All-optical phase and amplitude regeneration properties of a 40 Gbit/s DPSK black-box phase sensitive amplifier

We experimentally study the pure amplitude and phase regeneration capabilities of a blackbox degenerate four wave mixing (FWM) based bit-rate-flexible phase sensitive amplifier (PSA) for a 40 Gbit/s differential phase-shift keyed (DPSK) signal

Electrochemical activation and inhibition of neuromuscular systems through modulation of ion concentrations with ion-selective membranes

Conventional functional electrical stimulation aims to restore functional motor activity of patients with disabilities resulting from spinal cord injury or neurological disorders. However, intervention with functional electrical stimulation in neurological diseases lacks an effective implantable method that suppresses unwanted nerve signals. We have developed an electrochemical method to activate and inhibit a nerve by electrically modulating ion concentrations in situ along the nerve. Using ion-selective membranes to achieve different excitability states of the nerve, we observe either a reduction of the electrical threshold for stimulation by up to approximately 40%, or voluntary, reversible inhibition of nerve signal propagation. This low-threshold electrochemical stimulation method is applicable in current implantable neuroprosthetic devices, whereas the on-demand nerve-blocking mechanism could offer effective clinical intervention in disease states caused by uncontrolled nerve activation, such as epilepsy and chronic pain syndromes.Massachusetts Institute of Technology. Faculty Discretionary Research FundNational Institutes of Health (U.S.) (Award UL1 RR 025758)Harvard Catalyst (Grant

Patterns of public participation: opportunity structures and mobilization from a cross-national perspective

Purpose: The paper summarizes data from twelve countries, chosen to exhibit wide variation, on the role and place of public participation in the setting of priorities. It seeks to exhibit cross-national patterns in respect of public participation, linking those differences to institutional features of the countries concerned. Design/methodology/approach: The approach is an example of case-orientated qualitative assessment of participation practices. It derives its data from the presentation of country case studies by experts on each system. The country cases are located within the historical development of democracy in each country. Findings: Patterns of participation are widely variable. Participation that is effective through routinized institutional processes appears to be inversely related to contestatory participation that uses political mobilization to challenge the legitimacy of the priority setting process. No system has resolved the conceptual ambiguities that are implicit in the idea of public participation. Originality/value: The paper draws on a unique collection of country case studies in participatory practice in prioritization, supplementing existing published sources. In showing that contestatory participation plays an important role in a sub-set of these countries it makes an important contribution to the field because it broadens the debate about public participation in priority setting beyond the use of minipublics and the observation of public representatives on decision-making bodies

Performance characterisation of 42.65 Gbit/s dual-gate asynchronous digital optical regenerator using single MZM

The tolerance of a 42.65 Gbit/s dual-gate asynchronous digital optical regenerator using a single Mach-Zehnder modulator to optical signal-to-noise-ratio degradation and chromatic dispersion is experimentally demonstrated

Rational use of antibiotics by community health workers and caregivers for children with suspected pneumonia in Zambia: A cross-sectional mixed methods study

Background: Antibiotic resistance is an issue of growing global concern. One key strategy to minimise further development of resistance is the rational use of antibiotics, by providers and patients alike. Through integrated community case management (iCCM), children diagnosed with suspected pneumonia are treated with antibiotics; one component of an essential package to reduce child mortality and increase access to health care for remote populations. Through the use of clinical algorithms, supportive supervision and training, iCCM also offers the opportunity to improve the rational use of antibiotics and limit the spread of resistance in resource-poor contexts. This study provides evidence on antibiotic use by community health workers (CHWs) and caregivers to inform iCCM programmes, safeguarding current treatments whilst maximising access to care. Methods: 1497 CHW consultations were directly observed by non-clinical researchers, with measurement of respiratory rate by CHWs recorded by video. Videos were used to conduct a retrospective reference standard assessment of respiratory rate by experts. Fifty-five caregivers whose children were prescribed a 5-day course of antibiotics for suspected pneumonia were followed up on day six to assess adherence through structured interviews and pill counts. Six focus group discussions and nine in depth interviews were conducted with CHWs and caregivers to supplement quantitative findings. Results: The findings indicate that CHWs adhered to treatment guidelines for 92 % of children seen, prescribing treatment corresponding to their assessment. However, only 65 % of antibiotics prescribed were given for children with experts' confirmed fast breathing pneumonia. Qualitative data indicates that CHWs have a good understanding of pneumonia diagnosis, and although caregivers sometimes applied pressure to receive drugs, CHWs stated that treatment decisions were not influenced. 46 % of caregivers were fully adherent and gave their child the full 5-day course of dispersible amoxicillin. If caregivers who gave treatment for 3 to 5 days were considered, adherence increased to 76 %. Conclusions: CHWs are capable of prescribing treatment corresponding to their assessment of respiratory rate. However, rational use of antibiotics could be strengthened through improved respiratory rate assessment, and better diagnostic tools. Furthermore, a shorter course of dispersible amoxicillin could potentially improve caregiver adherence, reducing risk of resistance and cost

Mathematical models of drug-resistant tuberculosis lack bacterial heterogeneity: A systematic review

Drug-resistant tuberculosis (DR-TB) threatens progress in the control of TB. Mathematical models are increasingly being used to guide public health decisions on managing both antimicrobial resistance (AMR) and TB. It is important to consider bacterial heterogeneity in models as it can have consequences for predictions of resistance prevalence, which may affect decision-making. We conducted a systematic review of published mathematical models to determine the modelling landscape and to explore methods for including bacterial heterogeneity. Our first objective was to identify and analyse the general characteristics of mathematical models of DR-mycobacteria, including M. tuberculosis. The second objective was to analyse methods of including bacterial heterogeneity in these models. We had different definitions of heterogeneity depending on the model level. For between-host models of mycobacterium, heterogeneity was defined as any model where bacteria of the same resistance level were further differentiated. For bacterial population models, heterogeneity was defined as having multiple distinct resistant populations. The search was conducted following PRISMA guidelines in five databases, with studies included if they were mechanistic or simulation models of DR-mycobacteria. We identified 195 studies modelling DR-mycobacteria, with most being dynamic transmission models of non-treatment intervention impact in M. tuberculosis (n = 58). Studies were set in a limited number of specific countries, and 44% of models (n = 85) included only a single level of “multidrug-resistance (MDR)”. Only 23 models (8 between-host) included any bacterial heterogeneity. Most of these also captured multiple antibiotic-resistant classes (n = 17), but six models included heterogeneity in bacterial populations resistant to a single antibiotic. Heterogeneity was usually represented by different fitness values for bacteria resistant to the same antibiotic (61%, n = 14). A large and growing body of mathematical models of DR-mycobacterium is being used to explore intervention impact to support policy as well as theoretical explorations of resistance dynamics. However, the majority lack bacterial heterogeneity, suggesting that important evolutionary effects may be missed

Novel synchronous DPSK optical regenerator based on a feed-forward based carrier extraction scheme

We experimentally demonstrate a novel synchronous 10.66Gbit/s DPSK OEO regenerator which uses a feed-forward carrier extraction scheme with an injection-locked laser to synchronize the regenerated signal wavelength to the incoming signal wavelength. After injection-locking, a low-cost DFB laser used at the regenerator exhibited the same linewidth characteristics as the narrow line-width transmitter laser. The phase regeneration properties of the regenerator were evaluated by emulating random Gaussian phase noise applied to the DPSK signal before the regenerator using a phase modulator driven by an arbitrary waveform generator. The overall performance was evaluated in terms of electrical eye-diagrams, BER measurements, and constellation diagrams

Novel real-time homodyne coherent receiver using a feed-forward based carrier extraction scheme for phase modulated signals

We report a novel real-time homodyne coherent receiver based on a DPSK optical-electrical-optical (OEO) regenerator used to extract a carrier from carrier-less phase modulated signals based on feed-forward based modulation stripping. The performance of this non-DSP based coherent receiver was evaluated for 10.66Gbit/s BPSK signals. Self-homodyne coherent detection and homodyne detection with an injection-locked local oscillator laser was demonstrated. The performance was evaluated by measuring the electrical signal-to-noise (SNR) and recording the eye diagrams. Using injection-locking for the LO improves the performance and enables homodyne detection with optical injection-locking to operate with carrier-less BPSK signals without the need for polarization multiplexed pilot-tones

DPSK signal regeneration with a dual-pump nondegenerate phase-sensitive amplifier

We demonstrate, for the first time to our knowledge, regeneration of a 42.66-Gb/s differential phase-shift keyed signal using a dual-pump nondegenerate four-wave-mixing-based fiber-optic parametric amplifier. The regenerative performance of the subsystem is characterized in terms of bit-error rate against narrowband and wideband introduced noise. While a strong receiver sensitivity improvement, up to 20 dB, is noticed against narrowband noise, against quasi-random (wideband) noise we observe a regeneration of 2.7 dB

Comparison of frequency symmetric signal generation from a BPSK input using fiber and semiconductor-based nonlinear elements

This letter compares two nonlinear media for simultaneous carrier recovery and generation of frequency symmetric signals from a 42.7-Gb/s nonreturn-to-zero binary phase-shift-keyed input by exploiting four-wave mixing in a semiconductor optical amplifier and a highly nonlinear optical fiber for use in a phase-sensitive amplifier