“Mind the Gap” Addressing the Gap Between Health Care Policy & Health Care Reality in Madagascar & the Way Forward Integrating Traditional Medicine & Ethical Reform Within Health Care

At first glance the health care system in Madagascar looks pretty good. No health care system is perfect, in fact most are far from perfect, but some certainly work better than others. On paper it seems that the current system in Madagascar would be among those that “work better”. Sadly, there is oftentimes a disconnect between what a government writes on paper and what happens in reality; looking around the streets of Antananarivo it quickly became apparent that Madagascar is an example of this disconnect. You do not have to be a health care professional to see the lack of medical care among the people of Antananarivo. The city is filled with an overwhelming presence of poverty and illness, as is the rest of the country. Despite the idealistic claims of the government and the supposedly “free” access to medical care in public facilities, it is clear that the current health care system is not working in practice. Policy and practice are not the same thing. Even the best (and good intentioned) policies can crumble and deteriorate when they are actually implemented. There are many factors that can determine how effective the policy actually is. In health care policies these factors are extensive. There are economic, cultural, environmental, religious, political and ethical issues at play. I hope to better understand both the health care system in place in Madagascar and the factors that are influencing its efficiency and effectiveness. From there I will explore the ways in which the system could be improved through the integration of traditional medicine. If we can understand why a policy is unable to translate into reality, we have a better chance of discovering the best possible ways to improve it

Groundwork for the Development of Testing Plans for Concurrent Software

While multi-threading has become commonplace in many application domains (e.g., embedded systems, digital signal processing (DSP), networks, IP services, and graphics), multi-threaded code often requires complex co-ordination of threads. As a result, multi-threaded implementations are prone to subtle bugs that are difficult and time-consuming to locate. Moreover, current testing techniques that address multi-threading are generally costly while their effectiveness is unknown. The development of cost-effective testing plans requires an in-depth study of the nature, frequency, and cost of concurrency errors in the context of real-world applications. The full paper will lay the groundwork for such a study, with the purpose of informing the creation of a parametric cost model for testing multi-threaded software. The current version of the paper provides motivation for the study, an outline of the full paper, and a bibliography of related papers

Phosphate and Selective Anion Removal of Waste Water in Industrial Systems

Phosphorous is an essential nutrient for a functioning water ecosystem, however, heightened levels caused by waste water and agriculture can be damaging. High levels of PO43- cause toxic algae blooms, which kill wildlife and contaminate drinking water supplies. Therefore, cheap, efficient phosphate removal systems are beneficial for commercial settings in order to meet governmental standards. Similar research and technology can aid in the removal of toxic heavy metals in industrial waste water. Using a packed column with solid supported media, both phosphate and other selective anions were successfully removed from water. This was confirmed by inductively coupled plasma analysis. Constraints for this deliverable would include reagent cost as well as governmental regulations concerning substances in waste water. Another consideration was the ability to reuse spent columns through regeneration techniques. By creating a small scale column system, the team tested the effective removal of selective anions from water sources while keeping in mind the contact time and loading capacity of metals onto the media. Through design of experiment, optimal results were obtained. For removal, it was determined that, the higher the loading of the metal along with 4 minute contact times allowed for optimal removal. The most efficient media and regenerative were also determined. Future considerations should involve a real time controller to obtain instant analytical data allowing users to know when columns need to be regenerated. This ensures minimal waste of reagent during removal. This design is applicable to companies concerned with the environmental impact of their waste water.https://scholarscompass.vcu.edu/capstone/1086/thumbnail.jp

The Role of Fragile Sites in Sporadic Papillary Thyroid Carcinoma

The incidence of thyroid cancer is increasing, especially papillary thyroid carcinoma (PTC), making it currently the fastest-growing cancer among women. Reasons for this increase remain unclear, but several risk factors including radiation exposure and improved detection techniques have been suggested. Recently, the induction of chromosomal fragile site breakage was found to result in the formation of RET/PTC1 rearrangements, a common cause of PTC. Chromosomal fragile sites are regions of the genome with a high susceptibility to forming DNA breaks and are often associated with cancer. Exposure to a variety of external agents can induce fragile site breakage, which may account for some of the observed increase in PTC. This paper discusses the role of fragile site breakage in PTC development, external fragile site-inducing agents that may be potential risk factors for PTC, and how these factors are especially targeting women

Transcriptomic profiling of Leishmania parasites and host macrophages during an infection

Leishmania parasites cause leishmaniasis, a group of diseases that range in manifestations from skin lesions to fatal visceral disease. The parasite's life cycle is divided between its insect vector and its mammalian host, where it resides primarily inside of macrophages. Once intracellular, Leishmania parasites must avoid being killed by the innate and adaptive immune responses. We performed transcriptomic profiling using RNA-seq to simultaneously identify global changes in gene expression in Leishmania parasites across multiple lifecycle stages and in infected macrophages from both murine and human hosts. Using a novel approach based on a dual statistical test to identify genes that were differentially expressed relative to both uninfected macrophages and macrophages that had ingested inert particles, we were able to filter out genes that were differentially regulated as part of a general phagocytic response and thereby select genes specific to Leishmania infection. The most substantial and dynamic Leishmania-specific differential expression responses were observed during early infection, while changes observed later were common to phagocytosis more generally. An evaluation of RNA processing events within the parasite revealed precise UTR boundaries for a majority of genes and widespread alternative trans-splicing and polyadenylation. Collection of data from multiple biological replicates, the use of matched host control samples, careful statistical analysis of variation, and removal of batch effects enabled the detection of biological differences between samples and timepoints with high confidence and sensitivity. Pathway and gene ontology analyses provided insights into the higher level processes activated across parasite developmental stages and during intracellular infection to reveal signatures of Leishmania differentiation and infection

DNA Instability at Chromosomal Fragile Sites in Cancer

Human chromosomal fragile sites are specific genomic regions which exhibit gaps or breaks on metaphase chromosomes following conditions of partial replication stress. Fragile sites often coincide with genes that are frequently rearranged or deleted in human cancers, with over half of cancer-specific translocations containing breakpoints within fragile sites. But until recently, little direct evidence existed linking fragile site breakage to the formation of cancer-causing chromosomal aberrations. Studies have revealed that DNA breakage at fragile sites can induce formation of RET/PTC rearrangements, and deletions within the FHIT gene, resembling those observed in human tumors. These findings demonstrate the important role of fragile sites in cancer development, suggesting that a better understanding of the molecular basis of fragile site instability is crucial to insights in carcinogenesis. It is hypothesized that under conditions of replication stress, stable secondary structures form at fragile sites and stall replication fork progress, ultimately resulting in DNA breaks. A recent study examining an FRA16B fragment confirmed the formation of secondary structure and DNA polymerase stalling within this sequence in vitro, as well as reduced replication efficiency and increased instability in human cells. Polymerase stalling during synthesis of FRA16D has also been demonstrated. The ATR DNA damage checkpoint pathway plays a critical role in maintaining stability at fragile sites. Recent findings have confirmed binding of the ATR protein to three regions of FRA3B under conditions of mild replication stress. This review will discuss recent advances made in understanding the role and mechanism of fragile sites in cancer development

Learning Through Serving: Learning Service-Learning Pedagogy to Enhance your Teaching

This workshop is geared toward faculty and staff at universities who would want to integrate service learning into their courses as well as community partners who would like to explore a service-learning opportunity with a campus partner. The definition of service learning and how it is different from other forms of experiential learning will be discussed. Concepts will be illustrated using a short video clip and other real life examples. The service learning criteria of Meaningful Service, Enhanced Academic Learning, and Purposeful Civic Learning will be identified. The application of these criteria will be illustrated through BGSU service-learning courses - the Listening Post and Small Group Communication are two courses that have integrated older adults into the curriculum. Specific examples and strategies will be described. The role and importance of continuous reflection will be described. Participants will receive handouts on the What, So What, Now What model and the DEAL Model of Critical Reflection. Emphasis on the mutual benefit for community partners will be shared along with best practices in Community Partnerships.Participants will have the opportunity to brainstorm potential courses and community partnerships for service-learning. Using an Action Plan handout, faculty and staff participants will identify new or existing courses at their institutions to apply service-learning pedagogy, identify one learning objective related to each criteria, list potential community partner to support learning objectives, and list potential challenges. Community partner participants and practitioners will have the opportunity to develop a partnership action plan. They will receive a similar Action Plan handout to brainstorm how their organization might be able to utilize a service-learning partnership; identifying potential projects, why they would fit as service-learning, and what action steps they could take to initiate a partnership with a local campus. Additional resources for service-learning will be identified including Ohio Campus Compact (funding, program models), Campus Compact syllabi database, and Offices of Service-Learning on various campuses

A drug repurposing screen identifies decitabine as an HSV-1 antiviral

Herpes simplex virus type 1 (HSV-1) is a highly prevalent human pathogen that causes a range of clinical manifestations, including oral and genital herpes, keratitis, encephalitis, and disseminated neonatal disease. Despite its significant health and economic burden, there is currently only a handful of approved antiviral drugs to treat HSV-1 infection. Acyclovir and its analogs are the first-line treatment, but resistance often arises during prolonged treatment periods, such as in immunocompromised patients. Therefore, there is a critical need to identify novel antiviral agents against HSV-1. Here, we performed a drug repurposing screen, testing the ability of 1,900 safe-in-human drugs to inhibit HSV-1 infection in vitro. The screen identified decitabine, a cytidine analog that is used to treat myelodysplastic syndromes and acute myeloid leukemia, as a potent anti-HSV-1 agent. We show that decitabine is effective in inhibiting HSV-1 infection in multiple cell types, including human keratinocytes, that it synergizes with acyclovir, and acyclovir-resistant HSV-1 is still sensitive to decitabine. We further show that decitabine causes G > C and C > G transversions across the viral genome, suggesting it exerts its antiviral activity by lethal mutagenesis, although a role for decitabine’s known targets, DNA methyl-transferases, has not been ruled out

Absolute quantitative real-time polymerase chain reaction for the measurement of human papillomavirus E7 mRNA in cervical cytobrush specimens

BACKGROUND: Few reports of the utilization of an accurate, cost-effective means for measuring HPV oncogene transcripts have been published. Several papers have reported the use of relative quantitation or more expensive Taqman methods. Here, we report a method of absolute quantitative real-time PCR utilizing SYBR-green fluorescence for the measurement of HPV E7 expression in cervical cytobrush specimens. RESULTS: The construction of a standard curve based on the serial dilution of an E7-containing plasmid was the key for being able to accurately compare measurements between cervical samples. The assay was highly reproducible with an overall coefficient of variation of 10.4%. CONCLUSION: The use of highly reproducible and accurate SYBR-based real-time polymerase chain reaction (PCR) assays instead of performing Taqman-type assays allows low-cost, high-throughput analysis of viral mRNA expression. The development of such assays will help in refining the current screening programs for HPV-related carcinomas

Auditoría de gestión al Hospital de Especialidades San Juan S.A, de la ciudad de Riobamba provincia de Chimborazo, periodo 2012

En el presente trabajo proponemos la Auditoría de Gestión al Hospital de Especialidades San Juan S.A, de la ciudad de Riobamba, Provincia de Chimborazo, período 2012, en el cual se emiten conclusiones y recomendaciones razonables que contribuyan al eficiente desarrollo de las actividades del centro hospitalario y mejorar el desempeño del personal. La Auditoría que desarrollamos parte de un diagnóstico general para recopilar información sobre el funcionamiento actual de la empresa, para considerar las áreas críticas a auditarse, evaluación a los procesos aplicando técnicas de auditoría. Además se evalúo al sistema de control interno, evaluación de los procesos operativos, aplicamos indicadores de gestión como los de eficiencia, eficacia, economía, ética; y más pruebas de auditoría suficientes y pertinentes para determinarlos hallazgos, obteniendo como resultado el informe final de la auditoría de gestión que aporte a la toma de correctivos en la gestión empresarial. Auditoría de Gestión al Hospital de Especialidades San Juan S.A, de la ciudad de Riobamba, Provincia de Chimborazo, período 2012; se ha efectuado en base a la información proporcionada y recaba, la colaboración del personal y directivos de la empresa hospitalaria, a más de la observación directa, material bibliográfico y virtual que sustanció el trabajo práctico que realizamos. El informe de Auditoría de Gestión presentado se constituirá en una herramienta de apoyo importante para la gestión institucional del Hospital San Juan S.A., a sus directivos y su personal operativo que permitirá mejorar los procesos y actividades existentes en la empresa, por lo que se sugiere se aplique en su contexto. Las autoridades del Hospital San Juan deberán analizar las conclusiones y aplicar las recomendaciones emitidas en el informe final de auditoría de gestión, orientadas a corregir las posibles desviaciones encontradas durante el examen.In this paper we propose the Auditing to the “Hospital de Especialidades San Juan” S.A. in the city of Riobamba, Chimborazo Province, period 2012, in which reasonable conclusions and recommendations that contribute to the efficient development of the hospital and improve staff performance are issued. The Audit was developed, begins with a general diagnosis to gather information about the current operation of the business, to consider the critical areas audited, assessment processes using audit techniques. Also evaluated the internal control system, evaluation of business processes, we apply management indicators of efficiency, effectiveness, economy, ethics and evidence of sufficient and appropriate audit to determine the findings, resulting in the audit report management that contributes to making corrections in business management. The management audit to the “Hospital de Especialidades San Juan ” S.A. in the city of Riobamba, Chimborazo Province, period 2012; has been made based on the information provided and collected, staff collaboration and management of hospital business, more direct observation, bibliographic and virtual material that substantiated the practical work we do. The Audit Report Management was submitted, it will become an important support tool for the institutional management of the “Hospital San Juan” S.A. their managers and operational staff which will improve existing processes and activities in the company, so it is suggested that applies in context. The authorities of the “Hospital San Juan” should analyze the findings and implement the recommendations in the final report of audit, designed to correct any deviations found during the examination