192 research outputs found

    Resource Allocation Algorithm for MU-MIMO Systems with Double-Objective Optimization under the Existence of the Rank Deficient Channel Matrix

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    © 2013 IEEE. This paper proposes a double-objective optimization resource allocation algorithm for the multi-user multiple-input/multiple-output (MU-MIMO) system in the general wireless environment and demonstrates the maximum number of simultaneously supportable users and the achievable bit rates of users in the general wireless environment with full rank and rank-deficient channels. The double-objective joint optimization algorithm proposed in this paper simultaneously optimizes energy efficiency and system throughput by user selection and power allocation. On this basis, the proposed algorithm guarantees the different QoS requirements of various services, including rate requirements and delay requirements

    The Costs of Implementing Vaccination With the RTS,S Malaria Vaccine in Five Sub-Saharan African Countries.

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    Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of the expanded program on immunization at all levels in each country were interviewed on the resources required for implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach setting. Results. The costs per FVC ranged from US25(BurkinaFaso)toUS25 (Burkina Faso) to US37 (Kenya) assuming a vaccine price of US5perdose.Acrosscountries,recurrentcostsrepresentedthelargestsharedominatedbyvaccines(includingwastage)andsupplycosts.Nonrecurrentcostsvariedsubstantiallyacrosscountries,mainlybecauseofdifferencesinneedsforhiringpersonnel,inwages,incoldroomspace,andequipment.Recentvaccineintroductionsinthecountriesmayhavehadanimpactonresourceavailabilityforanewvaccineimplementation.Deliveringthefourthdoseinoutreachsettingsraisedthecosts,mostlyfuel,perFVCbylessthanUS5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the countries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose in outreach settings raised the costs, mostly fuel, per FVC by less than US1 regardless of the country. Conclusions. This study provides relevant information for donors and decision makers about the cost of implementing RTS,S. Variations within and across countries are important and the unknown future price per dose and wastage rate for this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation

    Leukocyte counts in urine reflect the risk of concomitant sepsis in bacteriuric infants: A retrospective cohort study

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    <p>Abstract</p> <p>Background</p> <p>When urine infections are missed in febrile young infants with normal urinalysis, clinicians may worry about the risk – hitherto unverified – of concomitant invasion of blood and cerebrospinal fluid by uropathogens. In this study, we determine the extent of this risk.</p> <p>Methods</p> <p>In a retrospective cohort study of febrile 0–89 day old infants evaluated for sepsis in an urban academic pediatric emergency department (1993–1999), we estimated rates of bacteriuric sepsis (urinary tract infections complicated by sepsis) after stratifying infants by urine leukocyte counts higher, or lower than 10 cells/hpf. We compared the global accuracy of leukocytes in urine, leukocytes in peripheral blood, body temperature, and age for predicting bacteruric sepsis. The global accuracy of each test was estimated by calculating the area under its receiver operating characteristic curve (AUC). Chi-square and Fisher exact tests compared count data. Medians for data not normally distributed were compared by the Kruskal-Wallis test.</p> <p>Results</p> <p>Two thousand two hundred forty-nine young infants had a normal screening dipstick. None of these developed bacteremia or meningitis despite positive urine culture in 41 (1.8%). Of 1516 additional urine specimens sent for formal urinalysis, 1279 had 0–9 leukocytes/hpf. Urine pathogens were isolated less commonly (6% vs. 76%) and at lower concentrations in infants with few, compared to many urine leukocytes. Urine leukocytes (AUC: 0.94) were the most accurate predictors of bacteruric sepsis. Infants with urinary leukocytes < 10 cells/hpf were significantly less likely (0%; CI:0–0.3%) than those with higher leukocyte counts (5%; CI:2.6–8.7%) to have urinary tract infections complicated by bacteremia (N = 11) or bacterial meningitis (N = 1) – relative risk, 0 (CI:0–0.06) [RR, 0 (CI: 0–0.02), when including infants with negative dipstick]. Bands in peripheral blood had modest value for detecting bacteriuric sepsis (AUC: 0.78). Cases of sepsis without concomitant bacteriuria were comparatively rare (0.8%) and equally common in febrile young infants with low and high concentrations of urine leukocytes.</p> <p>Conclusion</p> <p>In young infants evaluated for fever, leukocytes in urine reflect the likelihood of bacteriuric sepsis. Infants with urinary tract infections missed because of few leukocytes in urine are at relatively low risk of invasive bacterial sepsis by pathogens isolated from urine.</p

    TIME Impact - a new user-friendly tuberculosis (TB) model to inform TB policy decisions.

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    Tuberculosis (TB) is the leading cause of death from infectious disease worldwide, predominantly affecting low- and middle-income countries (LMICs), where resources are limited. As such, countries need to be able to choose the most efficient interventions for their respective setting. Mathematical models can be valuable tools to inform rational policy decisions and improve resource allocation, but are often unavailable or inaccessible for LMICs, particularly in TB. We developed TIME Impact, a user-friendly TB model that enables local capacity building and strengthens country-specific policy discussions to inform support funding applications at the (sub-)national level (e.g. Ministry of Finance) or to international donors (e.g. the Global Fund to Fight AIDS, Tuberculosis and Malaria).TIME Impact is an epidemiological transmission model nested in TIME, a set of TB modelling tools available for free download within the widely-used Spectrum software. The TIME Impact model reflects key aspects of the natural history of TB, with additional structure for HIV/ART, drug resistance, treatment history and age. TIME Impact enables national TB programmes (NTPs) and other TB policymakers to better understand their own TB epidemic, plan their response, apply for funding and evaluate the implementation of the response.The explicit aim of TIME Impact's user-friendly interface is to enable training of local and international TB experts towards independent use. During application of TIME Impact, close involvement of the NTPs and other local partners also builds critical understanding of the modelling methods, assumptions and limitations inherent to modelling. This is essential to generate broad country-level ownership of the modelling data inputs and results. In turn, it stimulates discussions and a review of the current evidence and assumptions, strengthening the decision-making process in general.TIME Impact has been effectively applied in a variety of settings. In South Africa, it informed the first South African HIV and TB Investment Cases and successfully leveraged additional resources from the National Treasury at a time of austerity. In Ghana, a long-term TIME model-centred interaction with the NTP provided new insights into the local epidemiology and guided resource allocation decisions to improve impact

    Black Soldier Fly (Hermitia illucens) Larvae Meal as Alternative Protein in Broiler Production in Ghana

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    Feed cost has been a major challenge to the competitiveness of the poultry industry of Ghana due mainly to high cost of proteins. Insect larvae meals seem convenient alternatives however their use on commercial scale is unknown in Ghana. Three 8-week feeding trial using three isonitrogenous, isocaloric diets in a three-phase feeding strategy involving 1320 broiler DOCs was conducted. BSFLM was used as replacement for fishmeal and as partial replacement for soybean meal to determine its effect on broiler productivity, profitability and carcass measurements. The results indicated that replacing fishmeal with BSFLM significantly improved weight gain, feed conversion efficiency and production efficiency factor (PEF). No detrimental effect was observed on carcass and specific organ measurements. Using the partial budgeting approach on a 500-bird estimation an increase of one thousand, one hundred and eleven Ghana cedis (GH₵1,111.00) was obtained when the fishmeal was replaced with BSFLM. Also, an increase of four hundred and sixty-seven Ghana cedis (GH₵467.00) was estimated when soybean meal was partially replaced with BSFLM. It was concluded that BSFLM can be used to improve the productivity and profitability of broiler production

    Green Supply Chain in Solid Waste Management: Case Study of EcoCare H2H Waste Collection, Goaso, Ghana

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    Today, Green supply chain management (GSCM) has become a multidisciplinary concept by constructing environmental management practices in the context of various supply chains including waste management services. Environmental issues have become an important integration into the supply chain management, so that each step from organization’s materials management and transportation functions to the end customer can be structured to include environmental awareness. The authors analyze the levels of application of GSCM in waste management value chain of Ghana and use our house-to-house waste collection model as case. Review of the social, environmental and economic impacts made by waste EcoCare and other solid waste management companies that incorporate circularity – at least a recovery and recycling channel at some point – into their service shows are setting a pace for understanding, adoption and replication of green supply chain management (GSCM) into waste management in the country. The authors recommend that private-public-partnerships for waste management in Goaso and other cities would be greener if they replicated the circular economy model implemented by EcoCare Waste Initiative and its H2H Waste Collection model

    Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases

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    BACKGROUND: Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. METHODS: Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. RESULTS: A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANY(r)); 16.8% (50/298) were isoniazid-mono-resistant (INH(r)), 16.8% (50/298) were rifampicin-mono-resistant (RIF(r)), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANY(r) were additionally resistant to at least one second line drug: 7.4% (2 RIF(r), 1 INH(r), and 10 MDR samples) resistant to only FQs and 2.3% (2 RIF(r), 1 INH(r), and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIF(r) and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INH(r) and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. CONCLUSION: The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance
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