Optimal timing of HIV home-based counselling and testing rounds in Western Kenya

Introduction: Weaknesses in care programmes providing anti‐retroviral therapy (ART) persist and are often instigated by late HIV diagnosis and poor linkage to care. We investigated the potential for a home‐based counselling and testing (HBCT) campaign to be improved through the optimal timing and enhancement of testing rounds to generate greater health outcomes at minimum cost. Methods: Using a mathematical model of HIV care calibrated to longitudinal data from The Academic Model Providing Access To Healthcare (AMPATH) in Kenya, we simulated HBCT campaigns between 2016 and 2036, assessing the impact and total cost of care for each, for a further 20 years. Results: We find that simulating five equally spaced rounds averts 1.53 million disability‐adjusted life‐years (DALYs) at a cost of $1617 million. By altering the timing of HBCT rounds, a four‐round campaign can produce greater impact for lower cost. With “front‐loaded” rounds, the cost per DALY averted is reduced by 12$937 vs. $1060). Furthermore, improvements to HBCT coverage and linkage to care avert over two million DALYs at a cost per DALY averted of$621 (41% less than the reference scenario). Conclusions: Countries implementing HBCT can reduce costs by optimally timing rounds and generate greater health outcomes through improving linkage, coverage, and retention. Tailoring HBCT campaigns to individual settings can enhance patient outcomes for minimal cost

Role of material properties and mesostructure on dynamic deformation and shear instability in Al-W granular composites

Dynamic experiments with Al-W granular/porous composites revealed qualitatively different behavior with respect to shear localization depending on bonding between Al particles. Two-dimensional numerical modeling was used to explore the mesomechanics of the large strain dynamic deformation in Al-W granular/porous composites and explain the experimentally observed differences in shear localization between composites with various mesostructures. Specifically, the bonding between the Al particles, the porosity, the roles of the relative particle sizes of Al and W, the arrangements of the W particles, and the material properties of Al were investigated using numerical calculations. It was demonstrated in simulations that the bonding between the "soft" Al particles facilitated shear localization as seen in the experiments. Numerical calculations and experiments revealed that the mechanism of the shear localization in granular composites is mainly due to the local high strain flow of "soft" Al around the "rigid" W particles causing localized damage accumulation and subsequent growth of the meso/macro shear bands/cracks. The "rigid" W particles were the major geometrical factor determining the initiation and propagation of "kinked" shear bands in the matrix of "soft" Al particles, leaving some areas free of extensive plastic deformation as observed in experiments and numerical calculations.Comment: 10 pages, 14 figures, submitted to Journal of Applied Physic

CURA Microcomputer Resources. Fall 1985

Center for Urban and Regional Affairs, University of Minnesota

Determination of Best Low-Frequency Microwave Antenna Approach for Future High Resolution Measurements from Space

Microwave remote sensing measurements at L-band (~1.2-1.6 GHz) of geophysical parameters such as soil moisture will need to be at higher spatial resolution than current systems (SMOS/ SMAP/ Aquarius) in order to meet the requirements of land surface, ocean, and numerical weather prediction models in the near future, which will operate at ~9-15 km global grids and 1-3 km regional grids in the next few years. In order to make progress toward these needed spatial resolutions, advancements in technology are necessary which would lead to improved effective (i.e. equivalent) antenna size. An architecture trade study was conducted to quantitatively define the value and limits of different microwave technology paths, and to select the most appropriate path to achieve the high spatial resolution required by science in the future without sacrificing performance, accuracy, and global coverage

Evaluating the Current Status of American Shad Stocks in Three Virginia Rivers

Directed commercial fisheries for American shad Alosa sapidissima in the primary Virginia tributaries of the Chesapeake Bay have been under moratorium since 1994. Monitoring of adult American shad within these rivers has been ongoing since 1998 through a cooperative program involving commercial fishers. The monitoring program is designed to mimic traditional commercial fishing practices so that stock status can be inferred by comparing contemporary catch-per-unit-effort levels with those derived from historic logbooks. In this paper, we present analyses of the available monitoring and historic catch rate data along with updated stock status information for American shad in the James, York, and Rappahannock rivers. Two analytical methods were used to derive annual indices of relative abundance; both methods yielded very similar patterns for each river system. Comparisons of contemporary and historic indices of relative abundance suggest that American shad in the James and York rivers continue to persist at low levels of abundance. Measures of stock abundance in the Rappahannock River have been higher than the logbook reference value for much of the monitoring period. However, current moratoria and restoration strategies, which include hatchery releases of fry, the removal of obstructions blocking spawning and nursery habitat, and reductions in bycatch from other fisheries, should continue into the foreseeable future

Use of a Natural Isotopic Signature in Otoliths to Evaluate Scale-Based Age Determination for American Shad

We used delta O-18 signatures in otoliths as a natural tag for hatch year to evaluate the scale-based age determination method used for adult American shad Alosa sapidissima in the York River, Virginia. Juveniles of the 2002 year-class exhibited high delta O-18 values in otolith cores that identified adult members of the cohort as they returned to spawn. Recruitment of the 2002 cohort was monitored for three consecutive years, identifying age-4, age-5, and age-6 individuals of the York River stock. The scale-based age determination method was not suitable for aging age-4, age-5, or age-6 American shad in the York River. On average, 50% of the individuals from the 2002 year-class were aged incorrectly using the scale-based method. These results suggest that the standard age determination method used for American shad is not applicable to the York River stock. Scientists and managers should use caution when applying scale-based age estimates to stock assessments for American shad in the York River and throughout their range, as the applicability of the scale-based method likely varies for each stock. This study highlights a promising new direction for otolith geochemistry to provide cohort-specific markers, and it identifies several factors that should be considered when applying the technique in the future

Practical recommendations on the use of lenalidomide in the management of myelodysplastic syndromes

Lenalidomide, an oral immunomodulatory agent, has received approval in the USA from the Food and Drug Administration (FDA) for the management of myelodysplastic syndromes (MDS) classified by the International Prognostic Scoring System (IPSS) as low risk or intermediate-1 risk and with a deletion 5q (del(5q)) cytogenetic abnormality. Although some patients with del(5q) have a relatively good prognosis, all del(5q) patients will become transfusion-dependent at some point during the course of their disease. The results of two clinical trials in more than 160 patients with MDS have demonstrated clear therapeutic benefits of lenalidomide, with >60% of patients achieving independence from transfusion during therapy, irrespective of age, prior therapy, sex, or disease-risk assessment. The recommendations presented in this review will aid the safe administration of lenalidomide for the treatment of patients with low-risk or intermediate-1-risk MDS and a del(5q) cytogenetic abnormality, and they will help physicians avoid unnecessary dose reduction or interruption, thus assuring the best efficacy for patients

A pilot study using tactile cueing for gait rehabilitation following stroke

Recovery of walking function is a vital goal of post-stroke rehabilitation. Cueing using audio metronomes has been shown to improve gait, but can be impractical when interacting with others, particularly outdoors where awareness of vehicles and bicycles is essential. Audio is also unsuitable in environments with high background noise, or for those with a hearing impairment. If successful, lightweight portable tactile cueing has the potential to take the benefits of cueing out of the laboratory and into everyday life. The Haptic Bracelets are lightweight wireless devices containing a computer, accelerometers and low-latency vibrotactiles with a wide dynamic range. In this paper we review gait rehabilitation problems and existing solutions, and present an early pilot in which the Haptic Bracelets were applied to post-stroke gait rehabilitation. Tactile cueing during walking was well received in the pilot, and analysis of motion capture data showed immediate improvements in gait