Management of expatriate medical assistance in Mozambique

This paper discusses how Mozambique coped with the health system needs in terms of specialized doctors since independence, in a troubled context of war, lack of financial resources and modifying settings of foreign aid. The Ministry of Health (MOH) managed to make up for its severe scarcity of specialist MDs especially through contracting expatriate technical assistance. Different scenarios, partnerships and contract schemes that have evolved since independence are briefly described, as well as self-reliance option possibility and implications. Lessons learned about donor initiatives aimed at contracting specialists from other developing countries are singled out. The issue of obtaining expertise and knowledge in the global market as cheap as possible is stressed, and realistic figures of cost planning are highlighted, as determined by the overall health system necessities and budget limitations

Measuring the Three-Dimensional Structure of Galaxy Clusters. II. Are clusters of galaxies oblate or prolate?

The intrinsic shape of galaxy clusters can be obtained through a combination of X-ray and Sunyaev-Zeldovich effect observations once cosmological parameters are assumed to be known. In this paper we discuss the feasibility of modelling galaxy clusters as either prolate or oblate ellipsoids. We analyze the intra-cluster medium distribution for a sample of 25 X-ray selected clusters, with measured Sunyaev-Zeldovich temperature decrements. A mixed population of prolate and oblate ellipsoids of revolution fits the data well, with prolate shapes preferred on a 60-76% basis. We observe an excess of clusters nearly aligned along the line of sight, with respect to what is expected from a randomly oriented cluster population, which might imply the presence of a selection bias in our sample. We also find signs that a more general triaxial morphology might better describe the morphology of galaxy clusters. Additional constraints from gravitational lensing could disentangle the degeneracy between an ellipsoidal and a triaxial morphology, and could also allow an unbiased determination of the Hubble constant.Comment: 9 pages, 8 figures, accepted for publication in Astrophys.

Velocity Field Statistics in Star-Forming Regions. I. Centroid Velocity Observations

The probability density functions (pdfs) of molecular line centroid velocity fluctuations and fluctuation differences at different spatial lags are estimated for several nearby molecular clouds with active internal star formation. The data consist of over 75,000 $^{13}$CO line profiles divided among twelve spatially and/or kinematically distinct regions. Although three regions (all in Mon R2) appear nearly Gaussian, the others show strong evidence for non-Gaussian, often nearly exponential, centroid velocity pdfs, possibly with power law contributions in the far tails. Evidence for nearly exponential centroid pdfs in the neutral HI component of the ISM is also presented, based on older optical and radio observations. These results are in contrast to pdfs found in isotropic incompressible turbulence experiments and simulations. Furthermore, no evidence is found for the scaling of difference pdf kurtosis with Reynolds number which is seen in incompressible turbulence, and the spatial distribution of high-amplitude velocity differences shows little indication of the filamentary appearance predicted by decay simulations dominated by vortical interactions. The variation with lag of the difference pdf moments is presented as a constraint on future simulations.Comment: LaTeX, 23 pages, with 15 Figures included separately as gif image files. Refereed/revised version accepted to the Astrophysical Journal. A complete (but much larger) postscript version is available from http://ktaadn.gsfc.nasa.gov/~miesc

Statistical nature of non-Gaussianity from cubic order primordial perturbations: CMB map simulations and genus statistic

We simulate CMB maps including non-Gaussianity arising from cubic order perturbations of the primordial gravitational potential, characterized by the non-linearity parameter $g_{NL}$. The maps are used to study the characteristic nature of the resulting non-Gaussian temperature fluctuations. We measure the genus and investigate how it deviates from Gaussian shape as a function of $g_{NL}$ and smoothing scale. We find that the deviation of the non-Gaussian genus curve from the Gaussian one has an antisymmetric, sine function like shape, implying more hot and more cold spots for $g_{NL}>0$ and less of both for $g_{NL}<0$. The deviation increases linearly with $g_{NL}$ and also exhibits mild increase as the smoothing scale increases. We further study other statistics derived from the genus, namely, the number of hot spots, the number of cold spots, combined number of hot and cold spots and the slope of the genus curve at mean temperature fluctuation. We find that these observables carry signatures of $g_{NL}$ that are clearly distinct from the quadratic order perturbations, encoded in the parameter $f_{NL}$. Hence they can be very useful tools for distinguishing not only between non-Gaussian temperature fluctuations and Gaussian ones but also between $g_{NL}$ and $f_{NL}$ type non-Gaussianities.Comment: 18+1 page

What if we decided to take care of everyone who needed treatment? Workforce planning in Mozambique using simulation of demand for HIV/AIDS care

Background: The growing AIDS epidemic in southern Africa is placing an increased strain on health systems, which are experiencing steadily rising patient loads. Health care systems are tackling the barriers to serving large populations in scaled-up operations. One of the most significant challenges in this effort is securing the health care workforce to deliver care in settings where the manpower is already in short supply. Methods: We have produced a demand-driven staffing model using simple spreadsheet technology, based on treatment protocols for HIV-positive patients that adhere to Mozambican guidelines. The model can be adjusted for the volumes of patients at differing stages of their disease, varying provider productivity, proportion who are pregnant, attrition rates, and other variables. Results: Our model projects the need for health workers using three different kinds of goals: 1) the number of patients to be placed on anti-retroviral therapy (ART), 2) the number of HIV-positive patients to be enrolled for treatment, and 3) the number of patients to be enrolled in a treatment facility per month. Conclusion: We propose three scenarios, depending on numbers of patients enrolled. In the first scenario, we start with 8000 patients on ART and increase that number to 58 000 at the end of three years (those were the goals for the country of Mozambique). This would require thirteen clinicians and just over ten nurses by the end of the first year, and 67 clinicians and 47 nurses at the end of the third year. In a second scenario, we start with 34 000 patients enrolled for care (not all of them on ART), and increase to 94 000 by the end of the third year, requiring a growth in clinician staff from 18 to 28. In a third scenario, we start a new clinic and enrol 200 new patients per month for three years, requiring 1.2 clinicians in year 1 and 2.2 by the end of year 3. Other clinician types in the model include nurses, social workers, pharmacists, phlebotomists, and peer counsellors. This planning tool could lead to more realistic and appropriate estimates of workforce levels required to provide high-quality HIV care in a low-resource settings

Scl-dE1 GC1: An Extended Globular Cluster in a Low-Luminosity Dwarf Elliptical Galaxy

We report the discovery from Hubble Space Telescope ACS images of an extended globular cluster, denoted by Scl-dE1 GC1, in the Sculptor Group dwarf Elliptical galaxy Scl-dE1 (Sc22). The distance of the dE is determined as 4.3 +/- 0.25 Mpc from the I magnitude of the tip of the red giant branch in the color-magnitude diagram. At this distance the half-light radius of Scl-dE1 GC1 is ~22 pc, placing it among the largest clusters known, particularly for globular clusters associated with dwarf galaxies. The absolute magnitude of Scl-dE1 GC1 is Mv = -6.7 and, to within the photometric uncertainties of the data, the cluster stellar population appears indistinguishable from that of the dE. We suggest that there may be two modes of globular cluster formation in dwarf galaxies, a "normal" mode with half-light radii of typically 3 pc, and an "extended" mode with half-light radii of ~10 pc or more.Comment: 18 pages, 5 figures, 1 Table. Accepted for publication in the Astronomical Journa

Asteroseismology and Interferometry

Asteroseismology provides us with a unique opportunity to improve our understanding of stellar structure and evolution. Recent developments, including the first systematic studies of solar-like pulsators, have boosted the impact of this field of research within Astrophysics and have led to a significant increase in the size of the research community. In the present paper we start by reviewing the basic observational and theoretical properties of classical and solar-like pulsators and present results from some of the most recent and outstanding studies of these stars. We centre our review on those classes of pulsators for which interferometric studies are expected to provide a significant input. We discuss current limitations to asteroseismic studies, including difficulties in mode identification and in the accurate determination of global parameters of pulsating stars, and, after a brief review of those aspects of interferometry that are most relevant in this context, anticipate how interferometric observations may contribute to overcome these limitations. Moreover, we present results of recent pilot studies of pulsating stars involving both asteroseismic and interferometric constraints and look into the future, summarizing ongoing efforts concerning the development of future instruments and satellite missions which are expected to have an impact in this field of research.Comment: Version as published in The Astronomy and Astrophysics Review, Volume 14, Issue 3-4, pp. 217-36

Preparation and grain silage processing wet corn in feed

Todos os textos, informa??es e resultados apresentados s?o de inteira responsabilidade dos autores.Objetivou-se a partir desse trabalho apresentar uma revis?o da literatura sobre, o processamento de silagem de gr?o ?mido de milho na alimenta??o animal. Visto que o gr?o do milho ? a principal fonte de energia para ruminantes e monog?stricos. O planejamento ? o primeiro passo para alcan?ar a produ??o de qualidade da silagem. Os mesmo cuidados da ensilagem da planta inteira s?o imprescind?veis para o processamento da ensilagem apenas de gr?os. Na t?cnica da ensilagem, s?o adotadas estrat?gias como o dimensionamento do silo adequado, rapidez no momento da colheita; transporte e moagem; compacta??o necess?ria para acomodar com efici?ncia as part?culas do material; agilidade na veda??o do silo e seu uso durante o fornecimento aos animais. Cada vez mais pesquisas v?m confirmando utiliza??o da silagem de gr?o ?mido de milho como um importante componente energ?tico da dieta para a maioria das esp?cies de interesse zoot?cnico. Considerando que elabora??o e processamentos da silagem de gr?o ?mido de milho ? uma tecnologia que pode contribuir de forma significativa a fim de melhorar os ?ndices de produtividade dos animais. Entretanto seu uso ainda e considerado incipiente no pais, com necessidade de novos estudos em sua utiliza??o em rela??o as dificuldades de processamento e fornecimento aos animais.The objective was to work from that present a literature review on the processing of wet grain corn silage for animal feed. Since the grain of corn is the primary source of energy for ruminants and monogastrics. Planning is the first step to achieve the production of silage quality. The same care of the whole plant silage are essential for processing silage only beans. In ensiling technique, strategies are adopted as designing the appropriate silo, speed at the time of harvest; Transport and crushing; compression required to efficiently accommodate the particles of the material; agility in the sealing of the silo and its use in animal feeding. Increasingly research have confirmed use of silage moisture corn as a major energy component of the diet for most livestock species. Whereas the preparation and processing of silage moisture corn is a technology that can significantly contribute to improve animal productivity. However its use is considered still incipient in the country, in need of new studies on its use in relation to the difficulties of processing and animal feeding

Congenital Hydrocephalus and Abnormal Subcommissural Organ Development in Sox3 Transgenic Mice

Congenital hydrocephalus (CH) is a life-threatening medical condition in which excessive accumulation of CSF leads to ventricular expansion and increased intracranial pressure. Stenosis (blockage) of the Sylvian aqueduct (Aq; the narrow passageway that connects the third and fourth ventricles) is a common form of CH in humans, although the genetic basis of this condition is unknown. Mouse models of CH indicate that Aq stenosis is associated with abnormal development of the subcommmissural organ (SCO) a small secretory organ located at the dorsal midline of the caudal diencephalon. Glycoproteins secreted by the SCO generate Reissner's fibre (RF), a thread-like structure that descends into the Aq and is thought to maintain its patency. However, despite the importance of SCO function in CSF homeostasis, the genetic program that controls SCO development is poorly understood. Here, we show that the X-linked transcription factor SOX3 is expressed in the murine SCO throughout its development and in the mature organ. Importantly, overexpression of Sox3 in the dorsal diencephalic midline of transgenic mice induces CH via a dose-dependent mechanism. Histological, gene expression and cellular proliferation studies indicate that Sox3 overexpression disrupts the development of the SCO primordium through inhibition of diencephalic roof plate identity without inducing programmed cell death. This study provides further evidence that SCO function is essential for the prevention of hydrocephalus and indicates that overexpression of Sox3 in the dorsal midline alters progenitor cell differentiation in a dose-dependent manner

Milk production systems retated momba?a grass

Todos os textos, informa??es e resultados apresentados s?o de inteira responsabilidade dos autores.A produ??o animal em pastagens apresenta vantagens em rela??o aos outros sistemas de produ??o. Geralmente, o pasto ? o alimento mais vi?vel economicamente para a alimenta??o de ruminantes. O capim-momba?a ? uma cultivar de Panicum maximum nativa da ?frica, essa cultivar apresenta desenvolvimento satisfat?rio em sistemas de manejo mais intensivos e com altas taxas de lota??o. Por?m, para garantir a produtividade animal, a fisiologia da forrageira deve ser respeitada com auxilio das alturas de entrada de sa?da adequadas a cada esp?cie.Livestock production in pastures has advantages over other production systems. Generally, the grass is the most economically viable food for feeding to ruminants. The momba?a is a cultivar of Panicum maximum native to Africa, this cultivar has developed satisfactorily in more intensive management systems and high stocking rates. However, to ensure animal productivity, forage physiology must be respected with the aid of input output heights appropriate to each species