An overview of chickpea breeding programs in Myanmar

Chickpea is an important legume in Myanmar, not only for local consumption but also for export earnings. Major chickpeaproducing area is the central dry zone which contributes 96% of the chickpea production. Kabuli chickpea is mainly grown for export, while desi chickpea is for local consumption. Eight improved varieties of chickpea (5 desi and 3 kabuli) have been released in Myanmar. The adoption of improved varieties and improved crop production practices has led to remarkable increase in chickpea yields and production

Association of proinflammatory cytokines and chemotherapy-associated cognitive impairment in breast cancer patients: a multi-centered, prospective, cohort study.

BackgroundExisting evidence suggests that proinflammatory cytokines play an intermediary role in postchemotherapy cognitive impairment. This is one of the largest multicentered, cohort studies conducted in Singapore to evaluate the prevalence and proinflammatory biomarkers associated with cognitive impairment in breast cancer patients.Patients and methodsChemotherapy-receiving breast cancer patients (stages I-III) were recruited. Proinflammatory plasma cytokines concentrations [interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor, interferon-γ and tumor necrosis factor-α] were evaluated at 3 time points (before chemotherapy, 6 and 12 weeks after chemotherapy initiation). The FACT-Cog (version 3) was utilized to evaluate patients' self-perceived cognitive disturbances and a computerized neuropsychological assessment (Headminder) was administered to evaluate patients' memory, attention, response speed and processing speed. Changes of cognition throughout chemotherapy treatment were compared against the baseline. Linear mixed-effects models were applied to test the relationships of clinical variables and cytokine concentrations on self-perceived cognitive disturbances and each objective cognitive domain.ResultsNinety-nine patients were included (age 50.5 ± 8.4 years; 81.8% Chinese; mean duration of education = 10.8 ± 3.3 years). Higher plasma IL-1β was associated with poorer response speed performance (estimate: -0.78; 95% confidence interval (CI) -1.34 to -0.03; P = 0.023), and a higher concentration of IL-4 was associated with better response speed performance (P = 0.022). Higher concentrations of IL-1β and IL-6 were associated with more severe self-perceived cognitive disturbances (P = 0.018 and 0.001, respectively). Patients with higher concentrations of IL-4 also reported less severe cognitive disturbances (P = 0.022).ConclusionsWhile elevated concentrations of IL-6 and IL-1β were observed in patients with poorer response speed performance and perceived cognitive disturbances, IL-4 may be protective against chemotherapy-associated cognitive impairment. This study is important because cytokines would potentially be mechanistic mediators of chemotherapy-associated cognitive changes

Cost effectiveness and resource allocation of Plasmodium falciparum malaria control in Myanmar: a modelling analysis of bed nets and community health workers.

BACKGROUND: Funding for malaria control and elimination in Myanmar has increased markedly in recent years. While there are various malaria control tools currently available, two interventions receive the majority of malaria control funding in Myanmar: (1) insecticide-treated bed nets and (2) early diagnosis and treatment through malaria community health workers. This study aims to provide practical recommendations on how to maximize impact from investment in these interventions. METHODS: A simple decision tree is used to model intervention costs and effects in terms of years of life lost. The evaluation is from the perspective of the service provider and costs and effects are calculated in line with standard methodology. Sensitivity and scenario analysis are undertaken to identify key drivers of cost effectiveness. Standard cost effectiveness analysis is then extended via a spatially explicit resource allocation model. FINDINGS: Community health workers have the potential for high impact on malaria, particularly where there are few alternatives to access malaria treatment, but are relatively costly. Insecticide-treated bed nets are comparatively inexpensive and modestly effective in Myanmar, representing a low risk but modest return intervention. Unlike some healthcare interventions, bed nets and community health workers are not mutually exclusive nor are they necessarily at their most efficient when universally applied. Modelled resource allocation scenarios highlight that in this case there is no "one size fits all" cost effectiveness result. Health gains will be maximized by effective targeting of both interventions

Performance Prediction of Helical-Type Seawater MHD Power Generator for Enlargement

Immunogenetics and cellular immunology of bacterial infectious disease

Assessing the irradiance levels of phototherapy devices in Jos, north central, Nigeria

Background: Neonatal jaundice (NNJ) remains a major cause of neonatal morbidity and mortality in Nigeria with significant contribution to the global figures. Effective phototherapy can reduce the complications associated with NNJ. The effectiveness of a phototherapy device (PD) depends mainly on the emitted irradiance of the device. We, therefore, assessed the irradiance of the PDs in Jos, North Central Nigeria in order to determine the effectiveness of the devices and to highlight the need for routine assessment of irradiance levels of PDs in low-middle income settings.Methods: This was a cross- sectional study involving 14 hospitals with a total of 38 functional PDs comprising of 25 (65.8%) locally fabricated, eight (21.0%) light- emitting diode (LED) and five (13.2%) conventional patented devices. The irradiance was measured using the BiliBlanket® light meter II.Results: The irradiance of the PDs ranged from 2 to 102μW/cm2/nm with a median value of 10.6 (IQR 6-18μW/cm2/nm).   Sixteen devices (42.1%) had a suboptimal irradiance (<10μW/cm2/nm); while only five (13.2%) provided irradiance at the intensive level (≥30μW/cm2/nm). The mean distance between the babies and phototherapy lights was 35.1±12.7cm (range 15-70cm).Conclusions: A significant proportion of the PDs in Jos delivered suboptimal irradiance which could reduce the effectiveness of the phototherapy. The irradiance of PDs needs to be assessed regularly and measures should be instituted to improve the irradiance to the optimum level in order to reduce the burden of kernicterus

Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy.

Healthcare services are often provided to a country as a whole, though in many cases the available resources can be more effectively targeted to specific geographically defined populations. In the case of malaria, risk is highly geographically heterogeneous, and many interventions, such as insecticide-treated bed nets and malaria community health workers, can be targeted to populations in a way that maximises impact for the resources available. This paper describes a framework for geographically targeted budget allocation based on the principles of cost-effectiveness analysis and applied to priority setting in malaria control and elimination. The approach can be used with any underlying model able to estimate intervention costs and effects given relevant local data. Efficient geographic targeting of core malaria interventions could significantly increase the impact of the resources available, accelerating progress towards elimination. These methods may also be applicable to priority setting in other disease areas

Successful elimination of falciparum malaria following the introduction of community-based health workers in Eastern Myanmar: a retrospective analysis

Background: Myanmar has a large majority of all malaria in the Greater Mekong Subregion. In the past decade, substantial progress was made in malaria control. The residual burden of malaria is in remote areas where currently recommended malaria elimination approaches are generally not feasible. In such hard-to-reach communities in Mon state, East Myanmar, Medical Action Myanmar introduced community health workers (CHWs) to deliver early diagnosis and treatment for malaria. We conducted a retrospective analysis to assess the impact of this intervention. Methods and findings: This retrospective analysis involved data collected routinely from a CHW programme in Mon state conducted between 2011 and 2018. A network of 172 CHWs serving a population of 236,340 was deployed. These CHWs carried out 260,201 malaria rapid diagnostic tests (RDTs) to investigate patients with acute febrile illness. The median blood examination rate was 1.33%; interquartile range (IQR) (0.38 to 3.48%); 95% CI [1.28%, 1.36%] per month. The changes in malaria incidence and prevalence in patients presenting with fever were assessed using negative binomial regression mixed effects models fitted to the observed data. The incidence of Plasmodium falciparum malaria (including mixed infections) declined by 70%; 95% CI [65%, 75%]; p < 0.001 for each year of CHW operation. The incidence of P. vivax malaria declined by 56%; 95% CI [50%, 62%]; p < 0.001 per year. Malaria RDT positivity rates for P. falciparum and P. vivax declined by 69%; 95% CI [62%, 75%]; p < 0.001 and 53%; 95% CI [47%, 59%]; p < 0.001 per year, respectively. Between 2017 and 2018, only 1 imported P. falciparum case was detected in 54,961 RDTs. The main limitations of the study are use of retrospective data with possible unidentified confounders and uncharacterised population movement. Conclusions: The introduction of CHWs providing community-based malaria diagnosis and treatment and basic health care services in remote communities in Mon state was associated with a substantial reduction in malaria. Within 6 years, P. falciparum was eliminated and the incidence of P. vivax fell markedly

Developing elastomeric cellular structures for multiple head impacts

Foam‐based materials were originally incorporated into helmets in the 1970’s, providing an effective method of absorbing impact energy and so protecting against severe head injury. Similar materials still exist in the majority of protective helmets today, indicating a need for an innovative approach that will achieve a step‐ change in energy absorption performance. This paper focusses on tailoring the Miura‐Ori (MO), origami‐derived geometry, as a method to achieve a material structure tailored to maximise impact energy absorption, whilst complying with existing product design constraints. This ambitious concept was then realised using an elastomeric, additive manufacturing powder, before being tested against foam derived from a commercially‐ available American football helmet. MO pads demonstrated comparable performance versus foam at relatively low impact velocities, though recorded a peak acceleration 15% less than foam at the highest impact velocity. This difference increased once the respective samples were exposed to their third impact, demonstrating the superior performance of MO over multiple impacts. The MO material demonstrated encouraging energy impact absorbing behaviour, with scope remaining to further optimise the geometry in order to further enhance performance. Furthermore, opportunities exist for achieving superior shear‐energy performance than contemporary materials and, ultimately, for harnessing the benefits of additive manufacturing to fabricate person‐specific headwear optimised for a given impact environment

Risk factors for lymphatic filariasis and mass drug administration non‑participation in Mandalay Region, Myanmar

Background Myanmar commenced a lymphatic filariasis (LF) elimination programme in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere; however, there remains little information on the factors that contribute in Myanmar. Methods We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and, if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and, if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for non-participation (never taking MDA). Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results After adjustment for covariates and survey design, being CFA positive was significantly associated with age [odds ratio (OR) 1.03, 95% CI 1.01–1.06), per year], male gender (OR 3.14, 1.27–7.76), elevation (OR 0.96, 0.94–0.99, per metre) and the density of people per household room (OR 1.59, 1.31–1.92). LF-related hydrocoele was associated with age (OR 1.06, 1.03–1.09, per year) and residing in Amarapura Township (OR 8.93, 1.37–58.32). Never taking MDA was associated with male gender [OR 6.89 (2.13–22.28)] and age, particularly in females, with a significant interaction term. Overall, compared to those aged 30–44 years, the proportion never taking MDA was higher in all age groups (OR highest in those  60 years, ranging from 3.37 to 12.82). Never taking MDA was also associated with residing in Amarapura township (OR 2.48, 1.15–5.31), moving to one’s current village from another (OR 2.62, 1.12–6.11) and ever having declined medication (OR 11.82, 4.25–32.91). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.16, 0.03–0.74) and the number visits by the MDA programme (OR 0.69, 0.48–1.00). Conclusions These results contribute to the understanding of LF and MDA participation-related risk factors and will assist Myanmar to improve its elimination and morbidity management programmes

Identifying conservation priorities for an understudied species in decline: Golden cats (Catopuma temminckii) in mainland Tropical Asia

Identifying conservation priorities for an understudied species can be challenging, as the amount and type of data available to work with are often limited. Here, we demonstrate a flexible workflow for identifying priorities for such data-limited species, focusing on the little-studied Asian golden cat (Catopuma temminckii) in mainland Tropical Asia. Using recent occurrence records, we modeled the golden cat's expected area of occurrence and identified remaining habitat strongholds (i.e., large intact areas with moderate-to-high expected occurrence). We then classified these strongholds by recent camera-trap survey status (from a literature review) and near-future threat status (based on publicly available forest loss projections and Bayesian Belief Network derived estimates of hunting-induced extirpation risk) to identify conservation priorities. Finally, we projected the species\u2019 expected area of occurrence in the year 2000, approximately three generations prior to today, to define past declines and better evaluate the species\u2019 current conservation status. Lower levels of hunting-induced extirpation risk and higher levels of closed-canopy forest cover were the strongest predictors of recent camera-trap records. Our projections suggest a 68% decline in area with moderate-to-high expected occurrence between 2000 and 2020, with a further 18% decline predicted over the next 20 years. Past and near-future declines were primarily driven by cumulatively increasing levels of hunting-induced extirpation risk, suggesting assessments of conservation status based solely on declines in habitat may underestimate actual population declines. Of the 40 remaining habitat strongholds, 77.5% were seriously threatened by forest loss and hunting. Only 52% of threatened strongholds had at least one site surveyed, compared to 100% of low-to-moderate threat strongholds, thus highlighting an important knowledge gap concerning the species\u2019 current distribution and population status. Our results suggest the golden cat has experienced, and will likely continue to experience, considerable population declines and should be considered for up-listing to a threatened category (i.e., VU/EN) under criteria A2c of the IUCN Red List