Doing HIV Medicine in Southern Africa. What does the Epidemic Teach Us?

Despite education and prevention campaigns, the HIV epidemic in southern Africa continues to spread. What do poverty, lack of leadership, stigma and culture mean in the context of personal choice? What can be done to assist the uninfected to make the right decisions? This article briefly reviews these ethical issues in HIV practice and suggests several solutions

Regional Geographies of Extreme Heat

Shaped by countless influences from the atmosphere, biosphere, hydrosphere, and anthroposphere acting across a wide spectrum of spatiotemporal scales, spatial variations in climate are ubiquitous. Meanwhile, the warming signal from anthropogenically elevated greenhouse-gas concentrations is emerging as an overriding determinant for more and more aspects of the climate system, extreme heat among them. In this dissertation, I explore the interaction of these two effects, and the implications of the patterns they create. A key finding is that rapid increases in extreme heat are already occurring, by some metrics having already doubled in the past 40 years, and further nonlinear increases are expected. Another is the strong dependence of extreme heat-humidity combinations on atmospheric moisture, creating subseasonal and interannual patterns dictated by the principal source of regional warm-season moisture — pre-monsoonal advection in some cases, local evapotranspiration in others. These relationships lead to the demonstrated potential for improvements in predictive power, on the basis of sea-surface temperatures and other canonical modes of large-scale climate variability. In contrast to this overall confidence in current temporal patterns and long-term projections, I show that extreme heat at small spatial scales is much more poorly characterized in gridded products, and that these biases are especially acute along coastlines. While summer daytime temperature differences between the shoreline of the Northeast U.S. and locations 60 km inland are often 5°C or more, I find that recent high-resolution downscaled Earth-system models typically represent no more than 25% of this difference. Across the globe, ERA-Interim reanalysis similarly underestimates extreme humid heat by >3°C, a highly significant margin given the large sensitivity of health and economic impacts to marginal changes in the most extreme conditions. I find that these biases propagate into projections, and their importance is also amplified by the large populations living in the affected areas. Rapid mean warming is pushing the climate system to more and more frequently include extreme heat-humidity combinations beyond that which the human species has likely ever experienced. Such conditions, which had not been previously reported in weather-station data, are described in detail and some of the associated characteristics examined. Several channels of analysis highlight that these events are driven primarily by rising sea-surface temperatures in shallow subtropical gulfs, and the subsequent impingement of marine air on the coastline. Given the severity of potential impacts on infrastructure and agriculture, and the size of the populations exposed, this result underscores that major research and adaptation efforts are needed to avoid calamitous outcomes from the emergence of extreme heat-humidity combinations too severe to tolerate in the absence of artificial cooling. This dissertation discusses strategies for advancing knowledge of extreme heat’s natural variations and its behavior under climate change, in order to design metrics, models, methodologies, and presentation types such that essential findings are translated into tangible action in the most effective way possible. Sustained and integrated efforts are necessary to transition to a climate-system management style encompassing more foresight than the effectively unplanned experiment which has been pursued so far, and which has already exacerbated extreme heat events so much

Hearing in dementia: defining deficits and assessing impact

The association between hearing impairment and dementia has emerged as a major public health challenge, with significant opportunities for earlier diagnosis, treatment and prevention. However, the nature of this association has not been defined. We hear with our brains, particularly within the complex soundscapes of everyday life: neurodegenerative pathologies target the auditory brain and are therefore predicted to damage hearing function early and profoundly. Here I present evidence for this proposition, based on structural and functional features of auditory brain organisation that confer vulnerability to neurodegeneration, the extensive, reciprocal interplay between ‘peripheral’ and ‘central’ hearing dysfunction, and recently characterised auditory signatures of canonical neurodegenerative dementias (Alzheimer’s disease and frontotemporal dementia). In chapter 3, I examine pure tone audiometric thresholds in AD and FTD syndromes and explore the functional interplay between the auditory brain and auditory periphery by assessing the contribution of auditory cognitive factors on pure tone detection. In chapter 4, I develop this further by examining the processing of degraded speech signals, leveraging the increased importance of top-down integrative and predictive mechanisms on resolving impoverished bottom-up sensory encoding. In chapter 5, I use a more discrete test of phonological processing to focus in on a specific brain region that is an early target in logopenic aphasia, to explore the potential of auditory cognitive tests as disease specific functional biomarkers. Finally, in chapter 6, I use auditory symptom questionnaires to capture real-world hearing in daily life amongst patients with dementia as well as their carers and measure how this correlates with audiometric performance and degraded speech processing. I call for a clinical assessment of real-world hearing in these diseases that moves beyond pure tone perception to the development of novel auditory ‘cognitive stress tests’ and proximity markers for the early diagnosis of dementia and management strategies that harness retained auditory plasticity

On the length of a random minimum spanning tree

We study the expected value of the length $L_n$ of the minimum spanning tree of the complete graph $K_n$ when each edge $e$ is given an independent uniform $[0,1]$ edge weight. We sharpen the result of Frieze \cite{F1} that \lim_{n\to\infty}\E(L_n)=\z(3) and show that \E(L_n)=\z(3)+\frac{c_1}{n}+\frac{c_2+o(1)}{n^{4/3}} where $c_1,c_2$ are explicitly defined constants.Comment: Added next term and two co-author

²¹⁰Pb- ²²⁶Ra chronology reveals rapid growth rate of Madrepora oculata and Lophelia pertusa on world's largest cold-water coral reef

Here we show the use of the 210Pb- 226Ra excess method to determine the growth rate of two corals from the world's largest known cold-water coral reef, Røst Reef, north of the Arctic circle off Norway. Colonies of each of the two species that build the reef, Lophelia pertusa and Madrepora oculata, were collected alive at 350 m depth using a submersible. Pb and Ra isotopes were measured along the major growth axis of both specimens using low level alpha and gamma spectrometry and trace element compositions were studied. 210Pb and 226Ra differ in the way they are incorporated into coral skeletons. Hence, to assess growth rates, we considered the exponential decrease of initially incorporated 210Pb, as well as the increase in 210Pb from the decay of 226Ra and contamination with 210Pb associated with Mn-Fe coatings that we were unable to remove completely from the oldest parts of the skeletons. 226Ra activity was similar in both coral species, so, assuming constant uptake of 210Pb through time, we used the 210Pb- 226Ra chronology to calculate growth rates. The 45.5 cm long branch of M. oculata was 31 yr with an average linear growth rate of 14.4 ± 1.1 mm yr -1 (2.6 polyps per year). Despite cleaning, a correction for Mn-Fe oxide contamination was required for the oldest part of the colony; this correction corroborated our radiocarbon date of 40 yr and a mean growth rate of 2 polyps yr -1. This rate is similar to the one obtained in aquarium experiments under optimal growth conditions. For the 80 cm-long L. pertusa colony, metal-oxide contamination remained in both the middle and basal part of the coral skeleton despite cleaning, inhibiting similar age and growth rate estimates. The youngest part of the colony was free of metal oxides and this 15 cm section had an estimated a growth rate of 8 mm yr -1, with high uncertainty (∼1 polyp every two to three years). We are less certain of this 210Pb growth rate estimate which is within the lowermost ranges of previous growth rate estimates. We show that 210Pb- 226Ra dating can be successfully applied to determine the age and growth rate of framework-forming cold-water corals if Mn-Fe oxide deposits can be removed. Where metal oxides can be removed, large M. oculata and L. pertusa skeletons provide archives for studies of intermediate water masses with an up to annual time resolution and spanning over many decades. © 2012 Author(s)

Paradox lost:disappearing female job satisfaction

The greater job satisfaction reported by female workers represents a puzzle given, on average, their worse labour market outcomes. Using the original data source of Clark (1997), we show that over the last two decades the female satisfaction gap has largely vanished. This reflects a strong secular decline in female job satisfaction. This decline happened for younger women in the 1990s as they aged and because of new female workers in more recent years that have lower job satisfaction than their early 1990s peers. Decompositions make clear that the decline does not reflect deteriorating job characteristics for women but rather their increasingly harsh evaluation of jobs characteristics. These findings fit with the suggestion that women in the early 1990s had a gap between their labour market expectations and actual experience that has since closed and that the gender satisfaction gap has vanished as a consequence

Definite orthogonal modular forms:Computations, Excursions and Discoveries

We consider spaces of modular forms attached to definite orthogonal groups of low even rank and nontrivial level, equipped with Hecke operators defined by Kneser neighbours. After reviewing algorithms to compute with these spaces, we investigate endoscopy using theta series and a theorem of Rallis. Along the way, we exhibit many examples and pose several conjectures. As a first application, we express counts of Kneser neighbours in terms of coefficients of classical or Siegel modular forms, complementing work of Chenevier-Lannes. As a second application, we prove new instances of Eisenstein congruences of Ramanujan and Kurokawa-Mizumoto type

Workers in the vanguard: the 1960 Industrial Relations Ordinance and the struggle for independence in Aden

The promulgation in 1960 of a new Industrial Relations Ordinance in Aden was a singular event in the history of British decolonisation because it made many forms of strike action illegal. Earlier initiatives to liberalise trade union law in the colonies were intended to channel and manage the discontent of workers; but for nationalist movements, the new order in industrial relations provided an opportunity to mobilise workers in the cause of independence. Aden, which was the location of a significant British base, a major oil refinery and a key commercial port, became the site of a bitter confrontation between the nascent trade union movement and the colonial administration. Three aspects of the conflict were of particular significance. First, Aden’s unique political status as a British colony in the Arab world and it strategic and economic value, contributed to the fractious industrial relations environment. Secondly, conflicts between workers and the colonial government demonstrate continuity with wider British efforts to suppress anti-colonial dissent and demonstrate that charges of appeasement in the last years of empire are not well founded. Lastly, the exceptional nature of the new legislation attracted the critical attention of the ILO and the major international trade union confederations, which internationalised the dispute over the IRO. An examination of the manner in which the British government sought to regulate its relations with various labour organisations, including the British TUC, the colonial ATUC and the two rival international labour confederations of the WFTU and ICFTU, demonstrates that the conduct of industrial relations in Aden was significant in the context of both the Cold War and decolonisation