Mass campaigns with antimalarial drugs: a modelling comparison of artemether-lumefantrine and DHA-piperaquine with and without primaquine as tools for malaria control and elimination

Antimalarial drugs are a powerful tool for malaria control and elimination. Artemisinin-based combination therapies (ACTs) can reduce transmission when widely distributed in a campaign setting. Modelling mass antimalarial campaigns can elucidate how to most effectively deploy drug-based interventions and quantitatively compare the effects of cure, prophylaxis, and transmission-blocking in suppressing parasite prevalence. A previously established agent-based model that includes innate and adaptive immunity was used to simulate malaria infections and transmission. Pharmacokinetics of artemether, lumefantrine, dihydroartemisinin, piperaquine, and primaquine were modelled with a double-exponential distribution-elimination model including weight-dependent parameters and age-dependent dosing. Drug killing of asexual parasites and gametocytes was calibrated to clinical data. Mass distribution of ACTs and primaquine was simulated with seasonal mosquito dynamics at a range of transmission intensities. A single mass campaign with antimalarial drugs is insufficient to permanently reduce malaria prevalence when transmission is high. Current diagnostics are insufficiently sensitive to accurately identify asymptomatic infections, and mass-screen-and-treat campaigns are much less efficacious than mass drug administrations. Improving campaign coverage leads to decreased prevalence one month after the end of the campaign, while increasing compliance lengthens the duration of protection against reinfection. Use of a long-lasting prophylactic as part of a mass drug administration regimen confers the most benefit under conditions of high transmission and moderately high coverage. Addition of primaquine can reduce prevalence but exerts its largest effect when coupled with a long-lasting prophylactic.Comment: 14 pages, 5 figure

Des images en retrait : petite poétique de la prière

L'oeuvre poétique de Pierre Vadeboncoeur constitue un signe représentatif de la modélisation artistique telle que définie dans la perspective peircienne du signe. Fondant sa relation à l'objet dont elle tient lieu sur la base d'une ressemblance de type analogique, elle peut, à ce titre, être tenue pour une icone troisième, une métaphore . L'homogénéité des représentations dans lesquelles elle prend forme, notamment dans l'Essai sur une penséeheureuse et le Bonheur excessif permet au lecteur d'identifier une forme culturelle signifiante, la prière, tandis que la nature de l'analogie qui fonde la possibilité de cette relation lui révélera la valeur esthétique de l'oeuvre, sa signification.The poetical work of Pierre Vadeboncoeur can be seen as a sign representative of artistic modeling, as defined within the Peircean perspective of sign. Founding its relation to the object for which it stands on an analogical type of likeness, it can, in this respect, be taken as a thirdtype icon, i.e., as metaphor. The homogeneity of representations it embodies, especially in Essai sur une pensée heureuse and le Bonheur excessif, will enable the reader to identify a significant cultural form, namely, prayer, while the nature of the analogy which underlies the possibility of this relation will reveal the sthetic value of the work, that is, its significance

Counterposed phase velocity and energy-transport velocity vectors in a dielectric-magnetic uniaxial medium

When a plane wave is launched from a plane surface in a linear, homogenous, dielectric-magnetic, uniaxial medium, we show that its phase velocity and the energy-transport velocity vectors can be counterposed (i.e., lie on different sides of the surface normal) under certain circumstances.Comment: 3 figure

A subKelvin scanning probe microscope for the electronic spectroscopy of an individual nano-device

We present a combined scanning force and tunneling microscope working in a dilution refrigerator that is optimized for the study of individual electronic nano-devices. This apparatus is equipped with commercial piezo-electric positioners enabling the displacement of a sample below the probe over several hundred microns at very low temperature, without excessive heating. Atomic force microscopy based on a tuning fork resonator probe is used for cryogenic precise alignment of the tip with an individual device. We demonstrate the local tunneling spectroscopy of a hybrid Josephson junction as a function of its current bias

Perencanaan Strategis Berdasarkan Analisis SWOT Puskesmas Ngletih Kediri

Sistem manajemen dalam pelayanan kesehatan pada masa post-pandemi perlu mengalami beberapa pembaruan yang disesuaikan dengan segala informasi dan isu internal maupun eksternal organisasi. Analisis SWOT digunakan sebagai alat bantu untuk menganalisis informasi dan isu yang dimaksud tersebut, sebagai bentuk awal perencanaan strategis. Penelitian ini bertujuan untuk membuat keputusan tindak lanjut mengenai pembaruan sistem manajemen di Puskesmas Ngletih Kediri, sebagai bentuk perencanaan strategis dengan melihat letak hasil perhitungan analisis SWOT Puskesmas Ngletih Kediri pada kuadran. Penelitian ini menggunakan jenis penelitian deskriptif, dengan seluruh pimpinan staf manajemen puskesmas sebanyak 7 orang sebagai responden yang dipilih dengan teknik sampling purposive sampling. Instrumen Penelitian menggunakan kuesioner SWOT, dengan 15 kriteria Faktor Strategis Internal dan 9 kriteria Faktor Strategis Eksternal. Hasil analisis SWOT menunjukkan Puskesmas Ngletih Kediri terletak pada kuadran 1 artinya strategi pertumbuhan cepat/agresif. Kuadran 1 merupakan situasi yang menguntungkan karena puskesmas memiliki peluang dan kekuatan yang baik dan bisa dioptimalkan dengan meminimalisir segala kelemahan dan hambatan. Strategi yang digunakan adalah meminimalisir kelemahan yang berasal dari SDM. Pihak manajemen Puskesmas Perawatan Ngletih diharapkan dapat mengadakan pelatihan dan pengembangan kompetensi yang dikhususkan untuk para tenaga kesehatan; mengoptimalkan sarana dan prasarana kerja; meningkatkan penggunaan insentif non finansial, seperti penghargaan terhadap prestasi kerja dan tanggungjawab tambahan; melakukan survey kepuasan kerja secara berkala; dan kerja sama dengan lintas sektor lebih di tingkatkan demi meningkatkan kualitas SDM puskesmas