Stable incidence rates of tuberculosis (TB) among human immunodeficiency virus (HIV)-negative South African gold miners during a decade of epidemic HIV-associated TB.

During the last decade, annual tuberculosis (TB) case-notification rates increased 4-fold, to >4000 cases/100000 person-years, in the study workforce, among whom prevalence of human immunodeficiency virus (HIV) was 30% in 2000. Three separate cohort studies, totalling 6454 HIV-negative participants, were combined and analyzed for time trends. Observed incidence of TB varied between 962 (1991-1994) and 1589 (1999-2000) cases/100000 person-years (P=.17, test for trend). There was, however, a progressive increase in age, and, for each period, older age was associated with increased incidence rates of TB (P<.001). Having adjusted for age differences, there was no significant association between incidence of TB and calendar period (P=.81, test for trend). Relative to 1991-1994, multivariate-adjusted incidence-rate ratios were 0.94, for 1995-1997, 0.96, for 1998-1999, and 1.05, for 1999-2000. Preventing a secondary epidemic of TB among HIV-negative individuals may be achievable with conventional means, even in settings with a high burden of HIV-associated TB

Heating of the molecular gas in the massive outflow of the local ultraluminous-infrared and radio-loud galaxy 4C12.50

We present a comparison of the molecular gas properties in the outflow vs. in the ambient medium of the local prototype radio-loud and ultraluminous-infrared galaxy 4C12.50 (IRAS13451+1232), using new data from the IRAM Plateau de Bure interferometer and 30m telescope, and the Herschel space telescope. Previous H_2 (0-0) S(1) and S(2) observations with the Spitzer space telescope had indicated that the warm (~400K) molecular gas in 4C12.50 is made up of a 1.4(+-0.2)x10^8 M_sun ambient reservoir and a 5.2(+-1.7)x10^7 M_sun outflow. The new CO(1-0) data cube indicates that the corresponding cold (25K) H_2 gas mass is 1.0(+-0.1)x10^10 M_sun for the ambient medium and <1.3x10^8 M_sun for the outflow, when using a CO-intensity-to-H_2-mass conversion factor alpha of 0.8 M_sun /(K km/s pc^2). The combined mass outflow rate is high, 230-800 M_sun/yr, but the amount of gas that could escape the galaxy is low. A potential inflow of gas from a 3.3(+-0.3)x10^8 M_sun tidal tail could moderate any mass loss. The mass ratio of warm-to-cold molecular gas is >= 30 times higher in the outflow than in the ambient medium, indicating that a non-negligible fraction of the accelerated gas is heated to temperatures at which star formation is inefficient. This conclusion is robust against the use of different alpha factor values, and/or different warm gas tracers (H_2 vs. H_2 plus CO): with the CO-probed gas mass being at least 40 times lower at 400K than at 25K, the total warm-to-cold mass ratio is always lower in the ambient gas than in the entrained gas. Heating of the molecular gas could facilitate the detection of new outflows in distant galaxies by enhancing their emission in intermediate rotational number CO lines.Comment: A&A, in pres

A Time Series Analysis of Effect of Tax Revenue on Economic Development of Nigeria

This study investigated the effect of tax revenue on the Economic development of Nigeria for the period of 1995-2014, with the purpose of finding out if tax revenue represented by Value Added Tax, Company Income Tax and Customs and Excise Duties could affect economic development proxied by Human Development Index for the period of the study. The data which are secondary in nature were analysed using Multiple Regression Analyses for the three research questions and three hypotheses in the study. The findings reveal that revenues collected by the federal government through CIT, VAT and CED have a positive relationship with Human Development Index. Based on the findings, it was concluded as follows: That revenues collected by the federal government through company income tax, value added tax, customs and excise duties help to improve the human development index of Nigeria. Based on the findings and conclusions, we make the following recommendations: The federal government should sensitize tax payers on the need for tax payment and punishment for non-compliance. Furthermore, it was recommended that incentives be provided to tax payers to encourage them (especially corporate bodies) to pay their taxes. Finally, we recommend that tax authorities should encourage tax education for its workforce in order to achieve the desired revenue drive. Keywords: Company income tax, value added tax, customs and excise duty, human development index

Beyond Good Intentions: New Legislation on Foreign Aid Effectiveness

The new law and the corresponding OMB and key foreign aid agencies\u27 guidelines require providers to follow best practices in the monitoring and evaluation (M&E) of U.S government (USG) foreign aid.2 A recent study conducted by the U.S. Government Accountability Office across the key USG foreign aid agencies identified a number of areas that needed improvement in the design, implementation, conclusions, and dissemination of foreign assistance evaluations.3 FATAA and the relevant guidelines will require providers to address those areas and focus their reporting requirements on tangible outcomes and the impact of their programming. In recent years, federal agencies have placed an increasing emphasis on demonstrating effectiveness through rigorous evaluations.6 But there are concerns that funding levels have increased, while the efficiency and effectiveness of aid remain opaque and uncertain.7 B. Focus of FATAA In response to these concerns, Congress passed the new FATAA legislation, which will impact all areas of U.S. foreign assistance.8 The main focus of the legislation is a shift toward outcomes and impact of foreign assistance funding.9 Agencies are required not only to measure outputs (i.e. number of kilometers built, malaria nets provided, or anti-corruption trainings held for judges), but also to assess outcomes and impacts (i.e. cost savings for vehicle owners, decreases in the prevalence of malaria, and corruption). Here are several examples: * The U.S. Department of State (DOS) issued an integrated Program Design and Performance Management Toolkit in October 2016;12 revised and updated a version of its program and project design, monitoring, and evaluation policy in November 2017;13 and updated its guidance in 2018.14 Subsequently, DOS issued an updated M&E policy in January 2018 in compliance with the January 2018 OMB Guidelines.15 * The U.S. Agency for International Development (USAID) revised its Automated Directives System (ADS) Chapter 201 addressing evaluation guidance, planning, and implementation in September 2016 and later in October 2018.16 USAID also developed toolkits to cover its work under FATAA-one for Monitoring, one for Evaluation, and one for Collaborating, Learning, and Adapting.17 * The Millennium Challenge Corporation (MCC) issued its March 2017 Policy for Monitoring and Evaluation,18 which requires that compact M&E plans identify and describe its evaluation methodologies, key evaluation questions, and data collection strategies. * The U.S. Department of Defense (DOD) issued agency-wide evaluation guidance for security cooperation in January 2017 in its DOD Instruction 5132.14 Assessment, Monitoring, and Evaluation Policy for the Security Cooperation Enterprise.19 III.Current Condition of Foreign Assistance Evaluations\u27 Quality, Cost, and Dissemination A recent study conducted by the U.S. Government Accountability Office (GAO)20 sheds some light on the current condition of M&E across USG.21 GAO\u27s study provides a baseline assessment of the quality, cost, and dissemination of foreign assistance evaluations when the legislation took effect.22 It focuses on the six agencies providing the largest amount of U.S. foreign assistance: USAID, DOS, MCC, USDA, HHS, and DOD.23 The study found that about three quarters of the 170 evaluations completed in fiscal year 2015 by these agencies and reviewed by GAO generally or partially addressed all of the quality criteria GAO identified for evaluation design, implementation, and conclusions.24 Agencies met some elements of the GAO quality criteria more often than other elements. B.Evaluation Implementation A key element in assessing evaluation implementation is the extent to which target population and sampling, data collection, and data analysis were appropriate for the study questions. Because the target population is the group the researcher would like to make statements in the evaluation, it is important that the group is clearly defined and includes all potential beneficiaries of the program

Statistical properties of coronal hole rotation rates: Are they linked to the solar interior?

The present paper discusses results of a statistical study of the characteristics of coronal hole (CH) rotation in order to find connections to the internal rotation of the Sun. The goal is to measure CH rotation rates and study their distribution over latitude and their area sizes. In addition, the CH rotation rates are compared with the solar photospheric and inner layer rotational profiles. We study coronal holes observed within $\pm 60$ latitude and longitude degrees from the solar disc centre during the time span from the 1 January 2013 to 20 April 2015, which includes the extended peak of solar cycle 24.We used data created by the Spatial Possibilistic Clustering Algorithm (SPoCA), which provides the exact location and characterisation of solar coronal holes using SDO=AIA 193 {\AA} channel images. The CH rotation rates are measured with four-hour cadence data to track variable positions of the CH geometric centre. North-south asymmetry was found in the distribution of coronal holes: about 60 percent were observed in the northern hemisphere and 40 percent were observed in the southern hemisphere. The smallest and largest CHs were present only at high latitudes. The average sidereal rotation rate for 540 examined CHs is $13:86 (\pm 0:05)$ degrees/d. Conclusions. The latitudinal characteristics of CH rotation do not match any known photospheric rotation profile. The CH angular velocities exceed the photospheric angular velocities at latitudes higher than 35-40 degrees. According to our results, the CH rotation profile perfectly coincides with tachocline and the lower layers of convection zone at around 0.71 $R_{\odot}$; this indicates that CHs may be linked to the solar global magnetic field, which originates in the tachocline region.Comment: 8 pages, 8 figures, Accepted for publication in A&

Managing alternative sports: new organisational spaces for the diffusion of Italian parkour

The article explores the encounter between parkour as an unstructured and culturally innovative practice, challenging both physical as well as organisational spaces, and UISP (Unione Italiana Sport per Tutti / Sport for All Italian Union) as a sport promotion body open to organisational and cultural experimentation. Drawing on a multi-method qualitative approach (analysis of documentary material, interviews and focus groups), we look at the role of UISP in the diffusion and legitimation of parkour within the Italian context, investigating the interplay between the cultural and organisational logics of both this new practice itself on the one hand, and the organisations that are trying to accommodate it on the other. The incorporation in a sport-for-all organisation like UISP provides traceurs with a safe and legitimised space, which is however ‘loose’ enough to maintain the fluidity of the practice. Nonetheless, by enabling the coexistence of different and competing definitions and uses of parkour, this fluid organisational space reproduces tensions among traceurs and weakens their voice in UISP’s decision-making processes

A framework for assessing the lifetime economic burden of congenital cytomegalovirus in the United States

Background: In the United States (US), congenital cytomegalovirus infection (cCMVi) is a major cause of permanent disabilities and the most common etiology of non-genetic sensorineural hearing loss. Evaluations of prevention strategies will require estimates of the economic implications of cCMVi. We aimed to develop a conceptual framework to characterize the lifetime economic burden of cCMVi in the US and to use that framework to identify data gaps. Methods: Direct health care, direct non-health care, indirect, and intangible costs associated with cCMVi were considered. An initial framework was constructed based on a targeted literature review, then validated and refined after consultation with experts. Published costs were identified and used to populate the framework. Data gaps were identified. Results: The framework was constructed as a chance tree, categorizing clinical event occurrence to form patient profiles associated with distinct economic trajectories. The distribution and magnitude of costs varied by patient life stage, cCMVi diagnosis, severity of impairment, and developmental delays/disabilities. Published studies could not fully populate the framework. The literature best characterized direct health care costs associated with the birth period. Gaps existed for direct non-health care, indirect, and intangible costs, as well as health care costs associated with adult patients and those severely impaired. Conclusions: Data gaps exist concerning the lifetime economic burden of cCMVi in the US. The conceptual framework provides the basis for a research agenda to address these gaps. Understanding the full lifetime economic burden of cCMVi would inform clinicians, researchers, and policymakers, when assessing the value of cCMVi interventions

Risk factors for poor virological outcome at 12 months in a workplace-based antiretroviral therapy programme in South Africa: A cohort study

<p>Abstract</p> <p>Background</p> <p>Reasons for the variation in reported treatment outcomes from antiretroviral therapy (ART) programmes in developing countries are not clearly defined.</p> <p>Methods</p> <p>Among ART-naïve individuals in a workplace ART programme in South Africa we determined virological outcomes at 12 months, and risk factors for suboptimal virological outcome, defined as plasma HIV-1 viral load >= 400 copies/ml.</p> <p>Results</p> <p>Among 1760 individuals starting ART before July 2004, 1172 were in follow-up at 12 months of whom 953 (81%) had a viral load measurement (median age 41 yrs, 96% male, median baseline CD4 count 156 × 10⁶/l). 71% (681/953) had viral load < 400 copies/ml at 12 months. In a multivariable analysis, independent predictors of suboptimal virological outcome at 12 months were <1 log decrease in viral load at six weeks (odds ratio [OR] 4.71, 95% confidence interval [CI] 2.56–8.68), viral load at baseline (OR 3.63 [95% CI 1.88–7.00] and OR 3.54 [95% CI 1.79–7.00] for 10,001–100,000 and >100,000 compared to <= 10,000 copies/ml, respectively), adherence at six weeks (OR 3.50 [95% CI 1.92–6.35]), WHO stage (OR 2.08 [95% CI 1.28–3.34] and OR 2.03 [95% CI 1.14–3.62] for stage 3 and 4 compared to stage 1–2, respectively) and site of ART delivery. Site of delivery remained an independent risk factor even after adjustment for individual level factors. At 6 weeks, of 719 patients with self-reported adherence and viral load, 72 (10%) reported 100% adherence but had <1 log decrease in viral load; conversely, 60 (8%) reported <100% adherence but had >= 1 log decrease in viral load.</p> <p>Conclusion</p> <p>Virological response at six weeks after ART start was the strongest predictor of suboptimal virological outcome at 12 months, and may identify individuals who need interventions such as additional adherence support. Self reported adherence was less strongly associated but identified different patients compared with viral load at 6 weeks. Site of delivery had an important influence on virological outcomes; factors at the health system level which influence outcome need further investigation to guide development of effective ART programmes.</p

Sensitivity of the lateral flow urine lipoarabinomannan assay in ambulant adults with advanced HIV disease: data from the TB Fast Track study.

BACKGROUND: WHO guidelines recommend the lateral flow urine lipoarabinomannan assay (LF-LAM) for TB diagnosis in hospitalised HIV-positive individuals. The role of LF-LAM among ambulant patients remains less well defined. We investigated the sensitivity of LF-LAM among ambulant HIV-positive adults in primary health clinics in South Africa. METHODS: We enrolled adults (aged ≥18 y) with CD4 counts of ≤150 cells/mm3 who had not received TB treatment or antiretroviral therapy in the preceding 3 or 6 mo, respectively. Research nurses performed the LF-LAM test on freshly voided urine. Results were compared with a reference standard of positive mycobacterial culture (sputum or urine). RESULTS: Of 1505 (54.5% female; median age 37 y; median CD4 count 73 cells/mm3) participants, 973 (64.7%) had a mycobacterial culture result; 105/973 (10.8%) were positive for Mycobacterium tuberculosis. LF-LAM sensitivity was 41.9% (95% CI 32.3 to 51.9%) and 19.0% (95% CI 12.0 to 27.9%) using grade 1+ and grade 2+ cut-off points, respectively. Sensitivity increased with severe immunosuppression and in the presence of poor prognostic indicators (low haemoglobin, body mass index). CONCLUSIONS: When used as the only TB diagnostic test, LF-LAM sensitivity is suboptimal, particularly using the grade 2+ cut-off. More sensitive tests for TB are needed that can be used in primary care settings