Addressing Inequity to Achieve the Maternal and Child Health Millennium Development Goals: Looking Beyond Averages.

Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania. We used the Lives Saved Tool (LiST) to estimate potential reductions in maternal and child mortality and the number of lives saved across wealth quintiles and between rural and urban settings. High impact maternal and child health interventions were modelled for a five-year scale up, by linking intervention coverage, effectiveness and cause of mortality using data from Tanzania. Concentration curves were drawn and the concentration index estimated to measure the equity impact of the scale up. In the poorest population quintiles in Tanzania, the lives of more than twice as many mothers and under-fives were likely to be saved, compared to the richest quintile. Scaling up coverage to equal levels across quintiles would reduce inequality in maternal and child mortality from a pro rich concentration index of -0.11 (maternal) and -0.12 (children) to a more equitable concentration index of -0,03 and -0.03 respectively. In rural areas, there would likely be an eight times greater reduction in maternal deaths than in urban areas and a five times greater reduction in child deaths than in urban areas. Scaling up priority maternal and child health interventions to equal levels would potentially save far more lives in the poorest populations, and would accelerate equitable progress towards maternal and child health MDGs

Active target TPC for study of photonuclear reactions at astrophysical energies

A setup designed to study photonuclear reactions at astrophysical energies - an active target Time Projection Chamber was developed and constructed at the Faculty of Physics, University of Warsaw. The device was successfully employed in two experiments at the Institute of Nuclear Physics Polish Academy of Sciences in Cracow, in which {\gamma}- and neutron-induced reactions with CO2 gas target were measured. The reaction products were detected and their momenta reconstructed. Preliminary results are shown.Comment: Presented at Zakopane Conference on Nuclear Physics 202

Mechanical collision simulation of potato tubers

This paper presents the results of an investigation on internal stress progression and the explicit dynamics simulation of the bruising behavior of potato tubers under dynamic mechanical collision. Physical measurements, mechanical tests, advanced solid modeling, and engineering simulation techniques were utilized in the study. The tuber samples used in the simulation were reverse engineered and finite element analysis (FEA) was set up to simulate the collision-based bruising behavior of the potato tubers. The total number of identical tuber models used in the simulation was 17. The numerical data of the FEA results revealed useful stress distribution and mechanical behavior visuals. These results are presented in a frame that can be used to describe bruise susceptibility value on potato-like agricultural crops. The modulus of elasticity was calculated from compression test data as 3.12 MPa. Structural stresses of 1.40 and 3.13 MPa on the impacting (hitting) and impacted (hit) tubers (respectively) were obtained. These stress values indicate that bruising is likely to occur on the tubers. This research paper provides a useful how-to-do strategy to further research on complicated bruising investigations of solid-like agricultural products through advanced engineering simulation techniques. Practical applications: This research aims to simulate realistic dynamic deformation of potato tubers during mechanical collision, which is very hard to achieve through physical or analytical expressions. This is attractive because related food processing industries have shown their interest in determining the physical properties and bruising behavior of food/agricultural products using experimental, numerical, and engineering simulation methods so that it can be used in their food processing technology. Very limited data have been found available in the literature about the subject of FEM-based explicit dynamics simulation of solid-like agricultural crops such as the self-collision case of potato tubers (which is very important for indoor or outdoor potato processing). Comparative investigations on determination of modulus of elasticity are very limited as well. Most of the research focused on single calculation theory and linear static loading assumption-based FEM simulation solutions. Here, we report a “how-to-do” case study for dynamic self-collision simulation of potato tubers

Pattern formation in directional solidification under shear flow. I: Linear stability analysis and basic patterns

An asymptotic interface equation for directional solidification near the absolute stabiliy limit is extended by a nonlocal term describing a shear flow parallel to the interface. In the long-wave limit considered, the flow acts destabilizing on a planar interface. Moreover, linear stability analysis suggests that the morphology diagram is modified by the flow near the onset of the Mullins-Sekerka instability. Via numerical analysis, the bifurcation structure of the system is shown to change. Besides the known hexagonal cells, structures consisting of stripes arise. Due to its symmetry-breaking properties, the flow term induces a lateral drift of the whole pattern, once the instability has become active. The drift velocity is measured numerically and described analytically in the framework of a linear analysis. At large flow strength, the linear description breaks down, which is accompanied by a transition to flow-dominated morphologies, described in a companion paper. Small and intermediate flows lead to increased order in the lattice structure of the pattern, facilitating the elimination of defects. Locally oscillating structures appear closer to the instability threshold with flow than without.Comment: 20 pages, Latex, accepted for Physical Review

Polarization and spectral energy distribution in OJ 287 during the 2016/17 outbursts

We report optical photometric and polarimetric observations of the blazar OJ 287 gathered during 2016/17. The high level of activity, noticed after the General Relativity Centenary flare, is argued to be part of the follow-up flares that exhibited high levels of polarization and originated in the primary black hole jet. We propose that the follow-up flares were induced as a result of accretion disk perturbations, travelling from the site of impact towards the primary SMBH. The timings inferred from our observations allowed us to estimate the propagation speed of these perturbations. Additionally, we make predictions for the future brightness of OJ 287. © 2017 by the authors

Surface effects in nucleation and growth of smectic B crystals in thin samples

We present an experimental study of the surface effects (interactions with the container walls) during the nucleation and growth of smectic B crystals from the nematic in free growth and directional solidification of a mesogenic molecule ($C_4H_9-(C_6H_{10})_2CN$) called CCH4 in thin (of thickness in the 10 $\mu$m range) samples. We follow the dynamics of the system in real time with a polarizing microscope. The inner surfaces of the glass-plate samples are coated with polymeric films, either rubbed polyimid (PI) films or monooriented poly(tetrafluoroethylene) (PTFE) films deposited by friction at high temperature. The orientation of the nematic and the smectic B is planar. In PI-coated samples, the orientation effect of SmB crystals is mediated by the nematic, whereas, in PTFE-coated samples, it results from a homoepitaxy phenomenon occurring for two degenerate orientations. A recrystallization phenomenon partly destroys the initial distribution of crystal orientations. In directional solidification of polycrystals in PTFE-coated samples, a particular dynamics of faceted grain boundary grooves is at the origin of a dynamical mechanism of grain selection. Surface effects also are responsible for the nucleation of misoriented terraces on facets and the generation of lattice defects in the solid.Comment: 15 pages, 24 figures, submitted to PR

Estimating the Capacity for ART Provision in Tanzania with the Use of Data on Staff Productivity and Patient Losses

BACKGROUND: International targets for access to antiretroviral therapy (ART) have over-estimated the capacity of health systems in low-income countries in Sub-Saharan Africa. The WHO target for number on treatment by end 2005 for Tanzania was 10 times higher than actually achieved. The target of the national Care and Treatment Plan (CTP) was also not reached. We aimed at estimating the capacity for ART provision and created five scenarios for ART production given existing resource limitations. METHODS: A situation analysis including scrutiny of staff factors, such as available data on staff and patient factors including access to ART and patient losses, made us conclude that the lack of clinical staff is the main limiting factor for ART scale-up, assuming that sufficient drugs and supplies are provided by donors. We created a simple formula to estimate the number of patients on ART based on availability and productivity of clinical staff, time needed to initiate vs maintain a patient on ART and patient losses using five different scenarios with varying levels of these parameters. FINDINGS: Our scenario assuming medium productivity (40% higher than that observed in 2002) and medium loss of patients (20% in addition to 15% first-year mortality) coincides with the actual reported number of patients initiated on ART up to 2008, but is considerably below the national CTP target of 90% coverage for 2009, corresponding to 420,000 on ART and 710,000 life-years saved (LY's). Our analysis suggests that a coverage of 40% or 175,000 on treatment and 350,000 LY's saved is more achievable. CONCLUSION: A comparison of our scenario estimations and actual output 2006-2008 indicates that a simple user-friendly dynamic model can estimate the capacity for ART scale-up in resource-poor settings based on identification of a limiting staff factor and information on availability of this staff and patient losses. Thus, it is possible to set more achievable targets

Trends in Immunization Completion and Disparities in the Context of Health Reforms: The case study of Tanzania

\ud Of global concern is the decline in under five children mortality which has reversed in some countries in sub Saharan Africa (SSA) since the early 1990 s which could be due to disparities in access to preventive services including immunization. This paper is aimed at determining the trend in disparities in completion of immunization using Tanzania Demographic and Health Surveys (DHS). DHS studies randomly selected representative households from all regions in Tanzania since 1980 s, is repeated every five years in the same enumeration areas. The last three data sets (1990, 1996 and 2004) were downloaded and analyzed using STATA 9.0. The analysis included all children of between 12-23 months who would have completed all vaccinations required at 12 months. Across the time periods 1990, 1996 to 2004/05 the percentage of children completing vaccination was similar (71.0% in 1990, 72.7% in 1996 and 72.3% in 2005). There was no disparity in completion of immunization with wealth strata in 1990 and 1996 (p > 0.05) but not 2004. In 2004/05 there was marked disparity as most poor experienced significant decline in immunization completion while the least poor had significant increase (p < 0.001). All three periods children from households whose head had low education were less likely to complete immunization (p < 0.01). Equity that existed in 1990 and more pronounced in 1996 regressed to inequity in 2005, thus though at national level immunization coverage did not change, but at sub-group there was significant disparity associated with the changing contexts and reforms. To address sub-group disparities in immunization it is recommended to adopt strategies focused at governance and health system to reach all population groups and most poor.\u

DNA and histone deacetylases as targets for neuroblastoma treatment

Neuroblastoma, a tumor of the peripheral sympathetic nervous system, is the most frequent solid extra cranial tumor in children and is a major cause of death from neoplasia in infancy. Still little improvement in therapeutic options has been made, requiring a need for the development of new therapies. In our laboratory, we address still unsettled questions, which of mechanisms of action of DNA-damaging drugs both currently use for treatment of human neuroblastomas (doxorubicin, cis-platin, cyclophosphamide and etoposide) and another anticancer agent decreasing growth of neuroblastomas in vitro, ellipticine, are predominant mechanism(s) responsible for their antitumor action in neuroblastoma cell lines in vitro. Because hypoxia frequently occurs in tumors and strongly correlates with advanced disease and poor outcome caused by chemoresistance, the effects of hypoxia on efficiencies and mechanisms of actions of these drugs in neuroblastomas are also investigated. Since the epigenetic structure of DNA and its lesions play a role in the origin of human neuroblastomas, pharmaceutical manipulation of the epigenome may offer other treatment options also for neuroblastomas. Therefore, the effects of histone deacetylase inhibitors on growth of neuroblastoma and combination of these compounds with doxorubicin, cis-platin, etoposide and ellipticine as well as mechanisms of such effects in human neuroblastona cell lines in vitro are also investigated. Such a study will increase our knowledge to explain the proper function of these drugs on the molecular level, which should be utilized for the development of new therapies for neuroblastomas

Authenticating the Presence of a Relativistic Massive Black Hole Binary in OJ 287 Using Its General Relativity Centenary Flare : Improved Orbital Parameters

Results from regular monitoring of relativistic compact binaries like PSR 1913+16 are consistent with the dominant (quadrupole) order emission of gravitational waves (GWs). We show that observations associated with the binary black hole (BBH) central engine of blazar OJ 287 demand the inclusion of gravitational radiation reaction effects beyond the quadrupolar order. It turns out that even the effects of certain hereditary contributions to GW emission are required to predict impact flare timings of OJ 287. We develop an approach that incorporates this effect into the BBH model for OJ 287. This allows us to demonstrate an excellent agreement between the observed impact flare timings and those predicted from ten orbital cycles of the BBH central engine model. The deduced rate of orbital period decay is nine orders of magnitude higher than the observed rate in PSR 1913+16, demonstrating again the relativistic nature of OJ 287's central engine. Finally, we argue that precise timing of the predicted 2019 impact flare should allow a test of the celebrated black hole "no-hair theorem" at the 10% level.Peer reviewe