Studying complex interventions : reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco

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Sea state and rain: a second take on dual-frequency altimetry

TOPEX and Jason were the first two dual-frequency altimeters in space, with both operating at Ku- and C-band. Each thus gives two measurements of the normalized backscatter, sigma0, (from which wind speed is calculated) and two estimates of wave height. Departures from a well-defined relationship between the Ku- and C-band sigma0 values give an indication of rain.This paper investigates differences between the two instruments using data from Jason's verification phase. Jason's Ku-band estimates of wave height are ~1.8% less than TOPEX's, whereas its sigma0 values are higher. When these effects have been removed the root mean square (r.m.s.) mismatch between TOPEX and Jason's Ku-band observations is close to that for TOPEX's observations at its two frequencies, and the changes in sigma0 with varying wave height conditions are the same for the two altimeters. Rain flagging and quantitative estimates of rain rate are both based on the atmospheric attenuation derived from the sigma0 measurements at the two frequencies. The attenuation estimates of TOPEX and Jason agree very well, and a threshold of -0.5 dB is effective at removing the majority of spurious data records from the Jason GDRs. In the high sigma0 regime, anomalous data can be cause by processes other than rain. Consequently, for these low wind conditions, neither can reliable rain detection be based on altimetry alone, nor can a generic rain flag be expected to remove all suspect data

GABAergic presubicular projections to the medial entorhinal cortex of the rat

We characterized presubicular neurons giving rise to bilateral projections to the medial entorhinal cortex (MEA) of the rat. Retrograde labeling of presubiculo–entorhinal projections with horseradish peroxidase and subsequent GABA immunocytochemistry revealed that 20–30 % of the ipsilaterally projecting neurons are GABAergic. No GABAergic projections to the contralateral MEA were observed. GABAergic projection neurons were observed only in the dorsal part of the presubiculum, which, when taking into account the topography of presubicular projections to MEA, indicates that only the dorsal part of MEA receives GABAergic input. The GABAergic projection neurons constitute �30-40 % of all GABAergic neurons present in the superficial layers of the dorsal presubiculum. Using doublelabel fluorescent retrograde tracing, we found that the ipsilateral and contralateral presubiculo–entorhinal projections originat

Assessment of the SC (US) performance-based incentive mechanism and economic analysis of the project Revitalizing and Improving Primary Health Care in Battagram District-.

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A combined DTI-fMRI approach for optimizing the delineation of posteromedial vs. anterolateral entorhinal cortex

In the entorhinal cortex (EC), attempts have been made to identify the human homologue regions of the medial (MEC) and lateral (LEC) subdivision using either functional magnetic resonance imaging (fMRI) or diffusion tensor imaging (DTI). However, there are still discrepancies between entorhinal subdivisions depending on the choice of connectivity seed regions and the imaging modality used. While DTI can be used to follow the white matter tracts of the brain, fMRI can identify functionally connected brain regions. In this study, we used both DTI and resting-state fMRI in 103 healthy adults to investigate both structural and functional connectivity between the EC and associated cortical brain regions. Differential connectivity with these regions was then used to predict the locations of the human homologues of MEC and LEC. Our results from combining DTI and fMRI support a subdivision into posteromedial (pmEC) and anterolateral (alEC) EC and reveal a discrete border between the pmEC and alEC. Furthermore, the EC subregions obtained by either imaging modality showed similar distinct connectivity patterns: While pmEC showed increased connectivity preferentially with the default mode network, the alEC exhibited increased connectivity with regions in the dorsal attention and salience networks. Optimizing the delineation of the human homologues of MEC and LEC with a combined, cross-validated DTI-fMRI approach allows to define a likely border between the two subdivisions and has implications for both cognitive and translational neuroscience research

Structural connectivity-based segmentation of the human entorhinal cortex

The medial (MEC) and lateral entorhinal cortex (LEC), widely studied in rodents, are well defined and characterized. In humans, however, the exact locations of their homologues remain uncertain. Previous functional magnetic resonance imaging (fMRI) studies have subdivided the human EC into posteromedial (pmEC) and anterolateral (alEC) parts, but uncertainty remains about the choice of imaging modality and seed regions, in particular in light of a substantial revision of the classical model of EC connectivity based on novel insights from rodent anatomy. Here, we used structural, not functional imaging, namely diffusion tensor imaging (DTI) and probabilistic tractography to segment the human EC based on differential connectivity to other brain regions known to project selectively to MEC or LEC. We defined MEC as more strongly connected with presubiculum and retrosplenial cortex (RSC), and LEC as more strongly connected with distal CA1 and proximal subiculum (dCA1pSub) and lateral orbitofrontal cortex (OFC). Although our DTI segmentation had a larger medial-lateral component than in the previous fMRI studies, our results show that the human MEC and LEC homologues have a border oriented both towards the posterior-anterior and medial-lateral axes, supporting the differentiation between pmEC and alEC

Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches without extension (n = 74) and with subjects who had worn a mandibular extension removable partial denture in the past (n = 19). Subjects with complete dentitions (n = 72) were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function

Toward Near‐Field Tsunami Forecasting Along the Cascadia Subduction Zone Using Rapid GNSS Source Models

Over the past 15 years and through multiple large and devastating earthquakes, tsunami warning systems have grown considerably in their efficacy in providing timely and accurate forecasts to affected communities. However, one part of tsunami warning that still needs improvement is forecasts catered to local, near‐field communities in the time after an earthquake rupture but before coastal inundation. In this study, we test a rapid, Global Navigation Satellite Systems (GNSS)‐driven earthquake characterization model using a large data set of synthetic megathrust ruptures for its near‐field tsunami forecasting potential. We also provide a framework for tsunami forecasting that focuses on the likelihood of exceedance of user‐defined coastal amplitudes that may be of use in the first 15 min following an earthquake. Specifically, we can estimate the earthquake magnitude, without saturation, for 82% of tested ruptures. We can also identify test ruptures as dominantly thrust events, without analyst guidance for 92% of tested thrust ruptures. Finally, modeling the tsunami component of our rapidly estimated fault rupture leads to greater than 80% accuracy in identifying tsunami impact at key coastal amplitude thresholds. This is promising for near‐field warning when the time prior to inundation is limited to tens of minutes. We focus this study on large megathrust ruptures along the quiescent Cascadia subduction zone where there is already a dense GNSS network

What adaptation to research is needed following crises: a comparative, qualitative study of the health workforce in Sierra Leone and Nepal

Background: Health workers are critical to the performance of health systems; yet, evidence about their coping strategies and support needs during and post crisis is lacking. There is very limited discussion about how research teams should respond when unexpected crises occur during on-going research. This paper critically presents the approaches and findings of two health systems research projects that explored and evaluated health worker performance and were adapted during crises, and provides lessons learnt on re-orientating research when the unexpected occurs. Methods: Health systems research was adapted post crisis to assess health workers’ experiences and coping strategies. Qualitative in-depth interviews were conducted with 14 health workers in a heavily affected earthquake district in Nepal and 25 frontline health workers in four districts in Ebola-affected Sierra Leone. All data were transcribed and analysed using the framework approach, which included developing coding frameworks for each study, applying the frameworks, developing charts and describing the themes. A second layer of analysis included analysis across the two contexts, whereas a third layer involved the research teams reflecting on the approaches used to adapt the research during these crises and what was learned as individuals and research teams. Results: In Sierra Leone, health workers were heavily stigmatised by the epidemic, leading to a breakdown of trust. Coping strategies included finding renewed purpose in continuing to serve their community, peer and family support (in some cases), and religion. In Nepal, individual determination, a sense of responsibility to the community and professional duty compelled staff to stay or return to their workplace. The research teams had trusting relationships with policy-makers and practitioners, which brought credibility and legitimacy to the change of research direction as well as the relationships to maximise the opportunity for findings to inform practice. Conclusions: In both contexts, health workers demonstrated considerable resilience in continuing to provide services despite limited support. Embedded researchers and institutions are arguably best placed to navigate emerging ethical and social justice challenges and are strategically positioned to support the co-production of knowledge and ensure research findings have impact