Kerala’s Grass-roots-led Pandemic Response: Deciphering the Strength of Decentralisation

This paper presents an analysis of the role of decentralised institutions to understand the learning and challenges of the grass-roots-led pandemic response of Kerala. The study is based on interviews with experts and frontline workers to ensure the representation of all stakeholders dealing with the outbreak, from the state level to the household level, and a review of published government orders, health guidelines, and news articles. The outcome of the study shows that along with the decentralised system of governance, the strong grass-roots-level network of Accredited Social Health Activists (ASHA) workers, volunteer groups, and Kudumbashree members played a pivotal role in pandemic management in the state. The efficient functioning of local bodies in the state, experience gained from successive disasters, and the Nipah outbreak naturally aided grass-roots-level actions. The lessons others can draw from Kerala are the importance of public expenditure on health, investment for building social capital, and developing the local self-delivery system.European Unio

BCG Revaccination Does Not Protect Against Leprosy in the Brazilian Amazon: A Cluster Randomised Trial

BCG is a vaccine developed and used to protect against tuberculosis, but it can also protect against leprosy. In Brazil, children receive BCG at birth, and since 1996 a trial has been conducted to find out if a second dose of BCG administered to schoolchildren gives additional protection against tuberculosis. We use this trial to find out if such vaccination protects against leprosy. The trial was conducted in the Brazilian Amazon, involving almost 100,000 children aged 7–14 years who had received neonatal BCG. Half of them received a second dose of BCG at school, and the other half did not. We followed the children for 6 years and observed that there were as many new cases of leprosy in the vaccinated children as in the unvaccinated children. Therefore, we concluded that a second dose of BCG given at school age in the Brazilian Amazon offers no additional protection against leprosy

Vehicle Detection Using Alex Net and Faster R-CNN Deep Learning Models: A Comparative Study

This paper has been presented at : 5th International Visual Informatics Conference (IVIC 2017)This paper presents a comparative study of two deep learning models used here for vehicle detection. Alex Net and Faster R-CNN are compared with the analysis of an urban video sequence. Several tests were carried to evaluate the quality of detections, failure rates and times employed to complete the detection task. The results allow to obtain important conclusions regarding the architectures and strategies used for implementing such network for the task of video detection, encouraging future research in this topic.S.A. Velastin is grateful to funding received from the Universidad Carlos III de Madrid, the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 600371, el Ministerio de Economía y Competitividad (COFUND2013-51509) and Banco Santander. The authors wish to thank Dr. Fei Yin for the code for metrics employed for evaluations. Finally, we gratefully acknowledge the support of NVIDIA Corporation with the donation of the GPUs used for this research. The data and code used for this work is available upon request from the authors

Identification and Characterization of Antifungal Compounds Using a Saccharomyces cerevisiae Reporter Bioassay

New antifungal drugs are urgently needed due to the currently limited selection, the emergence of drug resistance, and the toxicity of several commonly used drugs. To identify drug leads, we screened small molecules using a Saccharomyces cerevisiae reporter bioassay in which S. cerevisiae heterologously expresses Hik1, a group III hybrid histidine kinase (HHK) from Magnaporthe grisea. Group III HHKs are integral in fungal cell physiology, and highly conserved throughout this kingdom; they are absent in mammals, making them an attractive drug target. Our screen identified compounds 13 and 33, which showed robust activity against numerous fungal genera including Candida spp., Cryptococcus spp. and molds such as Aspergillus fumigatus and Rhizopus oryzae. Drug-resistant Candida albicans from patients were also highly susceptible to compounds 13 and 33. While the compounds do not act directly on HHKs, microarray analysis showed that compound 13 induced transcripts associated with oxidative stress, and compound 33, transcripts linked with heavy metal stress. Both compounds were highly active against C. albicans biofilm, in vitro and in vivo, and exerted synergy with fluconazole, which was inactive alone. Thus, we identified potent, broad-spectrum antifungal drug leads from a small molecule screen using a high-throughput, S. cerevisiae reporter bioassay

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries