Trends in Weekly Reported Net use by Children During and after Rainy Season in Central Tanzania.

The use of long-lasting insecticidal nets (LLINs) is one of the principal interventions to prevent malaria in young children, reducing episodes of malaria by 50% and child deaths by one fifth. Prioritizing young children for net use is important to achieve mortality reductions, particularly during transmission seasons. Households were followed up weekly from January through June 2009 to track net use among children under seven under as well as caretakers. Net use rates for children and caretakers in net-owning households were calculated by dividing the number of person-weeks of net use by the number of person-weeks of follow-up. Use was stratified by age of the child or caretaker status. Determinants of ownership and of use were assessed using multivariate models. Overall, 60.1% of the households reported owning a bed net at least once during the study period. Among net owners, use rates remained high during and after the rainy season. Rates of use per person-week decreased as the age of the child rose from 0 to six years old; at ages 0-23 months and 24-35 months use rates per person-week were 0.93 and 0.92 respectively during the study period, while for children ages 3 and 4 use rates per person-week were 0.86 and 0.80. For children ages 5-6 person-week ratios dropped to 0.55. This represents an incidence rate ratio of 1.67 for children ages 0-23 months compared to children aged 5-6. Caretakers had use rates similar to those of children age 0-35 months. Having fewer children under age seven in the household also appeared to positively impact net use rates for individual children. In this area of Tanzania, net use is very high among net-owning households, with no variability either at the beginning or end of the rainy season high transmission period. The youngest children are prioritized for sleeping under the net and caretakers also have high rates of use. Given the high use rates, increasing the number of nets available in the household is likely to boost use rates by older children

Characteristics of x-ray attenuation in electrospun bismuth oxide/polylactic acid nanofibre mats

The characteristics of the X-ray attenuation in electrospun nano(n)- and micro(m)-Bi2O3/polylactic acid (PLA) nanofibre mats with different Bi2O3 loadings were compared as a function of energy using mammography (i.e. tube voltages of 22–49 kV) and X-ray absorption spectroscopy (XAS) (7–20 keV). Results indicate that X-ray attenuation by electrospun n-Bi2O3/PLA nanofibre mats is distinctly higher than that of m-Bi2O3/PLA nanofibre mats at all energies investigated. In addition, with increasing filler loading (n-Bi2O3 or m-Bi2O3), the porosity of the nanofibre mats decreased, thus increasing the X-ray attenuation, except for the sample containing 38 wt% Bi2O3 (the highest loading in the present study). The latter showed higher porosity, with some beads formed, thus resulting in a sudden decrease in the X-ray attenuation

Parameter interdependence and uncertainty induced by lumping in a hydrologic model

Throughout the world, watershed modeling is undertaken using lumped parameter hydrologic models that represent real-world processes in a manner that is at once abstract, but nevertheless relies on algorithms that reflect real-world processes and parameters that reflect real-world hydraulic properties. In most cases, values are assigned to the parameters of such models through calibration against flows at watershed outlets. One criterion by which the utility of the model and the success of the calibration process are judged is that realistic values are assigned to parameters through this process. This study employs regularization theory to examine the relationship between lumped parameters and corresponding real-world hydraulic properties. It demonstrates that any kind of parameter lumping or averaging can induce a substantial amount of ‘structural noise’ which devices such as Box-Cox transformation of flows and auto-regressive moving average (ARMA) modeling of residuals are unlikely to render homoscedastic and uncorrelated. Furthermore, values estimated for lumped parameters are unlikely to represent average values of the hydraulic properties after which they are named and are often contaminated to a greater or lesser degree by the values of hydraulic properties which they do not purport to represent at all. As a result, the question of how rigidly they should be bounded during the parameter estimation process is still an open one

A Trial of the Efficacy, Safety and Impact on Drug Resistance of Four Drug Regimens for Seasonal Intermittent Preventive Treatment for Malaria in Senegalese Children

UNLABELLED: In the Sahel, most malaria deaths occur among children 1-4 years old during a short transmission season. A trial of seasonal intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) and a single dose of artesunate (AS) showed an 86% reduction in the incidence of malaria in Senegal but this may not be the optimum regimen. We compared this regimen with three alternatives. METHODS: 2102 children aged 6-59 months received either one dose of SP plus one dose of AS (SP+1AS) (the previous regimen), one dose of SP plus 3 daily doses of AS (SP+3AS), one dose of SP plus three daily doses of amodiaquine (AQ) (SP+3AQ) or 3 daily doses of AQ and AS (3AQ+3AS). Treatments were given once a month on three occasions during the malaria transmission season. The primary end point was incidence of clinical malaria. Secondary end-points were incidence of adverse events, mean haemoglobin concentration and prevalence of parasites carrying markers of resistance to SP. FINDINGS: The incidence of malaria, and the prevalence of parasitaemia at the end of the transmission season, were lowest in the group that received SP+3AQ: 10% of children in the group that received SP+1AS had malaria, compared to 9% in the SP+3AS group (hazard ratio HR 0.90, 95%CI 0.60, 1.36); 11% in the 3AQ+3AS group, HR 1.1 (0.76-1.7); and 5% in the SP+3AQ group, HR 0.50 (0.30-0.81). Mutations associated with resistance to SP were present in almost all parasites detected at the end of the transmission season, but the prevalence of Plasmodium falciparum was very low in the SP+3AQ group. CONCLUSIONS: Monthly treatment with SP+3AQ is a highly effective regimen for seasonal IPT. Choice of this regimen would minimise the spread of drug resistance and allow artemisinins to be reserved for the treatment of acute clinical malaria

Determinants of insecticide-treated net ownership and utilization among pregnant women in Nigeria

<p>Abstract</p> <p>Background</p> <p>Malaria during pregnancy is a major public health problem in Nigeria leading to increase in the risk of maternal mortality, low birth weight and infant mortality. This paper is aimed at highlighting key predictors of the ownership of insecticide treated nets (ITNs) and its use among pregnant women in Nigeria.</p> <p>Methods</p> <p>A total of 2348 pregnant women were selected by a multi-stage probability sampling technique. Structured interview schedule was used to elicit information on socio-demographic characteristics, ITN ownership, use, knowledge, behaviour and practices. Logistic regression was used to detect predictors of two indicators: ITN ownership, and ITN use in pregnancy among those who owned ITNs.</p> <p>Results</p> <p>ITN ownership was low; only 28.8% owned ITNs. Key predictors of ITN ownership included women who knew that ITNs prevent malaria (OR = 3.85; <it>p </it>< 0001); and registration at antenatal clinics (OR = 1.34; <it>p </it>= 0.003). The use of ITNs was equally low with only 7.5% of all pregnant women, and 25.7% of all pregnant women who owned ITNs sleeping under a net. The predictors of ITN use in pregnancy among women who owned ITNs (N = 677) identified by logistic regression were: urban residence (OR = 1.87; <it>p </it>= 0.001); knowledge that ITNs prevent malaria (OR = 2.93; <it>p </it>< 0001) and not holding misconceptions about malaria prevention (OR = 1.56; <it>p </it>= 0.036). Educational level was not significantly related to any of the two outcome variables. Although registration at ANC is significantly associated with ownership of a bednet (perhaps through free ITN distribution) this does not translate to significant use of ITNs.</p> <p>Conclusions</p> <p>ITN use lagged well behind ITN ownership. This seems to suggest that the current mass distribution of ITNs at antenatal facilities and community levels may not necessarily lead to use unless it is accompanied by behaviour change interventions that address the community level perceptions, misconceptions and positively position ITN as an effective prevention device to prevent malaria</p

Multiscale modelling methods in biomechanics

More and more frequently, computational biomechanics deals with problems where the portion of physical reality to be modelled spans over such a large range of spatial and temporal dimensions, that it is impossible to represent it as a single space-time continuum. We are forced to consider multiple space-time continua, each representing the phenomenon of interest at a characteristic space-time scale. Multiscale models describe a complex process across multiple scales, and account for how quantities transform as we move from one scale to another. This review offers a set of definitions for this emerging field, and provides a brief summary of the most recent developments on multiscale modelling in biomechanics. Of all possible perspectives, we chose that of the modelling intent, which vastly affect the nature and the structure of each research activity. To the purpose we organised all papers reviewed in three categories: さcausal confirmationざ, where multiscale models are used as materialisations of the causation theories; さpredictive accuracyざ, where multiscale modelling is aimed to improve the predictive accuracy; and さdetermination of effectざ, where multiscale modelling is used to model how a change at one scale manifest in an effect at another, radically different space-time scale. Consistently with the how the volume of computational biomechanics research is distributed across application targets, we extensively reviewed papers targeting the musculoskeletal and the cardiovascular system, and covered only a few exemplary papers targeting other organ systems. The review shows a research sub-domain still in its infancy, where causal confirmation papers remain the most common

Validation of the Cognitive Assessment of Later Life Status (CALLS) instrument: a computerized telephonic measure

<p>Abstract</p> <p>Background</p> <p>Brief screening tests have been developed to measure cognitive performance and dementia, yet they measure limited cognitive domains and often lack construct validity. Neuropsychological assessments, while comprehensive, are too costly and time-consuming for epidemiological studies. This study's aim was to develop a psychometrically valid telephone administered test of cognitive function in aging.</p> <p>Methods</p> <p>Using a sequential hierarchical strategy, each stage of test development did not proceed until specified criteria were met. The 30 minute Cognitive Assessment of Later Life Status (CALLS) measure and a 2.5 hour in-person neuropsychological assessment were conducted with a randomly selected sample of 211 participants 65 years and older that included equivalent distributions of men and women from ethnically diverse populations.</p> <p>Results</p> <p>Overall Cronbach's coefficient alpha for the CALLS test was 0.81. A principal component analysis of the CALLS tests yielded five components. The CALLS total score was significantly correlated with four neuropsychological assessment components. Older age and having a high school education or less was significantly correlated with lower CALLS total scores. Females scored better overall than males. There were no score differences based on race.</p> <p>Conclusion</p> <p>The CALLS test is a valid measure that provides a unique opportunity to reliably and efficiently study cognitive function in large populations.</p

Malaria control under the Taliban regime: insecticide-treated net purchasing, coverage, and usage among men and women in eastern Afghanistan

BACKGROUND: Scaling up insecticide-treated mosquito net (ITN) coverage is a key malaria control strategy even in conflict-affected countries 12. Socio-economic factors influence access to ITNs whether subsidized or provided free to users. This study examines reported ITN purchasing, coverage, and usage in eastern Afghanistan and explores women's access to health information during the Taliban regime (1996-2001). This strengthens the knowledge base on household-level health choices in complex-emergency settings. METHODS: Fifteen focus group discussions (FGDs) and thirty in-depth interviews were conducted with men and women from ITN-owning and non-owning households. FGDs included rank ordering, pile sorting and focused discussion of malaria knowledge and ITN purchasing. Interviews explored general health issues, prevention and treatment practices, and women's malaria knowledge and concerns. Seven key informant interviews with health-related workers and a concurrent survey of 200 ITN-owning and 214 non-owning households were used to clarify or quantify findings. RESULTS: Malaria knowledge was similar among men and women and ITN owners and non-owners. Women reported obtaining health information through a variety of sources including clinic staff, their husbands who had easier access to information, and particularly female peers. Most participants considered ITNs very desirable, though not usually household necessities. ITN owners reported more household assets than non-owners. Male ITN owners and non-owners ranked rugs and ITNs as most desired, while women ranked personal assets such as jewellery highest. While men were primarily responsible for household decision-making and purchasing, older women exerted considerable influence. Widow-led and landless households reported most difficulties purchasing ITNs. Most participants wanted to buy ITNs only if they could cover all household members. When not possible, preferential usage was given to women and children. CONCLUSIONS: Despite restricted access to health facilities and formal education, Afghan women were surprisingly knowledgeable about the causes of malaria and the value of ITNs in prevention. Inequities in ITN usage were noted between rather than within households, with some unable to afford even one ITN and others not wanting ITNs unless all household members could be protected. Malaria knowledge thus appears a lesser barrier to ITN purchasing and coverage in eastern Afghanistan than are pricing and distribution strategies

Isoreticular two-dimensional magnetic coordination polymers prepared through pre-synthetic ligand functionalization

Chemical functionalization is a powerful approach to tailor the physical and chemical properties of two-dimensional materials, increase their processability and stability, tune their functionalities and, even, create new 2D materials. This is typically achieved through post-synthetic functionalization by anchoring molecules on the surface of an exfoliated 2D crystal, but it inevitably alters the long-range structural order of the material. Here we present a pre-synthetic approach that allows the isolation of crystalline, robust, and magnetic functionalized monolayers of coordination polymers. A series of five isoreticular layered magnetic coordination polymers based on Fe(II) centres and different benzimidazole derivatives (bearing a Cl, H, CH3, Br or NH2 side group) were first prepared. On mechanical exfoliation, 2D materials are obtained that retain their long-range structural order and exhibit good mechanical and magnetic properties. This combination, together with the possibility to functionalize their surface at will, makes them good candidates to explore magnetism in the 2D limit and to fabricate mechanical resonators for selective gas sensing

Quantum criticality in ferroelectrics

Materials tuned to the neighbourhood of a zero temperature phase transition often show the emergence of novel quantum phenomena. Much of the effort to study these new effects, like the breakdown of the conventional Fermi-liquid theory of metals has been focused in narrow band electronic systems. Ferroelectric crystals provide a very different type of quantum criticality that arises purely from the crystalline lattice. In many cases the ferroelectric phase can be tuned to absolute zero using hydrostatic pressure or chemical or isotopic substitution. Close to such a zero temperature phase transition, the dielectric constant and other quantities change into radically unconventional forms due to the quantum fluctuations of the electrical polarization. The simplest ferroelectrics may form a text-book paradigm of quantum criticality in the solid-state as the difficulties found in metals due to a high density of gapless excitations on the Fermi surface are avoided. We present low temperature high precision data demonstrating these effects in pure single crystals of SrTiO3 and KTaO3. We outline a model for describing the physics of ferroelectrics close to quantum criticality and highlight the expected 1/T2 dependence of the dielectric constant measured over a wide temperature range at low temperatures. In the neighbourhood of the quantum critical point we report the emergence of a small frequency independent peak in the dielectric constant at approximately 2K in SrTiO3 and 3K in KTaO3 believed to arise from coupling to acoustic phonons. Looking ahead, we suggest that in ferroelectric materials supporting mobile charge carriers, quantum paraelectric fluctuations may mediate new effective electron-electron interactions giving rise to a number of possible states such as superconductivity.Comment: 10 pages, 4 figure