Nutritional care to people living with HIV/AIDS in Bunda Township

The HIV/AIDS pandemic is a global crisis with impacts that will be felt for decades to come. According to the estimates projected in the UNAIDS 2000 and 2003 AIDS Update December; forty million people were living with HIV/AIDS as of December 2003, of whom 2.5 million are children below fifteen years of age. During year 2003, 44.9 million people were already infected with HIV and three million died of AIDS. Also in year 2004 HIV/AIDS killed more than three million people and nearly five million people became infected (UNAIDS/WHO2004). More than twenty five million of these live in Sub-Sahara Africa, where Tanzania alone had 157,173 people living with HIV/AIDS; Mara Region had 3216 and Bunda district had 1057 as of December 2003. Recognizing this situation; several practitioners, Institutions, groups of persons and individuals are joining into the efforts of limiting or minimizing the speed of the sick to progress from HIV to AIDS disease. These efforts are being done through application of the antiretroviral drugs and utilization of good diet combined with recommended herbs that are immune stimulant and/or antioxidant in nature. Bunda Women Savings and Credit Cooperative Society has also opted joining an hand by establishing a nutritional care project to serve people living with HIV/AIDS in Bunda Township who according to the current statistics are now amounting to 482. The purpose of this document therefore is to justify the relevance and validity of establishing a project of this kind in the area and also to see whether the project is addressing the needs of the targeted community. In conducting the research to testify the above; several sources of information have been contacted; including literature reviews, various respondents in the area who involved -society members themselves; government officials; partner NGOS which are already working with the affected, as well as the society committee members. Several trial questions have been developed and used either to lead focus groups discussions or mailed to respondents; the answers of which, after the detailed analysis have enabled the research team to come up with findings and recommendations that appear in chapter four of the document. Several findings have been learned out of the study as they appear in the document; but briefly the research confirmed to have NGOS in Bunda District engaged in provision of various HIV/AIDS related services to the affected community, but none of the same was engaged in nutritional case services. This immediately indicates a need of having an organ, established to take care of nutritional care services so as to assist in filling the vacuum. The research also noted the high commitment of the society members have in preparing themselves to establish a nutritional care project. This was evidenced by contributions raised by the members, where as of now; more than Ten million Tanzanian Shillings have been set aside to assist the take off of the project - and lastly The findings predict good marketability of the products that will be produced by the project. This was evidenced by responses of the NGOS, where 77.8% of the total respondents confirmed the market. Basing on the above findings; the study confirms the establishment of a nutritional care project and recommends a proposal on nutritional care (which appears in chapter five) be developed to aid the Society in securing some of the items (like machineries) that are expensive for the society to afford. Instruments used in conducting the research appear at the end. (Author abstract)Lugira, S. S. Z. (2005). Nutritional care to people living with HIV/AIDS in Bunda Township. Retrieved from http://academicarchive.snhu.eduMaster of Science (M.S.)School of Community Economic Developmen

Influence of clamp-widening on the quality factor of nanomechanical silicon nitride resonators

Nanomechanical resonators based on strained silicon nitride (Si$_3$N$_4$) have received a large amount of attention in fields such as sensing and quantum optomechanics due to their exceptionally high quality factors ($Q$s). Room-temperature $Q$s approaching 1 billion are now in reach by means of phononic crystals (soft-clamping) and strain engineering. Despite great progress in enhancing $Q$s, difficulties in fabrication of soft-clamped samples limits their implementation into actual devices. An alternative means of achieving ultra-high $Q$s was shown using trampoline resonators with engineered clamps, which serves to localize the stress to the center of the resonator, while minimizing stress at the clamping. The effectiveness of this approach has since come into question from recent studies employing string resonators with clamp-tapering. Here, we investigate this idea using nanomechanical string resonators with engineered clampings similar to those presented for trampolines. Importantly, the effect of orienting the strings diagonally or perpendicularly with respect to the silicon frame is investigated. It is found that increasing the clamp width for diagonal strings slightly increases the $Q$s of the fundamental out-of-plane mode at small radii, while perpendicular strings only deteriorate with increasing clamp width. Measured $Q$s agree well with finite element method simulations even for higher-order resonances. The small increase cannot account for previously reported $Q$s of trampoline resonators. Instead, we propose the effect to be intrinsic and related to surface and radiation losses.Comment: 7 pages, 4 figure

Should aortic arch replacement be performed during initial surgery for aortic root aneurysm in patients with Marfan syndrome?†

OBJECTIVES The aim of this study was to investigate whether total arch replacement (TAR) during initial surgery for root aneurysm should be routinely performed in patients with Marfan syndrome (MFS). METHODS Retrospective analysis of 94 consecutive MFS patients fulfilling Ghent criteria who underwent 148 aortic surgeries and were followed at this institution during the past 16 years. RESULTS The mean follow-up interval was 8.8 ± 7 years. Initial presentation was acute aortic dissection (AAD) in 35% of patients (76% Type A and 24% Type B) and aneurismal disease in 65%. TAR was performed in 8% of patients during initial surgery for AAD (otherwise a hemi-arch replacement was performed) and 1.6% in elective root repair. Secondary TAR had to be performed in only 3% of patients without, but in 33% following AAD (33% Type A and 33% Type B; P = 0.0001). Thirty-day, 6-month, 1-year and overall mortalities were 3.2, 5.3, 6.4 and 11.7%, respectively. Operative and 30-day mortalities in secondary aortic arch replacement were zero. Secondary TAR after AAD did not increase the need for the replacement of the entire thoracoabdominal aorta during follow-up compared with patients without secondary TAR (37 vs 40%, P = 1.0). CONCLUSIONS MFS patients undergoing elective root repair have small risk of reinterventions on the aortic arch, and primary prophylactic replacement does not seem to be justified. In patients with AAD, the need for reinterventions is precipitated by the dissection itself and not by limiting the procedure to the hemi-arch replacement in the emergency setting. Limiting surgery to the aortic root, ascending aorta and proximal aortic arch is associated with low mortality in MFS patients presenting with AA

Single-layer graphene on silicon nitride micromembrane resonators

Due to their exceptional mechanical and optical properties, dielectric silicon nitride (SiN) micromembrane resonators have become the centerpiece of many optomechanical experiments. Efficient capacitive coupling of the membrane to an electrical system would facilitate exciting hybrid optoelectromechanical devices. However, capacitive coupling of such dielectric membranes is rather weak. Here we add a single layer of graphene on SiN micromembranes and compare electromechanical coupling and mechanical properties to bare dielectric membranes and to membranes metallized with an aluminium layer. The electrostatic coupling of graphene coated membranes is found to be equal to a perfectly conductive membrane. Our results show that a single layer of graphene substantially enhances the electromechanical capacitive coupling without significantly adding mass, decreasing the superior mechanical quality factor or affecting the optical properties of SiN micromembrane resonators

Quantifying volume loss from ice cliffs on debris-covered glaciers using high-resolution terrestrial and aerial photogrammetry

Mass losses originating from supraglacial ice cliffs at the lower tongues of debris-covered glaciers are a potentially large component of the mass balance, but have rarely been quantified. In this study, we develop a method to estimate ice cliff volume losses based on high-resolution topographic data derived from terrestrial and aerial photogrammetry. We apply our method to six cliffs monitored in May and October 2013 and 2014 using four different topographic datasets collected over the debris-covered Lirung Glacier of the Nepalese Himalayas. During the monsoon, the cliff mean backwasting rate was relatively consistent in 2013 (3.8 ± 0.3 cm w.e. d−1) and more heterogeneous among cliffs in 2014 (3.1 ± 0.7 cm w.e. d−1), and the geometric variations between cliffs are larger. Their mean backwasting rate is significantly lower in winter (October 2013–May 2014), at 1.0 ± 0.3 cm w.e. d−1. These results are consistent with estimates of cliff ablation from an energy-balance model developed in a previous study. The ice cliffs lose mass at rates six times higher than estimates of glacier-wide melt under debris, which seems to confirm that ice cliffs provide a large contribution to total glacier melt

MRI-targeted or standard biopsy for prostate-cancer diagnosis

Background Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited. Methods In a multicenter, randomized, noninferiority trial, we assigned men with a clinical suspicion of prostate cancer who had not undergone biopsy previously to undergo MRI, with or without targeted biopsy, or standard transrectal ultrasonography-guided biopsy. Men in the MRI-targeted biopsy group underwent a targeted biopsy (without standard biopsy cores) if the MRI was suggestive of prostate cancer; men whose MRI results were not suggestive of prostate cancer were not offered biopsy. Standard biopsy was a 10-to-12-core, transrectal ultrasonography-guided biopsy. The primary outcome was the proportion of men who received a diagnosis of clinically significant cancer. Secondary outcomes included the proportion of men who received a diagnosis of clinically insignificant cancer. Results A total of 500 men underwent randomization. In the MRI-targeted biopsy group, 71 of 252 men (28%) had MRI results that were not suggestive of prostate cancer, so they did not undergo biopsy. Clinically significant cancer was detected in 95 men (38%) in the MRI-targeted biopsy group, as compared with 64 of 248 (26%) in the standard-biopsy group (adjusted difference, 12 percentage points; 95% confidence interval [CI], 4 to 20; P=0.005). MRI, with or without targeted biopsy, was noninferior to standard biopsy, and the 95% confidence interval indicated the superiority of this strategy over standard biopsy. Fewer men in the MRI-targeted biopsy group than in the standard-biopsy group received a diagnosis of clinically insignificant cancer (adjusted difference, -13 percentage points; 95% CI, -19 to -7; P<0.001). Conclusions The use of risk assessment with MRI before biopsy and MRI-targeted biopsy was superior to standard transrectal ultrasonography-guided biopsy in men at clinical risk for prostate cancer who had not undergone biopsy previously. (Funded by the National Institute for Health Research and the European Association of Urology Research Foundation; PRECISION ClinicalTrials.gov number, NCT02380027 .)

Denitrification and nitrous oxide emissions from riparian forests soils exposed to prolonged nitrogen runoff

Compared to upland forests, riparian forest soils have greater potential to remove nitrate (NO3) from agricultural run-off through denitrification. It is unclear, however, whether prolonged exposure of riparian soils to nitrogen (N) loading will affect the rate of denitrification and its end products. This research assesses the rate of denitrification and nitrous oxide (N2O) emissions from riparian forest soils exposed to prolonged nutrient run-off from plant nurseries and compares these to similar forest soils not exposed to nutrient run-off. Nursery run-off also contains high levels of phosphate (PO4). Since there are conflicting reports on the impact of PO4 on the activity of denitrifying microbes, the impact of PO4 on such activity was also investigated. Bulk and intact soil cores were collected from N-exposed and non-exposed forests to determine denitrification and N2O emission rates, whereas denitrification potential was determined using soil slurries. Compared to the non-amended treatment, denitrification rate increased 2.7- and 3.4-fold when soil cores collected from both N-exposed and non-exposed sites were amended with 30 and 60 μg NO3-N g-1 soil, respectively. Net N2O emissions were 1.5 and 1.7 times higher from the N-exposed sites compared to the non-exposed sites at 30 and 60 μg NO3-N g-1 soil amendment rates, respectively. Similarly, denitrification potential increased 17 times in response to addition of 15 μg NO3-N g-1 in soil slurries. The addition of PO4 (5 μg PO4–P g-1) to soil slurries and intact cores did not affect denitrification rates. These observations suggest that prolonged N loading did not affect the denitrification potential of the riparian forest soils; however, it did result in higher N2O emissions compared to emission rates from non-exposed forests