Variations in visceral leishmaniasis burden, mortality and the pathway to care within Bihar, India

BACKGROUND: Visceral leishmaniasis (VL) has been targeted by the WHO for elimination as a public health problem (< 1 case/10,000 people/year) in the Indian sub-continent (ISC) by 2020. Bihar State in India, which accounts for the majority of cases in the ISC, remains a major target for this elimination effort. However, there is considerable spatial, temporal and sub-population variation in occurrence of the disease and the pathway to care, which is largely unexplored and a threat to achieving the target. METHODS: Data from 6081 suspected VL patients who reported being clinically diagnosed during 2012-2013 across eight districts in Bihar were analysed. Graphical comparisons and Chi-square tests were used to determine differences in the burden of identified cases by season, district, age and sex. Log-linear regression models were fitted to onset (of symptoms)-to-diagnosis and onset-to-treatment waiting times to estimate their associations with age, sex, district and various socio-economic factors (SEFs). Logistic regression models were used to identify factors associated with mortality. RESULTS: Comparisons of VL caseloads suggested an annual cycle peaking in January-March. A 17-fold variation in the burden of identified cases across districts and under-representation of young children (0-5 years) relative to age-specific populations in Bihar were observed. Women accounted for a significantly lower proportion of the reported cases than men (41 vs 59%, P < 0.0001). Age, district of residence, house wall materials, caste, treatment cost, travelling for diagnosis and the number of treatments for symptoms before diagnosis were identified as correlates of waiting times. Mortality was associated with age, district of residence, onset-to-treatment waiting time, treatment duration, cattle ownership and cost of diagnosis. CONCLUSIONS: The distribution of VL in Bihar is highly heterogeneous, and reported caseloads and associated mortality vary significantly across different districts, posing different challenges to the elimination campaign. Socio-economic factors are important correlates of these differences, suggesting that elimination will require tailoring to population and sub-population circumstances

Long-term impacts of integrated nutrient management with equivalent nutrient doses to mineral fertilization on soil organic carbon sequestration in a sub-tropical Alfisol of India

Limited evidence is available on carbon sequestration potential of long-term integrated nutrient management (INM) versus mineral fertilization, when equivalent amounts of nutrients were added. Hence, this study was carried out to understand the impact of 60 years of INM with adjusted nutrient doses and mineral fertilization in an Alfisol in a maize (Zea maysL.)-wheat (Triticum aestivumL.) system on soil organic carbon (SOC) sequestration in surface (0-30 cm) and deep (30-60 cm) soil layers. Conventional tillage was done twice before sowing of both maize and wheat using a spade. In farmyard manure (FYM) and lime treated plots (FYMP'K'L: plots with nitrogen (N) applied in terms of FYM; additional dose of phosphorus (P) and potassium (K) and lime) total SOC concentration was nearly 83% higher than unfertilized control plots. The FYMP'K'L plots had similar to 11% more total SOC concentration than plots treated with mineral fertilizer and lime (NPKL: recommended dose of N, P, K and lime) in the 0-30 cm soil layer. Labile C, including KMnO4-C, was more in plots with FYM than NPKL plots, whereas the recalcitrant C stock was more in NPKL than FYM treated plots. In the 0-60 cm soil layer, the labile C stock was highest in FYMP'K'L plots, but the recalcitrant C stock was highest in NPKL. Total SOC accumulation rate (over unfertilized control plots) was highest for FYMP'K'L plots (0.38 Mg ha(-1 )year(-1)) in the surface soil layer, whereas SOC sequestration rate was highest in NPKL plots (0.18 Mg ha(-1 )year(-1)) in the deep layer and in the 0-60 cm layer. Overall, although NPKL management practice had the highest C sequestration in the 0-60 cm layer, FYMP'K'L had the best CMI and labile C pools. Thus, resource poor farmers need not to use full doses of NPK and FYM for soil C management in the region

Molecular beam epitaxy and defect structure of Ge (111)/epi-Gd2O3 (111) /Si (111) heterostructures

Molecular beam epitaxy of Ge (111) thin films on epitaxial-Gd2O3/Si(111) substrates is reported, along with a systematic investigation of the evolution of Ge growth, and structural defects in the grown epilayer. While Ge growth begins in the Volmer-Weber growth mode, the resultant islands coalesce within the first 10 nm of growth, beyond which a smooth two-dimensional surface evolves. Coalescence of the initially formed islands results in formation of rotation and reflection microtwins, which constitute a volume fraction of less than 1 %. It is also observed that while the stacking sequence of the (111) planes in the Ge epilayer is similar to that of the Si substrate, the (111) planes of the Gd2O3 epilayer are rotated by 180 degree about the [111] direction. In metal-semiconductor-metal schottky photodiodes fabricated with these all-epitaxial Ge-on-insulator (GeOI) samples, significant suppression of dark current is observed due to the presence of the Gd2O3 epilayer. These results are promising for application of these GeOI structures as virtual substrates, or for realization of high-speed group-IV photonic components.Comment: 15 pages, 6 figure

A tachyonic extension of the stringy no-go theorem

We investigate the tachyon-dilaton-metric system to study the "graceful exit" problem in string theoretic inflation, where tachyon plays the role of the scalar field. From the phase space analysis, we find that the inflationary phase does not smoothly connect to a Friedmann-Robertson-Walker (FRW) expanding universe, thereby providing a simple tachyonic extension of the recently proved stringy no-go theorem.Comment: TeX file (PHYZZX), 10 pages, change in the title, many changes in the text (the version to appear in Phys. Rev. D

Cluster randomised trial and development of a sandfly sex pheromone lure to reduce Leishmania infantum infection

Introduction: Vector control tools are needed to combat leishmaniasis. A semi-synthetic version of a Lutzomyia longipalpis aggregation/sex pheromone (9-methlygermacrene-B) has been developed, and shown efficacy to attract sandflies in the lab and to chicken sheds in the field. Here, we present results from a cluster-randomised trial performed in Brazil where we test the efficacy of the pheromone deployed with insecticide, a novel lure-and-kill intervention, to reduce leishmaniasis transmission to the canine reservoir. Aim: Investigate the efficacy of sandfly sex pheromone baited + insecticide treated chicken roosts to reduce transmission of Leishmania infantum among the reservoir population (dogs). Methods: We conducted a cluster-randomised trial across 42 communities in Brazil. Pheromone lures plus insecticide were applied in 14 communities, and outcomes compared to that of 28 other communities that received either a placebo (sham lure + insecticide) or deltamethrin-impregnated collars fitted to dogs. We quantify the primary intervention effects by comparison of the number of uninfected dogs that seroconverted in each arm over the course of the 2-year trial. Results: A reduction in canine incidence is attributed to the pheromone + insecticide intervention, which is consistent across the levels of hierarchical analysis, though the errors are broad. The performance of the pheromone followed similar patterns as the collar arm which significantly reduced seroconversion incidence. Conclusion: These data represent the first trial of a synthetic vector pheromone applied in public health control, and the first cluster-randomised trial of dog collars in Brazil. Both methods show potential for the control of zoonotic visceral leishmaniasis in the Americas; developments of the pheromone lure-and-kill strategy are underway

Mitochondriotropic lanthanide nanorods : implications for multimodal imaging

Organelles such as mitochondria, lysosome, and nucleus, are essential for controlling basic cellular operations and metabolism. Because mitochondria play a critical role in energy production and programmed cell death, they act as prime therapeutic targets for various diseases and dysfunctional states. In this study, a multifunctional nanoplatform based on lanthanide upconverting nanorods is developed for concurrent mitochondria-targeted fluorescence imaging and preclinical MRI. This study provides critical insights into the spectral profiles of mitochondria and paves the way to developing novel, multimodal nanoprobes for mitochondria-targeted theranostics