Significant progress has been made to realize optically controlled phase correction micro-mirror arrays. The devices consist of silicon nitride spring plate mirrors optically actuated by integrated ...GaAs P-I-N photodetectors wafer bonded on a GaP platform.
We propose a hierarchical simulation methodology to assist application development on System-on-Chip architectures. Hierarchical simulation involves simulation of a SoC based system at different ...levels of abstraction. Thus, it enables a system designer to exploit simulation speed vs. accuracy of results trade-offs. Vertical simulation is a special case of hierarchical simulation, where a feedback mechanism between the different simulation levels helps in "interpreting" the results of stand-alone simulations in the system-wide context. The paper presents an approach to perform vertical simulation of a class of applications under a simplified scenario.
Oral pre-exposure prophylaxis (PrEP) has the potential to reduce HIV acquisition among adolescent girls and young women (AGYW) in sub-Saharan Africa. However, health care providers' (HCPs) ...perspectives and interactions with potential clients can substantially influence effective provision of quality health services. We examine if HCPs' knowledge, attitude, and skills, as well as their perceptions of facility readiness to provide PrEP are associated with their willingness to provide PrEP to AGYW at high risk of HIV in Tanzania.
A self-administered questionnaire was given to 316 HCPs from 74 clinics in two districts and 24 HCPs participated in follow-up in-depth interviews (IDIs). We conducted bivariate and multivariable Poisson regression to assess factors associated with willingness to provide PrEP to AGYW. Thematic content analysis was used to analyze the IDIs, which expanded upon the quantitative results.
Few HCPs (3.5%) had prior PrEP knowledge, but once informed, 61.1% were willing to prescribe PrEP to AGYW. Higher negative attitudes toward adolescent sexuality and greater concerns about behavioral disinhibition due to PrEP use were associated with lower willingness to prescribe PrEP. Qualitatively, HCPs acknowledged that biases, rooted in cultural norms, often result in stigmatizing and discriminatory care toward AGYW, a potential barrier for PrEP provision. However, better training to provide HIV services was associated with greater willingness to prescribe PrEP. Conversely, HCPs feared the potential negative impact of PrEP on the provision of existing HIV services (e.g., overburdened staff), and suggested the integration of PrEP into non-HIV services and the use of paramedical professionals to facilitate PrEP provision.
Preparing for PrEP introduction requires more than solely training HCPs on the clinical aspects of providing PrEP. It requires a two-pronged strategy: addressing HCPs' biases regarding sexual health services to AGYW; and preparing the health system infrastructure for the introduction of PrEP.
•We collected the measured data for an office building with radiant cooling system.•Used EnergyPlus to model the whole building energy performance.•Calibrated the model using measured HVAC energy ...consumption data.•CFD simulation was performed to evaluate the temperature distribution.•The radiant system with DOAS showed 30% savings over conventional all air system.
The paper describes a study developed to estimate the energy savings potential of a radiant cooling system installed in a commercial building in India. To evaluate thermal performance and energy consumption, simulations were carried out using FLUENT and EnergyPlus software, respectively. The building model was calibrated using the measured data for the installed radiant system. Then this calibrated model was used to simulate the energy consumption of a building using a conventional all-air system to determine the proportional energy savings. For proper handling of the latent load, a Dedicated Outside Air System (DOAS) was used as an alternative to Fan Coil Unit (FCU) that was installed in conjunction with the radiant cooling system. A comparison of energy consumption calculated that the radiant system was 17.5% more efficient than a conventional all-air system and that a 30% savings was achieved by using a DOAS system compared with a conventional system. The Computational Fluid Dynamics (CFD) simulation showed that a radiant system offers more uniform temperatures, as well as a better mean air temperature range, than a conventional system. To further enhance the energy savings in the radiant system, different operational strategies were analyzed based on thermal analysis using EnergyPlus.
Dissociative disorder patients often present with sudden and embarrassing symptoms, and it is difficult for the patient and care giver to understand initially, recognize the need for help and reach ...for appropriate treatment timely. This can result in high risk of engaging in dangerous behaviors such as self-harm and suicidal acts, impaired global functioning, and poor quality of life. Knowledge about the types of barriers which are there in treatment seeking, can help in planning strategies for their removal and to facilitate the treatment process.
Cross-sectional study among patients (n=133) with Dissociative disorders which were recruited from January 2023 to June 2023 in a tertiary care hospital. Pathways to care and barriers in treatment for Dissociative disorders were assessed by interviewing patients using semi-structured proforma. The Dissociative Experience Scale and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)) were used to assess disease severity and impact of illness on various domains of life respectively. Group comparison was made to assess differences in social- clinical profile of patients choosing different modalities of treatment.
133 patients of Dissociative disorders with mean age 29.6±9.2, showed their first-choice of help seeking from general practitioner/ neurologist (40.6%), traditional faith healers (35.3%), psychiatrist (18.1%) and 5.2% preferred alternative treatments. This trend changed with 2nd and 3rd contact of help seeking with greater preference for psychiatrist in their 2nd (n=45, 33.8%) and 3rd (n=69, 51.8%) contact. The median duration of untreated illness was 56 weeks (IQR 24–182 weeks). Social-clinical profile of patients varied with their choice of treatment, having lower education level (P = 0.013), longer duration of untreated illness (p=0.003), more severity of symptoms (p=0.032) and greater disability scores(p=0.002) in patients whose first treatment choice was traditional faith healers. More than 70% patients faced availability barriers, stigma, unawareness about mental illness and influence of others in treatment of choice as barriers in initiating and continuing treatment.
Patients with Dissociative disorders seek treatment from a multitude of healthcare providers including traditional faith healers, general physicians, and alternative medicine practitioners before reaching psychiatrist and undergoes various barriers in treatment. There is need to implement necessary measures for sensitization and awareness about Dissociative disorders to prevent prolonged and undue delays in initiation of appropriate management.
•Pathways to care in Dissociative disorders (DDs) patients reflected patient’s first-choice treatment was psychiatrist only in 18.1% cases. This shows lack of awareness of people about presentation and management of DDs.•There was change in trend with 2nd and 3rd contact of help seeking and a greater number of patients reached psychiatrist in their 2nd and 3rd contact.•Socio-clinical profile of patients showed that patients whose first treatment choice was traditional faith healers were having lower education level, longer duration of untreated illness, more severity of symptoms and greater disability scores.•Majority of patients faced availability barriers, stigma, unawareness about mental illness and influence of others in treatment of choice as barriers in initiating and continuing treatment.
Anaplastic thyroid carcinoma is a rare and a very aggressive thyroid malignancy with a dismal prognosis. It has a short history and presents with a rapidly increasing neck mass associated with ...compressive symptoms like pain, hoarseness of voice, dysphagia and shortness of breath. Osteoclastic variant is an extremely rare variant, which is, characterize by presence of a large number of multinucleated giant cells, which resemble osteoclasts. Here we report two cases of this unusual variant in a 68 years old and 49 years old male with a short history of thyroid swelling.
•Water withdrawals and consumption for electricity generation in India are analyzed.•Five modeling teams tested several scenarios for water use through 2050.•Effects of cooling technologies and water ...saving policies are analyzed.
This paper provides projections of water withdrawals and consumption for electricity generation in India through 2050. Based on the results from five energy-economic modeling teams, the paper explores the implications of economic growth, power plant cooling policies, and electricity CO2 emissions reductions on water withdrawals and consumption. To understand how different modeling approaches derive different results for energy-water interactions, the five teams used harmonized assumptions regarding economic and population growth, the distribution of power plants by cooling technologies, and withdrawals and consumption intensities. The multi-model study provides robust results regarding the different but potentially complementary implications of cooling technology policies and efforts to reduce CO2 emissions. The water implications of CO2 emissions reductions depend critically on the approach to these reductions. Focusing on wind and solar power reduces consumption and withdrawals, a focus on nuclear power increases both, and a focus on hydroelectric power could increase consumptive losses through evaporation. Policies focused specifically on cooling water can have substantial and complementary impacts.
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