Voluntary Counselling, HIV Testing and Sexual Behaviour Among Patients with Tuberculosis in a Rural District of Malawi.

OBJECTIVES: A study was conducted in new patients registered with tuberculosis (TB) in a rural district of Malawi in order to 1) verify the acceptability of voluntary counselling and testing for human immunodeficiency virus (HIV) infection; 2) describe sexual behaviour and condom use; and 3) identify socio-demographic and behavioural risk factors associated with 'no condom use'. DESIGN: Cross-sectional study. METHODS: Consecutive patients diagnosed with TB between January and December 2000 were offered voluntary counselling and HIV testing (VCT) and were subsequently interviewed. RESULTS: There were 1,049 new TB patients enrolled in the study. Of these, 1,007 (96%) were pre-test counselled, 955 (91%) underwent HIV testing and 912 (87%) were post-test counselled; 43 (4%) patients refused HIV testing. The overall HIV infection rate was 77%. Of all HIV-positive TB patients, 691 (94%) were put on cotrimoxazole. There were 479 (49%) TB patients who reported sexual encounters, of whom only 6% always used condoms. Unprotected sex was associated with having TB symptoms for over 1 month, having had less than 8 years of school education, being single, divorced or widowed or having sex with the same partner. CONCLUSIONS: Offering VCT to TB patients in this setting has a high acceptance rate and provides an opportunity to strengthen and integrate TB and HIV programmes

Voluntary Counselling, HIV Testing and Adjunctive Cotrimoxazole Reduces Mortality in Tuberculosis Patients in Thyolo, Malawi.

OBJECTIVES: To assess the feasibility and effectiveness of voluntary counselling, HIV testing and adjunctive cotrimoxazole in reducing mortality in a cohort of tuberculosis (TB) patients registered under routine programme conditions in a rural district of Malawi. DESIGN: 'Before' and 'after' cohort study using historical controls. METHODS: Between 1 July 1999 and 30 June 2000 all TB patients were started on standardized anti-TB treatment, and offered voluntary counselling and HIV testing (VCT). Those found to be HIV-positive were offered cotrimoxazole at a dose of 480 mg twice daily, provided there were no contraindications. Side-effects were monitored clinically. End-of-treatment outcomes in this cohort (intervention group) were compared with a cohort registered between 1 July 1998 and 30 June 1999 in whom VCT and cotrimoxazole was not offered (control group). FINDINGS: A total of 1986 patients was registered in the study: 1061 in the intervention group and 925 in the control cohort. In the intervention group, 1019 (96%) patients were counselled pre-test, 964 (91%) underwent HIV testing and 938 (88%) were counselled post-test. The overall HIV-seroprevalence rate was 77%. A total of 693 patients were given cotrimoxazole of whom 14 (2%) manifested minor dermatological reactions. The adjusted relative risk of death in the intervention group compared with the control group was 0.81 (P < 0.001). The number needed to treat with VCT and adjunctive cotrimoxazole to prevent one death during anti-TB treatment was 12.5. INTERPRETATION: This study shows that VCT and adjunctive cotrimoxazole is feasible, safe and reduces mortality rates in TB patients under routine programme conditions

Negative phase time for Scattering at Quantum Wells: A Microwave Analogy Experiment

If a quantum mechanical particle is scattered by a potential well, the wave function of the particle can propagate with negative phase time. Due to the analogy of the Schr\"odinger and the Helmholtz equation this phenomenon is expected to be observable for electromagnetic wave propagation. Experimental data of electromagnetic wells realized by wave guides filled with different dielectrics confirm this conjecture now.Comment: 10 pages, 6 figure

The Faraday Quantum Clock and Non-local Photon Pair Correlations

We study the use of the Faraday effect as a quantum clock for measuring traversal times of evanescent photons through magneto-refractive structures. The Faraday effect acts both as a phase-shifter and as a filter for circular polarizations. Only measurements based on the Faraday phase-shift properties are relevant to the traversal time measurements. The Faraday polarization filtering may cause the loss of non-local (Einstein-Podolsky-Rosen) two-photon correlations, but this loss can be avoided without sacrificing the clock accuracy. We show that a mechanism of destructive interference between consecutive paths is responsible for superluminal traversal times measured by the clock.Comment: 6 figure

VarFish - Collaborative and comprehensive variant analysis for diagnosis and research

VarFish is a user-friendly web application for the quality control, filtering, prioritization, analysis, and user-based annotation of panel and exome variant data for rare disease genetics. It is capable of processing variant call files with single or multiple samples. The variants are automatically annotated with population frequencies, molecular impact, and presence in databases such as ClinVar. Further, it provides support for pathogenicity scores including CADD, MutationTaster, and phenotypic similarity scores. Users can filter variants based on these annotations and presumed inheritance pattern and sort the results by these scores. Filtered variants are listed with their annotations and many useful link-outs to genome browsers, other gene/variant data portals, and external tools for variant assessment. VarFish allows user to create their own annotations including support for variant assessment following ACMG-AMP guidelines. In close collaboration with medical practitioners, VarFish was designed for variant analysis and prioritization in diagnostic and research settings as described in the software’s extensive manual. The user interface has been optimized for supporting these protocols. Users can install VarFish on their own in-house servers where it provides additional lab notebook features for collaborative analysis and allows re-analysis of cases, e.g., after update of genotype or phenotype databases

A human cell atlas of fetal gene expression

The gene expression program underlying the specification of human cell types is of fundamental interest. We generated human cell atlases of gene expression and chromatin accessibility in fetal tissues. For gene expression, we applied three-level combinatorial indexing to >110 samples representing 15 organs, ultimately profiling ~4 million single cells. We leveraged the literature and other atlases to identify and annotate hundreds of cell types and subtypes, both within and across tissues. Our analyses focused on organ-specific specializations of broadly distributed cell types (such as blood, endothelial, and epithelial), sites of fetal erythropoiesis (which notably included the adrenal gland), and integration with mouse developmental atlases (such as conserved specification of blood cells). These data represent a rich resource for the exploration of in vivo human gene expression in diverse tissues and cell types

Negative group delay for Dirac particles traveling through a potential well

The properties of group delay for Dirac particles traveling through a potential well are investigated. A necessary condition is put forward for the group delay to be negative. It is shown that this negative group delay is closely related to its anomalous dependence on the width of the potential well. In order to demonstrate the validity of stationary-phase approach, numerical simulations are made for Gaussian-shaped temporal wave packets. A restriction to the potential-well's width is obtained that is necessary for the wave packet to remain distortionless in the travelling. Numerical comparison shows that the relativistic group delay is larger than its corresponding non-relativistic one.Comment: 10 pages, 5 figure

Time of arrival in the presence of interactions

We introduce a formalism for the calculation of the time of arrival t at a space point for particles traveling through interacting media. We develop a general formulation that employs quantum canonical transformations from the free to the interacting cases to construct t in the context of the Positive Operator Valued Measures. We then compute the probability distribution in the times of arrival at a point for particles that have undergone reflection, transmission or tunneling off finite potential barriers. For narrow Gaussian initial wave packets we obtain multimodal time distributions of the reflected packets and a combination of the Hartman effect with unexpected retardation in tunneling. We also employ explicitly our formalism to deal with arrivals in the interaction region for the step and linear potentials.Comment: 20 pages including 5 eps figure

Helmholtz theorem and the v-gauge in the problem of superluminal and instantaneous signals in classical electrodynamics

In this work we substantiate the applying of the Helmholtz vector decomposition theorem (H-theorem) to vector fields in classical electrodynamics. Using the H-theorem, within the framework of the two-parameter Lorentz-like gauge (so called v-gauge), we show that two kinds of magnetic vector potentials exist: one of them (solenoidal) can act exclusively with the velocity of light c and the other one (irrotational) with an arbitrary finite velocity $v$ (including a velocity more than c . We show also that the irrotational component of the electric field has a physical meaning and can propagate exclusively instantaneously.Comment: This variant has been accepted for publication in Found. Phys. Letter