Obesity trends and body mass index changes after starting antiretroviral treatment : the Swiss HIV Cohort Study

BACKGROUND: The factors that contribute to increasing obesity rates in human immunodeficiency virus (HIV)-positive persons and to body mass index (BMI) increase that typically occurs after starting antiretroviral therapy (ART) are incompletely characterized. METHODS: We describe BMI trends in the entire Swiss HIV Cohort Study (SHCS) population and investigate the effects of demographics, HIV-related factors, and ART on BMI change in participants with data available before and 4 years after first starting ART. RESULTS: In the SHCS, overweight/obesity prevalence increased from 13% in 1990 (n = 1641) to 38% in 2012 (n = 8150). In the participants starting ART (n = 1601), mean BMI increase was 0.92 kg/m(2) per year (95% confidence interval, .83-1.0) during year 0-1 and 0.31 kg/m(2) per year (0.29-0.34) during years 1-4. In multivariable analyses, annualized BMI change during year 0-1 was associated with older age (0.15 [0.06-0.24] kg/m(2)) and CD4 nadir <199 cells/µL compared to nadir >350 (P < .001). Annualized BMI change during years 1-4 was associated with CD4 nadir <100 cells/µL compared to nadir >350 (P = .001) and black compared to white ethnicity (0.28 [0.16-0.37] kg/m(2)). Individual ART combinations differed little in their contribution to BMI change. CONCLUSIONS: Increasing obesity rates in the SHCS over time occurred at the same time as aging of the SHCS population, demographic changes, earlier ART start, and increasingly widespread ART coverage. Body mass index increase after ART start was typically biphasic, the BMI increase in year 0-1 being as large as the increase in years 1-4 combined. The effect of ART regimen on BMI change was limited.

Classification of sags according to their origin based on the waveform similarity

A statistical method for classification of sags their origin downstream or upstream from the recording point is proposed in this work. The goal is to obtain a statistical model using the sag waveforms useful to characterise one type of sags and to discriminate them from the other type. This model is built on the basis of multi-way principal component analysis an later used to project the available registers in a new space with lower dimension. Thus, a case base of diagnosed sags is built in the projection space. Finally classification is done by comparing new sags against the existing in the case base. Similarity is defined in the projection space using a combination of distances to recover the nearest neighbours to the new sag. Finally the method assigns the origin of the new sag according to the origin of their neighbours

Evaluation of Composite Pavement Unbonded Overlays: Phases I and II, April 2003

In recent years, thin whitetopping has evolved as a viable rehabilitation technique for deteriorated asphalt cement concrete (ACC) pavements. Numerous projects have been constructed and tested; these projects allow researchers to identify the important elements contributing to the projects’ successes. These elements include surface preparation, overlay thickness, synthetic fiber reinforcement usage, joint spacing, and joint sealing. Although the main factors affecting thin whitetopping performance have been identified by previous research, questions still existed as to the optimum design incorporating these variables. The objective of this research is to investigate the interaction between these variables over time. Laboratory testing and field-testing were planned in order to accomplish the research objective. Laboratory testing involved shear testing of the bond between the portland cement concrete (PCC) overlay and the ACC surface. Field-testing involved falling weight deflectometer deflection responses, measurement of joint faulting and joint opening, and visual distress surveys on the 9.6-mile project. The project was located on Iowa Highway 13 extending north from the city of Manchester, Iowa, to Iowa Highway 3 in Delaware County. Variables investigated included ACC surface preparation, PCC thickness, synthetic fiber reinforcement usage, and joint spacing. This report documents the planning, equipment selection, construction, field changes, and construction concerns of the project built in 2002. The data from this research could be combined with historical data to develop a design specification for the construction of thin, unbonded overlays.

Luovuus ja itsetuntemus ohjaajantyössä

This research deals with obstacles and opportunities with respect to creativity. It mainly focuses on the author's most meaningful discoveries as an individual and a professional in the field of theatre during the past two years of her education. The research is a description of that transitional phase in her life. Firstly, the research discusses creativity and presence. Secondly, it describes the author personally and professionally and compares her earlier and current ways of working. It contemplates the obstacles and opportunities considering her self-knowledge and creativity, and disucsses the problems she has faced on the way to freedom and well-being. Following this, the author presents the tools for increasing her creativity, self-knowledge and body awareness in theatre work: the Gestalt Method, Acting with the Inner Partner and the Authentic Movement. She discusses the relativity between overall well-being in life and the quality of theatre work. The final section of the present research discusses the process of directing the play Suurin on rakkaus in 2006. It deals with issues such as self-knowledge in directing, group management, the importance of terror and excitement in directing and ways of enduring both. The conclusion explanes the reasons behind the author's capability of working with small groups, with creative and passionate theatre workers. It also lists the benefits of exploring one's passions, cooperating with enthusiastic and creative artists and the pursuit for balance in art and in everyday life.

Nursing concepts and theories

The theory framework of nursing science is built in a dynamic process that arises from practice and is reproduced through research, mainly by analysis and development of concepts and theories. This study presents a theory reflection on nursing knowledge construction and points out subsidies for future studies in the area. The interrelation among theory, research, and clinical practice is required for continuous development of nursing as a profession and science. Ideally, the practice must be based on theory that is validated by research. Therefore, theory, research, and practice affect each other reciprocally and continuously.

As Barragens em cabo Verde - Avaliação dos Impactes Ambientais - Socioeconómicos e Culturais - Caso de Estudo - A Barragem do Poilão Ilha Santiago

Os sucessivos anos de seca têm agravado a crónica falta de água que marca o quadro hídrico de Cabo Verde. No arquipélago verifica-se a perda de um grande volume de água que se escoa para o mar, aquando das grandes chuvadas, e que é estimado em milhões de m3/ano. Para atenuar a problemática da falta de água, principalmente no setor agrícola, o Governo Cabo-verdiano tem apostado na política de construção de barragens. No ano de 2006 com o objetivo de aumentar os recursos hídricos disponíveis e concomitantemente alargar a área irrigada e diminuir a pobreza, foi inaugurada a barragem do Poilão, a primeira do arquipélago, no interior da ilha de Santiago no concelho de São Lourenço dos Órgãos. Baseado no pressuposto que as barragens são estruturas de grande impacte ambiental e socioeconómico, antes, durante e depois da sua construção, o presente trabalho tem como objetivo principal avaliar o desempenho ambiental, socioeconómico e cultural da Barragem de Poilão. Para tal, o trabalho segue uma metodologia DPSIR1e a aplicação de inquéritos e entrevistas, procurando integrar o conhecimento e a perceção da paisagem na área de influência da albufeira por parte de diversos atores locais. Espera-se colher subsídios que sirvam de base para os estudos futuros das demais barragens projetadas e a serem construídas em Cabo Verde.

Ageing with HIV: medication use and risk for potential drug-drug interactions.

OBJECTIVES: To compare the use of co-medication, the potential drug-drug interactions (PDDIs) and the effect on antiretroviral therapy (ART) tolerability and efficacy in HIV-infected individuals according to age, ≥ 50 years or <50 years. METHODS: All ART-treated participants were prospectively included once during a follow-up visit of the Swiss HIV Cohort Study. Information on any current medication was obtained by participant self-report and medical prescription history. The complete treatment was subsequently screened for PDDIs using a customized version of the Liverpool drug interaction database. RESULTS: Drug prescriptions were analysed for 1497 HIV-infected individuals: 477 age ≥ 50 and 1020 age <50. Older patients were more likely to receive one or more co-medications compared with younger patients (82% versus 61%; P < 0.001) and thus had more frequent PDDIs (51% versus 35%; P < 0.001). Furthermore, older patients tended to use a higher number of co-medications and certain therapeutic drug classes more often, such as cardiovascular drugs (53% versus 19%; P < 0.001), gastrointestinal medications (10% versus 6%; P = 0.004) and hormonal agents (6% versus 3%; P = 0.04). PDDIs with ART occurred mainly with cardiovascular drugs (27%), CNS agents (22%) and methadone (6%) in older patients and with CNS agents (27%), methadone (15%) and cardiovascular drugs (11%) in younger patients. The response to ART did not differ between the two groups. CONCLUSIONS: The risk for PDDIs with ART increased in older patients who take more drugs than their younger HIV-infected counterparts. However, medication use in older and younger patients did not differ in terms of effect on antiretroviral tolerability and response.

Performance of mechanical ventilators at the patient's home: a multicentric quality control study

Background: Quality control procedures vary considerably among the providers of equipment for home mechanical ventilation (HMV). Methods: A multicentre quality control survey of HMV was performed at the home of 300 patients included in the HMV programmes of four hospitals in Barcelona. It consisted of three steps: (1) the prescribed ventilation settings, the actual settings in the ventilator control panel, and the actual performance of the ventilator measured at home were compared; (2) the different ventilator alarms were tested; and (3) the effect of differences between the prescribed settings and the actual performance of the ventilator on non-programmed readmissions of the patient was determined. Results: Considerable differences were found between actual, set, and prescribed values of ventilator variables; these differences were similar in volume and pressure preset ventilators. The percentage of patients with a discrepancy between the prescribed and actual measured main ventilator variable (minute ventilation or inspiratory pressure) of more than 20% and 30% was 13% and 4%, respectively. The number of ventilators with built in alarms for power off, disconnection, or obstruction was 225, 280 and 157, respectively. These alarms did not work in two (0.9%), 52 (18.6%) and eight (5.1%) ventilators, respectively. The number of non-programmed hospital readmissions in the year before the study did not correlate with the index of ventilator error. Conclusions: This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation.

The effects of electron-hole separation on the photoconductivity of individual metal oxide nanowires

The responses of individual ZnO nanowires to UV light demonstrate that the persistent photoconductivity (PPC) state is directly related to the electron¿hole separation near the surface. Our results demonstrate that the electrical transport in these nanomaterials is influenced by the surface in two different ways. On the one hand, the effective mobility and the density of free carriers are determined by recombination mechanisms assisted by the oxidizing molecules in air. This phenomenon can also be blocked by surface passivation. On the other hand, the surface built-in potential separates the photogenerated electron¿hole pairs and accumulates holes at the surface. After illumination, the charge separation makes the electron¿hole recombination difficult and originates PPC. This effect is quickly reverted after increasing either the probing current (self-heating by Joule dissipation) or the oxygen content in air (favouring the surface recombination mechanisms). The model for PPC in individual nanowires presented here illustrates the intrinsic potential of metal oxide nanowires to develop optoelectronic devices or optochemical sensors with better and new performances.

Direct modulation of electroluminescence from silicon nanocrystals beyond radiative recombination rates

We propose a light emitting transistor based on silicon nanocrystals provided with 200 Mbits/ s built-in modulation. Suppression of electroluminescence from silicon nanocrystals embedded into the gate oxide of a field effect transistor is achieved by fast Auger quenching. In this process, a modulating drain signal causes heating of carriers in the channel and facilitates the charge injection into the nanocrystals. This excess of charge enables fast nonradiative processes that are used to obtain 100% modulation depths at modulating voltages of 1 V.

Measurement of Pavement Surface Variations, July 1974

The measurement of pavement roughness has been the concern of highway engineers for more than 70 years. This roughness is referred to as "riding quality" by the traveling public. Pavement roughness evaluating devices have attempted to place either a graphical or numerical value on the public's riding comfort or discomfort. Early graphical roughness recorders had many different designs. In 1900 an instrument called the "Viagraph" was developed by an Irish engineer.' The "Viagraph" consisted of a twelve foot board with graphical recorder drawn over the pavement. The "Profilometer" built in Illinois in 1922 was much more impressive. ' The instrument's recorder was mounted on a frame supported by 32 bicycle wheels mounted in tandem. Many other variations of profilometers with recorders were built but most were difficult to handle and could not secure uniformly reproducible results. The Bureau of Public Roads (BPR) Road Roughness Indicator b u i l t in 1941 is the most widely used numerical roughness recorder.' The BPR Road Roughness Indicator consists of a trailer unit with carefully selected springs, means of dampening, and balanced wheel.

Evaluation of 1977 Asphalt Concrete Sprinkle Treatments, December 1980

Iowa's first sprinkle treatment in 1974 was applied to a short section of old US 30 west of Ames. A roll type seal coat spreader was used to apply several types of sprinkle aggregates. The following year a spinner type tailgate spreader was used for sprinkle application of an Iowa 7 project in Webster County. Uniform spreading and tire marks were problems in these early projects. A special spinner spreader was built in 1976 and mounted on a truck specially equipped with smooth tires. This special unit was tested in early 1977 on a project that had been scheduled for 1976. Spinner type spreaders proved unacceptable due to non-uniformity of spreading.

The Iowa State Capitol Grounds 1913 Extension and Reconstruction Project, October 2012

The Capitol grounds have been evolving through planned and unplanned actions for more than 150 years. The 1857 Constitutio established Des Moines as the capital. The commissioners appointed to choose a site decided on land donated by Wilson Alexander Scott and Harrison Lyon. Located on the east side of the Des Moines River, on a gently rising hill, the site for the Iowa State Capitol began with fewer than 10 acres. The Old Brick Capitol was built in the center of that 10-acre plot, and the area to the north was used as a public park until work began on the present day Capitol. In 1884, the two-year process of moving from the Old Brick Capitol to the new Capitol began. The state commissioned John Weidenman to design the first formal decoration of the grounds. Weidenman’s plans for the west approach to the Capitol included planting statues, and walkways. The State held some additional land but not necessarily land adjacent to the Capitol. In 1909, legislation was passed, and in 1913, the Thirty-Fifth General Assembly enacted controversial legislation to acquire additional land. A commission was formed to locate a purposed monument honoring the long-serving U.S. Senator William B. Allison. E.L. Masqueray was hired as the architect expert focusing on the selection of a proper site for the proposed Allison Memorial. Masqueray’s plan detailed the placement of buildings and potential monuments. Growth of the Capitol Complex, as known today, began.

A benchmark test for a quantitative assessment of simple neuron models

Several methods and algorithms have recently been proposed that allow for the systematic evaluation of simple neuron models from intracellular or extracellular recordings. Models built in this way generate good quantitative predictions of the future activity of neurons under temporally structured current injection. It is, however, difficult to compare the advantages of various models and algorithms since each model is designed for a different set of data. Here, we report about one of the first attempts to establish a benchmark test that permits a systematic comparison of methods and performances in predicting the activity of rat cortical pyramidal neurons. We present early submissions to the benchmark test and discuss implications for the design of future tests and simple neurons models

Thin Bonded Overlay Evaluation, Construction Report, HR-559, 1999

In recent years, ultra-thin whitetopping (UTW) has evolved as a viable rehabilitation technique for deteriorated asphalt cement concrete (ACC) pavement. Numerous UTW projects have been constructed and tested, enabling researchers to identify key elements contributing to their successful performance. These elements include foundation support, the interface bonding condition, portland cement concrete (PCC) overlay thickness, synthetic fiber reinforcement usage, joint spacing, and joint sealing. The interface bonding condition is the most important of these elements. It enables the pavement to act as a composite structure, thus reducing tensile stresses and allowing an ultra-thin PCC overlay to perform as intended. Although the main factors affecting UTW performance have been identified in previous research, neither the impact that external variables have on the elements nor the element interaction have been thoroughly investigated. The objective of this research was to investigate the interface bonding condition between an ultra-thin PCC overlay and an ACC base over time, considering the previously mentioned variables. Laboratory testing and full scale field testing were planned to accomplish the research objective. Laboratory testing involved monitoring interface strains in fabricated PCC/ACC composite test beams subjected to either static or dynamic flexural loading. Variables investigated included ACC surface preparation, PCC thickness, and synthetic fiber reinforcement usage. Field testing involved monitoring PCC/ACC interface stains and temperatures, falling weight deflectometer (FWD) deflection responses, direct shear strengths, and distresses on a 7.2 mile Iowa Department of Transportation (Iowa DOT) UTW project (HR-559). The project was located on Iowa Highway 21 between Iowa Highway 212 and U.S. Highway 6 in Iowa County, near Belle Plaine, Iowa. Variables investigated included ACC surface preparation, PCC thickness, synthetic fiber reinforcement usage, joint spacing, and joint sealing. This report documents the planning, equipment selection, and construction of the project built in 1994.