Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa

Liver disease epidemiology in sub-Saharan Africa has shifted as a result of HIV and the increased use of antiretroviral therapy leading to a need for updated data on common causes of liver disease. We retrospectively reviewed records from all hospitalized patients who had liver biopsy at a single hospital in South Africa from 2001 to 2009 and compared diagnosis by HIV status. During the period of study 262 patients had liver biopsy, 108 (41%) were HIV-infected, 25 (10%) were HIV-sero-negative, and 129 (49%) had unknown or unrecorded HIV status. Overall 81% of biopsies provided additional diagnostic data. Malignancy was the most common finding reported on 56 (21%) biopsies followed by granuloma or TB, hepatic steatosis, and fibrosis or cirrhosis. HIV-infected patients were more likely to have granulomas and steatosis. Half of patients with granulomas were already on TB treatment, suggesting paradoxical reactions or drug induced liver injury may have been important causes of liver inflammation among these patients. We note that TB, paradoxical reactions during TB treatment, possible drug induced liver injury, and hepatic steatosis are important causes of liver pathology among HIV-infected hospitalized patients with unclear etiology of liver disease after initial assessment. Among HIV sero-negative patients, malignancy was the major cause of liver disease. Our findings re-enforce the importance of TB as a diagnosis among HIV-infected individuals.\ud \u

Superconducting-coil--resistor circuit with electric field quadratic in the current

It is shown for the first time that the observed [Phys. Lett. A 162 (1992) 105] potential difference Phi_t between the resistor and the screen surrounding the circuit is caused by polarization of the resistor because of the kinetic energy of the electrons of the superconducting coil. The proportionality of Phi_t to the square of the current and to the length of the superconducting wire is explained. It is pointed out that measuring Phi_t makes it possible to determine the Fermi quasimomentum of the electrons of a metal resistor.Comment: 2 pages, 1 figur

Relativistic calculations of the lifetimes and hyperfine structure constants in 67^{67}Zn+^{+}

This work presents accurate {\it ab initio} determination of the magnetic dipole (M1) and electric quadrupole (E2) hyperfine structure constants for the ground and a few low-lying excited states in $^{67}$Zn$^{+}$, which is one of the interesting systems in fundamental physics. The coupled-cluster (CC) theory within the relativistic framework has been used here in this calculations. Long standing demands for a relativistic and highly correlated calculations like CC can be able to resolve the disagreements among the lifetime estimations reported previously for a few low-lying states of Zn$^{+}$. The role of different electron correlation effects in the determination of these quantities are discussed and their contributions are presented.Comment: 9 pages, 1 figure. submitted to J. Phys. B Fast Trac

The chronostratigraphy of Late Pleistocene glacial and periglacial aeolian activity in the Tuktoyaktuk Coastlands, NWT, Canada

Aeolian periglacial sand deposits are common in the Tuktoyaktuk Coastlands of Western Arctic Canada. Regionally extensive and thick aeolian sand-sheet deposits have been observed in two major stratigraphic settings: within a sand unit characterized by large aeolian dune deposits; and interbedded with glaciofluvial outwash from the Laurentide Ice Sheet (LIS). Small, localized sand sheets have also been observed along the tops of sandy bluffs, within sequences of drained thermokarst lakes deposits and as an involuted veneer above buried basal ice of the LIS. On the basis of radiocarbon and optically stimulated luminescence (OSL) dates from preserved periglacial aeolian sand sheets and dunes a regional chronostratigraphy is presented which indicates that both extensive dunes and sand sheets accumulated mainly between ca 30 and 13 ka. A switch to dominantly sand-sheet aggradation at ca 14–13 ka, with sand sheets forming widely until ca 8 ka, is attributed to (a) surface armouring by glacial deposits associated with the advance of the LIS; and (b) amelioration of the climate from cold aridity. An absence of OSL dates between ca 8 and 1 ka suggests that sand sheets stabilized during much of the Holocene. Local sand-sheet aggradation during recent centuries has occurred near sandy bluffs and on the floors of drained thermokarst lakes. The OSL dates constrain the maximum extent of the LIS in the Tuktoyaktuk Coastlands to Marine Isotope Stage 2

Mortality associated with delays between clinic entry and ART initiation in resource-limited settings: results of a transition-state model.

OBJECTIVE: To estimate the mortality impact of delay in antiretroviral therapy (ART) initiation from the time of entry into care. DESIGN: A state-transition Markov process model. This technique allows for assessing mortality before and after ART initiation associated with delays in ART initiation among a general population of ART-eligible patients without conducting a randomized trial. METHODS: We used patient-level data from 3 South African cohorts to determine transition probabilities for pre-ART CD4 count changes and pre-ART and on-ART mortality. For each parameter, we generated probabilities and distributions for Monte Carlo simulations with 1-week cycles to estimate mortality 52 weeks from clinic entry. RESULTS: We estimated an increase in mortality from 11.0% to 14.7% (relative increase of 34%) with a 10-week delay in ART for patients entering care with our pre-ART cohort CD4 distribution. When we examined low CD4 ranges, the relative increase in mortality delays remained similar; however, the absolute increase in mortality rose. For example, among patients entering with CD4 count 50-99 cells per cubic millimeter, 12-month mortality increased from 13.3% with no delay compared with 17.0% with a 10-week delay and 22.9% with a 6-month delay. CONCLUSIONS: Delays in ART initiation, common in routine HIV programs, can lead to important increases in mortality. Prompt ART initiation for patients entering clinical care and eligible for ART, especially those with lower CD4 counts, could be a relatively low-cost approach with a potential marked impact on mortality

War without Surprises—Education for Command in the People’s Liberation Army Navy

The PLA Navy will play a key role in any flash points and conflicts in the western Pacific. This study of professional military education for senior PLA Navy officers supplements analyses of platforms and capabilities with a look at how senior navy commanders are prepared to lead in combat

China Maritime Report No. 24: Incubators of Sea Power: Vessel Training Centers and the Modernization of the PLAN Surface Fleet

The People’s Liberation Army Navy (PLAN) is building modern surface combatants faster than any other navy in the world. Before these new ships can be deployed, however, their crews must learn how to effectively operate them across the range of missions for which they were designed. In the PLAN, this “basic training” largely occurs at specialized organizations called Vessel Training Centers (VTCs). Since their creation in 1980, VTCs have played a key role in generating combat power for the fleet. But as China’s naval ambitions have grown, the VTCs have been forced to adapt. Since the early 2000s, and especially since 2012, they have faced tremendous pressure to keep pace with the rapid expansion and modernization of the PLAN surface fleet and its growing mission set, improve the standards and quality of vessel training, and uphold the integrity of training evaluations. This report argues that the PLAN’s VTCs have generally risen to the challenge, ensuring that new and recently-repaired ships can quickly reach operational units in a fairly high state of readiness.https://digital-commons.usnwc.edu/cmsi-maritime-reports/1023/thumbnail.jp

Panning for Gold: Assessing Chinese Maritime Strategy from Primary Sources

What are the drivers behind China’s vigorous pursuit of sea power? What are the interests Beijing seeks to advance by building a powerful blue- water navy and the world’s largest coast guard? What are the principles that guide its use of sea power in pursuit of its national interest? How are China’s state objectives, and approaches to pursuing them, evolving over time

Combined CI+MBPT calculations of energy levels and transition amplitudes in Be, Mg, Ca, and Sr

Configuration interaction (CI) calculations in atoms with two valence electrons, carried out in the V(N-2) Hartree-Fock potential of the core, are corrected for core-valence interactions using many-body perturbation theory (MBPT). Two variants of the mixed CI+MBPT theory are described and applied to obtain energy levels and transition amplitudes for Be, Mg, Ca, and Sr