Eliminating the barriers to uptake of cataract surgery in a resource‑poor setting: A focus on direct surgical cost

Background: Cataract remains a leading cause of blindness worldwide. Despite the high therapeutic efficacy of cataract surgical interventions, surgical uptake has been sub‑optimal, especially in low‑ and middle‑income countries.Objective: The objective was to investigate the effect of surgical fee reduction on the uptake of cataract surgical services at the University of Nigeria Teaching Hospital (UNTH) Enugu.Methods: In a retrospective comparative study, all patients who underwent cataract surgery at UNTH between January 2008 and December 2011 were identified from the eye theatre’s surgical logbook. Their clinical charts were recalled and relevant demographic and clinical data were abstracted, categorized into pre (January 2008 to December 2009, Group A), and post (January 2010 to December 2011, Group B) surgical fee reduction groups. Descriptive and comparative statistical analyses were performed.Results: A total of 376 cataract surgeries (Group A, 164 [43.6%]; Group B, 212 [56.4%]) was performed during the 4‑year study period. The surgeries were performed on 217 males, and 159 females aged 55.4 ± 23.4 standard deviation years (range, 7 months to 89 years). The average annual uptake of cataract surgery was 94 overall, 82 pre and 106 postsurgical fee reductions. The two groups did not differ significantly by age (P = 0.8750) or gender (P = 0.8337).Conclusion: There is low uptake of cataract surgery at UNTH Enugu. Direct surgical fee reduction alone caused only a modest increase in uptake without alteration in age and gender balance. Further fee reduction and exploration of other uptake barriers are warranted.Key words: Cataract surgery, surgical cost, uptak

A novel ANN fault diagnosis system for power systems using dual GA loops in ANN training

Fault diagnosis is of great importance to the rapid restoration of power systems. Many techniques have been employed to solve this problem. In this paper, a novel Genetic Algorithm (GA) based neural network for fault diagnosis in power systems is suggested, which adopts three-layer feed-forward neural network. Dual GA loops are applied in order to optimize the neural network topology and the connection weights. The first GA-loop is for structure optimization and the second one for connection weight optimization. Jointly they search the global optimal neural network solution for fault diagnosis. The formulation and the corresponding computer flow chart are presented in detail in the paper. Computer test results in a test power system indicate that the proposed GA-based neural network fault diagnosis system works well and is superior as compared with the conventional Back-Propagation (BP) neural network.published_or_final_versio

A novel radial basis function neural network for fault section estimation in transmission network

In this paper, the application of Radial Basis Function Neural Network (RBF NN) to fault section estimation in power systems is addressed. The orthogonal least square algorithm has been extended to optimize the parameters of RBF NN. In order to assess the effectiveness of RBF NN, a classical Back-Propagation Neural Network (BP NN) has been developed to solve the same problem for comparison. Computer test is conducted on a 4-bus test system and the test results show that the RBF NN is quite effective and superior to BP NN in fault section estimation.published_or_final_versio

Intellectual Property in Medical Imaging and Informatics: The Independent Inventor’s Perspective

While innovation and new product development is traditionally thought of as the exclusive domain of industry and academia, a large number of innovations in medicine and information technology have come from independent inventors, which account for almost 30% of new patents issued in the U.S. today. A large number of economic, political, and legal challenges exist within the current marketplace that serves as relative impediments to independent invention. This article explores the existing challenges facing the independent inventor and offers a number of recommendations and resources to facilitate independent inventors in their quest for innovation and entrepreneurship. The concept of “outsourcing innovation” is discussed as an alternative to the existing model of industry sponsored research and development (R&D), with the goal of combining the unique attributes and strengths of independent inventors and industry sponsors

Influence of Soaking Time and Sodium Hydroxide Concentration on the Chemical Composition of Treated Mango Seed Shell Flour for Composite Application

Lignin and hemicelluloses are the major impurities to be removed in natural fibers for it to be suitable in composite application and other uses. This research is based on evaluating the influence of soaking time and sodium hydroxide concentration on the chemical composition of treated mango seed shell (MSSF) by immersing the MSSF in NaOH solution at concentration of 2.5 - 7.5 wt % and soaking time of 2-6 hr, in order to decrease the lignin and hemicellulose content while increasing its cellulose content. The optimum conditions obtained for concentration and soaking time of NaOH were 6.09 % and 5.22 hr, respectively. At these conditions, cellulose content was increased to 94.8002%, while the hemicelluloses and lignin content were reduced to 2.2779% and 0.508502%, respectively. Theprocess parameter of MSSF was optimized using central composite design (CCD) to predict the cellulose, hemicelluloses, and lignin content. The quadratic model of response surface model (RSM) was adopted for the prediction of cellulose, hemicelluloses, and lignin content. The maximum error between the predicted using CCD and experimental results was less 0.38%. These errors in variation for both the predicted by the RSM and the actual gave good alignment with both results. Therefore, at these treatment conditions, MSSF can be utilized for composite application and other industrial purpose.Keywords: NaOH, Chemical Modification, Mango Seed Shell Flour, Chemical Compositio

Inattentive Consumers in Markets for Services

In an experiment on markets for services, we find that consumers are likely to stick to default tariffs and achieve suboptimal outcomes. We find that inattention to the task of choosing a better tariff is likely to be a substantial problem in addition to any task and tariff complexity effect. The institutional setup on which we primarily model our experiment is the UK electricity and gas markets, and our conclusion is that the new measures by the UK regulator Ofgem to improve consumer outcomes are likely to be of limited impact

Effect of Dietary Components on Larval Life History Characteristics in the Medfly (Ceratitis capitata: Diptera, Tephritidae)

Background: The ability to respond to heterogenous nutritional resources is an important factor in the adaptive radiation of insects such as the highly polyphagous Medfly. Here we examined the breadth of the Medfly’s capacity to respond to different developmental conditions, by experimentally altering diet components as a proxy for host quality and novelty. Methodology/Principal Findings: We tested responses of larval life history to diets containing protein and carbohydrate components found in and outside the natural host range of this species. A 40% reduction in the quantity of protein caused a significant increase in egg to adult mortality by 26.5%±6% in comparison to the standard baseline diet. Proteins and carbohydrates had differential effects on larval versus pupal development and survival. Addition of a novel protein source, casein (i.e. milk protein), to the diet increased larval mortality by 19.4%±3% and also lengthened the duration of larval development by 1.93±0.5 days in comparison to the standard diet. Alteration of dietary carbohydrate, by replacing the baseline starch with simple sugars, increased mortality specifically within the pupal stage (by 28.2%±8% and 26.2%±9% for glucose and maltose diets, respectively). Development in the presence of the novel carbohydrate lactose (milk sugar) was successful, though on this diet there was a decrease of 29.8±1.6 µg in mean pupal weight in comparison to pupae reared on the baseline diet. Conclusions: The results confirm that laboratory reared Medfly retain the ability to survive development through a wide range of fluctuations in the nutritional environment. We highlight new facets of the responses of different stages of holometabolous life histories to key dietary components. The results are relevant to colonisation scenarios and key to the biology of this highly invasive species

Photoemission "experiments" on holographic superconductors

We study the effects of a superconducting condensate on holographic Fermi surfaces. With a suitable coupling between the fermion and the condensate, there are stable quasiparticles with a gap. We find some similarities with the phenomenology of the cuprates: in systems whose normal state is a non-Fermi liquid with no stable quasiparticles, a stable quasiparticle peak appears in the condensed phase.Comment: 14 pages, 13 figures; v2: typos corrected and some clarification adde

Experimental evidence of pollination in marine flowers by invertebrate fauna

Pollen transport by water-flow (hydrophily) is a typical, and almost exclusive, adaptation of plants to life in the marine environment. It is thought that, unlike terrestrial environments, animals are not involved in pollination in the sea. The male flowers of the tropical marine angiosperm Thalassia testudinum open-up and release pollen in mucilage at night when invertebrate fauna is active. Here we present experimental evidence that, in the absence of water-flow, these invertebrates visit the flowers, carry and transfer mucilage mass with embedded pollen from the male flowers to the stigmas of the female flowers. Pollen tubes are formed on the stigmas, indicating that pollination is successful. Thus, T. testudinum has mixed abiotic–biotic pollination. We propose a zoobenthophilous pollination syndrome (pollen transfer in the benthic zone by invertebrate animals) which shares many characteristics with hydrophily, but flowers are expected to open-up during the night

Ears of the Armadillo: Global Health Research and Neglected Diseases in Texas

Neglected tropical diseases (NTDs) have\ud been recently identified as significant public\ud health problems in Texas and elsewhere in\ud the American South. A one-day forum on the\ud landscape of research and development and\ud the hidden burden of NTDs in Texas\ud explored the next steps to coordinate advocacy,\ud public health, and research into a\ud cogent health policy framework for the\ud American NTDs. It also highlighted how\ud U.S.-funded global health research can serve\ud to combat these health disparities in the\ud United States, in addition to benefiting\ud communities abroad