Potential impact of reactive vaccination in controlling cholera outbreaks: An exploratory analysis using a Zimbabwean experience

Background. To contain ongoing cholera outbreaks, the World Health Organization has suggested that reactive vaccination should be considered in addition to its previous control measures. Objectives. To explore the potential impact of a hypothetical reactive oral cholera vaccination using the example of the recent large-scale cholera outbreak in Zimbabwe. Methods. This was a retrospective cost-effectiveness analysis calculating the health and economic burden of the cholera outbreak in Zimbabwe with and without reactive vaccination. The primary outcome measure was incremental cost per disability-adjusted life year (DALY) averted. Results. Under the base-case assumptions (assuming 50% coverage among individuals aged ≥2 years), reactive vaccination could have averted 1 320 deaths and 23 650 DALYs. Considering herd immunity, the corresponding values would have been 2 920 deaths and 52 360 DALYs averted. The total vaccination costs would have been ~$74 million and ~$21 million, respectively, with per-dose vaccine price of US$5 and$1. The incremental costs per DALY averted of reactive vaccination were $2 770 and$370, respectively, for vaccine price set at $5 and$1. Assuming herd immunity, the corresponding cost was $980 with vaccine price of$5, and the programme was cost-saving with a vaccine price of $1. Results were most sensitive to case-fatality rate, per-dose vaccine price, and the size of the outbreak. Conclusions. Reactive vaccination has the potential to be a costeffective measure to contain cholera outbreaks in countries at high risk. However, the feasibility of implementation should be further evaluated, and caution is warranted in extrapolating the findings to different settings in the absence of other in-depth studies

Zeolitic imidazolate framework-coated acoustic sensors for room temperature detection of carbon dioxide and methane

The integration of nanoporous materials such as metal organic frameworks (MOFs) with sensitive transducers can result in robust sensing platforms for monitoring gases and chemical vapors for a range of applications. Here, we report on an integration of the zeolitic imidazolate framework-8 (ZIF-8) MOF with surface acoustic wave (SAW) and thickness shear mode quartz crystal microbalance (QCM) devices to monitor carbon dioxide (CO2) and methane (CH4) under ambient conditions. The MOF was directly coated on the Y-Z LiNbO3 SAW delay lines (operating frequency, f0 = 436 MHz) and AT-cut quartz TSM resonators (resonant frequency, f0 = 9 MHz) and the devices were tested for various gases in N2 under ambient conditions. The devices were able to detect the changes in CO2 or CH4 concentrations with relatively higher sensitivity to CO2, which was due to its higher adsorption potential and heavier molecular weight. The sensors showed full reversibility and repeatability which were attributed to the physisorption of the gases into the MOF and high stability of the devices. Both types of sensors showed linear responses relative to changes in the binary gas compositions thereby allowing to construct calibration curves which correlated well with the expected mass changes in the sorbent layer based on mixed-gas gravimetric adsorption isotherms measured on bulk samples. For 200 nm thick films, the SAW sensitivities to CO2 and CH4 were 1.44 × 10-6/vol% and 8 × 10-8/vol%, respectively, against the QCM sensitivities 0.24 × 10-6/vol% and 1 × 10-8/vol%, respectively, which were evaluated as the fractional change in the signal. The SAW sensors were also evaluated for 100 nm-300 nm thick films, the sensitivities of which were found to increase with the thickness due to the increased number of pores for the adsorption of a larger amount of gases. In addition, the MOF-coated SAW delay lines had a good response in wireless mode, demonstrating their potential to operate remotely for the detection of the gases at emission sites across the energy infrastructure

Diversity decoupled from ecosystem function and resilience during mass extinction recovery

The Chicxulub bolide impact 66 million years ago drove the near-instantaneous collapse of ocean ecosystems. The devastating loss of diversity at the base of ocean food webs probably triggered cascading extinctions across all trophic levels and caused severe disruption of the biogeochemical functions of the ocean, and especially disrupted the cycling of carbon between the surface and deep sea. The absence of sufficiently detailed biotic data that span the post-extinction interval has limited our understanding of how ecosystem resilience and biochemical function was restored; estimates of ecosystem ‘recovery’ vary from less than 100 years to 10 million years. Here, using a 13-million-year-long nannoplankton time series, we show that post-extinction communities exhibited 1.8 million years of exceptional volatility before a more stable equilibrium-state community emerged that displayed hallmarks of resilience. The transition to this new equilibrium-state community with a broader spectrum of cell sizes coincides with indicators of carbon-cycle restoration and a fully functioning biological pump. These findings suggest a fundamental link between ecosystem recovery and biogeochemical cycling over timescales that are longer than those suggested by proxies of export production, but far shorter than the return of taxonomic richness. The fact that species richness remained low as both community stability and biological pump efficiency re-emerged suggests that ecological functions rather than the number of species are more important to community resilience and biochemical functions

Cricket Flour-Laden Millet Flour Blends' Physical and Chemical Composition and Adaptation in Dried Pasta Products

Increasing the protein and antioxidant content of food products is a constant challenge amongst researchers. Dried pasta products are popular amongst all groups of society. The most important factor in pasta processing is the quality of the flour. Millet (Panicum miliaceum) flour has high nutritional value, enriching it with cricket (Gryllus bimaculatus) flour is good choice to increase the quality of protein composition and antioxidant properties of products. Flour mixtures of millet and insect flours (5% and 10%) were analysed after mixing and pasta processing. Addition of wheat gluten improved both texture and nutrition value of pasta products. Total polyphenol content, antioxidant capacity, total protein content, free and total amino acid composition were studied. Quality analysis of dried pasta products were carried out according to Hungarian standards. Data was analysed with Kruskal-Wallis test, Dunn's pair-wise post hoc test was used with Bonferroni correction. The correlation was determined by Spearman's rank. Addition of cricket flour modified the pH, acid value, moisture content, and colour of the samples, these changes lasted during storage. Enrichment could increase the total phenol content significantly even at the low level of 10%. Heat treatment during pasta processing had negative effect on the antioxidant capacity except at higher cricket flour contents. Cricket flour's high protein content proportionately increased millet flour's, thus pasta products'. Dried pasta products passed all quality norms. Enrichment of millet flour with cricket flour is favourable from both nutritional and quality aspects

An interdimensional correlation framework for real-time estimation of six degree of freedom target motion using a single x-ray imager during radiotherapy

© 2017 Institute of Physics and Engineering in Medicine. Increasing evidence suggests that intrafraction tumour motion monitoring needs to include both 3D translations and 3D rotations. Presently, methods to estimate the rotation motion require the 3D translation of the target to be known first. However, ideally, translation and rotation should be estimated concurrently. We present the first method to directly estimate six-degree-of-freedom (6DoF) motion from the target's projection on a single rotating x-ray imager in real-time. This novel method is based on the linear correlations between the superior-inferior translations and the motion in the other five degrees-of-freedom. The accuracy of the method was evaluated in silico with 81 liver tumour motion traces from 19 patients with three implanted markers. The ground-truth motion was estimated using the current gold standard method where each marker's 3D position was first estimated using a Gaussian probability method, and the 6DoF motion was then estimated from the 3D positions using an iterative method. The 3D position of each marker was projected onto a gantry-mounted imager with an imaging rate of 11 Hz. After an initial 110° gantry rotation (200 images), a correlation model between the superior-inferior translations and the five other DoFs was built using a least square method. The correlation model was then updated after each subsequent frame to estimate 6DoF motion in real-time. The proposed algorithm had an accuracy (±precision) of -0.03 ± 0.32 mm, -0.01 ± 0.13 mm and 0.03 ± 0.52 mm for translations in the left-right (LR), superior-inferior (SI) and anterior-posterior (AP) directions respectively; and, 0.07 ± 1.18°, 0.07 ± 1.00° and 0.06 ± 1.32° for rotations around the LR, SI and AP axes respectively on the dataset. The first method to directly estimate real-time 6DoF target motion from segmented marker positions on a 2D imager was devised. The algorithm was evaluated using 81 motion traces from 19 liver patients and was found to have sub-mm and sub-degree accuracy

Inhibitory effects of angiotensin II receptor blockade on human tenon fibroblast migration and reactive oxygen species production in cell culture

Purpose: We investigate the effect of angiotensin receptor blockade on the migration of human Tenon fibroblasts (HTF), using irbesartan, an angiotensin II receptor type 1 (AT1R) blocker (ARB) as a potential antifibrotic agent in glaucoma filtration surgery. Methods: Confluent HTF cultures were scratched with a 1 mL pipette tip and treated with either irbesartan (10, 50, and 100 μg/mL) or angiotensin II (2 μg/mL). The extent of HTF migration up to 30 hours, and cell number and morphology at 72 hours was evaluated. To assess the effect on reactive oxygen species (ROS) level, HTF were treated with either irbesartan (10 μg/mL) or angiotensin II (2 μg/mL) for 24 hours after scratching, and then stained with dihydroethidium (DHE) before evaluation by confocal microscopy. Results: Irbesartan inhibited HTF migration by 50% to 70% compared to controls (P < 0.05). Levels of ROS were almost completely attenuated by irbesartan (DHE fluorescence intensity of 5.68E-09) (P < 0.05). Irbesartan reduced cell numbers by 50% and induced morphologic changes with loss of pseudopods (P < 0.05). Conversely, angiotensin II increased cell numbers up to 4-fold while retaining cell viability. Conclusions: Irbesartan inhibited HTF migration and ROS production. It also reduced cell numbers and altered HTF morphology. Angiotensin II increased cell number without altering morphology. This initial study warrants future investigations for further potential antifibrotic effects of this drug. Translational Relevance: This in vitro study focused on investigations of irbesartan’s effects on HTF migration, ROS production, as well as HTF cell numbers and morphology. It suggests a potential therapeutic strategy worth further exploration with a view towards postoperative wound healing modulation in glaucoma filtration surgery

Optimal infinite scheduling for multi-priced timed automata

This paper is concerned with the derivation of infinite schedules for timed automata that are in some sense optimal. To cover a wide class of optimality criteria we start out by introducing an extension of the (priced) timed automata model that includes both costs and rewards as separate modelling features. A precise definition is then given of what constitutes optimal infinite behaviours for this class of models. We subsequently show that the derivation of optimal non-terminating schedules for such double-priced timed automata is computable. This is done by a reduction of the problem to the determination of optimal mean-cycles in finite graphs with weighted edges. This reduction is obtained by introducing the so-called corner-point abstraction, a powerful abstraction technique of which we show that it preserves optimal schedules

Can the salt-advection feedback be detected in internal variability of the atlantic meridional overturning circulation?

Evidence for the assumptions of the salt-advection feedback in box models is sought by studying the Atlantic meridional overturning circulation (AMOC) internal variability in the long preindustrial control runs of two Earth system models. The first assumption is that AMOC strength is proportional to the meridional density difference between the North Atlantic and the Southern Oceans. The model simulations support this assumption, with the caveat that nearly all the long time-scale variability occurs in the North Atlantic density. The second assumption is that the freshwater transport variability by the overturning at the Atlantic southern boundary is controlled by the strength of AMOC. Only one of the models shows some evidence that AMOC variability at 45°N leads variability in the overturning freshwater transport at the southern boundary by about 30 years, but the other model shows no such coherence. In contrast, in both models this freshwater transport variability is dominated by local salinity variations. The third assumption is that changes in the overturning freshwater transport at the Atlantic southern boundary perturb the north-south density difference, and thus feed back on AMOC strength in the north. No evidence for this assumption is found in either model at any time scale, although this does not rule out that the salt-advection feedback may be excited by a strong enough freshwater perturbation