Vitamin D Status and its Association with Morbidity including Wasting and Opportunistic Illnesses in HIV-Infected Women in Tanzania.

Vitamin D has a potential role in preventing HIV-related complications, based on its extensive involvement in immune and metabolic function, including preventing osteoporosis and premature cardiovascular disease. However, this association has not been examined in large studies or in resource-limited settings. Vitamin D levels were assessed in 884 HIV-infected pregnant women at enrollment in a trial of multivitamin supplementation (excluding vitamin D) in Tanzania. Information on HIV related complications was recorded during follow-up (median, 70 months). Proportional hazards models and generalized estimating equations were used to assess the relationship of vitamin D status with these outcomes. Women with low vitamin D status (serum 25-hydroxyvitamin D<32 ng/mL) had 43% higher risk of reaching a body mass index (BMI) less than 18 kg/m(2) during the first 2 years of follow-up, compared to women with adequate vitamin D levels (hazard ratio [HR]: 1.43; 95% confidence intervals: [1.03-1.99]). The relationship between continuous vitamin D levels and risk of BMI less than 18 kg/m(2) during follow-up was inverse and linear (p=0.03). Women with low vitamin D levels had significantly higher incidence of acute upper respiratory infections (HR: 1.27 [1.04-1.54]) and thrush (HR: 2.74 [1.29-5.83]) diagnosed during the first 2 years of follow-up. Low vitamin D status was a significant risk factor for wasting and HIV-related complications such as thrush during follow-up in this prospective cohort in Tanzania. If these protective associations are confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to improve health and quality of life of HIV-infected patients, particularly in resource-limited settings

Investigating the cyclic breaking of butyl-, methyland ethyl-biodiesel from waste vegetable oil using ultraviolet-visible spectrophotometry

The main advantage of biodiesel to fossil-diesel is attributed to the ester functional group in its structure. Many researchers have affirmed that the functional group assists the diesel engine to function at its peak. However, the efficiency of the biodiesel to keep the mechanical piston-strokes in the diesel engine is experimentally presumed low especially if the engine works for a long time. In this research, it was proposed that the cyclic break down of the ester functional group of biodiesel is a major disadvantage. Butanol, ethanol and methanol biodiesel were produced in the laboratory using waste vegetable oil from restaurant. The Ultraviolet-visible spectroscopy or spectrophotometer (UV–Vis) was used to investigate the cyclic break down in the Butyl-, Methyl- and Ethyl- biodiesel. The Ultraviolet-visible spectroscopy or spectrophotometer (UV–Vis) was used to probe the various biodiesel samples with a start and stop wavelength of 500 and 900 nm respectively. The wavelength interval was 1 nm at a high scanning speed. Between 500–550 and 800–850 nm, the Ethyl- and Butyl- biodiesel had an absorbance of 2.7 and 1.6 respectively with 3 peaks each. Methyl-biodiesel had the highest absorbance of 1.7 at 600–650 nm with 1 peak. The computational extrapolation of all outcomes affirms that cyclic breaking is highest in Butylbiodiesel. The most resilient biodiesel type was the Ethyl-biodiesel. However, it was recommended that cyclic breaking may be preserved by ratio-mixing of biodiesel with fossil-diesel

Implementation and evaluation of a transit dosimetry system for treatment verification

PURPOSE: To evaluate a formalism for transit dosimetry using a phantom study and prospectively evaluate the protocol on a patient population undergoing 3D conformal radiotherapy. METHODS: Amorphous silicon EPIDs were calibrated for dose and used to acquire images of delivered fields. The measured EPID dose map was back-projected using the planning CT images to calculate dose at pre-specified points within the patient using commercially available software, EPIgray (DOSIsoft, France). This software compared computed back-projected dose with treatment planning system dose. A series of tests were performed on solid water phantoms (linearity, field size effects, off-axis effects). 37 patients were enrolled in the prospective study. RESULTS: The EPID dose response was stable and linear with dose. For all tested field sizes the agreement was good between EPID-derived and treatment planning system dose in the central axis, with performance stability up to a measured depth of 18cm (agreement within -0.5% at 10cm depth on the central axis and within -1.4% at 2cm off-axis). 126 transit images were analysed of 37 3D-conformal patients. Patient results demonstrated the potential of EPIgray with 91% of all delivered fields achieved the initial set tolerance level of ΔD of 0±5-cGy or %ΔD of 0±5%. CONCLUSIONS: The in vivo dose verification method was simple to implement, with very few commissioning measurements needed. The system required no extra dose to the patient, and importantly was able to detect patient position errors that impacted on dose delivery in two of cases

Formation of the motivational-valuable relation to the physical culture in students in the social-cultural environment of the higher educational establishment

The article discusses theoretical and practical questions of motivational-valuable attitude formation toward the physical culture in students. The didactic approach of purpose formation on the physical-recreational activity, process of fixing the new behavioural scheme in the modern social-cultural environment of the higher educational establishment was represented. © 2015, Mediterranean Center of Social and Educational Research. All rights reserved

Facilities improvement for sustainability of existing public office buildings in Nigeria

The study examined the building design features of a cosmopolitan public office building in Abuja. The features were classified into Spatial Plan, Structure and Facilities, to determine which of the 3 variables requires urgent sustainable improvement from end-users' perspective in existing public office buildings in developing countries. A quantitative approach was adopted while the research strategy involved survey and direct observation. Post-Occupancy Evaluation was used to collect the survey data on a massive public office building in Nigeria, which reflected the quota system and federal character of the nation, as study area. A total of 339 useable questionnaires were retrieved from the respondents, and the analysis conducted revealed that facilities requires the most urgent improvement for sustainability. It was therefore recommended that facilities should be given priority for successful sustainable improvement of public office buildings above other design features.Keywords: Existing buildings, Facilities, Performance indicators, Sustainable improvement, Users' requiremen

Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease

PublishedOpen Access ArticleObjective To test the effectiveness of an integrated collaborative care model for people with depression and long term physical conditions. Design Cluster randomised controlled trial. Setting 36 general practices in the north west of England. Participants 387 patients with a record of diabetes or heart disease, or both, who had depressive symptoms (≥10 on patient health questionaire-9 (PHQ-9)) for at least two weeks. Mean age was 58.5 (SD 11.7). Participants reported a mean of 6.2 (SD 3.0) long term conditions other than diabetes or heart disease; 240 (62%) were men; 360 (90%) completed the trial. Interventions Collaborative care included patient preference for behavioural activation, cognitive restructuring, graded exposure, and/or lifestyle advice, management of drug treatment, and prevention of relapse. Up to eight sessions of psychological treatment were delivered by specially trained psychological wellbeing practitioners employed by Improving Access to Psychological Therapy services in the English National Health Service; integration of care was enhanced by two treatment sessions delivered jointly with the practice nurse. Usual care was standard clinical practice provided by general practitioners and practice nurses. Main outcome measures The primary outcome was reduction in symptoms of depression on the self reported symptom checklist-13 depression scale (SCL-D13) at four months after baseline assessment. Secondary outcomes included anxiety symptoms (generalised anxiety disorder 7), self management (health education impact questionnaire), disability (Sheehan disability scale), and global quality of life (WHOQOL-BREF). Results 19 general practices were randomised to collaborative care and 20 to usual care; three practices withdrew from the trial before patients were recruited. 191 patients were recruited from practices allocated to collaborative care, and 196 from practices allocated to usual care. After adjustment for baseline depression score, mean depressive scores were 0.23 SCL-D13 points lower (95% confidence interval −0.41 to −0.05) in the collaborative care arm, equal to an adjusted standardised effect size of 0.30. Patients in the intervention arm also reported being better self managers, rated their care as more patient centred, and were more satisfied with their care. There were no significant differences between groups in quality of life, disease specific quality of life, self efficacy, disability, and social support. Conclusions Collaborative care that incorporates brief low intensity psychological therapy delivered in partnership with practice nurses in primary care can reduce depression and improve self management of chronic disease in people with mental and physical multimorbidity. The size of the treatment effects were modest and were less than the prespecified effect but were achieved in a trial run in routine settings with a deprived population with high levels of mental and physical multimorbidity. Trial registration ISRCTN80309252.National Institute for Health ResearchCollaboration for Leadership in Applied Health ResearchCare for Greater Mancheste

Self-concordant Smoothing for Convex Composite Optimization

We introduce the notion of self-concordant smoothing for minimizing the sum of two convex functions: the first is smooth and the second may be nonsmooth. Our framework results naturally from the smoothing approximation technique referred to as partial smoothing in which only a part of the nonsmooth function is smoothed. The key highlight of our approach is in a natural property of the resulting problem's structure which provides us with a variable-metric selection method and a step-length selection rule particularly suitable for proximal Newton-type algorithms. In addition, we efficiently handle specific structures promoted by the nonsmooth function, such as $\ell_1$-regularization and group-lasso penalties. We prove local quadratic convergence rates for two resulting algorithms: Prox-N-SCORE, a proximal Newton algorithm and Prox-GGN-SCORE, a proximal generalized Gauss-Newton (GGN) algorithm. The Prox-GGN-SCORE algorithm highlights an important approximation procedure which helps to significantly reduce most of the computational overhead associated with the inverse Hessian. This approximation is essentially useful for overparameterized machine learning models and in the mini-batch settings. Numerical examples on both synthetic and real datasets demonstrate the efficiency of our approach and its superiority over existing approaches.Comment: 37 pages, 7 figures, 3 table

SCORE: approximating curvature information under self-concordant regularization

In this paper, we propose the SCORE (self-concordant regularization) framework for unconstrained minimization problems which incorporates second-order information in the Newton decrement framework for convex optimization. We propose the generalized Gauss-Newton with Self-Concordant Regularization (GGN-SCORE) algorithm that updates the minimization variables each time it receives a new input batch. The proposed algorithm exploits the structure of the second-order information in the Hessian matrix, thereby reducing computational overhead. GGN-SCORE demonstrates how we may speed up convergence while also improving model generalization for problems that involve regularized minimization under the SCORE framework. Numerical experiments show the efficiency of our method and its fast convergence, which compare favorably against baseline first-order and quasi-Newton methods. Additional experiments involving non-convex (overparameterized) neural network training problems show similar convergence behaviour thereby highlighting the promise of the proposed algorithm for non-convex optimization.Comment: 21 pages, 12 figure