Motivating bureaucrats through social recognition: External validity - A tale of two states

This is the final version. Available on open access from Elsevier via the DOI in this recordBureaucratic performance is a crucial determinant of economic growth, but little real-world evidence exists on how to improve it, especially in resource-constrained settings. We conducted a field experiment of a social recognition intervention to improve record keeping in health facilities in two Nigerian states, replicating the intervention – implemented by a single organization – on bureaucrats performing identical tasks. Social recognition improved performance in one state but had no effect in the other, highlighting both the potential benefits and also the sometimeslimited generalizability of behavioral interventions. Furthermore, differences in facility-level observables did not explain cross-state differences in impacts, suggesting that it may often be difficult to predict external validity

A Stability Indicating HPLC Assay Method for Analysis of Rivastigmine Hydrogen Tartrate in Dual-Ligand Nanoparticle Formulation Matrices and Cell Transport Medium

The objective of this study was to develop and validate a method for quantitative analysis of rivastigmine hydrogen tartrate (RHT) in dual-ligand polymeric nanoparticle formulation matrices, drug release medium, and cellular transport medium. An isocratic HPLC analysis method using a reverse phase C 18 column and a simple mobile phase without buffer was developed, optimised, and fully validated. Analyses were carried out at a flow rate of 1.5 mL/min at 50°C and monitored at 214 nm. This HPLC method exhibited good linearity, accuracy, and selectivity. The recovery (accuracy) of RHT from all matrices was greater than 99.2%. The RHT peak detected in the samples of a forced degradation study, drug loading study, release study, and cellular transport study was pure and free of matrix interference. The limit of detection (LOD) and limit of quantification (LOQ) of the assay were 60 ng/mL and 201 ng/mL, respectively. The method was rugged with good intra- and interday precision. This stability indicating HPLC method was selective, accurate, and precise for analysing RHT loading and its stability in nanoparticle formulation, RHT release, and cell transport medium

Changing trends in circulating rotavirus strains in Pune, western India in 2009–2012: Emergence of a rare G9P[4] rotavirus strain

AbstractBackgroundA vast diversity in rotaviruses at inter- and intra-genotypic level underscores the need for monitoring of circulating rotavirus strains. The aim of this study was to update the data on rotavirus disease and strains for the period from January 2009 to December 2012 in Pune, western India which has been one of the sites of the Indian Rotavirus Strain Surveillance Network since November 2005.MethodsChildren aged <5 years admitted for acute gastroenteritis in three different hospitals from Pune city were included in the study. The stool specimens were collected and tested for rotavirus antigen by a commercial enzyme immunoassay. The rotavirus strains were genotyped by multiplex reverse transcription polymerase chain reaction.ResultsDuring the study period, we found 35.1% of 685 stool specimens contained rotavirus antigen. Frequency of rotavirus detection was greatest (58.5%) among children aged 7–12 months. The G1P[8] (31.4%), G2P[4] (20.2%) and G9P[8] (11.8%) strains were the most common types. We noted predominance of G1P[8] strains (39.6%-46.1%) in all the years of study except 2009 wherein G9P[8] strains scored highest level (15.3%). Subsequent to this, we identified G9P[8] strains at the second highest position in 2010, their sudden decline and rise in G9P[4] strains in 2011–2012. We detected G12 strains in combination with P[6] and P[8] at variable rates (0–10.2%) and highest level (27.1%) of mixed rotavirus infections in 2009 as compared to 2010–2012 (0–3.8%).ConclusionThe study highlights the huge burden of rotavirus disease and changing profile of circulating rotavirus strains displaying emergence of G9P[4] reassortant strains in Pune, western India and emphasizes the need to analyze the entire genomic constellation of rotavirus strains for better evaluation of the impact of rotavirus

Overcoming behavioral obstacles to escaping poverty

This is the author accepted manuscriptInternational development policy is ripe for an overhaul. Behavioral science can help policymakers to spur changes in behaviors that are difficult to explain from a conventional economic perspective and impede economic development. We focus here on two well-documented, often-coinciding psychological phenomena that have particularly wide-ranging implications for development policy: present bias (favoring immediate rewards over long-term considerations) and limited attention. We present a number of general policy recommendations that are informed by insight into these phenomena and offer concrete examples of how the recommendations can be implemented to help low-income individuals improve their lives and reach their long-term goals

Detection Efficiencies and Generalized Breakdown Probabilities for Nanosecond-Gated Near Infrared Single-Photon Avalanche Photodiodes

A rigorous model is developed for determining single-photon quantum efficiency (SPQE) of single-photon avalanche photodiodes (SPADs) with simple or heterojunction multiplication regions. The analysis assumes nanosecond gated-mode operation of the SPADs and that band-to-band tunneling of carriers is the dominant source of dark current in the multiplication region. The model is then utilized to optimize the SPQE as a function of the applied voltage, for a given operating temperature and multiplication-region structure and material. The model can be applied to SPADs with In/sub 0.52/Al/sub 0.48/As or InP multiplication regions as well as In/sub 0.52/Al/sub 0.48/As--InP heterojunction multiplication regions for wavelengths of 1.3 and 1.55 /spl mu/m. The predictions show that the SPQE generally decreases with decreasing the multiplication-region thickness. Moreover, an InP multiplication region requires a lower breakdown electric field (and, hence, offers a higher SPQE) than that required by an In/sub 0.52/Al/sub 0.48/As layer of the same width. The model also shows that the fractional width of the In/sub 0.52/Al/sub 0.48/As layer in an In/sub 0.52/Al/sub 0.48/As--InP heterojunction multiplication region can be optimized to attain a maximum SPQE that is greater than that offered by an InP multiplication region. This effect becomes more pronounced in thin multiplication regions as a result of the increased significance of dead space

Management of acute appendicitis during the COVID-19 pandemic : a retrospective cohort study

Background: The Coronavirus Disease 2019 (COVID-19) pandemic profoundly impacted delivery of health care. South Western Sydney Local Health District (SWSLHD) experienced some of the highest cases, admissions and deaths during the Delta and Omicron waves in New South Wales. This study aims to determine the impact of the pandemic on emergency surgery services for adults presenting with acute appendicitis. Methods: A retrospective review of patient records was performed of adults presenting with acute appendicitis between 1st March 2021 and 31st March 2022, which was compared to a pre-COVID control period of the same dates in 2019–2020. Patients managed operatively or conservatively were included. Results: 1556 patients were included in the operative arm; 723 and 833 respectively in the study and control groups, which were comparable at baseline. 1.66% were COVID positive. During the pandemic, patients were significantly more likely to be investigated with computered tomography (CT) scan (p ≤ 0.001), present with complicated appendicitis (p = 0.03), and require caecectomy (p = 0.005). They had higher American Society of Anaesthesiology (ASA) scores (p = 0.001) and significantly lower negative appendectomy rates (p = 0.001). Fifty-two patients were included in the conservative arm; 29 and 23 respectively in the pandemic and control groups. Patients were comparable at baseline. There were two COVID positive patients. During the pandemic, there was a significant reduction in complications (p = 0.033), readmissions (0.044) and interval appendicectomy (p = 0.0044). Conclusion: We identified higher rates of complicated appendicitis, caecectomies and greater reliance on CT imaging preoperatively during the pandemic in SWSLHD

Combinatorial pharmacodynamics of polymyxin B and tigecycline against heteroresistant Acinetobacter baumannii

The prevalence of heteroresistant Acinetobacter baumannii is increasing. Infections due to these resistant pathogens pose a global treatment challenge. Here, the pharmacodynamic activities of polymyxin B (PMB) (2–20 mg/L) and tigecycline (0.15–4 mg/L) were evaluated as monotherapy and in combination using a 4 × 4 concentration array against two carbapenem-resistant and polymyxin-heteroresistant A. baumannii isolates. Time Kill Experiments was employed at starting inocula of 106 and 108 CFU/mL over 48 h. Clinically relevant combinations of PMB (2 mg/L) and tigecycline (0.90 mg/L) resulted in greater reductions in the bacterial population compared with polymyxin alone by 8 h (ATCC 19606, −6.38 vs. −3.43 log10 CFU/mL; FADDI AB115, −1.38 vs. 2.08 log10 CFU/mL). At 10× the clinically achievable concentration (PMB 20 mg/L in combination with tigecycline 0.90 mg/L), there was bactericidal activity against FADDI AB115 by 4 h that was sustained until 32 h, and against ATCC 19606 that was sustained for 48 h. These studies show that aggressive polymyxin-based dosing in combination with clinically achievable tigecycline concentrations results in early synergistic activity that is not sustained beyond 8 h, whereas combinations with higher tigecycline concentrations result in sustained bactericidal activity against both isolates at both inocula. These results indicate a need for optimised front-loaded polymyxin-based combination regimens that utilise high polymyxin doses at the onset of treatment to achieve good pharmacodynamic activity whilst minimising adverse events