a before-and-after study and scale-up process in Mozambique

BACKGROUND: The universal coverage bed nets campaign is a proven health intervention promoting increased access, ownership, and use of bed nets to reduce malaria burden. This article describes the intervention and implementation strategies that Mozambique carried out recently in order to improve access and increase demand for long-lasting insecticidal nets (LLINs). METHODS: A before-and-after study with a control group was used during Stage I of the implementation process. The following strategies were tested in Stage I: (1) use of coupons during household registration; (2) use of stickers to identify the registered households; (3) new LLIN ascription formula (one LLIN for every two people). In Stage II, the following additional strategies were implemented: (4) mapping and micro-planning; (5) training; and (6) supervision. Odds ratio (OR) and 95% confidence interval (CI) were used to compare and establish differences between intervened and control districts in Stage I. Main outcomes were: percentage of LLINs distributed, percentage of target households benefited. RESULTS: In Stage I, 87.8% (302,648) of planned LLINs were distributed in the intervention districts compared to 77.1% (219,613) in the control districts [OR: 2.14 (95% CI 2.11-2.16)]. Stage I results also showed that 80.6% (110,453) of households received at least one LLIN in the intervention districts compared to 72.8% (87,636) in the control districts [OR: 1.56 (95% CI 1.53-1.59)]. In Stage II, 98.4% (3,536,839) of the allocated LLINs were delivered, covering 98.6% (1,353,827) of the registered households. CONCLUSIONS: Stage I results achieved better LLINs and household coverage in districts with the newly implemented strategies. The results of stage II were also encouraging. Additional strategies adaptation is required for a wide-country LLIN campaignpublishersversionpublishe

Effectiveness of a new long-lasting insecticidal nets delivery model in two rural districts of Mozambique: a before-after study

BACKGROUND: In 2015, Mozambique piloted a new model of long-lasting insecticidal nets (LLINs) delivery in a campaign. The new delivery model was used in two rural districts were, and two others were considered as control, maintaining the old delivery model. The aim of this study is to compare the coverage of ownership and use of LLINs in intervention and control districts in Mozambique. METHODS: A before-after design with control group was carried out 6 months after LLINs distribution. Using systematic probabilistic sampling, 1547 households were surveyed by means of a questionnaire. To find associations between the district categories (intervention and control) and the main outcomes of the study (LLIN ownership, use, and universal coverage achievement), odds ratio (OR) and respective confidence intervals were calculated. RESULTS: Of the 760 households surveyed in the intervention districts, 98.8% had at least one LLIN; of the 787 households surveyed in the control districts, 89.6% had at least one LLIN [OR: 9.7, 95% (CI 4.84-19.46)]. Around 95 and 87% of households owning at least one LLIN reported having slept under the LLIN the previous night in the intervention and control districts, respectively [OR: 3.2; 95% (CI 2.12-4.69)]. Seventy-one percent of the households surveyed achieved universal coverage in the intervention districts against 59.6% in the control districts [OR: 1.6; 95% (CI 1.33-2.03)]. CONCLUSIONS: The universal coverage campaign piloted with the new delivery model has increased LLINs ownership, use, and progression for reaching universal coverage targets in the community.publishersversionpublishe

um panorama do conhecimento científico e tecnológico em malária no mundo e a contribuição de Portugal

Saúde Global e Doenças TropicaisO Século 21 trouxe grandes desafios para a gestão da informação e do Co-nhecimento em todas as áreas da ciência. No que tange à Saúde Pública, elas se intensificam não só para os países em desenvolvimento e os menos desenvolvidos, que incluem a problemática das doenças tropicais, mas tam-bém para os países desenvolvidos, uma vez a manifestação das reemergentes, mudanças climáticas e a associação às doenças negligenciadas. Estas, asso-ciadas às doenças crônicas ou agudas, se intensificam causando um grave problema de saúde pública. Assim, é salutar o monitoramento constante da ciência e tecnologia a fim de contribuir para o avanço de novos tratamentos e promoção da saúde. Não obstante, numa era em que diariamente 2,5 x 1018 bytes novos são adicionados à Web, é mister novos métodos de identi-ficação, extração e análise dos dados essenciais para os tomadores de decisão. Portanto, este trabalho apresenta um cenário das publicações científicas e o avanço tecnológico pelas patentes no campo da Malária no mundo e a parti-cipação dos cientistas em Portugal. Neste âmbito, foram utilizados softwares livre para mineração do Big Data em Saúde. O trabalho mostrou interesse crescente em P, D&I para Malária, bem como uma rede sólida e colaborativa em Portugal.O Século 21 trouxe grandes desafios para a gestão da informação e do Co-nhecimento em todas as áreas da ciência. No que tange à Saúde Pública, elas se intensificam não só para os países em desenvolvimento e os menos desenvolvidos, que incluem a problemática das doenças tropicais, mas tam-bém para os países desenvolvidos, uma vez a manifestação das reemergentes, mudanças climáticas e a associação às doenças negligenciadas. Estas, asso-ciadas às doenças crônicas ou agudas, se intensificam causando um grave problema de saúde pública. Assim, é salutar o monitoramento constante da ciência e tecnologia a fim de contribuir para o avanço de novos tratamentos e promoção da saúde. Não obstante, numa era em que diariamente 2,5 x 1018 bytes novos são adicionados à Web, é mister novos métodos de identi-ficação, extração e análise dos dados essenciais para os tomadores de decisão. Portanto, este trabalho apresenta um cenário das publicações científicas e o avanço tecnológico pelas patentes no campo da Malária no mundo e a parti-cipação dos cientistas em Portugal. Neste âmbito, foram utilizados softwares livre para mineração do Big Data em Saúde. O trabalho mostrou interesse crescente em P, D&I para Malária, bem como uma rede sólida e colaborativa em Portugal.O Século 21 trouxe grandes desafios para a gestão da informação e do Co-nhecimento em todas as áreas da ciência. No que tange à Saúde Pública, elas se intensificam não só para os países em desenvolvimento e os menos desenvolvidos, que incluem a problemática das doenças tropicais, mas tam-bém para os países desenvolvidos, uma vez a manifestação das reemergentes, mudanças climáticas e a associação às doenças negligenciadas. Estas, asso-ciadas às doenças crônicas ou agudas, se intensificam causando um grave problema de saúde pública. Assim, é salutar o monitoramento constante da ciência e tecnologia a fim de contribuir para o avanço de novos tratamentos e promoção da saúde. Não obstante, numa era em que diariamente 2,5 x 1018 bytes novos são adicionados à Web, é mister novos métodos de identi-ficação, extração e análise dos dados essenciais para os tomadores de decisão. Portanto, este trabalho apresenta um cenário das publicações científicas e o avanço tecnológico pelas patentes no campo da Malária no mundo e a parti-cipação dos cientistas em Portugal. Neste âmbito, foram utilizados softwares livre para mineração do Big Data em Saúde. O trabalho mostrou interesse crescente em P, D&I para Malária, bem como uma rede sólida e colaborativa em Portugal.O Século 21 trouxe grandes desafios para a gestão da informação e do Conhecimento em todas as áreas da ciência. No que tange à Saúde Pública, elas se intensificam não só para os países em desenvolvimento e os menos desenvolvidos, que incluem a problemática das doenças tropicais, mas também para os países desenvolvidos, uma vez a manifestação das reemergentes, mudanças climáticas e a associação às doenças negligenciadas. Estas, associadas às doenças crônicas ou agudas, se intensificam causando um grave problema de saúde pública. Assim, é salutar o monitoramento constante da ciência e tecnologia a fim de contribuir para o avanço de novos tratamentos e promoção da saúde. Não obstante, numa era em que diariamente 2,5 x 1018 bytes novos são adicionados à Web, é mister novos métodos de identificação, extração e análise dos dados essenciais para os tomadores de decisão. Portanto, este trabalho apresenta um cenário das publicações científicas e o avanço tecnológico pelas patentes no campo da Malária no mundo e a participação dos cientistas em Portugal. Neste âmbito, foram utilizados softwares livre para mineração do Big Data em Saúde. O trabalho mostrou interesse crescente em P, D&I para Malária, bem como uma rede sólida e colaborativa em Portugal. The 21st century has brought great challenges to the management of information and knowledge in all areas of science. In public health, there is a major issue due to problems of tropical diseases for developing countries and least developed countries. For developed countries, the same problem because of the appearance of reemerging diseases, climate change and the association with neglected diseases. On the other hand, these diseases associated with chronic or acute diseases, intensify causing a serious public health problem. Thus, it is constructive the constant monitoring of science and technology in order to contribute to the advancement of new treatments and health care. However, in times they are 2.5 x 1018 bytes daily in the Web. Therefore, it is necessary new methods of identification, extraction and analysis of core data for decision makers.Thus, this work presents a scenario of scientific publications and technological advancement by patents in the field of malaria in the world and the participation of scientists in Portugal. In this context, was used free software for mining of Big Data in Health.The work has shown increasing interest in R, D & I for Malaria, as well as a strong and collaborative network in Portugal.publishersversionpublishe

a supplementary tool for improving bed nets universal coverage campaign in Mozambique

BACKGROUND: WhatsApp (WA) is the most recent and attractive applicative among Smartphone users. The use of WA in healthcare environment has been shown of multiple benefices. Mozambique team involved in 2017 bed nets universal coverage campaign (UCC) implemented a distant mentoring strategy using WA. This study aims to perform a descriptive analysis of the use of WA as a supplementary tool for mentoring provincial and district health teams during bed nets universal coverage campaign in Mozambique. METHODS: Using WA, a qualitative study was carried out between March and July 2017. Seven WA groups were created. One group for central-level team, and six groups corresponding to each implementation province. The WA content was analyzed, grouped into separate themes, and subject to information triangulation among researchers and group participants. Saturation guided the quantity and quality of information. RESULTS: A total of 511 members were included in all WA groups. Of these, 96% were provincial WA groups. A total of 24,897 messages (text and images) were exchanged in all WA groups. The main communication form was text (22,660-91%), followed by images (2237-9%). Five themes emerged from content analyses: 1) administrative/financial, 2) logistic, 3) planning and implementation, 4) monitoring and evaluation, and 5) best practice. CONCLUSIONS: The use of WA during universal coverage bed nets campaign implementation in Mozambique fostered central-level coordination, providing implementation support to district and provincial teams, and promoting wider and timely information sharing among group members.publishersversionpublishe

Switching of magnetic domains reveals evidence for spatially inhomogeneous superconductivity

The interplay of magnetic and charge fluctuations can lead to quantum phases with exceptional electronic properties. A case in point is magnetically-driven superconductivity, where magnetic correlations fundamentally affect the underlying symmetry and generate new physical properties. The superconducting wave-function in most known magnetic superconductors does not break translational symmetry. However, it has been predicted that modulated triplet p-wave superconductivity occurs in singlet d-wave superconductors with spin-density wave (SDW) order. Here we report evidence for the presence of a spatially inhomogeneous p-wave Cooper pair-density wave (PDW) in CeCoIn5. We show that the SDW domains can be switched completely by a tiny change of the magnetic field direction, which is naturally explained by the presence of triplet superconductivity. Further, the Q-phase emerges in a common magneto-superconducting quantum critical point. The Q-phase of CeCoIn5 thus represents an example where spatially modulated superconductivity is associated with SDW order

LES-based Study of the Roughness Effects on the Wake of a Circular Cylinder from Subcritical to Transcritical Reynolds Numbers

This paper investigates the effects of surface roughness on the flow past a circular cylinder at subcritical to transcritical Reynolds numbers. Large eddy simulations of the flow for sand grain roughness of size k/D = 0.02 are performed (D is the cylinder diameter). Results show that surface roughness triggers the transition to turbulence in the boundary layer at all Reynolds numbers, thus leading to an early separation caused by the increased momentum deficit, especially at transcritical Reynolds numbers. Even at subcritical Reynolds numbers, boundary layer instabilities are triggered in the roughness sublayer and eventually lead to the transition to turbulence. The early separation at transcritical Reynolds numbers leads to a wake topology similar to that of the subcritical regime, resulting in an increased drag coefficient and lower Strouhal number. Turbulent statistics in the wake are also affected by roughness; the Reynolds stresses are larger due to the increased turbulent kinetic energy production in the boundary layer and separated shear layers close to the cylinder shoulders.We acknowledge “Red Española de Surpercomputación” (RES) for awarding us access to the MareNostrum III machine based in Barcelona, Spain (Ref. FI-2015-2-0026 and FI-2015-3-0011). We also acknowledge PRACE for awarding us access to Fermi and Marconi Supercomputers at Cineca, Italy (Ref. 2015133120). Oriol Lehmkuhl acknowledges a PDJ 2014 Grant by AGAUR (Generalitat de Catalunya). Ugo Piomelli acknowledges the support of the Natural Sciences and Engineering Research Council (NSERC) of Canada under the Discovery Grant Programme (Grant No. RGPIN-2016-04391). Ricard Borrell acknowledges a Juan de la Cierva postdoctoral grant (IJCI-2014-21034). Ivette Rodriguez, Oriol Lehmkuhl, Ricard Borrell and Assensi Oliva acknowledge Ministerio de Economía y Competitividad, Secretaría de Estado de Investigación, Desarrollo e Innovación, Spain (ref. ENE2014-60577-R).Peer ReviewedPostprint (author's final draft

Haptoglobin Phenotype, Preeclampsia Risk and the Efficacy of Vitamin C and E Supplementation to Prevent Preeclampsia in a Racially Diverse Population

Haptoglobin's (Hp) antioxidant and pro-angiogenic properties differ between the 1-1, 2-1, and 2-2 phenotypes. Hp phenotype affects cardiovascular disease risk and treatment response to antioxidant vitamins in some non-pregnant populations. We previously demonstrated that preeclampsia risk was doubled in white Hp 2-1 women, compared to Hp 1-1 women. Our objectives were to determine whether we could reproduce this finding in a larger cohort, and to determine whether Hp phenotype influences lack of efficacy of antioxidant vitamins in preventing preeclampsia and serious complications of pregnancy-associated hypertension (PAH). This is a secondary analysis of a randomized controlled trial in which 10,154 low-risk women received daily vitamin C and E, or placebo, from 9-16 weeks gestation until delivery. Hp phenotype was determined in the study prediction cohort (n = 2,393) and a case-control cohort (703 cases, 1,406 controls). The primary outcome was severe PAH, or mild or severe PAH with elevated liver enzymes, elevated serum creatinine, thrombocytopenia, eclampsia, fetal growth restriction, medically indicated preterm birth or perinatal death. Preeclampsia was a secondary outcome. Odds ratios were estimated by logistic regression. Sampling weights were used to reduce bias from an overrepresentation of women with preeclampsia or the primary outcome. There was no relationship between Hp phenotype and the primary outcome or preeclampsia in Hispanic, white/other or black women. Vitamin supplementation did not reduce the risk of the primary outcome or preeclampsia in women of any phenotype. Supplementation increased preeclampsia risk (odds ratio 3.30; 95% confidence interval 1.61-6.82, p<0.01) in Hispanic Hp 2-2 women. Hp phenotype does not influence preeclampsia risk, or identify a subset of women who may benefit from vitamin C and E supplementation to prevent preeclampsia

Investigating the Therapeutic Potential of a Probiotic in a Rat Model for Infection Following Fracture Fixation

Background: Staphylococcus aureus (S. aureus) is the most common pathogen responsible for osteomyelitis. Objectives: Our objective was to investigate the potential of a probiotic as a treatment for S. aureus-induced infection following fracture fixation in a rat model. Methods: Fifty male Sprague-Dawley rats were assigned to five groups (Control, S. aureus, S. aureus +ceftriaxone, S. aureus + once weekly probiotic, and S. aureus + twice weekly probiotic). Lactobacillus casei subsp. casei (ATCC: 39392) was selected from eight strains of probiotic bacteria with anti-staphylococcal activity. Infection was induced by inoculation with106 colony-forming units (CFU) of S. aureus in a closed femur fracture model stabilized with an intramedullary pin. Three weeks after the surgery, the development of infection and response to the therapy was documented using radiographs, microbiological and histopathological analysis. Results: No bacteria were recovered from rats in the Control group. The analysis of variance revealed a significant difference in the CFU/femur (P < 0.001) and CFU/pin (P = 0.001) across all five treatment groups. When the results were compared, the CFU/femur was significantly lower in the S. aureus + Probiotic twice weekly in comparison with S. aureus (P = 0.008) and the S. aureus + ceftriaxone (P = 0.012) groups. Repeated measure ANOVA to test the radiographic scores during the follow-up time between the intervention groups revealed no significant differences (P = 0.179). Conclusions: Parenteral administration of viable L. casei inhibits S. aureus-induced infection as shown by the bacteriologic analysis, but makes no difference to the radiological union rates. This could be the first step towards developing an effective, biologic adjunctive therapy for the management of osteomyelitis following fracture fixation

Searching for new strategies against biofilm infections: Colistin-AMP combinations against Pseudomonas aeruginosa and Staphylococcus aureus single- and double-species biofilms

Antimicrobial research is being pressured to look for more effective therapeutics for the ever-growing antibiotic-resistant infections, and antimicrobial peptides (AMP) and antimicrobial combinations are promising solutions. This work evaluates colistin-AMP combinations against two major pathogens, Pseudomonas aeruginosa and Staphylococcus aureus, encompassing non- and resistant strains. Colistin (CST) combined with the AMP temporin A (TEMP-A), citropin 1.1 (CIT-1.1) and tachyplesin I linear analogue (TP-I-L) was tested against planktonic, single- and double-species biofilm cultures. Overall synergy for planktonic P. aeruginosa and synergy/additiveness for planktonic S. aureus were observed. Biofilm growth prevention was achieved with synergy and additiveness. Pre-established 24 h-old biofilms were harder to eradicate, especially for S. aureus and double-species biofilms; still, some synergy and addictiveness was observed for higher concentrations, including for the biofilms of resistant strains. Different treatment times and growth media did not greatly influence AMP activity. CST revealed low toxicity compared with the other AMP but its combinations were toxic for high concentrations. Overall, combinations reduced effective AMP concentrations, mainly in prevention scenarios. Improvement of effectiveness and toxicity of therapeutic strategies will be further investigated.The authors acknowledge the Portuguese Foundation for Science and Technology (FCT) (http://www.fct.pt/), under the scope of the strategic funding of UID/B10/04469/2013 and COMPETE 2020 (POCI-01-0145-FEDER-006684). This study was also supported by FCT and the European Community fund FEDER, through Program COMPETE, and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 -Programa Operacional Regional do Norte. This work was also partially funded by the [14V105] Contract-Programme from the University of Vigo (https://mw.uvigo.gal/ uvigo_en/) and the Agrupamento INBIOMED (http://inbiomed.webs.uvigaes/) from DXPCTSUG-FEDER unha maneira de facer Europa (2012/273) and co-financed by the European Regional Development Fund (http://ec.europleuiregionaL policy/EN/fundingierdf/) under the Operational Programme Innovative Economy (WNP-POIG.01.04.00-22-052/11).). Lipopharm.pl (http://www.lipopharm.p1/) provided support in the form of salaries for authors DG and WK. The authors also acknowledge the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) (https://www.escmid.org/) for the Research Grant 2014 to Anglia Lourenco, and FCT for the PhD Grant of Paula Jorge (grant number SFRH/BD/88192/2012). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.info:eu-repo/semantics/publishedVersio

Evidence for distinct coastal and offshore communities of bottlenose dolphins in the north east Atlantic.

Bottlenose dolphin stock structure in the northeast Atlantic remains poorly understood. However, fine scale photo-id data have shown that populations can comprise multiple overlapping social communities. These social communities form structural elements of bottlenose dolphin (Tursiops truncatus) [corrected] populations, reflecting specific ecological and behavioural adaptations to local habitats. We investigated the social structure of bottlenose dolphins in the waters of northwest Ireland and present evidence for distinct inshore and offshore social communities. Individuals of the inshore community had a coastal distribution restricted to waters within 3 km from shore. These animals exhibited a cohesive, fission-fusion social organisation, with repeated resightings within the research area, within a larger coastal home range. The offshore community comprised one or more distinct groups, found significantly further offshore (>4 km) than the inshore animals. In addition, dorsal fin scarring patterns differed significantly between inshore and offshore communities with individuals of the offshore community having more distinctly marked dorsal fins. Specifically, almost half of the individuals in the offshore community (48%) had characteristic stereotyped damage to the tip of the dorsal fin, rarely recorded in the inshore community (7%). We propose that this characteristic is likely due to interactions with pelagic fisheries. Social segregation and scarring differences found here indicate that the distinct communities are likely to be spatially and behaviourally segregated. Together with recent genetic evidence of distinct offshore and coastal population structures, this provides evidence for bottlenose dolphin inshore/offshore community differentiation in the northeast Atlantic. We recommend that social communities should be considered as fundamental units for the management and conservation of bottlenose dolphins and their habitat specialisations