α-Thalassemia Impairs the Cytoadherence of Plasmodium falciparum-Infected Erythrocytes

α-Thalassemia results from decreased production of α-globin chains that make up part of hemoglobin tetramers (Hb; α(2)β(2)) and affects up to 50% of individuals in some regions of sub-Saharan Africa. Heterozygous (-α/αα) and homozygous (-α/-α) genotypes are associated with reduced risk of severe Plasmodium falciparum malaria, but the mechanism of this protection remains obscure. We hypothesized that α-thalassemia impairs the adherence of parasitized red blood cells (RBCs) to microvascular endothelial cells (MVECs) and monocytes--two interactions that are centrally involved in the pathogenesis of severe disease.We obtained P. falciparum isolates directly from Malian children with malaria and used them to infect αα/αα (normal), -α/αα and -α/-α RBCs. We also used laboratory-adapted P. falciparum clones to infect -/-α RBCs obtained from patients with HbH disease. Following a single cycle of parasite invasion and maturation to the trophozoite stage, we tested the ability of parasitized RBCs to bind MVECs and monocytes. Compared to parasitized αα/αα RBCs, we found that parasitized -α/αα, -α/-α and -/-α RBCs showed, respectively, 22%, 43% and 63% reductions in binding to MVECs and 13%, 33% and 63% reductions in binding to monocytes. α-Thalassemia was associated with abnormal display of P. falciparum erythrocyte membrane protein 1 (PfEMP1), the parasite's main cytoadherence ligand and virulence factor, on the surface of parasitized RBCs.Parasitized α-thalassemic RBCs show PfEMP1 display abnormalities that are reminiscent of those on the surface of parasitized sickle HbS and HbC RBCs. Our data suggest a model of malaria protection in which α-thalassemia ameliorates the pro-inflammatory effects of cytoadherence. Our findings also raise the possibility that other unstable hemoglobins such as HbE and unpaired α-globin chains (in the case of β-thalassemia) protect against life-threatening malaria by a similar mechanism

From staff-mix to skill-mix and beyond: towards a systemic approach to health workforce management

Throughout the world, countries are experiencing shortages of health care workers. Policy-makers and system managers have developed a range of methods and initiatives to optimise the available workforce and achieve the right number and mix of personnel needed to provide high-quality care. Our literature review found that such initiatives often focus more on staff types than on staff members' skills and the effective use of those skills. Our review describes evidence about the benefits and pitfalls of current approaches to human resources optimisation in health care. We conclude that in order to use human resources most effectively, health care organisations must consider a more systemic approach - one that accounts for factors beyond narrowly defined human resources management practices and includes organisational and institutional conditions

Speed dependent rotational angular momentum polarization of the O2 (a 1Deltag) fragment following ozone photolysis in the wavelength range 248-265 nm.

The translational anisotropy and rotational angular momentum polarization of a selection of rotational states of the O2 (a 1Deltag; v=0) photofragment formed from ozone photolysis at 248, 260, and 265 nm have been determined using the technique of resonance enhanced multiphoton ionization in combination with time of flight mass spectrometry. At 248 nm, the dissociation is well described as impulsive in nature with all rotational states exhibiting similarly large, near-limiting values for the bipolar moments describing their angular momentum alignment and orientation. At 265 nm, however, the angular momentum polarization parameters determined for consecutive odd and even rotational states exhibit clear differences. Studies at the intermediate wavelength of 260 nm strongly suggest that such a difference in the angular momentum polarization is speed dependent and this proposal is consistent with the angular momentum polarization parameters extracted and reported previously for longer photolysis wavelengths [G. Hancock et al., Phys. Chem. Chem. Phys. 5, 5386 (2003); S. J. Horrocks et al., J. Chem. Phys. 126, 044308 (2007)]. The alternation of angular momentum polarization for successive odd and even J states may be a consequence of the different mechanisms leading to the formation of the two O2 (a 1Deltag) Lambda doublets. Specifically, the involvement of out of plane parent rotational motion is proposed as the origin for the observed depolarization for the Delta- relative to the Delta+ state

Probing the O2 (a 1Delta g) photofragment following ozone dissociation within the long wavelength tail of the Hartley band.

The technique of resonance enhanced multiphoton ionization (REMPI) has been used in conjunction with time-of-flight mass spectrometry (TOFMS), to investigate the dynamics of ozone photolysis in the long wavelength region of the Hartley band (301-311 nm). Specifically, both the translational anisotropy and the rotational angular momentum orientation of the O(2) (a (1)Delta(g); nu=0, J=16-20) fragments have been measured as a function of photolysis wavelength. Within this region, the thermodynamic thresholds for the formation of these products in combination with O ((1)D(2)) are approached and passed, and consequently these studies have allowed an investigation into the effects on the dynamics of slowing fragment recoil velocities and the increasing importance of vibrationally mediated photolysis. The determined beta parameters for all the J states probed follow a similar trend, decreasing from a value typical for the initial (1)B(2)<--(1)A(1) excitation responsible for the Hartley band [for example, beta=1.40+/-0.12 for the O(2) (a (1)Delta(g); J=18) fragment], to a much lower value beyond the thermodynamic threshold for the fragment's production (for example, beta=0.63+/-0.19 for the J=18 fragment following photolysis at 311 nm). This trend, similar to that observed when probing the atomic fragment in a previous set of experiments, [Horrocks et al., J. Chem. Phys. 125, 133313 (2006); Denzer et al., Phys. Chem. Chem. Phys. 16, 1954 (2006)] is consistent with the photodissociation of vibrationally excited ozone molecules beyond the threshold wavelengths and we estimate approximately 1/3 of this to be from excitation in the nu(3) asymmetric stretching mode. These observations are substantiated by the values of the beta(0) (2)(2,1) orientation moment measured, which for photolysis at 301 nm are negative, indicating that a bond opening mechanism provides the key torque for the departing O(2) fragment. The orientation moment becomes positive again for photolysis beyond threshold, however, as the increasing impulsive dissociation again begins to dominate the nature of the rotation of the departing molecular fragment. In addition, a (2+2) REMPI scheme has been utilized to probe the O(2) (a (1)Delta(g)) "low" J fragments, where the majority of the population resides following photolysis within this region. The REMPI-TOFMS technique has been used to confirm the rotational character of a spectral feature through examination of the signal line shapes obtained using different experimental geometries. The dynamical information subsequently obtained, probing the "low" J O(2) (a (1)Delta(g)) fragments on these rotational transitions, has unified previous translational anisotropy results obtained by detecting the O ((1)D(2)) atomic fragment with data for the O(2) (a (1)Delta(g); J=16-20) fragments

Vector properties of the O(1D2) fragment produced from the photolysis of ozone in the wavelength range of 298 to 320 nm.

The speed averaged translational anisotropy and electronic angular momentum polarization of the O(1D2) atomic fragment formed from the photodissociation of ozone in the atmospherically important long wavelength region of the Hartley band (298 to 320 nm) have been measured using resonance enhanced multiphoton ionization time of flight mass spectrometry. The translational anisotropy parameter, beta, is found to decline from 1.1 for photolysis at 300 nm to a minimum value of 0 at 310 nm which is the threshold for production of O(1D2) in conjunction with the O2(a 1Deltag v = 0) molecular cofragment. For photolysis wavelengths greater than 310 nm, O(1D2) is formed from the dissociation of internally excited ozone molecules. The corresponding beta parameters are markedly lower than for atomic fragments produced with the same speed from the photolysis of ground state ozone molecules. This result is consistent with two different pathways contributing to the photolysis of internally excited ozone at the longest wavelengths studied corresponding to initial internal excitation either in the symmetric or asymmetric stretching vibration. In addition, the polarization of the atomic angular momentum has been determined with the incoherent polarization parameters a0(2)(||) and a0(2)(_|) increasing from values of -0.53 and -0.62 at 300 nm to -0.37 and -0.19 at 317 nm, consistent with the increasing contribution from the photolysis of internally excited ozone as the dissociation wavelength lengthens. Evaluation of these alignment parameters allows the populations of the magnetic substrates, mj, to be determined. For example, for a photolysis wavelength of 303 nm the populations of mj = 0, +/- 1, +/- 2 are in the ratio of 0.36: 0.56: 0.08 and this ratio is essentially independent of the photolysis wavelength. The coherent contribution to the atomic polarization is quantified by the Re{a1(2)(||, _|)} and Im{a1(1)(||, _|)} parameters and these are found to vary from -0.21 and 0.21 at 300 nm to -0.04 and 0.24 at 313 nm, respectively

REMPI-TOF studies of the translational anisotropy and the polarization of the O ((1)D2) photofragment angular momentum following ozone photolysis at 298 nm.

The translational anisotropy and the polarization of the electronic angular momentum of the O ((1)D2) fragment produced from the 298 nm photodissociation of ozone have been determined using resonance enhanced multiphoton ionization (REMPI) in conjunction with time-of-flight mass spectrometry (TOFMS). The translational anisotropy parameter beta, which is necessarily averaged over the O2 co-fragment rotational distribution, is measured to be 1.08 +/- 0.04. This is consistent with that expected for the (1)B2 <-- (1)A1 transition within an impulsive model if the tangential velocity associated with the zero point motion of the bend is constricted to opening the bond angle. Molecular frame polarization parameters of rank up to k = 4 have been extracted for the O ((1)D2) fragment and the calculated m(J) populations show a strong preference for the absolute value(m(J)) = 1 states. A small coherence term is also observed, a manifestation of the nuclear geometry of the dissociating molecule and the existence of possible non-adiabatic processes in the exit channel. The orientation associated with the mapping of the photon helicity onto the O ((1)D2) electronic angular momentum distribution was observed to have been quenched. However, the parameter gamma1', which describes the contribution to the orientation from a coherent superposition of a parallel and perpendicular excitation where the photofragment angular momentum lies perpendicular to both the recoil velocity and to the transition dipole moment, was determined to be -0.06

Photolysis wavelength dependence of the translational anisotropy and the angular momentum polarization of O2(a 1Deltag) formed from the UV photodissociation of O3.

The translational anisotropy and angular momentum polarization of the O(2)(a (1)Delta(g),v = 0;J = 15-27) molecular photofragment produced from the UV photodissociation of O(3) in the range from 270 to 300 nm have been determined using resonance-enhanced multiphoton ionization in conjunction with time-of-flight mass spectrometry. At the shortest photolysis wavelengths used, the fragments exhibit the anisotropic vector correlations expected from a prompt dissociation via the (1)B(2) <--(1)A(1) transition. Deviations from this behavior are observed at longer photolysis wavelengths with, in particular, the angular momentum orientation showing a significant reduction in magnitude. This indicates that the dissociation can no longer be described by a purely impulsive model and a change in geometry of the dissociating molecule is implied. This observation is substantiated by the variation of the translational anisotropy with photolysis wavelength. We also observe that the bipolar moments describing the angular momentum polarization of the odd J states probed are consistently lower in magnitude than those of the even J states and that this variation is observed for all photolysis wavelengths

Time-resolved detection of the CF3 photofragment using chirped QCL radiation.

This paper demonstrates how a quantum cascade laser (QCL) in its intrapulse mode can provide a simple method for probing the products of a photolysis event. The system studied is the 266 nm photodissociation of CF3I with the CF3 fragments subsequently detected using radiation at approximately 1253 cm(-1) generated by a pulsed QCL. The tuning range provided by the frequency down-chirp of the QCL operated in its intrapulse mode allows a approximately 1 cm(-1) segment of the CF3 nu3 band to be measured following each photolysis laser pulse. Identification of features within this spectral region allows the CF3 ( v = 0) number density to be calculated as a function of pump-probe delay, and consequently the processes which populate and deplete this quantum state may be examined. Rate constants for the population cascade from higher vibrational levels into the v = 0 state, k 1, and for the recombination of the CF3 radicals to form C2F6, k2, are measured. The returned values of k1 = (2.3 +/- 0.34) x 10(-12) cm(3) molecule(-1) s(-1) and k2 = (3.9 +/- 0.34) x 10(-12) cm(3) molecule(-1) s(-1) are found to be in good agreement with reported literature values