Meaning 'New Beginning' Ata Rangi is a small New Zealand winery with a big reputation for its Pinot Noir. Located in Martinborough at the south end of the North Island they have been making some of the country's finest wines since 1980. This second wine in their Pinot Noir range is named Crimson after New Zealands's native 'Christmas Trees' the rata and pohutukawa trees. Sales of this wine support Project Crimson, a charitable conservation trust which plants and protects these trees.
The 2014 Crimson reflects the relaxed harvest with its enticing nose, a medley of bright red fruits, cranberry, rosehip, loganberry and a note of spicy red liquorice. The palate is divinely silky with tannins that are velvety and long. Already this wine shows great balance and seductiveness, the hallmark of 2014.
Winemaking: The grapes were hand picked and 100% destemmed, keeping as much whole berry fruit as possible. Pre-fermentation maceration lasted between two and six days. The must was inoculated with indigenous yeasts and hand plunged during fermentation that lasted approximately two weeks. The wine was racked into barrel, of which 20% was new oak, where it remained for a further nine months after malolactic fermentation until bottling in February 2015.


text:
Salena Elish
Ann Kessler
Lee Orchard
A Broad View
Life in Balance
On Her Toes
Regional Recognition
36-hour B.A. in Theatre
Minors in Theatre
Theatre Colloquium
Box Office Auditions
The theatre department facilities are a workshop for actors, costumers, stagehands, and directors.
The theatre department facilities are located in the Center for the Arts, which was dedicated in September 1995, and in Kroencke Hall, which served for many years as the only theatre on campus. All theatre spaces have been designed to serve as teaching studios and laboratories. In every case, the interests of students — learning to do and make theatre — were given highest priority.
Each environment, including the rehearsal spaces, scene shop, costume shop, control booth, and dressing rooms, serves as a studio for the teaching of theatrical techniques. The theatre department is committed to teaching students using the most advanced methodology and technology. In addition, theatre faculty offices are located near the instructional spaces to support close working relationships between faculty and students.
The University Theatre
Studio Theatre
Kroencke Hall Dance Studio
Control Booths
The University Theatre is a 275-seat facility that offers a spacious stage area for performers and designers to exercise their imaginations while maintaining a highly intimate relationship between actor and audience. Under the gently curved stage apron is a 25-seat orchestra pit equipped with a full-trapped mainstage and double-decked side stages for environmental staging. This theatre is supported by two fully equipped control booths and an extensive catwalk lighting system and serves as the venue for most of the theatre department's major productions.
The Studio Theatre is a 40'x 40′ "black box" with its own state-of-the-art lighting and sound systems. A technical operations center opens out into an overhead gallery that may also be used for staging. The space is highly flexible and can accommodate arena, thrust, traverse, endstage, and environmental theatre arrangements for between 80-100 patrons. Each year, this venue holds faculty-directed mainstage productions, student-directed showcases, and experimental projects.
Formerly the campus theatre, Kroencke Hall is now the principal laboratory for acting and dance classes. Its transformation was completed with a newly installed sprung dance floor and mirrors along the entire east wall. The studio's footprint is almost exactly the dimensions of the University Theatre and therefore also serves when needed as a rehearsal hall for mainstage productions.
Directly adjacent to the University Theatre stage floor, the scene shop provides facilities for constructing scenery for all departmental productions throughout the year. Stagecraft students learn to work with wood, steel, and a variety of imaginative materials to create highly innovative environments representing a wide range of theatrical styles.
The scene shop employs up to 10 students per semester. With its great window and wonderful natural lighting, it is a pleasant and efficient place to work.
Located in the Center for the Arts, the Costume Shop is where costumes for theatre productions, musicals, operas, and dance are created. Costume assistants work alongside the costume shop supervisor on the construction, alteration, and maintenance of costumes and accessories for the theatre season. Features of the costume shop include: north-facing windows that allow an abundance of natural light into the space, domestic and industrial sewing machines, a dye vat, laundry facilities, and a crafts space.
Designed to accommodate as many as 20 performers each, the dressing rooms are fully equipped with shower and restrooms as well. The theatre department's makeup classes are also taught here, which allows students to learn the craft and later practice it in the same environment.
Located next to the dressing/makeup rooms, the spacious lounge, solely dedicated to theatre students, provides a welcoming place for students to study or relax and also serves as the central meeting room for Alpha Psi Omega, the National Theatre Honor Society. It is equipped with comfortable furniture, study space, student lockers and mailboxes, a theatre/script library, a microwave, and a refrigerator.
The theatre department is committed to teaching students using the latest technology. The University Theatre is equipped with a large technical gallery for the operation of lighting and soundboards and a stage manager's booth for calling cues. Likewise, the Studio Theatre is equipped with its own technical gallery, lighting and soundboards, and stage manager's station. Sound and lighting control in both theatres are fully computerized. Equipment is new and state-of-the-art.
The Center for the Arts functions as a working laboratory for artistic expression. The facility offers a wide range of opportunities for students in music and theatre, including performance, technical operations, recording, set construction, and more. The Center for the Arts is also home to the ceramic studio, a graphic design computer lab, digital photo and video facilities, color and black-and-white photo labs, and other resources. Learn more »

redpajama_set_name: RedPajamaCommonCrawl


text:
Prevalence of metabolic syndrome among HIV-positive and HIV-negative populations in sub-Saharan Africa—a systematic review and meta-analysis
Olamide O. Todowede ORCID: orcid.org/0000-0002-5785-14261,
Solange Z. Mianda1 &
Benn Sartorius1,2
Systematic Reviews volume 8, Article number: 4 (2019) Cite this article
Metabolic syndrome (MetS) is a constellation of conditions that increase the risk of cardiovascular diseases. It is an emerging concern in sub-Saharan African (SSA) countries, particularly because of an increasingly aging population and lifestyle changes. There is an increased risk of MetS and its components among people living with Human immune deficiency syndrome (HIV) individuals; however, the prevalence of metabolic syndrome in the SSA population and its differential contribution by HIV status is not yet established. This systematic review and meta-analysis were conducted to estimate the pooled prevalence of metabolic syndrome in people living with HIV and uninfected populations, its variation by sub-components.
We performed a comprehensive search on major databases—MEDLINE (PubMed), EBSCOhost, and Cochrane Database of Systematic Reviews and Web of sciences for original epidemiological research articles that compared proportions of the MetS and its subcomponents between people living with HIV and uninfected patients and published between January 1990–December 2017. The inclusion criteria were adults aged ≥ 18 years, with confirmed HIV status. We assessed the risk of bias using a prevalence studies tool, and random effect meta-analyses were used to compute the pooled overall prevalence.
A total of four cross-sectional studies comprising 496 HIV uninfected and 731 infected participants were included in the meta-analysis. The overall prevalence of MetS among people living with HIV was 21.5% (95% CI 15.09–26.86) versus uninfected 12.0% (95% CI 5.00–21.00%), with substantial heterogeneity. The reported relative risk estimate for MetS among the two groups was twofold (RR 1.83, 95% CI 0.98–3.41), with an estimated predictive interval of 0.15 to 22.43 and P = 0.055 higher for the infected population. Hypertension was the most prevalent MetS sub-components, with diverse proportions of people living with HIV (5.2–50.0%) and uninfected (10.0–59.0%) populations.
The high range of MetS prevalence in the HIV-infected population compared to the uninfected population highlights the possible presence of HIV related drivers of MetS. Also, the reported high rate of MetS, irrespective of HIV status, indicates a major metabolic disorder epidemic that requires urgent prevention and management programs in SSA. Similarly, in the era of universal test and treat strategy among people living with HIV cohorts, routine check-up of MetS sub-components is required in HIV management as biomarkers.
The problem of metabolic syndrome (MetS) has been the main scourge of high mortality and morbidity [1]. Globally, the prevalence of metabolic syndrome (MetS) is unknown [2], and country-specific prevalence varies with estimated prevalences in excess of 25.0% in developed countries [3,4,5]. In sub-Saharan Africa (SSA), the prevalence of metabolic syndrome is not well established. The growing burden of the global metabolic disorder is occurring at a time when SSA is experiencing an epidemiological transition, whereby the continent is affected by the dual burden of infectious and non-communicable diseases [6]. Further, SSA remains the worst affected region globally with over 25 million people living with HIV [7]. The coexistence of infectious diseases and non-communicable diseases is well documented in developed countries, and the intensity of this comorbidity is incomparable in SSA [8].
The global response to HIV has averted 30 million new infections and nearly 8 million AIDS-related deaths, as a result of antiretroviral therapy (ART) uptake [9]. This has resulted in an aging population of people living with HIV, living longer on ART and at greater risk of chronic diseases and metabolic disorders [10, 11]. While the global focus is on preventing and managing HIV infections, less attention is on the metabolic impact of HIV infection and treatment on infected individuals. The global pooled prevalence of metabolic risk factors among people living with HIV range from 16.7 to 31.3% [12].
Increased risk of MetS and its subcomponents among people living with HIV individuals is well documented and attributed to HIV infection, antiretroviral therapy, and other related factors [13, 14]. Of which is similar to the burden of MetS risk in the general population, as a result of associated modifiable risk factors [15, 16]. However, little is known about the pooled prevalence of MetS and the prevalence difference among people living with HIV and uninfected population in SSA. Studies from developed countries predominantly report MetS among HIV-positive cohorts than in negative counterparts [15,16,17]. Studies suggest that MetS outcomes are much lower among people living with HIV compared to the general population, but ART-treated patients have a higher risk of metabolic complication [18]. Whether this risk is more or less among people infected with HIV compared to uninfected population remains controversial. This systematic review and meta-analysis was conducted to understand the burden of metabolic syndrome and its subcomponents among people living with HIV and uninfected population in SSA.
Outcome of interest
The primary outcome of this study was to compare the pooled prevalence of metabolic syndrome among people living with HIV and uninfected populations in SSA. The secondary aim was to compare metabolic syndrome subcomponents (namely visceral obesity, hypertension, diabetes, triglycerides, HDL cholesterol) among people living with HIV and uninfected populations in SSA.
Protocol and registration
A study protocol (published) was developed prior to the conduct of this review [19]. The protocol was registered in the PROSPERO international prospective register of systematic reviews (CRD42016045727). The protocol was amended by removing the aspect of co-morbid diabetes and hypertension components. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed [20, 21].
All studies (randomized control trials, cross-sectional, case-control, and cohort studies) among adults (18+) published from January 1990–December 2017 reporting the prevalence of metabolic syndrome and its subcomponents in people living with HIV and/or uninfected populations were considered for inclusion. We excluded studies that presented estimates from study participants with unknown HIV status. The full inclusion and exclusion criteria are presented in the aforementioned published protocol [19].
Search strategy and selection process
MEDLINE (PubMed), EBSCOhost, and Cochrane Database of Systematic Reviews and Web of sciences databases were searched for papers published between January 1990 and December 2017. The search terms used a combination of relevant medical subject headings (MeSH) and database specific terms with an African search filter. The search strategy and the number of returned items are presented in Appendix 1 and 2. The reference lists of identified articles were traced through a web of science, and conference proceedings checked using the International AIDS society abstract archives. The titles of retrieved articles were examined to exclude ineligible articles. Given a large number of Francophile countries in SSA, this review included eligible studies published in French and were reviewed by a French-speaking reviewer (SM). The selection of studies was a multistep process with two reviewers (OO, SM) independently screening the abstract and full text for potential eligibility using the inclusion criteria, and discrepancies were resolved through arbitration with a third reviewer (BS). The flow diagram of the study selection and exclusion process is presented in Fig. 1. The interrater agreement for abstract and full-text screening was high at 90% and 100% respectively.
PRISMA flow diagram of study selection process
Assessment of the methodological quality and risk of bias of included studies
The methodological quality and risk of bias of selected articles were assessed using the Effective Public Health Practice Project/McMaster Evidence Review and Synthesis Centre Tool: Quality Assessment Tool for Quantitative Studies [22], and the risk of bias tool for prevalence studies [23]. A multistep process approach was employed by two reviewers (OO, SM), and the interrater agreement on quality and risk of bias were 80% and 90% respectively. A summary of the areas considered in the assessment of each domain is included in Appendix 1 and 2—the risk of bias and quality assessment of included studies.
Data item and collection process
Abstraction of meta-data from the included articles was performed using a specifically designed Google form, by two reviewers (OO and SM) independently. Information extracted included publication details, population sampled and sample size, metabolic prevalence estimates, participant's characteristics, and HIV status. Prevalence figures and 95% confidence intervals (CIs) were extracted or calculated from the available data using the Clopper-Pearson method [24]. Certain authors were contacted for clarifications and/or further data requests, and if contacted three times and no response, the article concerned was removed from the included studies.
Data were analyzed using Stata 13.0 (StataCorp. 2013. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP). Heterogeneity between study estimates was assessed using the I2 statistic, i.e., the percentage of variation not due to sampling error across studies. An I2 value above 50% indicates high heterogeneity. The meta-weighted prevalence (95% confidence interval (CI)) of metabolic syndrome among HIV-positive and HIV-negative populations was undertaken using a random effects model (to account for heterogeneity). For the studies with both HIV-positive and control HIV-negative population, we estimated a meta-weighted relative risk using a random effects approach. The influence of the estimates for all included studies was assessed by the level of risk of bias, quality of the study, study settings, and data collection methods. The risk of bias and study quality were classified as either low, moderate, or high, and we performed the Egger test (in addition to funnel plot for the HIV-positive only meta-analysis) to assess for potential publication/small-study bias. The association between HIV infection and MetS was estimated directly using the "metan" function in STATA, where the default is RR, i.e., pooled risk ratio. We also check for influential outlying studies using a random effects variance shift outlier model (RVSOM) for detecting and accommodating outliers in a meta-analysis [25].
In a meta-analysis of prevalence, when the estimate for a given study tends towards either 0.0% or 100.0%, the variance for that study moves towards zero, and as a result, its relative weight may be overestimated [26]. Thus, we transformed the prevalence estimates using the double arcsine method to correct for this potential discontinuity [26, 27]. For data analysis, we merged the estimates of people living with HIV population by ATP III, IDF, JIS, and WHO definitions criteria (average prevalence across those with multiple definitions). The final pooled meta-estimates and 95% CIs were back-transformed for ease of interpretation. We were unable to stratify prevalence estimates by age, sex, and location with sufficient power, due to the limited number of studies (four) that compared estimates between HIV-negative and HIV-positive and resultant sample sizes.
Included studies search process
Our search returned a total of 10,577 publications, and the titles were screened for eligibility and duplicates were removed. A total of 125 articles were eligible for abstracts screening. Based on the abstract screening, 94 articles were eligible for full-text screening and 31 articles were excluded. Among the 94 articles that were reviewed full-text, 18 articles met the inclusion criteria, contained or allowed the estimation of MetS prevalence estimates, and were selected for inclusion in this review [28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45].
Characteristics of included studies
Study participation
The characteristics of the included studies are summarized in Table 1. Of the 18 studies included in this review, 4 studies [33, 35, 38, 40] compared the prevalence of MetS among people living with HIV and uninfected populations while the other 14 presented MetS prevalence estimates among people living with HIV subjects only [28,29,30,31,32, 34, 36, 37, 39, 41,42,43,44,45].
Table 1 Characteristics of included studies
Study breakdown from the three regions of sub-Saharan Africa were as follows: West Africa, 11; Southern Africa, 3, and Eastern Africa, 4. By countries, the distribution of studies were as follows: Nigeria, 3 [32, 33, 45]; Benin Republic, 2 [28, 44]; Burkina Faso, 2 [31, 43]; Cameroon, 2 [38, 40]; Ghana, 1 [41]; Ivory Coast, 1 [30]; South Africa, 3 [29, 35, 37]; Uganda, 1 [39]; and three studies from Ethiopia [34, 36, 42]. Of the four studies that presented estimates by HIV status, two were in Cameroon and one was in Nigeria and South Africa respectively Fig. 2.
Map of Africa indicating the regions where the included studies were situated
Most of the studies (16 studies) were cross-sectionally designed [28, 29, 31,32,33,34, 36,37,38,39,40,41,42,43,44,45], with one randomized control trial and case-control study respectively [30, 35]. Most of the studies were hospital-based (16) with only two that were community-based. More than half (10 studies) were published after 2015–2016, and two studies were published in French [43, 44].
In the "Methods" section of the included studies, the projected sample sizes were bigger than the actual number of participants analyzed and reported. The number of participants presented in the studies analysis ranged between 50 to 300 HIV-negative participants and 79 to 755 participants in people living with HIV. About 25% of the total study participant's samples were men, and the age of participants ranged from 18 to 70 years. In the 12 studies with data on the duration of ART, the duration ranged from 3 to 92 months.
The included studies applied various international criteria to diagnose MetS. Six studies defined metabolic syndrome using the International Diabetes Foundation (IDF 2005) criteria, four studies used the Third Report of the National Cholesterol Education Program and Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (NCEP/ATP III) criteria, while four studies presented both NCEP/ATP III and IDF 2005 criteria. One study employed the IDF 2005, NCEP/ATP III, and JIS criteria and another with the IDF 2005, NCEP/ATP III, and WHO criteria. Two of the included studies did not clearly specify the definition employed. The included studies reported a variety of metabolic syndrome subcomponent [28, 30,31,32,33,34,35,36,37,38,39,40, 42,43,44,45] as described in Table 2.
Table 2 Qualitative description of metabolic syndrome subcomponents prevalence within included studies
A summary of the risk of bias of the included articles is shown in Appendix 1 and 2. Sixteen studies (88%) were considered to be at low risk of bias while the remaining two studies were classified as medium risk of bias. None of the studies was classified as high risk of bias. The major risks of bias were the lack of presentation of the representativeness of the study sample in relation to the broader target population (n = 8 studies, 44%) and the lack of specification of a random selection of subjects (n = 11 studies, 61%).
A summary of the quality assessment of the included studies shows that half of the studies (n = 9, 50%) were considered to be of low quality, six studies were considered to be of medium quality, and three studies were considered to be of high quality. Most of the studies were cross-sectional in design, and this was deemed the weakest identified quality domain during our assessment due to the associated temporality bias.
Outcome measurement
The MetS prevalence estimates (Table 3) for the included studies ranged from the highest observed in south-western Uganda (145/250; 58.0%) [39] to the lowest in Abidjan (47/755; 6.23%) among people living with HIV populations [30]. Similarly, the prevalence estimates among HIV-uninfected population ranged from lowest in Nigeria (1/50; 2.0%) [33] to the highest in South Africa (68/300; 22.6%) [35]. The prevalence rate of the sub-components varies by presentation in the included studies (Table 4). Fourteen (77.8%) and 3 (75.0%) studies reported hypertension prevalence among people living with HIV and uninfected study participants respectively. Diabetes was reported among the 4 (100.0%) HIV-uninfected focused studies, while 15 (83.3%) infected population studies. High triglycerides were reported in 12 (67.0%) studies among infected population while 1 (25.0%) uninfected population study. Visceral obesity prevalence was presented in 7 (39.0%) studies among infected cohorts, and 2 (50.0%) studies reported it among uninfected cohorts. Similarly, 7 (39.0%) studies among the infected participants reported low HDL cholesterol as against 1 (25.0%) study in the uninfected cohorts.
Table 3 Prevalence of MetS by definition
Sex variation
Seven studies [28, 31, 32, 34, 36, 37, 39] presented estimates of MetS stratified by sex among people living with HIV subjects. The prevalence estimates in males ranged from (6/95; 6.3%) [32] in Nigeria to (41/81; 50.6%) [39] in Uganda using ATP III definition. Similarly, the estimated prevalence using IDF definition among males ranged from (1/38; 3.1%) [28] in Benin to (8/93;14.9%) [31] in Burkina Faso. Among females, MetS estimate ranged from (9/38; 19.2% [28] and 46/207; 85.1% [31]) to (15/171; 8.9% [37] and 104/169; 61.5% [39]) using IDF and ATPIII definition respectively.
Notable, MetS were shown to be consistently more prevalent in female than male across the two criteria. There is a relative estimate of 12.7% was among the female against 3.6% using IDF criteria, and ATP III definition estimated MetS prevalence at 19.7% among females and 15.7% in males respectively. The sex variation in MetS prevalence among HIV-negative cohort could not be ascertained because it was not reported.
Meta-weighted prevalence of MetS
The meta-prevalence of MetS measured among people living with HIV subjects irrespective of the MetS definition employed was 21.5% (95% CI 16.09–26.86%)—Fig. 3. The prevalence of MetS among HIV-positive population measured by IDF was higher than those measured by the ATP III definition at 25.7% (95% CI 16.62–34.79%) versus 19.9% (95% CI 12.26–27.45). Similarly, the meta-prevalence of the MetS in HIV-negative subjects in this review was 12.0% (95% CI 5–21%). The overall relative risk of MetS prevalence among people living with HIV population compared with HIV-uninfected population was 1.83 (95% CI 0.99–3.41), with an estimated predictive interval of (0.15 to 22.43) P value = 0.055—Fig. 4.
Forest plot of the prevalence of metabolic syndrome in studies on HIV-positive subjects
Forest plot of the prevalence ratios of metabolic syndrome comparing HIV-positive to HIV-negative subjects
Publication bias
A funnel plot assessing the pooled prevalence of metabolic syndrome among people living with HIV populations suggested a weak publication bias among the included studies. Egger test results (P = 0.271) did not indicate significant small study effect bias when considering HIV-positive studies. Also, a random effects variance shift outlier model analysis suggested that the Muyanja et al. [39] study was a prominent and influential outlier in our study. Thus, further meta-regression analysis to identify the source of heterogeneity was performed and also suggests that risk of bias score and year were potential sources of heterogeneity. However, a meta-regression model including year and risk of bias score and excluding the aforementioned influential outlier study only reduced the adjusted I2 to ~ 65%. Hence, there was still a large residual heterogeneity which is a potential limitation of the underlying data.
MetS prevalence overview
To our knowledge, this is the first systematic review and meta-analysis of the MetS prevalence in the sub-Saharan African population by HIV status. Notably, the total prevalence of MetS among people living with HIV population was significantly higher at 21.5% (95% CI 15.09 to 26.86) with estimated predictive interval of (0.02 to 0.52) irrespective of the definition criteria compared with their HIV-negative counterparts at 12.0% (95% CI 5–21%). However, the wide prevalence range indicates substantial heterogeneities and this is as a result of influential outlying estimates from one of the included study.
As mentioned above this review suggests a twofold higher risk of MetS (RR 1.83, 95% CI 0.98–3.41), with an estimated predictive interval of (0.15 to 22.43) P value = 0.055 among people living with HIV subjects compared to their HIV-negative counterparts, and this ratio was not statistically significant. This finding suggests HIV infection and ART appear to contribute to a significant excess burden of MetS over and above the contribution of traditional lifestyle-related risk factors. The findings of this review are somewhat related to ones discussed in other studies [46,47,48]. The meta-prevalence of MetS among people living with HIV populations in SSA countries has shown to be higher when compared to reported estimates from developed countries [18, 49]. Similarly, the estimate of MetS among the uninfected population in this review is similar to the AGEhIV cohort study in the Netherlands, underpinning the significance of excess MetS risk among people living with HIV compared to HIV-negative [50]. Irrespective of the risk differences of MetS among people living with HIV and uninfected patients in this review not being significant, it is notable that the prevalence of MetS in both cohorts are high and ranged within the earmarked global burden. This implies that the burden of MetS is growing vehemently in SSA with or without HIV; hence, other related factors such as lifestyles, diets, aging, and other interlinked factors require crucial prevention and management beyond HIV.
Across the major criteria (ATP 2001, IDF 2005, JIS) used by most studies included in this review, the estimated MetS prevalence was highest based on the IDF 2005 definition (25.7%). This was different from a similar review that found higher estimates based on the ATP definition criteria [12]. This implies a large waist circumference band among the infected cohorts included in this review, especially females, as this is a compulsory requirement using IDF definition. This agrees with the finding underlining high adiposity (based on body mass index) and waist circumference among people living with HIV subjects [18, 51]. Further research is needed to understand the difference between waist circumferences by HIV status, as this was not established in this review.
The analysis of the meta-prevalence of MetS individual subcomponents was limited given the lack of adequate reporting in the included studies. Diabetes and hypertension were the most reported sub-components, but among people living with HIV cohorts. Nonetheless, studies have described the outcome of the high prevalence of hypertension and diabetes among people living with HIV populations [52, 53]. Further research is required to understand which of the sub-component is the most prevalent and contributes to the development of MetS by HIV status.
With the widespread ART uptake and the introduction of treat, all strategy irrespective of viral load and CD4 count, we anticipated an increase in the burden of MetS irrespective of age and sex in SSA. Despite an unbalance representation of people living with HIV studies against uninfected groups in this review, the prevalence of MetS was essentially higher among the infected population. The absence of study conducted specifically on populations with confirmed negative HIV status might have accounted to these findings. Otherwise, it may be the true reflection of the ubiquitous MetS burden in sub-Saharan Africa irrespective of HIV status, as a result of improved life expectancy, globalization, and lifestyles. Thus, a scale-up in the awareness, prevention, and management of metabolic disorder is directly needed in this continent, to curb the emerging epidemic.
This review strictly adhered to the PRISMA guidelines to maximize the robustness and rigor of the employed methodology. We also conducted a very rigorous quality and risk of bias assessment. To our knowledge, this is the first systematic review to attempt to compare the burden of MetS by HIV status. Furthermore, we did not exclude French-based studies given the region of focus in this review and a large number of Francophile countries with HIV burden.
Our findings may not be generalizable to all people living with HIV and uninfected individuals given the small number of included studies and potential non-representativeness. Given the varied methodological designs of the studies included in the review, the calculation of the pooled prevalence estimate may have been affected by this heterogeneity, as suggested by the very high I2 statistic of 96.05% based on the final eligible pool of studies included in this meta-analysis. Some of the included study's authors were contacted for raw data and further clarifications; however, some estimates had to be calculated from data provided in the article. One of the included studies among people living with HIV cohort was a randomized control trial study, but we do not suspect that the inclusion and exclusion criteria of the trial participants would introduce substantial bias to our study, as these are not related to the metabolic risk factors/conditions we are attempting to assess among adults living with HIV. The pooled risk ratio of the burden of metabolic syndrome among HIV-infected population compared to their negative counterparts should be interpreted with caution given that only 4 out of 18 studies compared MetS by HIV status. Furthermore, limited comparison of pooled prevalence of MetS combining all 18 studies versus meta-estimate among combined HIV-negative subjects in the 4 studies (and relatively small pooled sample size of HIV-negative subjects) can be done as the underlying epidemic profile varies tremendously across the region. A further limitation was the lack of standardized MetS definition employed across the various study settings.
Another limitation of this review was the limited subgroup stratification of MetS burden by sex and ART regimen among the eligible studies. However, the association of antiretroviral therapy with MetS has been previously documented [12, 54]. Also, the relationship between the use of ART and naïve with MetS prevalence could not be ascertained in this review, as 16 out of 18 studies on HIV-infected subjects reported that the participants were ART-experienced. This may explain the high prevalence of MetS quantified in this review. It is thus important to include routine and regular metabolic disorder check in the routine follow-ups of people living with HIV to optimize prevention and management, especially in the era of treat-all.
Thus, further research is required in estimating the extent and association of HIV status and metabolic syndrome and/or its subcomponents within SSA. Moreover, a more standardized approach of classifying MetS in SSA should be adopted to allow better comparability across countries in the region and whether conventional waist circumference cutoffs are appropriate in the Africa context.
Conclusion and implications
MetS prevalence in people living with HIV and uninfected individuals is high in sub-Saharan Africa; however, based on our findings, this appears to be a non-significant high prevalence comparing HIV-positive and HIV-negative group. However, this review needs to be interpreted with caution given the weaknesses alluded to above. More primary research is required in SSA to give a better understanding of the difference in the burden of metabolic syndrome in the context of high HIV burden. However, the findings of this review have implications for public health practice and policymakers within SSA as HIV-positive individual's life expectancy increases in the post ART rollout era and also in the context of an unfolding epidemiological transition where an increasing burden of non-communicable in the context of a high dual and persistent burden of infectious disease. Implementing an inclusive/integrated care plan for people living with HIV populations in the region is essential. This implies the increased presence of other healthcare needs beyond HIV and other communicable infection that might overburden our already overstrained healthcare systems. Early screening of metabolic syndrome subcomponents irrespective of HIV status to reduce future metabolic syndrome epidemic cost is important in the era of increased population aging and obesity, and this has been observed in SSA.
Antiretroviral therapy
ATP III/NCEP:
Adult Treatment Panel III report of the National Cholesterol Education Program
HIV+:
Human immunodeficiency virus-positive
HIV/AIDS:
Human immunodeficiency virus and acquired immune deficiency syndrome
HIV−:
Human immunodeficiency virus-negative
IDF:
International Diabetes Federation
MetS:
NCD:
NP:
Not presented
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The work was supported through the sub-Saharan African Network for TB/HIV Research Excellence (SANTHE), a DELTAS Africa Initiative [grant # DEL-15-006]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)'s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa's Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [grant # 107752/Z/15/Z] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK government.
Some of the information generated and analyzed during this study are included in this published article [and its supplementary information files] and other data that support the findings of this study are available from the list of included studies which the references are part of this article.
Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001, South Africa
Olamide O. Todowede, Solange Z. Mianda & Benn Sartorius
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, USA
Benn Sartorius
Olamide O. Todowede
Solange Z. Mianda
OO contributed to the study concept and design and in the drafting of the manuscript. OO and ZS contributed to the acquisition of data. OO, ZS and BS conducted the analysis and interpretation of data and the critical revision of the manuscript. BS contributed to the study supervision. All authors read and approved the final manuscript.
Correspondence to Olamide O. Todowede.
Table 5 Search strategy with MeSH terms
Table 6 Presentation of the risk of bias of included studies
Todowede, O.O., Mianda, S.Z. & Sartorius, B. Prevalence of metabolic syndrome among HIV-positive and HIV-negative populations in sub-Saharan Africa—a systematic review and meta-analysis. Syst Rev 8, 4 (2019). https://doi.org/10.1186/s13643-018-0927-y
DOI: https://doi.org/10.1186/s13643-018-0927-y
HIV-negative
HIV-positive


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Michigan Settlers vs. Malaria, or How the Midwest Was Won
Daniel Hager | August 2, 2001
A wet and rainy spring has translated into another Michigan summer full of swarming mosquitoes. But current residents have it much better than their 19th-century forebears did. Early generations of Michiganians suffered terribly from widespread outbreaks of malaria, until thousands of square miles of wetlands were drained to drastically reduce the habitat of the disease-carrying mosquitoes.
Why Not Allow a Market in Vanity Plates?
John Gear | August 1, 2001
Michigan, like many other states, allows motorists to purchase for their vehicles "vanity" license plates that carry unique combinations of letters and numbers, such as "GO BLUE." Rather than charging a flat fee for each unique vanity plate, the state should auction plates off to the highest bidder, giving motorists who want the same plate a chance to buy it and raising additional revenues to fund state transportation needs.
Fighting Urban Blight or Trashing Property Rights?
Donald J. Kochan | July 2, 2001
A proposal to fight "urban blight" by enhancing the government's power to confiscate private property is a bad idea.
Navigating the Maze of Michigan's Sales Tax
Dr. Gary L. Wolfram | June 29, 2001
Michigan's sales tax, first enacted in 1933 during the Great Depression, now contains some rather interesting, if not hard-to-explain, features.
Economic Growth Is Key to Environmental Quality
Dr. Steven Hayward | June 28, 2001
One of America's most enduring popular legends is that the environment is deteriorating and that economic growth is largely responsible. The facts suggest just the opposite.
Myths of the 1980s Distort Debate over Tax Cuts
Larry Schweikart | June 27, 2001
The success of President Reagan's tax cuts of 1981-83 must be acknowledged so that debate over future tax cuts is informed by the facts.
An Anniversary All Michigan Citizens Can Celebrate
Dr. Burton W. Folsom | May 30, 2001
By an overwhelming vote of citizens, the 1851 Michigan Constitution took the state out of economic development and gave wide berth to free markets and entrepreneurship.
Save a Life, Buy an SUV
Joseph G. Lehman and Peter VanDoren | May 29, 2001
Federal government safety data from other studies indicate a lower fatality rate for SUVs than for cars.
It's Time to Give Overtaxed Americans a Break
Dr. Mark J. Perry | May 25, 2001
Taxpayers might make louder demands for relief if they understood that as a percentage of total national income, federal taxes are higher than at any other time in U.S. history.
Future Detroit Mayor Could Learn from Motor City's Past
David Bardallis | May 25, 2001
The mayor made every effort to ensure that Detroit's taxes remained as low as possible.


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Q&A with Outdoor Action Program Coordinator Caroline Stone '14
By Catherine Wang | Mar 23, 2016
It's almost college decision day, which means Outdoor Action's frosh trips are just around the corner. Caroline Stone '14 graduated with a degree in Ecology & Evolutionary Biology and subsequently assumed the position of OA Program Coordinator. Staff Writer Catherine Wang contacted Stone to ask about Stone's experience with OA, what she's been working on as program coordinator and the big changes headed for OA this fall.
The Daily Princetonian: What was your experience with OA like, as an undergraduate and then as an OA leader?
Caroline Stone: I grew up spending a lot of time outside and have always been eager to try new things. I'd never been backpacking before coming to Princeton, but I was eager to go on OA. From singing silly songs to making pita pizza together, I knew by night three of my trip that I loved OA and wanted to become a leader.At the time, my decision was all about an opportunity to have fun and be outside; it was only later, after I went through leader training and took on other responsibilities with OA that I began to appreciate how much I learned and grew as a person from this experience.I'd held plenty of leadership positions in high school, but leading an OA trip was the first time that I started to actually think about leadership and actively work towards improving. Through OA, I've learned to be intentional with everything I do and say. Something as simple as selecting a game to play along the trail can have a huge impact — either positive or negative — on a group's dynamic. It's my responsibility as a leader to be aware of that.
DP: What's your favorite OA game/song?
CS: Definitely "Da Moose."
DP: Were there any particularly memorable experiences?
CS: I have so many favorite OA memories! I love meeting new people and building new relationships with them.One of the most unforgettable experiences was leading a training trip down to the Shenandoahs during Fall Break a few years ago. We got a late start driving down, and ended up hiking in the dark for a few hours before making it to camp. While setting up camp, my co-leader and I discovered that we were missing half of our tent.Keep in mind that it is late October—it's already in the low 40s and rain was predicted for the next few days, so it was very much not the kind of situation you'd want to be in without a tent. It was not our finest moment, but we eventually managed to improvise a shelter for the night that kept us all relatively warm.In the morning, the whole group talked through possible decisions and agreed on a plan to meet up with another group and share their tents; like most OA training events, we turned our mistake into a teachable moment. And the rest of the week was great!
DP: What is currently your role in organizing OA?
CS: As program coordinator, I handle most of the day-to-day logistics with OA. I organize all of leader training, and work with our student instructors and coordinators to update lesson plans and gather teaching materials. In the summer, we start planning for Frosh Trip, and I work with our student coordinators who plan all of the routes and trip details.When you're planning over 80 trips, every little detail— from identifying water sources to ordering dozens of cases of M&M's—needs to be planned out ahead of time. During Frosh Trip, I stay back on campus as part of Command Center, responding to new problems that arise and managing all of the behind-the-scenes logistics for evacs. I basically live in the basement of Butler for five days straight, eating a lot of take-out Mehek and sleeping on the floor — in order to always be available to the students out in the field.The highlight of my job is certainly whenever I get to lead training trips, spending time outside and really connecting with students. I'm able to reflect on my own experiences as an OA leader, but also am always picking up new things from my co-leaders and trainees.
DP: OA is having a lot of changes this year, with OA and CA becoming mandatory orientation programs. What does that mean for OA—have you guys had to include any major organizational changes?
CS: OA Frosh Trip is going to look pretty similar to the past few years. The biggest change, and the one we are most excited about, is that Leader Training is now free! The University is now covering all costs associated with leader training, including the five-day backcountry Leader Training Trip. OA has always strived to offer leadership development opportunities to all students, so it's great knowing that there are no longer economic barriers preventing people from learning these skills.
This fall, go beyond the 'Bubble'
A ramen tour of Princeton
Abolish sign-in clubs


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Tag Archives: Myrvoll
Exposing Shadows: an interview with Accuser of Revelation's Hammer
by Cecilie Molteberg
With venom coursing its veins and a ravenous hunger to its invention and exploration, the self-titled album from Norway metallers Revelation's Hammer is an enthralling expanse of compelling aural drama and rapacious antagonism, black metal at its more rapacious and provocative. A long time in emerging, the album is one of the startling high points of the year in metal so far and one we wanted to know much more about. Taking the opportunity to talk to its creator Accuser, we unveiled a long string of questions to explore more about his reason and intent on forming the project, the album and its long journey to finding its release, and much more.
Hi and many thanks for taking time to talk with us.
Reading the promo accompanying your debut album it is stated that Revelation's Hammer emerged as not only a vehicle for your creativity musically but also to give a freedom to express your thoughts and passions. Could you expand on that for us?
Greetings Pete! First of all, thanks for your great interest in Revelation's Hammer. The best way to express your true feelings regarding your surroundings or even visions of our chaotic world is in my opinion through something as simple (or insanely complex?) as music…At least if we think in terms of creativity and art. Clearly I don't believe in this glorifying society of happiness where everyone is living in a fucking bubble gum valley, loving and praising each other every day. So when I write my art, I'll search my soul for answers and strength instead of using time on a fictional God. It's so much bullshit going on in our world, and my way of expressing my hatred against it all is through my music.
What were your inspirations musically and personally for the project?
I really don't like to point out concrete sources for inspiration, or even analyse it…I think it's really more relevant to focus on the result and its possible improvements rather than the progressing methodology. When I sit down with the guitar on my lap to create music, I don't think of this or this band, or try to make a song similar to another band's song…I do my own thing, in my own way…Focusing on the parts that immediately give something to your soul. Regarding personal inspirations I would rather say that the strong spirit of this band evolves from myself exploring my inner (ref: human) side. I believe there's a hidden beast within every one of us.
You come from Sætre, a small town in Eastern Norway of course; did that setting make any distinct impacts on your thoughts and the atmospheric canvas for your startling sounds?
I guess everything is making an impact – really on a daily basis. As you form as a person every day, your creativity is developing based on your impressions, experiences and growing culture. Your ideas and passion gets stronger, and your own understanding of reality really affects you as an artist.
Was Revelation's Hammer originally intended just as a solo project and if so when did you realise you needed to expand personnel?
I started the project on my own cause I didn't know any musicians at that time that I wanted to work with. My original plan was to find full time members to the band ASAP, and personally only do the guitars on the album. About one year into the writing process, I met this drummer Bergh, and invited him to the line-up. Still, I was the only composing part of the band, and the only one really serious about it. I continued to look for other musicians while me and Bergh kept rehearsing…then, when I finished the writing of our first chapter in 2009, things didn't go as planned with Bergh…We had a lot of complications and disagreements between us, and I finally told him to quit. So on I started to feel more interested in getting session members instead of permanent members to get involved. Myrvoll (NIDINGR) joined on session drums shortly after, and while we rehearsed for the first recording session, it got more and more obvious that I was going to play all the instruments except drums. Today, I feel slightly different about it. I really want to be able to do shows, and by that reason I want to gather three more musicians for future gigs. It's not impossible that R.H will turn into a full band someday either, but then again, I really need to meet the right musicians before involving anyone into the inner circle.
You mentioned Myrvoll there, tell us how the link up with him, also the drummer of the excellent Nidingr, came about?
In fact, Myrvoll joined Revelation's Hammer as a session drummer about two years before he got recruited by Nidingr. Their album "Greatest of Deceivers" got released seven months before R.H's album, but was also recorded two years later. It was quite a coincidence that I met him actually. When I split up with Bergh in 2009, I needed a really good drummer ASAP, because the album was already about finished. It feels a bit like a coincidence, because I got introduced to him through a mutual friend of ours almost right after the split. Myrvoll was fortunately available at the time and really liked my music, so we figured out that we wanted to work together quite fast…
Was that the only aspect of your music you felt you needed or was able to bring in another's craft and skill for?
As I mentioned a bit earlier, in the early days I really planned to get more musicians to play on the album to separate the roles a bit more…But I guess I finally realized the benefits about being my own boss? More time to focus and a whole less time on discussions. The whole revelation was also evolving more and more into an important part of my personal life, so at one point in the recording process I guess it felt kind of unnatural to bring in more people. But I did really try working with several vocalists and even went into studio with one of them, but the result just didn't work. Maybe I'm hard to deal with cause I know how I want my music, I don't know…But at one point, it was whole lot of easier to just decide that this was going to be a solo album with session and guest members only. I was already familiar with my own bass lines, so I just needed to figure out how I was going to do the vocals.
You have just released your outstanding self-titled debut album, a release it is fair to say that is an exhausting and thrilling confrontation of compelling aural drama and rapacious antagonism. The album's recording was a prolonged experience from its first session in January of 2012, what held up its creation?
I guess you mean January 2010? You're absolutely right. In fact it's really ridiculous that it took us fucking 41 months from when we started to record until we actually got to release the album. But you know it was so many things that just didn't work out and caused everything to get more and more delayed. It was different line up problems, troubles with availability of the people I wanted to work with, difficulties in getting hold of a decent studio to record the vocals, back and forward with the mixing and mastering results etc. Several unfortunate events caused a lot of bullshit.
Taking so long to emerge did it evolve further than you originally envisaged in sound and presence with that extra time to think about things?
I would at least say that it made me really conscious about what I was doing. Of course, each separate process was quite hardworking and exhausting in many ways, partly because of the total focus and dedication to the music. Even if I had a day off or didn't really need to do anything regarding the project for a short period of time, I always found something to work on. I listened to the tapes over and over, and wrote a lot of notes for the next mixing or mastering session. Peter In de Betou actually started to master the album already in 2010, but I later realized I wasn't satisfied with the first mixing result and then the whole process had to start all over. Hah! You know…I'm a man of perfection, and really wanted to make an album I was going to be able to stand for in the next ten or fifty years. I'm very much into details, push my own limits quite far and always make sure that I'm in control over the result.
As we talked of the band allows you to express your feelings and views on life and the world, so we can assume the album and songs are a deeply personal?
Yes, as I talked about in the introduction…Still, the exact motivation behind Revelation's Hammer will remain untold. Everyone's responsible for laying their own puzzle.
Do you think your songs will always come from personal seeds?
The only thing that I'm certain about is that my lyrics will continue to be based on different themes I either find interesting, engaging or even provoking. What the hell is the point with writing something you can't relate to? That's just meaningless, dumb and not interesting.
How do you generally create songs, what is your favoured process?
It really depends…But often, I find myself with the guitar on my lap, and instead of figuring out what to play; I let the music flow natural while I just play various themes. When I've found something to work on, I usually write it down, before I'll test different assistant compositions with the other instruments (drums and bass). I usually arrange part for part with all instruments together. It's important to hear how it all sound together, cause if one instrument sounds like shit, the whole song will sound like shit! In the final process, I add eventual final details; and maybe rearrange the whole composition in an attempt to improve its correlation. It's a really hard process, but also a very giving one…
What is the core theme for the album and connecting songs?
A great keyword would be "ignorance", but each of the songs has really their own core theme and tells their own individual story. The different themes can still happen to be connected to each other or share common values, but not necessarily. The six hymns represent the first part of a greater truth and a greater world. But since Revelation's Hammer is not going to be revealed through this interview, I can't say any more about it than that. Your delusions are often easier to handle than the truth!
The tracks on the album confront and provoke reactions in the listener emotionally and in thought, even with some in your native tongue which is testament to your potent songwriting and sounds. Did you aim for this rich effect within songs or was it something which was organically bred as tracks evolved?
First, I want to say that I truly appreciate opinions like that about our work. I think some of the best compliments you can give an artist is that they have succeeded in creating an emotionally or psychological disturbing effect with their work. Either shocked, or made someone feel terrible ill. It's the same thing regarding the cinema industry…The really good movies are the ones that give you a true feeling. The feeling doesn't need to be positive, and could easily have been that a piece of music caused you mental illness or insanity…Because then it clearly has really strong powers and will definitely be remembered. When you're in the writing process I don't think you're able to aim at this concrete kind of art ideology… Because everything's very subjective, and when you basically write music for your own mind, it's even harder to be able to create something that causes other people reactions as for example sorrow or hatred.
There has been a wealth of releases utilising and exploring textures and layers within their sound recently but so often these are lost within one overwhelming aspect. Your album gives clarity and expression to all whilst seamlessly lying hand in hand with each other. How intensively do you have to work to achieve that success?
Personally, I appreciate both music and production that gives you the impression of being right in the middle of it. The concept of "less is more" doesn't fit my song writing. So the result is probably a combination of my own way of composing music, and a lot of hours in the studio; Recording, mixing, mastering…You know, when you're in the centre of a production like this, you really don't think of all the effort you put in along the way. However, when you look back at everything, it sure was tough to get the result I had in mind. So I guess the answer to your question is "very intensively"?
The album was as you said completed a couple of years ago, have you been tempted to continue adding or evolving things since or are you a person to say when something is done it is done?
From the first recordings in 2010 to the final mastering and my personal acceptance of the album in 2011 I continued to add elements and evolve the whole expression almost constantly. Looked for changes and improvements while I tried to get it 100% as the vision I had while writing the material. But after the final mastering in April 2011, I said to myself… This is it. Now it's done. Finished. And it gave me a psychological effect that truly worked. I finally managed to accept the album, and said stop to future changes. When I listen to the album today, of course I'll find sections I know that could have been performed better or done in a smarter way, but in my head I treat the album as something that belongs to my past, and chooses to not bother. If I wasn't able to think of it like this, I would probably have worked on the album forever and no one would ever been able to hear Revelation's Hammer.
The release was mastered by the legendary Peter In de Betou who you mentioned earlier, was it easy to persuade the man to bring his craft to the album?
I sent Peter an e-mail where I told him about the project. I wrote that Børge from Toproom was responsible for the mix and that he had recommended him to me to do the mastering. He responded in just a few hours and declared that he wanted to do this. I got kind of surprised by his positive response, because he seems to be a pretty busy man with an often full booked calendar. He actually started to work on the project only four days later.
What then held up its actual release after the studio work was finished and release mastered etc.?
The final mastering took place April 2011, and after that I spent very much time looking for a trustworthy label that I actually wanted to release our album through. This process took a lot more time than expected cause the interested labels either had their release schedule full for a long time or offered me contracts with terms I didn't feel satisfied with. I believe the music industry is really hard these days, causing more and more bands to just release and print everything on their own. Still, I chose to keep looking and got in touch with Francesco from Italian Dark Metal label My Kingdom Music in November 2012 and signed a worldwide recording and distribution contract with him in March the following year. I guess one of the positive side effects of all the delays is that we seem to have generated a group of followers over the years, and it's really amazing to see that many of our early followers is still hanging around as they did several years ago. Hopefully our album met their expectations when it finally got released.
What was it about My Kingdom Music which persuaded you they were the perfect vehicle for the album's release?
We negotiated and communicated for almost five months, so we really got to know each other and understood what we both wanted. In fact, I'm really glad that we used a lot of time talking. I think it's important to build trust with a partner you're probably going to cooperate with for several years. I'm certain that an artist that basically signs everything he gets on paper really regrets it afterwards.
Tell us about the sensational artwork wrapping the release.
The artwork is put together by the Portuguese artist Ricardo Fernandes. I'm really happy with his result, and I think he did succeed in making really extraordinary art which symbolizes R.H's vision of the world. We brainstormed several ideas and worked our way through several sketches to get to the final result. The cover art in front is really a collage built upon a careful selection of (anti)religious paintings. Ricardo's friend Marcelo Rodrigues designed our logo…I think he's primarily works as a tattoo artist in Portugal. And a Norwegian guy named Hans Jørgen Nygårdshaug inserted the lyrics and text to the booklet. The portraits is taken by Norwegian photographer Cecilie Molteberg and edited by myself.
How are things progressing towards the band performing live, have you anything in place to support the album live wise?
I'm definitely looking for live musicians, but haven't any official information to share with you regarding this yet. You will be able to see our revelation live one day, but when really depends on how fast I'll find the right kind of musicians to involve.
Such the gap between creating and releasing the album we assume you have more material or advanced ideas in the works for its successor. Anything you can reveal here and now?
Of course I have lots of ideas and thoughts around our next chapter, but it's too early to reveal how the progress is going besides that everything is basically in a very early phase. But continue to follow our sites and I'm going to keep you all updated.
Once again thank you for sharing time and thoughts with us, and may we say all dark metal fans should check out Revelation's Hammer band and album.
Any thoughts you would also like to leave us with?
Thank you Pete! Quite interesting interview and by far the longest I've ever accepted to respond to. Continue to spread our propaganda and keep fucking true to yourself. Blasphemy, fire, rebellion…This is just the beginning…
Buy our album at http://www.mykingdommusic.bigcartel.com !!!
Or order it directly from me at revelationshammer@gmail.com
Share our official album trailer: http://www.youtube.com/watch?v=Bi7w3fv_WA8
Explore our revelation online:
http://www.facebook.com/revelationshammer
http://www.youtube.com/revelationshammer
http://www.soundcloud.com/revelationshammer
http://www.reverbnation.com/revelationshammer
Read the Revelation's Hammer review @ https://ringmasterreviewintroduces.wordpress.com/2013/06/05/revelations-hammer-self-titled/
Pete RingMaster
The RingMaster Review 25/06/2013
Leave a comment Posted in Interviews, Music Tagged Accuser, Black Metal, Greatest Of Deceivers, My Kingdom Music, Myrvoll, Nidingr, Peter In de Betou, Revelation's Hammer, RingMaster Review
Revelation's Hammer – Self Titled
It may have pure sonic venom coursing through its veins but there is something irresistibly inviting about the arts and crafts of the self –titled debut album from Norwegian metallers Revelation's Hammer. Skilfully sculpted and ravenous in its hunger driven energy and invention, the release is wholly enthralling despite its spiteful air and offers certain reasons as to why the band is being talked of as the next big thing in Scandinavian black metal. Six tracks of compelling aural drama and rapacious antagonism, Revelation's Hammer is an exhausting, thrilling confrontation.
Created by Accuser (vocals, strings, and concept) in 2007 for his musical ideas, the project was joined by drummer Bergh. His departure saw the recruitment of Myrvoll from Nidingr with the beginning of the creation of the album began January 2010. The recordings expanded over ten months due to several setbacks, with the album being mixed by Børge Finstad at infamous Toproom Studio (Mayhem, Borknagar), mastered by legendary Peter In de Betou (Watain, Dark Funeral), and additionally featuring a guest appearance from Exilis from Troll on some tracks. March of this year saw the Oslo based band sign with Italian dark metal label My Kingdom Music and as its seditious charms stalk the world one suspects the album will set Revelation's Hammer to the fore of and ignite the current stance of black metal.
Obsessed Onslaught slowly crawls before the ear to start things off, its yawning sonic stretch and melodic call soon swept within an avalanche of destructive rhythms and equally ravenous riffs. As the intimidating guttural squalls of Accuser stare eye to eye with the listener and unleash their propaganda of malevolence, devious grooves strike out to seduce the senses whilst being still ravished by the vocal and lyrical grazing. It is a weapon the band and album uses frequently and persistently it persuades defences to relax allowing the annihilatory breath and intent of tracks to win their cause. Across its expansive length there is never time to catch breath before the next shift and evolution in direction and persuasion is ridden, that relentlessness only adding to the epic feel of the sound. As intriguing and eventful as it is barbaric, with blast beats pummelling the senses throughout and the excellently varied vocals holding a satanic compulsion in whatever guise they use, it is a striking and scintillating start.
The title track opens with another riveting grooved temptation before the vocals assault with a bedlamic hatred, their malice opening up the song for its corrosive and towering intensity to douse the senses in primal sonic filth. As its predecessor the track twists and flays within its invention, every corner of its course opening another rage of further blistering energy and captivating imagination. The savagery steps back as the climax approaches to allow its nightmare to unveil a sampled stark scenario before returning with a furnace of a finale which scorches ears and sears emotions.
The outstanding Den Blåøyde dances on the already wasted nerves and senses next, though its waltz is one of viciousness and sonic manipulation honed into a brutality which again across a varied gait has only full greed guiding its purpose. Within its immense appetite of violence the track has a web of melodic temptation and insidious beauty which secures honest ardour towards its just as threatening epic breath and virulently creative alchemy. The best moment of the album it offers all the evidence as to why the band is being harped over.
Both Buried as Filth and Avgudsdyrkelse continue to openly impress, the first seemingly bred from a warzone wasteland, sonic teasing skipping over its grave to offer further insanity whilst welcoming hostile futures crafted from the rhythmic maelstrom and riff loaded wall of intensity, The second of the two saunters in with a confrontational attitude and determined will to exploit all, which with further excellent senses examining rhythms from Myrvoll and the kaleidoscope of apocalyptic sonic enterprise from Accuser, it does with ease, senses and thoughts willing victims.
The thrash courting The Crown Of Malice which evolves into a blackened vat of serpentine degenerate toxicity you can taste on the lips, closes off the album with impressive and invigorating power. From start to finish the album only challenges and tests the listener but most of all rewards with one of the most striking and exhilarating genre debuts in a long time. Dare you face the Revelation's Hammer?
www.facebook.com/revelationshammer
1 Comment Posted in Album, Music Tagged Accuser, Black Metal, Dark Funeral, Exilis, My Kingdom Music, Myrvoll, Nidingr, Peter In de Betou, Revelation's Hammer, RingMaster Review, Troll, Watain


text:
US renews religious freedom blacklist
The United States has renewed its blacklist of eight countries considered violators of religious freedoms, turning back requests to add Pakistan, Uzbekistan and Turkmenistan.
China is cited for abuse of Falun Gong practitioners
Secretary of State Condoleezza Rice extended the designation of US ally Saudi Arabia as a "country of particular concern" as well as that of China, Iran, Myanmar, North Korea, Vietnam, Eritrea and Sudan.
"These are countries where governments have engaged in or tolerated particularly severe violations of religious freedom over the past year," Rice told a news conference on Tuesday.
"We are committed to seeking improvements in each of these countries," she said. Countries face US government sanctions 180 days after being included in the blacklist.
The announcement was made along with the separate release of the State Department's seventh annual report on international religious freedom, which took several US foes and friends to task for a lack of progress.
Laws modified
"In some countries we find that governments have modified laws and policies, improved enforcement or taken other concrete steps to increase and demonstrate respect for religious freedom," Rice said.
"In far too many countries, however, governments still fail to safeguard religious freedom. Across the globe, people are still persecuted or killed for practising their religion, or even for just being believers."
Rice: Some states have modified
policies to improve the situation
The report branded Myanmar, China, North Korea and Cuba as countries using "totalitarian or authoritarian actions to control religious belief or practice" but removed Vietnam from the list, citing "significant" progress.
Vietnam joined a list of seven countries, including Saudi Arabia, Iran, Sudan, Uzbekistan, Eritrea and Laos that exhibited "state hostility towards minority or nonapproved religions", according to the State Department.
The State Department annually blacklists countries for alleged religious freedom violations based on recommendations from a commission jointly appointed by President George Bush and Congress.
Rice's predecessor Colin Powell added Eritrea, Saudi Arabia and Vietnam to the blacklist in September 2004. But there has been no word on whether they faced US action.
Countries exempted
The recommending panel, called the US Commission on International Religious Freedom, said in May that it had sought to designate Pakistan, Turkmenistan and Uzbekistan as "countries of particular concern".
The commission said at the time it found the three governments had "engaged in or tolerated particularly severe violations of religious freedom". But the three were absent from the list released on Tuesday, US officials said.
The State Department report does list Pakistan as one of the countries that has "discriminatory legislation or policies prejudicial to certain religions, imposing elements of Islamic law on Muslims and religious minorities".
It added: "The government took steps to improve the treatment of religious minorities, but there were instances in which authorities failed to intervene in cases of societal violence directed at minority religious groups."
Former Soviet bloc
In Uzbekistan, the report noted "a slight decline in the already poor status of religious freedom".
Uzbekistan has jailed members
of Muslim groups
Authorities arrested numerous people as members of the errant Muslim groups and sentenced them to long prison terms.
A major confrontation with protesters in the eastern Uzbekistan city Andijan, which killed hundreds, was associated with the crackdown.
Turkmenistan was cited among the countries that made "significant improvements" in the promotion of religious freedom.
On Saudi Arabia, the State Department did not budge from its determination that "freedom of religion does not exist" and basic religious rights are denied to all but those who follow the state-sanctioned Sunni faith.
Washington's other key Middle East ally, Israel, also came in for criticism in the report despite Israel's pledge to provide full social and political equality for all.
"Some non-Jews, primarily Arab Muslims and Christians, continued to experience discrimination in the areas of education, housing and employment," the department said.
It also chided European allies Belgium, France and Germany, listing them among Western governments that "continued to use restrictive legislation and practices to brand minority religions as dangerous 'cults' or 'sects'".
Israel is mentioned for its
discrimination against non-Jews
The report said Christians, Muslims and followers of other religions in China are being harassed, arrested and worse for refusing to register with the government.
Some, such as practitioners of the Falun Gong spiritual regimen, are accused as cultists, and those who will not recant their beliefs are imprisoned or sent to labour camps, the department said.
"There were credible reports of deaths due to torture and abuse" of Falun Gong practitioners, the department said. "Underground Christian groups, Muslim Uighurs, Tibetan Buddhists and members of groups the government considered 'cults' were subjected to increased government scrutiny."
In Muslim Azerbaijan, the report cited abuses of the constitutional right to freedom of religion. The government of the former Soviet republic enforces the "law on religious freedom", which prohibits foreigners from proselytising.
The Indian government at times failed to stop attacks by Hindu mobs on members of religious minorities, partly because of legal constraints built into the country's federal structure that require central government action.
"Inter-religious tensions between Muslims and Hindus and also between Hindus and Christians continued," the report said.
"In some regions, local officials selectively enforced laws to the detriment of religious minorities."


Article Excerpt: "... According to the North Alabama Multiple Listing Service, Huntsville/Madison County residential sales totaled 349 units during January, an increase in sales growth of 16.7 percent or 50 units from the same period last year. Two more resources to review: Quarterly Report and Annual Report. For all of Huntsville's area housing data ..."


text:
Tracking the tropics: Barry downgrades to tropical depression as winds weaken over Louisiana
Child drowns at west Houston apartment complex pool, HPD says
PHOTOS: Tropical Storm Barry pounds Louisiana
Coast Guard rescues 12 people, pets from Louisiana floods
Nicholas Auger
Surveillance video shows moment small plane crashes into Katy community center
Local churches, community leaders react to upcoming ICE raids in Houston area
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Father of fallen Marine upset by president's letter
By Joel Eisenbaum - Investigative Reporter
Posted: 11:49 AM, October 09, 2012 Updated: 11:49 AM, October 09, 2012
A man who lost a son to the war in Afghanistan is disappointed in the condolence letter he received from President Barack Obama.
Tom Logan, a Willis resident, calls the note late, impersonal, disrespectful and essentially a form letter.
"It opened up a wound in our heart you can't fix. You can't send another letter. You can't make it right," Logan said.
Logan's son, USMC Cpl. Joseph D. Logan, was killed Jan. 19, 2012, along with five other men when the helicopter they were in crashed.
Joey Logan was 22.
"He would have been more mad about this than I am," Tom Logan said.
Tom Logan said he believes Obama did little more than sign his name to the document. He believes his son deserved more.
Local 2 Investigates examined two other letters sent by Obama to families of soldiers killed in action. The one-page typed condolence letters were identical other than names, ranks and service branches.
There is no standard or written protocol that we could find dealing with presidential condolence letters.
"Different presidents have approached the task in ways that are unique with their personalities and their priorities," University of Houston Professor and Historian Nancy Beck Young said.
Young examined the letter written to Tom Logan, which arrived by UPS truck four months after his son's death.
"I would agree, this is a personal sacrifice and an impersonal condolence," Young said.
Young said that it appears Obama's predecessor, George W. Bush, wrote more personal, individualized, sometimes hand-written notes to the families of soldiers.
Young also said that form letters, condolence, or otherwise, are a function of the modern age we live in.
"I think it's an indication of how of how the office of the presidency works in the early 21st century," Young said.
Tom Logan is convinced it shouldn't work like that, not now, not ever.
"Where are the representatives of our government? Where is the honor and the respect that all of these soldiers deserve?" Logan asked.
Local 2 Investigates attempted to contact the White House for comment three times. We have not received a response.
Remembering USMC Cpl. Joseph D. Logan
Immigration Rights hotline flooded with phone calls since ICE raids began
Houston Museum of Natural Science
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We were a party of six who met up here from all over Kent which had been organised by one of the group. Instantly made very welcome and shown to our reserved table. We were served by the most delightful character Jenny, who we later found out is the landlady. "Character" just begins to describe this fine lady and the pleasure she brought to our table for the four hours we were there. The food was a typical choice of Sunday roasts, cooked to perfection and brought to our table by excellent staff. If you're in Whitstable, give this pub a try; I'll doubt you'll be disappointed.


text:
Truman parade draws large crowd
Brooke Wohlrabe
bwohlrabe@fairmontsentinel.com
TRUMAN — The annual Truman Days parade brings in many people from near and far. The parade, which will take place on Saturday at 5 p.m., draws many participants and spectators and has been a highlight of the weekend festival. This year, Nancy Salic stepped up to organize the parade.
A lot of planning goes into setting up Truman Days and organizing the parade. Last year was long-time parade organizers, Glen and Melody Leimer and Greg and Adele Kaufman's last year putting on the parade. Knowing someone else needed to fill the spot, Salic decided to attend a Truman Days committee meeting.
"This year they needed help with it so I went to the meeting and someone was needed to pick up the parade stuff. So I did that and went though it. I went to the next meeting with nine units lined up and one paid. I just decided to keep doing it," Salic said.
The first meeting was in February but Salic has been attending meetings since March. While she wasn't originally planning on being so involved, she said it hasn't been too difficult to organize.
"The people prior had it so organized so it's basically just been getting a hold of the units. A lot of people have thanked me for doing it, which is really nice. We've had a lot of support," Salic said.
Salic said she's just given out a notice to previous units that have participated, but some other new businesses and entertainment groups have contacted her.
Several units have been lost this year, choosing to book other events, but quite a few new ones have also been added to bring the total to 96 units. Salic said she's been told some units drive up last minute to join the parade so she's left some spots open in anticipation of last minute units.
"Everyone wants to come to Truman. I've heard from a dozen units that they just love coming to Truman," Salic said.
The parade is usually about two hours long, but there are units who stop and perform during the parade to break it up.
The parade will follow the same route that it has in past years beginning at the west end of town near the post office and it goes past the park and ends by St. Paul's Lutheran Church.
Glen and Melody Leimer and Greg and Adele Kaufman will be grand marshals in the parade and will help with set up the morning of the parade to get the unit signs out. Salic said she's been in contact with them and they've been helping as questions come up. There will also be other volunteers who help during the parade.
Truman Days begins Thursday with city wide garage sale with 44 participating locations. Maps will be available at Truman stores.
A variety of events will take place Friday starting with a vintage tractor ride at 7:30 a.m. A bean bag tournament will take place at Graf Park at 6 p.m. with registration beginning at 5:30 p.m.
Many events take place Saturday including an all you can eat Belgian waffle breakfast, 5K run/walk, volleyball tournament and kid's tractor pull. Graf Park will have much to offer on Saturday including a petting zoo, inflatables for kids, craft and food vendors and entertainment.
"The park is the place to be," Salic said.
The will be musical entertainment at the park prior to the parade, and after the parade. The street dance begins in the park at 8:30 p.m.
New this year will be a silent auction that will take place from noon to 2 p.m. on Saturday at Graf Park. There will be more than 20 items, nine of which are valued over $100.
"We've never done a silent auction. We've done a live auction but it wasn't well-attended. We decided to do a silent one so we could do it for a longer period of time," Salic said, adding she thinks maybe live auctions intimidate people. She believes the silent auction will be well-attended.
Salic shared that next year, there will be an all-school reunion during Truman Days.
"Next year we're hoping for even bigger and better things. Hopefully we'll have more help next year, especially with it being the all school reunion. We want to make it nice," Salic said.
While there are high hopes for next year, this year's Truman Days will be nothing short of the fun that it has provided so many in the past.
"I think we have a very supportive community. People have given donations and it's been really good. It's been really nice to see," Salic said.
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Baeza, A.; Ruiz-Molina, D.; Vallet-Regi, M.
Abstract: Introduction: Nanotechnology has provided new tools for addressing unmet clinical situations, especially in the oncology field. The development of smart nanocarriers able to deliver chemotherapeutic agents specifically to the diseased cells and to release them in a controlled way has offered a paramount advantage over conventional therapy. Areas covered: Among the different types of nanoparticle that can be employed for this purpose, inorganic porous materials have received significant attention in the last decade due to their unique properties such as high loading capacity, chemical and physical robustness, low toxicity and easy and cheap production in the laboratory. This review discuss the recent advances performed in the application of porous inorganic and metal-organic materials for antitumoral therapy, paying special attention to the application of mesoporous silica, porous silicon and metal-organic nanoparticles. Expert opinion: The use of porous inorganic nanoparticles as drug carriers for cancer therapy has the potential to improve the life expectancy of the patients affected by this disease. However, much work is needed to overcome their drawbacks, which are aggravated by their hard nature, exploiting the advantages offered by highly the ordered pore network of these materials.
The Nanosfun group belongs to the Institut Català de Nanociència i Nanotecnologia (Catalan Institute of Nanoscience and Nanotechnology, ICN2). It is a public research centre with the objective of becoming a world-renowned centre for nanoscience and nanotechnology research.
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