The cost effectiveness of integrated care for people living with HIV including antiretroviral treatment in a primary health care centre in Bujumbura, Burundi

The incremental cost effectiveness of an integrated care package (i.e., medical care including antiretroviral therapy (ART) and other services such as psychological and social support) for people living with HIV/AIDS was calculated in a not-for-profit primary health care centre in Bujumbura run by Society of Women against AIDS-Burundi (SWAA-Burundi), an African non-governmental organisation (NGO). Results are expressed as cost-effectiveness ratio 2007, constant US$per disability-adjusted life year (DALY) averted. Unit costs are estimated from the NGO's accounting data and activity reports, healthcare utilisation is estimated from the medical records of a cohort of 149 patients. Effectiveness is modelled on the survival of this cohort, using standard calculation methods. The incremental cost of integrated care for people living with HIV/AIDS in the Bujumbura health centre of SWAA-Burundi is 258 US$ per DALY averted. The package of care provided by SWAA-Burundi is therefore a very cost-effective intervention in comparison with other interventions against HIV/AIDS that include ART. It is however, less cost effective than other types of interventions against HIV/AIDS, such as preventive activities

Efficient boundary integral solution for acoustic wave scattering by irregular surfaces

The left-right operator splitting method is studied for the efficient calculation of acoustic fields scattered by arbitrary rough surfaces. Here the governing boundary integral is written as a sum of left- and right-going components, and the solution expressed as an iterative series, expanding about the predominant direction of propagation. Calculation of each term is computationally inexpensive both in time and memory, and the field is often accurately captured using one or two terms. The convergence and accuracy are examined by comparison with exact solution for smaller problems, and a series of much larger problems are tackled. The method is also immediately applicable to other scatterers such as waveguides, of which examples are given

Random scattering by rough surfaces with spatially varying impedance

A method is given for evaluating electromagnetic scattering by an irregular surface with spatially-varying impedance. This uses an operator expansion with respect to impedance variation and allows examination of its effects and the resulting modification of the field scattered by the rough surface. For a fixed rough surface and randomly varying impedance, expressions are derived for the scattered field itself, and for the coherent field with respect to impedance variation for both flat and rough surfaces in the form of effective impedance conditions

Recovery of rough surface in ducting medium from grazing angle scattered wave

A method is developed for rough surface reconstruction using fields scattered at grazing angles in a medium with a linearly varying refractive index and Neumann boundary condition. This regime represents a ducting medium, bounded by a perfectly conducting surface with a TM incident field or an acoustically hard surface. This significantly extends the iterated marching method, based upon the parabolic integral equation for forward-scattered field components [Chen and Spivack, J. Opt. Soc. Am. A 35, 504–513 (2018)]. The approach, which uses a fixed frequency, is able to accurately recover multiscale surfaces and is found to be robust with respect to measurement noise and localized perturbations.</jats:p

Fourier transform infrared evidence for a predominantly alpha-helical structure of the membrane bound channel forming COOH-terminal peptide of colicin E1

The structure of the membrane bound state of the 178-residue thermolytic COOH-terminal channel forming peptide of colicin E1 was studied by polarized Fourier transform infrared (FTIR) spectroscopy. This fragment was reconstituted into DMPC liposomes at varying peptide/lipid ratios ranging from 1/25–1/500. The amide I band frequency of the protein indicated a dominant alpha-helical secondary structure with limited beta- and random structures. The amide I and II frequencies are at 1,656 and 1,546 cm-1, close to the frequency of the amide I and II bands of rhodopsin, bacteriorhodopsin and other alpha-helical proteins. Polarized FTIR of oriented membranes revealed that the alpha-helices have an average orientation less than the magic angle, 54.6 degrees, relative to the membrane normal. Almost all of the peptide groups in the membrane-bound channel protein undergo rapid hydrogen/deuterium (H/D) exchange. These results are contrasted to the alpha-helical membrane proteins, bacteriorhodopsin, and rhodopsin

Effect of Strain of Holstein-Friesian Cow and Feed System on Reproductive Performance in Seasonal-Calving Milk Production Systems Over Four Years

In Ireland most dairy farms operate seasonal calving grass-based milk production systems. Feed demand and supply are matched by having calving highly concentrated in spring. This requires high pregnancy rates within a short time following the start of mating in late April or early May, but has become increasingly difficult to achieve due to declining fertility in Irish dairy herds (Mee, 2004). In New Zealand, cows of North American Holstein-Friesian origin have poorer fertility than New Zealand Holstein-Friesians on pasture-based seasonal calving systems (Harris & Kolver, 2001). The present study sought to determine the effect of strain of Holstein-Friesian (HF) cow and feed system on reproductive performance within Irish milk production systems

Statistical moments for rough surface scatter from two-way parabolic integral equation at low grazing angles

The moments of a plane wave scattered at low grazing angles from a one-dimensional perfectly reflecting rough surface are considered. The mean intensity and autocorrelation of the scattered field and the corresponding angular spectrum are obtained to second order in surface height. The derivations are based on an operator expansion of the extended (two-way) parabolic integral equation solution. The resulting operator series describes successively higher-order surface interactions between forward and backward going components. The expressions derived may be regarded as backscatter corrections to those obtained via the standard (one-way) parabolic integral equation method

"Media Digidactic": Online-Seminarkonzept für ein "peer-created" MOOC zur digitalen Medienbildung

Digitale Medienkompetenzen in Schule und Hochschule sind mit Covid-19 in den besonderen Fokus der Bildungsangebote geraten. Bei Studierenden und Lehrkräften sind es dabei in erster Linie technische Nutzungskompetenzen, die als Desiderat beschrieben werden. Doch für den souveränen Einsatz in Bildungskontexten sind fachdidaktische Anwendungsszenarien mindestens ebenso wichtig. Dazu gehört die Fähigkeit, digital-mediale Kompetenzen in fachliche Kontexte zu implementieren - und zwar inhaltlich, technisch und arbeitsorganisatorisch. Diese Anforderungen wurden während der letzten beiden Corona-Semester in einer kooperativen digitalen Lehrveranstaltung der Pädagogischen Hochschule Ludwigsburg und der Technischen Universität Dortmund eingeübt. Mit Lehramtsstudierenden der Fächer Deutsch und Ethik wurde ein gemeinsamer Selbstlernkurs zum Thema "Medienbildung" entwickelt, der Theorie und Anwendungsfelder adressiert und zusätzlich die eigene Rolle als lehrende Person in digital-medialer Präsenz reflektiert. Der Beitrag stellt den Theoriehintergrund im Hinblick auf Lehrendenprofessionalisierung, den Entwicklungsprozess und die Kompetenzorientierung des Selbstlernkurses sowie Reflexionen der zweisemestrigen Entstehungsphase aus den Perspektiven der Studierenden und Lehrenden vor. (DIPF/Orig.

The effect of parallel static and microwave electric fields on excited hydrogen atoms

Motivated by recent experiments we analyse the classical dynamics of a hydrogen atom in parallel static and microwave electric fields. Using an appropriate representation and averaging approximations we show that resonant ionisation is controlled by a separatrix, and provide necessary conditions for a dynamical resonance to affect the ionisation probability. The position of the dynamical resonance is computed using a high-order perturbation series, and estimate its radius of convergence. We show that the position of the dynamical resonance does not coincide precisely with the ionisation maxima, and that the field switch-on time can dramatically affect the ionisation signal which, for long switch times, reflects the shape of an incipient homoclinic. Similarly, the resonance ionisation time can reflect the time-scale of the separatrix motion, which is therefore longer than conventional static field Stark ionisation. We explain why these effects should be observed in the quantum dynamics. PACs: 32.80.Rm, 33.40.+f, 34.10.+x, 05.45.Ac, 05.45.MtComment: 47 pages, 20 figure

Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

Results of the proton magnetic resonance spectroscopy carried out on normal, benign breast disease and locally advanced breast cancer patients are presented. The in-vivo MR spectra of malignant breast tissue of patients (n = 67) suffering from infiltrating ductal carcinoma are dominated by the water resonance, while the spectra of the unaffected contralateral breast tissue of these patients are mainly dominated by resonance arising from lipids which is similar to the spectra of normal breast tissue obtained from volunteers (controls, n = 16). In addition to the water and lipid peaks, in majority of the patients (~80%) the water suppressed spectra showed a resonance at 3.2 ppm due to choline containing compounds (TCho) before treatment. In patients receiving neoadjuvant chemotherapy, absence/reduction in choline was observed in 89% of the patients. TCho was also observed in 2 of 14 benign lesions. The sensitivity and specificity of in-vivo MRS in detecting TCho in malignant tumours was 78% and 86%, respectively. Observation of TCho before treatment and its disappearance (or reduction) after treatment may be a useful indicator of response of locally advanced breast cancer to neoadjuvant chemotherapy. © 2001 Cancer Research Campaign http://www.bjcancer.co