Identification of malaria hot spots for focused intervention in tribal state of India: a GIS based approach

<p>Abstract</p> <p>Background</p> <p>In India, presently malaria shows a declining trend whereas <it>Plasmodium falciparum (Pf) </it>cases show an up trend. In central India, specifically, Madhya Pradesh (M.P.) a forested and tribal area, control of malaria is logistically difficult and outbreaks are frequently recorded, reasons for this being inadequate surveillance, poor reporting, a time lag in reporting to decision makers and a lack of geo referenced information to pin point the trouble spots for a timely preventive action.</p> <p>Results</p> <p>An information management system based on Geographic Information System (GIS) using district and block wise malaria data, has been constructed for Madhya Pradesh for quick retrieval of info and dynamic generation of maps to highlight hot spots of malaria for formulating prompt and focused malaria control strategy. Out of total 48 districts consisting of 313 blocks, based on certain criteria GIS identified 58 blocks falling in 25 districts as Hot Spots. Malaria flares up from these pockets whenever favourable conditions for transmission occurs. It was suggested to National Vector Borne Disease Control Programme (NVBDCP) that focused malaria control in these hot pockets may be taken up on priority during the year 2007, it was implemented by State Health Authorities, M.P. under the directive of NVBDCP. Implementation of control measures were evaluated by NVBDCP.</p> <p>Conclusion</p> <p>GIS mapping would make it easy to update information instantly and to identify the trouble spots at the village level within the district which is the lowest unit equipped with computer facilities and the information can reach instantly to state and the policy makers to formulate focused and cost effective malaria control strategy. This is the first time when GIS has been used in national control programme for tribal malaria.</p

Positional dependence of transcriptional inhibition by DNA torsional stress in yeast chromosomes

How DNA helical tension is constrained along the linear chromosomes of eukaryotic cells is poorly understood. In this study, we induced the accumulation of DNA (+) helical tension in Saccharomyces cerevisiae cells and examined how DNA transcription was affected along yeast chromosomes. The results revealed that, whereas the overwinding of DNA produced a general impairment of transcription initiation, genes situated at <100 kb from the chromosomal ends gradually escaped from the transcription stall. This novel positional effect seemed to be a simple function of the gene distance to the telomere: It occurred evenly in all 32 chromosome extremities and was independent of the atypical structure and transcription activity of subtelomeric chromatin. These results suggest that DNA helical tension dissipates at chromosomal ends and, therefore, provides a functional indication that yeast chromosome extremities are topologically open. The gradual escape from the transcription stall along the chromosomal flanks also indicates that friction restrictions to DNA twist diffusion, rather than tight topological boundaries, might suffice to confine DNA helical tension along eukaryotic chromatin

An atypical presentation of cystic fibrosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>The presentation of cystic fibrosis is dependant upon which organs are affected. Common presentations include chronic respiratory infections and malabsorption. Patients with atypical disease tend to present late in childhood or as adults. Eye manifestations of cystic fibrosis are less well known.</p> <p>Case presentation</p> <p>A 14-year-old Caucasian boy presented with tiredness and difficulty seeing at night, over a period of 6 months. Good vision was only described in bright conditions. There was no history of jaundice, steatorrhea or diarrhoea.</p> <p>Conclusion</p> <p>This is the first reported case of newly diagnosed cystic fibrosis-related liver disease in a teenage boy, whose presenting symptom was night blindness secondary to vitamin A deficiency.</p

Imaging Invasion: Micro-CT imaging of adamantinomatous craniopharyngioma highlights cell type specific spatial relationships of tissue invasion.

Tissue invasion and infiltration by brain tumours poses a clinical challenge, with destruction of structures leading to morbidity. We assessed whether micro-CT could be used to map tumour invasion in adamantinomatous craniopharyngioma (ACP), and whether it could delineate ACPs and their intrinsic components from surrounding tissue.Three anonymised archival frozen ACP samples were fixed, iodinated and imaged using a micro-CT scanner prior to the use of standard histological processing and immunohistochemical techniques.We demonstrate that micro-CT imaging can non-destructively give detailed 3D structural information of tumours in volumes with isotropic voxel sizes of 4-6 microns, which can be correlated with traditional histology and immunohistochemistry.Such information complements classical histology by facilitating virtual slicing of the tissue in any plane and providing unique detail of the three dimensional relationships of tissue compartments

Sensitivity of an Ultrasonic Technique for Axial Stress Determination

In machine assembly it is often required that bolts used to fasten machine parts be installed with specific design preloads. Because it is inconvenient to measure preload directly, preload specifications are usually based on some more easily measured quantity with which the level of preload may be correlated. Most often this quantity is the torque to be applied to the bolt at installation. Studies by Blake and Kurtz [1] and Heyman [2] have shown that when bolts are torqued into place, the fraction of applied torque which translates into useful preload is small and widely variable. This is so because the large majority of applied torque is absorbed in overcoming friction in the bolt’s threads and at the underside of the bolt’s head. Consequently, even though the torque to install different bolts may be identical, small variations in frictional conditions from one installation to the next can result in large variations in preload. The unreliability of torque as an indicator of preload has been the motivating factor behind the development of a number of alternate methods of measurement [2–5]

Using fluorescence lymphangiography to define the ileocolic mesentery: proof of concept for the watershed area using real-time imaging

Recent advances in mesenteric science have demonstrated that the mesentery is a continuous structure with a ‘watershed’ area at the mesenteric apex between the right colon and terminal ileum, where lymphatic flow can proceed either proximally or distally. With this new understanding of the anatomy, functional features are emerging, which can have an impact on surgical management. Fluorescence lymphangiography or lymphoscintigraphy with indocyanine green allows real-time visualization of lymphatic channels, which highlights sentinel lymph nodes and may facilitate identification of the ideal margins for mesenteric lymphadenectomy during bowel resection for colon cancer. By using this novel technology, it is possible to demonstrate a watershed area in the ileocolic region and may facilitate more precise mesenteric dissection. In the present study, we provide proof of concept for the ileocolic watershed area using fluorescence lymphangiography

Validation of the Kidney Disease Quality of Life-Short Form: a cross-sectional study of a dialysis-targeted health measure in Singapore

<p>Abstract</p> <p>Background</p> <p>In Singapore, the prevalence of end-stage renal disease (ESRD) and the number of people on dialysis is increasing. The impact of ESRD on patient quality of life has been recognized as an important outcome measure. The Kidney Disease Quality Of Life-Short Form (KDQOL-SF™) has been validated and is widely used as a measure of quality of life in dialysis patients in many countries, but not in Singapore. We aimed to determine the reliability and validity of the KDQOL-SF™ for haemodialysis patients in Singapore.</p> <p>Methods</p> <p>From December 2006 through January 2007, this cross-sectional study gathered data on patients ≥21 years old, who were undergoing haemodialysis at National Kidney Foundation in Singapore. We used exploratory factor analysis to determine construct validity of the eight KDQOL-SF™ sub-scales, Cronbach's alpha coefficient to determine internal consistency reliability, correlation of the overall health rating with kidney disease-targeted scales to confirm validity, and correlation of the eight sub-scales with age, income and education to determine convergent and divergent validity.</p> <p>Results</p> <p>Of 1980 haemodialysis patients, 1180 (59%) completed the KDQOL-SF™. Full information was available for 980 participants, with a mean age of 56 years. The sample was representative of the total dialysis population in Singapore, except Indian ethnicity that was over-represented. The instrument designers' proposed eight sub-scales were confirmed, which together accounted for 68.4% of the variance. All sub-scales had a Cronbach's α above the recommended minimum value of 0.7 to indicate good reliability (range: 0.72 to 0.95), except for Social function (0.66). Correlation of items within subscales was higher than correlation of items outside subscales in 90% of the cases. The overall health rating positively correlated with kidney disease-targeted scales, confirming validity. General health subscales were found to have significant associations with age, income and education, confirming convergent and divergent validity.</p> <p>Conclusions</p> <p>The psychometric properties of the KDQOL-SF™ resulting from this first-time administration of the instrument support the validity and reliability of the KDQOL-SF™ as a measure of quality of life of haemodialysis patients in Singapore. It is, however, necessary to determine the test-retest reliability of the KDQOL-SF™ among the haemodialysis population of Singapore.</p

Plasmodium vivax lineages: geographical distribution, tandem repeat polymorphism, and phylogenetic relationship

<p>Abstract</p> <p>Background</p> <p>Multi-drug resistance and severe/complicated cases are the emerging phenotypes of vivax malaria, which may deteriorate current anti-malarial control measures. The emergence of these phenotypes could be associated with either of the two <it>Plasmodium vivax </it>lineages. The two lineages had been categorized as Old World and New World, based on geographical sub-division and genetic and phenotypical markers. This study revisited the lineage hypothesis of <it>P. vivax </it>by typing the distribution of lineages among global isolates and evaluated their genetic relatedness using a panel of new mini-satellite markers.</p> <p>Methods</p> <p><it>18S SSU rRNA S-type </it>gene was amplified from 420 <it>Plasmodium vivax </it>field isolates collected from different geographical regions of India, Thailand and Colombia as well as four strains each of <it>P. vivax </it>originating from Nicaragua, Panama, Thailand (Pak Chang), and Vietnam (ONG). A mini-satellite marker panel was then developed to understand the population genetic parameters and tested on a sample subset of both lineages.</p> <p>Results</p> <p><it>18S SSU rRNA S-type </it>gene typing revealed the distribution of both lineages (Old World and New World) in all geographical regions. However, distribution of <it>Plasmodium vivax </it>lineages was highly variable in every geographical region. The lack of geographical sub-division between lineages suggests that both lineages are globally distributed. Ten mini-satellites were scanned from the <it>P. vivax </it>genome sequence; these tandem repeats were located in eight of the chromosomes. Mini-satellites revealed substantial allelic diversity (7-21, <it>AE </it>= 14.6 ± 2.0) and heterozygosity (<it>He </it>= 0.697-0.924, <it>AE </it>= 0.857 ± 0.033) per locus. Mini-satellite comparison between the two lineages revealed high but similar pattern of genetic diversity, allele frequency, and high degree of allele sharing. A Neighbour-Joining phylogenetic tree derived from genetic distance data obtained from ten mini-satellites also placed both lineages together in every cluster.</p> <p>Conclusions</p> <p>The global lineage distribution, lack of genetic distance, similar pattern of genetic diversity, and allele sharing strongly suggested that both lineages are a single species and thus new emerging phenotypes associated with vivax malaria could not be clearly classified as belonging to a particular lineage on basis of their geographical origin.</p

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue.

: Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model.<br/