Effectiveness of Efavirenz-Based Regimens in Young HIV-Infected Children Treated for Tuberculosis: A Treatment Option for Resource-Limited Settings

Background: Antiretroviral treatment (ART) options for young children co-infected with HIV and tuberculosis are limited in resource-poor settings due to limited data on the use of efavirenz (EFV). Using available pharmacokinetic data, an EFV dosing schedule was developed for young co-infected children and implemented as the standard of care at Macha Hospital in Southern Province, Zambia. Treatment outcomes inchildren younger than 3 years of age or weighing less than 10 kg receiving either EFV-based ART plus anti-tuberculous treatment or nevirapine-based (NVP) ART were compared. Methods: Treatment outcomes were measured in a cohort of HIV-infected children seeking care at Macha Hospital in rural Zambia from 2007 to 2010. Informationon the diagnosis and treatment of tuberculosis was abstracted from medical records. Results: Forty-five children treated for tuberculosis initiated an EFV-based regimen and 69 children initiated a NVP-based regimen, 7 of whom also were treated for tuberculosis. Children receiving both regimens were comparable in age, but children receiving EFV started ART with a lower CD4+ T-cell percentage and weight-for-age z-score. Children receiving EFV experienced increases in both CD4+ T-cell percentage and weight-for-age z-score during follow-up, such that levels were comparable to children receiving NVP after two years of ART. Cumulative survival after 12 months of ART did not differ between groups (NVP:87%;EFV:80%;p = 0.25). Eleven children experienced virologic failure during follow-up.The adjusted hazard ratio of virologic failure comparing EFV to NVP was 0.25 (95% CI:0.05,1.24) and 0.13 (95% CI:0.03,0.62) using thresholds of 5000 and 400 copies/mL, respectively.Five children receiving EFV were reported to have had convulsions after ART initiation compared to only one child receiving NVP (p = 0.04). Conclusions: Despite poorer health at ART initiation, children treated for tuberculosis and receiving EFV-based regimens showed significant improvements comparable to children receiving NVP-based regimens. EFV-based regimens should be considered for young HIV-infected children co-infected with tuberculosis in resource-limited settings

Effective Operator Treatment of the Anharmonic Oscillator

We analyse the one dimensional quartic oscillator using the effective operator methodology of Lee and Suzuki. We reproduce known results for low lying energy eigenvalues.Comment: 9 Pages, Extended version with new references. To appear in Phys.ReV.

Vectorial bending characteristics of long-period grating written in D-shaped fibre

The curvature- or bend-sensing response of long-period gratings (LPG) UV-inscribed in D-shaped fiber has been investigated experimentally. Strong fiber orientation dependence of the spectral response when such LPGs are subjected to dynamic bending has been observed and is shown to form the basis for new vector sensors

Fiber Bragg gratings of type I in SMF-28 and B/Ge fibre and type IIA B/Ge fibre under gamma radiation up to 0.54 MGy

The sensitivities of type I and IIA fibre Bragg gratings written to different reflectivities in SMF-28 and B/Ge fibres to ionizing radiation up to 0.54MGy are investigated. The Bragg wavelength shows a small and rapid increase at the start of irradiation followed by either a plateau (type I) or a decrease (type IIA)

Kepler constraints on planets near hot Jupiters

We present the results of a search for planetary companions orbiting near hot Jupiter planet candidates (Jupiter-size candidates with orbital periods near 3 d) identified in the Kepler data through its sixth quarter of science operations. Special emphasis is given to companions between the 2∶1 interior and exterior mean-motion resonances. A photometric transit search excludes companions with sizes ranging from roughly two-thirds to five times the size of the Earth, depending upon the noise properties of the target star. A search for dynamically induced deviations from a constant period (transit timing variations) also shows no significant signals. In contrast, comparison studies of warm Jupiters (with slightly larger orbits) and hot Neptune-size candidates do exhibit signatures of additional companions with these same tests. These differences between hot Jupiters and other planetary systems denote a distinctly different formation or dynamical history

Differential birefringence in Bragg gratings in multicore fiber under transverse stress

We present experimental measurements of the peak splitting of the reflection spectra of fiber Bragg gratings as a result of birefringence induced by transverse loading of a multicore fiber. Measurements show that the splitting is a function of the applied load and the direction of the load relative to the azimuth of the fiber. A model for calculating the stress in the fiber that is due to an applied load is in good agreement with our experimental observations

Dynamic two-axis curvature measurement using multicore fiber Bragg gratings interrogated by arrayed waveguide gratings

We describe the use of arrayed waveguide gratings (AWGs) in the interrogation of fiber Bragg gratings (FBGs) for dynamic strain measurement. The ratiometric AWG output was calibrated in a static deflection experiment over a ±200 με range. Dynamic strain measurement was demonstrated with a FBG in a conventional single-mode fiber mounted on the surface of a vibrating cantilever and on a piezoelectric actuator, giving a resolution of 0.5 με at 2.4 kHz. We present results of this technique extended to measure the dynamic differential strain between two FBG pairs within a multicore fiber. An arbitrary cantilever oscillation of the multicore fiber was determined from curvature measurements in two orthogonal axes at 1125 Hz with a resolution of 0.05 m-1. © 2006 Optical Society of America

Recommendations for services for people with living with chronic breathlessness in advanced disease: results of a transparent expert consultation

Chronic breathlessness is highly distressing for people with advanced disease and their informal carers, yet health services for this group remain highly heterogeneous. We aimed to generate evidence-based stakeholder-endorsed recommendations for practice, policy and research concerning services for people with advanced disease and chronic breathlessness. We used transparent expert consultation, comprising modified nominal group technique during a stakeholder workshop, and an online consensus survey. Stakeholders, representing multiple specialities and professions, and patient/carers were invited to participate. Thirty-seven participants attended the stakeholder workshop and generated 34 separate recommendations, rated by 74 online survey respondents. Seven recommendations had strong agreement and high levels of consensus. Stakeholders agreed services should be person-centred and flexible, should cut across multiple disciplines and providers and should prioritize breathlessness management in its own right. They advocated for wide geographical coverage and access to expert care, supported through skills-sharing among professionals. They also recommended recognition of informal carers and their role by clinicians and policymakers. Overall, stakeholders' recommendations reflect the need for improved access to person-centred, multi-professional care and support for carers to provide or access breathlessness management interventions. Future research should test the optimal models of care and educational strategies to meet these recommendations

Strain and temperature sensitivity of a single-mode polymer optical fiber

We have measured the optical phase sensitivity of fiber based on poly(methyl methacrylate) under near-single-mode conditions at 632.8 nm wavelength. The elongation sensitivity is 131±3 × 105 rad m-1 and the temperature sensitivity is -212±26 rad m -1 K-1. These values are somewhat larger than those for silica fiber and are consistent with the values expected on the basis of the bulk polymer properties. © 2005 Optical Society of America