Measuring antibiotic availability and use in 20 low- and middle-income countries

Objective To assess antibiotic availability and use in health facilities in low- and middle-income countries, using the service provision assessment and service availability and readiness assessment surveys. Methods We obtained data on antibiotic availability at 13 561 health facilities in 13 service provision assessment and 8 service availability and readiness assessment surveys. In 10 service provision assessment surveys, child consultations with health-care providers were observed, giving data on antibiotic use in 22 699 children. Antibiotics were classified as access, watch or reserve, according to the World Health Organization’s AWaRe categories. The percentage of health-care facilities across countries with specific antibiotics available and the proportion of children receiving antibiotics for key clinical syndromes were estimated. Findings The surveys assessed the availability of 27 antibiotics (19 access, 7 watch, 1 unclassified). Co-trimoxazole and metronidazole were most widely available, being in stock at 89.5% (interquartile range, IQR: 11.6%) and 87.1% (IQR: 15.9%) of health facilities, respectively. In contrast, 17 other access and watch antibiotics were stocked, by fewer than a median of 50% of facilities. Of the 22 699 children observed, 60.1% (13 638) were prescribed antibiotics (mostly co-trimoxazole or amoxicillin). Children with respiratory conditions were most often prescribed antibiotics (76.1%; 8972/11 796) followed by undifferentiated fever (50.1%; 760/1518), diarrhoea (45.7%; 1293/2832) and malaria (30.3%; 352/1160). Conclusion Routine health facility surveys provided a valuable data source on the availability and use of antibiotics in low- and middle-income countries. Many access antibiotics were unavailable in a majority of most health-care facilities

A room temperature 19-channel magnetic field mapping device for cardiac signals

We present a multichannel cardiac magnetic field imaging system built in Fribourg from optical double-resonance Cs vapor magnetometers. It consists of 25 individual sensors designed to record magnetic field maps of the beating human heart by simultaneous measurements on a grid of 19 points over the chest. The system is operated as an array of second order gradiometers using sophisticated digitally controlled feedback loops.Comment: 3 pages, 3 figures, submitted to Applied Physics Letter

Resonant Formation of dμtd\mu t Molecules in Deuterium: An Atomic Beam Measurement of Muon Catalyzed dt Fusion

Resonant formation of $d\mu t$ molecules in collisions of muonic tritium ($\mu t$) on D$_2$ was investigated using a beam of $\mu t$ atoms, demonstrating a new direct approach in muon catalyzed fusion studies. Strong epithermal resonances in $d\mu t$ formation were directly revealed for the first time. From the time-of-flight analysis of $2036\pm 116$ $dt$ fusion events, a formation rate consistent with $0.73\pm (0.16)_{meas} \pm (0.09)_{model}$ times the theoretical prediction was obtained. For the largest peak at a resonance energy of $0.423 \pm 0.037$ eV, this corresponds to a rate of $(7.1 \pm 1.8) \times 10^9$ s$^{-1}$, more than an order of magnitude larger than those at low energies.Comment: To appear in Phys. Rev. Let

Influence of microstructure on synchrotron X-ray diffraction lattice strain measurement uncertainty

Accurate residual lattice strain measurements are highly dependent upon the precision of the diffraction peak location and the underlying microstructure suitability. The suitability of the microstructure is related to the requirement for valid powder diffraction sampling statistics and the associated number of appropriately orientated illuminated. In this work, these two sources of uncertainty are separated, and a method given for both the quantification of errors associated with insufficient grain sampling statistics and minimization of the total lattice strain measurement uncertainty. It is possible to reduce the total lattice strain measurement uncertainty by leveraging diffraction peak measurements made at multiple azimuthal angles. Lattice strain measurement data acquired during eight synchrotron X-ray diffraction experiments, monochromatic and energy dispersive, has been assessed as per this approach, with microstructural suitability being seen to dominate total measurement uncertainty when the number of illuminated grains was <106. More than half of the studied experimental data fell into this category, with a severe underestimation of total strain measurement uncertainty being possible when microstructural suitability is not considered. To achieve a strain measurement uncertainty under 10−4, approximately 3×105 grains must be within the sampled gauge volume, with this value varying with the multiplicity of the family of lattice planes under study. Where additional azimuthally arrayed data are available an in-plane lattice strain tensor can be extracted. This improves overall strain measurement accuracy and an uncertainty under 10−4 can then be achieved with just 4×104 grains

Degradation of zinc containing phosphate-based glass as a material for orthopedic tissue engineering

Phosphate-based glasses have been examined in many studies as a potential biomaterial for bone repair because of its degradation properties, which can be controlled and allow the release of various elements to promote osteogenic tissue growth. However most of these experiments studied either tertiary or quaternary glass systems. This study investigated a qinternary system that included titanium dioxide for degradation rate control and zinc that is considered to have a role in bone formation. Zinc and titanium phosphate glass discs of different compositions were melt synthesized and samples of each composition was tested for different physical, chemical and biological characteristics via density measurement, X-ray diffraction, differential thermal analysis, mass loss, ion release, scanning electron microscopy, biocompatibility studies via live/dead assays at three time points (day 1, 4, and 7). The results showed that the glass was amorphous and that the all thermal variables decreased as zinc oxide amount raised, mass loss as well as ion release increased as zinc oxide increased, and the maximum rise was with ZnO15. The cellular studies showed that all the formulation showed similar cytocompatibility properties with MG63 except ZnO15, which displayed cytotoxic properties and this was confirmed also by the scanning electron microscope images. In conclusion, replacing calcium oxide with zinc oxide in proportion less than 10 % can have a positive effect on bone forming cells

An excess of goodness? Volunteering among Aid professionals in Cambodia

This paper explores the meaning of volunteering among professional aid workers. While they experience disenchantment in their daytime work, volunteering provides them with benefits lacking in their paid jobs. At the same time, a compensatory model does not capture the complex dimensions of this relationship. One motive behind their professional work – bringing about positive change for others - is also the driving force behind their voluntary practices. Such excess of doing good may be indicative of their overall commitment. If aid workers make sense of their actions within a framework of alienated labour, rendering their waged aid work as a commodity, volunteering emerges as a remedial response. At the same time, their paid and unpaid work is animated by the impulse of giving. Such co-existence implies that gifts and commodities are not mutually exclusive; or indeed that both can be understood, following Parry (1986), as emerging from a highly developed capitalist system