Impact of antiretroviral therapy on adult HIV prevalence in a low-income rural setting in Uganda: a longitudinal population-based study.

OBJECTIVE: To estimate the contribution to HIV prevalence of lives saved due to the introduction of antiretroviral therapy (ART) in rural Uganda in 2004. DESIGN: Open population-based cohort study. METHODS: An open general population cohort with annual demographic and HIV serostatus data is used to estimate annual HIV prevalence, HIV incidence, and mortality from 2000 to 2010. We calculated standardized mortality rates among HIV-positive adults and the expected number of deaths in the cohort if ART had not been available during 2004-2010, based on the average mortality rate in the 4 years (2000-2003) before ART introduction. RESULTS: During 2004-2010, the estimated prevalence increased by 29% from 6.9% to 8.9%. HIV incidence was 5.6 cases per 1000 person-years in 2004, falling to 3.9 cases per 1000 person-years in 2006, and slightly rising to 5.1 in 2010. There was an increase of 182 in the number of HIV-positive participants during that period, cumulatively 228 lives were saved due to ART. Expected lives saved due to ART accounted for an increasing proportion of the estimated HIV prevalence from 4.0% in 2004 to 29.4% in 2010. CONCLUSIONS: Expected lives saved due to ART largely accounted for the increased estimated HIV prevalence from 2004 to 2010. Because HIV prevalence survey results are important for planning, programming, and policy, their interpretation requires consideration of the increasing impact of ART in decreasing mortality

Exact O(g^2 alpha_s) top decay width from general massive two-loop integrals

We calculate the b-dependent self-energy of the top quark at O(g^2 \alpha_s) by using a general massive two-loop algorithm proposed in a previous article. From this we derive by unitarity the O(\alpha_s) radiative corrections to the decay width of the top quark, where all effects associated with the $b$ quark mass are included without resorting to a mass expansion. Our results agree with the analytical results available for the O(\alpha_s) correction to the top quark width

Guidelines for Estimating Resources Needed to Earn a Specified Level of Income, South James Area, South Dakota

An economic problem confronting farmers of the South James Area in South Dakota involves the allocation and use of resources in the best combination to earn specified levels of income. How to develop guidelines for estimating the combination of resources needed to earn a specified level of income with a given set of prices and levels of high and average mechanization is the problem with which this study is concerned. Its purpose is to determine combinations of agricultural resources and enterprises required to obtain specified levels of farm income in the South James Area of South Dakota. Many farmers are trying to increase their income by adding additional land to their unit. They are bidding up land values and reducing the number of farm units. The reduction in the number of farms, the increase in the number of acres per farm, and the change in the value per acre of land from 1954 to 1964 in twelve co-utilities of the South James .Area of South Dakota is shown in Table 1. Farmers who desire to raise their income level must decide on expanding or improving their farming enterprises or decide on non-farm employment. The farmer and his family who decide to employ their labor and other resources in agriculture need to know the amounts and kinds of resources required to enable them to earn specified incomes. The objectives of this study were: 1.To determine the minimum resource requirements needed for specified income returns to operator labor and management with a given set of prices at high and average mechanization levels and efficiency of resource use. 2. To determine the best combination of farm enterprises utilizing resource requirements for specified income levels to operator labor and management. 3. To determine the effect that restricting lives tock enterprises has on the amounts and kinds of resources needed to attain specified levels of income to operator labor and management

The Corporate Profit Motive & Questionable Public Relations Practices during the Lead-up to the Affordable Care Act

The purpose of this Article is two-fold: first, to highlight two problems which threaten the effectiveness of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), and second, to invite civic and governmental dialogue to implement solutions to those problems. The Affordable Care Act is tailored to build upon what is good about the existing health care financing system in the United States. It is also calculated to maximize access to quality and affordable health care across the Nation. There remains, however, work that must be done to neutralize risks to the foundational requirements of consistency and predictability when it comes to payment for medical care. The balance of this article: i. discusses the drivers making American health care the most expensive in the world; ii. outlines the patchwork of public and private fiscal arrangements that comprise the American health care financing system; iii. reveals the legal means by which private insurance companies reduce or eliminate risk, through rescission, cancellation, coverage denials, and other methods; iv. evaluates the behind-the-scenes campaign America’s Health Insurance Plans (AHIP), the public relations and lobbying arm of the health insurance industry, waged to thwart reform without exposing its self-serving profit motive; v. explains how the Affordable Care Act was enacted despite stiff opposition; and vi. concludes with a call to open a dialogue with a view toward focusing efforts to implement solutions, among them:a. that Congress conduct hearings to develop the record and take action in light of the unvarnished facts; b. that states adopt licensing and enforcement procedures for public relations; c. that federal law require public relations practitioners to disclose the real-parties-in-interest who fund spin efforts and certify the good faith basis of claims placed into the media; and d. that law enforcement authorities evaluate the suitability of using existing laws to address apparent fraudulent misrepresentations

Development of a Consensus Statement for the Definition, Diagnosis, and Treatment of Acute Exacerbations of Idiopathic Pulmonary Fibrosis Using the Delphi Technique.

© 2015, The Author(s).Introduction: There is a lack of agreed and established guidelines for the treatment of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). This reflects, in part, the limited evidence-base underpinning the management of AE-IPF. In the absence of high-quality evidence, the aim of this research was to develop a clinician-led consensus statement for the definition, diagnosis and treatment of AE-IPF. Methods: A literature review was conducted to obtain published material on the definition and treatment of AE-IPF. The results of this review were circulated to an online panel of clinicians for review. Statements were then shared with ten expert respiratory clinicians who regularly treat patients with IPF. A Delphi technique was then used to develop a consensus statement for the definition, diagnosis and treatment of AE-IPF. During the first round of review, clinicians rated the clarity of each statement, the extent to which the statement should be included and provided comments. In two subsequent rounds of review, clinicians were provided with the group median inclusion rating for each statement, and any revised wording of statements to aid clarity. Clinicians were asked to repeat the clarity and inclusion ratings for the revised statements. Results: The literature review, online panel discussion, and face-to-face meeting generated 65 statements covering the definition, diagnosis, and management of AE-IPF. Following three rounds of blind review, 90% of clinicians agreed 39 final statements. These final statements included a definition of AE-IPF, approach to diagnosis, and treatment options, specifically: supportive measures, use of anti-microbials, immunosuppressants, anti-coagulants, anti-fibrotic therapy, escalation, transplant management, and long-term management including discharge planning. Conclusion: This clinician-led consensus statement establishes the ‘best practice’ for the management and treatment of AE-IPF based on current knowledge, evidence, and available treatments. Funding: Boehringer Ingelheim Ltd., Bracknell, West Berkshire, UK

The sensitivity of the ENSO to volcanic aerosol spatial distribution in the MPI large ensemble. In open review for ESD

Using the Max Planck Institute Grand Ensemble (MPI-GE) with 200 members for the historical simulation (1850–2005), we investigate the impact of the spatial distribution of volcanic aerosols on the ENSO response. In particular, we select 3 eruptions (El Chichón, Agung and Pinatubo) in which the aerosol is respectively confined to the Northern Hemisphere, the Southern Hemisphere or equally distributed across the equator. Our results show that the ENSO anomalies start at the end of the year of the eruption and peak the following one. Especially, we found that when the aerosol is located in the Northern Hemisphere or is symmetrically distributed, El Niño-like anomalies develop while aerosol distribution confined to the Southern Hemisphere leads to a La Niña-like anomaly. Our results strongly point to the volcanically induced displacement of the ITCZ as the main mechanism that drives the ENSO response, while suggesting that the other mechanisms (the ocean dynamical thermostat, the cooling of tropical northern Africa or of the Maritime continent) commonly invoked to explain the post-eruption ENSO response appear not to be at play in our mode