Preliminary Evaluation of Smart and Sustainable Water Distribution Systems in The Gambia

This is the author accepted manuscript.An estimated one-third of handpumps in rural sub-Saharan Africa are non-functioning at any one time because of lack of upkeep. Citizens are left without access to clean drinking water and this has multiple knock-on developmental impacts. An innovative ‘e-Tap’ based water pre-payment technology and management system, in operation in The Gambia since April 2016, cycles revenue back into operation and maintenance and collects accurate and real-time data on consumption and tap failures. Preliminary research has begun on evaluating this innovation. Technical tests were conducted to examine the efficiency of the e-Tap under varying conditions. Water use trends were then analysed using the cloud-collected data transmitted from operational e-Taps. Further, a baseline survey to investigate social parameters was undertaken on 20 user households. This exploratory research shows the e-Taps to work efficiently in the lab and The Gambia with negligible failures, and to reduce distances users must travel for clean water and time they spend collecting

AIDS in America — Forgotten but Not Gone

Over the past decade, limited attention has been paid to the human immunodeficiency virus (HIV) epidemic in the United States. The global epidemic — particularly the epidemic in sub-Saharan Africa, where approximately two thirds of the world's population living with AIDS resides — has rightfully received most of the focus. Meanwhile, however, the prevalence of HIV infection within some U.S. populations now rivals that in some sub-Saharan African countries

Locally Preferred Structure and Frustration in Glassforming Liquids: A Clue to Polyamorphism?

We propose that the concept of liquids characterized by a given locally preferred structure (LPS) could help in understanding the observed phenomenon of polyamorphism. ``True polyamorphism'' would involve the competition between two (or more) distinct LPS, one favored at low pressure because of its low energy and one favored at high pressure because of its small specific volume, as in tetrahedrally coordinated systems. ``Apparent polyamorphism'' could be associated with the existence of a poorly crystallized defect-ordered phase with a large unit cell and small crystallites, which may be illustrated by the metastable glacial phase of the fragile glassformer triphenylphosphite; the apparent polyamorphism might result from structural frustration, i. e., a competition between the tendency to extend the LPS and a global constraint that prevents tiling of the whole space by the LPS.Comment: 11, 6 figures, Proceedings of the Conference "Horizons in Complex Systems", Messina; in honor of the 60th birthday of H.E. Stanle

Water-like anomalies for core-softened models of fluids: One dimension

We use a one-dimensional (1d) core-softened potential to develop a physical picture for some of the anomalies present in liquid water. The core-softened potential mimics the effect of hydrogen bonding. The interest in the 1d system stems from the facts that closed-form results are possible and that the qualitative behavior in 1d is reproduced in the liquid phase for higher dimensions. We discuss the relation between the shape of the potential and the density anomaly, and we study the entropy anomaly resulting from the density anomaly. We find that certain forms of the two-step square well potential lead to the existence at T=0 of a low-density phase favored at low pressures and of a high-density phase favored at high pressures, and to the appearance of a point $C'$ at a positive pressure, which is the analog of the T=0 ``critical point'' in the $1d$ Ising model. The existence of point $C'$ leads to anomalous behavior of the isothermal compressibility $K_T$ and the isobaric specific heat $C_P$.Comment: 22 pages, 7 figure

Coronary sinus mapping to differentiate left versus right ventricular outflow tract tachycardias

Outflow tract ventricular tachycardia (OT-VT) can originate from several different segments of the outflow tract. Various ECG criteria have been proposed for localization of OT-VTs. We present two patients, one with left and one with right OT-VT. We used local ventricular electrograms in the coronary sinus to localize the focus of the OT-VT. Mapping of local ventricular electrograms in the coronary sinus may be a simple and effective method for differentiating right versus left ventricular outflow tract tachycardias. However, the diagnostic value and precision of this method should be evaluated in a series of patients before its implementation in the OT-VT ablation decision algorithm. © 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved

Transgender People and HIV Prevention: What We Know and What We Need to Know, a Call to Action

Abstract: Transgender people have been disproportionally affected by HIV, particularly transgender women. Their increased vulnerability to HIV is due to multiple issues, including biological (eg, increased efficiency of HIV transmission through receptive anal sex), epidemiological (eg, increased likelihood of having HIV-infected partners), structural (eg, social stigma limiting employment options), and individual factors (eg, internalized stigma leading to depression and substance use and risk-taking behaviors). There have been limited culturally appropriate HIV prevention interventions for transgender people, with many key prevention studies (eg, the iPrEx PrEP study) enrolling transgender women in a study focusing on men who have sex with men. This has resulted in limited understanding of the optimal ways to decrease transgender people's risk for HIV acquisition. The current supplement of JAIDS is designed to review what is known about HIV prevention for transgender people and to highlight new insights and best practices. The study reviews recent epidemiologic data, the pharmacology of HIV prophylactic agents in individuals who may be using exogenous hormones, and several recent multi-component interventions designed to address the lived experience of transgender people. Additionally, the study reviews the work going on at the NIH to address transgender health in general and HIV prevention in specific, as well as two important papers related to clinical trial design issues and the ethical conduct of research in this frequently disenfranchised population. It is the hope of the HIV Prevention Trials Network (HPTN) that this supplement will promote new knowledge around transgender health and the requisite issues that need to be addressed in order to conduct optimal clinical trials. The ultimate hope is that the information distilled in this supplement will inform investigators, clinicians, and public health officials in order to design further research to develop optimal prevention interventions for transgender people and to implement these interventions in ways that are culturally congruent and health promoting

A decision support system for boosting warfarin maintenance dose using fuzzy logic

Background: Warfarin is the most common oral anticoagulant. This drug is used for the prevention and treatment of thromboembolic patients. It is difficult for physician to predict the results of warfarin prescriptions because there is narrow boundary between therapeutic range and complications of warfarin. Therefore drug dose adjustment is normally performed by an expert physician. Decision support systems that use extracted knowledge from experts in the field of drug dose adjustment would be useful in reducing medical errors, especially in the clinics with limited access to experts. The aim of this study was to propose a method for boosting the maintenance dose of warfarin for a maximum period of three days to eliminate disruptions in International Normalized Ratio (INR). Methods: In a retrospective study, from December 2013 to February 2014 in Shahid Rajaee Heart Center, Tehran, Iran, 84 patients with International Normalized Ratio below (INR) the therapeutic range was selected who was undergone a boosting dose during three days. Patients with unstable maintenance dose were excluded from the study. In this study, data from 75 patients receiving warfarin therapy were used for developing and evaluation of the proposed model. The INR target range for 37 patients out of remaining 75 cases was between 2.5 and 3.5, while for 38 patients the intended INR range was between 2 and 3. A separate fuzzy model was designed for each of the above-mentioned therapeutic ranges. Results: The recommended dose for 37 patients having INR therapeutic range of 2.5 to 3.5 has mean absolute error and root mean squared error of 1.89 and 2.78 respectively for three days. These error rates are 1.97 and 2.88 respectively for 38 patients who are in therapeutic range 2 to 3. Conclusion: The results are promising and encourage one to consider this system for more study with the aim of possible use as a decision support system in the future. © 2015, Tehran University of Medical Sciences. All rights reserved