Transport and Loss of Ring Current Electrons Inside Geosynchronous Orbit During the 17 March 2013 Storm.

Ring current electrons (1-100 keV) have received significant attention in recent decades, but many questions regarding their major transport and loss mechanisms remain open. In this study, we use the four-dimensional Versatile Electron Radiation Belt code to model the enhancement of phase space density that occurred during the 17 March 2013 storm. Our model includes global convection, radial diffusion, and scattering into the Earth's atmosphere driven by whistler-mode hiss and chorus waves. We study the sensitivity of the model to the boundary conditions, global electric field, the electric field associated with subauroral polarization streams, electron loss rates, and radial diffusion coefficients. The results of the code are almost insensitive to the model parameters above 4.5 R E R E, which indicates that the general dynamics of the electrons between 4.5 R E and the geostationary orbit can be explained by global convection. We found that the major discrepancies between the model and data can stem from the inaccurate electric field model and uncertainties in lifetimes. We show that additional mechanisms that are responsible for radial transport are required to explain the dynamics of ≥40-keV electrons, and the inclusion of the radial diffusion rates that are typically assumed in radiation belt studies leads to a better agreement with the data. The overall effect of subauroral polarization streams on the electron phase space density profiles seems to be smaller than the uncertainties in other input parameters. This study is an initial step toward understanding the dynamics of these particles inside the geostationary orbit

Are health facilities well equipped to provide basic quality childbirth services under the free maternal health policy? Findings from rural Northern Ghana

© 2018 The Author(s). Background: Basic inputs and infrastructure including drugs, supplies, equipment, water and electricity are required for the provision of quality care. In the era of the free maternal health policy in Ghana, it is unclear if such basic inputs are readily accessible in health facilities. The study aimed to assess the availability of basic inputs including drugs, supplies, equipment and emergency transport in health facilities. Women and health providers' views on privacy and satisfaction with quality of care were also assessed. Methods: The study used a convergent parallel mixed methods in one rural municipality in Ghana, Kassena-Nankana. A survey among facilities (n = 14) was done. Another survey was carried out among women who gave birth in health facilities only (n = 353). A qualitative component involved focus group discussions (FGDs) with women (n = 10) and in-depth interviews (IDIs) with midwives and nurses (n = 25). Data were analysed using descriptive statistics for the quantitative study, while the qualitative data were recorded, transcribed, read and coded using themes. Results: The survey showed that only two (14%) out of fourteen facilities had clean water, and five (36%) had electricity. Emergency transport for referrals was available in only one (7%) facility. Basic drugs, supplies, equipment and infrastructure especially physical space were inadequate. Rooms used for childbirth in some facilities were small and used for multiple purposes. Eighty-nine percent (n = 314) of women reported lack of privacy during childbirth and this was confirmed in the IDIs. Despite this, 77% of women (n = 272) were very satisfied or satisfied with quality of care for childbirth which was supported in the FGDs. Reasons for women's satisfaction included the availability of midwives to provide childbirth services and to have follow-up homes visits. Some midwives were seen to be patient and empathetic. Providers were not satisfied due to health system challenges. Conclusion: Government should dedicate more resources to the provision of essential inputs for CHPS compounds providing maternal health services. Health management committees should also endeavour to play an active role in the management of health facilities to ensure efficiency and accountability. These would improve quality service provision and usage, helping to achieve universal health coverage

Has the free maternal health policy eliminated out of pocket payments for maternal health services? Views of women, health providers and insurance managers in Northern Ghana

© 2018 Dalinjong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction The free maternal health policy was implemented in Ghana in 2008 under the National Health Insurance Scheme (NHIS). The policy sought to eliminate out of pocket (OOP) payments and enhance the utilisation of maternal health services. It is unclear whether the policy had altered OOP payments for services. The study explored views on costs and actual OOP payments during pregnancy. The source of funding for payments was also explored. Methods A convergent parallel mixed methods design, involving quantitative and qualitative data collection approaches. The study was set in the Kassena-Nankana municipality, a rural area in Ghana. Women (n = 406) who utilised services during pregnancy were surveyed. Also, 10 focus groups discussions (FGDs) were held with women who used services during pregnancy as well as 28 in-depth interviews (IDIs) with midwives/nurses (n = 25) and insurance managers/directors (n = 3). The survey was analysed using descriptive statistics, focussing on costs from the women’s perspective. Qualitative data were audio recorded, transcribed and translated verbatim into English where necessary. The transcripts were read and coded into themes and sub-themes. Results The NHIS did not cover all expenses in relation to maternal health services. The overall mean for OOP cost during pregnancy was GH¢17.50 (US$8.60). Both FGDs and IDIs showed that women especially paid for drugs and ultrasound scan services. Sixty-five percent of the women used savings, whilst twenty-two percent sold assets to meet the OOP cost. Some women were unable to afford payments due to poverty and had to forgo treatment. Participants called for payments to be eliminated and for the NHIS to absorb the cost of emergency referrals. All participants admitted the benefits of the policy. Conclusion Women needed to make payments despite the policy. Measures should be put in place to eliminate payments to enable all women to receive services and promote universal health coverage

The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana

© 2017, The Author(s). Background: To promote skilled attendance at births and reduce maternal deaths, the government of Ghana introduced the free maternal care policy under the National Health Insurance Scheme (NHIS) in 2008. The objective is to eliminate financial barriers associated with the use of services. But studies elsewhere showed that out of pocket (OOP) payments still exist in the midst of fee exemptions. The aim of this study was to estimate OOP payments and the financial impact on women during childbirth in one rural and poor area of Northern Ghana; the Kassena-Nankana municipality. Costs were taken from the perspective of women. Methods: Quantitative and qualitative data collection techniques were used in a convergent parallel mixed methods study. The study used structured questionnaire (n = 353) and focus group discussions (FGDs =7) to collect data from women who gave birth in health facilities. Quantitative data from the questionnaire were analysed, using descriptive statistics. Qualitative data from the FGDs were recorded, transcribed and analysed to determine common themes. Results: The overall mean OOP payments during childbirth was GH¢33.50 (US$17), constituting 5.6% of the average monthly household income. Over one-third (36%, n = 145) of women incurred OOP payments which exceeded 10% of average monthly household income (potentially catastrophic). Sixty-nine percent (n = 245) of the women perceived that the NHIS did not cover all expenses incurred during childbirth; which was confirmed in the FGDs. Both survey and FGDs demonstrated that women made OOP payments for drugs and other supplies. The FGDs showed women bought disinfectants, soaps, rubber pads and clothing for newborns as well. Seventy-five percent (n = 264) of the women used savings, but 19% had to sell assets to finance the payments; this was supported in the FGDs. Conclusion: The NHIS policy has not eliminated financial barriers associated with childbirth which impacts the welfare of some women. Women continued to make OOP payments, largely as a result of a delay in reimbursement by the NHIS. There is need to re-examine the reimbursement system in order to prevent shortage of funding to health facilities and thus encourage skilled attendance for the reduction of maternal deaths as well as the achievement of universal health coverage

The implementation of the free maternal health policy in rural Northern Ghana: Synthesised results and lessons learnt

© 2018 The Author(s). Objective: A free maternal health policy was implemented under Ghana's National Health Insurance Scheme to promote the use of maternal health services. Under the policy, women are entitled to free services throughout pregnancy and at childbirth. A mixed methods study involving women, providers and insurance managers was carried out in the Kassena-Nankana municipality of Ghana. It explored the affordability, availability, acceptability and quality of services. In this manuscript, we present synthesised results categorised as facilitators and barriers to access as well as lessons learnt (implications). Results: Reasonable waiting times, cleanliness of facilities as well as good interpersonal relationships with providers were the facilitators to access. Barriers included out of pocket payments, lack of, or inadequate supply of drugs and commodities, equipment, water, electricity and emergency transport. Four lessons (implications) were identified. Firstly, out of pocket payments persisted. Secondly, the health system was not strengthened before implementing the free maternal health policy. Thirdly, lower level facilities were poorly resourced. Finally, the lack of essential inputs and infrastructure affected quality of care and therefore, access to care. It is suggested that the Government of Ghana, the Health Insurance Scheme and other stakeholders improve the provision of resources to facilities

Ultimate behavior of idealized composite floor elements at ambient and elevated temperature

This paper is concerned with the ultimate behavior of composite floor slabs under extreme loading situations resembling those occurring during severe building fires. The study focuses on the failure state associated with rupture of the reinforcement in idealized slab elements, which become lightly reinforced in a fire situation due to the early loss of the steel deck. The paper describes a fundamental approach for assessing the failure limit associated with reinforcement fracture in lightly reinforced beams, representing idealized slab strips. A description of the ambient-temperature tests on isolated restrained elements, carried out to assess the influence of key material parameters on the failure conditions, is firstly presented. The results of a series of material tests, undertaken mainly to examine the effect of elevated temperature on ductility, are also described. A simplified analytical model is employed, in conjunction with the experimental findings, to assess the salient material parameters and their implications on the ultimate response at both ambient and elevated temperature. © 2009 Springer Science+Business Media, LLC

Morbidity and mortality among very preterm singletons following fertility treatment in Australia and New Zealand, a population cohort study

© 2017 The Author(s). Background: Due to high rates of multiple birth and preterm birth following fertility treatment, the rates of mortality and morbidity among births following fertility treatment were higher than those conceived spontaneously. However, it is unclear whether the rates of adverse neonatal outcomes remain higher for very preterm (<32 weeks gestational age) singletons born after fertility treatment. This study aims to compare adverse neonatal outcomes among very preterm singletons born after fertility treatment including assisted reproductive technology (ART) hyper-ovulution (HO) and artificial insemination (AI) to those following spontaneous conception. Methods: The population cohort study included 24069 liveborn very preterm singletons who were admitted to Neonatal Intensive Care Unit (NICU) in Australia and New Zealand from 2000 to 2010. The in-hospital neonatal mortality and morbidity among 21753 liveborn very preterm singletons were compared by maternal mode of conceptions: spontaneous conception, HO, ART and AI. Univariate and multivariate binary logistic regression analysis was used to examine the association between mode of conception and various outcome factors. Odds ratio (OR) and adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. Results: The rate of small for gestational age was significantly higher in HO group (AOR 1.52, 95% CI 1.02-2.67) and AI group (AOR 2.98, 95% CI 1.53-5.81) than spontaneous group. The rate of birth defect was significantly higher in ART group (AOR 1.71, 95% CI 1.36-2.16) and AI group (AOR 3.01, 95% CI 1.47-6.19) compared to spontaneous group. Singletons following ART had 43% increased odds of necrotizing enterocolitis (AOR 1.43, 95% CI 1.04-1.97) and 71% increased odds of major surgery (AOR 1.71, 95% CI 1.37-2.13) compared to singletons conceived spontaneously. Other birth and NICU outcomes were not different among the comparison groups. Conclusions: Compared to the spontaneous conception group, risk of congenital abnormality significantly increases after ART and AI; the risk of morbidities increases after ART, HO and AI. Preconception planning should include comprehensive information about the benefits and risks of fertility treatment on the neonatal outcomes

Maintaining a reputation for consistently beating earnings expectations and the slippery slope to earnings manipulation

This paper investigates whether maintaining a reputation for consistently beating analysts’ earnings expectations can motivate executives to move from “within GAAP” earnings management to “outside of GAAP” earnings manipulation. We analyze firms subject to SEC enforcement actions and find that these firms consistently beat analysts’ quarterly earnings forecasts in the three years prior to the manipulation period and continue to do so by smaller “beats” during the manipulation period. We find that manipulating firms beat expectations around 86 percent of the time in the twelve quarters prior to the manipulation period (versus 75 percent for control firms) and that manipulation often ends with a miss in expectations. We document that executives of manipulating firms face strong stock market and CEO pressure to perform. Prior to the manipulation period, these firms have high analyst optimism, growing institutional interest, and high market valuations, along with powerful CEOs. Further, we find that maintaining a reputation for beating expectations is more important than CEO overconfidence and is incremental to CEO equity incentives for explaining manipulation. Our results suggest that pressure to maintain a reputation for beating analysts’ expectations can encourage aggressive accounting and, ultimately, earnings manipulation

Development of an Integrated Chip for Automatic Tracking and Positioning Manipulation for Single Cell Lysis

This study adopted a microelectromechanical fabrication process to design a chip integrated with electroosmotic flow and dielectrophoresis force for single cell lysis. Human histiocytic lymphoma U937 cells were driven rapidly by electroosmotic flow and precisely moved to a specific area for cell lysis. By varying the frequency of AC power, 15 V AC at 1 MHz of frequency configuration achieved 100% cell lysing at the specific area. The integrated chip could successfully manipulate single cells to a specific position and lysis. The overall successful rate of cell tracking, positioning, and cell lysis is 80%. The average speed of cell driving was 17.74 μm/s. This technique will be developed for DNA extraction in biomolecular detection. It can simplify pre-treatment procedures for biotechnological analysis of samples

Defense responses in tomato fruit induced by oligandrin against Botrytis cinerea

Oligandrin is known to induce resistance against a number of plant diseases. However, its effects on postharvest diseases are still unclear. The effects of oligandrin on the control of postharvest diseases in tomato fruit and its underlying mechanisms were investigated in this study. The treat01ent of tomato fruit with oligandrin (10 μg/ml) significantly reduced the incidence and severity of gray mould (caused by Botrytis cinerea). After 5, 7 and 9 days of artificial inoculation, the relative cure effect was 60.5, 52.1 and 48.5%, respectively. The results from bio-assay indicated that the treatment stimulated the activity of the defense related enzymes. Phenylalanine ammonia-lyase (PAL), polyphenol oxidase (PPO) and peroxidase (POD) activity in the oligandrin-treated fruit was about 39.2, 69.6 and 52.6% higher than that in control on the 3rd day, respectively. Furthermore, mRNA level of the genes encoding pathogenesis-related proteins (PRs), such as PR-2a (extracellular β-1, 3 -glucanase) and PR-3a (extracellular chitinase) in tomato fruit was about 2.7-fold and 4.6-fold above that of the control at the peak stage. The expression of LeERF2 and PR6, which confer an ethylene-dependent signaling pathway, were also significantly increased 6.6-fold and 3.6-fold by such treatment. These results indicate that oligandrin has the potential to control gray mould and it may play an important role in the induction of resistance to B. cinerea and the activation of the ethylene-dependent signaling pathway.Key words: Tomato, disease resistance, oligandrin, Botrytis cinerea