CD4 count and tuberculosis risk in HIV-positive adults not on ART: a systematic review and meta-analysis

Background: CD4 cell count in adults with human immunodeficiency virus (HIV) infection (PLHIV) not receiving antiretroviral therapy (ART) influences tuberculosis (TB) risk. Despite widespread use in models informing resource allocation, this relationship has not been systematically reviewed. Methods: We systematically searched MEDLINE, Aidsinfo, Cochrane review database and Google Scholar for reports in English describing TB incidence stratified by updated CD4 cell count in cohorts of HIV-positive adults (age ≥15 years) not on ART (PROSPERO protocol no: CRD42016048888). Among inclusion criteria were: reporting precision for TB incidence, repeated CD4 measurements, and TB incidence reported for those not on ART or monotherapy. Study quality was assessed via the Newcastle-Ottawa tool for cohort studies. A Bayesian hierarchical model was fitted to estimate the pooled factor increase in TB incidence with respect to CD4 cell count decrement. Results: A total of 1,555 distinct records were identified from which 164 full text articles were obtained. Common reasons for exclusion of full texts were: no valid TB incidence, no repeat CD4 measurements, and not reporting TB incidence by ART status. The seven studies included reported on 1,206 TB cases among 41,271 individuals, with a typical median follow-up of four years. Studies were generally rated as moderate or high quality. Our meta-analysis estimated a 1.43 (95% credible interval: 1.16-1.88)-fold increase in TB incidence per 100 cells per mm3 decrease in CD4 cell count. Discussion: Our analysis confirms previous estimates of exponential increase in TB incidence with declining CD4 cell count in adults, emphasizing the importance of early ART initiation to reduce TB risk in PLHIV

Endovascular Ruptured Abdominal Aortic Aneurysm Repair (EVRAR): A Systematic Review

BackgroundTo review evidence supporting the use of endovascular ruptured aneurysm repair (EVRAR) for treatment of ruptured abdominal aortic aneurysm (RAAA).MethodsA systematic review of the medical literature was performed for relevant studies. We searched a number of electronic databases and hand-searched relevant journals until November 2006 to identify studies for inclusion. We considered studies in which patients with a confirmed ruptured abdominal aortic aneurysm were treated with EVRAR, which reported endpoints of mortality and major complications.ResultsThere was 1 randomised controlled trial (RCT), 33 non-randomised case series (24 retrospective and 9 prospective) reports were identified comparing EVRAR (n=891) with conventional open surgical repair for the treatment of RAAA. Whilst no benefit in the primary outcome of mortality was noted in the only RCT, evidence from non-randomised studies suggest that EVRAR is feasible in selected patients, where it may be associated with a trend towards reductions in blood loss, duration of intensive care treatment, early complications, and mortality.ConclusionsFor the treatment of symptomatic or ruptured abdominal aortic aneurysm, emergency endovascular repair (EVRAR) is feasible in selected patients, with early outcomes comparable to best conventional open surgical repair for the treatment of RAAA

Evaluating the potential impact of online assessment on students' academic performance

Purpose With the outbreak of the COVID-19 pandemic, online assessment has become the dominant mode of examination in higher education institutions. However, there are contradictory findings on how students perceive online assessment and its impact on their academic performance. Thus, the purpose of this study is to evaluate the potential impact of online assessment on students' academic performance. Design/methodology/approach This study proposes a research model based on the task–technology fit theory and empirically validates the model using a survey from students in the UK. In addition, the study conducted four experiments based on paper-based and online assessments and analysed the data using paired sample t test and structural equation modelling. Findings The findings show that the use of online assessment has a positive impact on students' academic performance. Similarly, the results from the experiment also indicate that students perform better using online assessments than paper-based assessments. Practical implications The findings provide crucial evidence needed to shape policy towards institutionalising online assessment. In addition, the findings provide assurance to students, academics, administrators and policymakers that carefully designed online assessments can improve students' academic performance. Moreover, the study also provides important insights for curriculum redesign towards transitioning to online assessment in higher education institutions. Originality/value This study advances research by offering a more nuanced understanding of online assessment on students' academic performance since the majority of previous studies have offered contradictory findings. In addition, the study moves beyond existing research by complementing assessment results with the views of students in evaluating the impact of online assessment on their academic performance. Second, the study develops and validates a research model that explains how the fits between technology and assessment tasks influence students' academic performance. Lastly, the study provides evidence to support the wide use of online assessment in higher education

Disentangling Dimension Six Operators through Di-Higgs Boson Production

New physics near the TeV scale can generate dimension-six operators that modify the production rate and branching ratios of the Higgs boson. Here, we show how Higgs boson pair production can yield complementary information on dimension-six operators involving the gluon field strength. For example, the invariant mass distribution of the Higgs boson pair can show the extent to which the masses of exotic TeV-scale quarks come from electroweak symmetry breaking. We discuss both the current Tevatron bounds on these operators and the most promising LHC measurement channels for two different Higgs masses: 120 GeV and 180 GeV. We argue that the operators considered in this paper are the ones most likely to yield interesting Higgs pair physics at the LHC.Comment: 20 pages, 7 figures; v2: to match JHEP versio

Strangeness Production in Neutron Stars

Production of strange quarks in neutron stars is investigated in this work. Three cases, one in which the energy and neutrinos produced in the strangeness production reactions are retained in the reaction region, second in which the neutrinos are allowed to escape the reaction region but the energy is retained and the third in which both the energy and neutrinos escape the reaction region are considered. It is shown that the nonleptonic weak process dominates strange quark production while semileptonic weak processes, which produce neutrinos, lead to the cooling if the neutrinos escape the reaction region. It is found that the time required for the saturation of the strangeness fraction is between $10^{-7}$ and $10^{-5}$ sec, with the shorter time corresponding to the first two cases. About 0.2 neutrinos/baryon are emitted during the process in the first two cases where as the neutrino emission is somewhat suppressed in the last case. The average energy of the neutrinos produced in all the three cases is found to be several hundred $MeV$. We also find that a large amount of energy is released during the strangeness production in the first two cases and this leads to the heating of the reaction region. Implications of the neutrino production are investigated.Comment: Latex file. 3 figures available from SKG on request. accepted in Nucl Phys

The influence of medium effects on the gross structure of hybrid stars

We investigate the influence of medium effects on the structure of hybrid stars, i.e. neutron stars possessing a quark matter core. We found that medium effects reduce the extent of a pure quark matter phase in the interior of a hybrid star significantly in favor of a mixed phase of quark and hadronic matter. Over a wide range of the strong coupling constant - which parameterizes the influence of medium effects - quark matter is able to exist at least in a mixed phase in the interior of neutron stars.Comment: 20 pages, LaTeX, 4 inline eps-figures, 4 gif-figures, extended discussion, to be published in Nucl. Phys. A. Also available at http://theorie.physik.uni-giessen.de/~schertle/HybSta

The hadron-quark phase transition in dense matter and neutron stars

We study the hadron-quark phase transition in the interior of neutron stars (NS's). We calculate the equation of state (EOS) of hadronic matter using the Brueckner-Bethe-Goldstone formalism with realistic two-body and three-body forces, as well as a relativistic mean field model. For quark matter we employ the MIT bag model constraining the bag constant by using the indications coming from the recent experimental results obtained at the CERN SPS on the formation of a quark-gluon plasma. We find necessary to introduce a density dependent bag parameter, and the corresponding consistent thermodynamical formalism. We calculate the structure of NS interiors with the EOS comprising both phases, and we find that the NS maximum masses fall in a relatively narrow interval, $1.4 M_\odot \leq M_{\rm max} \leq 1.7 M_\odot$. The precise value of the maximum mass turns out to be only weakly correlated with the value of the energy density at the assumed transition point in nearly symmetric nuclear matter.Comment: 25 pages, Revtex4, 16 figures included as postscrip

Unified Maxwell-Einstein and Yang-Mills-Einstein Supergravity Theories in Five Dimensions

Unified N=2 Maxwell-Einstein supergravity theories (MESGTs) are supergravity theories in which all the vector fields, including the graviphoton, transform in an irreducible representation of a simple global symmetry group of the Lagrangian. As was established long time ago, in five dimensions there exist only four unified Maxwell-Einstein supergravity theories whose target manifolds are symmetric spaces. These theories are defined by the four simple Euclidean Jordan algebras of degree three. In this paper, we show that, in addition to these four unified MESGTs with symmetric target spaces, there exist three infinite families of unified MESGTs as well as another exceptional one. These novel unified MESGTs are defined by non-compact (Minkowskian) Jordan algebras, and their target spaces are in general neither symmetric nor homogeneous. The members of one of these three infinite families can be gauged in such a way as to obtain an infinite family of unified N=2 Yang-Mills-Einstein supergravity theories, in which all vector fields transform in the adjoint representation of a simple gauge group of the type SU(N,1). The corresponding gaugings in the other two infinite families lead to Yang-Mills-Einstein supergravity theories coupled to tensor multiplets.Comment: Latex 2e, 28 pages. v2: reference added, footnote 14 enlarge

Tau neutrino deep inelastic charged current interactions

The nu_mu -> nu_tau oscillation hypothesis will be tested through nu_tau production of tau in underground neutrino telescopes as well as long-baseline experiments. We provide the full QCD framework for the evaluation of tau neutrino deep inelastic charged current (CC) cross sections, including next-leading-order (NLO) corrections, charm production, tau threshold, and target mass effects in the collinear approximation. We investigate the violation of the Albright-Jarlskog relations for the structure functions F_4,5 which occur only in heavy lepton (tau) scattering. Integrated CC cross sections are evaluated naively over the full phase space and with the inclusion of DIS kinematic cuts. Uncertainties in our evaluation based on scale dependence, PDF errors and the interplay between kinematic and dynamical power corrections are discussed and/or quantified.Comment: 28 pages, 10 figure