Successful paediatric HIV treatment in rural primary care in Africa

<p>Objective: Clinical outcomes of HIV-infected children on antiretroviral treatment (ART) in a decentralised, nurse/counsellor-led programme.</p> <p>Design: Clinical cohort.</p> <p>Setting: KwaZulu-Natal, South Africa.</p> <p>Patients: HIV-infected children aged <= 15 years on ART, June 2004-2008.</p> <p>Main outcome measures: Survival according to baseline characteristics including age, WHO clinical stage, haemoglobin and CD4%, was assessed in Kaplan-Meier analyses. Hazard ratios for mortality were estimated using Cox proportional hazards regression and changes in laboratory parameters and weight-for-age z scores after 6-12 months' treatment were calculated.</p> <p>Results: 477 HIV-infected children began ART at a median age of 74 months (range 4-180), median CD4 count (CD4%) of 433 cells/mm(3) (17%) and median HIV viral load of log 4.2 copies/ml; 105 (22%) were on treatment for tuberculosis and 317 (76.6%) were WHO stage 3/4. There were significant increases after ART initiation in CD4% (17% vs 22%; p<0.001), haemoglobin (9.9 vs 11.7 g/l; p <= 0.001) and albumin (30 vs 36 g/l; p <= 0.001). 32 (6.7%) children died over 732 child-years of follow-up (43.7 deaths/1000 child-years; 95% CI 32.7 to 58.2), 17 (53.1%) within 90 days of treatment initiation; median age of death was 84 (IQR 10-181) months. Children with baseline haemoglobin <= 8 g/l were more likely to die (adjusted HR 4.5; 95% CI 1.6 to 12.3), as were those aged <18 months compared with >60 months (adjusted HR 3.2; 95% CI 1.2 to 9.1).</p> <p>Conclusions Good clinical outcomes in HIV-infected children on ART are possible in a rural, decentralised service. Few young children are on ART, highlighting the urgent need to identify HIV-exposed infants.</p&gt

Simple computer method provides contours for radiological images

Computer is provided with information concerning boundaries in total image. Gradient of each point in digitized image is calculated with aid of threshold technique; then there is invoked set of algorithms designed to reduce number of gradient elements and to retain only major ones for definition of contour

Comments on the superluminal motion in Cygnus X-3

Following the recent discovery that Cyg X-3 exhibits superluminal motion, the implications of superluminal expansion and contraction are investigated. We propose that the effect is due to either a propagating photon pattern or to outwardly moving shells illuminated by an intense beam of radiation.Comment: accepted for publication in MNRAS; 5 pages, 3 figure

Evaluating the New Zealand Individual Transferable Quota Market for Fisheries Management

The New Zealand ITQ system is a dynamic institution that has had many refinements since its inception more than 15 years ago. Nonetheless, the basic tenets of the system - setting a total allowable catch and leaving the market to determine the most profitable allocation of fishing effort - have remained intact. This paper assesses the New Zealand system to identify areas of success and/or possible improvement or expansion within it. The reasons for doing so are to highlight beneficial features and to identify features of the New Zealand ITQ system that are relevant to other potential tradable permit markets. Beneficial features include simple standardized rules for quota definition and trading across species and areas; very few restrictions on quota trading and holding; relative stability in the rules over time; and low levels of government involvement in the trading process. We find evidence that supports the assertion that fishers behave in a reasonably rational fashion and that the markets are relatively efficient. We do not find major changes in participation in these fisheries as a result of the system. We find evidence that suggests that the ITQ system is improving the profitability of fisheries in New Zealand. In general the evidence thus far suggests that the market is operating in a reasonably efficient manner and is providing significant economic gains. These factors suggest that New Zealand would want to have non-economic justifications for any significant changes to the system.

Perceptual recognition of familiar objects in different orientations

Recent approaches to object recognition have suggested that representations are view-dependent and not object-centred as was previously asserted by Marr (Marr and Nishihara, 1978). The exact nature of these view-centred representations however does not concord across the different theories. Palmer suggested that a single canonical view represents an object in memory (Palmer et al., 1981) whereas other studies have shown that each object may have more than one view-point representation (Tarr and Pinker 1989).A set of experiments were run to determine the nature of the visual representation of rigid, familiar objects in memory that were presented foveally and in peripheral vision. In the initial set of experiments recognition times were measured to a selection of common, elongated objects rotated in increments of 30˚ degrees in the 3 different axes and their combinations. Significant main effects of orientation were found in all experiments. This effect was attributed to the delay in recognising objects when foreshortened. Objects with strong gravitational uprights yielded the same orientation effects as objects without gravitational uprights. Recognition times to objects rotated around the picture plane were found to be independent of orientation. The results were not dependent on practice with the objects. There was no benefit found for shaded objects over silhouetted objects. The findings were highly consistent across the experiments. Four experiments were also carried out which tested the detectability of objects presented foveally among a set of similar objects. The subjects viewed an object picture (target) surrounded by eight search pictures arranged in a circular array. The task was to locate the picture-match of the target object (which was sometimes absent) as fast as possible. All of the objects had prominent elongated axes and were viewed perpendicular to this axis. When the object was present in the search array, it could appear in one of five orientations: in its original orientation, rotated in the picture plane by 30 or 60 , or rotated by 30 or 60 in depth. Highly consistent results were found across the four experiments. It was found that objects rotated in depth by 60 took longer to find and were less likely to be found in the first saccade than all other orientations. These findings were independent of the type of display (i.e. randomly rotated distractors or aligned distractors) and also of the task (matching to a picture or a name of an object). It was concluded that there was no evidence that an abstract 3-dimensional representation was used in searching for an object. The results from these experiments are compatible with the notion of multiple-view representations of objects in memory. There was no evidence found that objects were stored as single, object-centred representations. It was found that representations are initially based on the familiar views of the objects but with practice on other views, those views which hold the maximum information about the object are stored. Novel views of objects are transformed to match these stored views and different candidates for the transformation process are discussed

A pattern-recognition theory of search in expert problem solving

Understanding how look-ahead search and pattern recognition interact is one of the important research questions in the study of expert problem-solving. This paper examines the implications of the template theory (Gobet & Simon, 1996a), a recent theory of expert memory, on the theory of problem solving in chess. Templates are "chunks" (Chase & Simon, 1973) that have evolved into more complex data structures and that possess slots allowing values to be encoded rapidly. Templates may facilitate search in three ways: (a) by allowing information to be stored into LTM rapidly; (b) by allowing a search in the template space in addition to a search in the move space; and (c) by compensating loss in the "mind's eye" due to interference and decay. A computer model implementing the main ideas of the theory is presented, and simulations of its search behaviour are discussed. The template theory accounts for the slight skill difference in average depth of search found in chess players, as well as for other empirical data

Technological Change and the Environment

Environmental policy discussions increasingly focus on issues related to technological change. This is partly because the environmental consequences of social activity are frequently affected by the rate and direction of technological change, and partly because environmental policy interventions can themselves create constraints and incentives that have significant effects on the path of technological progress. This paper, prepared as a chapter draft for the forthcoming Handbook of Environmental Economics (North-Holland/Elsevier Science), summarizes for environmental economists current thinking on technological change in the broader economics literature, surveys the growing economic literature on the interaction between technology and the environment, and explores the normative implications of these analyses. We begin with a brief overview of the economics of technological change, and then examine three important areas where technology and the environment intersect: the theory and empirical evidence of induced innovation and the related literature on the effects of environmental policy on the creation of new, environmentally friendly technology; the theory and empirics of environmental issues related to technology diffusion; and analyses of the comparative technological impacts of alternative environmental policy instruments. We conclude with suggestions for further research on technological change and the environment.