Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria.

OBJECTIVE: There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups. METHODS: The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care. RESULTS: The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme. CONCLUSION: The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms

Are malaria treatment expenditures catastrophic to different socio-economic and geographic groups and how do they cope with payment? A study in southeast Nigeria.

OBJECTIVES: To determine the inequities in the household income depletion resulting from malaria treatment expenditures, the sacrifice of basic household needs (catastrophe) and the differences in payment strategies among different socio-economic and geographic groups in southeast Nigeria. METHODS: Data were gathered through pre-tested, structured questionnaires from a random sample of 2 250 householders in rural and urban parts of southeast Nigeria. The level of catastrophic malaria treatment expenditure was computed as the percentage of average monthly malaria treatment expenditure divided by the average monthly non-food household expenditure, using a threshold of 5%. Socio-economic inequity was established using a socio-economic status (SES) index, while a rural-urban comparison examined geographic disparities. RESULTS: The average cost to treat a case of malaria was 796.5 Naira ($6.64) for adults and 789.0 Naira ($6.58) for children. The monthly malaria treatment expenditure as a proportion of monthly household non-food expenditure was 7.8%, 8.5%, 5.5% and 3.9% for the most poor, very poor, poor and least poor SES groups respectively. Malaria treatment accounted for 7.1% and 5.0% of non-food expenditures for rural and urban dwellers, respectively. More than 95% of the people financed their treatment through out-of-pocket payment (OOP), with no SES and rural-urban variance, as opposed to insurance payment mechanisms and fee exemptions. CONCLUSION: There were socio-economic and geographic inequities in the financial burden resulting from malaria treatment. The treatment expenditure depleted more of the aggregate income of the two worse-off SES (Q1 and Q2) and of the rural dwellers. Government and donor agencies should institute the abolition of user fees for malaria, the transition from OOP to pre-payment mechanisms and the improvement of physical access to appropriate malaria treatment services, as well as subsidies and deferrals in order to engender financial risk protection from malaria treatment

Space-time singularities and the axion in the Poincare coset models ISO(2,1)/H

By promoting an invariant subgroup $H$ of $ISO(2,1)$ to a gauge symmetry of a WZWN action, we obtain the description of a bosonic string moving either in a curved 4-dimensional space--time with an axion field and curvature singularities or in 3-dimensional Minkowski space--time.Comment: LaTeX, 6 pages plus 2 figures in a separate postscript file, a LaTeX error fixe

Augmented Virtual Reality Laboratory

Real time motion tracking hardware has for the most part been cost prohibitive for research to regularly take place until recently. With the release of the Microsoft Kinect in November 2010, researchers now have access to a device that for a few hundred dollars is capable of providing redgreenblue (RGB), depth, and skeleton data. It is also capable of tracking multiple people in real time. For its original intended purposes, i.e. gaming, being used with the Xbox 360 and eventually Xbox One, it performs quite well. However, researchers soon found that although the sensor is versatile, it has limitations in real world applications. I was brought aboard this summer by William Little in the Augmented Virtual Reality (AVR) Lab at Kennedy Space Center to find solutions to these limitations

Automating Deep-Sea Video Annotation Using Machine Learning

As the world explores opportunities to develop offshore renewable energy capacity, there will be a growing need for pre-construction biological surveys and post-construction monitoring in the challenging marine environment. Underwater video is a powerful tool to facilitate such surveys, but the interpretation of the imagery is costly and time-consuming. Emerging technologies have improved automated analysis of underwater video, but these technologies are not yet accurate or accessible enough for widespread adoption in the scientific community or industries that might benefit from these tools. To address these challenges, we developed a website that allows us to: (1) Quickly play and annotate underwater videos, (2) Create a short tracking video for each annotation that shows how an annotated concept moves in time, (3) Verify the accuracy of existing annotations and tracking videos, (4) Create a neural network model from existing annotations, and (5) Automatically annotate unwatched videos using a model that was previously created. The website was seeded with 50 hours of high-resolution underwater videos that were generously provided by the Monterey Bay Aquarium Research Institute (MBARI). The biology students that were part of the project created more than 30,000 annotations that range over more than 20 concepts. About 3,000 of these annotations were then verified for accuracy by our marine biology experts. Using both validated and unvalidated annotations and automatically generated annotations from trackings, our software was able to count the number of Rathbunaster californicus (starfish) and Strongylocentrotus fragilis (sea urchin) with count accuracy of 97% and 99%, respectively, and F1 score accuracy of 0.90 and 0.81, respectively

Improved simulation of non-Gaussian temperature and polarization CMB maps

We describe an algorithm to generate temperature and polarization maps of the cosmic microwave background radiation containing non-Gaussianity of arbitrary local type. We apply an optimized quadrature scheme that allows us to predict and control integration accuracy, speed up the calculations, and reduce memory consumption by an order of magnitude. We generate 1000 non-Gaussian CMB temperature and polarization maps up to a multipole moment of l_max = 1024. We validate the method and code using the power spectrum and the fast cubic (bispectrum) estimator and find consistent results. The simulations are provided to the community.Comment: 18 pages, 19 figures. Accepted for publication in ApJS. Simulations can be obtained at http://planck.mpa-garching.mpg.de/cmb/fnl-simulation

Comparative analysis of two methods for measuring sales volumes during malaria medicine outlet surveys.

BACKGROUND: There is increased interest in using commercial providers for improving access to quality malaria treatment. Understanding their current role is an essential first step, notably in terms of the volume of diagnostics and anti-malarials they sell. Sales volume data can be used to measure the importance of different provider and product types, frequency of parasitological diagnosis and impact of interventions. Several methods for measuring sales volumes are available, yet all have methodological challenges and evidence is lacking on the comparability of different methods. METHODS: Using sales volume data on anti-malarials and rapid diagnostic tests (RDTs) for malaria collected through provider recall (RC) and retail audits (RA), this study measures the degree of agreement between the two methods at wholesale and retail commercial providers in Cambodia following the Bland-Altman approach. Relative strengths and weaknesses of the methods were also investigated through qualitative research with fieldworkers. RESULTS: A total of 67 wholesalers and 107 retailers were sampled. Wholesale sales volumes were estimated through both methods for 62 anti-malarials and 23 RDTs and retail volumes for 113 anti-malarials and 33 RDTs. At wholesale outlets, RA estimates for anti-malarial sales were on average higher than RC estimates (mean difference of four adult equivalent treatment doses (95% CI 0.6-7.2)), equivalent to 30% of mean sales volumes. For RDTs at wholesalers, the between-method mean difference was not statistically significant (one test, 95% CI -6.0-4.0). At retail outlets, between-method differences for both anti-malarials and RDTs increased with larger volumes being measured, so mean differences were not a meaningful measure of agreement between the methods. Qualitative research revealed that in Cambodia where sales volumes are small, RC had key advantages: providers were perceived to remember more easily their sales volumes and find RC less invasive; fieldworkers found it more convenient; and it was cheaper to implement than RA. DISCUSSION/CONCLUSIONS: Both RA and RC had implementation challenges and were prone to data collection errors. Choice of empirical methods is likely to have important implications for data quality depending on the study context

Exact structures for persistence modules

We discuss applications of exact structures and relative homological algebra to the study of invariants of multiparameter persistence modules. This paper is mostly expository, but does contain a pair of novel results. Over finite posets, classical arguments about the relative projective modules of an exact structure make use of Auslander-Reiten theory. One of our results establishes a new adjunction which allows us to "lift" these arguments to certain infinite posets over which Auslander-Reiten theory is not available. We give several examples of this lifting, in particular highlighting the non-existence and existence of resolutions by upsets when working with finitely presentable representations of the plane and of the closure of the positive quadrant, respectively. We then restrict our attention to finite posets. In this setting, we discuss the relationship between the global dimension of an exact structure and the representation dimension of the incidence algebra of the poset. We conclude with our second novel contribution. This is an explicit description of the irreducible morphisms between relative projective modules for several exact structures which have appeared previously in the literature.Comment: v2: corrected typos and minor erros, 25 page

Isolating and Assaying Unspecific Peroxygenase and Flavin Binding Enzymes for in vitro Terpenoid Biosynthesis

University of Minnesota M.S. thesis. May 2018. Major: Biochemistry, Molecular Bio, and Biophysics. Advisor: Claudia Schmidt-Dannert. 1 computer file (PDF); viii, 71 pages.Terpenoids are an exceptionally large family of natural products, and contain numerous bioactive members that are pharmaceutically important. While most research into terpenoids and their metabolism has thus far occurred in non-fungal organisms, chiefly plants, Basidiomycota (mushroom forming fungi) are well known as prolific producers of bioactive sesquiterpenoids, such as the potent anticancer compounds Illudin M and S. While natural products have traditional been a huge driver of pharmaceutical discovery, this natural abundance is often hampered by very low expression in the native host and slow growth or rarity of the host itself. This drives up financial and environmental costs, and in many cases makes the production of otherwise useful natural products impracticable. One potential solution to this quandary is heterologous production of secondary metabolites in non-native hosts such as Escherichia coli and Saccharomyces cerevisiae. Another avenue is in vitro biocatalysis, wherein the biosynthetic enzymes of the native host are heterologously expressed, isolated, and used to perform synthesis outside of the cell. This approach avoids the fragility of the in vivo system and would allow the creation of combinatorial enzymatic pathways to create novel bioactive structures. With regards to constructing a sesquiterpenoid biosynthetic pathway, many stable terpene synthases have been isolated and shown to be active in vitro. However, the most well studied terpene scaffold modifying enzymes, cytochrome P450s, are notoriously difficult to heterologously express in active form. In order to obtain scaffold modifying oxygenases capable of being part of an in vitro terpenoid biosynthetic pathway, fungal oxygenases aside from cytochrome P450s were investigated. Specifically, unspecific peroxygenase from Agrocybe aegerita and flavin binding oxidoreductases from Δ6-protoilludene biosynthetic gene clusters were expressed and assayed against the sesquiterpene scaffold