Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos, north central Nigeria

Background: Accurate and reliable diagnosis of HIV opportunistic infections plays a central role in effective HIV intervention programmes. Pulmonary infections are the leading cause of  morbidity and mortality in HIV infected individuals.Objectives: We set out to determine the prevalence of Pulmonary candidiasis by isolating Candida species from the sputum of HIV sero-positive patient’s presenting to hospital with complaint of cough for more than two weeks and related the level of CD4 count to Pulmonary candidiasis.Methods: Using sterile wire loop, each sputum sample was inoculated into duplicate SDA (Thermo Scientific, UK); one tube without antibiotics, another tube supplemented with Chloramphenicol (0.05%) and Cycloheximide (0.5%) antibiotics. The patient’s CD4 count was determined using a Cyflow machine (PARTECR, Germany).Result: Fifty two (54.2%) female and 44(45.8%) male HIV positive subjects were compared with a control group made up of, 52(54.2%) female and 44(45.8%) male HIV negative subjects. Twenty one (21.9%) HIV positive subjects had Candida species in their sputum samples compared to 12(12.5%) in the HIV negative subjects. Among HIV positive subjects, 17(17.7%) had Candida albicans isolated from their sputum, 11(11.5%) of whom had a CD4 count of <200 cells/ul.Conclusion: We concluded that, there is a risk of pulmonary candidiasis occurring in HIV infected patients with CD4 count <200cells/ul and that, Candida species contributes to chronic cough experienced by HIV infected patients. We recommend that HIV positive patients who have chronic cough and whose CD4 count is <200cells/ul be placed on systemic antifungal medication.Keywords: Candida, Cough, Nigeria, Sputu

Quantifying the Surface Energy Fluxes in South Greenland during the 2012 High Melt Episodes Using In-situ Observations

Two high melt episodes occurred on the Greenland ice sheet in July 2012, during which nearly the entire ice sheet surface experienced melting. Observations from an automatic weather station (AWS) in the lower ablation area in South Greenland reveal the largest daily melt rates (up to 28 cm d-1 ice equivalent) ever recorded on the ice sheet. The two melt episodes lasted 6 days, equivalent to 6% of the June-August melt period, but contributed 14 % to the total annual ablation of 8.5 m ice equivalent. We employ a surface energy balance model driven by AWS data to quantify the relative importance of the energy budget components contributing to melt through the melt season. During the days with largest daily melt rates, surface turbulent heat input peaked at 552 Wm-2, 77 % of the surface melt energy, which is otherwise typically dominated by absorbed solar radiation. We find that rain contributed ca. 7 % to melt during these episodes

Measuring Metacognition in Cancer: Validation of the Metacognitions Questionnaire 30 (MCQ-30)

Objective The Metacognitions Questionnaire 30 assesses metacognitive beliefs and processes which are central to the metacognitive model of emotional disorder. As recent studies have begun to explore the utility of this model for understanding emotional distress after cancer diagnosis, it is important also to assess the validity of the Metacognitions Questionnaire 30 for use in cancer populations. Methods 229 patients with primary breast or prostate cancer completed the Metacognitions Questionnaire 30 and the Hospital Anxiety and Depression Scale pre-treatment and again 12 months later. The structure and validity of the Metacognitions Questionnaire 30 were assessed using factor analyses and structural equation modelling. Results Confirmatory and exploratory factor analyses provided evidence supporting the validity of the previously published 5-factor structure of the Metacognitions Questionnaire 30. Specifically, both pre-treatment and 12 months later, this solution provided the best fit to the data and all items loaded on their expected factors. Structural equation modelling indicated that two dimensions of metacognition (positive and negative beliefs about worry) were significantly associated with anxiety and depression as predicted, providing further evidence of validity. Conclusions These findings provide initial evidence that the Metacognitions Questionnaire 30 is a valid measure for use in cancer populations

Entropy on Spin Factors

Recently it has been demonstrated that the Shannon entropy or the von Neuman entropy are the only entropy functions that generate a local Bregman divergences as long as the state space has rank 3 or higher. In this paper we will study the properties of Bregman divergences for convex bodies of rank 2. The two most important convex bodies of rank 2 can be identified with the bit and the qubit. We demonstrate that if a convex body of rank 2 has a Bregman divergence that satisfies sufficiency then the convex body is spectral and if the Bregman divergence is monotone then the convex body has the shape of a ball. A ball can be represented as the state space of a spin factor, which is the most simple type of Jordan algebra. We also study the existence of recovery maps for Bregman divergences on spin factors. In general the convex bodies of rank 2 appear as faces of state spaces of higher rank. Therefore our results give strong restrictions on which convex bodies could be the state space of a physical system with a well-behaved entropy function.Comment: 30 pages, 6 figure

Reduction in adolescent depression after contact with mental health services: a longitudinal cohort study in the UK

Background: Evidence regarding the association between service contact and subsequent mental health in adolescents is scarce, and previous findings are mixed. We aimed to longitudinally assess the extent to which depressive symptoms in adolescents change after contact with mental health services. Methods: As part of a longitudinal cohort study, between April 28, 2005, and March 17, 2010, we recruited 1238 14-year-old adolescents and their primary caregivers from 18 secondary schools in Cambridgeshire, UK. Participants underwent follow-up assessment at months 18 and 36. Trained researchers assessed the adolescents for current mental disorder using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL). Caregivers and adolescents reported contact with mental health services in the year before baseline. Adolescents self-reported depressive symptoms (Mood and Feelings Questionnaire [MFQ]) at each timepoint. We assessed change in MFQ sum scores from baseline contact with mental health services using multilevel mixed-effects regression adjusted for sociodemographic, environmental, individual, and mental health confounders, with multiple imputation of missing data. We used propensity score weighting to balance confounders between treatment (users of mental health services) and control (non-users of mental health services) groups. We implemented an MFQ clinical cutoff following the results of receiver operating characteristic analysis. Findings: 14-year-old adolescents who had contact with mental health services in the past year had a greater decrease in depressive symptoms than those without contact (adjusted coefficient −1·68, 95% CI −3·22 to −0·14; p=0·033). By age 17 years, the odds of reporting clinical depression were higher in individuals without contact than in service users who had been similarly depressed at baseline (adjusted odds ratio 7·38, 1·73–31·50; p=0·0069). Interpretation: Our findings show that contact with mental health services at age 14 years by adolescents with a mental disorder reduced the likelihood of depression by age 17 years. This finding supports the improvement of access to adolescent mental health services.This study was funded by The Wellcome Trust (grant number 074296), and the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care for Cambridgeshire and Peterborough

Inhuman shields - children caught in the crossfire of domestic violence

Background. Child abuse is a worldwide scourge. One of its most devastating manifestations is non-accidental head injury (NAHI).Methods. This is a retrospective chart review of children presenting to the Red Cross Children's Hospital trauma unit with a diagnosis of NAHI over a 3-year period.Results. Sixty-eight children were included in the study and 2 different groups were identified. Fifty-three per cent of the children were deliberately injured (median age 2 years), while 47% were allegedly not the intended target of the assailant (median age 9 months). The assailant was male in 65% of the intentional assaults and male in 100% of the unintentional assaults, with the intended adult victim female in 85% of the latter cases. Overall, 85% of the assaults were committed in the child's own home.Conclusions. The high proportion of cases in which a young child was injured unintentionally suggests that these infants effectively become shields in assaults committed by adults. In this context any attempts to deal with child abuse must also address the concurrent intimate partner violence

Completeness for a First-order Abstract Separation Logic

Existing work on theorem proving for the assertion language of separation logic (SL) either focuses on abstract semantics which are not readily available in most applications of program verification, or on concrete models for which completeness is not possible. An important element in concrete SL is the points-to predicate which denotes a singleton heap. SL with the points-to predicate has been shown to be non-recursively enumerable. In this paper, we develop a first-order SL, called FOASL, with an abstracted version of the points-to predicate. We prove that FOASL is sound and complete with respect to an abstract semantics, of which the standard SL semantics is an instance. We also show that some reasoning principles involving the points-to predicate can be approximated as FOASL theories, thus allowing our logic to be used for reasoning about concrete program verification problems. We give some example theories that are sound with respect to different variants of separation logics from the literature, including those that are incompatible with Reynolds's semantics. In the experiment we demonstrate our FOASL based theorem prover which is able to handle a large fragment of separation logic with heap semantics as well as non-standard semantics.Comment: This is an extended version of the APLAS 2016 paper with the same titl