Hearing Loss in HIV-Infected Children in Lilongwe, Malawi.

INTRODUCTION: With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. METHODS: This was a cross-sectional survey of 380 HIV-infected children aged 4-14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. RESULTS: Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2-13.0) and ear drainage (OR 6.4, 3.6-11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2-4.5) or Stage 4 (OR 6.4, 2.7-15.2) and history of malnutrition (OR 2.1, 1.3-3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child's hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). CONCLUSIONS: There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most hearing loss was conductive in nature, likely due to frequent ear infections, and many children with hearing loss qualified for hearing aids. Screening strategies need to be developed and tested since caregivers were not reliable at identifying hearing loss, and often mis-identified children with normal hearing as having hearing loss. Children with frequent ear infections, ear drainage, TB, severe HIV disease, or low BMI should receive more frequent ear assessments and hearing evaluations

Unveiling the carrier transport mechanism in epitaxial graphene for forming wafer-scale, single-domain graphene

Graphene epitaxy on the Si face of a SiC wafer offers monolayer graphene with unique crystal orientation at the wafer-scale. However, due to carrier scattering near vicinal steps and excess bilayer stripes, the size of electrically uniform domains is limited to the width of the terraces extending up to a few microns. Nevertheless, the origin of carrier scattering at the SiC vicinal steps has not been clarified so far. A layer-resolved graphene transfer (LRGT) technique enables exfoliation of the epitaxial graphene formed on SiC wafers and transfer to flat Si wafers, which prepares crystallographically single-crystalline monolayer graphene. Because the LRGT flattens the deformed graphene at the terrace edges and permits an access to the graphene formed at the side wall of vicinal steps, components that affect the mobility of graphene formed near the vicinal steps of SiC could be individually investigated. Here, we reveal that the graphene formed at the side walls of step edges is pristine, and scattering near the steps is mainly attributed by the deformation of graphene at step edges of vicinalized SiC while partially from stripes of bilayer graphene. This study suggests that the two-step LRGT can prepare electrically single-domain graphene at the wafer-scale by removing the major possible sources of electrical degradation

Case Study Hydrologic Effects of Size and Location of Fields Converted from Drained Pine Forest to Agricultural Cropland

Abstract: Hydrological effects of land-use change are of great concern to ecohydrologists and watershed managers, especially in the Atlantic coastal plain of the southeastern United States. The concern is attributable to rapid population growth and the resulting pressure to develop forested lands. Many researchers have studied these effects in various scales, with varying results. An extended watershed-scale forest hydrologic model, calibrated with 1996–2000 data, was used to evaluate long-term hydrologic effects of conversion to agriculture (corn–wheat–soybean cropland) of a 29.5-km2 intensively managed pine-forested watershed in Washington County in eastern North Carolina. Fifty years of weather data (1951–2000) from a nearby weather station were used for simulating hydrology to evaluate effects on outflows, evapotranspiration, and water table depth compared with the baseline scenario. Other simulation scenarios were created for each of five different percentages (10, 25, 50, 75, and 100%) of land-use conversion occurring at upstream and downstream locations in the pine-forest watershed. Simulations revealed that increased mean annual outflow was significant (α 0.05) only for 100 % conversion from forest (261 mm) to agricultural crop (326 mm), primarily attributed to a reduction in evapotranspiration. Although high flow rates>5 mm day−1 increased from 2.3 to 2.6 % (downstream) and 2.6 to 4.2 % (upstream) for 25 to 50 % conversion, the frequency was higher for the upstream location than the downstream. These results were attributed to a substantial decrease in soil hydraulic conductivity of one of the dominant soils in the upstream location, which is expected after land-use conversion to agriculture. As a result, predicted subsurface drainage decreased, and surface runoff increased as soil hydraulic conductivity decreased for the soil upstream. These results indicate tha

Downward Longwave Radiation Retrieved from MODIS Imagery and Possible Application on Water Resource Management at Turkey Creek Watershed in South Carolina

2010 S.C. Water Resources Conferences - Science and Policy Challenges for a Sustainable Futur

Downward Longwave Radiation Retrieved from MODIS Imagery and Possible Application on Water Resource Management at Turkey Creek Watershed in South Carolina

2010 S.C. Water Resources Conferences - Science and Policy Challenges for a Sustainable Futur

Assessment of the Reach and Ecological Condition of Freshwater Tidal Creeks in the Lower Coastal Plain, Charleston County, South Carolina with Advanced Geospatial Technology Application

Tidal freshwater wetlands are the interface between marine and terrestrial ecosystems; hence they are directly impacted by sea level rise and climate change (James & Callahan, 2012). Little is known about the hydro-ecological functions and ecosystem services provided by these important and widely-distributed ecosystems. These wetlands are common in the urbanizing landscape of the southeastern Atlantic coastal plain, as well as other coastal areas. Tidal fresh-water forested wetlands (TFFW) occur in floodplains situated near the coastal zone along freshwater rivers that are subject to tides. They are most prominent along the Southeastern Atlantic lower Coastal Plain, where it is estimated that 200,000 ha of TFFW exist. The majority of TFFW are concentrated along the coasts of the South Carolina, Georgia, Florida, Virginia and Maryland, with other areas along the Gulf coast and upper portions of the Atlantic Coastal Plain. South Carolina is considered to have the most land area, over 40,000 ha, due to the relatively large tide range and low topographic gradient. There is considerable uncertainty in the estimates of TFFW area, and inconsistent use of terminology complicates assessments of the resource

Anatomy and variations of the carina and its cartilaginous makeup: a cadaveric study

Purpose: The carina, located at the bifurcation of the trachea, has been regarded as a part of the trachea. Although clinically useful as an anatomical landmark, studies of its detailed morphology are lacking in the literature. Methods: The distal trachea and left and right main bronchi were harvested from 32 cadavers and the carina studied using microsurgical dissection, endoscopy, micro-CT, and histology. Results: The right bronchial cartilages were most commonly involved in forming the carina (72.41%), and the left bronchial cartilages were the second most commonly involved (37.93%). The carinal cartilages were slightly deviated to the left of midline in 4.37%. Micro-CT clearly identified the contributions to the carinal cartilages. Conclusion: Although the carina has been regarded as a part of the distal trachea, the present study found that most of the carinal cartilages were composed of the most inferior tracheal ring or bronchial cartilage(s). The right main bronchial cartilage was the most common contributor, and the left main bronchus was the second most common contributor. Additional knowledge of this structure can benefit patient care