Changing the malaria treatment protocol policy in Timor-Leste: an examination of context, process, and actors’ involvement

In 2007 Timor-Leste, a malaria endemic country, changed its Malaria Treatment Protocol for uncomplicated falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. The change in treatment policy was based on the rise in morbidity due to malaria and perception of increasing drug resistance. Despite a lack of nationally available evidence on drug resistance, the Ministry of Health decided to change the protocol. The policy process leading to this change was examined through a qualitative study on how the country developed its revised treatment protocol for malaria. This process involved many actors and was led by the Timor-Leste Ministry of Health and the WHO country office. This paper examines the challenges and opportunities identified during this period of treatment protocol change

Design, Construction, and Performance of Low-Level Radioactive Waste Disposal Facility

A mixed low-level radioactive waste (LLRW) and Resource Conservation and Recovery Act (RCRA) waste on-site disposal facility (OSDF) was constructed as part of the remediation of the U.S. Department of Energy Feed Material Production Center in Fernald, Ohio. The 56-acre OSDF is fully constructed, filled with waste, and closed. Post-closure monitoring is ongoing. This paper presents the design, construction, and performance of the OSDF. Waste acceptance criteria and waste placement requirements are described. Results from three sets of pre-design field and laboratory investigations are summarized. Currently available performance data for the OSDF’s leachate collection system and leakage detection system are reported. Post-closure monitoring activities are briefly described. The value of this case study is in providing a detailed framework for the conceptual and detailed design of land-based disposal facilities for mixed LLRW and RCRA waste

Histological evidence for a supraspinous ligament in sauropod dinosaurs

Supraspinous ossified rods have been reported in the sacra of some derived sauropod dinosaurs. Although different hypotheses have been proposed to explain the origin ofthis structure, histological evidence has never been provided to support or reject any of them. In order to establish its origin, we analyse and characterize the microstructure of thesupraspinous rod of two sauropod dinosaurs from the Upper Cretaceous of Argentina. The supraspinous ossified rod is almost entirely formed by dense Haversian bone. Remains ofprimary bone consist entirely of an avascular tissue composed of two types of fibre-like structures, which are coarse and longitudinally (parallel to the main axis of the element) oriented. These structures are differentiated on the basis of their optical properties under polarized light. Very thin fibrous strands are also observed in some regions. These small fibres are all oriented parallel to one another but perpendicular to the element main axis. Histological features of the primary bone tissue indicate that the sacral supraspinous rod corresponds to an ossified supraspinous ligament. The formation of this structure appears to have been a non-pathological metaplastic ossification, possibly induced by the continuous tensile forces applied to the element.Fil: Cerda, Ignacio Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigación en Paleobiología y Geología; Argentina. Universidad Nacional de Río Negro; ArgentinaFil: Casal, Gabriel. Universidad Nacional de la Patagonia; ArgentinaFil: Martínez, Rubén Darío. Universidad Nacional de la Patagonia ; ArgentinaFil: Ibiricu, Lucio Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; Argentin

Defining County-Level Terrestrial Rabies Freedom Using the US National Rabies Surveillance System: Surveillance Data Analysis

Background: Rabies is a deadly zoonotic disease with nearly 100% fatality rate. In the United States, rabies virus persists in wildlife reservoirs, with occasional spillover into humans and domestic animals. The distribution of reservoir hosts in US counties plays an important role in public health decision-making, including the recommendation of lifesaving postexposure prophylaxis upon suspected rabies exposures. Furthermore, in surveillance data, it is difficult to discern whether counties have no cases reported because rabies was not present or because counties have an unreported rabies presence. These epizootics are monitored by the National Rabies Surveillance System (NRSS), to which approximately 130 state public health, agriculture, and academic laboratories report animal rabies testing statistics. Historically, the NRSS classifies US counties as free from terrestrial rabies if, over the previous 5 years, they and any adjacent counties did not report any rabies cases and they tested ≥15 reservoir animals or 30 domestic animals. Objective: This study aimed to describe and evaluate the historical NRSS rabies-free county definition, review possibilities for improving this definition, and develop a model to achieve more precise estimates of the probability of terrestrial rabies freedom and the number of reported county-level terrestrial rabies cases. Methods: Data submitted to the NRSS by state and territorial public health departments and the US Department of Agriculture Wildlife Services were analyzed to evaluate the historical rabies-free definition. A zero-inflated negative binomial model created county-level predictions of the probability of rabies freedom and the expected number of rabies cases reported. Data analyzed were from all animals submitted for laboratory diagnosis of rabies in the United States from 1995 to 2020 in skunk and raccoon reservoir territories, excluding bats and bat variants. Results: We analyzed data from 14,642 and 30,120 county-years in the raccoon and skunk reservoir territories, respectively. Only 0.85% (9/1065) raccoon county-years and 0.79% (27/3411) skunk county-years that met the historical rabies-free criteria reported a case in the following year (99.2% negative predictive value for each), of which 2 were attributed to unreported bat variants. County-level model predictions displayed excellent discrimination for detecting zero cases and good estimates of reported cases in the following year. Counties classified as rabies free rarely (36/4476, 0.8%) detected cases in the following year. Conclusions: This study concludes that the historical rabies freedom definition is a reasonable approach for identifying counties that are truly free from terrestrial raccoon and skunk rabies virus transmission. Gradations of risk can be measured using the rabies prediction model presented in this study. However, even counties with a high probability of rabies freedom should maintain rabies testing capacity, as there are numerous examples of translocations of rabies-infected animals that can cause major changes in the epidemiology of rabies

MetroMMC: Electron-Capture Spectrometry with Cryogenic Calorimeters for Science and Technology

Accurate decay data of radionuclides are necessary for many fields of science and technology, ranging from medicine and particle physics to metrology. However, data that are in use today are mostly based on measurements or theoretical calculation methods that are rather old. Recent measurements with cryogenic detectors and other methods show significant discrepancies to both older experimental data and theory in some cases. Moreover, the old results often suffer from large or underestimated uncertainties. This is in particular the case for electron-capture (EC) decays, where only a few selected radionuclides have ever been measured. To systematically address these shortcomings, the European metrology project MetroMMC aims at investigating six radionuclides decaying by EC. The nuclides are chosen to cover a wide range of atomic numbers Z, which results in a wide range of decay energies and includes different decay modes, such as pure EC or EC accompanied by γ- and/or β+-transitions. These will be measured using metallic magnetic calorimeters (MMCs), cryogenic energy-dispersive detectors with high-energy resolution, low-energy threshold and high, adjustable stopping power that are well suited for measurements of the total decay energy and X-ray spectrometry. Within the MetroMMC project, these detectors are used to obtain X-ray emission intensities of external sources as well as fractional EC probabilities of sources embedded in a 4 π absorber. Experimentally determined nuclear and atomic data will be compared to state-of-the-art theoretical calculations which will be further developed within the project. This contribution introduces the MetroMMC project and in particular its experimental approach. The challenges in EC spectrometry are to adapt the detectors and the source preparation to the different decay channels and the wide energy range involved, while keeping the good resolution and especially the low-energy threshold to measure the EC from outer shells. © 2019, The Author(s)

Investigation of Radiation-Induced Toxicity in Head and Neck Cancer Patients through Radiomics and Machine Learning: A Systematic Review

Background. Radiation-induced toxicity represents a crucial concern in oncological treatments of patients affected by head and neck neoplasms, due to its impact on survivors' quality of life. Published reports suggested the potential of radiomics combined with machine learning methods in the prediction and assessment of radiation-induced toxicities, supporting a tailored radiation treatment management. In this paper, we present an update of the current knowledge concerning these modern approaches. Materials and Methods. A systematic review according to PICO-PRISMA methodology was conducted in MEDLINE/PubMed and EMBASE databases until June 2019. Studies assessing the use of radiomics combined with machine learning in predicting radiation-induced toxicity in head and neck cancer patients were specifically included. Four authors (two independently and two in concordance) assessed the methodological quality of the included studies using the Radiomic Quality Score (RQS). The overall score for each analyzed study was obtained by the sum of the single RQS items; the average and standard deviation values of the authors' RQS were calculated and reported. Results. Eight included papers, presenting data on parotid glands, cochlea, masticatory muscles, and white brain matter, were specifically analyzed in this review. Only one study had an average RQS was ≤ 30% (50%), while 3 studies obtained a RQS almost ≤ 25%. Potential variability in the interpretations of specific RQS items could have influenced the inter-rater agreement in specific cases. Conclusions. Published radiomic studies provide encouraging but still limited and preliminary data that require further validation to improve the decision-making processes in preventing and managing radiation-induced toxicities

Osteology and phylogenetic relationships of Tehuelchesaurus benitezii (Dinosauria, Sauropoda) from the Upper Jurassic of Patagonia

The diversification and early evolution of neosauropod dinosaurs is mainly recorded from the Upper Jurassic of North America, Europe, and Africa. Our understanding of this evolutionary stage is far from complete, especially in the Southern Hemisphere. A partial skeleton of a large sauropod from the Upper Jurassic Cañadón Calcáreo Formation of Patagonia was originally described as a 'cetiosaurid' under the name Tehuelchesaurus benitezii. The specimen is here redescribed in detail and the evidence presented indicates that this taxon is indeed a neosauropod, thus representing one of the oldest records of this clade in South America. A complete preparation of the type specimen and detailed analysis of its osteology revealed a great number of features of phylogenetic significance, such as fully opisthocoelous dorsal vertebrae, the persistence of true pleurocoels up to the first sacral vertebra, associated with large camerae in the centrum and supraneural camerae, and an elaborate neural arch lamination, including two apomorphic laminae in the infradiapophyseal fossa. The phylogenetic relationships of this taxon are tested through an extensive cladistic analysis that recovers Tehuelchesaurus as a non-titanosauriform camarasauromorph, deeply nested within Neosauropoda. Camarasauromorph sauropods were widely distributed in the Late Jurassic, indicating a rapid evolution and diversification of the group. © 2011 The Linnean Society of London.Fil: Carballido, José Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Paleontológico Egidio Feruglio; ArgentinaFil: Rauhut, Oliver Walter Mischa. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Paleontológico Egidio Feruglio; Argentina. Ludwig-Maximilians-University; AlemaniaFil: Pol, Diego. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Paleontológico Egidio Feruglio; ArgentinaFil: Salgado, Leonardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; Argentin

A New Basal Sauropodomorph (Dinosauria: Saurischia) from Quebrada del Barro Formation (Marayes-El Carrizal Basin), Northwestern Argentina

BACKGROUND: Argentinean basal sauropodomorphs are known by several specimens from different basins; Ischigualasto, El Tranquilo, and Mogna. The Argentinean record is diverse and includes some of the most primitive known sauropodomorphs such as Panphagia and Chromogisaurus, as well as more derived forms, including several massospondylids. Until now, the Massospondylidae were the group of basal sauropodomorphs most widely spread around Pangea with a record in almost all continents, mostly from the southern hemisphere, including the only record from Antarctica. METHODOLOGY/PRINCIPAL FINDING: We describe here a new basal sauropodomorph, Leyesaurus marayensis gen. et sp. nov., from the Quebrada del Barro Formation, an Upper Triassic-Lower Jurassic unit that crops out in northwestern Argentina. The new taxon is represented by a partial articulated skeleton that includes the skull, vertebral column, scapular and pelvic girdles, and hindlimb. Leyesaurus is diagnosed by a set of unique features, such as a sharply acute angle (50 degrees) formed by the ascending process of the maxilla and the alveolar margin, a straight ascending process of the maxilla with a longitudinal ridge on its lateral surface, noticeably bulging labial side of the maxillary teeth, greatly elongated cervical vertebrae, and proximal articular surface of metatarsal III that is shelf-like and medially deflected. Phylogenetic analysis recovers Leyesaurus as a basal sauropodomorph, sister taxon of Adeopapposaurus within the Massospondylidae. Moreover, the results suggest that massospondylids achieved a higher diversity than previously thought. CONCLUSIONS/SIGNIFICANCE: Our phylogenetic results differ with respect to previous analyses by rejecting the massospondylid affinities of some taxa from the northern hemisphere (e.g., Seitaad, Sarahsaurus). As a result, the new taxon Leyesaurus, coupled with other recent discoveries, suggests that the diversity of massospondylids in the southern hemisphere was higher than in other regions of Pangea. Finally, the close affinities of Leyesaurus with the Lower Jurassic Massospondylus suggest a younger age for the Quebrada del Barro Formation than previously postulated