976 resultados para 650
Resumo:
The epidemic of HIV/AIDS in the United States is constantly changing and evolving, starting from patient zero to now an estimated 650,000 to 900,000 Americans infected. The nature and course of HIV changed dramatically with the introduction of antiretrovirals. This discourse examines many different facets of HIV from the beginning where there wasn't any treatment for HIV until the present era of highly active antiretroviral therapy (HAART). By utilizing statistical analysis of clinical data, this paper examines where we were, where we are and projections as to where treatment of HIV/AIDS is headed.
Chapter Two describes the datasets that were used for the analyses. The primary database utilized was collected by myself from an outpatient HIV clinic. The data included dates from 1984 until the present. The second database was from the Multicenter AIDS Cohort Study (MACS) public dataset. The data from the MACS cover the time between 1984 and October 1992. Comparisons are made between both datasets.
Chapter Three discusses where we were. Before the first anti-HIV drugs (called antiretrovirals) were approved, there was no treatment to slow the progression of HIV. The first generation of antiretrovirals, reverse transcriptase inhibitors such as AZT (zidovudine), DDI (didanosine), DDC (zalcitabine), and D4T (stavudine) provided the first treatment for HIV. The first clinical trials showed that these antiretrovirals had a significant impact on increasing patient survival. The trials also showed that patients on these drugs had increased CD4+ T cell counts. Chapter Three examines the distributions of CD4 T cell counts. The results show that the estimated distributions of CD4 T cell counts are distinctly non-Gaussian. Thus distributional assumptions regarding CD4 T cell counts must be taken, into account when performing analyses with this marker. The results also show the estimated CD4 T cell distributions for each disease stage: asymptomatic, symptomatic and AIDS are non-Gaussian. Interestingly, the distribution of CD4 T cell counts for the asymptomatic period is significantly below that of the CD4 T cell distribution for the uninfected population suggesting that even in patients with no outward symptoms of HIV infection, there exists high levels of immunosuppression.
Chapter Four discusses where we are at present. HIV quickly grew resistant to reverse transcriptase inhibitors which were given sequentially as mono or dual therapy. As resistance grew, the positive effects of the reverse transcriptase inhibitors on CD4 T cell counts and survival dissipated. As the old era faded a new era characterized by a new class of drugs and new technology changed the way that we treat HIV-infected patients. Viral load assays were able to quantify the levels of HIV RNA in the blood. By quantifying the viral load, one now had a faster, more direct way to test antiretroviral regimen efficacy. Protease inhibitors, which attacked a different region of HIV than reverse transcriptase inhibitors, when used in combination with other antiretroviral agents were found to dramatically and significantly reduce the HIV RNA levels in the blood. Patients also experienced significant increases in CD4 T cell counts. For the first time in the epidemic, there was hope. It was hypothesized that with HAART, viral levels could be kept so low that the immune system as measured by CD4 T cell counts would be able to recover. If these viral levels could be kept low enough, it would be possible for the immune system to eradicate the virus. The hypothesis of immune reconstitution, that is bringing CD4 T cell counts up to levels seen in uninfected patients, is tested in Chapter Four. It was found that for these patients, there was not enough of a CD4 T cell increase to be consistent with the hypothesis of immune reconstitution.
In Chapter Five, the effectiveness of long-term HAART is analyzed. Survival analysis was conducted on 213 patients on long-term HAART. The primary endpoint was presence of an AIDS defining illness. A high level of clinical failure, or progression to an endpoint, was found.
Chapter Six yields insights into where we are going. New technology such as viral genotypic testing, that looks at the genetic structure of HIV and determines where mutations have occurred, has shown that HIV is capable of producing resistance mutations that confer multiple drug resistance. This section looks at resistance issues and speculates, ceterus parabis, where the state of HIV is going. This section first addresses viral genotype and the correlates of viral load and disease progression. A second analysis looks at patients who have failed their primary attempts at HAART and subsequent salvage therapy. It was found that salvage regimens, efforts to control viral replication through the administration of different combinations of antiretrovirals, were not effective in 90 percent of the population in controlling viral replication. Thus, primary attempts at therapy offer the best change of viral suppression and delay of disease progression. Documentation of transmission of drug-resistant virus suggests that the public health crisis of HIV is far from over. Drug resistant HIV can sustain the epidemic and hamper our efforts to treat HIV infection. The data presented suggest that the decrease in the morbidity and mortality due to HIV/AIDS is transient. Deaths due to HIV will increase and public health officials must prepare for this eventuality unless new treatments become available. These results also underscore the importance of the vaccine effort.
The final chapter looks at the economic issues related to HIV. The direct and indirect costs of treating HIV/AIDS are very high. For the first time in the epidemic, there exists treatment that can actually slow disease progression. The direct costs for HAART are estimated. It is estimated that the direct lifetime costs for treating each HIV infected patient with HAART is between $353,000 to $598,000 depending on how long HAART prolongs life. If one looks at the incremental cost per year of life saved it is only $101,000. This is comparable with the incremental costs per year of life saved from coronary artery bypass surgery.
Policy makers need to be aware that although HAART can delay disease progression, it is not a cure and HIV is not over. The results presented here suggest that the decreases in the morbidity and mortality due to HIV are transient. Policymakers need to be prepared for the eventual increase in AIDS incidence and mortality. Costs associated with HIV/AIDS are also projected to increase. The cost savings seen recently have been from the dramatic decreases in the incidence of AIDS defining opportunistic infections. As patients who have been on HAART the longest start to progress to AIDS, policymakers and insurance companies will find that the cost of treating HIV/AIDS will increase.
Resumo:
光瞳滤波器作为实现超分辨的基本元件之一,它的设计以及制作都非常重要。设计了一种正弦变化的振幅型光瞳滤波器,可以通过调节少量的参量实现各种不同的超分辨模式。选择正弦函数的周期以及光瞳中心点透过率变化两个参量来实现对最终超分辨效果的调节。数值计算结果表明:在整个人射光瞳上的透过率瞳函数分布具有0.5~2个正弦振幅周期时,较为合适。小于0.5个周期将不会有任何超分辨效果,大于2个周期超分辨效果反而变差。数值计算中还注意到,当周期数为整数时,斯特雷尔比将保持0.25不变。对正弦变化振幅型光瞳滤波器的计算结果,显示
Resumo:
Esse trabalho teve o objetivo de analisar a fidelidade da referência externa em tecidos moles no auxílio do posicionamento vertical da maxila. Foram selecionados 40 pacientes portadores de deformidade dentofacial e submetidos à osteotomia total da maxila. Os indivíduos foram divididos em 2 grupos no intuíto de avaliar duas técnicas de referência externa: a utilização da sutura em tecidos moles e o uso do fio de Kirschner. Esta última foi utilizada como a técnica do grupo-controle. Os dados foram colhidos em duas fases. Na primeira delas, foi realizada a mensuração da posição vertical da maxila antes da osteotomia Le Fort I e após a fixação da maxila, utilizando a referência externa. A partir desses números, foi obtida a alteração vertical de cada caso, colhida durante a cirurgia. Na segunda fase da coleta de dados, foram realizadas mensurações verticais da maxila baseadas nas radiografias cefalométricas pré e pós-operatórias. Assim, foi obtido o valor da alteração vertical de cada caso, baseado na documentação radiográfica. Após esta etapa, foi calculada a diferença entre a alteração vertical obtida durante a cirurgia e a alteração vertical colhida a partir das radiografias. Dessa forma, foram obtidos valores que correspondem às imperfeições no posicionamento vertical da maxila de cada paciente, tendo como base a posição do incisivo central superior. Os resultados foram comparados e analisados estatisticamente. A média aritmética da precisão no posicionamento vertical da maxila no grupo-controle foi de 0,52mm e do grupo da referência em tecidos moles foi de 0,65mm. A aplicação do teste t de Student a 5% revelou que não houve diferença estatística significativa entre o grau de precisão das duas técnicas de referência externa (P=0,429). Como conclusão, observou-se que as duas técnicas foram eficazes no auxílio ao posicionamento vertical da maxila e que a referência externa em tecidos moles apresentou um grau de precisão semelhante ao valor obtido com a técnica do fio de Kirschner.
Resumo:
Politically the Colorado river is an interstate as well as an international stream. Physically the basin divides itself distinctly into three sections. The upper section from head waters to the mouth of San Juan comprises about 40 percent of the total of the basin and affords about 87 percent of the total runoff, or an average of about 15 000 000 acre feet per annum. High mountains and cold weather are found in this section. The middle section from the mouth of San Juan to the mouth of the Williams comprises about 35 percent of the total area of the basin and supplies about 7 percent of the annual runoff. Narrow canyons and mild weather prevail in this section. The lower third of the basin is composed of mainly hot arid plains of low altitude. It comprises some 25 percent of the total area of the basin and furnishes about 6 percent of the average annual runoff.
The proposed Diamond Creek reservoir is located in the middle section and is wholly within the boundary of Arizona. The site is at the mouth of Diamond Creek and is only 16 m. from Beach Spring, a station on the Santa Fe railroad. It is solely a power project with a limited storage capacity. The dam which creats the reservoir is of the gravity type to be constructed across the river. The walls and foundation are of granite. For a dam of 290 feet in height, the back water will be about 25 m. up the river.
The power house will be placed right below the dam perpendicular to the axis of the river. It is entirely a concrete structure. The power installation would consist of eighteen 37 500 H.P. vertical, variable head turbines, directly connected to 28 000 kwa. 110 000 v. 3 phase, 60 cycle generators with necessary switching and auxiliary apparatus. Each unit is to be fed by a separate penstock wholly embedded into the masonry.
Concerning the power market, the main electric transmission lines would extend to Prescott, Phoenix, Mesa, Florence etc. The mining regions of the mountains of Arizona would be the most adequate market. The demand of power in the above named places might not be large at present. It will, from the observation of the writer, rapidly increase with the wonderful advancement of all kinds of industrial development.
All these things being comparatively feasible, there is one difficult problem: that is the silt. At the Diamond Creek dam site the average annual silt discharge is about 82 650 acre feet. The geographical conditions, however, will not permit silt deposites right in the reservoir. So this design will be made under the assumption given in Section 4.
The silt condition and the change of lower course of the Colorado are much like those of the Yellow River in China. But one thing is different. On the Colorado most of the canyon walls are of granite, while those on the Yellow are of alluvial loess: so it is very hard, if not impossible, to get a favorable dam site on the lower part. As a visitor to this country, I should like to see the full development of the Colorado: but how about THE YELLOW!
Resumo:
Electric dipole internal conversion has been experimentally studied for several nuclei in the rare earth region. Anomalies in the conversion process have been interpreted in terms of nuclear structure effects. It was found that all the experimental results could be interpreted in terms of the j ∙ r type of penetration matrix element; the j ∙ ∇ type of penetration matrix element was not important. The ratio λ of the El j ∙ r penetration matrix element to the El gamma-ray matrix element was determined from the experiments to be:
Lu175,396 keV, λ = - 1000 ± 100;
282 keV, λ = 500 ± 100;
144 keV, λ = 500 ± 250;
Hf177, 321 keV λ = - 1400 ± 200;
208 keV λ = - 90 ± 40;
72 keV |λ| ≤ 650;
Gd155, 86 keV λ = - 150 ± 100;
Tm169, 63 keV λ = - 100 ± 100;
W182, 152 keV, λ = - 160 ±80;
67 keV, λ = - 100 ± 100.
Predictions for λ are made using the unified nuclear model.
Resumo:
O Distrito Grafitífero Aracoiába-Baturité apresenta depósitos do tipo gnaisse grafitoso (minério disseminado) e veio (minério maciço) com diferentes origens genéticas e com características físicas e ambientes geológicos de formação próprios. O minério tipo gnaisse grafitoso é de origem sedimentar, singenético, com teores de 1,5 a 8% de C, que se distribuem ao longo de duas extensas faixas paralelas, hospedadas na Subunidade Baturité, que constitui um importante metalotecto regional. A associação de grafita metamórfica disseminada em metassedimentos da Sequência Acarápe constitui um geoindicador de antiga bacia sedimentar neoproterozóica e, também, pode ser considerado como zona de geosutura resultante do subsequente fechamento de um oceano primitivo. As rochas desta subunidade correspondem na paleogeografia da Sequência Acarápe aos fácies de sopé de talude e de planície abissal. O minério tipo veio (fluido depositado) é epigenético e, com teores entre 20% e 70% de C, forma corpos tabulares e bolsões, controlados em escala local por estruturas de alívio (falhas, fraturas, zonas de contato, eixos de dobras etc.) que permitiram a percolação de soluções penumatolíticas relacionadas ao corpo plutônico de Pedra Aguda. As variações dos valores das relações entre isótopos estáveis de carbono (δ13C) na grafita do minério disseminado são de -26,72 a -23,52 e do minério maciço de -27,03 a -20,83, revelando sinal de atividades biológicas (bioassinaturas) e permitem afirmar que a grafita das amostras acima são derivadas de matéria orgânica. Foram apresentados os principais guias de prospecção para grafita e testados os seguintes métodos geofísicos: Eletro-Resistividade; GPR - Ground Penetrating Radar; Magnetometria; VLF (Very Low Frequency); e Polarização Induzida Espectral (IPS) / Resistividade (ER). A conjugação dos métodos de Polarização Induzida Espectral (IPS) e Eletro Resistividade (ER) foi o que demonstrou a melhor eficiência. Com relação à determinação do teor de carbono por termogravimetria (ATG), que é o método mais utilizado para este elemento. Verificou-se, que as faixas de queima atribuídas ao carbono no minério do Distrito de Aracoiába-Baturité (340 a 570C e de 570 a 1050C) eram diferentes das faixas do minério de Minas Gerais (350C a 650C e 650C a 1.050C). Esta constatação indica a necessidade de se determinar previamente as faixas de temperatura para cada região pesquisada.
Resumo:
A novel metallized azo dye has been synthesized. The absorption spectra of the thin film and thermal characteristic are measured. Static optical recording properties with and without the Bi mask layer super-resolution near-field structure (Super-RENS) of the metal-azo dye are investigated. The results show that the metal-azo dye film has a broad absorbance band in the region of 450-650 nm and the maximum absorbance wavelength is located at 603 nm. It is also found that the new metallized azo dye occupies excellent thermal stability, initiatory decomposition temperature is at 270 degrees C and the mass loss is about 48% in a narrow temperature region (15 degrees C). The complex refractive index N (N = n + ik) is measured. High refractive index (n = 2.45) and low extinction coefficient (k = 0.2) at the recording wavelength 650nm are attained. Static optical recording tests with and without Super-RENS are carried out using a 650nm semiconductor diode laser with recording power of 7mW and laser pulse duration of 200ns. The AFM images show that the diameter of recording mark on the dye film with the Bi mask layer is reduced about 42%, compared to that of recorded mark on the dye film without Super-RENS. It is indicated that Bi can well performed as a mask layer of the dye recording layer and the metallized azo dye can be a promising candidate for recording media with the super-resolution near-field structure.
Resumo:
合成了2-(2-氨基-6-乙氧基苯并噻唑基偶氮)-5-(N,N-二乙基氨基)三氟甲基磺酰苯胺偶氮染料(EBTDATFS)及其与乙酸镍、乙酸钴、乙酸铜、乙酸锌等金属盐鏊合的金属鏊合物。通过红外光谱、紫外-可见吸收光谱和MALDI质谱等对染料及其金属鏊合物进行了结构表征;使用旋涂方法在K9玻璃和抛光的单晶硅基片上制备薄膜;研究了镍金属鏊合物的热学性能;使用椭偏仪研究了Ni和Zn鏊合物的光学常数。结果表明:4种金属鏊合物薄膜最大吸收光谱为621-629nm,且长波边吸收峰陡峭;TGA-DSC测试结果表明镍金属鏊
Resumo:
本文设计并实现了一台高重复率,紧凑型微脉冲全固态激光器。YAG晶体, Nd:YAG晶体和Cr4+:YAG晶体键合为一个单块晶体作为谐振腔。优化计算了Cr4+:YAG晶体的初始透过率,耦合输出透射率和泵浦光斑大小。对激光器的性能进行了测试,结果表明该激光器适合于空间激光测距。
Resumo:
提出了一种新的光束质量膨因子实时检测技术,利用一个普通正交衍射光栅组将一束待测激光束分成3×3共9路光,并利用光路调整器使9路光束通过不同的光程后有序地排列在CCD相机的探测面上,并使得各路光的光程差分布在束腰附近两倍瑞利距离内,从而可利用单一CCD探测面来同时获取待测光束多个位置上的光斑图样。再利用二阶矩理论求出各个位置上的光束束宽,通过曲线拟合进而实现光束质量的实时检测。结果表明,对于连续He-Ne激光器的输出光束,采用实时检测技术得到的测量结果与用传统方法得到的结果基本一致。
Resumo:
测定了Cr14—05铬镱铒共掺磷酸盐玻璃的主要热光参数,并测试了吸收、荧光光谱和激光性能等。结果表明该玻璃具有较好的光谱和热光性质,其激光输出性能可满足人眼安全激光测距光源应用的要求。
Resumo:
Intense Tm3+ blue upconversion emission has been observed in Tm3+-Yb3+ codoped oxyfluoride tellurite glass under excitation with a diode laser at 976 nm. Three emission bands centered at 475, 650 and 796 nm corresponding to the transitions (1)G(4) -> H-3(6), (1)G(4) -> H-3(4) and F-3(4) -> H-3(6), respectively, simultaneously occur. The dependence of upconversion intensities on Tm3+ ions concentration and excitation power are investigated. For fixed Yb2O3 concentrations of 5.0 mol%, the maximum upconversion intensity was obtained with Tm2O3 concentration of about 0.1 mol%. The blue upconversion luminescence lifetimes of the Tm3+ transitions (1)G(4) -> H-3(6) are measured. The results are evaluated by the possible upconversion mechanisms.
Resumo:
Yb3+/Tm3+-codoped oxychloride germanate glasses for developing potential upconversion lasers have been fabricated and characterized. Structural properties were obtained based on the Raman spectra analysis, indicating that PbCl2 plays an important role in the formation of glass network and has an important influence on the maximum phonon energies of host glasses. Intense blue and weak red emissions centered at 477 and 650 nm, corresponding to the transitions (1)G(4) -> H-3(6) and (1)G(4) -> H-3(4), respectively, were observed at room temperature. With increasing PbCl2 content, the intensity of blue (477 nm) emission increases significantly, while the red (650 nm) emission increases slowly. The results indicate that PbCl2 has more influence on the blue emissions than the red emission in oxychloride germanate glasses. The possible upconversion mechanisms are discussed and estimated. Intense blue upconversion luminescence indicates that these oxychloride germanate glasses can be used as potential host material for upconversion lasers. C (c) 2005 Springer Science + Business Media, Inc.
Resumo:
Structural and up-conversion fluorescence properties in ytterbium-sensitized thulium-doped novel oxychloride bismuth-germanium glass have been studied. The structure of novel bismuth-germanium glass was investigated by peak-deconvolution of Raman spectrum, and the structural information was obtained from the peak wave numbers. The Raman spectrum investigation indicates that PbCl2 plays an important role in the formation of glass network, and has an important influence on the up-conversion luminescence. Intense blue and weak red emissions centered at 477 and 650 mn, corresponding to the transitions 1G(4) -> H-3(6) and (1)G(4) -> H-3(4), respectively, were observed at room temperature. The possible up-conversion mechanisms are discussed and estimated. This novel oxychloride bismuth-germanium glass with low maximum phonon energy (similar to 730 cm(-1)) can be used as potential host material for up-conversion lasers. (c) 2005 Elsevier Ltd. All rights reserved.
Resumo:
Tm3+/Yb3+-codoped heavy metal oxide-halide glasses have been synthesized by conventional melting and quenching method. Structural properties were obtained based on the Raman spectra, indicating that halide ion has an important influence on the phonon density and maximum phonon energy of host glasses. Intense blue and weak red emissions centered at 477 and 650 nm, corresponding to the transitions (1)G(4) -> H-3(6) and (1)G(4) -> H-3(4), respectively, were observed at room temperature. The possible up-conversion mechanisms are discussed and estimated. With increasing halide content, the up-conversion luminescence intensity and blue luminescence lifetimes of Tm3+ ion increase notably. Our results show that with the substitution of halide ion for oxygen ion, the decrease of phonon density and maximum phonon energy of host glasses both contribute to the enhanced up-conversion emissions. (c) 2005 Elsevier B.V. All rights reserved.