A test of tau neutrino interactions with atmospheric neutrinos and K2K

The presence of a tau component in the flux of atmospheric neutrinos inside the Earth, due to flavor oscillations, makes these neutrinos a valuable probe of interactions of the tau neutrino with matter. We study -- analytically and numerically -- the effects of nonstandard interactions in the nu_e-nu_tau sector on atmospheric neutrino oscillations, and calculate the bounds on the exotic couplings that follow from combining the atmospheric neutrino and K2K data. We find very good agreement between numerical results and analytical predictions derived from the underlying oscillation physics. While improving on existing accelerator bounds, our bounds still allow couplings of the size comparable to the standard weak interaction. The inclusion of new interactions expands the allowed region of the vacuum oscillation parameters towards smaller mixing angles, 0.2 ~< sin^2 theta_{23} ~< 0.7, and slightly larger mass squared splitting, 1.5 * 10^{-3} eV^2 ~< |\Delta m^2_{23}| ~< 4.0 * 10^{-3} eV^2, compared to the standard case. The impact of the K2K data on all these results is significant; further important tests of the nu_e-nu_tau exotic couplings will come from neutrino beams experiments such as MINOS and long baseline projects.Comment: 8 figures, some typos corrected, minor editing in the reference

An overview of pharmacodynamic modelling, ligand-binding approach and its application in clinical practice

AbstractThe study of the magnitude and variation of drug response is defined as pharmacodynamics (PDs). PD models examine plasma concentration and effect relationship. It can predict the archetypal effect (E) of a drug as a function of the drug concentration (C) and estimate an unknown PD parameter (θpd). The PD models have been described as fixed, linear, log-linear, Emax, sigmoid Emax, and indirect PD response. Ligand binding model is an example of a PD model that works on the underpinning PD principle of a drug, eliciting its pharmacological effect at the receptor site. The pharmacological effect is produced by the drug binding to the receptor to either activate or antagonise the receptor. Ligand binding models describe a system of interacting components, i.e. the interaction of one or more ligands with one or more binding sites. The Emax model is the central method that provides an empirical justification for the concentration/dose-effect relationship. However, for ligand binding models justification is provided by theory of receptor occupancy. In essence, for ligand binding models, the term fractionaloccupancy is best used to describe the fraction of receptors occupied at a particular ligand concentration. It is stated that the fractionaloccupancy=occupiedbindingsites/totalbindingsites, which means the effect of a drug should depend on the fraction of receptors that are occupied. In the future, network-based systems pharmacology models using ligand binding principles could be an effective way of understanding drug-related adverse effects. This will facilitate and strengthen the development of rational drug therapy in clinical practice

Association and path coefficient analysis among yield attributes and berry yield in black pepper (Piper nigrum L.)

Eighty two germplasm accessions of black pepper aggregated from pepper cultivating tracts of Karnataka, Kerala, Goa and Maharashtra were characterized for 17 quantitative traits as per the IPGRI descriptors during 2018-19 at the field gene bank of ICAR-Indian Institute of Spices Research, Experimental Farm, Kozhikode. Wide range and high coefficient of variation (CV) were recorded for dry berry weight, fresh berry weight and number of spikes vine-1 whereas, lower CV was observed for berry size. Fresh berry weight showed significant positive correlation with dry berry weight followed by number of spikes vine-1 whereas, number of immature berries spike-1 and berry size showed significant negative association with setting percentage. High positive direct effect of fresh berry weight on dry berry weight was observed during path analysis. Both fresh rachis weight and number of spike vine-1 had indirect positive effects on dry berry weight through fresh berry weight. Residual effect was meagre suggesting that the 17 quantitative traits explained 99% variability. Traits like number of spikes vine-1 and fresh berry weight are the important traits that need to be augmented during improvement of black pepper for yield

Effect of pay for performance to improve quality of maternal and child care in low- and middle-income countries: a systematic review.

BACKGROUND: Pay for Performance (P4P) mechanisms to health facilities and providers are currently being tested in several low- and middle-income countries (LMIC) to improve maternal and child health (MCH). This paper reviews the existing evidence on the effect of P4P program on quality of MCH care in LMICs. METHODS: A systematic review of literature was conducted according to a registered protocol. MEDLINE, Web of Science, and Embase were searched using the key words maternal care, quality of care, ante natal care, emergency obstetric and neonatal care (EmONC) and child care. Of 4535 records retrieved, only eight papers met the inclusion criteria. Primary outcome of interest was quality of MCH disaggregated into structural quality, process quality and outcomes. Risk of bias across studies was assessed through a customized quality checklist. RESULTS AND DISCUSSION: There were four controlled before after intervention studies, three cluster randomized controlled trials and one case control with post-intervention comparison of P4P programs for MCH care in Burundi, Democratic Republic of Congo, Egypt, the Philippines, and Rwanda. There is some evidence of positive effect of P4P only on process quality of MCH. The effect of P4P on delivery, EmONC, post natal care and under-five child care were not evaluated in these studies. There is weak evidence for P4P's positive effect on maternal and neonatal health outcomes and out-of-pocket expenses. P4P program had a few negative effects on structural quality. CONCLUSION: P4P is effective to improve process quality of ante natal care. However, further research is needed to understand P4P's impact on MCH and their causal pathways in LMICs. TRIAL REGISTRATION: PROSPERO registration number CRD42014013077

Maternal and neonatal service usage and determinants in fragile and conflict-affected situations: a systematic review of Asia and the Middle-East.

BACKGROUND: Fragile and conflict-affected situations (FCS) in Asia and the Middle-East contribute significantly to global maternal and neonatal deaths. This systematic review explored maternal and neonatal health (MNH) services usage and determinants in FCS in Asia and the Middle-East to inform policy on health service provision in these challenging settings. METHODS: This systematic review was conducted using a standardised protocol. Pubmed, Embase, Web of Science, and selected development agency websites were searched for studies meeting inclusion criteria. Studies were assessed for methodological quality using an adapted evaluation tool. Qualitative and quantitative data were synthesized and pooled odds ratios generated for meta-analysis of service-usage determinants. RESULTS: Of 18 eligible peer-reviewed studies, eight were from Nepal, four from Afghanistan, and two each from Iraq, Yemen, and the Palestinian Territories. Fragile situations provide limited evidence on emergency obstetric care, postnatal care, and newborn services. Usage of MNH services was low in all FCS, irrespective of economic growth level. Demand-side determinants of service-usage were transportation, female education, autonomy, health awareness, and ability-to-pay. Supply-side determinants included service availability and quality, existence of community health-workers, costs, and informal payments in health facilities. Evidence is particularly sparse on MNH in acute crises, and remains limited in fragile situations generally. CONCLUSIONS: Findings emphasize that poor MNH status in FCS is a leading contributor to the burden of maternal and neonatal ill-health in Asia and the Middle-East. Essential services for skilled birth attendance and emergency obstetric, newborn, and postnatal care require improvement in FCS. FCS require additional resources and policy attention to address the barriers to appropriate MNH care. Authors discuss the 'targeted policy approach for vulnerable groups' as a means of addressing MNH service usage inequities

What makes health demand-side financing schemes work in low- and middle-income countries? A realist review

This realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluation designs. Based on methodological rigor and content relevance, only 24 studies published up to April 2013 were selected for the final review. A conceptual framework consisting of various program theories on potential context-mechanism-outcome (C-M-O) configuration of DSF initiative was designed, tested and adapted during the review. Synthesized results were presented as a C-M-O configuration for each of the consumer-side effect. DSF was effective to improve health seeking behaviour considerably and health status to some extent. The causal pathway of DSF’s functioning and effectiveness was not linear. Key demand-side contextual factors which affected DSF’s consumer-side effects were background characteristics of the beneficiaries including their socio-cultural beliefs, motivations, and level of health awareness. At the supply-side, service availability status and provider incentives were contextual determinants. The mechanisms which enabled the interaction of contextual influence were consumer and provider accountability and consumer trust on providers. In order to enhance DSF programs’ effectiveness, their design and implementation should carefully consider the potential contextual elements that may influence the causal pathways

Challenges and opportunities for policy decisions to address health equity in developing health systems: case study of the policy processes in the Indian state of Orissa

<p>Abstract</p> <p>Introduction</p> <p>Achieving health equity is a pertinent need of the developing health systems. Though policy process is crucial for planning and attaining health equity, the existing evidences on policy processes are scanty in this regard. This article explores the magnitude, determinants, challenges and prospects of 'health equity approach' in various health policy processes in the Indian State of Orissa - a setting comparable with many other developing health systems.</p> <p>Methods</p> <p>A case-study involving 'Walt-Gilson Policy Triangle' employed key-informant interviews and documentary reviews. Key informants (n = 34) were selected from the departments of Health and Family Welfare, Rural Development, and Women and Child Welfare, and civil societies. The documentary reviews involved various published and unpublished reports, policy pronouncements and articles on health equity in Orissa and similar settings.</p> <p>Results</p> <p>The 'health policy agenda' of Orissa was centered on 'health equity' envisaging affordable and equitable healthcare to all, integrated with public health interventions. However, the subsequent stages of policy process such as 'development, implementation and evaluation' experienced leakage in the equity approach. The impediment for a comprehensive approach towards health equity was the nexus among the national and state health priorities; role, agenda and capacity of actors involved; and existing constraints of the healthcare delivery system.</p> <p>Conclusion</p> <p>The health equity approach of policy processes was incomprehensive, often inadequately coordinated, and largely ignored the right blend of socio-medical determinants. A multi-sectoral, unified and integrated approach is required with technical, financial and managerial resources from different actors for a comprehensive 'health equity approach'. If carefully geared, the ongoing health sector reforms centered on sector-wide approaches, decentralization, communitization and involvement of non-state actors can substantially control existing inequalities through an optimally packaged equitable policy. The stakeholders involved in the policy processes need to be given orientation on the concept of health equity and its linkage with socio-economic development.</p

Testing CPT Symmetry with Supernova Neutrinos

Diagnosing core of supernova requires favor-dependent reconstruction of three species of neutrino spectra, \nu_e, \bar{\nu}_{e} and \nu_x (a collective notation for \nu_{\mu}, \bar{\nu}_{\mu}, \nu_{\tau}, and \bar{\nu}_{\tau}). We point out that, assuming the information available, CPT symmetry can be tested with supernova neutrinos. We classify all possible level crossing patterns of neutrinos and antineutrinos into six cases and show that half of them contains only the CPT violating mass and mixing patterns. We discuss how additional informations from terrestrial experiments help identifying CPT violation by narrowing down the possible flux patterns. Although the method may not be good at precision test, it is particularly suited to uncover gross violation of CPT such as different mass patterns of neutrinos and antineutrinos. The power of the method is due to the nature of level crossing in supernova which results in the sensitivity to neutrino mass hierarchy and to the unique characteristics of in situ preparation of both \nu and \bar{\nu} beams. Implications of our discussion to the conventional analyses with CPT conservation are also briefly mentioned.Comment: 24 pages, 4 figures, discussion added on narrowing down flux patterns by terrestrial measuremen