Treatment of falciparum malaria in the age of drug-resistance

The growing problem of drug resistance has greatly complicated the treatment for falciparum malaria. Whereaschloroquine and sulfadoxine/ pyrimethamine could once cure most infections, this is no longer true and requiresexamination of alternative regimens. Not all treatment failures are drug resistant and other issues such asexpired antimalarials and patient compliance need to be considered. Continuation of a failing treatment policyafter drug resistance is established suppresses infections rather than curing them, leading to increasedtransmission of malaria, promotion of epidemics and loss of public confidence in malaria control programs.Antifolate drug resistance (i.e. pyrimethamine) means that new combinations are urgently needed particularlybecause addition of a single drug to an already failing regimen is rarely effective for very long. Atovaquone/proguanil and mefloquine have been used against multiple drug resistant falciparum malaria with resistance toeach having been documented soon after drug introduction. Drug combinations delay further transmission ofresistant parasites by increasing cure rates and inhibiting formation of gametocytes. Most currentlyrecommended drug combinations for falciparum malaria are variants of artemisinin combination therapy wherea rapidly acting artemisinin compound is combined with a longer half-life drug of a different class. Artemisininsused include dihydroartemisinin, artesunate, artemether and companion drugs include mefloquine, amodiaquine,sulfadoxine/ pyrimethamine, lumefantrine, piperaquine, pyronaridine, chlorproguanil/dapsone. The standard ofcare must be to cure malaria by killing the last parasite. Combination antimalarial treatment is vital not only tothe successful treatment of individual patients but also for public health control of malaria

Synergistic mortality caused by Plasmodium falciparum during the 1918 influenza pandemic

At the end of World War I, British medical officers noted that soldiers infected with malaria were more likely to die during the 1918 influenza pandemic than those without malaria. This synergistic mortality appeared to be specific to Plasmodium falciparum and has not been generally noted since 1920. A possible explanation is that a malaria-induced procoagulant state enhanced the activation of influenza virus to increase inflammation and subsequent severe clinical outcomes. Falciparum proteins bind and likely inhibit antithrombin 3 and other factors. Pathogens interact in ways that may inform pathophysiology studies of remote epidemics

A cost comparison of traditional drainage and SUDS in Scotland

The Dunfermline Eastern Expansion (DEX) is a 350 ha mixed development which commenced in 1996. Downstream water quality and flooding issues necessitated a holistic approach to drainage planning and the site has become a European showcase for the application of Sustainable Urban Drainage Systems (SUDS). However, there is minimal data available regarding the real costs of operating and maintaining SUDS to ensure they continue to perform as per their design function. This remains one of the primary barriers to the uptake and adoption of SUDS. This paper reports on what is understood to be the only study in the UK where actual costs of constructing and maintaining SUDS have been compared to an equivalent traditional drainage solution. To compare SUDS costs with traditional drainage, capital and maintenance costs of underground storage chambers of analogous storage volumes were estimated. A whole life costing methodology was then applied to data gathered. The main objective was to produce a reliable and robust cost comparison between SUDS and traditional drainage. The cost analysis is supportive of SUDS and indicates that well designed and maintained SUDS are more cost effective to construct, and cost less to maintain than traditional drainage solutions which are unable to meet the environmental requirements of current legislation

Sum of Two Squares - Pair Correlation and Distribution in Short Intervals

In this work we show that based on a conjecture for the pair correlation of integers representable as sums of two squares, which was first suggested by Connors and Keating and reformulated here, the second moment of the distribution of the number of representable integers in short intervals is consistent with a Poissonian distribution, where "short" means of length comparable to the mean spacing between sums of two squares. In addition we present a method for producing such conjectures through calculations in prime power residue rings and describe how these conjectures, as well as the above stated result, may by generalized to other binary quadratic forms. While producing these pair correlation conjectures we arrive at a surprising result regarding Mertens' formula for primes in arithmetic progressions, and in order to test the validity of the conjectures, we present numericalz computations which support our approach.Comment: 3 figure

The 2005 survey of information systems research in Australia

As part of a study to investigate the state of Information Systems research in Australia, a survey of the heads of all IS discipline groups in Australian universities was conducted in mid 2005. The study revealed a wide range of topics researched (with rapid growth in Electronic Commerce and Knowledge Management), a range of foci, a balance between positivist and interpretivist research, survey was the most frequently used research method, and most research was directed at informing IS professionals. A SWOT analysis identified the growing importance of industry relevance and collaboration

The war in America : its origin and object

UT Librarie

Properties of hydrophobically modified polyacrylamide with low molecular weight and interaction with surfactant in aqueous solution

Hydrophobically modified polyacrylamide (HMPAM), with a molecular weight of 104 g/mol, was studied using a range of rheological methods and dynamic light scattering (DLS). DLS measurements indicate that the association of the modified polymer begins at low concentration. The modified polymer with high substitution forms transient networks below the critical concentration, but the networks are disrupted by the micelles formed by the polymer itself, and the networks do not contribute to viscosity enhancement. The modified polymers exhibited surface activity, and so they may be regarded as nonionic polymeric surfactants rather than thickeners. On the other hand, HMPAM is shown to interact with the surfactant SDS while PAM is inert to SDS. In the hydrophobic domains, it undergoes a surfactant-induced association process; in the hydro-phobe-surfactant transition regions, the surfactant binds to the polymer in a noncooperative way and forms a polymer-surfactant complex. Contracted polymer chains begin to extend because of electrostatic repulsion, which can overcome the association at surfactant domains. The conformation of HMPAM polymer chains could be controlled by adding a specific amount of surfactant

Pathogenic Responses among Young Adults during the 1918 Influenza Pandemic

These responses after secondary exposures caused bacterial pneumonia and most deaths