When Knowledge Flows: A Case Study of Village Health Workers’ Motivations in Jamkhed

Across the field of global health, there have been many attempts to cater to the health needs of the most marginalized populations. Community health workers (CHWs) are individuals that live in the communities they serve and are typically low-­‐income women with little to no formal education. After a period of training by their program, they enter their communities equipped as a bridge between the community and the health system. Although CHWs do play a substantial role in health delivery and education, the structure of CHW programs varies widely, but a common characteristic of these programs is that the CHWs are usually unpaid. So, why do they do it? The implications of CHWs’ motivations are critical, as they may predict the sustainability and effectiveness of the health programs they serve. This qualitative case study explores one successful CHW program in an attempt to understand what motivates Village Health Workers (VHWs), and how that contributes to the success of CRHP’s model of community-­‐based health and development

Introduction of Decker Type Maize Sheller to Selected Areas of Eastern Tigray and Its Socioeconomic Impact Assessment

Maize production has increased in the last few years in the region and country. Despite the increase, there are still many problems that are not solved in the production system, among them shelling system or operation is the first. The traditional methods of shelling; i.e. rubbing the cob together, fringe by hand finger, beating the cobs using sick, or by pestle  and animal tramping are labor intensive, time consuming, cause damage, and cause loss of grains. In order to solve problem the Mekelle Agricultural Mechanization and Rural Energy center manufactures decker type maize Sheller to small holder farmers. And this paper evaluates the socioeconomic impact of this decker in comparing with rubbing the cob of corn together, fraying by hand finger, beating the cobs by using stick, and using decker type maize Sheller. This paper overcome through two approaches these are technical and socioeconomic evaluation. Keywords: Sheller; Decker type; maize cob; maize increase production, post-harvest los

Soil and water management in spate irrigation systems in Eritrea

Spate irrigation has been practised over 100 years in the Red Sea coastal zone of Eritrea such as the Sheeb area. Main problem of the spate irrigation system is water shortage caused by irregular rainfall in the highlands of Eritrea and breaching of the irrigation structures by destructive big floods. Annually, a tremendous amount of soil with nutrients is eroded from the adjacent highlands, transported by seasonal streams (wadis) and deposited on the lowlands in the irrigated fields. The dominant types of soils of Sheeb area are the Fluvisols, which have good physical and chemical properties. The annual sedimentation on the spate fields enables the farmers to harvest a crop without application of fertilisers. A nutrient balance study revealed no soil mining in the spate fields. Farmers in Sheeb could obtain a more uniform water distribution over their fields with better levelling. Of the total area of Sheeb (8,000 ha), about 3,160 ha of land was classified as highly and moderately suitable for spate irrigation. When the flood diversion structures (at wadis Laba and Maiule) are made more permanent, an additional 2, 000 ha of land can be irrigated. In general, spate irrigation production system is a 'cost effective' system if the irrigation structures are properly maintained at low cost and if the fields receive enough water and nutrients.</p

Characterization of glucose-related metabolic pathways in differentiated rat oligodendrocyte lineage cells

Although oligodendrocytes constitute a significant proportion of cells in the central nervous system (CNS), little is known about their intermediary metabolism. We have therefore characterised metabolic functions of primary oligodendrocyte precursor cell cultures at late stages of differentiation using isotope-labelled metabolites. We report that differentiated oligodendrocyte lineage cells avidly metabolise glucose in the cytosol and pyruvate derived from glucose in the mitochondria. The labelling patterns of metabolites obtained after incubation with [1,2-13C]glucose demonstrated that the pentose phosphate pathway (PPP) is highly active in oligodendrocytes (approximately 10% of glucose is metabolised via the PPP as indicated by labelling patterns in phosphoenolpyruvate). Mass spectrometry and magnetic resonance spectroscopy analyses of metabolites after incubation of cells with [1-13C]lactate or [1,2-13C]glucose, respectively, demonstrated that anaplerotic pyruvate carboxylation, which was thought to be exclusive to astrocytes, is also active in oligodendrocytes. Using [1,2-13C]acetate we show that oligodendrocytes convert acetate into acetyl-CoA which is metabolized in the tricarboxylic acid cycle. Analysis of labelling patterns of alanine after incubation of cells with [1,2-13C]acetate and [1,2-13C]glucose showed catabolic oxidation of malate or oxaloacetate. In conclusion, we report that oligodendrocyte lineage cells at late differentiation stages are metabolically highly active cells that are likely to contribute considerably to the metabolic activity of the CNS.Grant sponsor: The UK Multiple Sclerosis Society and Qatar Foundation. The work was further supported by core funding from the Wellcome Trust and MRC to the Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/glia.2290

Management of congenital esophageal stenosis associated with esophageal atresia and its impact on postoperative esophageal stricture

Aim The aim of this work was to study the incidence, management of congenital esophageal stenosis (CES) associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF), and its impact on esophageal stricture (ES) after primary repair.Patients and methods From January 2006 to December 2014, 41 sequential cases of EA with distal TEF were retrospectively studied. Cases with significant ES after primary repair were included in the study. Associated CES was diagnosed in the neonatal period by taking histopathologic samples from the tips of the esophageal pouches, failure to pass a size-6 nasogastric tube distally during primary repair, and by initial esophagogram.Results Significant ES developed in 19 patients (46.3%); of them, six had CES (32%). Three patients had tracheobronchial remnants at the anastomotic site. Two of them had refractory strictures requiring resections and one had mainly major esophageal dysmotility. Patients 4 and 5 had CES distal to the anastomotic site on initial esophagogram. Patient 4 responded well to dilatations, whereas the other one had refractory stricture. Patient 6 had distal CES due to fibromuscular stenosis diagnosed by failure to pass a size-6 nasogastric tube distally. The patient responded well to dilatation, myectomy, and Thal’s fundoplication.Conclusion One-third of the patients with significant stricture had CES; half of them were refractory to dilatation. Failure to have histology specimens and a high index of suspicion will make the incidence of this association a rarity. Diagnosis and management of CES with EA/TEF in the neonatal period is possible. Esophageal dilatation is the initial management for all cases with a low threshold for gastric fundoplication and gastrostomy. Resection is reserved for refractory stenosis.Keywords: congenital esophageal stenosis, esophageal atresia, esophageal stricture, tracheoesophageal fistul

Optimal maintenance scheduling of a gas engine power plant using generalized disjunctive programming

A new continuous-time model for long-term scheduling of a gas engine power plant with parallel units is presented. Gas engines are shut down according to a regular maintenance plan that limits the number of hours spent online. To minimize salary expenditure with skilled labor, a single maintenance team is considered which is unavailable during certain periods of time. Other challenging constraints involve constant minimum and variable maximum power demands. The objective is to maximize the revenue from electricity sales assuming seasonal variations in electricity pricing by reducing idle times and shutdowns in high-tariff periods. By first developing a generalized disjunctive programming model and then applying both big-M and hull reformulation techniques, we reduce the burden of finding the appropriate set of mixed-integer linear constraints. Through the solution of a real-life problem, we show that the proposed formulations are very efficient computationally, while gaining valuable insights about the system

Oligodendrocytes Do Not Export NAA-Derived Aspartate In Vitro.

Oligodendroglial cells are known to de-acetylate the N-acetylaspartate (NAA) synthesized and released by neurons and use it for lipid synthesis. However, the role of NAA regarding their intermediary metabolism remains poorly understood. Two hypotheses were proposed regarding the fate of aspartate after being released by de-acetylation: (1) aspartate is metabolized in the mitochondria of oligodendrocyte lineage cells; (2) aspartate is released to the medium. We report here that aspartoacylase mRNA expression increases when primary rat oligodendrocyte progenitor cells (OPCs) differentiate into mature cells in culture. Moreover, characterising metabolic functions of acetyl coenzyme A and aspartate from NAA catabolism in mature oligodendrocyte cultures after 5 days using isotope-labelled glucose after 5-days of differentiation we found evidence of extensive NAA metabolism. Incubation with [1,6-13C]glucose followed by gas chromatography-mass spectrometry and high performance liquid chromatography analyses of cell extracts and media in the presence and absence of NAA established that the acetate moiety produced by hydrolysis of NAA does not enter mitochondrial metabolism in the form of acetyl coenzyme A. We also resolved the controversy concerning the possible release of aspartate to the medium: aspartate is not released to the medium by oligodendrocytes in amounts detectable by our methods. Therefore we propose that: aspartate released from NAA joins the cytosolic aspartate pool rapidly and takes part in the malate-aspartate shuttle, which transports reducing equivalents from glycolysis into the mitochondria for ATP production and enters the tricarboxylic acid cycle at a slow rate.This work was supported by grants from the UK Multiple Sclerosis Society and from Qatar Foundation. The work was further supported by core funding from the Wellcome Trust and MRC to the Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute. The authors acknowledge the excellent technical support in GC-MS and HPLC analysis from Lars Evje (NTNU, Norway).This is the final version of the article. It first appeared from Springer at http://dx.doi.org/10.1007/s11064-016-1985-y