Overcoming health systems barriers to successful malaria treatment.

The success of malaria control programmes is recognised to be handicapped by the capacity of the health system to deliver interventions such as first-line treatment at optimal coverage and quality. Traditional approaches to strengthening the health system such as staff training have had a less sustained impact than hoped. However, novel strategies including the use of mobile phones to ease stockouts, task-shifting to community health workers, and inclusion of the informal sector appear more promising. As global health funding slows, it is critical to better understand how to deliver a proven intervention most effectively through the existing system

Achievements of Soil Research in Dryland Regions of Andhra Pradesh

Not AvailableThe global rainfed crop lands were estimated at 1.132 billion hectares at the end of the last millennium. This is 2.78 times the net irrigated areas (407 m ha) of the world. Rainfed agro-ecosystems occupy a considerable place in Indian agriculture too, covering 80 million ha, in arid, semi-arid and sub-humid climatic zones; constituting nearly 58% of the net cultivated area. Rainfed regions support 60% of livestock, 40% of human population and contribute 40% of food grains and several special attribute commodities. Rainfed agro ecologies are complex, diverse, fragile, risky, under invested and require regionally differentiated investments and management strategies. Achieving high production potential is difficult in these rainfed areas due to vagaries of rainfall.Not Availabl

Zinc Cream and Reliability of Tuberculosis Skin Testing

In 50 healthy Peruvian shantytown residents, zinc cream applied to tuberculosis skin-test sitescaused a 32% increase in induration compared with placebo cream. Persons with lower plasma zinc had smaller skin-test reactions and greater augmentation with zinc cream. Zinc deficiency caused false-negative skin-test results, and topical zinc supplementation augmented antimycobacterial immune responses enough to improve diagnosis

Pneumococcal conjugate vaccine use during humanitarian crises.

Streptococcus pneumoniae is a common human commensal that causes a sizeable part of the overall childhood mortality in low income settings. Populations affected by humanitarian crises are at especially high risk, because a multitude of risk factors that are enhanced during crises increase pneumococcal transmission and disease severity. Pneumococcal conjugate vaccines (PCVs) provide effective protection and have been introduced into the majority of routine childhood immunisation programmes globally, though several barriers have hitherto limited their uptake during humanitarian crises. When PCV coverage cannot be sustained during crises or when PCV has not been part of routine programmes, mass vaccination campaigns offer a quick acting and programmatically feasible bridging solution until services can be restored. However, we currently face a paucity of evidence on which to base the structure of such campaigns. We believe that, now that PCV can be procured at a substantially reduced price through the Humanitarian Mechanism, this lack of information is a remaining hurdle to PCV use in humanitarian crises. Considering the difficulties in conducting research in crises, we propose an evidence generation pathway consisting of primary data collection in combination with mathematical modelling followed by quasi-experimental evaluation of a PCV intervention, which can inform on optimal vaccination strategies that consider age targeting, dosing regimens and impact duration

The Set2/Rpd3S Pathway Suppresses Cryptic Transcription without Regard to Gene Length or Transcription Frequency

In cells lacking the histone methyltransferase Set2, initiation of RNA polymerase II transcription occurs inappropriately within the protein-coding regions of genes, rather than being restricted to the proximal promoter. It was previously reported that this “cryptic” transcription occurs preferentially in long genes, and in genes that are infrequently transcribed. Here, we mapped the transcripts produced in an S. cerevisiae strain lacking Set2, and applied rigorous statistical methods to identify sites of cryptic transcription at high resolution. We find that suppression of cryptic transcription occurs independent of gene length or transcriptional frequency. Our conclusions differ with those reported previously because we obtained a higher-resolution dataset, we accounted for the fact that gene length and transcriptional frequency are not independent variables, and we accounted for several ascertainment biases that make cryptic transcription easier to detect in long, infrequently transcribed genes. These new results and conclusions have implications for many commonly used genomic analysis approaches, and for the evolution of high-fidelity RNA polymerase II transcriptional initiation in eukaryotes

INFLUENCE OF PRESTRESSING FORCE ON BOX GIRDER BRIDGE SUBJECTED TO SEISMIC LOAD

Bridges are often considered to be engineering marvels. Whether we need to cross rivers or valleys, connect islands to mainland, carry cars people etc are obstacles that are achieved only by bridges. Pre stressed concrete is ideally suited for the construction of medium to long span bridges. The composition of pre stressed concrete is nothing but high strength concrete and high tensile steel which is aesthetically appealing and economical. The present study deals with the analysis of reinforced concrete and prestressed concrete bridges. Reinforced concrete and Post-tensioned bridges of spans 15m, 30m and 45m are considered. Analysis of these bridges is performed with SAP2000 software for various Earthquake zones. The bending moments due to load combinations, viz.,(Dead load+ live load), (Dead load+ Earthquake load in X-direction), (Dead load+ Earthquake load in Y-direction), (Dead load+ live load+ Earthquake load in X-direction) and (Dead load+ live load+ Earthquake load in Y-direction) by considering with and without application of prestressing are obtained and compared. Maximum deflections under these load combinations are obtained by considering with and without application of prestressing and compared

THE DEVELOPMENT OF HIGH PERFORMANCED CONCRETE WHEN CEMENT & SAND ARE REPLACED BY GGBS AND ROBO SAND IN VARIOUS PROPORTIONS

Most popular and widely used building material is concrete in the field of construction. It was found suitable than any other materials and hence very important for the constructional developments. The consumption of the concrete is huge and increasing continuously all over the world. The normal concrete may not achieve the properties like uniformity and better performance hence the high performance concrete is becoming the need of time. Improvement in the quality leads to experimentation on the conventional material with addition of other materials. Addressing the problem related to the environment conservation while producing the cement is also the necessary. During the process the carbon dioxide gets produced in huge amount. Authors have concentrated on M35 concrete with part replacement of cement with Ground Granulated Blast furnace Slag (GGBS) and sand with the ROBO sand (crusher dust). The testing is carried out on the cube and cylinder to study the strength. The improvement in the sustainability of concrete by improving cement strength is the motive of the study carried out

The potential impact of improving appropriate treatment for fever on malaria and non-malarial febrile illness management in under-5s: a decision-tree modelling approach.

BACKGROUND: As international funding for malaria programmes plateaus, limited resources must be rationally managed for malaria and non-malarial febrile illnesses (NMFI). Given widespread unnecessary treatment of NMFI with first-line antimalarial Artemisinin Combination Therapies (ACTs), our aim was to estimate the effect of health-systems factors on rates of appropriate treatment for fever and on use of ACTs. METHODS: A decision-tree tool was developed to investigate the impact of improving aspects of the fever care-pathway and also evaluate the impact in Tanzania of the revised WHO malaria guidelines advocating diagnostic-led management. RESULTS: Model outputs using baseline parameters suggest 49% malaria cases attending a clinic would receive ACTs (95% Uncertainty Interval:40.6-59.2%) but that 44% (95% UI:35-54.8%) NMFI cases would also receive ACTs. Provision of 100% ACT stock predicted a 28.9% increase in malaria cases treated with ACT, but also an increase in overtreatment of NMFI, with 70% NMFI cases (95% UI:56.4-79.2%) projected to receive ACTs, and thus an overall 13% reduction (95% UI:5-21.6%) in correct management of febrile cases. Modelling increased availability or use of diagnostics had little effect on malaria management outputs, but may significantly reduce NMFI overtreatment. The model predicts the early rollout of revised WHO guidelines in Tanzania may have led to a 35% decrease (95% UI:31.2-39.8%) in NMFI overtreatment, but also a 19.5% reduction (95% UI:11-27.2%), in malaria cases receiving ACTs, due to a potential fourfold decrease in cases that were untested or tested false-negative (42.5% vs.8.9%) and so untreated. DISCUSSION: Modelling multi-pronged intervention strategies proved most effective to improve malaria treatment without increasing NMFI overtreatment. As malaria transmission declines, health system interventions must be guided by whether the management priority is an increase in malaria cases receiving ACTs (reducing the treatment gap), reducing ACT waste through unnecessary treatment of NMFI or expanding appropriate treatment of all febrile illness