Strengthening surgical and anaesthetic services at district level in the African region: issues, challenges and proposed actions

Health care delivery systems are organized at several levels with the district hospital serving as the first referral for comprehensive care in the majority of countries worldwide. The provision of comprehensive surgical services requires several inputs and tools to be in place, among which are an adequately trained surgical, anaesthesia and obstetric healthcare workforce, infrastructure and functioning equipment, and essential medicines and supplies. These, however, are not in place in the majority of commonly received surgical cases, such as trauma, obstetric, abdominal and orthopedic emergencies, thus limiting the capacity of district hospitals to address them. Global and regional public health initiatives have traditionally neglected the necessity of the provision of surgical services despite the fact that these constitute an essential component of comprehensive primary healthcare (PHC)1. In fact, because surgery so frequently cannot be safely postponed, this deficiency prevents the transfer of patients to a secondary or tertiarylevel hospital where further care can be provided.

Effect of aerosolized uridine-5'-triphosphate on airway clearance with cough in patients with primary ciliary dyskinesia

Primary ciliary dyskinesia (PCD) is a genetic disease characterized by abnormal ciliary structure and function and impaired mucociliary clearance. Because patients with PCD use cough clearance as an airway defense mechanism, we tested the hypothesis that aerosolized uridine-5'-triphosphate (UTP) would improve clearance during cough by its actions to stimulate CI secretion and mucin release by goblet cells. We measured clearance during cough in 12 patients with PCD (ages 14 to 71 yr, FEV1 43% to 89% predicted) in a double blind, randomized, crossover study after aerosolization of a single dose of UTP (5 mg/ml, 3.5 ml) or vehicle (0.12% saline, 3.5 ml). Clearance during cough (whole lung) was quantified during and after a series of controlled coughs by measuring the clearance of [99mTc]Fe2O3 particles via gamma camera scanning over 120 min. Safety parameters were recorded during and after drug delivery. Aerosolized UTP improved whole-lung clearance during cough as compared with vehicle (from 0 to 60 min: 0.40 ± 0.07%/min [UTP] versus 0.26 ± 0.04%/min [vehicle] [mean ± SEMI, p = 0.01), and from 0 to 120 min: 0.38 ± 0.05%/min [UTP] versus 0.25 ± 0.04%/min [vehicle], p = 0.02), Aerosolized UTP is safe, with no serious adverse effects. Whole-lung clearance during cough in patients with defective ciliary function is enhanced after inhalation of UTP

Red Queen Coevolution on Fitness Landscapes

Species do not merely evolve, they also coevolve with other organisms. Coevolution is a major force driving interacting species to continuously evolve ex- ploring their fitness landscapes. Coevolution involves the coupling of species fit- ness landscapes, linking species genetic changes with their inter-specific ecological interactions. Here we first introduce the Red Queen hypothesis of evolution com- menting on some theoretical aspects and empirical evidences. As an introduction to the fitness landscape concept, we review key issues on evolution on simple and rugged fitness landscapes. Then we present key modeling examples of coevolution on different fitness landscapes at different scales, from RNA viruses to complex ecosystems and macroevolution.Comment: 40 pages, 12 figures. To appear in "Recent Advances in the Theory and Application of Fitness Landscapes" (H. Richter and A. Engelbrecht, eds.). Springer Series in Emergence, Complexity, and Computation, 201

Search for Exotic Mesons in pi- P Interactions at 18 GeV/c

The recent search for non $q \bar{q}$ mesons in $\pi^{-}p$ interactions at Brookhaven National Laboratory is summarized. Many final states such as $\eta \pi$, $\eta' \pi^{-}$, $a_{0} \pi$, $f_{1} \pi$, $a_{2} \pi$, $b_{1} \pi$, which are favored decay modes of exotics, are under investigation.Comment: 9 pages, PostScript, Presented at the International School of Nuclear Physics, Erice, Sicily, Italy, September 199

Confirmation of a pi_1^0 Exotic Meson in the \eta \pi^0 System

The exclusive reaction $\pi^- p \to \eta \pi^0 n$, $\eta \to \pi^+ \pi^- \pi^0$ at 18 GeV$/c$ has been studied with a partial wave analysis on a sample of 23~492 $\eta \pi^0 n$ events from BNL experiment E852. A mass-dependent fit is consistent with a resonant hypothesis for the $P_+$ wave, thus providing evidence for a neutral exotic meson with $J^{PC} = 1^{-+}$, a mass of $1257 \pm 20 \pm 25$ MeV$/c^2$, and a width of $354 \pm 64 \pm 60$ MeV$/c^2$. New interpretations of the meson exotics in neutral $\eta \pi^0$ system observed in E852 and Crystal Barrel experiments are discussed.Comment: p3, rewording the paragraph (at the bottom) about the phase variations. p4, rewording paragrath "The second method ..." . p4, at the bottom of paragrath "The third method ..." added consistent with the results of methods 1 and 2

Exotic Meson Production in the f1(1285)π−f_{1}(1285)\pi^{-} System observed in the Reaction π−p→ηπ+π−π−p\pi^{-} p \to \eta\pi^{+}\pi^{-}\pi^{-} p at 18 GeV/c

This letter reports results from the partial wave analysis of the $\pi^{-}\pi^{-}\pi^{+}\eta$ final state in $\pi^{-}p$ collisions at 18GeV/c. Strong evidence is observed for production of two mesons with exotic quantum numbers of spin, parity and charge conjugation, $J^{PC} = 1^{-+}$ in the decay channel $f_{1}(1285)\pi^{-}$. The mass $M = 1709 \pm 24 \pm 41$ MeV/c^2 and width $\Gamma = 403 \pm 80 \pm 115$ MeV/c^2 of the first state are consistent with the parameters of the previously observed $\pi_{1}(1600)$. The second resonance with mass $M = 2001 \pm 30 \pm 92$ MeV/c^2 and width $\Gamma = 333 \pm 52 \pm 49$ MeV/c^2 agrees very well with predictions from theoretical models. In addition, the presence of $\pi_{2}(1900)$ is confirmed with mass $M = 2003 \pm 88 \pm 148$ MeV/c^2 and width $\Gamma = 306 \pm 132 \pm 121$ MeV/c^2 and a new state, $a_{1}(2096)$, is observed with mass $M = 2096 \pm 17 \pm 121$ MeV/c^2 and width $\Gamma = 451 \pm 41 \pm 81$ MeV/c^2. The decay properties of these last two states are consistent with flux tube model predictions for hybrid mesons with non-exotic quantum numbers

Observation of a New J(PC)=1(+-) Isoscalar State in the Reaction Pi- Proton -> Omega Eta Neutron at 18 GeV/c

Results are presented on a partial wave analysis of the Omega Eta final state produced in Pi- Proton interactions at 18 GeVc where Omega -> Pi+ Pi- Pi0, Pi0 -> 2 Gammas, and Eta -> 2 Gammas. We observe the previously unreported decay mode Omega(1650) -> Omega Eta and a new 1(+-) meson state h1(1595) with a mass M=1594(15)(+10)(-60) MeV/c^2 and a width Gamma=384(60)(+70)(-100) MeV/c^2. The h1(1595) state exhibits resonant-like phase motion relative to the Omega(1650).Comment: Submitted to Physics Letters B Eight total pages including 11 figures and 1 tabl

Observation of Pseudoscalar and Axial Vector Resonances in pi- p -> K+ K- pi0 n at 18 GeV

A new measurement of the reaction pi- p -> K+ K- pi0 n has been made at a beam energy of 18 GeV. A partial wave analysis of the K+ K- pi0 system shows evidence for three pseudoscalar resonances, eta(1295), eta(1416), and eta(1485), as well as two axial vectors, f1(1285), and f1(1420). Their observed masses, widths and decay properties are reported. No signal was observed for C(1480), an IG J{PC} = 1+ 1{--} state previously reported in phi pi0 decay.Comment: 7 pages, 6 figs, to be submitted to Phys. Let

A partial wave analysis of the π0π0\pi ^0\pi ^0 system produced in π−p\pi ^-p charge exchange collisions

A partial wave analysis of the of the $\pi ^0\pi ^0$ system produced in the charge exchange reaction: $\pi ^-p\to \pi ^0\pi ^0n$ at an incident momentum of $18.3 GeV/c$ is presented as a function of ${\pi ^0\pi ^0}$ invariant mass, $m_{\pi^0\pi^0}$, and momentum transfer squared, $| {t} |$, from the incident $\pi^-$ to the outgoing ${\pi ^0\pi ^0}$ system.Comment: 24 pages total,8 pages text, 14 figures, 1 table. Submitted to Phys Rev