Short Term Advantages of a Public-Private Partnership for Tuberculosis in Guinea Bissau: Reduction of Mortality and increased Diagnostic Capacity

Background: Tuberculosis (TB) is widespread in Africa, but weak health systems in developing countries, often display poor quality of care with delays in case identification, irrational therapy and drug shortage, clinical mismanagement, unnecessary expenditures for patients, reduced adherence and increased mortality. Public-private partnership has demonstrated to increase TB case detection, but less is known about its effects on quality of care, mortality and costs for hospitalized TB patients. Methods: Clinical outcomes and costs for TB patients at the TB National Reference Center of Bissau, in Guine Bissau, West Africa were determined during the first 5 months of the public-private management and compared to the ones of previous years when the hospitals was under  direct Government’s management. Results: 215 (2009) and 194 (2013) patients were admitted, respectively. Improvement (p<0.05) was observed in mortality reduction (21% vs 6%), analysis prescription and diagnosis (39% vs 100%), cause of death determination (50% vs 85%), treatment abandonment (15 vs 1). Direct costs for patients during TB diagnostic pathway and inpatient care were significantly reduced, 475 vs 0 USD. Conclusions: Public-private partnerships displays important short term benefits in National TB reference centers, even in post-conflict and low-resource countries. Further studies could aid in determining the overall long term benefits of  this type of cooperation and the specific characteristic of TB and concomitant hematologic and infectious diseases in TB admitted patients

Atmospheric Stability & Turbulence from Temperature Profiles over Sicily During Summer 2002 & 2003 HASI Balloon Campaigns

Experimental results and interpretation of the temperature measurements data retrieved during the balloon campaigns (in 2002 and in 2003) for testing HASI (Huygens Atmospheric Structure Instrument), launched from the Italian Space Agency Base in Trapani (Sicily), are presented. Both ascending and descending phases are analysed; data reveal interesting features near the tropopause (present in the region between 11km-14km), where temperature cooling can be related to layers with strong winds (2002 flight); in the troposphere a multistratified structure of the temperature field is observed and discussed (particularly in the 2003 flight) Finally, stability and turbulence of the atmosphere are analysed; the buoyancy N2 parameters for both the flights show lowers value respect to standard tropospheric values corresponding to a lower stability of the atmosphere; still there is a higher stability above the tropopause. The energy spectrum of temperature data is consistent with the Kolmogorov theory: the characteristic k(sup -5/3) behaviour is reproduced

Exomars entry and descent science

The entry, descent and landing of ExoMars offer a rare (once-per-mission) opportunity to perform in situ investigation of the martian environment over a wide altitude range. We present an initial assessment of the atmospheric science that can be performed using sensors of the Entry, Descent and Landing System (EDLS), over and above the expected engineering information. This is intended to help fulfill the concept of an Atmospheric Parameters Package (APP), as mentioned in the ExoMars draft Science Management Plan [ESA, 2005]. Mars' atmosphere is highly variable in time and space, due to phenomena including inertio-gravity waves, thermal tide effects, dust, solar wind conditions, and diurnal, seasonal and topographic effects. Atmospheric profile measurements, drawing on heritage from the Huygens Atmospheric Structure Instrument (HASI), which encountered Titan's atmosphere in 2005 [1], should allow us to address questions of the martian atmosphere's structure, dynamics and variability

Huygens HASI servo accelerometer: a review and lessons learned

The Servo accelerometer constituted a vital part of the Huygens Atmospheric Structure Instrument (HASI): flown aboard the Huygens probe, it operated successfully during the probe's entry, descent, and landing on Titan, on 14th January 2005. This paper reviews the Servo accelerometer, starting from its development/assembly in the mid-1990s, to monitoring its technical performance through its seven-year long in-flight (or cruise) journey, and finally its performance in measuring acceleration (or deceleration) upon encountering Titan's atmosphere. The aim of this article is to review the design, ground tests, in-flight tests and operational performance of the Huygens Servo accelerometer. Techniques used for data analysis and lessons learned that may be useful for accelerometry payloads on future planetary missions are also addressed. The main finding of this review is that the conventional approach of having multiple channels to cover a very broad measurement range: from 10-6 g to the order of 10 g (where g = Earth's surface gravity, 9.8 m/s2), with on-board software deciding which of the channels to telemeter depending on the magnitude of the measured acceleration, works well. However, improvements in understanding the potential effects of the sensor drifts and ageing on the measurements can be achieved in future missions by monitoring the 'scale factor' – a measure of such sensors' sensitivity, along with the already implemented monitoring of the sensor's offset during the in-flight phase

ExoMars entry, descent and landing science

The entry, descent and landing of ExoMars offer a rare (once-per-mission) opportunity to perform in situ investigation of the martian environment over a wide altitude range. Entry, Descent and Landing System (EDLS) measurements can provide essential data for atmospheric scientific investigations. We intend to perform atmospheric science measurements by exploiting data from EDLS engineering sensors and exploiting their readings beyond the expected engineering information

The Huygens Atmospheric Structure Instrument (HASI): Expected Results at Titan and Performance Verification in Terrestrial Atmosphere

The Huygens ASI is a multi-sensor package resulting from an international cooperation, it has been designed to measure the physical quantities characterizing Titan's atmosphere during the Huygens probe mission. On 14th January, 2005, HASI will measure acceleration, pressure, temperature and electrical properties all along the Huygens probe descent on Titan in order to study Titan s atmospheric structure, dynamics and electric properties. Monitoring axial and normal accelerations and providing direct pressure and temperature measurements during the descent, HASI will mainly contribute to the Huygens probe entry and trajectory reconstruction. In order to simulate the Huygens probe descent and verify HASI sensors performance in terrestrial environment, stratospheric balloon flight experiment campaigns have been performed, in collaboration with the Italian Space Agency (ASI). The results of flight experiments have allowed to determine the atmospheric vertical profiles and to obtain a set of data for the analysis of probe trajectory and attitude reconstruction

Point-of-care testing allows successful simultaneous screening of sickle cell disease, HIV, and tuberculosis for households in rural Guinea-Bissau, West Africa

Diagnosis of noncommunicable genetic diseases like sickle cell disease (SCD) and com municable diseases such as human immunodeficiency virus (HIV) or tuberculosis (TB) is often difficult in rural areas of Africa due to the lack of infrastructures, trained staff, or capacity to involve families living in remote areas. The availability of point-of-care (POC) tests for the above diseases offers the opportunity to build joint programs to tackle all conditions. We report successful simultaneous screening of SCD, HIV, and TB utilizing POC tests in 898 subjects in Fanhe, in rural Guinea-Bissau. Adherence was 100% and all diagnosed subjects were enrolled in care program

Targeted delivery of photosensitizers: efficacy and selectivity issues revealed by multifunctional ORMOSIL nanovectors in cellular systems

PEGylated and non-PEGylated ORMOSIL nanoparticles prepared by microemulsion condensation of vinyltriethoxy-silane (VTES) were investigated in detail for their micro-structure and ability to deliver photoactive agents. With respect to pure silica nanoparticles, organic modification substantially changes the microstructure and the surface properties. This in turn leads to a modulation of both the photophysical properties of embedded photosensitizers and the interaction of the nanoparticles with biological entities such as serum proteins. The flexibility of the synthetic procedure allows the rapid preparation and screening of multifunctional nanosystems for photodynamic therapy (PDT). Selective targeting of model cancer cells was tested by using folate, an integrin specific RGD peptide and anti-EGFR antibodies. Data suggest the interference of the stealth-conferring layer (PEG) with small targeting agents, but not with bulky antibodies. Moreover, we showed that selective photokilling of tumour cells may be limited even in the case of efficient targeting because of intrinsic transport limitations of active cellular uptake mechanisms or suboptimum localization