Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use. Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known. Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals. Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored

Non-Standard Errors

In statistics, samples are drawn from a population in a data-generating process (DGP). Standard errors measure the uncertainty in estimates of population parameters. In science, evidence is generated to test hypotheses in an evidence-generating process (EGP). We claim that EGP variation across researchers adds uncertainty: Non-standard errors (NSEs). We study NSEs by letting 164 teams test the same hypotheses on the same data. NSEs turn out to be sizable, but smaller for better reproducible or higher rated research. Adding peer-review stages reduces NSEs. We further find that this type of uncertainty is underestimated by participants

Credit risk management and financial performance among deposit money banks in Nigeria: A case study of Zenith Bank Plc

Risk is an intrinsic attribute that is existent in virtually all fields of human endeavour. The financial environment has turned out to be extremely precarious, unstable and unpredictable by dint of defective risk management practice. In giving out credit, Deposit Money Banks (DMBs) take the risk of the loan or advances (LAD) being fully or partially lost, or of the interest-income accrued not eventually materialising. The review of empirical literature revealed a plethora of approaches to measuring the credit risks facing financial institutions. They showed that the management of risks has a positive impact on profitability. Concentrating on deposit money banks in Nigeria and using Zenith Bank Plc as a case study, the objective of this study is to show in simple terms that risks can be represented by the LAD and the loan loss provision (LLP) made by DMBs, just as performance can be measured by the return on equity (ROE), while total assets (TAS) are included as the control variable. Using data extracted from the financial statements from 2002 to 2017 (16 years), it was established, by means of descriptive statistics and regression analysis, that loan loss provision does not exert a significant impact on profitability

Monolithic 8 × 40 Gb/s tunableWDM transmitter based on generic III-V technology

\u3cp\u3eWe demonstrate an 8-channel tunableWDMtransmitter capable of 320 Gb/s operation. It exhibits high integration density on 36 mm\u3csup\u3e2\u3c/sup\u3e chip area and was fabricated in an experimental generic integration platform.\u3c/p\u3

Monolithically integrated 40 Gbit/s tunable transmitter in an experimental generic foundry process for large-scale integration

We present a tunable transmitter photonic integrated circuit fabricated on an experimental generic III-V foundry platform, consisting of a DBR-laser with 10 nm continuous tuning range, monolithically integrated with a traveling-wave Mach-Zehnder modulator capable of 40 Gbit/s operation

Monolithic 300 Gb/s parallel transmitter in InP based generic photonic integration technology

\u3cp\u3eIn order to meet the constantly rising traffic demands in optical transport systems for data and telecommunications, compact, power efficient, and low-cost optical transmitters are needed that offer easy scalability toward higher transmission capacities. Photonic integrated circuit technology based on the InP material has long enabled the monolithic integration of tunable sources with modulators and opened the way toward large-scale wavelength-division multiplexed parallel transmitters. In this paper, we present the design and performance of a monolithic tunable 8 × 40 Gb/s parallel transmitter chip with more than 220 components and state-of-the-art capacity density metric. A generic photonic integration approach was followed, in which the transmitter is constituted from well-developed subcircuits and building blocks, facilitating its design and manufacturing. With the trend toward large-scale integration with increasing component densities and smaller chip sizes, proximity effects in form of crosstalk are limiting further miniaturization efforts. We analyze electrical, thermal, and optical crosstalk effects that are relevant to the transmitter design, discuss appropriate mitigation techniques, and indicate the limitations of the current technology.\u3c/p\u3

Monolithic 300 Gb/s parallel transmitter in InP based generic photonic integration technology

\u3cp\u3eIn order to meet the constantly rising traffic demands in optical transport systems for data and telecommunications, compact, power efficient, and low-cost optical transmitters are needed that offer easy scalability toward higher transmission capacities. Photonic integrated circuit technology based on the InP material has long enabled the monolithic integration of tunable sources with modulators and opened the way toward large-scale wavelength-division multiplexed parallel transmitters. In this paper, we present the design and performance of a monolithic tunable 8 × 40 Gb/s parallel transmitter chip with more than 220 components and state-of-the-art capacity density metric. A generic photonic integration approach was followed, in which the transmitter is constituted from well-developed subcircuits and building blocks, facilitating its design and manufacturing. With the trend toward large-scale integration with increasing component densities and smaller chip sizes, proximity effects in form of crosstalk are limiting further miniaturization efforts. We analyze electrical, thermal, and optical crosstalk effects that are relevant to the transmitter design, discuss appropriate mitigation techniques, and indicate the limitations of the current technology.\u3c/p\u3

Thermal crosstalk investigation in an integrated InP multiwavelength laser

We numerically investigate the thermal crosstalk effects in an integrated InP multiwavelength laser. The multiwavelength laser under investigation consists of a number of Distributed Bragg Reflector lasers and an Arrayed Waveguide Grating. Each laser generates a fixed wavelength and the Arrayed Waveguide Grating collects the emitted wavelengths leading all of them in a common output waveguide. Temperature distribution and heat flow are obtained through thermal simulations. Our model predicts the thermal crosstalk between lasers in relation to: injected current, distance between lasers and number of lasers. The aim of this paper is to define guidelines to design low thermal crosstalk multiwavelength lasers