced 1830.3 person year of observation. One hundred sixty one new TB cases occurred during the follow up period. The overall incidence density of TB was 8.79 per 100 person-year (PY). It was high (148.71/100 PY) in the first year of enrolment. The cumulative proportion of TB free survival was 79% and 67% at the end of first and sixth years, respectively. Not having formal education(AHR=2.68, 95%CI: 1.41, 5.11 ), base line WHO clinical stage IV (AHR = 3.22, 95% CI=1.91-5.41), CD4 count <50 cell/ul (AHR=2.41, 95%CI=1.31, 4.42), Being bed redden (AHR= 2.89, 95%CI=1.72, 3.78), past TB history (AHR=1.65, 95% CI = 1.06,2.39), substance use (AHR=1.46, 95% CI=1.03,2.06) and being on pre ART (AHR=1.62, 95%CI:1.03-2.54 ) were independently predicted tuberculosis occurrence. Advanced WHO clinical stage, limited functional status, past TB history, addiction and low CD4 (<50cell/ul) count at enrollment were found to be the independent predictor of tuberculosis occurrence. Therefore early initiation of treatment and intensive follow up is important
1,5-Anhydro-2-deoxy-1,2-C-dichloromethylene-3,4,6-tri-O-(4-methoxybenzyl)-d-glycero-d-gulo-hexitol
The pyranosyl ring in the title compound, C31H34Cl2O7, adopts a twist-boat conformation. The 4-methoxybenzyl groups are located in equatorial positions with the methoxy groups nearly coplanar with their respective rings [dihedral angles of 0.2 (3) and 9.4 (2)°]. The aromatic rings adopt orientations enabling them to participate in C—H⋯π interactions with neighboring methoxy groups. The crystal structure is additionally stabilized by weak C—H⋯O interactions
Kinetic versus Magnetic Chaos in Toroidal Plasmas: A systematic quantitative comparison
Magnetic field line chaos occurs under the presence of non-axisymmetric
perturbations of an axisymmetric equilibrium and is manifested by the
destruction of smooth flux surfaces formed by the field lines. These
perturbations also render the particle motion, as described by the guiding
center dynamics, non-integrable and, therefore, chaotic. However, the
chaoticities of the magnetic field lines and the particle orbits significantly
differ both in strength and radial location in a toroidal configuration, except
for the case of very low-energy particles whose orbits closely follow the
magnetic field lines. The chaoticity of more energetic particles, undergoing
large drifts with respect to the magnetic field lines, crucially determines the
confinement properties of a toroidal device but cannot be inferred from that of
the underlying magnetic field. In this work, we implement the Smaller ALignment
Index (SALI) method for detecting and quantifying chaos, allowing for a
systematic comparison between magnetic and kinetic chaos. The efficient
quantification of chaos enables the assignment of a value characterizing the
chaoticity of each orbit in the space of the three constants of the motion,
namely energy, magnetic moment and toroidal momentum. The respective diagrams
provide a unique overview of the different effects of a specific set of
perturbations on the entire range of trapped and passing particles, as well as
the radial location of the chaotic regions, offering a valuable tool for the
study of particle energy and momentum transport and confinement properties of a
toroidal fusion device.Comment: 27 pages, 7 figure
Effectiveness of a simple lymphoedema treatment regimen in podoconiosis management in southern Ethiopia: one year follow-up
Background: Podoconiosis is a non-filarial elephantiasis caused by long-term barefoot exposure to volcanic soils in endemic areas. Irritant silicate particles penetrate the skin, causing a progressive, debilitating lymphoedema of the lower leg, often starting in the second decade of life. A simple patient-led treatment approach appropriate for resource poor settings has been developed, comprising (1) education on aetiology and prevention of podoconiosis, (2) foot hygiene (daily washing with soap, water and an antiseptic), (3) the regular use of emollient, (4) elevation of the limb at night, and (5) emphasis on the consistent use of shoes and socks.
Methodology/Principal Findings: We did a 12-month, non-comparative, longitudinal evaluation of 33 patients newly presenting to one clinic site of a non-government organization (the Mossy Foot Treatment & Prevention Association, MFTPA) in southern Ethiopia. Outcome measures used for the monitoring of disease progress were (1) the clinical staging system for podoconiosis, and (2) the Amharic Dermatology Life Quality Index (DLQI), both of which have been recently validated for use in this setting. Digital photographs were also taken at each visit. Twenty-seven patients completed follow up. Characteristics of patients completing follow-up were not significantly different to those not. Mean clinical stage and lower leg circumference decreased significantly (mean difference -0.67 (95% CI -0.38 to -0.96) and -2.00 (95% CI -1.26 to -2.74), respectively, p<0.001 for both changes). Mean DLQI diminished from 21 (out of a maximum of 30) to 6 (p<0.001). There was a non-significant change in proportion of patients with mossy lesions (p = 0.375).
Conclusions/Significance: This simple, resource-appropriate regimen has a considerable impact both on clinical progression and self-reported quality of life of affected individuals. The regimen appears ideal for scaling up to other endemic regions in Ethiopia and internationally. We recommend that further research in the area include analysis of cost-effectiveness of the regimen
High prevalence of vaccine-preventable anal human papillomavirus infections is associated with HIV infection among gay, bisexual, and men who have sex with men in Nairobi, Kenya
Background: Human papillomavirus (HPV) infection is associated with anal cancers and is more prevalent in gay, bisexual, and men who have sex with men (gbMSM), partly due to their vulnerability to HIV infection. Baseline HPV genotype distributions and risk factors can inform the design of next-generation HPV vaccines to prevent anal cancer.
Methods: A cross-sectional study was conducted among gbMSM receiving care at a HIV/STI clinic in Nairobi, Kenya. Anal swabs were genotyped using a Luminex microsphere array. Multiple logistic regression methods were used to identify risk factors for four HPV outcomes (any HPV, any HR-HPV, and 4- and 9-valent vaccine-preventable HPVs).
Results: Among 115 gbMSM, 51 (44.3%) were HIV-infected. Overall HPV prevalence was 51.3%; 84.3% among gbMSM living with HIV and 24.6% among gbMSM without HIV (p \u3c 0.001). One-third (32.2%) had HR-HPV and the most prevalent vaccine-preventable HR-HPV genotypes were 16, 35, 45, and 58. HPV-18 was uncommon (n = 2). The 9-valent Gardasil vaccine would have prevented 61.0% of HPV types observed in this population. In multivariate analyses, HIV status was the only significant risk factor for any HPV (adjusted odds ratio [aOR]:23.0, 95% confidence interval [95% CI]: 7.3–86.0, p \u3c 0.001) and for HR-HPV (aOR: 8.9, 95% CI: 2.8–36.0, p \u3c 0.001). Similar findings were obtained for vaccine-preventable HPVs. Being married to a woman significantly increased the odds of having HR-HPV infections (aOR: 8.1, 95% CI: 1.6–52.0, p = 0.016).
Conclusions: GbMSM living with HIV in Kenya are at higher risk of anal HPV infections including genotypes that are preventable with available vaccines. Our findings support the need for a targeted HPV vaccination campaign in this population
Quantum Phase Transition in a Resonant Level Coupled to Interacting Leads
An interacting one-dimensional electron system, the Luttinger liquid, is
distinct from the "conventional" Fermi liquids formed by interacting electrons
in two and three dimensions. Some of its most spectacular properties are
revealed in the process of electron tunneling: as a function of the applied
bias or temperature the tunneling current demonstrates a non-trivial power-law
suppression. Here, we create a system which emulates tunneling in a Luttinger
liquid, by controlling the interaction of the tunneling electron with its
environment. We further replace a single tunneling barrier with a
double-barrier resonant level structure and investigate resonant tunneling
between Luttinger liquids. For the first time, we observe perfect transparency
of the resonant level embedded in the interacting environment, while the width
of the resonance tends to zero. We argue that this unique behavior results from
many-body physics of interacting electrons and signals the presence of a
quantum phase transition (QPT). In our samples many parameters, including the
interaction strength, can be precisely controlled; thus, we have created an
attractive model system for studying quantum critical phenomena in general. Our
work therefore has broadly reaching implications for understanding QPTs in more
complex systems, such as cold atoms and strongly correlated bulk materials.Comment: 11 pages total (main text + supplementary
Opportunities and Challenges of Harnessing Biomass Wastes for Decentralized Heat and Energy Generation and Climate Mitigation via Fluidized-bed Gasification Pathway
Biomass wastes offer immense potential as a renewable energy source, holding the promise to replace fossil fuels for heat and energy generation, in particular for decentralized power production. Furthermore, the utilization of biomass promotes circular economy by enabling the conversion of local resources into useful products and energy. However, the conversion of biomass into end-use products and heat/energy is a complex process with multiple pathways, such as fluidized bed gasification, a well-established and efficient method for converting coal and biomass into heat. Despite its merits, this process is currently limited to industrial applications and encounters certain limitations and obstacles. Notably, the low energy density of biomass wastes and downstream pipe contamination from tar and polycyclic aromatic hydrocarbon (PAH) growth poses significant technological challenges. Nonetheless, a roadmap has been developed to guide the widespread adoption of fluidized bed gasification of biomass for decentralized power generation and climate mitigation. This book chapter delves into the opportunities and challenges of fluidized bed gasification as a viable option for decentralized power generation and climate mitigation through biomass waste conversion. The significance of well-crafted policies supporting renewable energy sources and optimizing fluidized bed gasifiers to achieve desirable end products are also emphasized
Podoconiosis treatment in northern Ethiopia (GoLBet): study protocol for a randomised controlled trial
BACKGROUND
Podoconiosis is one of the forgotten types of leg swelling (elephantiasis) in the tropics. Unlike the other, better-known types of leg swelling, podoconiosis is not caused by any parasite, virus or bacterium, but by an abnormal reaction to minerals found in the clay soils of some tropical highland areas. Non-governmental Organizations (NGOs) have been responsible for the development of simple treatment methods without systematic evaluation of its effectiveness. It is essential that a large scale, fully controlled, pragmatic trial of the intervention is conducted. We aim to test the hypothesis that community-based treatment of podoconiosis lymphoedema reduces the frequency of acute dermatolymphangioadenitis episodes ('acute attacks') and improves other clinical, social and economic outcomes.
METHODS/DESIGN
This is a pragmatic, individually randomised controlled trial. We plan to randomly allocate 680 podoconiosis patients from the East Gojjam Zone in northern Ethiopia to one of two groups: 'Standard Treatment' or 'Delayed Treatment'. Those randomised to standard treatment will receive the hygiene and foot-care intervention from May 2015 for one year, whereas those in the control arm will be followed through 2015 and be offered the intervention in 2016. The trial will be preceded by an economic context survey and a Rapid Ethical Assessment to identify optimal methods of conveying information about the trial and the approaches to obtaining informed consent preferred by the community. The primary outcome will be measured by recording patient recall and using a simple, patient-held diary that will be developed to record episodes of acute attacks. Adherence to treatment, clinical stage of disease, quality of life, disability and stigma will be considered secondary outcome measures. Other outcomes will include adverse events and economic productivity. Assessments will be made at baseline and at 3, 6, 9 and 12 months thereafter.
DISCUSSION
The evidence is highly likely to inform implementation of the new master plan for integrated control of Neglected Tropical Diseases (NTDs), in which podoconiosis is identified as one of eight NTDs prioritised for control. Potentially, an estimated 3 million patients in Ethiopia will therefore benefit from the results of this trial.
TRIAL REGISTRATION
International Standard Randomised Controlled Trial Number.
REGISTRATION NUMBER
ISRCTN67805210 . Date of registration: 24 January 2013
Dopamine Signaling and Oxytocin Administration in a Rat Model of Empathy
The rat model is commonly used to study prosocial and empathetic behavior. However, the neural underpinnings of such behavior are unknown. We investigated the potential roles of two neurotransmitters, dopamine (DA) and oxytocin (OT), in prosocial behavior of rats. Our first experiment used a Pavlovian association task with two rats to investigate how DA release was modulated by social context. This experiment used fast-scan cyclic voltammetry (FSCV) to measure subsecond DA release in the nucleus accumbens (NAc). Consistent with previous work, cues that predicted reward were associated with increased DA release, and cues that predicted shock inhibited DA release non-discriminately across trial types. However, during shock trials, DA release was modulated by social context in two ways. First, reductions in DA release during shock trials were weaker in the presence of the conspecific, suggesting a consoling effect which was supported by behavioral indicators. Second, DA release during shock trials increased when shock was administered to the conspecific, suggesting that recording rats used the reactions of the conspecific to verify personal safety. We concluded that DA release is modulated by social context in that rats use social cues to optimize predictions about their own well-being. In our second experiment, we investigated the influence of oxytocin on prosocial behavior. Oxytocin was administered intranasally prior to a distress task in which a lever press resulted in reward delivery and one of three additional outcomes: no shock (‘reward-only’), shock to engaged rat (‘shock-self’), or shock to the conspecific (‘shock-other’). Results demonstrated that oxytocin did not significantly increase prosocial behaviors
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