Impact of Human Immunodeficiency Virus Infection on the Outcome of Treatment and Survival of Tuberculosis Patients in Mwanza, Tanzania.

Little is known about the outcome of tuberculosis (TB) treatment and subsequent survival of human immunodeficiency virus (HIV) infected patients treated under routine programme conditions in a developing country. We followed a cohort of HIV-positive and HIV-negative tuberculosis patients during therapy and assessed their vital and tuberculosis status 3 years after completion of treatment in Mwanza, Tanzania. Newly diagnosed and relapse tuberculosis cases consecutively registered over a 6-month period were enrolled into an epidemiological study of TB/HIV. Treatment outcome was based on information in tuberculosis treatment registers. Patients surviving treatment were assessed 3 years later by personal interview. Cause of death was determined by verbal autopsy. Of 561 patients enrolled into the study, 505 patients alive at completion of treatment were eligible for assessment at 3 years. Except for mortality, HIV infection was not statistically associated with differing treatment outcomes. At time of follow-up, the overall mortality was 19% and was associated with HIV infection (hazard ratio [hr] 3.7, 95% confidence interval [CI] 2.6-5.2) and age 35 years and over (hr 1.5, 95% CI 1.02-2.1), but not with type of tuberculosis, gender, or initial drug resistance. By life table analysis, probability of survival at 4 years was 35% for HIV-positive patients compared to 90% for HIV-negative patients. Although no relapse cases were diagnosed, verbal autopsy suggested equivalent low rates of relapse in both groups. These results demonstrate the effectiveness of the current approach to the treatment of tuberculosis patients regardless of HIV status. However, HIV-related mortality remains high both during and following completion of treatment, and further studies are needed to determine if this mortality might be reduced by simple interventions which are feasible in developing countries.\u

Mechanics of cooling liquids by forced evaporation in bubbles

Injecting a non-dissolvable gas into a saturated liquid results in sub-cooling of the liquid due to forced evaporation into the bubble. Previous studies assumed the rate of evaporation of liquid into the bubble to be independent of the degree of sub-cooling. In our study we quantify the bubble growth by direct observation using high speed imaging and prove that this hypothesis is not true. A phenomenological model of the bubble growth as a function of the degree of sub-cooling is developed and we find excellent agreement between the measurements and theory. This bubble cooling process is employed in cooling a liquid. By identification of all heat flows, we can well describe the cool down curve using bubble cooling. Bubble cooling provides an alternative cooling method for liquids without the use of complicated cooling techniques

Incremental Distance Transforms (IDT)

A new generic scheme for incremental implementations of distance transforms (DT) is presented: Incremental Distance Transforms (IDT). This scheme is applied on the cityblock, Chamfer, and three recent exact Euclidean DT (E2DT). A benchmark shows that for all five DT, the incremental implementation results in a significant speedup: 3.4×−10×. However, significant differences (i.e., up to 12.5×) among the DT remain present. The FEED transform, one of the recent E2DT, even showed to be faster than both city-block and Chamfer DT. So, through a very efficient incremental processing scheme for DT, a relief is found for E2DT’s computational burden

Brain computer interfaces as intelligent sensors for enhancing human-computer interaction

BCIs are traditionally conceived as a way to control apparatus, an interface that allows you to act on" external devices as a form of input control. We propose an alternative use of BCIs, that of monitoring users as an additional intelligent sensor to enrich traditional means of interaction. This vision is what we consider to be a grand challenge in the field of multimodal interaction. In this article, this challenge is introduced, related to existing work, and illustrated using some best practices and the contributions it has received

Techno-thermodynamic multi-objective optimization of organic Ranckine cycles for waste heat recovery

Papers presented to the 11th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, South Africa, 20-23 July 2015.Organic Rankine cycles (ORC) are considered a mature technology in waste heat recovery applications. Yet, many of the commercially available implementations have comparable design characteristics. They operate under subcritical regime and only few working fluids are considered. In this work, three ORC configurations are analyzed on thermodynamic and technical grounds. The cycles under consideration are the subcritical cycle (SCORC), the transcritical cycle (TCORC) and the partial evaporation cycle (PEORC). Technical design constraints on the expander generally limit the cycles which can be considered feasible. Yet, their impact on the optimization process is not clear. Therefore, in this work, the technical performance criteria are optimized in conjunction with maximization of the net power output. Thus the investigation results in a multi-objective optimization strategy. The proposed strategy is performed on two representative but distinctive waste heat recovery cases. The results of the investigation are particularly useful for manufacturers of ORCs. The thermodynamic performance of the cycles is compared under equal boundary conditions, expander criteria are taken into account, actual cases are used and a ranking is created.am201

Social & Indigenous Entrepreneurship

This lecture will discuss social entrepreneurship, students and remote indigenous Australia. Researching, teaching or learning about entrepreneurship is very different to researching teaching or learning about functional disciplines such as accounting and finance. In functional disciplines there is generally a well defined skill set, this is not the case with entrepreneurship as it is as much a mind set as it is a set of activities. Identification of opportunities, learning about them and taking actions all take place within a context

Immunoproteasomes largely replace constitutive proteasomes during an antiviral and antibacterial immune response in the liver

The proteasome is critically involved in the production of MHC class I-restricted T cell epitopes. Proteasome activity and epitope production are altered by IFN-gamma treatment, which leads to a gradual replacement of constitutive proteasomes by immunoproteasomes in vitro. However, a quantitative analysis of changes in the steady state subunit composition of proteasomes during an immune response against viruses or bacteria in vivo has not been reported. Here we show that the infection of mice with lymphocytic choriomeningitis virus or Listeria monocytogenes leads to an almost complete replacement of constitutive proteasomes by immunoproteasomes in the liver within 7 days. Proteasome replacements were markedly reduced in IFN-gamma(-/-) mice, but were only slightly affected in IFN-alphaR(-/-) and perforin(-/-) mice. The proteasome regulator PA28alpha/beta was up-regulated, whereas PA28gamma was reduced in the liver of lymphocytic choriomeningitis virus-infected mice. Proteasome replacements in the liver strongly altered proteasome activity and were unexpected to this extent, since an in vivo half-life of 12 days had been previously assigned to constitutive proteasomes in the liver. Our results suggest that during the peak phase of viral and bacterial elimination the antiviral cytotoxic T lymphocyte response is directed mainly to immunoproteasome-dependent T cell epitopes, which would be a novel parameter for the design of vaccines

Secondary traumatisation and emotional exhaustion in mental healthcare providers:The mediating role of social support

Background: Burnout, especially emotional exhaustion, is common among mental healthcare providers (MHP). It is caused by exposure to prolonged stress related job conditions, such as secondary traumatisation. Social support is a protective factor for developing emotional exhaustion. In addition, higher levels of social support are associated with lower levels of secondary traumatisation. However, it is unclear how social support and secondary traumatisation are related. Social support may be a protective factor for developing secondary traumatisation, as it is for emotional exhaustion. On the other hand, MHP who suffer more from secondary traumatisation might experience less social support, for example because they fear stigmatisation. This study examined whether social support mediates the relationship between secondary traumatisation and emotional exhaustion. Further, it is explored whether the relation between secondary traumatisation and social support is moderated by profession (physicians, psychologists and case managers). Method: In total, 593 MHP participated in this cross-sectional study. Participants completed a questionnaire including demographic characteristics, secondary traumatisation, emotional exhaustion, and social support. Results: It was shown that no MHP experience high levels of secondary traumatisation and relatively few experience high levels of emotional exhaustion, while they do experience much social support. Furthermore, as hypothesized, it was found that the relationship between secondary traumatisation and emotional exhaustion is partially mediated by social support. Finally, no moderation effect of profession was found. Conclusion: These results imply that MHP have access to social support and make use of it, preventing emotional exhaustion. Mental healthcare organisations should maintain these resources for social support to prevent emotional exhaustion. MHP who are less inclined to seek social support should receive extra attention, as should MHP who are more at risk of secondary traumatisation. Even though MHP experience the availability of social support, still 25% of the MHP do experience emotional exhaustion. Future research should examine which factors for this group contribute to the development of emotional exhaustion so that appropriate measures can be taken

Multi-objective optimization of a low-temperature transcritical organic Rankine cycle for waste heat recovery

Paper presented to the 10th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Florida, 14-16 July 2014.The subcritical Organic Rankine Cycle (SCORC) is widely recognized as a viable technology for converting waste heat to electricity. However, a relative large exergy share is destroyed in the evaporator because of the subcritical heat exchange process. A transcritical cycle has the potential to reduce these irreversibilities in detriment of a financial cost. Therefore the inclusion of financial parameters is crucial for a sound comparison. First, a thermo-hydraulic sizing model for the supercritical ORC is developed. Second, from this model a thermo-economic analysis is provided based on a multi-objective optimization. The Pareto front of net power output versus investment costs are compared for the subcritical and transcritical ORC. Also a single objective criterion, the minimum specific investment cost, is calculated. The results can be used as a guideline to the design of new ORCs.dc201