The cost effectiveness of integrated care for people living with HIV including antiretroviral treatment in a primary health care centre in Bujumbura, Burundi

The incremental cost effectiveness of an integrated care package (i.e., medical care including antiretroviral therapy (ART) and other services such as psychological and social support) for people living with HIV/AIDS was calculated in a not-for-profit primary health care centre in Bujumbura run by Society of Women against AIDS-Burundi (SWAA-Burundi), an African non-governmental organisation (NGO). Results are expressed as cost-effectiveness ratio 2007, constant US$per disability-adjusted life year (DALY) averted. Unit costs are estimated from the NGO's accounting data and activity reports, healthcare utilisation is estimated from the medical records of a cohort of 149 patients. Effectiveness is modelled on the survival of this cohort, using standard calculation methods. The incremental cost of integrated care for people living with HIV/AIDS in the Bujumbura health centre of SWAA-Burundi is 258 US$ per DALY averted. The package of care provided by SWAA-Burundi is therefore a very cost-effective intervention in comparison with other interventions against HIV/AIDS that include ART. It is however, less cost effective than other types of interventions against HIV/AIDS, such as preventive activities

Multiwavelength observations of the blazar BL Lacertae: a new fast TeV γ-ray flare

Proceedings of the 35th International Cosmic Ray Conference (ICRC 2017), Busan (South Korea). Published in Proceeding of Science.Observations of fast TeV γ-ray flares from blazars reveal the extreme compactness of emitting regions in blazar jets. Combined with very-long-baseline radio interferometry measurements, they probe the structure and emission mechanism of the jet. We report on a fast TeV γ-ray flare from BL Lacertae observed by VERITAS, with a rise time of about 2.3 hours and a decay time of about 36 minutes. The peak flux at >200 GeV measured with the 4-minute binned light curve is (4.2±0.6)×10−6photonsm−2s−1, or ∼180% the Crab Nebula flux. Variability in GeV γ-ray, X-ray, and optical flux, as well as in optical and radio polarization was observed around the time of the TeV γ-ray flare. A possible superluminal knot was identified in the VLBA observations at 43 GHz. The flare constrains the size of the emitting region, and is consistent with several theoretical models with stationary shocks

Auto-calibration of ultrasonic lubricant-film thickness measurements

The measurement of oil film thickness in a lubricated component is essential information for performance monitoring and design. It is well established that such measurements can be made ultrasonically if the lubricant film is modelled as a collection of small springs. The ultrasonic method requires that component faces are separated and a reference reflection recorded in order to obtain a reflection coefficient value from which film thickness is calculated. The novel and practically useful approach put forward in this paper and validated experimentally allows reflection coefficient measurement without the requirement for a reference. This involves simultaneously measuring the amplitude and phase of an ultrasonic pulse reflected from a layer. Provided that the acoustic properties of the substrate are known, the theoretical relationship between the two can be fitted to the data in order to yield reflection coefficient amplitude and phase for an infinitely thick layer. This is equivalent to measuring a reference signal directly, but importantly does not require the materials to be separated. The further valuable aspect of this approach, which is demonstrated experimentally, is its ability to be used as a self-calibrating routine, inherently compensating for temperature effects. This is due to the relationship between the amplitude and phase being unaffected by changes in temperature which cause unwanted changes to the incident pulse. Finally, error analysis is performed showing how the accuracy of the results can be optimized. A finding of particular significance is the strong dependence of the accuracy of the technique on the amplitude of reflection coefficient input data used. This places some limitations on the applicability of the technique. © 2008 IOP Publishing Ltd

Behaviour of the Blazar CTA 102 during two giant outbursts

Blazar CTA 102 underwent exceptional optical and high-energy outbursts in 2012 and 2016-2017. We analyze its behaviour during these events, focusing on polarimetry as a tool that allows us to trace changes in the physical conditions and geometric configuration of the emission source close to the central black hole. We also use Fermi gamma-ray data in conjunction with optical photometry in an effort to localize the origin of the outbursts.AST-1615796 - Boston Universit

Correlation effects during liquid infiltration into hydrophobic nanoporous mediums

Correlation effects arising during liquid infiltration into hydrophobic porous medium are considered. On the basis of these effects a mechanism of energy absorption at filling porous medium by nonwetting liquid is suggested. In accordance with this mechanism, the absorption of mechanical energy is a result expenditure of energy for the formation of menisci in the pores on the shell of the infinite cluster and expenditure of energy for the formation of liquid-porous medium interface in the pores belonging to the infinite cluster of filled pores. It was found that in dependences on the porosity and, consequently, in dependences on the number of filled pores neighbors, the thermal effect of filling can be either positive or negative and the cycle of infiltration-defiltration can be closed with full outflow of liquid. It can occur under certain relation between percolation properties of porous medium and the energy characteristics of the liquid-porous medium interface and the liquid-gas interface. It is shown that a consecutive account of these correlation effects and percolation properties of the pores space during infiltration allow to describe all experimental data under discussion

Transition phenomena in unstably stratified turbulent flows

We study experimentally and theoretically transition phenomena caused by the external forcing from Rayleigh-Benard convection with the large-scale circulation (LSC) to the limiting regime of unstably stratified turbulent flow without LSC whereby the temperature field behaves like a passive scalar. In the experiments we use the Rayleigh-B\'enard apparatus with an additional source of turbulence produced by two oscillating grids located nearby the side walls of the chamber. When the frequency of the grid oscillations is larger than 2 Hz, the large-scale circulation (LSC) in turbulent convection is destroyed, and the destruction of the LSC is accompanied by a strong change of the mean temperature distribution. However, in all regimes of the unstably stratified turbulent flow the ratio $\big[(\ell_x \nabla_x T)^2 + (\ell_y \nabla_y T)^2 + (\ell_z \nabla_z T)^2\big] /$ varies slightly (even in the range of parameters whereby the behaviour of the temperature field is different from that of the passive scalar). Here $\ell_i$ are the integral scales of turbulence along x, y, z directions, T and \theta are the mean and fluctuating parts of the fluid temperature. At all frequencies of the grid oscillations we have detected the long-term nonlinear oscillations of the mean temperature. The theoretical predictions based on the budget equations for turbulent kinetic energy, turbulent temperature fluctuations and turbulent heat flux, are in agreement with the experimental results.Comment: 14 pages, 14 figures, REVTEX4-1, revised versio

Effects of neo-adjuvant chemotherapy for oesophago-gastric cancer on neuro-muscular gastric function

Delayed gastric emptying symptoms are often reported after chemotherapy. This study aims to characterise the effects of chemotherapy on gastric neuro-muscular function. Patients undergoing elective surgery for oesophago-gastric cancer were recruited. Acetylcholinesterase, nNOS, ghrelin receptor and motilin expressions were studied in gastric sections from patients receiving no chemotherapy (n = 3) or oesophageal (n = 2) or gastric (n = 2) chemotherapy. A scoring system quantified staining intensity (0–3; no staining to strong). Stomach sections were separately suspended in tissue baths for electrical field stimulation (EFS) and exposure to erythromycin or carbachol; three patients had no chemotherapy; four completed cisplatin-based chemotherapy within 6 weeks prior to surgery. AChE expression was markedly decreased after chemotherapy (scores 2.3 ± 0.7, 0.5 ± 0.2 and 0 ± 0 in non-chemotherapy, oesophageal- and gastric-chemotherapy groups (p < 0.03 each) respectively. Ghrelin receptor and motilin expression tended to increase (ghrelin: 0.7 ± 0.4 vs 2.0 ± 0.4 and 1.2 ± 0.2 respectively; p = 0.04 and p = 0.2; motilin: 0.7 ± 0.5 vs 2.2 ± 0.5 and 2.0 ± 0.7; p = 0.06 and p = 0.16). Maximal contraction to carbachol was 3.7 ± 0.7 g and 1.9 ± 0.8 g (longitudinal muscle) and 3.4 ± 0.4 g and 1.6 ± 0.6 (circular) in non-chemotherapy and chemotherapy tissues respectively (p < 0.05 each). There were loss of AChE and reduction in contractility to carbachol. The tendency for ghrelin receptors to increase suggests an attempt to upregulate compensating systems. Our study offers a mechanism by which chemotherapy markedly alters neuro-muscular gastric function