Serum 25-Hydroxyvitamin D Levels and C-Reactive Protein in Persons with Human Immunodeficiency Virus Infection

Human immunodeficiency virus (HIV) infection has frequently been associated with vitamin D deficiency as well as chronic inflammatory response. We tested the hypothesis of an independent relationship between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and high-sensitivity C-reactive protein (CRP) in a cohort of HIV-positive people. A cross-sectional survey was conducted among 316 HIV-positive people (181 men and 135 women) aged 16 to 60 years residing in the Kathmandu Valley, Nepal. Serum high-sensitivity CRP concentrations and serum 25(OH)D levels were measured by the latex agglutination nephelometry method and the competitive protein-binding assay, respectively. The relationship between serum CRP concentrations and 25(OH)D serum level was assessed using multiple logistic regression analysis with adjustment of potential cardiovascular and HIV-related factors. The proportions of participants with 25(OH)D serum levels \u3c 20 ng/ml, 20–30 ng/ml, and ‡ 30 ng/ml were 83.2%, 15.5%, and 1.3%, respectively. The mean 25(OH)D serum levels in men and women were 15.3 ng/ml and 14.4 ng/ml, respectively. Participants with a 25(OH)D serum level of \u3c 20 ng/ml had a 3.2-fold higher odds of high CRP ( \u3e 3mg/liter) compared to those with a 25(OH)D serum level of ‡ 20 ng/ml ( p = 0.005). Men and women with a 25(OH)D serum level of \u3c 20 ng/ml had 3.2- and 2.7-fold higher odds of high CRP ( \u3e 3mg/liter), respectively, compared to those with a 25(OH)D serum level of ‡ 20 ng/ml. The relationships remained significant only in men ( p = 0.02) but not in women ( p = 0.28). The risk of having a high level of inflammation (CRP \u3e 3mg/liter) may be high among HIV-positive men and women with a 25(OH)D serum level of \u3c 20 ng/ml

Energy Management System Considering Battery Lifetime

The contribution of renewable energy resources in the global energy generation has been increasing at a fast pace. Variability and uncertainty are the two main issues related to renewable energy integration. Thus, energy storage systems (ESSs) are used in such systems to smooth the power generated by the renewable energy sources. In order to ensure reliable and economic operation of the system, energy management system (EMS) is implemented to control the dispatch of the available resources. ESS such as a battery requires significant capital investment and frequent replacement. A battery has a maximum lifetime called float life, regardless of energy throughput. Furthermore, the useful lifetime of these batteries varies considerably based on the operating conditions. Generally, the batteries are used excessively without considering the impact on the useful lifetime when used in systems that are isolated from the utility. On the contrary, the batteries are rarely used in the systems that are connected to the utility such that the available output is wasted at the end of the float life of the batteries. Thus, the consideration of the battery lifetime characteristics in EMS can maximize the battery utilization during its useful life. In this work, implementation of EMS including the battery lifetime for the operation of hybrid power systems– a remote microgrid, and a data center are investigated. Implementation of EMS for the annual operation of a remote microgrid considering the battery lifetime is performed. A heuristic search technique– genetic implementor (genitor) algorithm has been implemented as the inclusion of fuel consumption of diesel generator and battery degradation models in objective function yields in high nonlinearity. The fuel consumption and battery output minimization are achieved. Similar to a remote microgrid, EMS can also be implemented in large scale systems like data centers. Data centers consume a large amount of energy and have backup resources allocated for emergency conditions. These resources can be utilized to participate in demand response (DR) to reduce the peak load demand. Real-time dispatch module of a data center is developed to consume daily allocated budget for battery usage to ensure utilization of the battery. The real-time operational cost of a data center is reduced for participation in DR as compared to the operational cost without DR

INTEREST-BASED FILTERING OF SOCIAL DATA IN DECENTRALIZED ONLINE SOCIAL NETWORKS

In Online Social Networks (OSNs) users are overwhelmed with huge amount of social data, most of which are irrelevant to their interest. Due to the fact that most current OSNs are centralized, people are forced to share their data with the site, in order to be able to share it with their friends, and thus they lose control over it. Decentralized Online Social Networks have been proposed as an alternative to traditional centralized ones (such as Facebook, Twitter, Google+, etc.) to deal with privacy problems and to allow users to maintain control over their data. This thesis presents a novel peer-to-peer architecture for decentralized OSN and a mechanism that allows each node to filter out irrelevant social data, while ensuring a level of serendipity (serendipitous are social data which are unexpected since they do not belong in the areas of interest of the user but are desirable since they are important or popular). The approach uses feedback from recipient users to construct a model of different areas of interest along the relationships between sender and receiver, which acts as a filter while propagating social data in this area of interest. The evaluation of the approach, using an Erlang simulation shows that it works according to the design specification: with the increasing number of social data passing through the network, the nodes learn to filter out irrelevant data, while serendipitous important data is able to pass through the network

Dietary B Vitamins and Depression in Persons with Human Immunodeficiency Virus Infection: The Positive Living with HIV (POLH) Study

B vitamins have beneficial roles in mental health functional impairments; however, research on the role of B vitamins in depression among HIV-infected persons is limited. This study assessed the association between dietary B vitamin intake and depressive symptoms in a cohort of HIV-infected persons. A cross-sectional survey was conducted among 314 HIV-infected persons (180 men and 134 women) aged 18 to 60 y residing in the Kathmandu, Nepal. The Beck Depression Inventory-I was used to measure depression, with a cutoff score of 20 or higher. Dietary intake was assessed using two nonconsecutive 24-h dietary recalls. The relationships between B vitamins and depressive symptoms were assessed using multiple logistic regression analysis. Twenty-six percent participants (men: 23%; women: 29%) were depressed. More than two thirds of participants’ B vitamins intake were below the estimated average requirements (EAR) level. Low intake of riboflavin was associated with an increased risk of depression in women but not in men. Multivariate OR (95% CI) for depression in the first, second, and third tertiles of riboflavin in total participants were 1 (reference), 0.87 (0.46–1.64), and 0.49 (0.24–0.98), respectively (p for trend = 0.048) and in women were 1 (reference), 0.94 (0.36–2.40), and 0.23 (0.07–0.77), respectively (p for trend = 0.020). No clear associations were seen between other B vitamins and depressive symptoms in either sex. Low intake of riboflavin was independently associated with an increased risk of depressive symptoms in all participants and in HIV-infected women. Further prospective studies are warranted to confirm the role of vitamin B vitamins in depressive symptoms among HIV-infected persons

Investigation on contamination of enteric pathogens in different sources of water and its association with gastroenteritis in the Kathmandu Valley, Nepal

University of Yamanashi (山梨大学)博士(工学)医工農博甲第24号thesi

Utilisation of sexual health services by female sex workers in Nepal

Background The Nepal Demographic Health Survey (NDHS) in 2006 showed that more than half (56%) of the women with sexually transmitted infections (STIs), including HIV, in Nepal sought sexual health services. There is no such data for female sex workers (FSWs) and the limited studies on this group suggest they do not even use routine health services. This study explores FSWs use of sexual health services and the factors associated with their use and non-use of services. Methods This study aimed to explore the factors associated with utilisation of sexual health services by FSWs in the Kathmandu Valley of Nepal, and it used a mixed-method approach consisting of an interviewer administered questionnaire-based survey and in-depth interviews. Results The questionnaire survey, completed with 425 FSWs, showed that 90% FSWs self-reported sickness, and (30.8%) reported symptoms of STIs. A quarter (25%) of those reporting STIs had never visited any health facilities especially for sexual health services preferring to use non-governmental clinics (72%), private clinics (50%), hospital (27%) and health centres (13%). Multiple regression analysis showed that separated, married and street- based FSWs were more likely to seek health services from the clinics or hospitals. In- depth interviews with 15 FSWs revealed that FSWs perceived that personal, structural and socio-cultural barriers, such as inappropriate clinic opening hours, discrimination, the judgemental attitude of the service providers, lack of confidentiality, fear of public exposure, and higher fees for the services as barriers to their access and utilisation of sexual health services. Conclusion FSWs have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints. The ‘education’ to change individual behaviour, health worker and community perceptions, as well as the training of the health workers, is necessary

Financing sources for mitigation of adverse climate change: a systematic review

Accelerating climate change has harmed food and water security and affected both terrestrial and aquatic systems, hindering efforts to meet many Sustainable Development Goals [SDGs]. Climate finance can help mobilize financial resources and tackle the effects of climate change. This study analyzes existing literature on climate finance more broadly from its beginning to its current status. It reviewed 311 relevant articles from 2005 to 2023 using qualitative content analysis [QCA] and meta-analysis to identify common themes and their classification based on pre-determined article criteria. We also identify research gaps within each theme and suggest priority finance areas. Our result suggests that the periodic publications have drastically increased in the past few years, especially after the Paris Agreement in 2015. With content analysis of prior research, most of the research used quantitative and econometric approaches. With the review of papers, it can be concluded that climate finance is mostly constrained in vulnerable regions in which the risk of climate change and its adverse impacts are delicate, including low-lying coastal areas, SIDS, deserts, mountains, and Polar Regions. Innovative climate finance funding should focus on renewable energy, energy efficiency, and infrastructure that aids adaptation in vulnerable communities. Emphasis should be placed on initiatives that provide both mitigation and adaptation advantages, ensuring a resilient and sustainable future. While research primarily focuses on adaptation and mitigation, the interplay between these two areas requires further exploration. We highlight the knowledge gap in this research domain examining the financing sources for mitigation of adverse climate change from private and public sectors

Removal of Selenium from Difficult-to-treat Wastewaters Using an Innovative Reductive-adsorptive Media

Removal of Selenium from Difficult-to-treat Wastewaters Using an Innovative Reductive-adsorptive Media Authors Mr. Patrick McKeown - United States - ECT2 Dr. Madan Tandukar - United States - ECT2 Dr. Steve Woodard - United States - ECT2 Mr. Mike Nickelsen - United States - ECT2 Abstract Selenium is one of the more difficult-to-treat emerged contaminants, and is mostly prevalent in mining and power wastewater. In water and wastewater, selenium generally exists as soluble oxyanions, selenite (SeO32−) and selenate (SeO42−). Out of these, selenate is the more mobile and prevalent species, which also is more difficult to remove. With increasing focus on water quality, the EPA is moving towards tighter selenium discharge limits to as low as 3 µg/L (ppb). This abstract presents two case studies of selenium removal from mining wastewater and coal combustion residue (CCR) effluent using an innovative media. In the mining and CCR wastewaters, selenium is one of the key contaminants that is naturally occurring in soil, groundwater and coal. The new media developed for selenium removal is an engineered and surface-modified iron-based media, which has high surface area, reactivity and contaminant capacity. The media functions by reducing selenate/selenite to elemental selenium, which is then strongly adsorbed on the media surface. Study1: influent mining water had 30 ± 12.6 µg/L of selenium (all selenate) and high concentrations of co-contaminants such as, aluminum, silica, sulfate and phosphate. The pH of the raw water was approximately 2.7. Over 59 days of run time, the system consistently removed selenium to below the target limit of 3 µg/L. The pilot also removed the remaining aluminum in the wastewater. This is an added benefit because aluminum is one of the contaminants that the local government is planning to regulate in the future. Study2: CCR effluent, which contained 374 ± 38.2 µg/L of selenium along with molybdenum, arsenic, boron, sulfate, nitrate. The treatment target for selenium was 12 µg/L. The pilot unit was operated continuously for 30 days with selenium consistently removed below 12 µg/L Additionally, the pilot also consistently removed molybdenum, from 3,000 µg/L to almost non-detect levels

Delays in Antiretroviral Therapy Initiation Among HIV-Positive Individuals: Results of the Positive Living with HIV Study

Background: Lack of early initiation of antiretroviral therapy (ART) remains a major health concern due to increased risk of premature mortality and further HIV transmission. This study explored CD4+ cell count monitoring in relation to delays in ART initiation among HIV-positive individuals in the Kathmandu Valley, Nepal, where ART coverage was only 23.7% in 2011. Design: We recruited a total of 87 ART-naïve, HIV-positive individuals aged 18 to 60 years through the networks of five non-government organizations working with HIV-positive individuals. We collected data on the history of ART initiation, CD4+ cell count monitoring, socio-demographic variables, perceived family support (measured with 10-item Nepali Family Support and Difficulty Scale), depression, and HIV symptom burden. Correlates of ART eligibility were examined using multivariable logistic regression analysis. Results: A total of 72 of the 87 ART-naïve participants (82.8%) had monitored their CD4+ cell count in the past 6 months. Of these, 36 (50%) participants were eligible for ART initiation with CD4+ cell count /mm3. A total of 12 participants had CD4+ cell count /mm3. Lower level of perceived family support was associated with 6.05-fold higher odds (95% confidence interval =1.95 to 18.73) of being ART eligible with a CD4+ cell count /mm3. Conclusions: High rate of delays in ART initiation and the strong association of low perceived family support with ART eligibility in our study participants suggest that HIV service providers should consider the role and impact of family support in influencing individual decisions to initiate ART among eligible HIV-positive individuals