The hidden costs of installing xpert machines in a tuberculosis high-burden country: experiences from Nigeria

Introduction: Since the endorsement of GeneXpert MTB/RIF by the WHO, many countries have embarked on implementing this technology.Objective: We outline the cost of installing GeneXpert in district hospitals in Abuja, Nigeria.Methods: We prospectively documented costs related to the installation of GeneXpert at five sites. Costs were collected from receipts received from suppliers and normalized to USD 2012 values.Results: Costs were often identified after initiating installation for many reasons. Installation varied  widely between sites with sufficient space and power supply; sites with insufficient space or power supply and costs not directly associated with site installation. The basic cost for installation was USD 2,621.98 per machine. Sites that required additional space cost close to USD 7,000.00.Conclusion: Space and power requirements have a significant effect on installation costs. Countries need to carefully consider the placement of Xpert machines based on the quality and size of the available infrastructure.Key words: Tuberculosis, Xpert-Installation, low resource –settings, hidden cost, operational researc

Hybrid loss exceedance curve (HLEC) for risk assessment

Countries need to assess the expected risk due to natural hazards as a permanent activity in their financial plan; otherwise, they will experience a lack in the information required by the application of disaster risk reduction policies. In this article, a risk assessment methodology is proposed that uses, in one hand, empiric estimations of loss, based on information available in local disaster data bases, allowing to estimate losses due to small events; on the ot her hand, it uses probabilistic evaluations to estimate loss for greater or even catastrophic events for which information is not available due the lack of historical data. A “hybrid” loss exceedance curve, which represents the disaster risk in a proper and complete way, is thus determined. This curve merges two components: the corresponding to small and moderate losses, calculated by using an inductive and retrospective analysis, and the corresponding to extreme losses, calculated by using a deductive and prospective analysis. Applications of this new probabilistic risk assessment technique are given in this article for three countries.Postprint (published version

ESTUDIO DE LA TECNOLOGÍA DE TVWS EN COLOMBIA Y COMPARACIÓN CON EL MUNDO

Este artículo trata acerca, del estudio de la tecnología de espacios en blanco (TVWS) en beneficio del Ejército Nacional; como una opción para brindar internet libre en zonas alejadas, entre las frecuencias en la banda de 480 MHz a 698 MHz, dadas por la normatividad en Colombia. La orientación que se presentó, es la revisión del estado del arte de la tecnología TVWS en Colombia, frente a los diferentes países en el mundo que han trabajado en esta área; con el fin de llevar a cabo un análisis en cuanto a: regulación, aspectos técnicos, desarrollo de pruebas piloto e implementaciones

Behavior and Design of Transfer Slabs Subjected to Shear Wall Loads

This paper investigates the behavior of a transfer slab system used in medium rise building. For this purpose, two slab-wall full-scale specimens were designed, built, and tested to cyclic loads. The two slab-wall prototypes were exposed to three load stages: (a) vertical load, (b) horizontal load, and (c) vertical and horizontal combined load. The first specimen, SP1, includes a masonry wall situated on top of a squared two-way slab of 4.25 m by side, thickness of 12 cm, on four reinforced concrete girders, while the second specimen, SP2, consists of an identical slab but was constructed with a reinforced concrete wall. Some numerical finite element slab-wall models were built using linear and nonlinear models. The most important results presented herein are the change on lateral stiffness and resistance capacity of the load-bearing wall supported on a slab versus the wall supported on a fixed base and the effects that these walls cause on the slabs. During the experimental test process of horizontal loading, we detected that the stiffness of the two slab-wall systems decreased significantly compared to the one on the fixed base wall, a result supported by the numerical models. The models indicated suitable correlation and were used to conduct a detailed parametric study on various design configurations

Can Interferon-Gamma or Interferon-Gamma-Induced-Protein-10 Differentiate Tuberculosis Infection and Disease in Children of High Endemic Areas?

Diagnosis of childhood tuberculosis (TB) is difficult in high TB burden settings. Interferon-gamma-induced protein 10 (IP10) has been suggested as a marker of TB infection and disease, but its ability to differentiate the two conditions remains uncertain.To describe Interferon-gamma (INFγ) and IP10 expression in children with TB infection and disease and controls to assess their potential to differentiate latent and active TB. TB), 335 children in contact with adults with pulmonary TB and 156 community controls in Southern Ethiopia. The Tuberculin Skin Test (TST) and Quantiferon-In-Tube (QFT-IT) were performed. INFγ and IP10 were measured in plasma supernatants.INFγ and IP10 can identify children with TB infection and disease, but cannot differentiate between the two conditions. HIV status did not affect the expression of IP10

Plan prospectivo y estratégico retos y desafíos de la deserción estudiantil en la educación superior en Colombia al año 2027

Anexos incluidos en el documentoEl trabajo contempla un plan Prospectivo y Estratégico para los retos y desafíos de la deserción estudiantil a nivel profesional en Colombia al año 2027; a partir de la investigación de fuentes bibliográficas, tomando opinión de diferentes expertos sobre el tema quiénes permitieron determinar los actores y factores de cambio que influyen en el estudio. Los datos fueron tabulados y consolidados a partir de herramientas de métodos prospectivos, arrojando resultados y datos cuantitativos y cualitativos que permitieron analizar todas las variables, divergencias, convergencias, políticas y actores que influyen en el escenario más apropiado para desarrollar el plan estratégico y así reducir el índice de deserción estudiantil.The work contemplates the realization of a Prospective and Strategic plan for the challenges and challenges of student dropout at professional level in Colombia to the year 2027; from the research of bibliographical sources, it was taken the opinion of different experts on the subject who from their experience allowed to determine the actors and factors of change that influence in the study. The data were tabulated and consolidated using tools of prospective methods, which yielded results and quantitative and qualitative data that allowed to analyze all the variables, Divergences, convergences, policies and actors that influence the most appropriate scenario to develop the strategic plan and thus reduce the dropout rate

Sistema de desarrollo para aplicaciones basadas en µcontrolador

Los equipos de prácticas de distintas especialidades tienen un precio muy elevado y son muy dispares entre sí, no ajustándose completamente al programa de las diferentes asignaturas que pueden abarcar. Se planteo interesante en nuestro Grupo de Trabajo desarrollar un "SISTEMA DE DESARROLLO PARA APLICACIONES BASADAS EN µCONTROLADOR", de forma que fuese lo más polivalente posible. En este sistema se incorporan todos los recursos característicos en el diseño de sistemas con microprocesadores tales como; la típica expansión de buses de datos y direcciones “mapeando” todos los dispositivos direccionados por el microprocesador, la incorporación de dispositivos I2C que con tan solo dos líneas permiten ser gestionados por la CPU, comunicaciones RS-232 y RS-485 que permiten la posibilidad de crear sistemas distribuidos. De forma paralela se introducen todos los bloques combinacionales y secuenciales que anteriormente se implementaban con componentes discretos de la serie TTL 74xx o CMOS 40xx en PLD’s y FPGA’s programados con lenguajes descriptivos de hardware como VHDL

Front-Loading Sputum Microscopy Services: An Opportunity to Optimise Smear-Based Case Detection of Tuberculosis in High Prevalence Countries

Setting. Ethiopia, Nepal, Nigeria, and Yemen. Objective. To reduce the time to complete sputum microscopy. Design. Cross-sectional surveys enrolling 923 patients with chronic cough in the 4 countries and using similar protocols. Spot-morning-spot sputum specimens were collected. An additional sputum specimen (Xspot) was collected one hour after the first, and the yields of the first two or the three specimens collected as spot-morning-spot or spot-Xspot-morning were compared. Results. 216 patients had ≥ one positive smear. 210 (97%) were identified by the spot-morning-spot, and 210 (97%) were identified by the spot-Xspot-morning specimens, with 203 and 200 identified by the first 2 specimens of each approach, respectively. Neither difference was significant. Conclusions. The time to complete smear microscopy could be reduced

Point of care diagnostics for tuberculosis

The goals of the End TB strategy, which aims to achieve a 90% reduction in tuberculosis (TB) incidence and a 95% reduction in TB mortality by 2035, will not be achieved without new tools to fight TB. These include improved point of care (POC) diagnostic tests that are meant to be delivered at the most decentralised levels of care where the patients make the initial contact with the health system, as well as within the community. These tests should be able to be performed on an easily accessible sample and provide results in a timely manner, allowing a quick treatment turnaround time of a few minutes or hours (in a single clinical encounter), hence avoiding patient loss-to-follow-up. There have been exciting developments in recent years, including the WHO endorsement of Xpert MTB/RIF, Xpert MTB/RIF Ultra, loop-mediated isothermal amplification (TB-LAMP) and lateral flow lipoarabinomannan (LAM). However, these tests have limitations that must be overcome before they can be optimally applied at the POC. Furthermore, worrying short- to medium-term gaps exist in the POC diagnostic test development pipeline. Thus, not only is better implementation of existing tools and algorithms needed, but new research is required to develop new POC tests that allow the TB community to truly make an impact and find the ‘‘missed TB cases’’

Rescatando películas: directores malos, desconocidos o one hit wonders

¿Michael Bay y Robert Rodríguez realmente tienen alguna película rescatable? ¿Se acuerdan de cintas de Herk Harvey, Les Blank o Jonathan Glazer? Pues bien, a continuación, una lista comentada de películas muy apreciables de directores malos o casi olvidados para algunos de nuestros colaboradores