Impact of introducing human immunodeficiency virus testing, treatment and care in a tuberculosis clinic in rural Kenya

SETTING: In July 2005, Médecins Sans Frontières and the Ministry of Health, Kenya, implemented an integrated tuberculosis-human immunodeficiency virus (TB-HIV) programme in western Kenya. OBJECTIVE: To evaluate the impact of an integrated TB-HIV programme on patient care and TB programme outcomes. DESIGN: Retrospective evaluation of three time periods: before (January-June 2005), shortly after (January-June 2006) and medium term after (January-December 2007) the implementation of the integrated programme. RESULTS: Respectively 79% and 91% of TB patients were HIV tested shortly and at medium term after service integration. The HIV-positive rate varied from 96% before the intervention to respectively 88% (305/347) and 74% (301/405) after. The estimated number of HIV-positive cases was respectively 303, 323 and 331 in the three periods. The proportion of patients receiving cotrimoxazole prophylaxis increased significantly from 47% (142/303) to 94% (303/323) and 86% (285/331, P < 0.05). Before the intervention, 87% (171/197) of the TB-HIV patients would have been missed when initiating antiretroviral treatment, compared to respectively 29% (60/210) and 36% (78/215) after the integration. The TB programme success rate increased from 56% (230/409) to 71% (319/447) in the third period (P < 0.05); however, there was no significant decrease in the default rate: 20% to 22% (P = 0.66) and 18% (P = 0.37). CONCLUSION: Integrated TB-HIV care has a very positive impact on the management of TB-HIV patients and on TB treatment outcomes

Understanding Teacher Leadership in Middle School Mathematics: A Collaborative Research Effort

We report findings from a collaborative research effort designed to examine how teachers act as leaders in their schools. We find that teachers educated by the Math in the Middle Institute act as key sources of advice for colleagues within their schools while drawing support from a network consisting of other teachers in the program and university-level advisors. In addition to reporting on our findings, we reflect on our research process, noting some of the practical challenges involved, as well as some of the benefits of collaboration

Secure self-calibrating quantum random bit generator

Random bit generators (RBGs) are key components of a variety of information processing applications ranging from simulations to cryptography. In particular, cryptographic systems require "strong" RBGs that produce high-entropy bit sequences, but traditional software pseudo-RBGs have very low entropy content and therefore are relatively weak for cryptography. Hardware RBGs yield entropy from chaotic or quantum physical systems and therefore are expected to exhibit high entropy, but in current implementations their exact entropy content is unknown. Here we report a quantum random bit generator (QRBG) that harvests entropy by measuring single-photon and entangled two-photon polarization states. We introduce and implement a quantum tomographic method to measure a lower bound on the "min-entropy" of the system, and we employ this value to distill a truly random bit sequence. This approach is secure: even if an attacker takes control of the source of optical states, a secure random sequence can be distilled.Comment: 5 pages, 2 figure

Study of the 12C+12C fusion reactions near the Gamow energy

The fusion reactions 12C(12C,a)20Ne and 12C(12C,p)23Na have been studied from E = 2.10 to 4.75 MeV by gamma-ray spectroscopy using a C target with ultra-low hydrogen contamination. The deduced astrophysical S(E)* factor exhibits new resonances at E <= 3.0 MeV, in particular a strong resonance at E = 2.14 MeV, which lies at the high-energy tail of the Gamow peak. The resonance increases the present non-resonant reaction rate of the alpha channel by a factor of 5 near T = 8x10^8 K. Due to the resonance structure, extrapolation to the Gamow energy E_G = 1.5 MeV is quite uncertain. An experimental approach based on an underground accelerator placed in a salt mine in combination with a high efficiency detection setup could provide data over the full E_G energy range.Comment: 4 Pages, 4 figures, accepted for publication in Phys. Rev. Let

Jet quenching in shock waves

We study the propagation of an ultrarelativistic light quark jet inside a shock wave using the holographic principle. The maximum stopping distance and its dependency on the energy of the jet is obtained

A Double‐Blind Randomized Placebo‐Controlled Trial of Oral Naltrexone for Heavy‐Drinking Smokers Seeking Smoking Cessation Treatment

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137315/1/acer13396.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137315/2/acer13396_am.pd

Heavy ion beam measurement of the hydration of cementitious materials

The setting and development of strength of Portland cement concrete depends upon the reaction of water with various phases in the Portland cement. Nuclear resonance reaction analysis (NRRA) involving the 1H(15N,α,γ)12C reaction has been applied to measure the hydrogen depth profile in the few 100 nm thick surface layer that controls the early stage of the reaction. Specific topics that have been investigated include the reactivity of individual cementitious phases and the effects of accelerators and retarders