Has there been a turning point in the numbers of AIDS and HIV antibody positive cases in Ireland?

Significant developments in the prevention and treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have taken place in recent years. Changes in the size of the HIV and AIDS epidemic need to be monitored to assess these developments and plan future services. This paper describes temporal trends in the incidence of HIV and AIDS in Ireland, describing separately the major risk groups, and to explore possible associations between these trends with developments in care. The annual numbers of HIV and AIDS in Ireland were analysed to determine whether there has been a turning point in incidence. There has been an overall decrease in the numbers of AIDS cases since 1993, with both homosexual and intravenous drug users (IDU) risk groups exhibiting a decrease. For HIV antibody positive individuals, overall numbers have remained constant. However, there has been an upward trend in the heterosexual risk group and a downward trend in the IDU risk group. Thus both AIDS and HIV numbers exhibit turning points. Declines in HIV and AIDS incidence in the homosexual and IDU risk groups are indirectly attributable to health safety and treatment programmes. The increase in HIV antibody positive cases among heterosexuals may reflect a relapse in safe sex behaviour

Optimal energy management of a grid-connected multiple energy carrier micro-grid

© 2019 Elsevier Ltd This paper presents a novel modeling approach to optimize the electrical and thermal energy management of a multiple energy carrier micro-grid with the aim of minimizing the operation cost such that system constraints are satisfied. The proposed micro-grid includes a micro-turbine, a fuel cell, a rubbish burning power plant, a wind turbine generator system, a boiler, an anaerobic reactor-reformer system, an inverter, a rectifier, and some energy storage units. The model uses day-ahead forecasting (24 h) to estimate the electrical and thermal loads on a micro-grid network. A day-ahead forecast is also used to estimate electricity generation from wind turbines. Due to the uncertainty associated with day-ahead forecasts, a Monte Carlo simulation is used to estimate thermal loads, electrical loads, and wind power generation. Also, a real-time pricing demand response program is used to shift non-vital loads. The operating cost of the micro-grid is minimized through the particle swarm optimization algorithm. The simulation results demonstrate the proposed modeling framework is superior over conventional centralized optimal scheduling models widely used in the literature in terms of reducing operating cost and computational complexity. In addition, the results obtained by applying the proposed modeling framework are analyzed and validated through scenario testing

Optimal operation of an energy hub considering the uncertainty associated with the power consumption of plug-in hybrid electric vehicles using information gap decision theory

© 2019 Elsevier Ltd An energy hub is a multi-carrier energy system that is capable of coupling various energy networks. It increases the flexibility of energy management and creates opportunities to increase the efficiency and reliability of energy systems. When plug-in hybrid electric vehicles (PHEVs)are incorporated into the energy hub, batteries can act as an aggregated storage system, increasing the potential integration of variable renewable energy sources (RES)into power system networks. This paper presents a new model for the optimal operation of an energy hub that includes RES, PHEVs, fuel cell vehicles, a fuel cell, an electrolyzer, a hydrogen tank, a boiler, an inverter, a rectifier, and a heat storage system. A novel model is developed to estimate the uncertainty associated with the power consumption of PHEVs during trips using information gap decision theory (IGDT)under risk-averse and risk-seeking strategies. Simulation results demonstrate that the proposed method maximizes the objective function under the risk-neutral and risk-averse strategies, while minimizing the objective function under the risk-seeking strategy. Results from the modeling show that considering the uncertainty associated with the power consumption of PHEVs using IGDT enables the energy hub operator to make appropriate decisions when optimizing the operation of the energy hub against possible changes in power consumption of PHEVs

Identification of diverse lipid-binding modes in the groove of zinc α2 glycoprotein reveals its functional versatility

ZAG is a multifunctional glycoprotein with a class I MHC-like protein fold and an α1-α2 lipid-binding groove. The intrinsic ZAG ligand is unknown. Our previous studies showed that ZAG binds the dansylated C11 fatty acid, DAUDA, differently to the boron dipyrromethane C16 fatty acid, C16-BODIPY. Here, the molecular basis for this difference was elucidated. Multi-wavelength analytical ultracentrifugation confirmed that DAUDA and C16-BODIPY individually bind to ZAG and compete for the same binding site. Molecular docking of lipid-binding in the structurally related CD1-proteins predicted nine conserved ligand contact residues in ZAG. Twelve mutants were accordingly created by alanine scanning site directed mutagenesis for characterisation. Mutation of Y12 caused ZAG to misfold. Mutation of K147, R157 and A158 abrogated C16-BODIPY but not DAUDA binding. L69 and T169 increased the fluorescence emission intensity of C16-BODIPY but not of DAUDA compared to wild-type ZAG and showed that C16-BODIPY binds close to T169 and L69. Distance measurements of the crystal structure revealed K147 forms a salt bridge with D83. A range of bioactive bulky lipids including phospholipids and sphingolipids displaced DAUDA from the ZAG binding site but unexpectedly did not displace C16-BODIPY. We conclude that the ZAG α1-α2 groove contains separate but overlapping sites for DAUDA and C16-BODIPY and is involved in binding to a bulkier and wider repertoire of lipids than previously reported. This work suggested that the in vivo activity of ZAG may be dictated by its lipid ligand

Depression and Prostate Cancer: Examining Comorbidity and Male-Specific Symptoms

© The Author(s) 2018. Depression in men with prostate cancer is a significant and complex issue that can challenge clinicians’ diagnostic efforts. The objective of the current study was to evaluate prototypic and male-specific depression symptoms and suicidal ideation in men with a diagnosis of prostate cancer relative to those with and without comorbidity. The Patient Health Questionnaire-9 (PHQ-9) and Male Depression Risk Scale-22 (MDRS-22) were completed online along with demographic and background variables by 100 men with a diagnosis of prostate cancer (n = 54 prostatectomy, n = 33 receiving active treatment). Hierarchical logistic regression was used to examine recent (past 2 weeks) suicide ideation. Over one-third of the sample (38%) reported a comorbidity, and this group had significantly higher total depression scores on the PHQ-9 (Cohen’s d = 0.65), MDRS-22 emotion suppression (d = 0.35), and drug use subscales (d = 0.38) compared to respondents without comorbidity. A total of 14% reported recent suicidal ideation, of which 71.4% of cases were identified by the PHQ-9 “moderate” cut-off, and 85.7% of cases were identified by the MDRS-22 “elevated” cut-off. After control variables, MDRS-22 subscales accounted for 45.1% of variance in recent suicidal ideation. While limited by the exclusive use of self-report data, findings point to the potential benefits of evaluating male-specific symptoms as part of depression and suicide risk screening in men with prostate cancer and the need to be mindful of the heightened risk for depression among men with prostate cancer who have comorbidity

Statistical Signal Properties of the Pressure-Reactivity Index (PRx)

Objectives: The pressure-reactivity index (PRx) is defined in terms of the moving correlation coefficient between intracranial pressure (ICP) and mean arterial pressure (MAP) and is a measure of cerebral autoregulation ability. Histograms of PRx against cerebral perfusion pressure (CPP) show U-shaped behaviour- the minimum reflecting optimal cerebral autoregulation (CPPopt). However U-shaped behavior may also occur by chance. To date there has been no evaluation of the statistical properties of these signals. Materials and Methods: We simulated PRx/CPP distributions using synthetic ICP and MAP signals from Gaussian noise with known cross-correlation. We calculated the statistical distribution of extrema in the PRx/CPP relationship. Results: The calculation of PRx on random data is statistically biased to show a U-shaped behavior when the signals are positively cross-correlated (equivalent to PRx>0). For PR<0, the bias is towards inverse U-shaped behavior. We demonstrate that this bias is eliminated by Fisher transforming the PRx data before CPPopt analysis. Conclusions: Cross-correlated signals are biased to show a U-shaped distribution. A “CPPopt-like” behavior will be observed more often than not even from random ICP and MAP signals that do not exhibit autoregulation unless PRx is Fisher transformed. Care must be taken in interpreting CPPopt in terms of physiology calculated from untransformed dat

Indirect interaction between two native thistles mediated by an invasive exotic floral herbivore

Spatial and temporal variation in insect floral herbivory is common and often important. Yet, the determinants of such variation remain incompletely understood. Using 12 years of flowering data and 4 years of biweekly insect counts, we evaluated four hypotheses to explain variation in damage by the Eurasian flower head weevil, Rhinocyllus conicus, to the native North American wavyleaf thistle, Cirsium undulatum. The four factors hypothesized to influence weevil impact were variations in climate, weevil abundance, phenological synchrony, and number of flower heads available, either on wavyleaf thistle or on the other co-occurring, acquired native host plant (Platte thistle, Cirsium canescens), or on both. Climate did not contribute significantly to an explanation of variation in R. conicus damage to wavyleaf thistle. However, climate did influence weevil synchrony with wavyleaf flower head initiation, and phenological synchrony was important in determining R. conicus oviposition levels on wavyleaf thistle. The earlier R. conicus was active, the less it oviposited on wavyleaf thistle, even when weevils were abundant. Neither weevil abundance nor availability of wavyleaf flower heads predicted R. conicus egg load. Instead, the strongest predictor of R. conicus egg load on wavyleaf thistle was the availability of flower heads on Platte thistle, the more common, earlier flowering native thistle in the sand prairie. Egg load on wavyleaf thistle decreased as the number of Platte thistle flower heads at a site increased. Thus, wavyleaf thistle experienced associational defense in the presence of flowering by its now declining native congener, Platte thistle. These results demonstrate that prediction of damage to a native plant by an exotic insect may require knowledge of both likely phenological synchrony and total resource availability to the herbivore, including resources provided by other nontarget native species

A rare presentation of atypical demyelination: tumefactive multiple sclerosis causing Gerstmann's syndrome

r. KS has been supported by a Higher Education Funding Council for England (HEFCE) Clinical Senior Lectureshi

How important is the context of an adolescent's first alcoholic drink? Evidence that parental provision may reduce later heavy episodic drinking

Objective: This study examined the extent to which a retrospective measure of parental provision of the first alcoholic beverage was related to current heavy episodic drinking and current responsible drinking practices. Sample: 608 14- to 17-year-olds from the 2007 Australian National Drug Strategy Household Survey. Measures: Source of first alcoholic beverage (friends/parents/others), source of current alcohol, age of onset of alcohol use, current responsible drinking practices, and proportion of current friends who drink. Results: Binary logistic and multiple regression procedures revealed that parental provision of an adolescent's first alcoholic beverage predicted lower current heavy episodic drinking, and responsible drinking mediated this association. Discussion: The results suggested that for adolescents who become alcohol users, parental provision of the first drink may reduce subsequent alcohol-related risks compared to introduction to alcohol by friends and other sources. Alcohol-related risks remain significant for adolescents who consume alcohol, independent of who is the provider. Copyright (C) 2012 S. Karger AG, Base