Adherence to the combination of sulphadoxine-pyrimethamine and artesunate in the Maheba refugee settlement, Zambia.

Artemisinin-based combination therapy (ACT) is one strategy recommended to increase cure rates in malaria and to contain resistance to Plasmodium falciparum. In the Maheba refugee settlement, children aged 5 years or younger with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulphadoxine-pyrimethamine (1 day) and artesunate (3 days). To measure treatment adherence, home visits were carried out the day after the last treatment dose. Patients who had any treatment dose left were considered certainly non-adherent. Other patients' classification was based on the answers to the questionnaire: patients whose caretakers stated the child had received the treatment regimen exactly as prescribed were considered probably adherent; all other patients were considered probably non-adherent. Reasons for non-adherence were assessed. We found 21.2% (95% CI [15.0-28.4]) of the patients to be certainly non-adherent, 39.4% (95% CI [31.6-47.6]) probably non-adherent, and 39.4% (95% CI [31.6-47.6]) probably adherent. Insufficient explanation by the dispenser was identified as an important reason for non-adherence. When considering the use of ACT, the issue of patient adherence remains challenging. However, it should not be used as an argument against the introduction of ACT. For these treatment regimens to remain efficacious on a long-term basis, specific and locally adapted strategies need to be implemented to ensure completion of the treatment

Immuno-virological and toxicity outcomes of HIV-infected patients after 48 months of ART in Phnom Penh, Cambodia

Mexico AIDS Conference 200

Death rates from malaria epidemics, Burundi and Ethiopia.

Death rates exceeded emergency thresholds at 4 sites during epidemics of Plasmodium falciparum malaria in Burundi (2000-2001) and in Ethiopia (2003-2004). Deaths likely from malaria ranged from 1,000 to 8,900, depending on site, and accounted for 52% to 78% of total deaths. Earlier detection of malaria and better case management are needed

Information support and interactive planning in the digital factory : approach and industry-driven evaluation

In the modern world we are continuously surrounded by information. The human brain has to analyse and interpret this information to transform into useable knowledge that is then used in decision making activities. The advent and implementation of Industry 4.0 will make it a requirement for systems within factories to interact and share large quantities of information with each other. This large volume of information will make it even more difficult for the human resources within the factory to sift through the large amount of information required since there is a limit to the information that our brains can cope with. Just in time information retrieval (JITIR) within the digital factory environment aims to provide support to the human stakeholders in the system by proactively yet non-intrusively providing the required information at the right time based on the users context. This paper will therefore provide an insight into the cognitive difficulties experienced by humans in the digital factory and how JITIR can tackle these challenges. By validating the JITIR concept, several industry scenarios have been evaluated: an exemplary model, concerning the machine tool industry, is presented in the paper. The results of this research are a set of guidelines for the development of a digital factory support tool.peer-reviewe

Shaping surfaces and interfaces of 2D materials on mica with intercalating water and ethanol

Interfaces between mica and graphene, as well as the transition metal dichalcogenides (TMDCs) MoS2 and WS2, were wetted with water and ethanol, and investigated employing scanning force microscopy and molecular dynamics (MD) simulations. Below 25% RH, water wets the graphene-mica interface with labyrinthine structures, exhibiting branch widths of about 50 nm for single layers of graphene, increasing to almost an order of magnitude more for four graphene layers. At mica-TMDC interfaces, water films exhibit a transition from labyrinthine to compact morphology upon going from single- to multi-layers of the TMDCs. Ethanol films show a compact morphology at all the interfaces, regardless of the number of 2D material layers on top. The film morphologies are attributed to an equilibrium between electrostatic repulsion of preferentially oriented molecular dipoles, and the line tension of the wetted areas, which is dominated by the deformation of the 2D materials at the edges of the wet areas. The compact front of the water wetting film under multilayers of TMDCs is attributed to a much larger bending stiffness of these materials than of graphene multilayers. The thickness dependent stiffness of the 2D materials may be employed to shape their surfaces from the nano- to the micrometer scale.Peer Reviewe

Repurpose 2D Character Animations for a VR Environment Using BDH Shape Interpolation.

Virtual Reality technology has spread rapidly in recent years. However, its growth risks ending soon due to the absence of quality content, except for few exceptions. We present an original framework that allows artists to use 2D characters and animations in a 3D Virtual Reality environment, in order to give an easier access to the production of content for the platform. In traditional platforms, 2D animation represents a more economic and immediate alternative to 3D. The challenge in adapting 2D characters to a 3D environment is to interpret the missing depth information. A 2D character is actually flat, so there is not any depth information, and every body part is at the same level of the others. We exploit mesh interpolation, billboarding and parallax scrolling to simulate the depth between each body segment of the character. We have developed a prototype of the system, and extensive tests with a 2D animation production show the effectiveness of our framework

Is rejection a diffuse or localized process in small-bowel transplantation?

Utilization of endoscopy to both visualize and selectively biopsy an intestinal allograft has become the standard for early recognition and treatment of intestinal allograft rejection. Despite the widespread acceptance of the need for selective mucosal biopsies, it has not been shown that the histological features of intestinal allograft rejection are either localized or occur as part of a more diffuse phenomenon within a tubular allograft. To resolve these issues, 88 ileoscopies were performed in 12 small-bowel allograft recipients and mucosal biopsy samples were obtained at 5, 10, and 15 cm, respectively, from the ileal stoma. Each mucosal biopsy was labeled, processed, and evaluated individually for the presence and severity of any evidence for allograft rejection. The data obtained suggest that intestinal allograft rejection is a diffuse process, and biopsies obtained randomly from an ileal graft are likely to demonstrate evidence of allograft rejection when such is present. © 1994 Springer-Verlag New York Inc

Timeliness of Clinic Attendance is a good predictor of Virological Response and Resistance to Antiretroviral drugs in HIV-infected patients

Ensuring long-term adherence to therapy is essential for the success of HIV treatment. As access to viral load monitoring and genotyping is poor in resource-limited settings, a simple tool to monitor adherence is needed. We assessed the relationship between an indicator based on timeliness of clinic attendance and virological response and HIV drug resistance

Cost and cost‐effectiveness of a simplified treatment model with direct‐acting antivirals for chronic hepatitis C in Cambodia

Background & Aims In 2016, Médecins Sans Frontières established the first general population Hepatitis C virus (HCV) screening and treatment site in Cambodia, offering free direct‐acting antiviral (DAA) treatment. This study analysed the cost‐effectiveness of this intervention. Methods Costs, quality adjusted life years (QALYs) and cost‐effectiveness of the intervention were projected with a Markov model over a lifetime horizon, discounted at 3%/year. Patient‐level resource‐use and outcome data, treatment costs, costs of HCV‐related healthcare and EQ‐5D‐5L health states were collected from an observational cohort study evaluating the effectiveness of DAA treatment under full and simplified models of care compared to no treatment; other model parameters were derived from literature. Incremental cost‐effectiveness ratios (cost/QALY gained) were compared to an opportunity cost‐based willingness‐to‐pay threshold for Cambodia ($248/QALY). Results The total cost of testing and treatment per patient for the full model of care was$925(IQR $668‐1631), reducing to$376(IQR $344‐422) for the simplified model of care. EQ‐5D‐5L values varied by fibrosis stage: decompensated cirrhosis had the lowest value, values increased during and following treatment. The simplified model of care was cost saving compared to no treatment, while the full model of care, although cost‐effective compared to no treatment ($187/QALY), cost an additional $14 485/QALY compared to the simplified model, above the willingness‐to‐pay threshold for Cambodia. This result is robust to variation in parameters. Conclusions The simplified model of care was cost saving compared to no treatment, emphasizing the importance of simplifying pathways of care for improving access to HCV treatment in low‐resource settings