Mohammed-Awel, Jemal; Numfor, Eric
2017-03-01
We propose and study a mathematical model for malaria-HIV co-infection transmission and control, in which malaria treatment and insecticide-treated nets are incorporated. The existence of a backward bifurcation is established analytically, and the occurrence of such backward bifurcation is influenced by disease-induced mortality, insecticide-treated bed-net coverage and malaria treatment parameters. To further assess the impact of malaria treatment and insecticide-treated bed-net coverage, we formulate an optimal control problem with malaria treatment and insecticide-treated nets as control functions. Using reasonable parameter values, numerical simulations of the optimal control suggest the possibility of eliminating malaria and reducing HIV prevalence significantly, within a short time horizon.
2014-01-01
Background Insecticide-treated bed nets (ITNs), used extensively to reduce human exposure to malaria, work through physical and chemical means to block or deter host-seeking mosquitoes. Despite the importance of ITNs, very little is known about how host-seeking mosquitoes behave around occupied bed nets. As a result, evidence-based evaluations of the effects of physical damage on bed net effectiveness are not possible and there is a dearth of knowledge on which to base ITN design. Methods The dispersion of colony-raised female Anopheles gambiae and Anopheles albimanus was observed in 2-hr laboratory experiments in which up to 200 mosquitoes were released inside a mosquito-proof 3 m × 3 m tent housing a bed net arrayed with 18 30 cm × 30 cm sticky screen squares on the sides, ends and roof. Numbers of mosquitoes caught on the sticky squares were interpreted as the ‘mosquito pressure’ on that part of the net. Results Presence of a human subject in the bed net significantly increased total mosquito pressure on the net for both species and significantly re-oriented An. gambiae to the roof of the net. Anopheles albimanus pressure was greatest on the bed net roof in both host-present and no-host conditions. The effects of different human subjects in the bed net, of different ambient conditions (dry, cool conditions vs warm, humid conditions) and of bed net treatment (deltamethrin-treated or no insecticide) on mosquito pressure patterns were tested for both species. Species-specific pressure patterns did not vary greatly as a result of any of these factors though some differences were noted that may be due the size of the different human subjects. Conclusions As a result of the interaction between host-seeking responses and the convective plume from the net occupant, species-specific mosquito pressure patterns manifest more or less predictably on the bed net. This has implications for bed net design and suggests that current methods of assessing damaged bed nets, which do not take damage location into account, should be modified. PMID:25080389
Kayedi, Mohammad Hassan; Khamisabadi, Kiumars; Haghdoost, Ali Akbar; Kayedi, Zohreh; Fallahi, Shirzad; Abdali, Nargess
2017-01-01
ABSTRACT The aim of the present study was to examine the resistance of PermaNet® 2.0 bed nets against repeated washing and environmental factors by using bioassay tests. After 5, 15 and 21 washings with detergents and by using bioassay tests, the resistance of 40 PermaNet® 2.0 bed nets was compared with that of 40 bed nets conventionally treated with one K-O tablet. To examine the long-term resistance, 31 PermaNet® 2.0 bed nets were also distributed among villagers, and were re-collected to perform bioassay tests after 1, 2 and 5 years. In the first phase of this study, the insecticidal effect of the conventionally-treated nets significantly decreased due to repeated washings (P < 0.001); however, it was not significant regarding PermaNet® 2.0 bed nets (P = 0.92 in continuous exposure and P = 0.12 in mortality tests). In the long-term phase of this study, the time required for knockdown of PermaNet® 2.0 increased over the first 2 years and then decreased. In addition, the mortality rate decreased over the first 2 years and then increased. In conclusion, it seems that the technique used by the manufacturer for impregnation of PermaNet® 2.0 bed nets has an acceptable efficiency in comparison with conventional techniques. PMID:28423093
Sahu, S S; Vijayakumar, T; Kalyanasundaram, M; Subramanian, S; Jambulingam, P
2008-09-01
Insecticide treated mosquito nets are increasingly being used in malaria control programmes. One of the problems with the treatment of bed nets with conventional formulations of insecticides was that regular washing of treated nets diminish insecticidal effect. Lambdacyhalothrin 2.5 capsule suspension (CS) (2.5% a.i., w/v), a new water-based microencapsulated formulation is reported to have wash-resistant property and longer persistence on the netting material than other formulations. We evaluated the impact of the use of nylon bed nets treated with lambdacyhalothrin 2.5 CS at 10 mg (a.i.)/m(2) in comparison to untreated nets and no nets on malaria in tribal villages in Orissa. Nine foothill villages, highly endemic for falciparum malaria, from the Primary Health Centre (PHC) areas of Khairput and Kudumulugumma of Malkangiri district, Orissa, were divided into three groups, each with a population of about 500 and allocated randomly for treated (TN) and untreated nets (UN) and no nets (NN). Bed nets were distributed in September 2001 and retreatment was done in June 2002. The impact was assessed based on the changes in vector density, parous rate, malaria incidence and parasite rates. Indoor-resting collections of Anopheles fluviatilis and An. culicifacies were made at fortnightly intervals from fixed human dwellings. Mass blood surveys before and after distribution of nets and fortnightly active surveillance were carried out to assess the change in parasite rates and malaria incidence. Bioassays were conducted at fortnightly intervals on the bed nets supplied to the villagers. The reductions in indoor resting catches of An. fluviatilis and An. culicifacies were 96 and 38 per cent in villages with treated nets and 2.6 and 23 per cent in villages with untreated nets respectively compared to no net villages. For six months following treatment, 100 per cent mortality of An. fluviatilis was observed on the unwashed nets and on the nets washed once or twice. After re-treatment, 100 per cent mortality of An. fluviatilis or An. culicifacies was observed for nine months even after two washes. Usage rates of treated and untreated nets varied seasonally; 58.9 and 46.3 per cent in rainy season, 48.6 and 37.1 per cent in winter season and 38.1 and 31.6 per cent in summer season respectively. Reductions in malaria parasite rates were about 65 per cent in the treated net villages and 39 per cent in the untreated net villages compared to no net villages. About 75 per cent of treated nets and 60 per cent of untreated nets were in usable condition 19 months after distribution. The estimated protection factor based on malaria incidence was 86 per cent for the treated nets during both post-treatment and post-retreatment periods and 34 and 51 per cent for untreated nets for the corresponding periods compared to no nets. The results of the study showed that the use of bed nets treated nets with CS formulation of lambdacyhalothrin at 10 mg (a.i.)/m(2) was acceptable to the community and re-treatment of nets at nine-monthly intervals can significantly reduce density and survival of An. fluviatilis and incidence of falciparum malaria.
Spitzen, Jeroen; Koelewijn, Teun; Mukabana, W Richard; Takken, Willem
2017-08-01
Insecticide-treated nets are currently a major tool to reduce malaria transmission. Their level of repellency affects contact of the mosquito with the net, but may also influence the mosquito's entry into the house. The response of host-seeking malaria mosquitoes approaching the eave of an experimental house was recorded within a large screen house. We compared entry- and exit rates in relation to the presence in the house of different insecticide-treated bed nets (ITNs) with an untreated net. Mosquitoes were lured towards the house by dispensing a synthetic host-odour blend from within the net in the house. Complementary WHO bioassays revealed that the treated nets caused high knock-down- and mortality responses to the Anopheles gambiae sensu stricto strain tested. The proportion of mosquitoes that came into view of the cameras and subsequently entered the house did not differ between treated nets and the untreated net. Treated nets did not affect proportions of mosquitoes that exited the house and departed from view around the eave. However, the percentage of house-leaving and re-entering mosquitoes when an insecticide- treated net was present, was lower than in the presence of an untreated net. Our results indicated that there was no spatial repellent effect from pyrethroid-treated nets that influences house-entry at eave level. It is argued that the toxic effect of treated bed nets resulted in a reduced number of mosquitoes re-entering the house, which could thereby affect malaria transmission in neighbouring, unprotected houses. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Luxemburger, C; Perea, W A; Delmas, G; Pruja, C; Pecoul, B; Moren, A
1994-01-01
A double-blind controlled trial was undertaken from August 1990 to February 1991 among Karen children on the Thai-Burmese border to evaluate the effects on malaria incidence and prevalence of permethrin-treated bed nets. Three hundred and fifty schoolchildren, aged 4 to 15 years, were allocated at random to receive either a permethrin-impregnated net or a non-treated net. The incidence of malaria infections, confirmed by a blood film, was assessed during 6 months. Three surveys were conducted, on admission and 3 and 6 months later, to measure the prevalence of infections and spleen rates. Compliance was assessed by monthly home visiting. The use of permethrin-treated bed nets reduced the number of parasitaemic Plasmodium falciparum infections by 38% and the number of symptomatic episodes by 42%. The number of P. vivax malaria attacks was similar in each group. The prevalence of positive blood films in the 2 groups did not change significantly during the study. A reduction in spleen rate by 50% in both groups at the end of the study period could not be related to the overall use of nets. Compliance was high and no side-effect was reported. The long-term effects on morbidity and mortality need to be assessed after distribution of permethrin treated bed nets at the village level.
Navy Entomologists Assist CDC’s Fight Against Malaria
2013-01-01
long - lasting insec- ticide treated bed nets (LLINs): 2) indoor residual spraying (IRS) of living quarters using long - lasting residual ... insecticide susceptible malaria mosquitoes for residual insecticide testing of IRS sprayed walls and long lasting insecticide -treated bed nets . which is...the Navy Entomology Center of Excellence sprays panels, made of materials
Gu, Weidong; Novak, Robert J
2009-11-16
Insecticide-treated bed nets (ITNs), including long-lasting insecticidal nets (LLINs), play a primary role in global campaigns to roll back malaria in tropical Africa. Effectiveness of treated nets depends on direct impacts on individual mosquitoes including killing and excite-repellency, which vary considerably among vector species due to variations in host-seeking behaviours. While monitoring and evaluation programmes of ITNs have focuses on morbidity and all-cause mortality in humans, local entomological context receives little attention. Without knowing the dynamics of local vector species and their responses to treated nets, it is difficult to predict clinical outcomes when ITN applications are scaled up across African continent. Sound model frameworks incorporating intricate interactions between mosquitoes and treated nets are needed to develop the predictive capacity for scale-up applications of ITNs. An established agent-based model was extended to incorporate the direct outcomes, e.g. killing and avoidance, of individual mosquitoes exposing to ITNs in a hypothetical village setting with 50 houses and 90 aquatic habitats. Individual mosquitoes were tracked throughout the life cycle across the landscape. Four levels of coverage, i.e. 40, 60, 80 and 100%, were applied at the household level with treated houses having only one bed net. By using Latin hypercube sampling scheme, parameters governing killing, diverting and personal protection of net users were evaluated for their relative roles in containing mosquito populations, entomological inoculation rates (EIRs) and malaria incidence. There were substantial gaps in coverage between households and individual persons, and 100% household coverage resulted in circa 50% coverage of the population. The results show that applications of ITNs could give rise to varying impacts on population-level metrics depending on values of parameters governing interactions of mosquitoes and treated nets at the individual level. The most significant factor in determining effectiveness was killing capability of treated nets. Strong excito-repellent effect of impregnated nets might lead to higher risk exposure to non-bed net users. With variabilities of vector mosquitoes in host-seeking behaviours and the responses to treated nets, it is anticipated that scale-up applications of INTs might produce varying degrees of success dependent on local entomological and epidemiological contexts. This study highlights that increased ITN coverage led to significant reduction in risk exposure and malaria incidence only when treated nets yielded high killing effects. It is necessary to test efficacy of treated nets on local dominant vector mosquitoes, at least in laboratory, for monitoring and evaluation of ITN programmes.
Ndjinga, Julie K; Minakawa, Noboru
2010-10-12
Malaria is the most prominent disease in the Democratic Republic of the Congo (DRC), and long-lasting insecticide-treated nets (LLINs) have been distributed free of charge since 2006 to combat the disease. However, the success of this bed net campaign depends on sufficient bed net use in all age groups. This study was designed to examine the factors affecting bed net use in villages outside of Kinshasa. Two villages along the Congo River, totalling 142 households with 640 residents, were surveyed using a standard questionnaire. The interview determined the number, ages, and sexes of family members; the education level of the family head; the number, colour, and type of nets owned; and the number of nets used in the previous night. The size of house was also measured, and numbers of rooms and beds were recorded. These variables were examined to reveal important factors that affect bed net use. A total of 469 nets were counted, and nearly all nets were white LLINs. Of these nets, 229 (48.8%) nets were used by 284 (44.4%) residents. Bed nets were used by over 90% of children 5 to 15 years of age, whereas less than 50% of the residents in other age groups used bed nets. The important variables affecting bed net use were numbers of beds and rooms in the house and the education level of the family head of household. Education was the most important factor affecting bed net use in the villages outside Kinshasa. Development of an educational programme, particularly one directed toward parents, is necessary to reduce misconceptions and increase prevalence of bed net use among all age groups.
Xu, Jian-wei; Liao, Yuan-mei; Liu, Hui; Nie, Ren-hua; Havumaki, Joshua
2014-01-01
Insecticide-treated nets (ITNs) are an integral part of vector control recommendations for malaria elimination in China. This study investigated the extent to which bed nets were used and which factors influence bed net use among Jinuo Ethnic Minority in China-Myanmar-Laos border areas. This study combined a quantitative household questionnaire survey and qualitative semi-structured in-depth interviews (SDI). Questionnaires were administered to 352 heads of households. SDIs were given to 20 key informants. The bed net to person ratio was 1∶2.1 (i.e., nearly one net for every two people), however only 169 (48.0%) households owned at least one net and 623 (47.2%) residents slept under bed nets the prior night. The percentages of residents who regularly slept under nets (RSUN) and slept under nets the prior night (SUNPN) were similar (48.0% vs. 47.2%, P>0.05), however the percentage correct use of nets (CUN) was significantly lower (34.5%, P<0.0001). The annual cash income per person (ACIP) was an independent factor that influenced bed net use (P<0.0001), where families with an ACIP of CNY10000 or more were much more likely to use nets. House type was strongly associated with bed net use (OR: 4.71, 95% CI: 2.81, 7.91; P<0.0001), where those with traditional wood walls and terracotta roofs were significantly more likely to use nets, and the head of household's knowledge was an independent factor (OR: 5.04, 95% CI: 2.72, 9.35; P<0.0001), where those who knew bed nets prevent malaria were significantly more likely to use nets too. High bed net availability does not necessarily mean higher coverage or bed net use. Household income, house type and knowledge of the ability of bed nets to prevent malaria are all independent factors that influence bed net use among Jinuo Ethnic Minority.
Gimnig, John E; Vulule, John M; Lo, Terrence Q; Kamau, Luna; Kolczak, Margarette S; Phillips-Howard, Penelope A; Mathenge, Evan M; ter Kuile, Feiko O; Nahlen, Bernard L; Hightower, Allen W; Hawley, William A
2003-04-01
The effect of permethrin-treated bed nets (ITNs) on malaria vectors was studied as part of a large-scale, randomized, controlled trial in western Kenya. Indoor resting densities of fed Anopheles gambiae s.l. and An. funestus in intervention houses were 58.5% (P = 0.010) and 94.5% (P = 0.001) lower, respectively, compared with control houses. The sporozoite infection rate in An. gambiae s.l. was 0.8% in intervention areas compared with 3.4% (P = 0.026) in control areas, while the sporozoite infection rates in An. funestus were not significantly different between the two areas. We estimated the overall transmission of Plasmodium falciparum in intervention areas to be 90% lower than in control areas. Permethrin resistance was not detected during the study period. As measured by densities of An. gambiae s.l., the efficacy of bed nets decreased if one or more residents did not sleep under a net or if bed nets had not been re-treated within six months. These results indicate that ITNs are optimally effective if used every night and if permethrin is reapplied at least biannually.
Ernst, Kacey C; Erly, Steven; Adusei, Charity; Bell, Melanie L; Kessie, David Komla; Biritwum-Nyarko, Alberta; Ehiri, John
2017-01-04
Despite progress made in the last decades, malaria persists as a pressing health issue in sub-Saharan Africa. Pregnant women are particularly vulnerable to infection and serious health outcomes for themselves and their unborn child. Risk can be mitigated through appropriate use of control measures such as insecticide-treated bed nets. Although social networks can influence uptake of preventive strategies, the role of social influence on bed net ownership has not been explored. During an evaluation of a bed net distribution programme, the influence of non-health care advisors on ownership and use of bed nets by pregnant women in Kumasi, Ghana was examined. Data were collected through in-person interviews with 300 pregnant women seeking antenatal care in an urban hospital in Kumasi, Ghana. Participants were asked about their bed net ownership, bed net use, and information about three personal contacts that they go to for pregnancy advice. Information about these advisors was combined into an influence score. Logistic regression models were used to determine the association between the score and bed net ownership. Those who owned a bed net were further assessed to determine if interpersonal influence was associated with self-reported sleeping under the bed net the previous night. Of the 294 women in the analysis, 229 (78%) reported owning bed nets. Of these bed net owners, 139 (61%) reported using a bed net the previous night. A dose response relationship was observed between the interpersonal influence score and bed net ownership and use. Compared to the lowest influence score, those with the highest influence score (>1 SD above the mean) were marginally more likely to own a bed net [OR = 2.37, 95% CI (0.87, 6.39)] and much more likely to use their bed net [5.38, 95% CI (1.89, 15.25)] after adjusting for other factors. Interpersonal influence appears to have modest impact on ownership and use of bed nets by pregnant women in an urban area of Ghana. Further investigations would need to be conducted to determine if the relationship is causal or if individuals who associate are simply more likely to have similar practices.
Bed net ownership in Kenya: the impact of 3.4 million free bed nets
2010-01-01
Background In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated. Methods A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data. Results In targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%). Conclusions The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels. PMID:20576145
Bed net ownership in Kenya: the impact of 3.4 million free bed nets.
Hightower, Allen; Kiptui, Rebecca; Manya, Ayub; Wolkon, Adam; Vanden Eng, Jodi Leigh; Hamel, Mary; Noor, Abdisalan; Sharif, Shahnaz K; Buluma, Robert; Vulule, John; Laserson, Kayla; Slutsker, Laurence; Akhwale, Willis
2010-06-24
In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated. A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data. In targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%). The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.
The association between household bed net ownership and all-cause child mortality in Madagascar.
Meekers, Dominique; Yukich, Joshua O
2016-09-17
Malaria continues to be an important cause of morbidity and mortality in Madagascar. It has been estimated that the malaria burden costs Madagascar over $52 million annually in terms of treatment costs, lost productivity and prevention expenses. One of the key malaria prevention strategies of the Government of Madagascar consists of large-scale mass distribution campaigns of long-lasting insecticide-treated bed nets (LLIN). Although there is ample evidence that child mortality has decreased in Madagascar, it is unclear whether increases in LLIN ownership have contributed to this decline. This study analyses multiple recent cross-sectional survey data sets to examine the association between household bed net ownership and all-cause child mortality. Data on household-level bed net ownership confirm that the percentage of households that own one or more bed nets increased substantially following the 2009 and 2010 mass LLIN distribution campaigns. Additionally, all-cause child mortality in Madagascar has declined during the period 2008-2013. Bed net ownership was associated with a 22 % reduction in the all-cause child mortality hazard in Madagascar. Mass bed net distributions contributed strongly to the overall decline in child mortality in Madagascar during the period 2008-2013. However, the decline was not solely attributable to increases in bed net coverage, and nets alone were not able to eliminate most of the child mortality hazard across the island.
2010-01-01
treatment for uncomplicated malaria, whether confirmed, or suspected, in 2004 and SIP- based IPTp was introduced in 2005.1•3 Indoor residual spray - ing...emigrations recorded. Although many women may have been using long - lasting ITNs during pregnancy, this quality of the bed nets could not be determined with...care, provision and wide use of insecticide -treated bed nets (ITNs), and intensified health education. Ghana readily adopted and began implementa
Dhawan, Gaurav; Joseph, Nidhin; Pekow, Penelope S; Rogers, Christine A; Poudel, Krishna C; Bulzacchelli, Maria T
2014-08-07
India accounts for the highest number of malaria cases outside of Africa. Eighty per cent of India's population lives in malaria-risk areas, with cases increasing in urban areas. Mumbai, India, one of the most populous cities in the world, has experienced such an increase. To be successful, many malaria control efforts require community participation, which in turn depends on individuals' knowledge and awareness of the disease. This study assessed the knowledge and prevention practices regarding malaria in residents of four different areas of Mumbai, India, around the time of a malaria outbreak and the start of a widespread awareness campaign. A cross-sectional comparative study assessed malaria-related knowledge and prevention practices in four geographically and socio-demographically distinct areas of Mumbai, India. A structured interviewer-administered questionnaire was administered to a stratified random sample of 119 households between 16 December 2010 and 30 January 2011. Participant socio-demographic characteristics, malaria knowledge, malaria prevention practices, and household environmental factors were examined overall and compared across the four areas of Mumbai. Overall, respondents had excellent knowledge of the mosquito as the means of transmission of malaria, mosquito biting times and breeding sites, and fever as a symptom of malaria. However, many respondents also held misconceptions about malaria transmission and symptoms. Respondents generally knew that bed nets are an effective prevention strategy, but only 30% used them, and only 4% used insecticide-treated bed nets. Knowledge and prevention practices varied across the four areas of Mumbai. Although most residents know that bed nets are effective in preventing malaria, usage of bed nets is very low, and almost no residents use insecticide-treated bed nets. As the four areas of Mumbai differed in knowledge, prevention practices, and primary sources of information, malaria control campaigns should be tailored according to the knowledge gaps, practices, environments, resources, and preferences in different areas of the city, using the interpersonal and media channels most likely to reach the target audiences. Malaria control efforts involving bed nets should emphasize use of insecticide-treated bed nets.
Odhiambo, M. T. O.; Skovmand, O.; Vulule, J. M.; Kokwaro, E. D.
2013-01-01
We studied the effect on malaria incidence, mosquito abundance, net efficacy, net use rate, chemical analysis, and holes of a long lasting insecticide treated bed net (Netprotect) in western Kenya, 2007–2010. Nets were hung in 150 households 6 months before they were hung in a second, 2 km away. Indoor resting densities were monitored by pyrethrum spray catch and malaria cases by passive detection using clinical manifestations and rapid diagnostic test. The probability of finding An. arabiensis in the control area was 2.6 times higher than that in intervention area during the first 6 months. Human blood feeding index of Anopheles funestus declined 17%. After bed nets were hung in the second area, malaria incidence declined 25% down to the level in the first area. Incidence remained at this low level for 2 years. 90% of collected nets were efficacious after 3-year use. Deltamethrin dosage declined from 1.9 to 0.5 g/kg over 3 years. Attrition rate after 3 years was 21%. WHO hole index changed from 333 to 114 to 381 over the three years. This index summarizes the numbers of holes in size categories and multiplies with the mean hole area per category. It is very sensitive to the impact of big holes in a few nets. PMID:24194770
Determinants of household demand for bed nets in a rural area of southern Mozambique
Chase, Claire; Sicuri, Elisa; Sacoor, Charfudin; Nhalungo, Delino; Nhacolo, Ariel; Alonso, Pedro L; Menéndez, Clara
2009-01-01
Background A key to making insecticide-treated nets (ITNs) a long-term, sustainable solution to the spread of malaria is understanding what drives their purchase and use. Few studies have analysed the determinants of demand for bed nets for malaria prevention at the household level, and in particular, how demand for nets compares with demand for other mosquito prevention methods. Methods This study uses a household survey to assess the determinants of demand for bed nets in an area of endemic malaria transmission in rural, southern Mozambique. The study looks at willingness to pay (WTP) for bed nets, net ownership, usage, and past purchase behaviour, alongside expenditure and frequency of use of alternate methods for malaria prevention. Results While overall net ownership in the sample is low, the evidence fails to suggest that poorer households are less likely to own bed nets, when controlling for covariates, nor does the likelihood of receiving a free net depend on socioeconomic status (SES). Formal schooling and market knowledge seem to indicate higher average willingness to pay, while use of alternate methods for malaria prevention, and receipt of Indoor Residual Spraying (IRS) are found to decrease demand for bed nets. Conclusion For long-term sustainability of ITNs to be realized, results suggest that either full or partial subsidies may be necessary in some contexts to encourage households to obtain and use nets. Given the possible substitution effects of combined malaria control interventions, and the danger of not taking into consideration household preferences for malaria prevention, successful malaria control campaigns should invest a portion of their funds towards educating recipients of IRS and users of other preventive methods on the importance of net use even in the absence of mosquitoes. PMID:19527505
Plucinski, M M; Chicuecue, S; Macete, E; Chambe, G A; Muguande, O; Matsinhe, G; Colborn, J; Yoon, S S; Doyle, T J; Kachur, S P; Aide, P; Alonso, P L; Guinovart, C; Morgan, J
2015-12-01
Universal coverage with insecticide-treated bed nets is a cornerstone of modern malaria control. Mozambique has developed a novel bed net allocation strategy, where the number of bed nets allocated per household is calculated on the basis of household composition and assumptions about who sleeps with whom. We set out to evaluate the performance of the novel allocation strategy. A total of 1994 households were visited during household surveys following two universal coverage bed net distribution campaigns in Sofala and Nampula provinces in 2010-2013. Each sleeping space was observed for the presence of a bed net, and the sleeping patterns for each household were recorded. The observed coverage and efficiency were compared to a simulated coverage and efficiency had conventional allocation strategies been used. A composite indicator, the product of coverage and efficiency, was calculated. Observed sleeping patterns were compared with the sleeping pattern assumptions. In households reached by the campaign, 93% (95% CI: 93-94%) of sleeping spaces in Sofala and 84% (82-86%) in Nampula were covered by campaign bed nets. The achieved efficiency was high, with 92% (91-93%) of distributed bed nets in Sofala and 93% (91-95%) in Nampula covering a sleeping space. Using the composite indicator, the novel allocation strategy outperformed all conventional strategies in Sofala and was tied for best in Nampula. The sleeping pattern assumptions were completely satisfied in 66% of households in Sofala and 56% of households in Nampula. The most common violation of the sleeping pattern assumptions was that male children 3-10 years of age tended not to share sleeping spaces with female children 3-10 or 10-16 years of age. The sleeping pattern assumptions underlying the novel bed net allocation strategy are generally valid, and net allocation using these assumptions can achieve high coverage and compare favourably with conventional allocation strategies. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Phyo Than, Wint; Oo, Tin; Wai, Khin Thet; Thi, Aung; Owiti, Philip; Kumar, Binay; Deepak Shewade, Hemant; Zachariah, Rony
2017-09-14
Myanmar lies in the Greater Mekong sub-region of South-East Asia faced with the challenge of emerging resistance to artemisinin combination therapies (ACT). Migrant populations are more likely than others to spread ACT resistance. A vital intervention to reduce malaria transmission, resistance spread and eliminate malaria is the use of bed nets. Among seasonal and stable migrants in an artemisinin resistance containment region of Myanmar, we compared a) their household characteristics, b) contact with health workers and information material, and c) household knowledge, access and utilization of bed nets. Secondary data from community-based surveys on 2484 migrant workers (2013 and 2014, Bago Region) were analyzed of which 37% were seasonal migrants. Bed net access and utilization were assessed using a) availability of at least one bed net per household, and b) one bed net per two persons, and c) proportion of household members who slept under abed net during the previous night (Indicator targets = 100%). Over 70% of all migrants were from unstable work settings with short transitory stays. Average household size was five (range 1-25) and almost half of all households had children under-five years. Roughly 10 % of migrants were night-time workers. Less than 40% of households had contact with health workers and less than 30% had exposure to information education and communication (IEC) materials, the latter being significantly lower among seasonal migrants. About 70% of households were aware of the importance of insecticide-treated bed-nets/long-lasting insecticidal nets (ITNs/LLINs), but knowledge on insecticide impregnation and retreatment of ITNs was poor (< 10%). Although over 95% of households had access to at least one bed net, the number with one bed net per two persons was grossly inadequate (13% for stable migrants and 9% for seasonal migrants, P = 0.001). About half of all household members slept under a bed net during the previous night. This study reveals important short-falls in knowledge, access and utilization of bed nets among migrants in Myanmar. Possible ways forward include frequent distribution campaigns to compensate for short transitory stays, matching household distributions to household size, enhanced information campaigns and introducing legislation to make mosquito repellents available for night-time workers at plantations and farms. Better understanding through qualitative research is also merited.
[Malaria: knowledge, behaviour and practices among a rural population of Gossas, Senegal].
Ndour, C T; Ba, O; Manga, N M; Fortes, M L; Nyamwasa, D; Sow, P S
2006-10-01
Malaria remains a major public health problem in Sub-Saharian Africa, in terms of morbidity and mortality rate. To assess the knowledge and behaviour of population regarding the transmission, the treatment and the prevention of malaria, we conducted a cluster sample household survey in Gossas, a rural District in Senegal, from May 2nd to May 6th 2005. A questionnaire that focused on socioeconomic conditions, beliefs, knowledge about and behavior toward antimalarial medication and the prevention means used was given to 480 household owners. Overall, 107 pregnant women and 1,201 children aged less than 5 years old lived within these household. More than a half of the household owners (51%) were illiterate and 25.2% ignored how malaria is transmitted. Fever was the most common symptom suggesting malaria (61%). In 46.1% of febrile cases, people did not seek for treatment from a physician. Home treatment of febrile episodes was based on paracetamol or aspirin (84%), chloroquine (13%) and cotrimoxazole (2.9%). Overall, the proportion of insecticide treated nets users were 22.7%. This percentage was 14.9% and 11.4% for pregnant women and children younger than 5 years old, respectively. People having radio sets, regular access to television, and people aware of the transmission route of malaria were more likely to use bed nets. In most cases, organic material burning was used as repellent against mosquitoes. The low prevalence of bed net use was most often explained by participants' limited accessibility to and by the high cost of insecticide-treated nets. Knowledge about malaria prevention and treatment is low in the rural district of Gossas. The rate of insecticide-treated-bed nets use in vulnerable people is very low, far from the Abuja meeting objective. A sensibilization program and a social marketing plan for insecticide-treated-bed nets could improve this situation.
Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon.
Dionne-Odom, Jodie; Westfall, Andrew O; Apinjoh, Tobias O; Anchang-Kimbi, Judith; Achidi, Eric A; Tita, Alan T N
2017-03-27
Malaria in pregnancy is common in sub-Saharan Africa where it contributes to perinatal morbidity and mortality. Use of insecticide-treated bed nets and intermittent preventive therapy with sulfadoxine-pyrimethamine during pregnancy are effective but underutilized interventions to prevent infection. Factors associated with bed net ownership and usage, and use of prophylaxis among recently pregnant women in Cameroon were investigated. National data from the 2011 Cameroon Demographic Health Survey was used to identify women with a pregnancy within the previous 5 years. Logistic regression models were created to assess for independent predictors of reported bed net ownership, bed net usage, and the use of malaria prophylaxis medications during pregnancy. Nearly one in two women surveyed had a recent pregnancy (n = 7647). In this group, bed net ownership and usage rates were low (33.7 and 16.9%, respectively); 61.6% used medication for malaria prophylaxis during pregnancy. Bed net ownership and usage were associated with maternal literacy (aOR 1.4 for net usage, 95% CI 1.1-1.8) and the presence of children under age 5 in the home (aOR 2.3 for net usage, 95% CI 1.6-3.3). The use of malaria prophylaxis medication was associated with measures of healthcare access (aOR 17.8, 95% CI 13-24.5 for ≥4 antenatal care visits), higher maternal education (aOR 1.5, 95% CI 1.1-2.1) and maternal literacy (aOR 1.4, 95% CI 1.1-1.7). Women in Cameroon and their antenatal providers missed many opportunities to prevent malaria in pregnancy. Efforts toward ensuring universal bed net provision, consistent antenatal care and the education of girls are likely to improve birth outcomes attributable to malaria infection.
Owusu Adjah, Ebenezer S; Panayiotou, Andrie G
2014-03-28
Media messages have been used in Ghana to promote insecticide-treated net (ITN)/bed net usage in an effort to impact on malaria prevention. The aim of this study was to assess the effect of such malaria-related messages delivered through electronic/print media and by volunteers/health workers on the use of ITNs by children living in a household. Data was collected from September to November of 2008 using a structured, interviewer-administered questionnaire by the Ghana Statistical Service as part of a national demographic and health survey (DHS). Secondary data analysis was performed on the collected data using multivariate logistic regression for both individual messages and a composite (any of) message variable. From the 11,788 households surveyed, 45% had at least one net. Households with male heads were more likely to have a child sleeping under a bed net the previous night (p = 0.0001). Individual Messages delivered by a health worker or a dedicated radio programme, had the highest effect for one or more children sleeping under a net the night before (OR(adjusted) = 1.65; 95% CI = 1.44 to 1.88 and OR(adjusted) = 1.26; 95% CI =1.12 to 1.42 respectively) while hearing any of the eight messages (composite score) resulted in the highest odds for one or more children (OR(adjusted) = 3.06; 95% CI = 2.27 to 4.12) sleeping under a bed net. Efforts to relate ITN messages to the public are very useful in increasing use of bed nets and having multiple ways of reaching the public increases their effect, with the biggest effect seen when health workers and volunteers were used to deliver malaria-related messages to the public.
2013-01-01
Background Knowledge of the interactions between mosquitoes and humans, and how vector control interventions affect them, is sparse. A study exploring host-seeking behaviour at a human-occupied bed net, a key event in such interactions, is reported here. Methods Host-seeking female Anopheles gambiae activity was studied using a human-baited ‘sticky-net’ (a bed net without insecticide, coated with non-setting adhesive) to trap mosquitoes. The numbers and distribution of mosquitoes captured on each surface of the bed net were recorded and analysed using non-parametric statistical methods and random effects regression analysis. To confirm sticky-net reliability, the experiment was repeated using a pitched sticky-net (tilted sides converging at apex, i.e., neither horizontal nor vertical). The capture efficiency of horizontal and vertical sticky surfaces were compared, and the potential repellency of the adhesive was investigated. Results In a semi-field experiment, more mosquitoes were caught on the top (74-87%) than on the sides of the net (p < 0.001). In laboratory experiments, more mosquitoes were caught on the top than on the sides in human-baited tests (p < 0.001), significantly different to unbaited controls (p < 0.001) where most mosquitoes were on the sides (p = 0.047). In both experiments, approximately 70% of mosquitoes captured on the top surface were clustered within a 90 × 90 cm (or lesser) area directly above the head and chest (p < 0.001). In pitched net tests, similar clustering occurred over the sleeper’s head and chest in baited tests only (p < 0.001). Capture rates at horizontal and vertical surfaces were not significantly different and the sticky-net was not repellent. Conclusion This study demonstrated that An. gambiae activity occurs predominantly within a limited area of the top surface of bed nets. The results provide support for the two-in-one bed net design for managing pyrethroid-resistant vector populations. Further exploration of vector behaviour at the bed net interface could contribute to additional improvements in insecticide-treated bed net design or the development of novel vector control tools. PMID:23902661
Parker, Josephine E.A.; Angarita-Jaimes, Natalia; Abe, Mayumi; Towers, Catherine E.; Towers, David; McCall, Philip J.
2015-01-01
Long-lasting insecticidal bed nets (LLINs) protect humans from malaria transmission and are fundamental to malaria control worldwide, but little is known of how mosquitoes interact with nets. Elucidating LLIN mode of action is essential to maintain or improve efficacy, an urgent need as emerging insecticide resistance threatens their future. Tracking multiple free-flying Anopheles gambiae responding to human-occupied bed nets in a novel large-scale system, we characterised key behaviours and events. Four behavioural modes with different levels of net contact were defined: swooping, visiting, bouncing and resting. Approximately 75% of all activity occurred at the bed net roof where multiple brief contacts were focussed above the occupant’s torso. Total flight and net contact times were lower at LLINs than untreated nets but the essential character of the response was unaltered. LLINs did not repel mosquitoes but impacted rapidly: LLIN contact of less than 1 minute per mosquito during the first ten minutes reduced subsequent activity; after thirty minutes, activity at LLINs was negligible. Velocity measurements showed that mosquitoes detected nets, including unbaited untreated nets, prior to contact. This is the most complete characterisation of mosquito-LLIN interactions to date, and reveals many aspects of LLIN mode of action, important for developing the next generation of LLINs. PMID:26323965
2014-01-01
Background High coverage of the bed nets can reduce mortality and morbidity of mosquito-borne diseases including malaria. Although the migrant workers are at high risk of malaria, there are many hidden challenges in universal coverage and utilization of the insecticide-treated nets (ITNs) in this populations. Methods Cross sectional study was conducted in 170 migrant workers in palm oil plantation sites in Tanintharyi Region and 175 in rubber plantation sites in Mon State. A multistage stratified cluster sampling was applied to select the participants. During household visit, face-to-face interviews using structured pre-coded, pre tested questionnaires and direct observation on installation of the bed nets was conducted. Two focus group discussions in each site were done by sample stratified purposive sampling method mainly focused on effective utilization of bed nets. Results Among them, 332 (96.2%) had a bed net and 284 (82.3%) had an ITN, while 204 (59.1%) had unused extranets. Among the ITNs users, 28.9% reported problems including insecticide smell (56.9%), dizziness (20.2%), headache (12.8%) and itchiness (9.2%). More than 75% received ITNs from health authorities and NGOs free-of-charge. More than 70% wanted to buy a net but they were unaffordable for 64% of them. On observation, only five families could show no bed net, but 80% showed 1–3 ITNs. Consistent utilization in all seasons was noted in 189 (53.1%), that was higher in palm oil plantation than rubber plantation workers (p = 0.0001) due to the nature of the work at night. Perceived malaria risk was also significantly higher ITNs consistent users than non-users (p = 0.0004) and better willingness to buy an ITN by themselves (p = 0.0005). They said that effectiveness of the ITNs was reduced after 6 months and 2–3 times washing. They wished to receive more durable smooth nets with small holes in lace. Misuses of the ITNs such as use the nets for animals and fishing, were also noted. Conclusion There should be efforts to improve effective utilization of ITNs by continuous mass free distribution, durability monitoring, surveillance of insecticide resistance of the vector and behaviour change interventions in migrant plantation workers. PMID:24888548
Stanton, Michelle C; Bockarie, Moses J; Kelly-Hope, Louise A
2013-01-01
Vector control, including the use of bed nets, is recommended as a possible strategy for eliminating lymphatic filariasis (LF) in post-conflict countries such as the Democratic Republic of Congo (DRC). This study examined the geographical factors that influence bed net ownership in DRC in order to identify hard-to-reach communities that need to be better targeted. In particular, urban/rural differences and the influence of population density, proximity to cities and health facilities, plus access to major transport networks were investigated. Demographic and Health Survey geo-referenced cluster level data were used to map bed net coverage (proportion of households with at least one of any type of bed net or at least one insecticide-treated net (ITN)), and ITN density (ITNs per person) for 260 clusters. Bivariate and multiple logistic or Poisson regression analyses were used to determine significant relationships. Overall, bed net (30%) and ITN (9%) coverage were very low with significant differences found between urban and rural clusters. In rural clusters, ITN coverage/density was positively correlated with population density (r = 0.25, 0.27 respectively, p<0.01), and negatively with the distance to the two largest cities, Kinshasa or Lubumbashi (r = -0.28, -0.30 respectively, p<0.0001). Further, ownership was significantly negatively correlated with distance to primary national roads and railways (all three measures), distance to main rivers (any bed net only) and distance to the nearest health facility (ITNs only). Logistic and Poisson regression models fitted to the rural cluster data indicated that, after controlling for measured covariates, ownership levels in the Bas-Congo province close to Kinshasa were much larger than that of other provinces. This was most noticeable when considering ITN coverage (odds ratio: 5.3, 95% CI: 3.67-7.70). This analysis provides key insights into the barriers of bed net ownership, which will help inform both LF and malaria bed net distribution campaigns as part of an integrated vector management strategy.
Stanton, Michelle C.; Bockarie, Moses J.; Kelly-Hope, Louise A.
2013-01-01
Vector control, including the use of bed nets, is recommended as a possible strategy for eliminating lymphatic filariasis (LF) in post-conflict countries such as the Democratic Republic of Congo (DRC). This study examined the geographical factors that influence bed net ownership in DRC in order to identify hard-to-reach communities that need to be better targeted. In particular, urban/rural differences and the influence of population density, proximity to cities and health facilities, plus access to major transport networks were investigated. Demographic and Health Survey geo-referenced cluster level data were used to map bed net coverage (proportion of households with at least one of any type of bed net or at least one insecticide-treated net (ITN)), and ITN density (ITNs per person) for 260 clusters. Bivariate and multiple logistic or Poisson regression analyses were used to determine significant relationships. Overall, bed net (30%) and ITN (9%) coverage were very low with significant differences found between urban and rural clusters. In rural clusters, ITN coverage/density was positively correlated with population density (r = 0.25, 0.27 respectively, p<0.01), and negatively with the distance to the two largest cities, Kinshasa or Lubumbashi (r = −0.28, −0.30 respectively, p<0.0001). Further, ownership was significantly negatively correlated with distance to primary national roads and railways (all three measures), distance to main rivers (any bed net only) and distance to the nearest health facility (ITNs only). Logistic and Poisson regression models fitted to the rural cluster data indicated that, after controlling for measured covariates, ownership levels in the Bas-Congo province close to Kinshasa were much larger than that of other provinces. This was most noticeable when considering ITN coverage (odds ratio: 5.3, 95% CI: 3.67–7.70). This analysis provides key insights into the barriers of bed net ownership, which will help inform both LF and malaria bed net distribution campaigns as part of an integrated vector management strategy. PMID:23308281
Impact of insecticide-treated bed nets on malaria transmission indices on the south coast of Kenya
2011-01-01
Background Besides significantly reducing malaria vector densities, prolonged usage of bed nets has been linked to decline of Anopheles gambiae s.s. relative to Anopheles arabiensis, changes in host feeding preference of malaria vectors, and behavioural shifts to exophagy (outdoor biting) for the two important malaria vectors in Africa, An. gambiae s.l. and Anopheles funestus. In southern coastal Kenya, bed net use was negligible in 1997-1998 when Anopheles funestus and An. gambiae s.s. were the primary malaria vectors, with An. arabiensis and Anopheles merus playing a secondary role. Since 2001, bed net use has increased progressively and reached high levels by 2009-2010 with corresponding decline in malaria transmission. Methods To evaluate the impact of the substantial increase in household bed net use within this area on vector density, vector composition, and human-vector contact, indoor and outdoor resting mosquitoes were collected in the same region during 2009-2010 using pyrethrum spray catches and clay pots for indoor and outdoor collections respectively. Information on bed net use per sleeping spaces and factors influencing mosquito density were determined in the same houses using Poisson regression analysis. Species distribution was determined, and number of mosquitoes per house, human-biting rates (HBR), and entomological inoculation rate (EIR) were compared to those reported for the same area during 1997-1998, when bed net coverage had been minimal. Results Compared to 1997-1998, a significant decline in the relative proportion of An. gambiae s.s. among collected mosquitoes was noted, coupled with a proportionate increase of An. arabiensis. Following > 5 years of 60-86% coverage with bed nets, the density, human biting rate and EIR of indoor resting mosquitoes were reduced by more than 92% for An. funestus and by 75% for An. gambiae s.l. In addition, the host feeding choice of both vectors shifted more toward non-human vertebrates. Besides bed net use, malaria vector abundance was also influenced by type of house construction and according to whether one sleeps on a bed or a mat (both of these are associated with household wealth). Mosquito density was positively associated with presence of domestic animals. Conclusions These entomological indices indicate a much reduced human biting rate and a diminishing role of An. gambiae s.s. in malaria transmission following high bed net coverage. While increasing bed net coverage beyond the current levels may not significantly reduce the transmission potential of An. arabiensis, it is anticipated that increasing or at least sustaining high bed net coverage will result in a diminished role for An. funestus in malaria transmission. PMID:22165904
Physical condition and maintenance of mosquito bed nets in Kwale County, coastal Kenya
2013-01-01
Background Despite the extensive ownership and use of insecticide-treated nets (ITNs) over the last decade, the effective lifespan of these nets, especially their physical integrity, under true operational conditions is not well-understood. Usefulness of nets declines primarily due to physical damage or loss of insecticidal activity. Methods A community based cross-sectional survey was used to determine the physical condition and to identify predictors of poor physical condition for bed nets owned by individuals from communities in Kwale County, coastal Kenya. A proportionate hole index (pHI) was used as a standard measure, and the cut-offs for an ‘effective net’ (offer substantial protection against mosquito bites) and ‘ineffective nets’ (offer little or no protection against mosquito bites) were determined (pHI ≤88 (about ≤500 cm2 of holes surface area) and pHI of >88 (≥500 cm2 of holes surface area), respectively). Results The vast majority (78%) of the surveyed nets had some holes. The median pHI was 92 (range: 1–2,980). Overall, half of the nets were categorized as ‘effective nets’ or ‘serviceable nets’. Physical deterioration of nets was associated with higher use and washing frequency. Young children and older children were found to use ineffective bed nets significantly more often than infants, while the physical integrity of nets owned by pregnant women was similar to those owned by infants. Estuarine environment inhabitants owned nets with the worst physical condition, while nets owned by the coastal slope inhabitants were in fairly good physical condition. The results suggest that bed nets are optimally utilized when they are new and physically intact. Thereafter, bed net utilization decreases gradually with increasing physical deterioration, with most net owners withdrawing physically damaged nets from routine use. This withdrawal commonly happens following 1.5 years of use, making bed net use the most important predictor of physical integrity. On average, the nets were washed twice within six months prior to the survey. Washing frequency was significantly influenced by the bed net colour and bed net age. Lack of knowledge on reasons for net retreatment and the retreatment procedure was evident, while net repair was minimal and did not seem to improve the physical condition of the nets. The “catch-up” bed net distribution strategies are sufficient for ensuring adequate ownership and utilization of ‘effective nets’ in the targeted groups, but bi-annual mass distribution is necessary to provide similar ownership and utilization for the other groups not targeted by “catch-up” strategies. Conclusions Monitoring and maintenance strategies that will deliver locally appropriate education messages on net washing and repair will enhance the effectiveness of malaria control programmes, and further research to assess ineffective nets need is needed. PMID:23374429
Hill, N; Lenglet, A; Arnéz, A M; Carneiro, I
2007-11-17
To determine the effectiveness in reducing malaria of combining an insect repellent with insecticide treated bed nets compared with the nets alone in an area where vector mosquitoes feed in the early evening. A double blind, placebo controlled cluster-randomised clinical study. Rural villages and peri-urban districts in the Bolivian Amazon. 4008 individuals in 860 households. All individuals slept under treated nets; one group also used a plant based insect repellent each evening, a second group used placebo. Episodes of Plasmodium falciparum or P vivax malaria confirmed by rapid diagnostic test or blood slide, respectively. We analysed 15,174 person months at risk and found a highly significant 80% reduction in episodes of P vivax in the group that used treated nets and repellent (incidence rate ratio 0.20, 95% confidence interval 0.11 to 0.38, P<0.001). Numbers of P falciparum cases during the study were small and, after adjustment for age, an 82% protective effect was observed, although this was not significant (0.18, 0.02 to 1.40, P=0.10). Reported episodes of fever with any cause were reduced by 58% in the group that used repellent (0.42, 0.31 to 0.56, P<0.001). Insect repellents can provide protection against malaria. In areas where vectors feed in the early evening, effectiveness of treated nets can be significantly increased by using repellent between dusk and bedtime. This has important implications in malaria vector control programmes outside Africa and shows that the combined use of treated nets and insect repellents, as advocated for most tourists travelling to high risk areas, is fully justified. NCT 00144716.
Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis
2012-01-01
Background The World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs). LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan), but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time. Methods We modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price) and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need. Results If conventional and long-lasting bed nets have the same physical lifespan (3 years), LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price without the cheaper net (of the same type) becoming more cost effective. Distributing replenishment nets each year in addition to the replacement of all nets every 3-4 years increases the number of under-5 deaths averted by 5-14% at a cost of USD 17-25 per additional person protected per annum or USD 1080-1610 per additional under-5 death averted. Conclusions Our results support the World Health Organization recommendation to distribute only LLINs, while giving guidance on the price thresholds above which this recommendation will no longer hold. Programme planners should be willing to pay a premium for nets which have a longer physical lifespan, and if planners are willing to pay USD 1600 per under-5 death averted, investing in replenishment is cost effective. PMID:22475679
Galvin, Kathleen T; Petford, Nick; Ajose, Frances; Davies, Dai
2011-01-01
Background: The effectiveness of malaria control programs is determined by an array of complex factors, including the acceptability and sustained use of preventative measures such as the bed net. A small-scale exploratory study was conducted in several locations in the Niger Delta region, Nigeria, to discover barriers against the use of bed nets, in the context of a current drive to scale up net use in Nigeria. Methods: A qualitative approach with a convenience sample was used. One to one interviews with mostly male adult volunteers were undertaken which explored typical living and sleeping arrangements, and perceptions about and barriers against the use of the mosquito prevention bed net. Results: Several key issues emerged from the qualitative data. Bed nets were not reported as widely used in this small sample. The reasons reported for lack of use included issues of convenience, especially net set up and dismantling; potential hazard and safety concerns; issues related to typical family composition and nature of accommodation; humid weather conditions; and perceptions of cost and effectiveness. Most barriers to net use concerned issues about everyday practical living and sleeping arrangements and perceptions about comfort. Interviewees identified were aware of malaria infection risks, but several also indicated certain beliefs that were barriers to net use. Conclusions: Successful control of malaria and scale up of insecticide-treated net coverage relies on community perceptions and practice. This small study has illuminated a number of important everyday life issues, which remain barriers to sustained net use, and has clarified further questions to be considered in net design and in future research studies. The study highlights the need for further research on the human concerns that contribute to sustained use of nets or, conversely, present significant barriers to their use. PMID:21544249
Ordinioha, Best
2012-01-01
Insecticide-treated bed net (ITN) is currently distributed free of charge to vulnerable groups in Nigeria, for malaria control. Consistent use of the nets is required for maximum effectiveness; but studies indicate that the nets are often jettisoned in periods of low mosquito activity and high night time temperature. The objective of this study has been to assess the use of mass distributed nets in a semi-urban community in Rivers State, south-south Nigeria, during the late dry season, when mosquito activity is at the lowest in the community. The study was carried out in Ishiodu - Emohua, using a cross-sectional study design. The data was collected using a structured, interviewer-administered questionnaire, administered to female head of households in the community, with under-five children. A total of 170 respondents were studied; they had an average age of 34.3 ± 7.6 years, most were married (86.5%), and had secondary school education (68.2%). All the households owned at least one ITN, and an average of 1.7 nets, with 75.3% of the households owning two or more ITNs. Almost all the nets (99.4%) were obtained free of charge. Of the 170 households that received the nets, 71.8% had hanged the nets as at the time of the survey; 83.6% of these hanged the nets over a bed, while 10.7% used the nets as window curtain. Of the 102 ITNs that were properly deployed, only 27.5% were occupied the night before the survey, by an average of 2.5 persons, mainly under-five children (37.7%). The distribution of free ITNs has resulted in universal household ownership, but the use of the nets is still very poor. Proper health education is required to encourage the consistent use of the nets, even in hot night, with low mosquito activity.
Ferreira, Claudia P; Lyra, Silas P; Azevedo, Franciane; Greenhalgh, David; Massad, Eduardo
2017-09-15
Evidence of changing in biting and resting behaviour of the main malaria vectors has been mounting up in recent years as a result of selective pressure by the widespread and long-term use of insecticide-treated bed nets (ITNs), and indoor residual spraying. The impact of resistance behaviour on malaria intervention efficacy has important implications for the epidemiology and malaria control programmes. In this context, a theoretical framework is presented to understand the mechanisms determining the evolution of feeding behaviour under the pressure of use of ITNs. An agent-based stochastic model simulates the impact of insecticide-treated bed nets on mosquito fitness by reducing the biting rates, as well as increasing mortality rates. The model also incorporates a heritability function that provides the necessary genetic plasticity upon which natural selection would act to maximize the fitness under the pressure of the control strategy. The asymptotic equilibrium distribution of mosquito population versus biting time is shown for several daily uses of ITNs, and the expected disruptive selection on this mosquito trait is observed in the simulations. The relative fitness of strains that bite at much earlier time with respect to the wild strains, when a threshold of about 50% of ITNs coverage highlights the hypothesis of a behaviour selection. A sensitivity analysis has shown that the top three parameters that play a dominant role on the mosquito fitness are the proportion of individuals using bed nets and its effectiveness, the impact of bed nets on mosquito oviposition, and the mosquito genetic plasticity related to changing in biting time. By taking the evolutionary aspect into account, the model was able to show that the long-term use of ITNs, although representing an undisputed success in reducing malaria incidence and mortality in many affected areas, is not free of undesirable side effects. From the evolutionary point of view of the parasite virulence, it should be expected that plasmodium parasites would be under pressure to reduce their virulence. This speculative hypothesis can eventually be demonstrated in the medium to long-term use of ITNs.
Expanding the scope of medical mission volunteer groups to include a research component.
Rovers, John; Andreski, Michael; Gitua, John; Bagayoko, Abdoulaye; DeVore, Jill
2014-02-20
Serving on volunteer groups undertaking medical mission trips is a common activity for health care professionals and students. Although volunteers hope such work will assist underserved populations, medical mission groups have been criticized for not providing sustainable health services that focus on underlying health problems. As members of a volunteer medical mission group, we performed a bed net indicator study in rural Mali. We undertook this project to demonstrate that volunteers are capable of undertaking small-scale research, the results of which offer locally relevant results useful for disease prevention programs. The results of such projects are potentially sustainable beyond the duration of a mission trip. Volunteers with Medicine for Mali interviewed 108 households in Nana Kenieba, Mali during a routine two-week medical mission trip. Interviewees were asked structured questions about family demographics, use of insecticide treated bed nets the previous evening, as well as about benefits of net use and knowledge of malaria. Survey results were analyzed using logistic regression. We found that 43.7% of households had any family member sleep under a bed net the previous evening. Eighty seven percent of households owned at least one ITN and the average household owned 1.95 nets. The regression model showed that paying for a net was significantly correlated with its use, while low perceived mosquito density, obtaining the net from the public sector and more than four years of education in the male head of the household were negatively correlated with net use. These results differ from national Malian data and peer-reviewed studies of bed net use. We completed a bed net study that provided results that were specific to our service area. Since these results were dissimilar to peer-reviewed literature and Malian national level data on bed net use, the results will be useful to develop locally specific teaching materials on malaria prevention. This preventive focus is potentially more sustainable than clinical services for malaria treatment. Although we were not able to demonstrate that our work is sustainable, our study shows that volunteer groups are capable of undertaking research that is relevant to their service area.
Expanding the scope of medical mission volunteer groups to include a research component
2014-01-01
Background Serving on volunteer groups undertaking medical mission trips is a common activity for health care professionals and students. Although volunteers hope such work will assist underserved populations, medical mission groups have been criticized for not providing sustainable health services that focus on underlying health problems. As members of a volunteer medical mission group, we performed a bed net indicator study in rural Mali. We undertook this project to demonstrate that volunteers are capable of undertaking small-scale research, the results of which offer locally relevant results useful for disease prevention programs. The results of such projects are potentially sustainable beyond the duration of a mission trip. Methods Volunteers with Medicine for Mali interviewed 108 households in Nana Kenieba, Mali during a routine two-week medical mission trip. Interviewees were asked structured questions about family demographics, use of insecticide treated bed nets the previous evening, as well as about benefits of net use and knowledge of malaria. Survey results were analyzed using logistic regression. Results We found that 43.7% of households had any family member sleep under a bed net the previous evening. Eighty seven percent of households owned at least one ITN and the average household owned 1.95 nets. The regression model showed that paying for a net was significantly correlated with its use, while low perceived mosquito density, obtaining the net from the public sector and more than four years of education in the male head of the household were negatively correlated with net use. These results differ from national Malian data and peer-reviewed studies of bed net use. Conclusions We completed a bed net study that provided results that were specific to our service area. Since these results were dissimilar to peer-reviewed literature and Malian national level data on bed net use, the results will be useful to develop locally specific teaching materials on malaria prevention. This preventive focus is potentially more sustainable than clinical services for malaria treatment. Although we were not able to demonstrate that our work is sustainable, our study shows that volunteer groups are capable of undertaking research that is relevant to their service area. PMID:24555713
Msellemu, Daniel; Shemdoe, Aloysia; Makungu, Christina; Mlacha, Yeromini; Kannady, Khadija; Dongus, Stefan; Killeen, Gerry F; Dillip, Angel
2017-10-23
Bed nets reduce malaria-related illness and deaths, by forming a protective barrier around people sleeping under them. When impregnated with long-lasting insecticide formulations they also repel or kill mosquitoes attempting to feed upon sleeping humans, and can even suppress entire populations of malaria vectors that feed predominantly upon humans. Nevertheless, an epidemiological study in 2012 demonstrated higher malaria prevalence among bed net users than non-users in urban Dar es Salaam, Tanzania. Focus group discussions were conducted with women from four selected wards of Dar es Salaam city, focusing on four major themes relating to bed net use behaviours: (1) reasons for bed net use, (2) reasons for not using bed nets, (3) stimuli or reminders for people to use a bed net (4) perceived reasons for catching malaria while using a bed net. An analytical method by framework grouping of relevant themes was used address key issues of relevance to the study objectives. Codes were reviewed and grouped into categories and themes. All groups said the main reason for bed net use was protection against malaria. Houses with well-screened windows, with doors that shut properly, and that use insecticidal sprays against mosquitoes, were said not to use bed nets, while frequent attacks from malaria was the main stimulus for people to use bed nets. Various reasons were mentioned as potential reasons that compromise bed net efficacy, the most common of which were: (1) bed net sharing by two or more people, especially if one occupant tends to come to bed late at night, and does not tuck in the net 71%; (2) one person shares the bed but does not use the net, moving it away from the side on which s/he sleeps 68%; (3) ineffective usage habits, called ulalavi, in which a sprawling sleeper either touches the net while sleeping up against it or leaves a limb hanging outside of it 68%. Less common reasons mentioned included: (1) Small bed nets which become un-tucked at night (31%); (2) Bed nets with holes large enough to allow mosquitoes to pass (28%); and (3) Going to bed late after already being bitten outdoors (24%). Behaviours associated with bed net use like; bed sharing, bed net non compliant-bedfellow, sleeping pattern like ulalavi and some physical bed net attributes compromise its effectiveness and supposedly increase of malaria infection to bed net users. While some well-screened houses looked to instigate low malaria prevalence to non-bed net users.
Parker, Josephine E A; Angarita Jaimes, Natalia C; Gleave, Katherine; Mashauri, Fabian; Abe, Mayumi; Martine, Jackline; Towers, Catherine E; Towers, David; McCall, Philip J
2017-07-04
Understanding how mosquitoes respond to long lasting insecticide treated nets (LLINs) is fundamental to sustaining the effectiveness of this essential control tool. We report on studies with a tracking system to investigate behaviour of wild anophelines at an LLIN, in an experimental hut at a rural site in Mwanza, Tanzania. Groups of adult female mosquitoes (n = 10 per replicate) reared from larvae of a local population, identified as predominantly (95%) Anopheles arabiensis, were released in the hut. An infrared video tracking system recorded flight and net contact activity over 1 h as the mosquitoes attempted to reach a supine human volunteer within a bed net (either a deltamethrin-treated LLIN or an untreated control net). A range of activities, including flight path, position in relation to the bed net and duration of net contact, were quantified and compared between treatments. The total time that female An. arabiensis spent in flight around LLINs was significantly lower than at untreated nets [F(1,10) = 9.26, p = 0.012], primarily due to a substantial reduction in the time mosquitoes spent in persistent 'bouncing' flight [F(1,10) = 18.48, p = 0.002]. Most activity occurred at the net roof but significantly less so with LLINs (56.8% of total) than untreated nets [85.0%; Χ 2 (15) = 234.69, p < 0.001]. Activity levels at the bed net directly above the host torso were significantly higher with untreated nets (74.2%) than LLINs [38.4%; Χ 2 (15) = 33.54, p = 0.004]. 'Visiting' and 'bouncing' rates were highest above the volunteer's chest in untreated nets (39.9 and 50.4%, respectively) and LLINs [29.9 and 42.4%; Χ 2 (13) = 89.91, p < 0.001; Χ 2 (9) = 45.73, p < 0.001]. Highest resting rates were above the torso in untreated nets [77%; Χ 2 (9) = 63.12, p < 0.001], but in LLINs only 33.2% of resting occurred here [Χ 2 (9) = 27.59, p = 0.001], with resting times spread between the short vertical side of the net adjacent to the volunteer's head (21.8%) and feet (16.2%). Duration of net contact by a single mosquito was estimated at 204-290 s on untreated nets and 46-82 s on LLINs. While latency to net contact was similar in both treatments, the reduction in activity over 60 min was significantly more rapid for LLINs [F(1,10) = 6.81, p = 0.026], reiterating an 'attract and kill' rather than a repellent mode of action. The study has demonstrated the potential for detailed investigations of behaviour of wild mosquito populations under field conditions. The results validate the findings of earlier laboratory studies on mosquito activity at LLINs, and reinforce the key role of multiple brief contacts at the net roof as the critical LLIN mode of action.
Kateera, Fredrick; Ingabire, Chantal M; Hakizimana, Emmanuel; Rulisa, Alexis; Karinda, Parfait; Grobusch, Martin P; Mutesa, Leon; van Vugt, Michèle; Mens, Petra F
2015-10-06
Universal long-lasting insecticidal net (LLIN) coverage (ULC) has reduced malaria morbidity and mortality across Africa. Although information is available on bed net use in specific groups, such as pregnant women and children under 5 years, there is paucity of data on their use among the general population. Bed net source, ownership and determinants of use among individuals from households in an eastern Rwanda community 8 months after a ULC were characterized. Using household-based, interviewer-administered questionnaires and interviewer-direct observations, data on bed net source, ownership and key determinants of net use, including demographics, socio-economic status indicators, house structure characteristics, as well as of bed net quantity, type and integrity, were collected from 1400 randomly selected households. Univariate and mixed effects logistic regression modelling was done to assess for determinants of bed net use. A total of 1410 households and 6598 individuals were included in the study. Overall, the proportion of households with at least one net was 92 % while bed net usage was reported among 72 % of household members. Of the households surveyed, a total ownership of 2768 nets was reported, of which about 96 % were reportedly LLINs received from the ULC. By interviewer-physical observation, 88 % of the nets owned were of the LLIN type with the remaining 12 % did not carry any mark to enable type recognition. The odds of bed net use were significantly lower among males and individuals: from households of low socio-economic status, from households with
Quantifying the impact of decay in bed-net efficacy on malaria transmission
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ngonghala, Calistus N.; Del Valle, Sara Y.; Zhao, Ruijun
Insecticide-treated nets (ITNs) are at the forefront of malaria control programs and even though the percentage of households in sub-Saharan Africa that owned nets increased from 3% in 2000 to 53% in 2012, many children continue to die from malaria. The potential impact of ITNs on reducing malaria transmission is limited due to inconsistent or improper use, as well as physical decay in effectiveness. Most mathematical models for malaria transmission have assumed a fixed effectiveness rate for bed-nets, which can overestimate the impact of nets on malaria control. We develop a model for malaria spread that captures the decrease inmore » ITN effectiveness due to physical and chemical decay, as well as human behavior as a function of time. We perform uncertainty and sensitivity analyses to identify and rank parameters that play a critical role in malaria transmission. These analyses show that the basic reproduction number R 0, and the infectious human population are most sensitive to bed-net coverage and the biting rate of mosquitoes. Our results show the existence of a backward bifurcation for the case in which ITN efficacy is constant over time, which occurs for some range of parameters and is characterized by high malaria mortality in humans. This result implies that bringing R 0 to less than one is not enough for malaria elimination but rather additional efforts will be necessary to control the disease. For the case in which ITN efficacy decays over time, we determine coverage levels required to control malaria for different ITN efficacies and demonstrate that ITNs with longer useful lifespans perform better in malaria control. We conclude that malaria control programs should focus on increasing bed-net coverage, which can be achieved by enhancing malaria education and increasing bed-net distribution in malaria endemic regions.« less
Quantifying the impact of decay in bed-net efficacy on malaria transmission
Ngonghala, Calistus N.; Del Valle, Sara Y.; Zhao, Ruijun; ...
2014-08-23
Insecticide-treated nets (ITNs) are at the forefront of malaria control programs and even though the percentage of households in sub-Saharan Africa that owned nets increased from 3% in 2000 to 53% in 2012, many children continue to die from malaria. The potential impact of ITNs on reducing malaria transmission is limited due to inconsistent or improper use, as well as physical decay in effectiveness. Most mathematical models for malaria transmission have assumed a fixed effectiveness rate for bed-nets, which can overestimate the impact of nets on malaria control. We develop a model for malaria spread that captures the decrease inmore » ITN effectiveness due to physical and chemical decay, as well as human behavior as a function of time. We perform uncertainty and sensitivity analyses to identify and rank parameters that play a critical role in malaria transmission. These analyses show that the basic reproduction number R 0, and the infectious human population are most sensitive to bed-net coverage and the biting rate of mosquitoes. Our results show the existence of a backward bifurcation for the case in which ITN efficacy is constant over time, which occurs for some range of parameters and is characterized by high malaria mortality in humans. This result implies that bringing R 0 to less than one is not enough for malaria elimination but rather additional efforts will be necessary to control the disease. For the case in which ITN efficacy decays over time, we determine coverage levels required to control malaria for different ITN efficacies and demonstrate that ITNs with longer useful lifespans perform better in malaria control. We conclude that malaria control programs should focus on increasing bed-net coverage, which can be achieved by enhancing malaria education and increasing bed-net distribution in malaria endemic regions.« less
2012-01-01
Background The elimination of malaria in Zanzibar is highly dependent on sustained effective coverage of bed-nets to avoid malaria resurgence. The Health Belief Model (HBM) framework was used to explore the perceptions of malaria and bed-net use after a noticeable reduction in malaria incidence. Methods Nineteen in-depth interviews were conducted with female and male caretakers of children under five in North A district, Zanzibar. Deductive content analysis was used to identify meaning units that were condensed, coded and assigned to pre-determined elements of the HBM. Results Awareness of malaria among caretakers was high but the illness was now seen as easily curable and uncommon. In addition to the perceived advantage of providing protection against malaria, bed-nets were also thought to be useful for avoiding mosquito nuisance, especially during the rainy season when the malaria and mosquito burden is high. The discomfort of sleeping under a net during the hot season was the main barrier that interrupted consistent bed-net usage. The main cue to using a bed-net was high mosquito density, and children were prioritized when it came to bed-net usage. Caretakers had high perceived self-efficacy and did not find it difficult to use bed-nets. Indoor Residual Spraying (IRS), which was recognized as an additional means of mosquito prevention, was not identified as an alternative for bed-nets. A barrier to net ownership was the increasingly high cost of bed-nets. Conclusions Despite the reduction in malaria incidence and the resulting low malaria risk perceptions among caretakers, the benefit of bed-nets as the most proficient protection against mosquito bites upholds their use. This, in combination with the perceived high self-efficacy of caretakers, supports bed-net usage, while seasonality interrupts consistent use. High effective coverage of bed-nets could be further improved by reinforcing the benefits of bed-nets, addressing the seasonal heat barrier by using nets with larger mesh sizes and ensuring high bed-net ownership rates through sustainable and affordable delivery mechanisms. PMID:22863188
Stevens, Elizabeth R; Aldridge, Abigail; Degbey, Yawo; Pignandi, Akou; Dorkenoo, Monique A; Hugelen-Padin, Justin
2013-05-16
Malaria remains a substantial public health problem in Togo. An integrated child health campaign was conducted in Togo in October 2011. This campaign included a component of free distribution of 2,799,800 long-lasting, insecticide-treated nets (LLINs) to households throughout Togo. This distribution marked the first effort in Togo at universal LLIN coverage and was not targeted specifically to children under five years and pregnant women, but to all household members. This study reports the results of the LLIN distribution campaign in terms of bed net possession and utilization. A representative household survey was implemented during the rainy season nine months after the LLIN distribution component of the campaign. Some 6,015 households selected through two stages of probability proportion to size stratified random sampling were interviewed using a brief questionnaire that included a demographic section with questions on the number of household members and sleeping spaces, and a campaign participation section with questions used to evaluate non-LLIN aspects of the campaign. A net roster listed all nets and their characteristics, and a household roster listed all members and visitors with information about bed net use. The questions addressed different aspects of bed net and LLIN possession and utilization. Crude weighted frequencies, percentages, and t- tests of association were calculated using the Stata 12.0 Survey features. Possession of at least one bed net and/or LLIN increased from 41.3% to 96.7% (P <0.001). Household possession of at least one campaign LLIN was 93.3%. Report LLIN among pregnant women was 77.5% and 79.3% for children under five. For the general population LLIN use was 68.3%. Due to the gap in LLIN possession and use and the significant number of individuals reporting a lack of nets as a reason for non-use, additional national LLIN distribution campaigns with a stronger educational component need to be implemented in order increase the use of available LLINs and to reach and maintain universal coverage of LLINs in Togo. The LLIN distribution campaign focusing on universal coverage of the general population in Togo was more successful at increasing LLIN possession and use of children under five years and pregnant women than other campaigns focusing only on these target groups.
Macedo de Oliveira, Alexandre; Wolkon, Adam; Krishnamurthy, Ramesh; Erskine, Marcy; Crenshaw, Dana P; Roberts, Jacquelin; Saúte, Francisco
2010-08-04
Insecticide-treated bed nets (ITNs) are an efficacious intervention for malaria prevention. During a national immunization campaign in Mozambique, vouchers, which were to be redeemed at a later date for free ITNs, were distributed in Manica and Sofala provinces. A survey to evaluate ITN ownership and usage post-campaign was conducted. Four districts in each province and four enumeration areas (EAs) in each district were selected using probability proportional to size. Within each EA, 32 households (HHs) were selected using a simple random sample. Interviews to assess ownership and usage were conducted in each of the selected HHs using personal digital assistants. Valid interviews were completed for 947 (92.5%) (440 in Manica and 507 in Sofala) of the 1,024 selected HHs. Among participating HHs, 65.0% in Manica and 63.1% in Sofala reported that at least one child under five years of age slept in the house the previous night. HH ownership of at least one bed net of any kind was 20.6% (95% confidence interval [CI]: 7.9%-43.6%) and 35.6% (95% CI: 27.8%-44.3%) pre-campaign; and 55.1% (95% CI: 43.6%-66.1%) and 59.6 (95% CI: 42.4%-74.7%) post-campaign in Manica and Sofala, respectively. Post-campaign HH ownership of at least one ITN was 50.2% (95% CI: 41.8%-58.5%) for both provinces combined. In addition, 60.3% (95% CI: 50.6%-69.2%) of children under five years of age slept under an ITN the previous night. This ITN distribution increased bed net ownership and usage rates. Integration of ITN distribution with immunization campaigns presents an opportunity for reaching malaria control targets and should continue to be considered.
Ernst, Kacey C; Hayden, Mary H; Olsen, Heather; Cavanaugh, Jamie L; Ruberto, Irene; Agawo, Maurice; Munga, Stephen
2016-04-14
Challenges persist in ensuring access to and optimal use of long-lasting, insecticidal bed nets (LLINs). Factors associated with ownership and use may differ depending on the history of malaria and prevention control efforts in a specific region. Understanding how the cultural and social-environmental context of bed net use may differ between high- and low-risk regions is important when identifying solutions to improve uptake and appropriate use. Community forums and a household, cross-sectional survey were used to collect information on factors related to bed net ownership and use in western Kenya. Sites with disparate levels of transmission were selected, including an endemic lowland area, Miwani, and a highland epidemic-prone area, Kapkangani. Analysis of ownership was stratified by site. A combined site analysis was conducted to examine factors associated with use of all available bed nets. Logistic regression modelling was used to determine factors associated with ownership and use of owned bed nets. Access to bed nets as the leading barrier to their use was identified in community forums and cross-sectional surveys. While disuse of available bed nets was discussed in the forums, it was a relatively rare occurrence in both sites. Factors associated with ownership varied by site. Education, perceived risk of malaria and knowledge of individuals who had died of malaria were associated with higher bed net ownership in the highlands, while in the lowlands individuals reporting it was easy to get a bed net were more likely to own one. A combined site analysis indicated that not using an available bed net was associated with the attitudes that taking malaria drugs is easier than using a bed net and that use of a bed net will not prevent malaria. In addition, individuals with an unused bed net in the household were more likely to indicate that bed nets are difficult to use, that purchased bed nets are better than freely distributed ones, and that bed nets should only be used during the rainy season. Variations in factors associated with ownership should be acknowledged when constructing messaging and distribution campaigns. Despite reports of bed nets being used for other purposes, those in the home were rarely unused in these communities. Disuse seemed to be related to beliefs that can be addressed through education programmes. As mass distributions continue to take place, additional research is needed to determine if factors associated with LLIN ownership and use change with increasing availability of LLIN.
Atkinson, Jo-An; Bobogare, Albino; Fitzgerald, Lisa; Boaz, Leonard; Appleyard, Bridget; Toaliu, Hilson; Vallely, Andrew
2009-01-01
Background In March 2008, the Solomon Islands and Vanuatu governments raised the goal of their National Malaria Programmes from control to elimination. Vector control measures, such as indoor residual spraying (IRS) and long-lasting insecticidal bed nets (LLINs) are key integral components of this programme. Compliance with these interventions is dependent on their acceptability and on the socio-cultural context of the local population. These factors need to be investigated locally prior to programme implementation. Method Twelve focus group discussions (FGDs) were carried out in Malaita and Temotu Provinces, Solomon Islands in 2008. These discussions explored user perceptions of acceptability and preference for three brands of long-lasting insecticide-treated bed nets (LLINs) and identified a number of barriers to their proper and consistent use. Results Mosquito nuisance and perceived threat of malaria were the main determinants of bed net use. Knowledge of malaria and the means to prevent it were not sufficient to guarantee compliance with LLIN use. Factors such as climate, work and evening social activities impact on the use of bed nets, particularly in men. LLIN acceptability plays a varying role in compliance with their use in villages involved in this study. Participants in areas of reported high and year round mosquito nuisance and perceived threat of malaria reported LLIN use regardless of any reported unfavourable characteristics. Those in areas of low or seasonal mosquito nuisance were more likely to describe the unfavourable characteristics of LLINs as reasons for their intermittent or non-compliance. The main criterion for LLIN brand acceptability was effectiveness in preventing mosquito bites and malaria. Discussions highlighted considerable confusion around LLIN care and washing which may be impacting on their effectiveness and reducing their acceptability in Solomon Islands. Conclusion Providing LLINs that are acceptable will be more important for improving compliance in areas of low or seasonal mosquito nuisance and malaria transmission. The implications of these findings on malaria elimination in Solomon Islands are discussed. PMID:19497127
Noor, Abdisalan M.; Moloney, Grainne; Borle, Mohamed; Fegan, Greg W.; Shewchuk, Tanya; Snow, Robert W.
2008-01-01
Background There have been resurgent efforts in Africa to estimate the public health impact of malaria control interventions such as insecticide treated nets (ITNs) following substantial investments in scaling-up coverage in the last five years. Little is known, however, on the effectiveness of ITN in areas of Africa that support low transmission. This hinders the accurate estimation of impact of ITN use on disease burden and its cost-effectiveness in low transmission settings. Methods and Principal Findings Using a stratified two-stage cluster sample design, four cross-sectional studies were undertaken between March-June 2007 across three livelihood groups in an area of low intensity malaria transmission in South Central Somalia. Information on bed net use; age; and sex of all participants were recorded. A finger prick blood sample was taken from participants to examine for parasitaemia. Mantel-Haenzel methods were used to measure the effect of net use on parasitaemia adjusting for livelihood; age; and sex. A total of 10,587 individuals of all ages were seen of which 10,359 provided full information. Overall net use and parasite prevalence were 12.4% and 15.7% respectively. Age-specific protective effectiveness (PE) of bed net ranged from 39% among <5 years to 72% among 5–14 years old. Overall PE of bed nets was 54% (95% confidence interval 44%–63%) after adjusting for livelihood; sex; and age. Conclusions and Significance Bed nets confer high protection against parasite infection in South Central Somalia. In such areas where baseline transmission is low, however, the absolute reductions in parasitaemia due to wide-scale net use will be relatively small raising questions on the cost-effectiveness of covering millions of people living in such settings in Africa with nets. Further understanding of the progress of disease upon infection against the cost of averting its consequent burden in low transmission areas of Africa is therefore required. PMID:18461178
Noor, Abdisalan M; Moloney, Grainne; Borle, Mohamed; Fegan, Greg W; Shewchuk, Tanya; Snow, Robert W
2008-05-07
There have been resurgent efforts in Africa to estimate the public health impact of malaria control interventions such as insecticide treated nets (ITNs) following substantial investments in scaling-up coverage in the last five years. Little is known, however, on the effectiveness of ITN in areas of Africa that support low transmission. This hinders the accurate estimation of impact of ITN use on disease burden and its cost-effectiveness in low transmission settings. Using a stratified two-stage cluster sample design, four cross-sectional studies were undertaken between March-June 2007 across three livelihood groups in an area of low intensity malaria transmission in South Central Somalia. Information on bed net use; age; and sex of all participants were recorded. A finger prick blood sample was taken from participants to examine for parasitaemia. Mantel-Haenzel methods were used to measure the effect of net use on parasitaemia adjusting for livelihood; age; and sex. A total of 10,587 individuals of all ages were seen of which 10,359 provided full information. Overall net use and parasite prevalence were 12.4% and 15.7% respectively. Age-specific protective effectiveness (PE) of bed net ranged from 39% among <5 years to 72% among 5-14 years old. Overall PE of bed nets was 54% (95% confidence interval 44%-63%) after adjusting for livelihood; sex; and age. Bed nets confer high protection against parasite infection in South Central Somalia. In such areas where baseline transmission is low, however, the absolute reductions in parasitaemia due to wide-scale net use will be relatively small raising questions on the cost-effectiveness of covering millions of people living in such settings in Africa with nets. Further understanding of the progress of disease upon infection against the cost of averting its consequent burden in low transmission areas of Africa is therefore required.
An adjusted bed net coverage indicator with estimations for 23 African countries
2013-01-01
Background Many studies have assessed the level of bed net coverage in populations at risk of malaria infection. These revealed large variations in bed net use across countries, regions and social strata. Such studies are often aimed at identifying populations with low access to bed nets that should be prioritized in future interventions. However, often spatial differences in malaria endemicity are not taken into account. By ignoring variability in malaria endemicity, these studies prioritize populations with little access to bed nets, even if these happen to live in low endemicity areas. Conversely, populations living in regions with high malaria endemicity will receive a lower priority once a seizable proportion is protected by bed nets. Adequately assigning priorities requires accounting for both the current level of bed net coverage and the local malaria endemicity. Indeed, as shown here for 23 African countries, there is no correlation between the level of bed net coverage and the level of malaria endemicity in a region. Therefore, the need for future interventions can not be assessed based on current bed net coverage alone. This paper proposes the Adjusted Bed net Coverage (ABC) statistic as a measure taking into account both local malaria endemicity and the level of bed net coverage. The measure allows setting priorities for future interventions taking into account both local malaria endemicity and bed net coverage. Methods A mathematical formulation of the ABC as a weighted difference of bed net coverage and malaria endemicity is presented. The formulation is parameterized based on a model of malaria epidemiology (Smith et al. Trends Parasitol 25:511-516, 2009). By parameterizing the ABC based on this model, the ABC as used in this paper is proxy for the steady-state malaria burden given the current level of bed net coverage. Data on the bed net coverage in under five year olds and malaria endemicity in 23 Sub-Saharan countries is used to show that the ABC prioritizes different populations than the level of bed net coverage by itself. Data from the following countries was used: Angola, Burkina Faso, Burundi, Cameroon, Congo Democratic Republic, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Nigeria, Rwanda, Senegal, Sierra Leone, Tanzania, Uganda, Zambia and Zimbabwe. The priority order given by the ABC and the bed net coverage are compared at the countries’ level, the first level administrative divisions and for five different wealth quintiles. Results Both at national level and at the level of the administrative divisions the ABC suggests a different priority order for selecting countries and divisions for future interventions. When taking into account malaria endemicity, measures assessing equality in access to bed nets across wealth quintiles, such as slopes of inequality, are prone to change. This suggests that when assessing inequality in access to bed nets one should take into account the local malaria endemicity for populations from different wealth quintiles. Conclusion Accounting for malaria endemicity highlights different countries, regions and socio-economic strata for future intervention than the bed net coverage by itself. Therefore, care should be taken to factor out any effects of local malaria endemicity in assessing bed net coverage and in prioritizing populations for further scale-up of bed net coverage. The ABC is proposed as a simple means to do this that is derived from an existing model of malaria epidemiology. PMID:24359227
Sutcliffe, James; Ji, Xin; Yin, Shaoman
2017-08-01
Insecticide-treated bed nets (ITNs) have played an integral role in malaria reduction but how insecticide depletion and accumulating physical damage affect ITN performance is poorly understood. More accurate methods are needed to assess damage to bed nets so that they can be designed, deployed and replaced optimally. Video recordings of female Anopheles gambiae in near approach (1-½ cm) to occupied untreated rectangular bed nets in a laboratory study were used to quantify the amount of mosquito activity (appearances over time) around different parts of the net, the per-appearance probability of a mosquito coming close to holes of different sizes (hole encounter) and the per-encounter probability of mosquitoes passing through holes of different sizes (hole passage). Appearance frequency on different parts of the net reflected previously reported patterns: the area of the net under greatest mosquito pressure was the roof, followed by the bottom 30 cm of the sides, followed by the 30 cm area immediately above this, followed by the upper two-thirds of the sides. The ratio of activity in these areas was (respectively) 250:33:5:1. Per-appearance probability of hole encounter on all parts of the net was strongly predicted by a factor combining hole perimeter and area. Per-encounter probability of hole passage, in turn, was strongly predicted by hole width. For a given width, there was a 20% greater risk of passage through holes on the roof than holes on the sides. Appearance, encounter and passage predictors correspond to various mosquito behaviours that have previously been described and are combined into a prototype mosquito entry risk tool that predicts mosquito entry rates for nets with various amounts of damage. Scenarios that use the entry risk tool to test the recommendations of the WHOPES proportionate hole index (pHI) suggest that the pHI hole size categories and failure to account for hole location likely sometimes lead to incorrect conclusions about net serviceability that could be avoided by using an entry risk tool of the form presented here instead. Practical methods of collecting hole position, shape and size information for bed net assessments using the tool in the field are discussed and include using image analysis and on-line geometric analysis tools.
Russell, Cheryl L.; Sallau, Adamu; Emukah, Emmanuel; Graves, Patricia M.; Noland, Gregory S.; Ngondi, Jeremiah M.; Ozaki, Masayo; Nwankwo, Lawrence; Miri, Emmanuel; McFarland, Deborah A.; Richards, Frank O.; Patterson, Amy E.
2015-01-01
Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the global malaria control strategy. LLIN ownership, however, does not necessarily guarantee use. Thus, even in the ideal setting in which universal coverage with LLINs has been achieved, maximal malaria protection will only be achieved if LLINs are used both correctly and consistently. This study investigated the factors associated with net use, independent of net ownership. Data were collected during a household survey conducted in Ebonyi State in southeastern Nigeria in November 2011 following a statewide mass LLIN distribution campaign and, in select locations, a community-based social behavior change (SBC) intervention. Logistic regression analyses, controlling for household bed net ownership, were conducted to examine the association between individual net use and various demographic, environmental, behavioral and social factors. The odds of net use increased among individuals who were exposed to tailored SBC in the context of a home visit (OR = 17.11; 95% CI 4.45–65.79) or who received greater degrees of social support from friends and family (ptrend < 0.001). Factors associated with decreased odds of net use included: increasing education level (ptrend = 0.020), increasing malaria knowledge level (ptrend = 0.022), and reporting any disadvantage of bed nets (OR = 0.39; 95% CI 0.23–0.78). The findings suggest that LLIN use is significantly influenced by social support and exposure to a malaria-related SBC home visit. The malaria community should thus further consider the importance of community outreach, interpersonal communication and social support on adoption of net use behaviors when designing future research and interventions. PMID:26430747
Fishing with bed nets on Lake Tanganyika: a randomized survey.
McLean, Kate A; Byanaku, Aisha; Kubikonse, Augustine; Tshowe, Vincent; Katensi, Said; Lehman, Amy G
2014-10-07
Malaria is among the most common causes of death along Lake Tanganyika, a problem which many aid organizations have attempted to combat through the distribution of free mosquito bed nets to high-risk communities. The Lake Tanganyika Floating Health Clinic (LTFHC), a health-based non-governmental organization (NGO), has observed residents of the Lake Tanganyika basin using bed nets to fish small fry near the shoreline, despite a series of laws that prohibit bed net use and other fine-gauge nets for fishing, implemented to protect the near-shore fish ecology. The LTFHC sought to quantify the sources of bed nets and whether they were being used for fishing. The LTFHC conducted a survey of seven lakeside villages in Lagosa Ward, Tanzania. The government has divided each village into two to six pre-existing geographic sub-villages depending on population size. Seven households per sub-village were chosen at random for survey administration. The survey consisted of 23 questions regarding mosquito bed net practices, including the use of bed nets for fishing, as well as questions pertaining to any perceived changes to the fish supply. A total of 196 surveys were administered over a four-week period with a 100% response rate. Over 87% of households surveyed have used a mosquito bed net for fishing at some point. The majority of respondents reported receiving their bed net for free (96.4%), observing "many" residents of their village using bed nets for fishing (97.4%), and noticing a subjective decrease in the fish supply over time (64.9%). The findings of this study raise concerns that the use of free malaria bed nets for fishing is widespread along Lake Tanganyika, and that this dynamic will have an adverse effect on fish ecology. Further studies are indicated to fully define the scope of bed net misuse and the effects of alternative vector control strategies in water-based communities.
Ahmed, Syed M; Hossain, Shamim; Kabir, Mohammad M; Roy, Sanjit
2011-12-13
BRAC, an indigenous non-governmental development organization (NGO), has been implementing a programme to prevent and control malaria in the 13 malaria-endemic districts of Bangladesh since 2007. One of the critical preventive interventions is the distribution of insecticidal bed nets (long-lasting insecticide-treated nets, LLINs and insecticide-treated ordinary nets, ITNs) to the community free of cost. This study aimed to assess progress in the possession, preferential use, and knowledge on use of the LLIN/ITNs including the programme's avowed pro-poor inclination one and three and half years after intervention began. A convenient sampling strategy based on malaria endemicity in the districts was adopted. First, thirty upazila (sub-district, with a population around 250,000)s were selected at random, with high prevalent districts contributing more upazilas; second, from each upazila, one (2008) to two (2011) villages (covered by insecticidal bed net distribution programme) were selected. From each village, households that had either one under-five child and/or a pregnant woman were included in the survey, one household being included only once. Data were collected using a pre-tested structured questionnaire. In all, 3,760 households in 2008 and 7,895 households in 2011 were surveyed for collecting relevant information. Proportion of households with at least one LLIN, and at least one LLIN/ITN increased (22-59 to 62-67% and 22-64% to 74-76% respectively) over time, including increase in the mean number of LLIN/ITNs per household (≤ 1 to 1 +). The programme achieved > 80% coverage in sleeping under an LLIN/ITN in the case of under-five children and pregnant women, especially in the high-endemic districts. Knowledge regarding critical time of hanging the net also increased over time (7-22 to 44-54%), but remained low. The pro-poor inclination of the programme is reflected in the status of relevant indicators according to self-rated poverty status of the households. There has been a substantial improvement in possession and usage of insecticidal bed nets especially for the two most vulnerable groups (under-five children and pregnant women), including a reduction of gaps between the high and low endemic districts, and the deficit and non-deficit households during the study period.
Prevention of malaria with pyrethroid treated bednets.
Curtis, C
1997-01-01
Malaria parasites (Plasmodium) are carried from person to person by female mosquitoes of the genus Anopheles. 80-90% of malaria incidence worldwide occurs in Africa. The main Anopheles species in Africa which bite humans are A. gambiae and A. funestus. Since these animals feed upon humans mainly during late night when most people are in bed, the consistent use of bednets can block the transmission of malaria. However, bednets should be treated with synthetic pyrethroid insecticides, for the physical barrier of bednets is often inadequate to prevent the entry of Anopheles. In addition, the mosquitoes are drawn to the bednets by the carbon dioxide and body odor emitted by the occupant. The insecticide-treated nets therefore double as mosquito traps. Bednets are treated by dipping them into an aqueous emulsion of a pyrethroid, wringing them out, then laying them out to dry. A considerable number of mosquitoes can be killed with a relatively small amount of insecticide. A treated net's insecticidal power can be tested by wrapping part of it around a wire frame, then introducing some Anopheles mosquitoes inside the frame. A median mosquito knockdown time of less than 10 minutes inside the net indicates a good pyrethroid deposit. The persistence of a net's insecticidal power is considerably reduced if the net is vigorously washed. People vary in the frequency they wash their nets. Most villagers in Tanzania were found to wash and retreat their nets every 6 months.
Airflow attenuation and bed net utilization: observations from Africa and Asia.
von Seidlein, Lorenz; Ikonomidis, Konstantin; Bruun, Rasmus; Jawara, Musa; Pinder, Margaret; Knols, Bart Gj; Knudsen, Jakob B
2012-06-15
Qualitative studies suggest that bed nets affect the thermal comfort of users. To understand and reduce this discomfort the effect of bed nets on temperature, humidity, and airflow was measured in rural homes in Asia and Africa, as well as in an experimental wind tunnel. Two investigators with architectural training selected 60 houses in The Gambia, Tanzania, Philippines, and Thailand. Data-loggers were used to measure indoor temperatures in hourly intervals over a 12 months period. In a subgroup of 20 houses airflow, temperature and humidity were measured at five-minute intervals for one night from 21.00 to 6.00 hrs inside and outside of bed nets using sensors and omni-directional thermo-anemometers. An investigator set up a bed net with a mesh size of 220 holes per inch 2 in each study household and slept under the bed net to simulate a realistic environment. The attenuation of airflow caused by bed nets of different mesh sizes was also measured in an experimental wind tunnel. The highest indoor temperatures (49.0 C) were measured in The Gambia. During the hottest months of the year the mean temperature at night (9 pm) was between 33.1 C (The Gambia) and 26.2 C (Thailand). The bed net attenuated the airflow from a minimum of 27% (Philippines) to a maximum of 71% (The Gambia). Overall the bed nets reduced airflow compared to un-attenuated airflow from 9 to 4 cm sec-1 or 52% (p<0.001). In all sites, no statistically significant difference in temperature or humidity was detected between the inside and outside of the bed net. Wind tunnel experiments with 11 different mesh-sized bed nets showed an overall reduction in airflow of 64% (range 55 - 71%) compared to un-attenuated airflow. As expected, airflow decreased with increasing net mesh size. Nets with a mesh of 136 holes inch-2 reduced airflow by 55% (mean; range 51 - 73%). A denser net (200 holes inch-2) attenuated airflow by 59% (mean; range 56 - 74%). Despite concerted efforts to increase the uptake of this intervention in many areas uptake remains poor. Bed nets reduce airflow, but have no influence on temperature and humidity. The discomfort associated with bed nets is likely to be most intolerable during the hottest and most humid period of the year, which frequently coincides with the peak of malaria vector densities and the force of pathogen transmission. These observations suggest thermal discomfort is a factor limiting bed net use and open a range of architectural possibilities to overcome this limitation.
Faulde, Michael K; Albiez, Gunther; Nehring, Oliver
2010-03-01
A novel long-lasting repellent-treated net (LLRTN) has been designed by binding the skin repellents N,N-diethyl-m-toluamide (DEET), or IR3535, onto the fibres of bed net fabric using a new polymer-coating technique. The repellent toxicological effectiveness and residual activity of a factory-based repellent-impregnated fabric has been evaluated by laboratory testing against adult Aedes aegypti mosquitoes and nymphal Ixodes ricinus ticks. By using this repellent-embedding impregnation technique, concentrations exceeding 10 g/m(2) could be achieved with one single polymer layer. Both DEET- and IR3535-impregnated fabrics revealed a dose-dependent insecticidal as well as acaricidal activity. One hundred percent knockdown times of DEET-treated bed nets ranged from 187.5 +/- 31.8 to 27.5 +/- 3.5 min against A. aegypti, and between 214 +/- 47 and 22.6 +/- 5 min against nymphal I. ricinus, linked to a DEET concentration of 1.08 and 10.58 g/m(2), respectively. With IR3535, A. aegypti produced dose-dependent 100% knockdown times varying from 87.5 +/- 10.6 to 57.5 +/- 3.5 min and between 131.4 +/- 6.5 and 33.8 +/- 5 min against nymphal I. ricinus, respectively, linked to concentrations between 1.59 and 10.02 g/m(2). One hundred percent repellency measured by complete landing and biting protection of impregnated fabric by using the arm-in-cage test could be achieved at DEET concentrations exceeding 3.7 to 3.9 g/m(2), and for IR3535 concentrations over 10 g/m(2). One hundred percent landing and biting protection could be preserved with DEET-treated fabrics for 29 weeks at an initial concentration of 4.66 g/m(2), 54 weeks at 8.8 g/m(2), 58 weeks at 9.96 g/m(2) and 61 weeks at 10.48 g/m(2) for DEET, and 23 weeks for IR3535-treated fabric at a concentration of 10.02 g/m(2). Unlike repellent-treated fabric, a brand of a commercially available long-lasting insecticide-treated net tested containing 500 mg permethrin/m(2) did not protect from mosquito bites. First results on bioactivity and long-lasting efficacy show that the new LLRTN technique is highly promising as a potential candidate for future malaria control strategies, especially in areas where pyrethroid resistance occurs.
2013-01-01
Background The last decade has witnessed increased funding for malaria control. Malaria experts have used the opportunity to advocate for rollout of such interventions as free bed nets. A free bed net distribution strategy is seen as the quickest way to improve coverage of effective malaria control tools especially among poorest communities. Evidence to support this claim is however, sparse. This study explored the effectiveness of targeted free bed net distribution strategy in achieving equity in terms of ownership and use of bed nets and also reduction of malaria prevalence among children under-five years of age. Methods National malaria indicator survey (MIS) data from Angola, Tanzania and Uganda was used in the analysis. Hierarchical multilevel logistic regression models were used to analyse the relationship between variables of interest. Outcome variables were defined as: childhood test-confirmed malaria infections, household ownership of any mosquito net and children’s use of any mosquito nets. Marginal effects of having free bed net distribution on households with different wealth status were calculated. Results Angolan children from wealthier households were 6.4 percentage points less likely to be parasitaemic than those in poorest households, whereas those from Tanzania and Uganda were less likely to test malaria positive by 7 and 11.6 percentage points respectively (p < 0.001). The study estimates and present results on the marginal effects based on the impact of free bed net distribution on children's malaria status given their socio-economic background. Poorest households were less likely to own a net by 21.4% in Tanzania, and 2.8% in Uganda, whereas both poorer and wealthier Angolan households almost achieved parity in bed net ownership (p < 0.001). Wealthier households had a higher margin of using nets than poorest people in both Tanzania and Uganda by 11.4% and 3.9% respectively. However, the poorest household in Angola had a 6.1% net use advantage over children in wealthier households (p < 0.001). Conclusion This is the first study to use nationally representative data to explore inequalities in bed net ownership and related consequences on childhood malaria infection rates across different countries. While targeted distribution of free bed nets improved overall bed net ownership, it did not overcome ownership inequalities as measured by household socioeconomic status. Use of bed nets was disproportionately lower among poorest children, except for Angola where bed net use was higher among poorest households when compared to children in wealthier households. The study highlights the need for malaria control world governing bodies and policy makers to continue working on finding appropriate strategies to improve access to effective malaria control tools especially by the poorest who often times bears the brunt of malaria burden than their wealthier counterparts. PMID:23855893
Norris, Laura C; Norris, Douglas E
2013-04-01
In 2007, the first free mass distribution of insecticide-treated bed nets (ITNs) occurred in southern Zambia. To determine the effect of ITNs on heterogeneity in biting rates, human DNA from Anopheles arabiensis blood meals was genotyped to determine the number of hosts that had contributed to the blood meals. The multiple feeding rate decreased from 18.9% pre-ITN to 9.1% post-ITN, suggesting that mosquito biting had focused onto a smaller fraction of the population. Pre-ITN, 20% of persons in a household provided 40% of blood meals, which increased to 59% post-ITN. To measure heterogeneity over a larger scale, mosquitoes were collected in 90 households in two village areas. Of these households, 25% contributed 78.1% of An. arabiensis, and households with high frequencies of An. arabiensis were significantly spatially clustered. The results indicate that substantial heterogeneity in malaria risk exists at local and household levels, and household-level heterogeneity may be influenced by interventions, such as ITNs.
Moon, Troy D; Hayes, Caleb B; Blevins, Meridith; Lopez, Melanie L; Green, Ann F; González-Calvo, Lazaro; Olupona, Omo
2016-04-11
Malaria remains a major threat to some 3.2 billion persons globally. Malaria contributes heavily to the overall disease burden in Mozambique and is considered endemic. A cornerstone of Mozambique's vector control strategy has been to strive for universal coverage of insecticide-treated nets (ITN). The study is a population-based cross-sectional survey of female heads-of-household in Zambézia Province, Mozambique conducted during August-September, 2010 and April-May, 2014. Analyses accounted for a stratified two-stage cluster sample design. Outcomes of interest included sleeping under a mosquito net during the previous night. Descriptive statistics were calculated for three oversampled districts and for the entire province. Multivariable logistic regression analysis was used to estimate factors associated with both changes over time and increased mosquito bed net usage. Of the 3916 households interviewed in 2010 and 3906 households in 2014, 64.3% were in possession of at least one mosquito bed net. A higher proportion of households in Namacurra (90%) reported possession of a mosquito net, compared to Alto Molócuè (77%) and Morrumbala (34%), respectively in 2014. Of pregnant respondents, 58.6% reported sleeping under a mosquito net the previous night in 2010 compared to 68.4% in 2014. Fifty percent of children 0-59 months slept under a mosquito net the previous night in 2010 compared to 60% in 2014. Factors associated with use of a mosquito net for female head-of-household respondents were higher education, understanding Portuguese, larger household size, having electricity in the household, and larger household monthly income. As travel time to a health facility increased (per 1 h), respondents had 13% lower odds of sleeping under a mosquito net (OR 0.87; 95% CI 0.74-1.01, p = 0.07). Pregnant women in 2014 had a 2.4 times higher odds of sleeping under a bed net if they lived in Namacurra compared to Alto Molócuè (95% CI 0.91-6.32, p = 0.002 for district). Higher maternal education, living in Namacurra, and acquisition of mosquito bed nets were associated with a child 0-59 months reporting sleeping under the net in the previous night in 2014. Intensified focus on the poorest, least educated, and most distant from health services is needed to improve equity of ITN availability and usage. Additionally, while some districts have already surpassed goals in terms of coverage and utilization of ITN, renewed emphasis should be placed on bringing all geographic regions of the province closer to meeting these targets.
Okoyo, Collins; Mwandawiro, Charles; Kihara, Jimmy; Simiyu, Elses; Gitonga, Caroline W; Noor, Abdisalan M; Njenga, Sammy M; Snow, Robert W
2015-12-22
Under trial conditions insecticide-treated nets have been shown to provide significant clinical and mortality protection under a range of malaria transmission intensity conditions. There are, however, few operational impact data, notably in very intense transmission conditions. This study, reports on malaria infection among Kenyan schoolchildren living in areas of intense malaria transmission and their reported use of insecticide-treated bed nets. 5188 children in 54 schools were randomly sampled from seven counties surrounding Lake Victoria between May and June 2014. A questionnaire was administered to schoolchildren in classes 2-6 on the use of a long-lasting, insecticide-treated net (LLIN) the night before the survey and provided a single blood sample for a rapid diagnostic test for malaria infection. Analysis of the impact of insecticide-treated net use on malaria prevalence was undertaken using a multivariable, mixed effects, logistic regression at 95% confidence interval (CI), taking into account hierarchical nature of the data and results adjusted for school clusters. The overall prevalence of malaria infection was 48.7%, two-thirds (67.9%) of the children reported using LLIN, 91.3% of the children reported that their households own at least one LLIN and the household LLIN coverage was 2.5 persons per one LLIN. The prevalence of infection showed variation across the counties, with prevalence being highest in Busia (66.9%) and Homabay (51.8%) counties, and lowest in Migori County (29.6%). Generally, malaria parasite prevalence differed between age groups and gender with the highest prevalence occurring in children below 7 years (50.6%) and males (52.2%). Adjusting for county and school, there was a significant reduction in odds of malaria infection among the schoolchildren who reported LLIN use the previous night by 14 % (aOR 0.86, 95% CI 0.74-0.98, P < 0.027). Malaria transmission continues to be high around Lake Victoria. Despite evidence of increasing pyrethroid resistance and the likely overall efficacy of LLIN distributed several years prior to the survey, LLIN continue to provide protection against infection among school-aged children.
Sand fly control in Kenya with residual pesticide application on HESCO barriers
USDA-ARS?s Scientific Manuscript database
US military operations in hot-arid regions still face significant impacts from mosquito and sand fly vectors of diseases. Personal protective measures (PPM) such as DEET or treated bed nets and clothing can reduce contact with disease vectors and nuisance insects; however, irregular use of PPM coupl...
Iwasaki, Toshiki; Nelson, Jonathan M.; Shimizu, Yasuyuki; Parker, Gary
2017-01-01
Asymptotic characteristics of the transport of bed load tracer particles in rivers have been described by advection-dispersion equations. Here we perform numerical simulations designed to study the role of free bars, and more specifically single-row alternate bars, on streamwise tracer particle dispersion. In treating the conservation of tracer particle mass, we use two alternative formulations for the Exner equation of sediment mass conservation: the flux-based formulation, in which bed elevation varies with the divergence of the bed load transport rate, and the entrainment-based formulation, in which bed elevation changes with the net deposition rate. Under the condition of no net bed aggradation/degradation, a 1-D flux-based deterministic model that does not describe free bars yields no streamwise dispersion. The entrainment-based 1-D formulation, on the other hand, models stochasticity via the probability density function (PDF) of particle step length, and as a result does show tracer dispersion. When the formulation is generalized to 2-D to include free alternate bars, however, both models yield almost identical asymptotic advection-dispersion characteristics, in which streamwise dispersion is dominated by randomness inherent in free bar morphodynamics. This randomness can result in a heavy-tailed PDF of waiting time. In addition, migrating bars may constrain the travel distance through temporary burial, causing a thin-tailed PDF of travel distance. The superdiffusive character of streamwise particle dispersion predicted by the model is attributable to the interaction of these two effects.
NASA Astrophysics Data System (ADS)
Iwasaki, Toshiki; Nelson, Jonathan; Shimizu, Yasuyuki; Parker, Gary
2017-04-01
Asymptotic characteristics of the transport of bed load tracer particles in rivers have been described by advection-dispersion equations. Here we perform numerical simulations designed to study the role of free bars, and more specifically single-row alternate bars, on streamwise tracer particle dispersion. In treating the conservation of tracer particle mass, we use two alternative formulations for the Exner equation of sediment mass conservation: the flux-based formulation, in which bed elevation varies with the divergence of the bed load transport rate, and the entrainment-based formulation, in which bed elevation changes with the net deposition rate. Under the condition of no net bed aggradation/degradation, a 1-D flux-based deterministic model that does not describe free bars yields no streamwise dispersion. The entrainment-based 1-D formulation, on the other hand, models stochasticity via the probability density function (PDF) of particle step length, and as a result does show tracer dispersion. When the formulation is generalized to 2-D to include free alternate bars, however, both models yield almost identical asymptotic advection-dispersion characteristics, in which streamwise dispersion is dominated by randomness inherent in free bar morphodynamics. This randomness can result in a heavy-tailed PDF of waiting time. In addition, migrating bars may constrain the travel distance through temporary burial, causing a thin-tailed PDF of travel distance. The superdiffusive character of streamwise particle dispersion predicted by the model is attributable to the interaction of these two effects.
Komazawa, Osuke; Kaneko, Satoshi; K’Opiyo, James; Kiche, Ibrahim; Wanyua, Sheru; Shimada, Masaaki; Karama, Mohamed
2012-01-01
Background Increasing the distribution and use of insecticide-treated nets (ITNs) in Sub-Saharan Africa has made controlling malaria with ITNs more practical. We evaluated community effects induced by ITNs, specifically long-lasting insecticidal nets (LLINs), under ordinary conditions in an endemic malaria area of Western Kenya. Methods Using the database from Mbita Health and Demographic Surveillance System (HDSS), children younger than 5 years old were assessed over four survey periods. We analyzed the effect of bed net usage, LLIN density and population density of young people around a child on all-cause child mortality (ACCM) rates using Cox PH models. Results During the study, 14,554 children were followed and 250 deaths were recorded. The adjusted hazard ratios (HRs) for LLIN usage compared with no net usage were not significant among the models: 1.08 (95%CI 0.76–1.52), 1.19 (95%CI 0.69–2.08) and 0.92 (95%CI 0.42–2.02) for LLIN users, untreated net users, and any net users, respectively. A significant increasing linear trend in risk across LLIN density quartiles (HR = 1.25; 95%CI 1.03–1.51) and a decreasing linear trend in risk across young population density quartiles among non-net user children (HR = 0.77; 95%CI 0.63–0.94) were observed. Conclusions Although our data showed that current LLIN coverage level (about 35%) could induce a community effect to protect children sleeping without bed nets even in a malaria-endemic area, it appears that a better system is needed to monitor the current malaria situation globally in order to optimize malaria control programs with limited resources. PMID:23185378
Equity trends in ownership of insecticide-treated nets in 19 sub-Saharan African countries.
Taylor, Cameron; Florey, Lia; Ye, Yazoume
2017-05-01
To examine the change in equity of insecticide-treated net (ITN) ownership among 19 malaria-endemic countries in sub-Saharan Africa before and after the launch of the Cover The Bed Net Gap initiative. To assess change in equity in ownership of at least one ITN by households from different wealth quintiles, we used data from Demographic and Health Surveys and Malaria Indicator Surveys. We assigned surveys conducted before the launch (2003-2008) as baseline surveys and surveys conducted between 2009-2014 as endpoint surveys. We did country-level and pooled multicountry analyses. Pooled analyses based on malaria transmission risk, were done by dividing geographical zones into either low- and intermediate-risk or high-risk. To assess changes in equity, we calculated the Lorenz concentration curve and concentration index (C-index). Out of the 19 countries we assessed, 13 countries showed improved equity between baseline and endpoint surveys and two countries showed no changes. Four countries displayed worsened equity, two favouring the poorer households and two favouring the richer. The multicountry pooled analysis showed an improvement in equity (baseline survey C-index: 0.11; 95% confidence interval, CI: 0.10 to 0.11; and endpoint survey C-index: 0.00; 95% CI: -0.01 to 0.00). Similar trends were seen in both low- and intermediate-risk and high-risk zones. The mass ITN distribution campaigns to increase coverage, linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of ITN ownership across sub-Saharan Africa with significant reduction in inequity among wealth quintiles.
2014-01-01
Background One of the control tools to reduce malaria transmission is the use of LLINs. However, several studies show that household bed net use is quite low. A study was developed to better understand the cultural factors that might explain these gaps in Benin. One reason mentioned is that bed nets can catch on fire and cause harm. This paper presents a summary of these findings, their analysis and the ensuing issues. Methods This anthropological study is based on an inductive qualitative approach, including 91 semi-structured interviews conducted from July 2011 to March 2012 in a health district in Southern Benin. Results Fifty-six persons stated that bed nets can catch on fire but do not always refer to specific facts. However, 34 of the 56 people narrate specific events they heard or experienced. 39 accounts were geographically located and situated in time, with various details. In 27 situations, people were burned, for which 12 people reportedly died. Discussion The disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found. Bed net fires were noted in 10 countries, but it is impossible to ascertain the frequency of such events. Moreover, bodily harm can be significant, and several cases of death attributed to bed net fires were noted. Conclusions Indisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method. However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some. If some people fear the risk of fires, this possibility must be addressed during information and prevention sessions on malaria, with a communication strategy tailored to specific social contexts. Moreover, all possible measures should be taken to limit the harm suffered by individuals and their families. PMID:24972637
Snow, R W; McCabe, E; Mbogo, C N; Molyneux, C S; Some, E S; Mung'ala, V O; Nevill, C G
1999-03-01
The results of recently completed trials in Africa of insecticide-treated bed nets (ITBN) offer new possibilities for malaria control. These experimental trials aimed for high ITBN coverage combined with high re-treatment rates. Whilst necessary to understand protective efficacy, the approaches used to deliver the intervention provide few indications of what coverage of net re-treatment would be under operational conditions. Varied delivery and financing strategies have been proposed for the sustainable delivery of ITBNs and re-treatment programmes. Following the completion of a randomized, controlled trial on the Kenyan coast, a series of suitable delivery strategies were used to continue net re-treatment in the area. The trial adopted a bi-annual, house-to-house re-treatment schedule free of charge using research project staff and resulted in over 95% coverage of nets issued to children. During the year following the trial, sentinel dipping stations were situated throughout the community and household members informed of their position and opening times. This free re-treatment service achieved between 61-67% coverage of nets used by children for three years. In 1997 a social marketing approach, that introduced cost-retrieval, was used to deliver the net re-treatment services. The immediate result of this transition was that significantly fewer of the mothers who had used the previous re-treatment services adopted this revised approach and coverage declined to 7%. The future of new delivery services and their financing are discussed in the context of their likely impact upon previously defined protective efficacy and cost-effectiveness estimates.
Oduro, Abraham R.; Fryauff, David J.; Koram, Kwadwo A.; Rogers, William O.; Anto, Francis; Atuguba, Frank; Anyorigiya, Thomas; Adjuik, Martin; Ansah, Patrick; Hodgson, Abraham; Nkrumah, Francis
2010-01-01
Demographics and health practices of 2,232 pregnant women in rural northeastern Ghana and characteristics of their 2,279 newborns were analyzed to determine benefits associated with intermittent preventive treatment (IPTp), antenatal care, and/or bed net use during pregnancy. More than half reported bed net use, 90% reported at least two antenatal care visits, and > 82% took at least one IPTp dose of sulfadoxine-pyrimethamine. Most used a bed net and IPTp (45%) or IPTp alone (38%). Low birth weight (< 2,500 grams) characterized 18.3% of the newborns and was significantly associated with female sex, Nankam ethnicity, first-born status, and multiple births. Among newborns of primigravidae, IPTp was associated with a significantly greater birth weight, significantly fewer low birth weight newborns, improved hemoglobin levels, and less anemia. Babies of multigravidae derived no benefit to birth weight or hemoglobin level from single or multiple doses of sulfadoxine-pyrimethamine during pregnancy. No differences or benefits were seen when a bed net was the only protective factor. PMID:20595482
Equity trends in ownership of insecticide-treated nets in 19 sub-Saharan African countries
Florey, Lia; Ye, Yazoume
2017-01-01
Abstract Objective To examine the change in equity of insecticide-treated net (ITN) ownership among 19 malaria-endemic countries in sub-Saharan Africa before and after the launch of the Cover The Bed Net Gap initiative. Methods To assess change in equity in ownership of at least one ITN by households from different wealth quintiles, we used data from Demographic and Health Surveys and Malaria Indicator Surveys. We assigned surveys conducted before the launch (2003–2008) as baseline surveys and surveys conducted between 2009–2014 as endpoint surveys. We did country-level and pooled multicountry analyses. Pooled analyses based on malaria transmission risk, were done by dividing geographical zones into either low- and intermediate-risk or high-risk. To assess changes in equity, we calculated the Lorenz concentration curve and concentration index (C-index). Findings Out of the 19 countries we assessed, 13 countries showed improved equity between baseline and endpoint surveys and two countries showed no changes. Four countries displayed worsened equity, two favouring the poorer households and two favouring the richer. The multicountry pooled analysis showed an improvement in equity (baseline survey C-index: 0.11; 95% confidence interval, CI: 0.10 to 0.11; and endpoint survey C-index: 0.00; 95% CI: −0.01 to 0.00). Similar trends were seen in both low- and intermediate-risk and high-risk zones. Conclusion The mass ITN distribution campaigns to increase coverage, linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of ITN ownership across sub-Saharan Africa with significant reduction in inequity among wealth quintiles. PMID:28479633
Noor, Abdisalan M; Amin, Abdinasir A; Akhwale, Willis S; Snow, Robert W
2007-01-01
Background Inexpensive and efficacious interventions that avert childhood deaths in sub-Saharan Africa have failed to reach effective coverage, especially among the poorest rural sectors. One particular example is insecticide-treated bed nets (ITNs). In this study, we present repeat observations of ITN coverage among rural Kenyan homesteads exposed at different times to a range of delivery models, and assess changes in coverage across socioeconomic groups. Methods and Findings We undertook a study of annual changes in ITN coverage among a cohort of 3,700 children aged 0–4 y in four districts of Kenya (Bondo, Greater Kisii, Kwale, and Makueni) annually between 2004 and 2006. Cross-sectional surveys of ITN coverage were undertaken coincidentally with the incremental availability of commercial sector nets (2004), the introduction of heavily subsidized nets through clinics (2005), and the introduction of free mass distributed ITNs (2006). The changing prevalence of ITN coverage was examined with special reference to the degree of equity in each delivery approach. ITN coverage was only 7.1% in 2004 when the predominant source of nets was the commercial retail sector. By the end of 2005, following the expansion of heavily subsidized clinic distribution system, ITN coverage rose to 23.5%. In 2006 a large-scale mass distribution of ITNs was mounted providing nets free of charge to children, resulting in a dramatic increase in ITN coverage to 67.3%. With each subsequent survey socioeconomic inequity in net coverage sequentially decreased: 2004 (most poor [2.9%] versus least poor [15.6%]; concentration index 0.281); 2005 (most poor [17.5%] versus least poor [37.9%]; concentration index 0.131), and 2006 with near-perfect equality (most poor [66.3%] versus least poor [66.6%]; concentration index 0.000). The free mass distribution method achieved highest coverage among the poorest children, the highly subsidised clinic nets programme was marginally in favour of the least poor, and the commercial social marketing favoured the least poor. Conclusions Rapid scaling up of ITN coverage among Africa's poorest rural children can be achieved through mass distribution campaigns. These efforts must form an important adjunct to regular, routine access to ITNs through clinics, and each complimentary approach should aim to make this intervention free to clients to ensure equitable access among those least able to afford even the cost of a heavily subsidized net. PMID:17713981
Sedlmayr, Richard; Fink, Günther; Miller, John M; Earle, Duncan; Steketee, Richard W
2013-03-18
Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia's cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme. The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia's NMCP. The results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial.
Monroe, April; Harvey, Steven A; Lam, Yukyan; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel
2014-03-06
Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious "crusades" where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective.
A climate-based malaria model with the use of bed nets.
Wang, Xiunan; Zhao, Xiao-Qiang
2018-07-01
Insecticide-treated bed nets (ITNs) are among the most important and effective intervention measures against malaria. In order to investigate the impact of bed net use on disease control, we formulate a periodic vector-bias malaria model incorporating the juvenile stage of mosquitoes and the use of ITNs. We derive the vector reproduction ratio [Formula: see text] and the basic reproduction ratio [Formula: see text]. We show that the global dynamics of the model is completely determined by these two reproduction ratios. More precisely, the mosquito-free periodic solution is globally attractive if [Formula: see text]; the unique disease-free periodic solution is globally attractive if [Formula: see text] and [Formula: see text]; and the model admits a unique positive periodic solution and it is globally attractive if [Formula: see text] and [Formula: see text]. Numerically, we study the malaria transmission case in Port Harcourt, Nigeria. Our findings show that the use of ITNs has a positive effect on reducing [Formula: see text], and that malaria may be eliminated from this area if over 75% of the human population were to use ITNs. The simulation about the long term behavior of solutions has good agreement with the obtained analytic result. Moreover, we find that the ignorance of the vector-bias effect may result in underestimation of the basic reproduction ratio [Formula: see text]. Another notable result is that the infection risk would be underestimated if the basic reproduction ratio [Formula: see text] of the time-averaged autonomous system were used.
Chourasia, Mehul Kumar; Abraham, Vinod J; John, Jacob
2014-10-01
Malaria is endemic in several states of India with high tribal population. Effective use of long-lasting insecticide treated bed nets (LLITNs) can reduce the burden of malaria in these settings. This study assessed the knowledge and behaviour regarding malaria in a tribal population and compared two health education strategies for enhancing effective utilisation of bed nets. A community-based intervention study was carried out among 218 households in two villages. One community received household level training on effective utilisation of LLITNs while the others received training in a mass campaign and outcomes were measured after 2 months. The study showed that the proportion utilising LLITNs was significantly higher among those receiving household level training as compared to those who received the mass campaign. Household level training appears to be a more effective form of health education for improving knowledge and promoting use of LLITNs in these isolated community groups. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Impact of a mass media campaign on bed net use in Cameroon
2013-01-01
Background In 2011, Cameroon and its health partners distributed over eight million free long-lasting insecticide treated nets (LLINs) in an effort to reduce the significant morbidity and mortality burden of malaria in the country. A national communications campaign was launched in July 2011 to ensure that as the nets were delivered, they would be used consistently to close a net use gap: only 51.6% of adults and 63.4% of their children in households with at least one net were sleeping under nets before the distribution. Even in households with at least one net for every two people, over 35% of adults were not sleeping under a net. Malaria No More (MNM) adapted its signature NightWatch communications programme to fit within the coordinated “KO Palu” (Knock Out Malaria) national campaign. This study evaluates the impact of KO Palu NightWatch activities (that is, the subset of KO Palu-branded communications that were funded by MNM’s NightWatch program) on bed net use. Methods Using national survey data collected at baseline (in March/April 2011, before the national LLIN distribution and KO Palu NightWatch launch) and post-intervention (March/April 2012), this study evaluates the impact of exposure to KO Palu NightWatch activities on last-night net use by Cameroonian adults and their children under five. First, a plausible case for causality was established by comparing net use in 2011 and 2012 and measuring exposure to KO Palu NightWatch; next, a propensity score matching (PSM) model was used to estimate the impact of exposure on net use by simulating a randomized control trial; finally, the model was tested for sensitivity to unmeasured factors. Results The PSM model estimated that among Cameroonians with at least one net in their household, exposure to KO Palu NightWatch activities was associated with a 6.6 percentage point increase in last-night net use among respondents (65.7% vs 59.1%, p < 0.05) and a 12.0 percentage point increase in last-night net use among respondents’ children under five (79.6% vs 67.6%, p < 0.025). Sensitivity analysis suggests only a very small risk of bias from omitted factors influencing exposure and net use. Conclusions Extrapolating the results of the PSM model to the population of Cameroonians with access to at least one mosquito net, this analysis estimates that approximately 298,000 adults and over 221,000 of their children under five slept under a bed net because of the knowledge, motivation, and/or timely reminder provided by KO Palu NightWatch activities. The programme cost less than $0.16 per adult reached, and less than $1.62 per additional person protected by a net. The results suggest a strong role for mass media communication interventions in support of investments in malaria control commodities such as LLINs. PMID:23351674
2014-01-01
Background To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. Methods In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007 2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. Results There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. Conclusion The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria. PMID:24884786
Eze, Ikenna C; Kramer, Karen; Msengwa, Amina; Mandike, Renata; Lengeler, Christian
2014-05-27
To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007-2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria.
INSECTICIDE-TREATED BED NETS IN RONDÔNIA, BRAZIL: EVALUATION OF THEIR IMPACT ON MALARIA CONTROL
Vieira, Gabriel de Deus; Basano, Sergio de Almeida; Katsuragawa, Tony Hiroshi; Camargo, Luís Marcelo Aranha
2014-01-01
Mosquito nets treated with long-lasting insecticide (LLINs), when used in compliance with guidelines of the World Health Organization, may be effective for malaria vector control. In 2012, approximately 150,000 LLINs were installed in nine municipalities in the state of Rondônia. However, no studies have assessed their impact on the reduction of malaria incidence. This study analyzed secondary data of malaria incidence, in order to assess the impact of LLINs on the annual parasite incidence (API). The results showed no statistically significant differences in API one year after LLIN installation when compared to municipalities without LLINs. The adoption of measures for malaria vector control should be associated with epidemiological studies and evaluations of their use and efficiency, with the aim of offering convincing advantages that justify their implementation and limit malaria infection in the Amazon Region. PMID:25351543
2014-01-01
Background Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. Methods To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. Results In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Conclusions Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious “crusades” where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective. PMID:24602371
Soe, Htin Zaw; Thi, Aung; Aye, Ni Ni
2017-11-06
Malaria is a major public health problem in Myanmar. Migrant populations are at high risk of contracting malaria and its control is more difficult than for settled population. Studies on malaria and migration are rare in Myanmar. This study was undertaken with the main objective of identifying socioeconomic and behavioural determinants of malaria among the migrant workers involved in gold mining, rubber and oil palm plantations. A cross-sectional analytic study was conducted using pretested interview-administered questionnaires among internal migrants (n = 406) in the malaria endemic townships of Shwegyin, Bago Region, Thanbyuzayat, Mon State and Kawthaung, Taninthayi Region from August to November, 2015. Data were collected by well-trained Basic Health Staff members in study areas, and then analysed by SPSS version 16.0 using Chi-square tests with significant level at 0.05. Majority of participants were male, Bahmar nationals, married and with primary basic education level and below. The mean duration of migratory work was 4.51 years. 43.1% of them gave definite previous history of malaria within last two years during migration. 92.9% (377/406) of them always used bed nets. Malaria determinants found were male gender (OR = 1.84, 95% CI: 1.22-2.77; P = 0.0040), habit of going out at dawn (OR = 2.36, 95% CI: 1.58-3.52; P < 0.001), usual sleeping indoors (OR = 2.14, 95% CI: 1.04-4.42; P = 0.036), torn bed net or net with large hole(s) (OR = 2.0, 95% CI: 1.21-3.3; P = 0.006), habit of not always sleeping under a bed net at night (OR = 2.02, 95% CI: 1.15-3.52; P = 0.014), alcohol drinking (OR = 2.71, 95% CI: 1.73-4.26; P < 0.001) and failure to attend malaria health talk (OR = 1.78, 95% CI: 1.2-2.65; P = 0.004). The present study highlighted that it is warranted to launch an effective health education programme for malaria, and to encourage the proper use of insecticide-treated bed nets, blankets and/or mufflers and mosquito repellents to reduce the occurrence of malaria among the migrants.
Ahmed, Syed Masud; Zerihun, Abebual
2010-01-01
Background The use of insecticidal bed nets is found to be an effective public health tool for control of malaria, especially for under-five children and pregnant women. BRAC, an indigenous Bangladeshi non-governmental development organization, started working in the East African state of Uganda in June 2006. As part of its efforts to improve the health and well-being of its participants, BRAC Uganda has been distributing long lasting insecticide-treated bed nets (LLIN) at a subsidized price through health volunteers since February 2008. This study was conducted in March-April 2009 to examine how equitable the programme had been in consistence with BRAC Uganda's pro-poor policy. Methodology/Principal Findings Information on possession of LLINs and relevant knowledge on its proper use and maintenance was collected from households either with an under-five child and/or a pregnant woman. The sample included three villages from each of the 10 branch offices where BRAC Uganda's community-based health programme was operating. Data were collected by trained enumerators through face-to-face interviews using a hand-held personal digital assistant (PDA). Findings reveal that the study population had superficial knowledge on malaria and its transmission, including the use and maintenance of LLINs. The households' rate of possession of bed nets (41–59%), and the proportion of under-five children (17–19%) and pregnant women (25–27%) who reported sleeping under an LLIN were not encouraging. Inequity was observed in the number of LLINs possessed by the households, in the knowledge on its use and maintenance, and between the two programme areas. Conclusions/Significance The BRAC Uganda's LLINs distribution at a subsidized price appeared to be inadequate and inequitable, and BRAC's knowledge dissemination is insufficient for initiating preventive actions such as proper use of LLINs to interrupt malaria transmission. Findings contribute to the on-going debate on LLINs distribution in Africa and make a strong case for its free distribution. PMID:20844749
West, Philippa A; Protopopoff, Natacha; Rowland, Mark W; Kirby, Matthew J; Oxborough, Richard M; Mosha, Franklin W; Malima, Robert; Kleinschmidt, Immo
2012-08-10
Insecticide-treated nets (ITN) are one of the most effective measures for preventing malaria. Mass distribution campaigns are being used to rapidly increase net coverage in at-risk populations. This study had two purposes: to evaluate the impact of a universal coverage campaign (UCC) of long-lasting insecticidal nets (LLINs) on LLIN ownership and usage, and to identify factors that may be associated with inadequate coverage. In 2011 two cross-sectional household surveys were conducted in 50 clusters in Muleba district, north-west Tanzania. Prior to the UCC 3,246 households were surveyed and 2,499 afterwards. Data on bed net ownership and usage, demographics of household members and household characteristics including factors related to socio-economic status were gathered, using an adapted version of the standard Malaria Indicator Survey. Specific questions relating to the UCC process were asked. The proportion of households with at least one ITN increased from 62.6% (95% Confidence Interval (CI) = 60.9-64.2) before the UCC to 90.8% (95% CI = 89.0-92.3) afterwards. ITN usage in all residents rose from 40.8% to 55.7%. After the UCC 58.4% (95% CI = 54.7-62.1) of households had sufficient ITNs to cover all their sleeping places. Households with children under five years (OR = 2.4, 95% CI = 1.9-2.9) and small households (OR = 1.9, 95% CI = 1.5-2.4) were most likely to reach universal coverage. Poverty was not associated with net coverage. Eighty percent of households surveyed received LLINs from the campaign. The UCC in Muleba district of Tanzania was equitable, greatly improving LLIN ownership and, more moderately, usage. However, the goal of universal coverage in terms of the adequate provision of nets was not achieved. Multiple, continuous delivery systems and education activities are required to maintain and improve bed net ownership and usage.
Ouattara, Jean Pierre Nabléni; Louwagie, Johanna; Pigeon, Olivier; Spanoghe, Pieter
2013-01-01
Background One of the best ways to prevent malaria is the use of insecticide-treated bed nets. Manufacturers pursue easier, safer and more efficient nets. Hence, many studies on the efficacy and wash resistance using World Health Organization standards have been reported. The commonly used detergent is “Savon de Marseille”, because it closely resembles actually used soaps. At the 54th Collaborative International Pesticides Analytical Council (CIPAC) Technical Meeting in 2010, it was suggested to replace it by a standardized “CIPAC washing agent”. The aim of this study was to investigate the difference between a laboratory hand washing simulation using the CIPAC washing agent (method-1) and a domestic washing (method-2) on different bed nets, as well as the effect of the drying process on the release of active ingredient. Methods Interceptor®, Permanet®2.0 and Netprotect® nets were used in three treatments, each repeated 20 times. The first treatment included method-1 washing and indoor drying. The second treatment included method-2 washing and indoor drying. The third treatment used method-2 washing and UV-drying. The residual insecticide contents were determined using gas chromatography. Results The washing procedure and the number of washes have a significant effect on the release of active ingredient. Statistically, the two washing methods have the same effect on removing the active ingredient from the Interceptor® and Permanet®2.0 net, but a significantly different influence on the Netprotect® nets. The drying process has no significant effect on the insecticide. Conclusion Both washing procedures affected the amount of insecticide remaining on nets independently of the impregnation technology. The active ingredient decreases with the number of washing cycles following an exponential or logarithmic model for coated nets. The laboratory hand washing simulation had more impact on the decrease of active ingredient content of the Netprotect® nets. All net types seemed to be effectively protected against UV-light. PMID:24130671
Sharma, Surya K; Tyagi, Prajesh K; Upadhyay, Ashok K; Haque, Mohammed A; Mohanty, Suman S; Raghavendra, Kamaraju; Dash, Aditya P
2009-11-01
Studies were conducted on the efficacy of Olyset nets-a long-lasting insecticidal net (LLIN) factory treated with 2% (w/w) permethrin on malaria transmission in an area under the influence of pyrethroid susceptible vector species Anopheles culicifacies and A. fluviatilis in Sundargarh District, Orissa, India. The study area comprised 22 villages that were randomized into three clusters and designated as Olyset net, untreated net, and no net area. Malaria incidence in the study population was measured through longitudinal active surveillance at fortnightly intervals. There was a reduction of 65-70% in malaria incidence in Olyset net area as compared to the control areas. The attack rate of Plasmodium falciparum or number of episodes per person per year in different age groups also showed significant reduction in Olyset net area as compared to untreated net and no net areas. Cross-sectional point prevalence surveys showed 45.7% reduction of malaria prevalence in Olyset net users, whereas there was an increase of 33.3% and 51% in untreated net and no net villages respectively. The compliance rate of Olyset net usage in the study population was 80-98% during different months, whereas it was between 70% and 90% for untreated nets. There were minimal complains of skin irritation (4%), itching (8%) and eye irritation (1.2%). However, these effects were only transitory in nature lasting for few hours of the first usage. Olyset nets also provided collateral benefits in terms of relief not only from mosquitoes and malaria but also from other household pests such as head lice, bed bugs, cockroaches, ants and houseflies. The Olyset nets were found to be safe to humans as no adverse event was recorded in the net users that can be attributed to the use of net. The study showed that Olyset nets are effective personal protection tool that can be used in a community based intervention programme.
2012-01-01
Background Control of mosquitoes that transmit malaria has been the mainstay in the fight against the disease, but alternative methods are required in view of emerging insecticide resistance. Entomopathogenic fungi are candidate alternatives, but to date, few trials have translated the use of these agents to field-based evaluations of their actual impact on mosquito survival and malaria risk. Mineral oil-formulations of the entomopathogenic fungi Metarhizium anisopliae and Beauveria bassiana were applied using five different techniques that each exploited the behaviour of malaria mosquitoes when entering, host-seeking or resting in experimental huts in a malaria endemic area of rural Tanzania. Results Survival of mosquitoes was reduced by 39-57% relative to controls after forcing upward house-entry of mosquitoes through fungus treated baffles attached to the eaves or after application of fungus-treated surfaces around an occupied bed net (bed net strip design). Moreover, 68 to 76% of the treatment mosquitoes showed fungal growth and thus had sufficient contact with fungus treated surfaces. A population dynamic model of malaria-mosquito interactions shows that these infection rates reduce malaria transmission by 75-80% due to the effect of fungal infection on adult mortality alone. The model also demonstrated that even if a high proportion of the mosquitoes exhibits outdoor biting behaviour, malaria transmission was still significantly reduced. Conclusions Entomopathogenic fungi strongly affect mosquito survival and have a high predicted impact on malaria transmission. These entomopathogens represent a viable alternative for malaria control, especially if they are used as part of an integrated vector management strategy. PMID:22449130
2013-01-01
Background Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). Methods The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia’s cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme. Results The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia’s NMCP. Conclusions The results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial. PMID:23506170
Jegede, Feyisayo Ebenezer; Oyeyi, Tinuade Ibijoke; Abdulrahman, Surajudeen Abiola; Mbah, Henry Akwen; Badru, Titilope; Agbakwuru, Chinedu; Adedokun, Oluwasanmi
2017-01-01
Human immunodeficiency virus (HIV) and malaria co-infection may present worse health outcomes in the tropics. Information on HIV/malaria co-infection effect on immune-hematological profiles is critical for patient care and there is a paucity of such data in Nigeria. To evaluate immune-hematological profiles among HIV infected patients compared to HIV/malaria co-infected for ART management improvement. This was a cross sectional study conducted at Infectious Disease Hospital, Kano. A total of 761 consenting adults attending ART clinic were randomly selected and recruited between June and December 2015. Participants' characteristics and clinical details including two previous CD4 counts were collected. Venous blood sample (4ml) was collected in EDTA tube for malaria parasite diagnosis by rapid test and confirmed with microscopy. Hematological profiles were analyzed by Sysmex XP-300 and CD4 count by Cyflow cytometry. Data was analyzed with SPSS 22.0 using Chi-Square test for association between HIV/malaria parasites co-infection with age groups, gender, ART, cotrimoxazole and usage of treated bed nets. Mean hematological profiles by HIV/malaria co-infection and HIV only were compared using independent t-test and mean CD4 count tested by mixed design repeated measures ANOVA. Statistical significant difference at probability of <0.05 was considered for all variables. Of the 761 HIV infected, 64% were females, with a mean age of ± (SD) 37.30 (10.4) years. Prevalence of HIV/malaria co-infection was 27.7% with Plasmodium falciparum specie accounting for 99.1%. No statistical significant difference was observed between HIV/malaria co-infection in association to age (p = 0.498) and gender (p = 0.789). A significantly (p = 0.026) higher prevalence (35.2%) of co-infection was observed among non-ART patients compared to (26%) ART patients. Prevalence of co-infection was significantly lower (20.0%) among cotrimoxazole users compared to those not on cotrimoxazole (37%). The same significantly lower co-infection prevalence (22.5%) was observed among treated bed net users compared to those not using treated bed nets (42.9%) (p = 0.001). Out of 16 hematology profiles evaluated, six showed significant difference between the two groups (i) packed cell volume (p = <0.001), (ii) mean cell volume (p = 0.005), (iii) mean cell hemoglobin concentration (p = 0.011), (iv) absolute lymphocyte count (p = 0.022), (v) neutrophil percentage count (p = 0.020) and (vi) platelets distribution width (p = <0.001). Current mean CD4 count cell/μl (349±12) was significantly higher in HIV infected only compared to co-infected (306±17), (p = 0.035). A significantly lower mean CD4 count (234.6 ± 6.9) was observed among respondents on ART compared to non-ART (372.5 ± 13.2), p<0.001, mean difference = -137.9). The study revealed a high burden of HIV and malaria co-infection among the studied population. Co-infection was significantly lower among patients who use treated bed nets as well as cotrimoxazole chemotherapy and ART. Six hematological indices differed significantly between the two groups. Malaria and HIV co-infection significantly reduces CD4 count. In general, to achieve better management of all HIV patients in this setting, diagnosing malaria, prompt antiretroviral therapy, monitoring CD4 and some hematology indices on regular basis is critical.
Wanzira, Humphrey; Yeka, Adoke; Kigozi, Ruth; Rubahika, Denis; Nasr, Sussann; Sserwanga, Asadu; Kamya, Moses; Filler, Scott; Dorsey, Grant; Steinhardt, Laura
2014-05-19
Universal coverage of long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria was adopted by the Uganda National Malaria Control Programme in 2007. The first mass distribution of LLINs was implemented in 2010. Initially, a campaign targeted to households with pregnant women and children aged
2014-01-01
Background Universal coverage of long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria was adopted by the Uganda National Malaria Control Programme in 2007. The first mass distribution of LLINs was implemented in 2010. Initially, a campaign targeted to households with pregnant women and children aged
Seregni, E; Maccauro, M; Chiesa, C; Mariani, L; Pascali, C; Mazzaferro, V; De Braud, F; Buzzoni, R; Milione, M; Lorenzoni, A; Bogni, A; Coliva, A; Lo Vullo, S; Bombardieri, E
2014-02-01
Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues has been demonstrated to be an effective therapeutic option in patients with disseminated neuroendocrine tumours (NET). Treatment with tandem [(90)Y]DOTA-TATE and [(177)Lu]DOTA-TATE may improve the efficacy of PRRT without increasing the toxicity. In a phase II study we evaluated the feasibility of combined PPRT with a high-energy beta emitter ((90)Y) and a medium-energy beta/gamma emitter ([(177)Lu) in patients with metastatic NET refractory to conventional therapy. A group of 26 patients with metastatic NET were treated with four therapeutic cycles of alternating [[(177)Lu]DOTA-TATE (5.55 GBq) and [(90)Y]DOTA-TATE (2.6 GBq). A dosimetric evaluation was carried out after administration of [[(177)Lu]DOTA-TATE to calculate the absorbed doses in healthy organs. The acute and long-term toxicities of repeated treatment were analysed. PRRT efficacy was evaluated according to RECIST. Administration of tandem [(90)Y]DOTA-TATE and [[(177)Lu]DOTA-TATE induced objective responses in 42.3 % of patients with metastatic NET with a median progression-free survival longer than 24 months. Of patients with pretreatment carcinoid syndrome, 90 % showed a symptomatic response or a reduction in tumour-associated pain. The cumulative biologically effective doses (BED) were below the toxicity limit in the majority of patients, in the absence of renal function impairment. The results of our study indicates that combined [(90)Y]DOTA-TATE and [(177)Lu]DOTA-TATE therapy is a feasible and effective therapeutic option in NET refractory to conventional therapy. Furthermore, the absence of kidney damage and the evaluated cumulative BEDs suggest that increasing the number of tandem administrations is an interesting approach.
Pennetier, Cédric; Costantini, Carlo; Corbel, Vincent; Licciardi, Séverine; Dabiré, Roch K; Lapied, Bruno; Chandre, Fabrice; Hougard, Jean-Marc
2009-11-19
Chemicals are used on bed nets in order to prevent infected bites and to kill aggressive malaria vectors. Because pyrethroid resistance has become widespread in the main malaria vectors, research for alternative active ingredients becomes urgent. Mixing a repellent and a non-pyrethroid insecticide seemed to be a promising tool as mixtures in the laboratory showed the same features as pyrethroids. We present here the results of two trials run against free-flying Anopheles gambiae populations comparing the effects of two insect repellents (either DEET or KBR 3023, also known as icaridin) and an organophosphate insecticide at low-doses (pirimiphos-methyl, PM) used alone and in combination on bed nets. We showed that mixtures of PM and the repellents induced higher exophily, blood feeding inhibition and mortality among wild susceptible and resistant malaria vectors than compounds used alone. Nevertheless the synergistic interactions are only involved in the high mortality induced by the two mixtures. These field trials argue in favour of the strategy of mixing repellent and organophosphate on bed nets to better control resistant malaria vectors.
Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania.
Khatib, Rashid A; Killeen, Gerry F; Abdulla, Salim M K; Kahigwa, Elizeus; McElroy, Peter D; Gerrets, Rene P M; Mshinda, Hassan; Mwita, Alex; Kachur, S Patrick
2008-06-02
Tanzania has a well-developed network of commercial ITN retailers. In 2004, the government introduced a voucher subsidy for pregnant women and, in mid 2005, helped distribute free nets to under-fives in small number of districts, including Rufiji on the southern coast, during a child health campaign. Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed. Cross-sectional household survey in 6,331 members of randomly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district, Southern Tanzania was conducted in 2006. A questionnaire was administered to every consenting respondent about net use, treatment status and delivery mechanism. Net use was 62.7% overall, 87.2% amongst infants (0 to 1 year), 81.8% amongst young children (>1 to 5 years), 54.5% amongst older children (6 to 15 years) and 59.6% amongst adults (>15 years). 30.2% of all nets had been treated six months prior to interview. The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy (41.8%). Half of nets used by young children (50.0%) and over a third of those used by older children (37.2%) were obtained free of charge through the vaccination campaign. The largest source of nets amongst the population overall was commercial purchase (45.1% use) and was the primary means for protecting adults (60.2% use). All delivery mechanisms, especially sale of nets at full market price, under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets. All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population. Each of them reached their relevant target group and free nets only temporarily suppressed the net market, illustrating that in this setting that these are complementary rather than mutually exclusive approaches.
Hospital-level changes in adult ICU bed supply in the United States
Wallace, David J.; Seymour, Christopher W.; Kahn, Jeremy M.
2017-01-01
Objective Although the number of intensive care beds in the United States is increasing, little is known about the hospitals responsible for this growth. We sought to better characterize national growth in intensive care beds by identifying hospital-level factors associated with increasing numbers of intensive care beds over time. Design We performed a repeated-measures time series analysis of hospital-level intensive care bed supply using data from Centers for Medicare and Medicaid Services. Setting All United States acute care hospitals with adult intensive care beds over the years 1996 to 2011. Measurements & Main Results We described the number of beds, teaching status, ownership, intensive care occupancy and urbanicity for each hospital in each year of the study. We then examined the relationship between increasing intensive care beds and these characteristics, controlling for other factors. The study included 4,457 hospitals and 55,865 hospital-years. Overall, the majority of intensive care bed growth occurred in teaching hospitals (net +13,471 beds, 72.1% of total growth), hospitals with 250 or more beds (net +18,327 beds, 91.8% of total growth) and hospitals in the highest quartile of occupancy (net +10,157 beds, 54.0% of total growth). In a longitudinal multivariable model, larger hospital size, teaching status, and high intensive care occupancy were associated with subsequent-year growth. Furthermore, the effects of hospital size and teaching status were modified by occupancy: the greatest odds of increasing intensive care unit beds were in hospitals with 500 or more beds in the highest quartile of occupancy (adjusted OR: 18.9; 95% CI: 14.0 – 25.5; p<0.01) and large teaching hospitals in the highest quartile of occupancy (adjusted OR: 7.3; 95% CI: 5.3 – 9.9; p<0.01). Conclusions Increasingly, intensive care bed expansion in the United States is occurring in larger hospitals and teaching centers, particularly following a year with high intensive care unit occupancy. PMID:27661861
Gilman, Matlin; Hockenberry, Jason M; Adams, E Kathleen; Milstein, Arnold S; Wilson, Ira B; Becker, Edmund R
2015-09-15
Medicare's value-based purchasing (VBP) and the Hospital Readmissions Reduction Program (HRRP) could disproportionately affect safety-net hospitals. To determine whether safety-net hospitals incur larger financial penalties than other hospitals under VBP and HRRP. Cross-sectional analysis. United States in 2014. 3022 acute care hospitals participating in VBP and the HRRP. Safety-net hospitals were defined as being in the top quartile of the Medicare disproportionate share hospital (DSH) patient percentage and Medicare uncompensated care (UCC) payments per bed. The differences in penalties in both total dollars and dollars per bed between safety-net hospitals and other hospitals were estimated with the use of bivariate and graphical regression methods. Safety-net hospitals in the top quartile of each measure were more likely to be penalized under VBP than other hospitals (62.9% vs. 51.0% under the DSH definition and 60.3% vs. 51.5% under the UCC per-bed definition). This was also the case under the HRRP (80.8% vs. 69.0% and 81.9% vs. 68.7%, respectively). Safety-net hospitals also had larger payment penalties ($115 900 vs. $66 600 and $150 100 vs. $54 900, respectively). On a per-bed basis, this translated to $436 versus $332 and $491 versus $314, respectively. Sensitivity analysis setting the cutoff at the top decile rather than the top quartile decile led to similar conclusions with somewhat larger differences between safety-net and other hospitals. The quadratic fit of the data indicated that the larger effect of these penalties is in the middle of the distribution of the DSH and UCC measures. Only 2 measures of safety-net status were included in the analyses. Safety-net hospitals were disproportionately likely to be affected under VBP and the HRRP, but most incurred relatively small payment penalties in 2014. Patient-Centered Outcomes Research Institute.
Experiments and simulation of a net closing mechanism for tether-net capture of space debris
NASA Astrophysics Data System (ADS)
Sharf, Inna; Thomsen, Benjamin; Botta, Eleonora M.; Misra, Arun K.
2017-10-01
This research addresses the design and testing of a debris containment system for use in a tether-net approach to space debris removal. The tether-net active debris removal involves the ejection of a net from a spacecraft by applying impulses to masses on the net, subsequent expansion of the net, the envelopment and capture of the debris target, and the de-orbiting of the debris via a tether to the chaser spacecraft. To ensure a debris removal mission's success, it is important that the debris be successfully captured and then, secured within the net. To this end, we present a concept for a net closing mechanism, which we believe will permit consistently successful debris capture via a simple and unobtrusive design. This net closing system functions by extending the main tether connecting the chaser spacecraft and the net vertex to the perimeter and around the perimeter of the net, allowing the tether to actuate closure of the net in a manner similar to a cinch cord. A particular embodiment of the design in a laboratory test-bed is described: the test-bed itself is comprised of a scaled-down tether-net, a supporting frame and a mock-up debris. Experiments conducted with the facility demonstrate the practicality of the net closing system. A model of the net closure concept has been integrated into the previously developed dynamics simulator of the chaser/tether-net/debris system. Simulations under tether tensioning conditions demonstrate the effectiveness of the closure concept for debris containment, in the gravity-free environment of space, for a realistic debris target. The on-ground experimental test-bed is also used to showcase its utility for validating the dynamics simulation of the net deployment, and a full-scale automated setup would make possible a range of validation studies of other aspects of a tether-net debris capture mission.
Sutcliffe, James; Colborn, Kathryn L
2015-05-13
Holes in netting provide potential routes for mosquitoes to enter ITNs. Despite this, there is little information on how mosquitoes respond to holes in bed nets and how their responses are affected by hole size, shape and orientation or by ambient conditions around the net. Female Anopheles gambiae (G3) were recorded in a simulated bed net consisting of two sizes of untreated netting-covered behavioural arenas placed above and beside (to simulate the bed net roof and sides respectively) the experimenter who was a source of host cues from 'inside' the net. A round hole of 9 mm or 13 mm diameter was cut into the centre of the netting of each arena. Videos of unfed female mosquitoes in arenas were analysed for time spent flying, walking and standing still and for exit through the hole. The effects of the experimenter on temperature and relative humidity around the simulated net were also measured. Mosquitoes were significantly more active in overhead arenas than in arenas to the side. Hole passage was significantly more likely in smaller arenas than larger ones and for larger holes than smaller ones. In arenas to the side, hole passage rate through small holes was about 50% less likely than what could be explained by area alone. Passage rate through holes in overhead arenas was consistent with hole area. Temperature in arenas did not strongly reflect the experimenter's presence in the simulated net. Relative humidity and absolute humidity in overhead arenas, but not in arenas to the side, were immediately affected by experimenter presence. Higher levels of activity in overhead arenas than in arenas to the side were likely due to the rising heat and humidity plume from the experimenter. Lower than expected passage rates through smaller vertically oriented holes may have been be due to an edge effect that does not apply to horizontally oriented holes. Results suggest that current methods of assessing the importance of physical damage to ITNs may not accurately reflect mosquito entry risk in all cases.
Dambach, Peter; Jorge, Margarida Mendes; Traoré, Issouf; Phalkey, Revati; Sawadogo, Hélène; Zabré, Pascal; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Becker, Norbert; Beiersmann, Claudia
2018-03-23
Vector and malaria parasite's rising resistance against pyrethroid-impregnated bed nets and antimalarial drugs highlight the need for additional control measures. Larviciding against malaria vectors is experiencing a renaissance with the availability of environmentally friendly and target species-specific larvicides. In this study, we analyse the perception and acceptability of spraying surface water collections with the biological larvicide Bacillus thuringiensis israelensis in a single health district in Burkina Faso. A total of 12 focus group discussions and 12 key informant interviews were performed in 10 rural villages provided with coverage of various larvicide treatments (all breeding sites treated, the most productive breeding sites treated, and untreated control). Respondents' knowledge about the major risk factors for malaria transmission was generally good. Most interviewees stated they performed personal protective measures against vector mosquitoes including the use of bed nets and sometimes mosquito coils and traditional repellents. The acceptance of larviciding in and around the villages was high and the majority of respondents reported a relief in mosquito nuisance and malarial episodes. There was high interest in the project and demand for future continuation. This study showed that larviciding interventions received positive resonance from the population. People showed a willingness to be involved and financially support the program. The positive environment with high acceptance for larviciding programs would facilitate routine implementation. An essential factor for the future success of such programs would be inclusion in regional or national malaria control guidelines.
Lay perceptions of kala-azar, mosquitoes and bed nets in Bihar, India.
Mishra, Rabindra N; Singh, S P; Vanlerberghe, Veerle; Sundar, Shyam; Boelaert, Marleen; Lefèvre, Pierre
2010-07-01
To describe the lay perception of kala-azar (KA) in an endemic area of Muzaffarpur District, Bihar, India: local names, symptoms, affected persons, perceived severity and modes of transmission, as well as perceived mosquito nuisance, modes of protection and use of bed nets. We held 16 focus group discussions (FGD) in eight remote villages with altogether 157 participants in March 2008. Separate FGDs were held according to gender, socio-economic status (SES) and with key informants. Kala-azar is most commonly named pilahi. Poor people were said to be the most affected. Knowledge about symptoms was satisfactory. Fever and prolonged fever were the most stated symptoms. KA was perceived as a life-threatening disease with a heavy economic burden. Mosquito bites were perceived as the main mode of transmission but in lower socio-economic groups, non-vector-related explanations were also provided. The main modes of protection from mosquitoes mentioned were the use of fumes and bed nets. Season was the strongest factor influencing the use of bed nets and non-affordability for not owning them. Although the sand fly is not recognised as the vector, the relatively good awareness of disease transmission by mosquitoes and the nuisance caused by their high density might be an entry point for adopting preventive measures to protect from mosquito bite and thereby indirectly preventing from KA. Educational campaigns targeted to the poorer segments of society are needed to enhance knowledge about KA, its mode of transmission, risks of getting infected and to increase bed net use.
Pennetier, Cédric; Costantini, Carlo; Corbel, Vincent; Licciardi, Séverine; Dabiré, Roch K.; Lapied, Bruno; Chandre, Fabrice; Hougard, Jean-Marc
2009-01-01
Background Chemicals are used on bed nets in order to prevent infected bites and to kill aggressive malaria vectors. Because pyrethroid resistance has become widespread in the main malaria vectors, research for alternative active ingredients becomes urgent. Mixing a repellent and a non-pyrethroid insecticide seemed to be a promising tool as mixtures in the laboratory showed the same features as pyrethroids. Methodology/Principal Findings We present here the results of two trials run against free-flying Anopheles gambiae populations comparing the effects of two insect repellents (either DEET or KBR 3023, also known as icaridin) and an organophosphate insecticide at low-doses (pirimiphos-methyl, PM) used alone and in combination on bed nets. We showed that mixtures of PM and the repellents induced higher exophily, blood feeding inhibition and mortality among wild susceptible and resistant malaria vectors than compounds used alone. Nevertheless the synergistic interactions are only involved in the high mortality induced by the two mixtures. Conclusion These field trials argue in favour of the strategy of mixing repellent and organophosphate on bed nets to better control resistant malaria vectors. PMID:19936249
Boussougou-Sambe, Stravensky T; Awono-Ambene, Parfait; Tasse, Geraud C T; Etang, Josiane; Binyang, Jerome A; Nouage, Lynda D; Wamba, Gaston; Enyong, Peter; Fokam, Eric B
2017-01-17
Long-lasting insecticidal nets (LLINs) are effective tools at reducing malaria transmission. In Cameroon, following the first national mass distribution campaign in 2011, there has been no follow up on the efficacy of LLINs distributed. The aim of this report is to assess the physical integrity and insecticidal potency of LLINs distributed in three cities with contrasting socio economic status (SES) and to evaluate the use and care for bed nets owned by individuals. The study was conducted in Limbe, Tiko and Buea three localities in the Fako division of the South West Region of Cameroon. Tiko had the highest SES based on the type of building materials used, followed respectively by Limbe and Buea. The use and care for bed nets was assessed using a questionnaire, the physical state of bed nets evaluated following WHOPES recommendation for determining size of holes and the residual insecticidal activity of retrieved bed nets determined through a cone bioassay using susceptible strains of mosquitoes. Of the 241 households visited in Limbe (n = 81), Tiko (n = 80) and Buea (n = 80), 186 (77.2%) had LLINs, with no significant variations from the selected study locations. However, bed net coverage was not meeting World Health Organization standards (p < 0.0001). Six different brands of LLINs were recorded, and the majority were those provided by the NMCP through the 2011 national mass campaign or antenatal care programme. Based on the calculation of the Proportionate Hole Index (PHI) as indicator of physical integrity of nets, the proportion of nets classified as serviceable (versus too torn) differed statistically according to locations (p value = 0.04), with 63.8% in Tiko, 50% in Limbe and 47% in Buea. Of the 20 nets tested for their efficacy against susceptible strains of mosquito, 42.6% (3 nets) were optimally effective in Tiko, 57.4% (4), 16.7% (1) and 14.3% (1) were minimally effective in Tiko, Buea and Limbe respectively. Finally; 85.7% (6) and 83.3% (5) were not effective in Limbe and Buea. These findings pinpoint the need for more frequent replacement of LLINs especially for people with low SES and also the need for the promotion of good practices on the maintenance and washing of nets.
Mosquito repellents for malaria prevention
Maia, Marta F; Kliner, Merav; Richardson, Marty; Lengeler, Christian; Moore, Sarah J
2018-01-01
Background Malaria is an important cause of illness and death across endemic regions. Considerable success against malaria has been achieved within the past decade mainly through long-lasting insecticide-treated nets (LLINs). However, elimination of the disease is proving difficult as current control methods do not protect against mosquitoes biting outdoors and when people are active. Repellents may provide a personal protection solution during these times. Objectives To assess the impact of topical repellents, insecticide-treated clothing, and spatial repellents on malaria transmission. Search methods We searched the following databases up to 26 June 2017: the Cochrane Infectious Diseases Group Specialized Register; the Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; Embase; US AFPMB; CAB Abstracts; and LILACS. We also searched trial registration platforms and conference proceedings; and contacted organizations and companies for ongoing and unpublished trials. Selection criteria We included randomized controlled trials (RCTs) and cluster-randomized controlled trials of topical repellents proven to repel mosquitoes; permethrin-treated clothing; and spatial repellents such as mosquito coils. We included trials that investigated the use of repellents with or without LLINs, referred to as insecticide-treated nets. Data collection and analysis Two review authors independently reviewed trials for inclusion, extracted the data, and assessed the risk of bias. A third review author resolved any discrepancies. We analysed data by conducting meta-analysis and stratified by whether the trials had included LLINs. We combined results from cRCTs with individually RCTs by adjusting for clustering and presented results using forest plots. We used GRADE to assess the certainty of the evidence. Main results Eight cRCTs and two RCTs met the inclusion criteria. Six trials investigated topical repellents, two trials investigated insecticide-treated clothing, and two trials investigated spatial repellents. Topical repellents Six RCTS, five of them cluster-randomized, investigated topical repellents involving residents of malaria-endemic regions. Four trials used topical repellents in combination with nets, but two trials undertaken in displaced populations used topical repellents alone. It is unclear if topical repellents can prevent clinical malaria (RR 0.65, 95% CI 0.4 to 1.07, very low certainty evidence) or malaria infection (RR 0.84, 95% CI 0.64 to 1.12, low-certainty evidence) caused by P. falciparum. It is also unclear if there is any protection against clinical cases of P. vivax (RR 1.32, 95% CI 0.99 to 1.76, low-certainty evidence) or incidence of infections (RR 1.07, 95% CI 0.80 to 1.41, low-certainty evidence). Subgroup analysis of trials including insecticide-treated nets did not show a protective effect of topical repellents against malaria. Only two studies did not include insecticide-treated nets, and they measured different outcomes; one reported a protective effect against clinical cases of P. falciparum (RR 0.40, 95% CI 0.23 to 0.71); but the other study measured no protective effect against malaria infection incidence caused by either P. falciparum or P. vivax. Insecticide-treated clothing Insecticide-treated clothing were investigated in trials conducted in refugee camps in Pakistan and amongst military based in the Colombian Amazon. Neither study provided participants with insecticide-treated nets. In the absence of nets, treated clothing may reduce the incidence of clinical malaria caused by P. falciparum by approximately 50% (RR 0.49, 95% CI 0.29 to 0.83, low-certainty evidence) and P. vivax (RR 0.64, 95% CI 0.40 to 1.01, low-certainty evidence). Spatial repellents Two cluster-randomized RCTs investigated mosquito coils for malaria prevention. We do not know the effect of spatial repellents on malaria prevention (RR 0.24, 95% CI 0.03 to 1.72, very low certainty evidence). There was large heterogeneity between studies and one study had high risk of bias. Authors' conclusions There is insufficient evidence to conclude topical or spatial repellents can prevent malaria. There is a need for better designed trials to generate higher certainty of evidence before well-informed recommendations can be made. Adherence to daily compliance remains a major limitation. Insecticide-treated clothing may reduce risk of malaria infection in the absence of insecticide-treated nets; further studies on insecticide-treated clothing in the general population should be done to broaden the applicability of the results. Mosquito repellents for malaria prevention What was the aim of this review? The aim of this Cochrane Review was to find out if mosquito repellents — topical repellents (applied to the skin); insecticide-treated clothing; or spatial repellents such as mosquito coils — can prevent malaria. We collected and analysed the results of all relevant studies to answer this question and found data from ten trials: six on topical repellents, two on insecticide-treated clothing, and two on spatial repellents. Key messages We do not know if the use of repellent lotions or burning of mosquito coils can provide protection from malaria to communities living in endemic regions. In situations where long-lasting insecticide-treated bed nets (LLINs) cannot be rolled out, such as after a natural disaster or amongst displaced populations, the use of insecticide-treated clothing may reduce the risk of malaria infection by 50%. Most studies included in our analysis were poorly designed and had high risk of bias. In order to draw well-informed conclusions, further high-quality studies must be conducted to improve the certainty of the evidence. However, it is questionable if topical repellents can be used for malaria prevention in the general population as daily compliance and poor standardization (amount of repellent used, surface area applied, time of application, and period between repeated applications) are major limitations of this intervention. What was studied in this review Mosquito repellents provide protection from mosquito bites. There are three different types of repellents: topical repellents, which can be applied on the skin; insecticide-treated clothing, through impregnation of clothing with repellent compounds; and spatial repellents, such as mosquito coils. Malaria has decreased in many countries because people have been given highly effective LLINs. However people are still being bitten before they go to bed. There is a need to find a way to offer protection from malaria during these hours. Mosquito repellents may address this gap. What are the main results of the review? A total of six trials investigated the use of topical repellents for malaria prevention. The trials took place in different malaria-endemic regions across South America, Asia, and sub-Saharan Africa. The topical repellents tested included lotions, treated soap, and local cosmetics. We analysed the studies in groups according to LLIN inclusion. Most studies rolled out LLINs to the population and investigated topical repellents as a complementary intervention to the treated bed-nets. The poor design of the included studies provided low to very low certainty evidence, consequently we do not know if there is a benefit of using topical repellents in addition to LLINs to prevent malaria. The compliance of participants to adhere to the daily application of repellents remains a challenge to further research. Insecticide-treated clothing was investigated in two trials conducted with refugees in Pakistan and military deployed in the Amazon; neither study rolled out or reported the use of bed-nets. In the absence of LLINs, there is some evidence that insecticide-treated clothing may reduce the risk of malaria infection by 50%. Given that the findings relate to special populations living in particularly harsh conditions it is unclear if the results are applicable to the general population. Further studies involving civilian populations should be done to improve the certainty of these findings. Two studies investigated the practice of burning mosquito coils to reduce malaria infections. One study was conducted in China and the other in Indonesia. The study designs were substantially different and one study had high risk of bias leading to very low certainty evidence. We do not know if mosquito coils offer protection against malaria. The findings underline the need for further research. How up to date is this review? The review authors searched for studies that had been published up to 26 June 2017. PMID:29405263
Batisso, Esey; Habte, Tedila; Tesfaye, Gezahegn; Getachew, Dawit; Tekalegne, Agonafer; Kilian, Albert; Mpeka, Betty; Lynch, Caroline
2012-06-07
Since 2002/03, an estimated 4.7 million nets have been distributed in the Southern Nations, Nationalities and Peoples Region (SNNPR) among an at risk population of approximately 10 million people. Evidence from the region suggests that large-scale net ownership rapidly increased over a relatively short period of time. However, little is known about how coverage is being maintained given that the last mass distribution was in 2006/2007. This study sought to determine the status of current net ownership, utilization and rate of long lasting insecticide-treated nets (LLIN) loss in the previous three years in the context of planning for future net distribution to try to achieve sustainable universal coverage. A total of 750 household respondents were interviewed across malarious, rural kebeles of SNNPR. Households were randomly selected following a two-stage cluster sampling design where kebeles were defined as clusters. Kebeles were chosen using proportional population sampling (PPS), and 25 households within 30 kebeles randomly chosen. Approximately 67.5% (95%CI: 64.1-70.8) of households currently owned at least one net. An estimated 31.0% (95%CI 27.9-34.4) of all nets owned in the previous three years had been discarded by owners, the majority of whom considered the nets too torn, old or dirty (79.9%: 95%CI 75.8-84.0). Households reported that one-third of nets (33.7%) were less than one year old when they were discarded. The majority (58.8%) of currently owned nets had 'good' structural integrity according to a proportionate Hole Index. Nearly two-thirds of households (60.6%) reported using their nets the previous night. The overriding reason for not using nets was that they were too torn (45.7%, 95% CI 39.1-50.7). Yet, few households are making repairs to their nets (3.7%, 95% CI: 2.4-5.1). Results suggest that the life span of nets may be shorter than previously thought, with little maintenance by their owners. With the global move towards malaria elimination it makes sense to aim for sustained high coverage of LLINs. However, in the current economic climate, it also makes sense to hark back to simple tools and messages on the importance of careful net maintenance, which could increase their lifespans.
Wolkon, Adam; Vanden Eng, Jodi L.; Morgah, Kodjo; Eliades, M. James; Thwing, Julie; Terlouw, Dianne J.; Takpa, Vincent; Dare, Aboudou; Sodahlon, Yao K.; Doumanou, Yao; Hightower, Allen W.; Lama, Marcel; Thawani, Neeta; Slutsker, Laurence; Hawley, William A.
2010-01-01
In December 2004, Togo was the first country to conduct a nationwide free insecticide-treated net (ITN) distribution as part of its National Integrated Child Health Campaign. Community-based cross-sectional surveys were conducted one and nine months post-campaign as part of a multidisciplinary evaluation of the nationwide distribution of ITNs to children 9–59 months of age to evaluate ITN ownership, equity, and use. Our results demonstrated that at one month post-campaign, 93.1% of all eligible children received an ITN. Household ITN ownership and equity increased significantly post-campaign. Nine months post-campaign, 78.6% of households with a child eligible to participate in the campaign retained at least one campaign net. Use by eligible children was 43.5% at one month post-campaign (during the dry season) and 52.9% at nine months post-campaign (during the rainy season). Household ownership of at least one ITN increased from 8.0% pre-campaign to 62.5% one month post-campaign. Together, these findings demonstrate that in this setting, increased household ITN ownership, equity, and retention can be achieved on a national scale through free ITN distribution during an integrated campaign. PMID:21036829
Cost of Community Integrated Prevention Campaign for Malaria, HIV, and Diarrhea in Rural Kenya
2011-01-01
Background Delivery of community-based prevention services for HIV, malaria, and diarrhea is a major priority and challenge in rural Africa. Integrated delivery campaigns may offer a mechanism to achieve high coverage and efficiency. Methods We quantified the resources and costs to implement a large-scale integrated prevention campaign in Lurambi Division, Western Province, Kenya that reached 47,133 individuals (and 83% of eligible adults) in 7 days. The campaign provided HIV testing, condoms, and prevention education materials; a long-lasting insecticide-treated bed net; and a water filter. Data were obtained primarily from logistical and expenditure data maintained by implementing partners. We estimated the projected cost of a Scaled-Up Replication (SUR), assuming reliance on local managers, potential efficiencies of scale, and other adjustments. Results The cost per person served was $41.66 for the initial campaign and was projected at $31.98 for the SUR. The SUR cost included 67% for commodities (mainly water filters and bed nets) and 20% for personnel. The SUR projected unit cost per person served, by disease, was $6.27 for malaria (nets and training), $15.80 for diarrhea (filters and training), and $9.91 for HIV (test kits, counseling, condoms, and CD4 testing at each site). Conclusions A large-scale, rapidly implemented, integrated health campaign provided services to 80% of a rural Kenyan population with relatively low cost. Scaling up this design may provide similar services to larger populations at lower cost per person. PMID:22189090
An exploratory study of treated-bed nets in Timor-Leste: patterns of intended and alternative usage
2011-01-01
Background The Timor-Leste Ministry of Health has recently finalized the National Malaria Control Strategy for 2010-2020. A key component of this roadmap is to provide universal national coverage with long-lasting insecticide-treated nets (LLINs) in support of achieving the primary goal of reducing both morbidity and mortality from malaria by 30% in the first three years, followed by a further reduction of 20% by end of the programme cycle in 2020 [1]. The strategic plan calls for this target to be supported by a comprehensive information, education and communication (IEC) programme; however, there is limited prior research into household and personal usage patterns to assist in the creation of targeted, effective, and socio-culturally specific behaviour change materials. Methods Nine separate focus group discussions (FGDs) were carried out in Dili, Manatuto, and Covalima districts, Democratic Republic of Timor-Leste, in July 2010. These focus groups primarily explored themes of perceived malaria risk, causes of malaria, net usage patterns within families, barriers to correct and consistent usage, and the daily experience of users (both male and female) in households with at least one net. Comprehensive qualitative analysis utilized open source analysis software. Results The primary determinants of net usage were a widespread perception that nets could or should only be used by pregnant women and young children, and the availability of sufficient sleeping space under a limited number of nets within households. Both nuisance biting and disease prevention were commonly cited as primary motivations for usage, while seasonality was not a significant factor. Long-term net durability and ease of hanging were seen as key attributes in net design preference. Very frequent washing cycles were common, potentially degrading net effectiveness. Finally, extensive re-purposing of nets (fishing, protecting crops) was both reported and observed, and may significantly decrease availability of nighttime sleeping space for all family members if distributed nets do not remain within the household. Conclusions Emphasizing that net usage is acceptable and important for all family members regardless of age or gender, and addressing the complex behavioural economics of alternative net usages could have significant impacts on malaria control efforts in Timor-Leste, as the country's programmes make progress towards universal net coverage. PMID:21777415
Faraj, Chafika; Yukich, Joshua; Adlaoui, El Bachir; Wahabi, Rachid; Mnzava, Abraham Peter; Kaddaf, Mustapha; El Idrissi, Abderrahmane Laamrani; Ameur, Btissam; Kleinschmidt, Immo
2016-01-01
Cutaneous leishmaniasis (CL) remains an important public health problem in Morocco. A cluster-randomized trial was conducted with the following three study arms: 1) long-lasting insecticide-treated nets (LLINs) plus standard of care environmental management (SoC-EM), 2) indoor residual spraying (IRS) with α-cypermethrin plus SoC-EM, and 3) SoC-EM alone. Incidence of new CL cases by passive and active case detection, sandfly abundance, and cost and cost-effectiveness was compared between study arms over 5 years. Incidence of CL and sandfly abundance were significantly lower in the IRS arm compared with SoC-EM (CL incidence rate ratio = 0.32, 95% confidence interval [CI] = 0.15–0.69, P = 0.005 and sandfly abundance ratio = 0.39, 95% CI = 0.18–0.85, P = 0.022). Reductions in the LLIN arm of the study were not significant, possibly due to poor compliance. IRS was effective and more cost-effective for the prevention of CL in Morocco. PMID:26811431
Norris, Douglas E.
2014-01-01
Culex quinquefasciatus , an arboviral and filarial vector, is present in high numbers throughout sub-Saharan Africa, and insecticide-resistant populations have been reported worldwide. In order to determine the insecticide resistance status of Cx. quinquefasciatus in Macha, Zambia, adult mosquitoes reared from eggs collected from oviposition traps were tested by bioassay. High levels of resistance to DDT, pyrethroids, malathion, and deltamethrin-treated net material were detected, and molecular assays revealed that the knockdown resistance (kdr) allele was frequent in the Cx. quinquefasciatus population, with 7.0% homozygous for the kdr L1014 allele and 38.5% heterozygous (0.263 kdr frequency). The kdr frequency was significantly higher in mosquitoes that had successfully fed on human hosts, and screening archived specimens revealed that kdr was present at lower frequency prior to the introduction of ITNs, indicating that ITNs might be a selective force in this population. Additionally, metabolic detoxification enzyme activity assays showed upregulated glutathione S-transferases, α-esterases, and β-esterases. Continued monitoring and assessment of the Cx. quinquefasciatus population is necessary to determine levels of resistance. PMID:22129413
Hidden burden of malaria in Indian women.
Sharma, Vinod P
2009-12-08
Malaria is endemic in India with an estimated 70-100 million cases each year (1.6-1.8 million reported by NVBDCP); of this 50-55% are Plasmodium vivax and 45-50% Plasmodium falciparum. A recent study on malaria in pregnancy reported from undivided Madhya Pradesh state (includes Chhattisgarh state), that an estimated over 220,000 pregnant women contract malaria infection each year. Malaria in pregnancy caused- abortions 34.5%; stillbirths 9%; and maternal deaths 0.45%. Bulk of this tragic outcome can be averted by following the Roll Back Malaria/WHO recommendations of the use of malaria prevention i.e. indoor residual spraying (IRS)/insecticide-treated bed nets (ITN) preferably long-lasting treated bed nets (LLIN); intermittent preventive therapy (IPT); early diagnosis, prompt and complete treatment using microscopic/malaria rapid diagnostics test (RDT) and case management. High incidence in pregnancy has arisen because of malaria surveillance lacking coverage, lack of age and sex wise data, staff shortages, and intermittent preventive treatment (IPT) applicable in high transmission states/pockets is not included in the national drug policy- an essential component of fighting malaria in pregnancy in African settings. Inadequate surveillance and gross under-reporting has been highlighted time and again for over three decades. As a result the huge problem of malaria in pregnancy reported occasionally by researchers has remained hidden. Malaria in pregnancy may quicken severity in patients with drug resistant parasites, anaemia, endemic poverty, and malnutrition. There is, therefore, urgent need to streamline malaria control strategies to make a difference in tackling this grim scenario in human health.
2013-01-01
Background Mass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time. Methods A stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net ‘decay’ parameters and other factors including the feasibility and accuracy of identifying existing nets in the field. Results Results indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered. Conclusions Where pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage. PMID:23763773
Yukich, Joshua; Bennett, Adam; Keating, Joseph; Yukich, Rudy K; Lynch, Matt; Eisele, Thomas P; Kolaczinski, Kate
2013-06-14
Mass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time. A stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net 'decay' parameters and other factors including the feasibility and accuracy of identifying existing nets in the field. Results indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered. Where pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage.
2006-01-01
Background Insecticide-treated bed nets (ITN) provide real hope for the reduction of the malaria burden across Africa. Understanding factors that determine access to ITN is crucial to debates surrounding the optimal delivery systems. The influence of homestead wealth on use of nets purchased from the retail sector is well documented, however, the competing influence of mother's education and physical access to net providers is less well understood. Methods Between December 2004 and January 2005, a random sample of 72 rural communities was selected across four Kenyan districts. Demographic, assets, education and net use data were collected at homestead, mother and child (aged < 5 years) levels. An assets-based wealth index was developed using principal components analysis, travel time to net sources was modelled using geographic information systems, and factors influencing the use of retail sector nets explored using a multivariable logistic regression model. Results Homestead heads and guardians of 3,755 children < 5 years of age were interviewed. Approximately 15% (562) of children slept under a net the night before the interview; 58% (327) of the nets used were purchased from the retail sector. Homestead wealth (adjusted OR = 10.17, 95% CI = 5.45–18.98), travel time to nearest market centres (adjusted OR = 0.51, 95% CI = 0.37–0.72) and mother's education (adjusted OR = 2.92, 95% CI = 1.93–4.41) were significantly associated with use of retail sector nets by children aged less than 5 years. Conclusion Approaches to promoting access to nets through the retail sector disadvantage poor and remote communities where mothers are less well educated. PMID:16436216
Costs and cost-effectiveness of vector control in Eritrea using insecticide-treated bed nets.
Yukich, Joshua O; Zerom, Mehari; Ghebremeskel, Tewolde; Tediosi, Fabrizio; Lengeler, Christian
2009-03-30
While insecticide-treated nets (ITNs) are a recognized effective method for preventing malaria, there has been an extensive debate in recent years about the best large-scale implementation strategy. Implementation costs and cost-effectiveness are important elements to consider when planning ITN programmes, but so far little information on these aspects is available from national programmes. This study uses a standardized methodology, as part of a larger comparative study, to collect cost data and cost-effectiveness estimates from a large programme providing ITNs at the community level and ante-natal care facilities in Eritrea. This is a unique model of ITN implementation fully integrated into the public health system. Base case analysis results indicated that the average annual cost of ITN delivery (2005 USD 3.98) was very attractive when compared with past ITN delivery studies at different scales. Financing was largely from donor sources though the Eritrean government and net users also contributed funding. The intervention's cost-effectiveness was in a highly attractive range for sub-Saharan Africa. The cost per DALY averted was USD 13 - 44. The cost per death averted was USD 438-1449. Distribution of nets coincided with significant increases in coverage and usage of nets nationwide, approaching or exceeding international targets in some areas. ITNs can be cost-effectively delivered at a large scale in sub-Saharan Africa through a distribution system that is highly integrated into the health system. Operating and sustaining such a system still requires strong donor funding and support as well as a functional and extensive system of health facilities and community health workers already in place.
2014-01-01
Background It is well established that insecticide-treated bed nets (ITNs), in particular long-lasting, insecticidal nets (LLINs), can be used as one of the primary interventions for effective malaria control. A consistent gap between net ownership and use has been observed, indicating that factors exist that prevent an owned mosquito net from being used. One approach used in the context of LLIN campaigns is a post-distribution, door-to-door visit of households with educational messages and to physically assist with hang-up of nets. Methods A cluster randomized trial was conducted in the Plateaux Region of Togo to evaluate the effectiveness of different approaches to post-LLIN campaign home visits (number of visits and timing) by volunteers to enhance LLIN hang-up and utilization. Results It was found that, in general, households that received intervention visits, particularly the most recent intervention visit, had levels of use that were typically 5 to 10% higher than the control households, while access did not differ among control and intervention households. Eight months post-campaign, ITN use by all individuals, children under five years and women of reproductive age was 11.3 to 14.4 percentage points greater in the study arm that received all three intervention visits than in the control communities. In households that received one or two additional door-to-door visits, the majority of respondents indicated that the volunteer provided new information during the visit regarding the use and importance of ITNs despite having received previous multiple visits. Conclusions The impact of the interventions appears to have been primarily through the delivery and reinforcement of key behaviour-change communication (BCC) messages regarding the importance of using an ITN and its care. Regardless of whether the respondents in fact received new information or had forgotten earlier information, this suggests that regular visits from community agents are useful in reinforcing key BCC messages. PMID:25005572
Malaria in pregnancy: the relevance of animal models for vaccine development.
Doritchamou, Justin; Teo, Andrew; Fried, Michal; Duffy, Patrick E
2017-10-06
Malaria during pregnancy due to Plasmodium falciparum or P. vivax is a major public health problem in endemic areas, with P. falciparum causing the greatest burden of disease. Increasing resistance of parasites and mosquitoes to existing tools, such as preventive antimalarial treatments and insecticide-treated bed nets respectively, is eroding the partial protection that they offer to pregnant women. Thus, development of effective vaccines against malaria during pregnancy is an urgent priority. Relevant animal models that recapitulate key features of the pathophysiology and immunology of malaria in pregnant women could be used to accelerate vaccine development. This review summarizes available rodent and nonhuman primate models of malaria in pregnancy, and discusses their suitability for studies of biologics intended to prevent or treat malaria in this vulnerable population.
2012-01-01
Background The burden of malaria has decreased in parts of Africa following the scaling up of control interventions. However, similar data are limited from high transmission settings. Methods A cohort of 100 children, aged six weeks to 10 months of age, were enrolled in an area of high malaria transmission intensity and followed through 48 months of age. Children were given a long-lasting insecticide-treated bed net (LLIN) at enrolment and received all care, including monthly blood smears and treatment with artemisinin-based combination therapy (ACT) for uncomplicated malaria, at a dedicated clinic. The incidence of malaria was estimated by passive surveillance and associations between malaria incidence and age, calendar time and season were measured using generalized estimating equations. Results Reported compliance with LLINs was 98% based on monthly routine evaluations. A total of 1,633 episodes of malaria were observed, with a median incidence of 5.3 per person-year (PPY). There were only six cases of complicated malaria, all single convulsions. Malaria incidence peaked at 6.5 PPY at 23 months of age before declining to 3.5 PPY at 48 months. After adjusting for age and season, the risk of malaria increased by 52% from 2008 to 2011 (RR 1.52, 95% CI 1.10-2.09). Asymptomatic parasitaemia was uncommon (monthly prevalence <10%) and rarely observed prior to 24 months of age. Conclusions In Tororo, despite provision of LLINs and prompt treatment with ACT, the incidence of malaria is very high and appears to be rising. Additional malaria control interventions in high transmission settings are likely needed. Trial registration Current Controlled Trials Identifier NCT00527800 PMID:23273022
Demand and willingness-to-pay for bed nets in Tanzania: results from a choice experiment.
Gingrich, Chris D; Ricotta, Emily; Kahwa, Amos; Kahabuka, Catherine; Koenker, Hannah
2017-07-14
Universal coverage campaigns for long-lasting insecticide-treated nets do not always reach the goal of one net for every two household members, and even when ownership of at least one net per household is high, many households may not own enough nets. The retail market provides these households options for replacing or increasing the number of nets they own with products that best fit their needs since a variety of net shapes, sizes, and colours are available. Hence, it is important to understand the factors affecting private net demand. This study explores private demand for nets in Tanzania using a discrete choice experiment. The experiment provides participants the option to buy nets with their own money, and thus should prove more accurate than a hypothetical survey of net preferences. Nearly 800 participants sampled in two regions showed an overall strong demand for nets, with 40% choosing to buy a net across all seven combinations of net prices and characteristics such as size, shape, and insecticide treatment. Only 8% of all participants chose not to buy a single net. A key factor influencing demand was whether a participant's household currently owned sufficient nets for all members, with rural participants showing lower net coverage and greater demand than urban participants. Both poor and less poor households showed strong evidence of making purchase decisions based on more than price alone. Mean willingness-to-pay values for a net started at US$1.10 and grew by US$0.50-1.40 for various attributes such as rectangular shape, large size, and insecticide treatment. The impact of price on demand was negative but small, with elasticity values between -0.25 and -0.45. The results suggest that private demand for nets in Tanzania could potentially supplement future coverage campaigns. Net manufacturers and retailers should advertise and promote consumers' preferred net attributes to improve sales and further expand net access and coverage. To overcome household liquidity concerns and best replicate the experiment results, policy makers should consider making credit available for interested buyers.
Ly, Po; Thwing, Julie; McGinn, Colleen; Quintero, Cesia E; Top-Samphor, Narann; Habib, Najibullah; Richards, Jack S; Canavati, Sara E; Vinjamuri, Seshu Babu; Nguon, Chea
2017-09-19
Multi-drug-resistant Plasmodium falciparum threatens malaria elimination efforts in Cambodia and the Greater Mekong Subregion (GMS). Malaria burden in the GMS is higher among certain high-risk demographic groups in Cambodia, especially among migrant and mobile populations (MMPs). This respondent driven sampling (RDS) study was conducted in order to determine malaria knowledge, treatment-seeking behaviours and preventive practices among two MMP groups in Western Cambodia. An RDS survey of MMPs was implemented in four purposively-selected communes along the Thai-Cambodia border; two in Veal Veang District and two in Pailin Province, chosen due to their sizeable MMP groups, their convenience of access, and their proximity to Thailand, which allowed for comparison with RDS studies in Thailand. There were 764 participants in Pailin Province and 737 in Veal Veang District. Health messages received in Veal Veang were most likely to come from billboards (76.5%) and family and friends (57.7%), while in Pailin they were most likely to come from sources like radio (57.1%) and television (31.3%). Knowledge of malaria transmission by mosquito and prevention by bed net was above 94% in both locations, but some misinformation regarding means of transmission and prevention methods existed, predominantly in Veal Veang. Ownership of treated bed nets was lower in Pailin than in Veal Veang (25.3% vs 53.2%), while reported use the night before the survey was higher in Pailin than in Veal Veang (57.1% vs 31.6%). Use of private sector health and pharmaceutical services was common, but 81.1% of patients treated for malaria in Pailin and 86.6% in Veal Veang had received a diagnostic test. Only 29.6% of patients treated in Pailin and 19.6% of those treated in Veal Veng reported receiving the indicated first-line treatment. Barriers in access to malaria prevention and case management were common among MMPs, with marked variation by site. Resolving both nation-wide and MMP-specific challenges will require targeted interventions that take into account this heterogeneity.
Shahzad, Muhammad; Hussain, Mubshar; Farooq, Muhammad; Farooq, Shahid; Jabran, Khawar; Nawaz, Ahmad
2017-11-01
Wheat productivity and profitability is low under conventional tillage systems as they increase the production cost, soil compaction, and the weed infestation. Conservation tillage could be a pragmatic option to sustain the wheat productivity and enhance the profitability on long term basis. This study was aimed to evaluate the economics of different wheat-based cropping systems viz. fallow-wheat, rice-wheat, cotton-wheat, mung bean-wheat, and sorghum-wheat, with zero tillage, conventional tillage, deep tillage, bed sowing (60/30 cm beds and four rows), and bed sowing (90/45 cm beds and six rows). Results indicated that the bed sown wheat had the maximum production cost than other tillage systems. Although both bed sowing treatments incurred the highest production cost, they generated the highest net benefits and benefit: cost ratio (BCR). Rice-wheat cropping system with bed sown wheat (90/45 cm beds with six rows) had the highest net income (4129.7 US$ ha -1 ), BCR (2.87), and marginal rate of return compared with rest of the cropping systems. In contrast, fallow-wheat cropping system incurred the lowest input cost, but had the least economic return. In crux, rice-wheat cropping system with bed sown wheat (90/45 cm beds with six rows) was the best option for getting the higher economic returns. Moreover, double cropping systems within a year are more profitable than sole planting of wheat under all tillage practices.
Norris, Laura C; Norris, Douglas E
2011-12-01
Culex quinquefasciatus, an arboviral and filarial vector, is present in high numbers throughout sub-Saharan Africa, and insecticide-resistant populations have been reported worldwide. In order to determine the insecticide resistance status of Cx. quinquefasciatus in Macha, Zambia, adult mosquitoes reared from eggs collected from oviposition traps were tested by bioassay. High levels of resistance to DDT, pyrethroids, malathion, and deltamethrin-treated net material were detected, and molecular assays revealed that the knockdown resistance (kdr) allele was frequent in the Cx. quinquefasciatus population, with 7.0% homozygous for the kdr L1014 allele and 38.5% heterozygous (0.263 kdr frequency). The kdr frequency was significantly higher in mosquitoes that had successfully fed on human hosts, and screening archived specimens revealed that kdr was present at lower frequency prior to the introduction of ITNs, indicating that ITNs might be a selective force in this population. Additionally, metabolic detoxification enzyme activity assays showed upregulated glutathione S-transferases, α-esterases, and β-esterases. Continued monitoring and assessment of the Cx. quinquefasciatus population is necessary to determine levels of resistance. © 2011 The Society for Vector Ecology.
Solar tower power plant using a particle-heated steam generator: Modeling and parametric study
NASA Astrophysics Data System (ADS)
Krüger, Michael; Bartsch, Philipp; Pointner, Harald; Zunft, Stefan
2016-05-01
Within the framework of the project HiTExStor II, a system model for the entire power plant consisting of volumetric air receiver, air-sand heat exchanger, sand storage system, steam generator and water-steam cycle was implemented in software "Ebsilon Professional". As a steam generator, the two technologies fluidized bed cooler and moving bed heat exchangers were considered. Physical models for the non-conventional power plant components as air- sand heat exchanger, fluidized bed coolers and moving bed heat exchanger had to be created and implemented in the simulation environment. Using the simulation model for the power plant, the individual components and subassemblies have been designed and the operating parameters were optimized in extensive parametric studies in terms of the essential degrees of freedom. The annual net electricity output for different systems was determined in annual performance calculations at a selected location (Huelva, Spain) using the optimized values for the studied parameters. The solution with moderate regenerative feed water heating has been found the most advantageous. Furthermore, the system with moving bed heat exchanger prevails over the system with fluidized bed cooler due to a 6 % higher net electricity yield.
Repellents and New “Spaces of Concern” in Global Health
Kelly, Ann H.; Koudakossi, Hermione N. Boko; Moore, Sarah J.
2017-01-01
ABSTRACT Today, malaria prevention hinges upon two domestic interventions: insecticide-treated bed nets and indoor residual spraying. As mosquitoes grow resistant to these tools, however, novel approaches to vector control have become a priority area of malaria research and development. Spatial repellency, a volumetric mode of action that seeks to reduce disease transmission by creating an atmosphere inimical to mosquitoes, represents one way forward. Drawing from research that sought to develop new repellent chemicals in conversation with users from sub-Saharan Africa and the United States, we consider the implications of a non-insecticidal paradigm of vector control for how we understand the political ecology of malaria. PMID:28594568
Africa's largest long-lasting insecticide-treated net producer: lessons from A to Z Textiles.
Masum, Hassan; Shah, Ronak; Schroeder, Karl; Daar, Abdallah S; Singer, Peter A
2010-12-13
Field trials have demonstrated the efficacy of insecticide-treated nets, and the WHO has recently endorsed a shift toward Long-Lasting Insecticide Treated nets (LLINs) due to factors such as reduced distribution costs. However, the need for LLINs poses several challenges. Is it possible to manufacture LLINs in large quantities in the African continent, where malaria is most endemic? When production is located in low-income countries, what role is played by local funding and employment, scaling up manufacturing, and partnerships? What factors influence availability and pricing? A case study of A to Z Textiles was undertaken to answer the question of how large-scale production of LLINs can occur in a low income setting. One of the largest sources of bed nets for Africa, A to Z Textiles is Africa-based, and its Tanzanian operations have a production capacity of 30 million LLINs per year, along with full WHO recommendation for its nets. Our analysis is based on semi-structured interviews with key informants familiar with A to Z, site visits in Tanzania, and literature reviews.This paper discusses the history and current status of A to Z Textiles, identifies the factors that led to its success, and suggests policy considerations that could support similar initiatives in the future. Local funding, scaling up manufacturing, technology transfer, and partnerships all played important roles in A to Z's ascent, as did perceived benefits of local employment and capacity-building. Regulatory issues and procurement rules acted as barriers. A to Z cost-effectively manufactures high-quality LLINs where malaria is most endemic. With a production capacity of 30 million LLINs per year, and full WHOPES (WHO Pesticide Evaluation Scheme) certification, A to Z Textiles demonstrates how key health goods can be successfully produced in the low-income countries that use them. Its example may be instructive and of high interest to readers in the malaria community, especially in developing countries, and to those who wish to support or partner with efforts by developing countries to build their health innovation capacity.
Africa's largest long-lasting insecticide-treated net producer: lessons from A to Z Textiles
2010-01-01
Background Field trials have demonstrated the efficacy of insecticide-treated nets, and the WHO has recently endorsed a shift toward Long-Lasting Insecticide Treated nets (LLINs) due to factors such as reduced distribution costs. However, the need for LLINs poses several challenges. Is it possible to manufacture LLINs in large quantities in the African continent, where malaria is most endemic? When production is located in low-income countries, what role is played by local funding and employment, scaling up manufacturing, and partnerships? What factors influence availability and pricing? Discussion A case study of A to Z Textiles was undertaken to answer the question of how large-scale production of LLINs can occur in a low income setting. One of the largest sources of bed nets for Africa, A to Z Textiles is Africa-based, and its Tanzanian operations have a production capacity of 30 million LLINs per year, along with full WHO recommendation for its nets. Our analysis is based on semi-structured interviews with key informants familiar with A to Z, site visits in Tanzania, and literature reviews. This paper discusses the history and current status of A to Z Textiles, identifies the factors that led to its success, and suggests policy considerations that could support similar initiatives in the future. Local funding, scaling up manufacturing, technology transfer, and partnerships all played important roles in A to Z’s ascent, as did perceived benefits of local employment and capacity-building. Regulatory issues and procurement rules acted as barriers. A to Z cost-effectively manufactures high-quality LLINs where malaria is most endemic. Summary With a production capacity of 30 million LLINs per year, and full WHOPES (WHO Pesticide Evaluation Scheme) certification, A to Z Textiles demonstrates how key health goods can be successfully produced in the low-income countries that use them. Its example may be instructive and of high interest to readers in the malaria community, especially in developing countries, and to those who wish to support or partner with efforts by developing countries to build their health innovation capacity. PMID:21144077
... screens on the windows and doors. Use a mosquito net over your bed. Spray the net with permethrin, a spray that repels mosquitoes. Wear light-colored pants and shirts with long sleeves. Protect yourself with a bug repellent spray that contains no more than 35% of ...
NASA Astrophysics Data System (ADS)
Kholis, N.; Patria, M. P.; Soedjiarti, T.
2017-07-01
Research of composition and diversity of fish species in seagrass bed ecosystem at Muara Binuangeun, Lebak, Banten, had been conducted in May and November 2015. Catch per Unit of Effort (CPUE) was used as a method with push net and boat net as fishing gear. Fishing was conducted during low tide. Collected samples were preserved with 10 % Formalin Solution and then being identified in the laboratory. In total, 286 fishes were collected from 17 families and 38 species. Moolgarda sp. was the most relative abundant species (17,13 %) and Istiblennius edentulus was a fish species with the highest relative frequency. Diversity index value of seagrass bed ecosystem was 2,973. Different sampling time showed the different composition of fish, in an example of Arothron immaculatus.
Aleme, Adisu; Girma, Eshetu; Fentahun, Netsanet
2014-01-01
Understanding the feasibility of achieving widespread coverage with Insecticide-Treated Nets has to be preceded by learning how people value the Insecticide-Treated Nets and estimating the potential demand and willingness to pay so that sustainability of the intervention can be assured. The objective of this study was to determine willingness to pay for Insecticide-Treated Nets among households in Berehet District, Northern Ethiopia. A community-based cross-sectional study was conducted using both quantitative and qualitative methods in five randomly selected Kebeles from January-February 2012. Open ended contingent valuation technique with follow-up method was used. Qualitative data were collected through focus group discussions and observation methods. Binary logistic regression was used to determine the association between dependent and independent variables. The average number of individuals per Insecticide-Treated Nets was 3.83. Nearly 68.5% persons had willingness to buy Insecticide-Treated Nets if they have access to these Nets. The median maximum price a person is willingness to pay for blue rectangular Insecticide-Treated Net was 20 ETB. People had willingness to pay 30 ETB for blue and white conical insecticide-treated nets. Working on knowledge of malaria (OR=0.68, CI (0.47, 0.98; p<0.05), perceived benefit of Insecticide-Treated Nets (OR=0.28, CI (0.2-0.4; p<0.05), perceived susceptibility (OR=0.64(0.44-0.93; p<0.05) and perceived severity of malaria (OR=0.65(0.47-0.91, p<0.05) had significant association with a willingness to pay Insecticide-Treated Nets. Respondents who prefer Kebele/place/ to buy Insecticide-Treated Net for rectangular shape had a significant association with a willingness to pay for Insecticide-Treated Nets (OR=1.92, CI= 1.07-3.92). Promotions, products, price and place had significant association with willingness to pay for Insecticide-Treated Nets. Designing a social marketing strategy helps ensure sustainable supply of Insecticide-Treated Nets and proper use of Insecticide-Treated Nets.
Tsuang, Angela; Lines, Jo; Hanson, Kara
2010-07-22
Household ownership of insecticide-treated mosquito nets (ITNs) is increasing, and coverage targets have been revised to address universal coverage with ITNs. However, many households do not have enough nets to cover everyone, and the nets available vary in physical condition and insecticide treatment status. Since 2004, the Government of Tanzania has been implementing the Tanzania National Voucher Scheme (TNVS), which distributes vouchers for ITNs through antenatal clinics to target pregnant women and their infants. This analysis aimed to determine the following: (1) coverage patterns of bed nets within households according to physical condition and treatment status; (2) who might be at risk if mosquitoes were diverted from occupants of untreated nets to those not using nets? (3) the degree to which those at highest risk of malaria use the most protective nets. Data from the 2006 TNVS household survey were analysed to assess within-household distribution of net use. The associations between net characteristics and net user were also evaluated. Multivariate analysis was applied to the relationship between the number of holes per net and user characteristics while adjusting for confounders. In households with a net:person ratio better than 1:4 (one net for every four household members), more than 80% of the people in such households reported using a net the previous night. ITNs were most likely to be used by infants, young children (1-4 y), and women of childbearing age; they were least likely to be used by older women (>or=50 y), older children (5-14 y), and adult men. The nets used by infants and women of childbearing age were in better-than-average physical condition; the nets used by older women and older children were in worse-than-average condition; while young children and adult men used nets in intermediate (average) condition. When adjusted for confounders, the nets used by young and older children had more holes than nets used by infants. Infants and other vulnerable groups were most likely to sleep under the most protective nets. Nevertheless, more communication efforts are needed to increase use of intact ITNs within households for children. Further research is necessary to fully understand motivations influencing within-household net distribution.
Soleimani Ahmadi, Mussa; Vatandoost, Hassan; Shaeghi, Mansoreh; Raeisi, Ahmad; Abedi, Farshid; Eshraghian, Mohammad Reza; Aghamolaei, Teimur; Madani, Abdol Hossein; Safari, Reza; Jamshidi, Mahin; Alimorad, Abbas
2012-01-01
Long-lasting insecticidal nets (LLINs) have been advocated as an effective tool against malaria transmission. However, success of this community based intervention largely depends on the knowledge and practice regarding malaria and its prevention. According to the national strategy plan on evaluation of LLINs (Olyset nets), this study was conducted to determine the perceptions and practices about malaria and to improve use of LLINs in Bashagard district, one of the important foci of malaria in southeast Iran. The study area comprised 14 villages that were randomized in two clusters and designated as LLINs and untreated nets. Each of households in both clusters received two bed nets by the free distribution and delivery. After one month quantitative data collection method was used to collect information regarding the objectives of the study. On the basis of this information, an educational program was carried out in both areas to increase motivation for use of bed nets. Community knowledge and practice regarding malaria and LLIN use assessed pre- and post-educational program. The data were analyzed using SPSS ver.16 software. At baseline, 77.5% of respondents in intervention and 69.4 % in control area mentioned mosquito bite as the cause of malaria, this awareness increased significantly in intervention (90.3%) and control areas (87.9%), following the educational program. A significant increase also was seen in the proportion of households who used LLINs the previous night (92.5%) compared with untreated nets (87.1%). Educational status was an important predictor of LLINs use. Regular use of LLIN was considerably higher than the targeted coverage (80%) which recommended by World Heaths Organization. About 81.1% and 85.3% of respondents from LLIN and control areas reported that mosquito nuisance and subsequent malaria transmission were the main determinants of bed net use. These findings highlight a need for educational intervention in implementation of long-lasting insecticidal nets; this should be considered in planning and decision-making in the national malaria control program during the next campaigns of LLINs in Iran. © 2012 Tehran University of Medical Sciences. All rights reserved.
NASA Astrophysics Data System (ADS)
Frattini, Paul L.; Shaqfeh, Eric S. G.; Levy, Jeffrey L.; Koch, Donald L.
1991-11-01
Direct microstructural evidence for net tracer particle orientation induced solely by hydrodynamic interactions in a dilute, disordered, fibrous media is reported. A dilute fixed bed of randomly placed fibers was constructed and glycerol/water suspensions of either synthetic akaganeite (βFeOOH, average aspect ratio 6.3) or hematite (αFe2O3, average aspect ratio 1.6) tracer particles were made to flow axially through the bed at prescribed flow rates. Conservative linear dichroism, a noninvasive light scattering technique, was employed to provide a direct measure of the orientational order parameter for the tracer particle population at the end of the bed. The effect of Brownian motion on the hydrodynamically induced order in the suspensions was studied over three orders of magnitude in scaled rotary Peclet number, 5
Wu, Chao; Guo, Xiaofang; Zhao, Jun; Lv, Quan; Li, Hongbin; McNeil, Edward B; Chongsuvivatwong, Virasakdi; Zhou, Hongning
2017-10-15
Background : In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods : A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old) and eight schools were used for children (<18 years old). A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results : Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion : Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases.
Wu, Chao; Guo, Xiaofang; Zhao, Jun; Lv, Quan; Li, Hongbin; McNeil, Edward B.; Chongsuvivatwong, Virasakdi; Zhou, Hongning
2017-01-01
Background: In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods: A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adults (≥18 years old) and eight schools were used for children (<18 years old). A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results: Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion: Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases. PMID:29036937
Socio-cultural factors associated with malaria transmission: a review.
Pinikahana, J
1992-06-01
Poverty creates preconditions for malaria and ways for its spread, thereby making it difficult to control malaria. Individual perceptions of illness, in this case malaria, determine people's response to seeking medical care. For example, in Orissa state, India, tribal peoples do not take treatment for malaria or take part in parasite control because they do not consider mosquito bites to be harmful and consider malaria as a mild disease. Untreated people are potential sources of malaria infection. Research from rural areas in other developing countries show the widespread belief that mosquitoes do not transmit malaria. The bad smell emitted by insecticides keep people from various areas in developing countries from spraying their households. The practice forbidding nonkin males from entering houses where only women assemble (purdah) prevents teams from spraying Muslim households in Sri Lanka. Thus, refusal to allow spraying increases the density of mosquitoes, resulting in an increased frequency of mosquito bites, and spread of malaria. Sleeping habits which contribute to the spread of malaria include not using mosquito nets or any protective device, outdoor sleeping, and children sharing a bed. People should protect themselves from mosquito bites by using bed nets, protective repellents, and screening and site selection for dwellings. A study in the Gambia revealed that, among 3 ethnic groups, Mandinkas children had the lowest prevalence rate because almost everyone used bed nets while 1-6% of people in Fula and Wolof villages did. Further, Mandinka children slept on mattresses and the other children slept on the floor. Research needs to examine whether cultural beliefs and values or poverty prevent some people from not using bed nets or any other protective device.
Magesa, Stephen M; Lengeler, Christian; deSavigny, Don; Miller, Jane E; Njau, Ritha JA; Kramer, Karen; Kitua, Andrew; Mwita, Alex
2005-01-01
Introduction Malaria is the largest cause of health services attendance, hospital admissions and child deaths in Tanzania. At the Abuja Summit in April 2000 Tanzania committed itself to protect 60% of its population at high risk of malaria by 2005. The country is, therefore, determined to ensure that sustainable malaria control using insecticide-treated nets is carried out on a national scale. Case description Tanzania has been involved for two decades in the research process for developing insecticide-treated nets as a malaria control tool, from testing insecticides and net types, to assessing their efficacy and effectiveness, and exploring new ways of distribution. Since 2000, the emphasis has changed from a project approach to that of a concerted multi-stakeholder action for taking insecticide-treated nets to national scale (NATNETS). This means creating conditions that make insecticide-treated nets accessible and affordable to all those at risk of malaria in the country. This paper describes Tanzania's experience in (1) creating an enabling environment for insecticide-treated nets scale-up, (2) promoting the development of a commercial sector for insecticide-treated nets, and (3) targeting pregnant women with highly subsidized insecticide-treated nets through a national voucher scheme. As a result, nearly 2 million insecticide-treated nets and 2.2 million re-treatment kits were distributed in 2004. Conclusion National upscaling of insecticide-treated nets is possible when the programme is well designed, coordinated and supported by committed stakeholders; the Abuja target of protecting 60% of those at high risk is feasible, even for large endemic countries. PMID:16042780
Grietens, Koen Peeters; Muela Ribera, Joan; Soto, Veronica; Tenorio, Alex; Hoibak, Sarah; Aguirre, Angel Rosas; Toomer, Elizabeth; Rodriguez, Hugo; Llanos Cuentas, Alejandro; D'Alessandro, Umberto; Gamboa, Dionicia; Erhart, Annette
2013-01-01
While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p<0.001). Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent, appropriate quantitative and qualitative methods for collecting information on net preference should be developed before any LLIN procurement decision is made.
Grietens, Koen Peeters; Muela Ribera, Joan; Soto, Veronica; Tenorio, Alex; Hoibak, Sarah; Aguirre, Angel Rosas; Toomer, Elizabeth; Rodriguez, Hugo; Llanos Cuentas, Alejandro; D'Alessandro, Umberto; Gamboa, Dionicia; Erhart, Annette
2013-01-01
Background While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. Methods The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). Results A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p<0.001). Conclusion Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent, appropriate quantitative and qualitative methods for collecting information on net preference should be developed before any LLIN procurement decision is made. PMID:23300943
ARD remediation with limestone in a CO2 pressurized reactor
Sibrell, Philip L.; Watten, Barnaby J.; Friedrich, Andrew E.; Vinci, Brian J.
2000-01-01
We evaluated a new process for remediation of acid rock drainage (ARD). The process treats ARD with intermittently fluidized beds of granular limestone maintained within a continuous flow reactor pressurized with CO2. Tests were performed over a thirty day period at the Toby Creek mine drainage treatment plant, Elk County, Pennsylvania in cooperation with the Pennsylvania Department of Environmental Protection. Equipment performance was established at operating pressures of 0, 34, 82, and 117 kPa using an ARD flow of 227 L/min. The ARD had the following characteristics: pH, 3.1; temperature, 10 °C; dissolved oxygen, 6.4 mg/L; acidity, 260 mg/L; total iron, 21 mg/L; aluminum, 22 mg/L; manganese, 7.5 mg/L; and conductivity, 1400 μS/cm. In all cases tested, processed ARD was net alkaline with mean pH and alkalinities of 6.7 and 59 mg/L at a CO2 pressure of 0 kPa, 6.6 and 158 mg/L at 34 kPa, 7.4 and 240 mg/L at 82 kPa, and 7.4 and 290 mg/L at 117 kPa. Processed ARD alkalinities were correlated to the settled bed depth (p<0.001) and CO2 pressure (p<0.001). Iron, aluminum, and manganese removal efficiencies of 96%, 99%, and 5%, respectively, were achieved with filtration following treatment. No indications of metal hydroxide precipitation or armoring of the limestone were observed. The surplus alkalinity established at 82 kPa was successful in treating an equivalent of 1136 L/min (five-fold dilution) of the combined three ARD streams entering the Toby Creek Plant. This side-stream capability provides savings in treatment unit scale as well as flexibility in treatment effect. The capability of the system to handle higher influent acidity was tested by elevating the acidity to 5000 mg/L with sulfuric acid. Net alkaline effluent was produced, indicating applicability of the process to highly acidic ARD.
Gama, Elvis; Were, Vincent; Ouma, Peter; Desai, Meghna; Niessen, Louis; Buff, Ann M; Kariuki, Simon
2016-11-21
Historically, Kenya has used various distribution models for long-lasting insecticide-treated bed nets (LLINs) with variable results in population coverage. The models presently vary widely in scale, target population and strategy. There is limited information to determine the best combination of distribution models, which will lead to sustained high coverage and are operationally efficient and cost-effective. Standardised cost information is needed in combination with programme effectiveness estimates to judge the efficiency of LLIN distribution models and options for improvement in implementing malaria control programmes. The study aims to address the information gap, estimating distribution cost and the effectiveness of different LLIN distribution models, and comparing them in an economic evaluation. Evaluation of cost and coverage will be determined for 5 different distribution models in Busia County, an area of perennial malaria transmission in western Kenya. Cost data will be collected retrospectively from health facilities, the Ministry of Health, donors and distributors. Programme-effectiveness data, defined as the number of people with access to an LLIN per 1000 population, will be collected through triangulation of data from a nationally representative, cross-sectional malaria survey, a cross-sectional survey administered to a subsample of beneficiaries in Busia County and LLIN distributors' records. Descriptive statistics and regression analysis will be used for the evaluation. A cost-effectiveness analysis will be performed from a health-systems perspective, and cost-effectiveness ratios will be calculated using bootstrapping techniques. The study has been evaluated and approved by Kenya Medical Research Institute, Scientific and Ethical Review Unit (SERU number 2997). All participants will provide written informed consent. The findings of this economic evaluation will be disseminated through peer-reviewed publications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Gender and willingness to pay for insecticides treated bed nets in a poor rural area in Tanzania.
Mujinja, P G M; Makwaya, C K; Sauerborn, R
2004-12-01
To examine socio-economic and malaria related differences between males and females that may cause gender differences in willingness to pay (WTP) for insecticide treated bed nets in a poor rural area. A two-week-interval (test re-test) cross-sectional study. Kisarawe District in coastal Tanzania. Two hundred and fifty one males and two hundred dollars females were interviewed. Females had about 50% of the males' income. The monthly average income was about US dollars 10.50 for females and US dollars 20.20 for males. The proportion of respondents willing to pay for an ITN, for both males and females, declined as the ITN prices increased (P<0.05). The mean maximum WTP difference between men and women, between both rounds were not statistically significant (p>0.05). Male respondents reported a higher mean number of own underfives living in the household compared to women, the difference was not statistically significant (P>0.8). Willingness to pay for ITN was found to be independent of having an under five child with recent history of malaria. Among both males and females, there was an association between a recent experience with malaria episode and WTP, p=0.05 and p=0.02 respectively. Among females, the proportion of those willing to pay for another person, at the lowest ITN price, was significantly higher in those with under five children in their households than in those with no underfives. This was not the case among the male respondents as the association was not statistically significant. Contrary to expectations were was no statistically significant difference in WTP for an ITN between females and males. Further studies that link willingness and ability to pay are required in rural poor population, such studies may be valuable inputs to government policy on and planning of ITN interventions in the public and private sector.
NASA Astrophysics Data System (ADS)
Mclaughlin, M. K.; Tumolo, B.; Sklar, L. S.; Albertson, L.; Daniels, M.
2017-12-01
The influence of life on geomorphic processes is commonly inferred from correlations between the size and abundance of individual organisms and the change in process thresholds and rates from abiotic conditions. However, to understand and model the underlying mechanisms, it is helpful to make direct measurements of the forces acting between organisms and the earth materials they inhabit. For example, flume studies have found that the presence of net-spinning caddisfly larvae (Trichoptera: Hydropsychidae) can increase the shear stress required to initiate particle motion by more than a factor of two, with potentially significant implications for the timing and magnitude of bedload sediment transport in gravel-bedded rivers. To explore the underlying mechanics we conducted flume experiments at the Stroud Water Research center in Avonadale, Pennsylvania, using strain gages to measure the forces acting between caddisfly nets and sediment particles of various sizes, during the process of initial particle motion. We combine these measurements with high-speed video images to document for the first time, the three dimensional dynamics of net stretching, tearing, and detachment that govern the magnitude of the increase in critical shear stress. We are using these data and insights to substantially improve a previously published theoretical model for the mechanics of sediment stabilization by caddisfly larvae. In particular, we seek to constrain the range of particle sizes potentially stabilized by caddisfly larvae and explain mechanistically why the effect of caddisfly nets varies with particle size. These predictions have implications for understanding feedbacks between bed stabilization by caddisflies, insect density, inter-specific niche partitioning, and the movement of sediment that shapes gravel-bed channels.
Field trial of a pulsed limestone diversion well
Sibrell, Philip L.; Denholm, C.; Dunn, Margaret
2013-01-01
The use of limestone diversion wells to treat acid mine drainage (AMD) is well-known, but in many cases, acid neutralization is not as complete as would be desired. Reasons for this include channeling of the water through the limestone bed, and the slow reaction rate of the limestone gravel. A new approach to improve the performance of the diversion well was tested in the field at the Jennings Environmental Education Center, near Slippery Rock, PA. In this approach, a finer size distribution of limestone was used so as to allow fluidization of the limestone bed, thus eliminating channeling and increasing particle surface area for faster reaction rates. Also, water flow was regulated through the use of a dosing siphon, so that consistent fluidization of the limestone sand could be achieved. Testing began late in the summer of 2010, and continued through November of 2011. Initial system performance during the 2010 field season was good, with the production of net alkaline water, but hydraulic problems involving air release and limestone sand retention were observed. In the summer of 2011, a finer size of limestone sand was procured for use in the system. This material fluidized more readily, but acid neutralization tapered off after several days. Subsequent observations indicated that the hydraulics of the system was compromised by the formation of iron oxides in the pipe leading to the limestone bed, which affected water distribution and flow through the bed. Although results from the field trial were mixed, it is believed that without the formation of iron oxides and plugging of the pipe, better acid neutralization and treatment would have occurred. Further tests are being considered using a different hydraulic configuration for the limestone sand fluidized bed.
2014-01-01
Background Mass insecticide treated bed net (ITN) deployment, and its associated coverage of populations at risk, had “pushed” a decline in malaria transmission. However, it is unknown whether malaria control is being enhanced by zooprophylaxis, i.e., mosquitoes diverted to feed on hosts different from humans, a phenomenon that could further reduce malaria entomological transmission risk in areas where livestock herding is common. Methods Between May and July 2009, we collected mosquitoes in 104 houses from three neighboring villages with high ITN coverage (over 80%), along Lake Victoria. We also performed a census of livestock in the area and georeferenced tethering points for all herds, as well as, mosquito larval habitats. Bloodmeal contents from sampled mosquitoes were analyzed, and each mosquito was individually tested for malaria sporozoite infections. We then evaluated the association of human density, ITN use, livestock abundance and larval habitats with mosquito abundance, bloodfeeding on humans and malaria sporozoite rate using generalized linear mixed effects models. Results We collected a total of 8123 mosquitoes, of which 1664 were Anopheles spp. malaria vectors over 295 household spray catches. We found that vector household abundance was mainly driven by the number of householders (P < 0.05), goats/sheep tethered around the house (P < 0.05) and ITNs, which halved mosquito abundance (P < 0.05). In general, similar patterns were observed for Anopheles arabiensis, but not An. gambiae s.s. and An. funestus s.s., whose density did not increase with the presence of livestock animals. Feeding on humans significantly increased in all species with the number of householders (P < 0.05), and only significantly decreased for An. arabiensis in the presence of cattle (P < 0.05). Only 26 Anopheles spp. vectors had malaria sporozoites with the sporozoite rate significantly decreasing as the proportion of cattle feeding mosquitoes increased (P < 0.05). Conclusion Our data suggest that cattle, in settings with large ITN coverage, have the potential to drive an unexpected “push-pull” malaria control system, where An. arabiensis mosquitoes “pushed” out of human contact by ITNs are likely being further “pulled” by cattle. PMID:24472517
Nebraska | Midmarket Solar Policies in the United States | Solar Research |
project development, sales, use, and property tax exemptions, and production based tax credits. Net personal property for use in a community-based energy development (C-BED) project. (A C-BED project is limited to $50,000. Nebraska is not accepting applications for the program as of July 2016. Property Tax
Surveillance of malaria vector population density and biting behaviour in western Kenya.
Ototo, Ednah N; Mbugi, Jenard P; Wanjala, Christine L; Zhou, Guofa; Githeko, Andrew K; Yan, Guiyun
2015-06-17
Malaria is a great public health burden and Africa suffers the largest share of malaria-attributed deaths. Despite control efforts targeting indoor malaria transmission, such as insecticide-treated bed nets (ITNs) and deployment of indoor residual spraying, transmission of the parasite in western Kenya is still maintained. This study was carried out to determine the impact of ITNs on indoor vector densities and biting behaviour in western Kenya. Indoor collection of adult mosquitoes was done monthly in six study sites in western Kenya using pyrethrum spray collections from 2012 to 2014. The rotator trap collections were done in July-August in 2013 and May-June in 2014. Mosquitoes were collected every 2 h between 18.00 and 08.00 h. Human behaviour study was conducted via questionnaire surveys. Species within Anopheles gambiae complex was differentiated by PCR and sporozoite infectivity was determined by ELISA. Species distribution was determined and bed net coverage in the study sites was recorded. During the study a total of 5,469 mosquito vectors were collected from both PSC and Rotator traps comprising 3,181 (58.2%) Anopheles gambiae and 2,288 (41.8%) Anopheles funestus. Compared to all the study sites, Rae had the highest density of An. gambiae with a mean of 1.2 (P<0.001) while Kombewa had the highest density of An. funestus with a mean of 1.08 (P<0.001). Marani had the lowest density of vectors with 0.06 An. gambiae and 0.17 An. funestus (P<0.001). Among the 700 PCR confirmed An. gambiae s.l. individuals, An. gambiae s.s. accounted for 49% and An. arabiensis 51%. Over 50% of the study population stayed outdoors between 18.00 and 20.00 and 06.00 and 08.00 which was the time when highest densities of blood fed vectors were collected. Anopheles gambie s.s. was the main malaria parasite vector in the highland sites and An. arabiensis in the lowland sites. Bed net ownership in 2012 averaged 87% across the study sites. This study suggests that mass distribution of ITNs has had a significant impact on vector densities, species distribution and sporozoite rate. However, shift of biting time poses significant threats to the current malaria vector control strategies which heavily rely on indoor controls.
Okumu, Fredros O; Kiware, Samson S; Moore, Sarah J; Killeen, Gerry F
2013-01-16
Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset, PermaNet 2.0, Icon Life nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset or PermaNet 2.0 nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus.
Behaviour of Anopheles albimanus in relation to pyrethroid-treated bednets.
Arredondo-Jiménez, J I; Rodríguez, M H; Loyola, E G; Bown, D N
1997-01-01
Responses of the malaria vector Anopheles albimanus to pyrethroid impregnated bednets made of cotton or nylon, compared with untreated nets, were investigated in houses occupied by two people inside and/or outside two bednets, in coastal Chiapas, México. The pyrethroid used was lambdacyhalothrin 30 mg a.i./m2. Bioassay mortality rates of An.albimanus exposed to treated nets for 3 or 15 min, rose from 40-55% to 90-100% for nylon nets 3-19 weeks post-treatment, but were consistently lower for treated cotton nets. An.albimanus females (collected unfed on human bait) were released in houses surrounded by curtains for trapping mosquitoes that exited from the house. Floor sheets were used in and around each experimental house for retrieving any mosquitoes knocked-down and/or killed. During post-treatment assessment for 17 weeks, An.albimanus blood-feeding success rates were 23-24% with untreated nets, 14-18% with treated cotton nets and 8-15% with treated nylon nets, significantly reduced when both human baits were inside the treated bednets, but not when one or more baits were outside the treated bednet(s) within the house. Proportions of mosquitoes leaving houses < 3 h post-release were 53-59% from houses with untreated bednets versus 65-78% with treated bednets. Except in one case (when both humans were outside treated cotton nets), these increased early exit rates were significant, whether or not the human baits were inside the treated bednets indoors. Mortality rates of An.albimanus females exiting overnight (22.00-06.00 hours) averaged 15-39% from houses with treated cotton and 16-46% with treated nylon nets, very significantly greater than the control mean rates of 6-8% mortality with untreated nets. Observations on wild-caught An.albimanus females marked with fluorescent powder and released indoors revealed that few mosquitoes (3-11%) actually contacted the bednets unless both human baits remained under them - when contact rates were 22% on treated nylon, 23% on treated cotton and 42% on untreated nets (P approximately 0.05). The mean resting time was significantly longer on untreated (14.4 min) than on treated nylon (5.8 min) or cotton (9.5 min) bednets, whereas mean resting times on other surfaces indoors were 16.5-19.8 min. Proportions exiting within 2h of release were significantly more from houses with treated houses (33-35%) than with untreated nets (8%). However, mortality rates of mosquitoes that landed on treated nets were very significantly greater (90-100%) than after landing on untreated nets (10%). Thus, despite some excito-repellency, lambdacyhalothrin-impregnated bednets (especially made of nylon) proved to be effective as an alternative to house-spraying against An.albimanus.
NASA Astrophysics Data System (ADS)
Omoniyi, Bayonle; Stow, Dorrik
2016-04-01
One of the major challenges in the assessment of and production from turbidite reservoirs is to take full account of thin and medium-bedded turbidites (<10cm and <30cm respectively). Although such thinner, low-pay sands may comprise a significant proportion of the reservoir succession, they can go unnoticed by conventional analysis and so negatively impact on reserve estimation, particularly in fields producing from prolific thick-bedded turbidite reservoirs. Field development plans often take little note of such thin beds, which are therefore bypassed by mainstream production. In fact, the trapped and bypassed fluids can be vital where maximising field value and optimising production are key business drivers. We have studied in detail, a succession of thin-bedded turbidites associated with thicker-bedded reservoir facies in the North Brae Field, UKCS, using a combination of conventional logs and cores to assess the significance of thin-bedded turbidites in computing hydrocarbon pore thickness (HPT). This quantity, being an indirect measure of thickness, is critical for an accurate estimation of original-oil-in-place (OOIP). By using a combination of conventional and unconventional logging analysis techniques, we obtain three different results for the reservoir intervals studied. These results include estimated net sand thickness, average sand thickness, and their distribution trend within a 3D structural grid. The net sand thickness varies from 205 to 380 ft, and HPT ranges from 21.53 to 39.90 ft. We observe that an integrated approach (neutron-density cross plots conditioned to cores) to HPT quantification reduces the associated uncertainties significantly, resulting in estimation of 96% of actual HPT. Further work will focus on assessing the 3D dynamic connectivity of the low-pay sands with the surrounding thick-bedded turbidite facies.
The role of commercial tanning beds and ultraviolet A light in the treatment of psoriasis.
Su, Johanna; Pearce, Daniel J; Feldman, Steven R
2005-01-01
Phototherapy is an effective, safe psoriasis treatment administered via office-based units or home devices. There is controversy over the use of commercial tanning beds; ultraviolet B (UVB) has documented efficacy although commercial beds emit largely UVA. To determine the efficacy of UVA and the role of commercial tanning beds in treating psoriasis. A literature search of UVA and commercial tanning was performed. UVA can be effective for psoriasis, but achieving the high doses required may not be practical. Tanning beds do emit UVB although amounts are variable. Because of variability in UVA and UVB output in different tanning bulbs, it is difficult to predict response rates using commercial tanning beds. UVA can be used to treat psoriasis but may not be practical. Commercial tanning beds, emitting both UVA and UVB, have a role in treating psoriasis as an alternative to office-based therapy.
Yakob, Laith; Cameron, Mary; Lines, Jo
2017-03-13
Malaria is spread by mosquitoes that are increasingly recognised to have diverse biting behaviours. How a mosquito in a specific environment responds to differing availability of blood-host species is largely unknown and yet critical to vector control efficacy. A parsimonious mathematical model is proposed that accounts for a diverse range of host-biting behaviours and assesses their impact on combining long-lasting insecticidal nets (LLINs) with a novel approach to malaria control: livestock treated with insecticidal compounds ('endectocides') that kill biting mosquitoes. Simulations of a malaria control programme showed marked differences across biting ecologies in the efficacy of both LLINs as a stand-alone tool and the combination of LLINs with endectocide-treated cattle. During the intervals between LLIN mass campaigns, concordant use of endectocides is projected to reduce the bounce-back in malaria prevalence that can occur as LLIN efficacy decays over time, especially if replacement campaigns are delayed. Integrating these approaches can also dramatically improve the attainability of local elimination; endectocidal treatment schedules required to achieve this aim are provided for malaria vectors with different biting ecologies. Targeting blood-feeding mosquitoes by treating livestock with endectocides offers a potentially useful complement to existing malaria control programmes centred on LLIN distribution. This approach is likely to be effective against vectors with a wide range of host-preferences and biting behaviours, with the exception of species that are so strictly anthropophilic that most blood meals are taken on humans even when humans are much less available than non-human hosts. Identifying this functional relationship in wild mosquito populations and ascertaining the extent to which it differs, within as well as between species, is a critical next step before targets can be set for employing this novel approach and combination.
Koenker, Hannah M; Loll, Dana; Rweyemamu, Datius; Ali, Abdullah S
2013-06-13
Intensive malaria control interventions in the United Republic of Tanzania have contributed to reductions in malaria prevalence. Given that malaria control remains reliant upon continued use of long-lasting insecticidal bed nets (LLINs) even when the threat of malaria has been reduced, this qualitative study sought to understand how changes in perceived risk influence LLIN usage, and to explore in more detail the benefits of net use that are unrelated to malaria. Eleven focus group discussions were conducted in Bukoba Rural district and in Zanzibar Urban West district in late 2011. Participants were males aged 18 and over, females between the ages of 18 and 49, and females at least 50 years old. The perceived risk of malaria had decreased among the respondents, and malaria control interventions were credited for the decline. Participants cited reductions in both the severity of malaria and in their perceived susceptibility to malaria. However, malaria was still considered a significant threat. Participants' conceptualization of risk appeared to be an important consideration for net use. At the same time, comfort and aspects of comfort (getting a good night's sleep, avoiding biting pests) appeared to play a large role in personal decisions to use nets consistently or not. Barriers to comfort (feeling uncomfortable or trapped; perceived difficulty breathing, or itching/rashes) were frequently cited as reasons not to use a net consistently. While it was apparent that participants acknowledged the malaria-prevention benefits of net use, the exploration of the risk and comfort determinants of net use provides a richer understanding of net use behaviours, particularly in a setting where transmission has fallen and yet consistent net use is still crucial to maintaining those gains. Future behaviour change communication campaigns should capitalize on the non-malaria benefits of net use that provide a long-term rationale for consistent use even when the immediate threat of malaria transmission has been reduced.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Liu, X; Rahimian, J; Cosmatos, H
2014-06-01
Purpose: The goal of this research is to calculate and compare the Biological Equivalent Dose (BED) between permanent prostate Iodine-125 implant brachytherapy as monotherapy with the BED of conventional external beam radiation therapy (EBRT). Methods: A retrospective study of 605 patients treated with Iodine-125 seed implant was performed in which physician A treated 274 patients and physician B treated 331 patients. All the Brachytherapy treatment plans were created using VariSeed 8 planning system. The Iodine-125 seed source activities and loading patterns varied slightly between the two physicians. The prescription dose is 145 Gy to PTV for each patient. The BEDmore » and Tumor Control Probability (TCP) were calculated based on the TG 137 formulas. The BED for conventional EBRT of the prostate given in our institution in 2Gy per fraction for 38 fractions was calculated and compared. Results: Physician A treated 274 patients with an average BED of 123.92±0.87 Gy and an average TCP of 99.20%; Physician B treated 331 patients with an average BED of 124.87±1.12 Gy and an average TCP of 99.30%. There are no statistically significant differences (T-Test) between the BED and TCP values calculated for these two group patients.The BED of the patients undergoing conventional EBRT is calculated to be 126.92Gy. The BED of the patients treated with permanent implant brachytherapy and EBRT are comparable. Our BED and TCP values are higher than the reported values by TG 137 due to higher Iodine-125 seed activity used in our institution. Conclusion: We calculated the BED,a surrogate of the biological response to a permanent prostate brachytherapy using TG 137 formulas and recommendation. The TCP of better than 99% is calculated for these patients. A clinical outcome study of these patients correlating the BED and TCP values with PSA and Gleason Levels as well as patient survival is warranted.« less
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Behavioral Responses of the Common Bed Bug, Cimex lectularius, to Insecticide Dusts.
Agnew, John L; Romero, Alvaro
2017-08-08
Bed bugs have reemerged recently as a serious and growing problem not only in North America but in many parts of the world. These insects have become the most challenging pest to control in urban environments. Residual insecticides are the most common methods used for bed bug control; however, insecticide resistance limits the efficacy of treatments. Desiccant dusts have emerged as a good option to provide a better residual effect for bed bug control. Several studies have focused on determining the efficacy of dust-based insecticides against bed bugs. However, behavioral responses of bed bugs to insecticide dusts could influence their efficacy. The behavioral responses of bed bugs to six insecticide dusts commonly used in the United States were evaluated with an advanced video tracking technique (Ethovision). Bed bugs took longer to make first contact with areas treated with the diatomaceous earth (DE)-based products MotherEarth D and Alpine than pyrethroid, pyrethrins or silica gel based products, DeltaDust, Tempo 1% Dust and CimeXa, respectively. Lower visitation rates of bed bugs were recorded for areas treated with MotherEarth D, Alpine and CimeXa than that of DeltaDust, Tempo 1% Dust, and Tri-Die Silica + Pyrethrum Dust. Bed bugs spent less time in areas treated with Tri-Die Dust, CimeXa, Alpine, and MotherEarth D than DeltaDust and Tempo 1% Dust, and they exhibited a reduction in locomotor parameters when crawling on areas treated with CimeXa and Alpine. The implications of these responses to bed bug control are discussed.
Behavioral Responses of the Common Bed Bug, Cimex lectularius, to Insecticide Dusts
Agnew, John L.; Romero, Alvaro
2017-01-01
Bed bugs have reemerged recently as a serious and growing problem not only in North America but in many parts of the world. These insects have become the most challenging pest to control in urban environments. Residual insecticides are the most common methods used for bed bug control; however, insecticide resistance limits the efficacy of treatments. Desiccant dusts have emerged as a good option to provide a better residual effect for bed bug control. Several studies have focused on determining the efficacy of dust-based insecticides against bed bugs. However, behavioral responses of bed bugs to insecticide dusts could influence their efficacy. The behavioral responses of bed bugs to six insecticide dusts commonly used in the United States were evaluated with an advanced video tracking technique (Ethovision). Bed bugs took longer to make first contact with areas treated with the diatomaceous earth (DE)-based products MotherEarth D and Alpine than pyrethroid, pyrethrins or silica gel based products, DeltaDust, Tempo 1% Dust and CimeXa, respectively. Lower visitation rates of bed bugs were recorded for areas treated with MotherEarth D, Alpine and CimeXa than that of DeltaDust, Tempo 1% Dust, and Tri-Die Silica + Pyrethrum Dust. Bed bugs spent less time in areas treated with Tri-Die Dust, CimeXa, Alpine, and MotherEarth D than DeltaDust and Tempo 1% Dust, and they exhibited a reduction in locomotor parameters when crawling on areas treated with CimeXa and Alpine. The implications of these responses to bed bug control are discussed. PMID:28786920
A preliminary report on a zone containing thick lignite beds, Denver Basin, Colorado
Soister, Paul E.
1973-01-01
A zone of lignite beds of Paleocene age in the Denver Formation (Upper Cretaceous and Paleocene) lies about 800-1,500 feet above the well-known and extensively mined coal beds of the Laramie Formation (Upper Cretaceous). The zone is a few hundred to as much as 500 feet thick. Where lignite beds lie within 1,000 feet of the surface, this zone underlies an area about 30 miles wide by about 75 miles long, stretching from just northeast of Denver to several miles south of Calhan. Fifteen mines were operated at various periods between 1874 and 1940 and probably produced a total of less than 100,000 tons of lignite, mostly for local use. From 1874 to 1974, several geologists have reported on this lignite zone or the enclosing beds, but no detailed reports have been written except for one by this writer. Drill holes are the main source of geologic data, owing to poor exposure. There are generally about 3 to 6 lignite beds, and they are mostly about 15 or 20 to a few tens of feet apart. Most or all beds typically contain numerous non-coal partings from a fraction of an inch to several inches thick, so that thickness of lignite beds should be stated as gross thickness and as net lignite thickness; net lignite thickness is generally from 70 to 90 percent of gross thickness. Many partings are composed of kaolin, but others are composed of other clay minerals, siltstone, and sandstone. The lignite beds range generally from 1 or 2 to several feet thick, and some are as much as 10-25 feet thick; the thickest known bed has a maximum thickness of 54.5 feet, with a net lignite thickness of 40 feet. Most lignite beds seem to have fair lateral continuity, and at least some beds are several miles in extent. The thickest known lignite bed was traced for at least 18 miles, from northwest to southeast of Watkins. The lignite is brownish-black to black, weathers, checks, and disintegrates rapidly, and even in drill cores from a few hundred feet in depth the lignite is easily broken by hand pressure. Quality of the lignite is lowered by the non-coal partings and, locally at least, by some small blebs and balls of clay in the lignite itself, especially at the base. Available analyses indicate that the following general figures, on an as-received basis, may be applied to relatively clean lignite from this zone: 6,000-7,000 Btu, 20-35 percent moisture, 8-18 percent ash, and 0.3-0.5 percent sulfur. Rank of the lignite is lignite A as calculated by the formulas of the American Society for Testing and . Materials (ASTM), although some parts, especially of deeper beds, may be as high as subbituminous C coal in rank. Best utilization of the lignite probably would be by gasification, liquefaction, or similar methods, because of the numerous non-coal partings and low quality. The thickest known lignite bed is estimated to contain at least 1.25 billion short tons of lignite. Two methods of roughly estimating the order of magnitude of lignite resources, in beds at least 4 feet thick and within 1,000 feet of the surface in this zone, indicate resources are on the order of 20 billion tons.
Effectiveness of insecticide-treated and untreated nets to prevent malaria in India.
Van Remoortel, Hans; De Buck, Emmy; Singhal, Maneesh; Vandekerckhove, Philippe; Agarwal, Satya P
2015-08-01
India is the most malaria-endemic country in South-East Asia, resulting in a high socio-economic burden. Insecticide-treated or untreated nets are effective interventions to prevent malaria. As part of an Indian first-aid guideline project, we aimed to investigate the magnitude of this effect in India. We searched MEDLINE, Embase and Central to systematically review Indian studies on the effectiveness of treated or untreated vs. no nets. Parasite prevalence and annual parasite incidence served as malaria outcomes. The overall effect was investigated by performing meta-analyses and calculating the pooled risk ratios (RR) and incidence rate ratios. Of 479 articles, we finally retained 16 Indian studies. Untreated nets decreased the risk of parasite prevalence compared to no nets [RR 0.69 (95% CI; 0.55, 0.87) in high-endemic areas, RR 0.49 (95% CI; 0.28, 0.84) in low-endemic areas], as was the case but more pronounced for treated nets [RR 0.35 (95% CI; 0.26, 0.47) in high-endemic areas, risk ratio 0.16 (95% CI; 0.06, 0.44) in low-endemic areas]. Incidence rate ratios showed a similar observation: a significantly reduced rate of parasites in the blood for untreated nets vs. no nets, which was more pronounced in low-endemic areas and for those who used treated nets. The average effect of treated nets (vs. no nets) on parasite prevalence was higher in Indian studies (RR 0.16-0.35) than in non-Indian studies (data derived from a Cochrane systematic review; RR 0.58-0.87). Both treated and untreated nets have a clear protective effect against malaria in the Indian context. This effect is more pronounced there than in other countries. © 2015 John Wiley & Sons Ltd.
Strode, Clare; Donegan, Sarah; Garner, Paul; Enayati, Ahmad Ali; Hemingway, Janet
2014-03-01
Pyrethroid insecticide-treated bed nets (ITNs) help contribute to reducing malaria deaths in Africa, but their efficacy is threatened by insecticide resistance in some malaria mosquito vectors. We therefore assessed the evidence that resistance is attenuating the effect of ITNs on entomological outcomes. We included laboratory and field studies of African malaria vectors that measured resistance at the time of the study and used World Health Organization-recommended impregnation regimens. We reported mosquito mortality, blood feeding, induced exophily (premature exit of mosquitoes from the hut), deterrence, time to 50% or 95% knock-down, and percentage knock-down at 60 min. Publications were searched from 1 January 1980 to 31 December 2013 using MEDLINE, Cochrane Central Register of Controlled Trials, Science Citation Index Expanded, Social Sciences Citation Index, African Index Medicus, and CAB Abstracts. We stratified studies into three levels of insecticide resistance, and ITNs were compared with untreated bed nets (UTNs) using the risk difference (RD). Heterogeneity was explored visually and statistically. Included were 36 laboratory and 24 field studies, reported in 25 records. Studies tested and reported resistance inconsistently. Based on the meta-analytic results, the difference in mosquito mortality risk for ITNs compared to UTNs was lower in higher resistance categories. However, mortality risk was significantly higher for ITNs compared to UTNs regardless of resistance. For cone tests: low resistance, risk difference (RD) 0.86 (95% CI 0.72 to 1.01); moderate resistance, RD 0.71 (95% CI 0.53 to 0.88); high resistance, RD 0.56 (95% CI 0.17 to 0.95). For tunnel tests: low resistance, RD 0.74 (95% CI 0.61 to 0.87); moderate resistance, RD 0.50 (95% CI 0.40 to 0.60); high resistance, RD 0.39 (95% CI 0.24 to 0.54). For hut studies: low resistance, RD 0.56 (95% CI 0.43 to 0.68); moderate resistance, RD 0.39 (95% CI 0.16 to 0.61); high resistance, RD 0.35 (95% CI 0.27 to 0.43). However, with the exception of the moderate resistance category for tunnel tests, there was extremely high heterogeneity across studies in each resistance category (chi-squared test, p<0.00001, I² varied from 95% to 100%). This meta-analysis found that ITNs are more effective than UTNs regardless of resistance. There appears to be a relationship between resistance and the RD for mosquito mortality in laboratory and field studies. However, the substantive heterogeneity in the studies' results and design may mask the true relationship between resistance and the RD, and the results need to be interpreted with caution. Our analysis suggests the potential for cumulative meta-analysis in entomological trials, but further field research in this area will require specialists in the field to work together to improve the quality of trials, and to standardise designs, assessment, and reporting of both resistance and entomological outcomes.
Wojciechowska, Ewa; Gajewska, Magdalena
2013-01-01
The retention of heavy metals at two pilot-scale treatment wetlands (TWs), consisting of two vertical flow beds (VSSF) followed by a horizontal flow bed (HSSF) was studied. The TWs received high-strength wastewater: reject waters from sewage sludge centrifugation (RW) and landfill leachate (LL). The concentrations of the metals Fe, Mn, Zn, Al, Pb, Cu, Cd, Co, and Ni were measured in treated wastewater, substrate of the beds and in plant material harvested from the beds (separately in above ground (ABG) parts and below ground (BG) parts). The TWs differed in metals retention. In the RW treating TW the metal removal efficiencies varied from 27% for Pb to over 97% for Fe and Al. In the LL treating system the concentrations of most metals decreased after VSSF-1 and VSSF-2 beds; however, in the outflow from the last (HSSF) bed, the concentrations of metals (apart from Al) increased again, probably due to the anaerobic conditions at the bed. A major removal pathway was sedimentation and adsorption onto soil substrate as well as precipitation and co-precipitation. In the LL treating facility the plants contained substantially higher metal concentrations in BG parts, while the upward movement of metals was restricted. In the RW treating facility the BG/ABG ratios were lower, indicating that metals were transported to shoots.
Suspended and Bedload Sand dynamics in the Mekong River Channel and Export to the Coastal Ocean
NASA Astrophysics Data System (ADS)
Stephens, J. D.; Di Leonardo, D. R.; Weathers, H. D., III; Allison, M. A.
2016-02-01
Two field campaigns were conducted in the tidal and estuarine reach of the Song Hau distributary of the Mekong River to examine the dynamics of sand transport and export to the coastal ocean. This study examines variation in suspended sand concentration and net transport with respect to changes in discharge between the October 2014 high discharge and March 2015 low discharge studies, and over semi-diurnal and spring-neap tidal cycles between Can Tho and the Tran De and Dinh An distributary channels in the Mekong Delta. Suspended sand concentrations were measured using a P-61 isokinetic suspended sediment sampler and a Sequoia Scientific LISST-100X used in vertical profiling mode. Stationary ADCP data are used to examine bed stress at cast sites. Bed load transport rates were calculated using a repeat multibeam transect methodology and dune translation rates with flow. Preliminary results indicate that suspended sand concentration increases towards the bed and is positively correlated with increasing shear stress controlled by river discharge and tides. However, sites with non-sandy bottoms, as indicated by multibeam bathymetry, have low suspended sand concentrations, suggesting a close linkage with a bed sand source. Bed load transport rates vary cross-sectionally with shear stress and are linked to dune size. Most bed load transport is taking place in or near the thalweg. The reduction in ebb flows at low discharge and the mantling of sand fields by salinity driven mud deposition, is suspected to control the low suspended sand concentrations observed in March. Results to date suggest that net sand export (suspended plus bed load) to the ocean occurs predominantly during the high discharge monsoon season.
Prevent, identify, and treat bed bug infestations using EPA’s step-by-step guides, based on IPM principles. Find pesticides approved for bed bug control, check out the information clearinghouse, and dispel bed bug myths.
Deribew, Amare; Birhanu, Zewdie; Sena, Lelisa; Dejene, Tariku; Reda, Ayalu A; Sudhakar, Morankar; Alemseged, Fessehaye; Tessema, Fasil; Zeynudin, Ahmed; Biadgilign, Sibhatu; Deribe, Kebede
2012-01-06
Long-lasting insecticide-treated bed nets (LLITN) have demonstrated a significant effect in reducing malaria-related morbidity and mortality. However, barriers on the utilization of LLITN have hampered the desired outcomes. The aim of this study was to assess the effect of community empowerment on the burden of malaria and anaemia in under-five children in Ethiopia. A cluster randomized trial was done in 22 (11 intervention and 11 control) villages in south-west Ethiopia. The intervention consisted of tailored training of household heads about the proper use of LLITN and community network system. The burden of malaria and anaemia in under-five children was determined through mass blood investigation at baseline, six and 12 months of the project period. Cases of malaria and anaemia were treated based on the national protocol. The burden of malaria and anaemia between the intervention and control villages was compared using the complex logistic regression model by taking into account the clustering effect. Eight Focus group discussions were conducted to complement the quantitative findings. A total of 2,105 household heads received the intervention and the prevalence of malaria and anaemia was assessed among 2410, 2037 and 2612 under-five children at baseline, six and 12 months of the project period respectively. During the high transmission/epidemic season, children in the intervention arm were less likely to have malaria as compared to children in the control arm (OR = 0.42; 95%CI: 0.32, 0.57). Symptomatic malaria also steadily declined in the intervention villages compared to the control villages in the follow up periods. Children in the intervention arm were less likely to be anaemic compared to those in the control arm both at the high (OR = 0.84; 95%CI: 0.71, 0.99)) and low (OR = 0.73; 95%CI: 0.60, 0.89) transmission seasons. Training of household heads on the utilization of LLITN significantly reduces the burden of malaria in under-five children. The Ministry of Health of Ethiopia in collaboration with other partners should design similar strategies in high-risk areas to control malaria in Ethiopia. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000035022.
Singer, Michael B.; Dunne, Thomas
2006-01-01
A stochastic flood generator and calibrated sediment transport formulae were used to assess the decadal impact of major river rehabilitation strategies on two fraction bed material sediment flux and net storage, first‐order indicators of aquatic riverine habitat, in a large river system. Model boundary conditions were modified to reflect the implementation of three major river rehabilitation strategies being considered in the Sacramento River Valley: gravel augmentation, setting back of levees, and flow alteration. Fifty 30‐year model simulations were used to compute probabilities of the response in sediment flux and net storage to these strategies. Total annual average bed material sediment flux estimates were made at six gauged river cross sections, and ∼60 km reach‐scale sediment budgets were evaluated between them. Gravel augmentation to improve spawning habitat induced gravel accumulation locally and/or downstream, depending on the added mixture. Levee setbacks to recreate the river corridor reduced flow stages for most flows and hence lowered sediment flux. Flow alteration to mimic natural flow regimes systematically decreased total annual average flux, suggesting that high‐magnitude low‐frequency transport events do not affect long‐term trends in bed material flux. The results indicate that each rehabilitation strategy reduces sediment transport in its target reaches and modulates imbalances in total annual bed material sediment budgets at the reach scale. Additional risk analysis is necessary to identify extreme conditions associated with variable hydrology that could affect rehabilitation over decades. Sensitivity analysis suggests that sorting of bed material sediment is the most important determinant of modeled transport and storage patterns.
Use of soft hydrothermal processing to improve and recycle bedding for laboratory animals.
Miyamoto, T; Li, Z; Kibushi, T; Yamasaki, N; Kasai, N
2008-10-01
Cage bedding for laboratory rodents can influence animal wellbeing and thus the experimental data. In addition, a large amount of used bedding containing excrement is discharged as medical waste from life science institutes and breeding companies. We developed a ground-breaking system to improve fresh bedding and recycle used bedding by applying a soft hydrothermal process with high-temperature and high-pressure dry steam. The system removes both harmful organic components and aromatic hydrocarbons that can affect animals' metabolism. The purpose of the present study was to evaluate the chemical and physical properties of the improved fresh bedding and the recycled used bedding treated by the system. The results showed that 68-99% of the predominant aromatic hydrocarbons were removed from fresh bedding treated at 0.35 MPa and 140 degrees C for 120 min ('improved bedding'). In addition, 59.4-99.0% of predominant harmful organic compounds derived from excrement were removed from used bedding treated at 0.45 MPa and 150 degrees C for 60 min ('recycled bedding'). The soft hydrothermal treatment increased the number of acidic functional groups on the bedding surface and gave it the high adsorptive efficiency of ammonia gas. Harmful substances such as microorganisms, heavy metals and pesticides decreased below the detection limit. The results clearly showed that the improved and recycled bedding is safer for laboratory rodents and has the potential to ameliorate conditions in primary and secondary enclosures (e.g. cages and animal rooms) used for maintaining laboratory animals. This process may be one of the most advanced techniques in providing an alternative to softwood and other bedding, economizing through the recycling of used bedding and reducing bedding waste from animal facilities.
2013-01-01
Background Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. Methods A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset®, PermaNet 2.0®, Icon Life® nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Results Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset® or PermaNet 2.0® nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life® nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Conclusions Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus. PMID:23324456
Regional Disease Vector Ecology Profile: The Koreas
2015-01-01
Lymantriidae): The larvae, pupae and adults of E. flava are covered with hairs that cause dermatitis (papulourticarial reaction) when they contact ...Information Services Division at (301) 295-8310/7476, DSN 295- 8310/7476 or the AFPMB Webmaster, http://www.afpmb.org/ contact . Current Information: Current...timely manner. For insect repellents, pesticides, pesticide application equipment, PPMs (bed nets, head nets, etc.) and respirators contact the DLA
Spatial distribution of impacts to channel bed mobility due to flow regulation, Kootenai River, USA
Michael Burke; Klaus Jorde; John M. Buffington; Jeffrey H. Braatne; Rohan Benjakar
2006-01-01
The regulated hydrograph of the Kootenai River between Libby Dam and Kootenay Lake has altered the natural flow regime, resulting in a significant decrease in maximum flows (60% net reduction in median 1-day annual maximum, and 77%-84% net reductions in median monthly flows for the historic peak flow months of May and June, respectively). Other key hydrologic...
Kweka, Eliningaya J; Munga, Stephen; Mahande, Aneth M; Msangi, Shandala; Mazigo, Humphrey D; Adrias, Araceli Q; Matias, Jonathan R
2012-09-05
The reduction of malaria parasite transmission by preventing human-vector contact is critical in lowering disease transmission and its outcomes. This underscores the need for effective and long lasting arthropod/insect repellents. Despite the reduction in malaria transmission and outcomes in Tanzania, personal protection against mosquito bites is still not well investigated. This study sought to determine the efficacy of menthol propylene glycol carbonate (MR08), Ocimum suave as compared to the gold standard repellent N, N-diethyl-methylbenzamide (DEET), either as a single dose or in combination (blend), both in the laboratory and in the field against Anopheles gambiae s.l and Culex quinquefasciatus. In the laboratory evaluations, repellents were applied on one arm while the other arm of the same individual was treated with a base cream. Each arm was separately exposed in cages with unfed female mosquitoes. Repellents were evaluated either as a single dose or as a blend. Efficacy of each repellent was determined by the number of mosquitoes that landed and fed on treated arms as compared to the control or among them. In the field, evaluations were performed by human landing catches at hourly intervals from 18:00 hr to 01:00 hr. A total of 2,442 mosquitoes were collected during field evaluations, of which 2,376 (97.30%) were An. gambiae s.l while 66 (2.70%) were Cx. quinquefaciatus. MR08 and DEET had comparatively similar protective efficacy ranging from 92% to 100 for both single compound and blends. These findings indicate that MR08 has a similar protective efficacy as DEET for personal protection outside bed nets when used singly and in blends. Because of the personal protection provided by MR08, DEET and blends as topical applicants in laboratory and field situations, these findings suggest that, these repellents could be used efficiently in the community to complement existing tools. Overall, Cx. quinquefasciatus were significantly prevented from blood feeding compared to An. gambiae s.l. The incorporation of these topical repellents for protection against insect bites can be of additional value in the absence or presence of IRS and ITNs coverage. However, a combination of both the physical (bed nets) and the repellent should be used in an integrated manner for maximum protection, especially before going to bed. Additional research is needed to develop repellents with longer duration of protection.
Picado, Albert; Kumar, Vijay; Das, Murari; Burniston, Ian; Roy, Lalita; Suman, Rijal; Dinesh, Diwakar; Coosemans, Marc; Sundar, Shyam; Shreekant, Kesari; Boelaert, Marleen; Davies, Clive; Cameron, Mary
2009-12-01
Observational studies in the Indian subcontinent have shown that untreated nets may be protective against visceral leishmaniasis (VL). In this study, we evaluated the effect of untreated nets on the blood feeding rates of Phlebotomus argentipes as well as the human blood index (HBI) in VL endemic villages in India and Nepal. The study had a 'before and after intervention' design in 58 households in six clusters. The use of untreated nets reduced the blood feeding rate by 85% (95% CI 76.5-91.1%) and the HBI by 42.2% (95% CI 11.1-62.5%). These results provide circumstantial evidence that untreated nets may provide some degree of personal protection against sand fly bites.
2011-01-01
Background In 2009, the first national long-lasting insecticide-treated net (LLIN) distribution campaign in Senegal resulted in the distribution of 2.2 million LLINs in two phases to children aged 6-59 months. Door-to-door teams visited all households to administer vitamin A and mebendazole, and to give a coupon to redeem later for an LLIN. Methods A nationwide community-based two-stage cluster survey was conducted, with clusters selected within regions by probability proportional to size sampling, followed by GPS-assisted mapping, simple random selection of households in each cluster, and administration of a questionnaire using personal digital assistants (PDAs). The questionnaire followed the Malaria Indicator Survey format, with rosters of household members and bed nets, and questions on campaign participation. Results There were 3,280 households in 112 clusters representing 33,993 people. Most (92.1%) guardians of eligible children had heard about the campaign, the primary sources being health workers (33.7%), neighbours (26.2%), and radio (22.0%). Of eligible children, 82.4% received mebendazole, 83.8% received vitamin A, and 75.4% received LLINs. Almost all (91.4%) LLINs received during the campaign remained in the household; of those not remaining, 74.4% had been given away and none were reported sold. At least one insecticide-treated net (ITN) was present in 82.3% of all households, 89.2% of households with a child < 5 years and 57.5% of households without a child < 5 years. Just over half (52.4%) of ITNs had been received during the campaign. Considering possible indicators of universal coverage, 39.8% of households owned at least one ITN per two people, 21.6% owned at least one ITN per sleeping space and 34.7% of the general population slept under an ITN the night before the survey. In addition, 45.6% of children < 5 years, and 49.2% of pregnant women had slept under an ITN. Conclusions The nationwide integrated LLIN distribution campaign allowed household ITN ownership of one or more ITNs to surpass the RBM target of 80% set for 2010, though additional distribution strategies are needed to reach populations missed by the targeted campaign and to reach the universal coverage targets of one ITN per sleeping space and 80% of the population using an ITN. PMID:21489278
Smithuis, Frank M; Kyaw, Moe Kyaw; Phe, U Ohn; van der Broek, Ingrid; Katterman, Nina; Rogers, Colin; Almeida, Patrick; Kager, Piet A; Stepniewska, Kasia; Lubell, Yoel; Simpson, Julie A; White, Nicholas J
2013-10-11
Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study's objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services. A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services. In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of -2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval -7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective. In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN.
Kayedi, Mohammad Hassan; Khamisabadi, Kiumars; Dehghani, Nader; Haghdoost, Ali Akbar
2015-06-01
The residual insecticidal power of two types of ITNs (PermaNet 2.0® (PN2) and K-O Tab 1-2-3® (KO 123)), compared to K-O Tab® (KO) treated nets, was assessed. The nets were tested unwashed, and after being washed, by hand 5, 15 and 21 times, respectively. After each wash, the nets were dried vertically on a line, in the shade. Two types of bioassays (mean median knock down times (MMKDT) and mortality 24 hours after a 3-minute exposure (%mortality)) were used, along with reared female Anopheles stephensi. The number of washes had a great impact on MMKDT and %mortality of all types of nets. This impact was greater for conventionally treated nets, indicating that PN2 and KO 123 nets are significantly more wash resistant than KO nets after 21 washes. There was no significant difference between PN2 and KO 123 with respect to %mortality 24 hours after a 3-minute exposure at 0, 15 and 21 washes. Similarly, the same results were obtained for MMKDT, and the differences between PN2 and KO 123 were not statistically significant. This study demonstrates that the efficacy of KO 123 nets is as beneficial as the efficacy of PN2 nets up to 21 washes.
Assessing the performance of freestanding hospitals.
McCue, Michael J; Diana, Mark L
2007-01-01
Freestanding hospitals are becoming less common as more hospitals are joining or establishing relationships with multihospital systems. These associations are driven by factors, such as unrelenting competition in local markets, aging physical plants, increasing labor costs, and higher physician fees, that place a high demand on financial assets. Despite these factors, many freestanding hospitals continue to do well financially, showing increases in total profit margins and total cash flow margins. This article examines which market, management, financial, and mission factors are associated with freestanding hospitals with consistently positive cash flows, relative to those without consistently positive cash flows. The study sample consisted of freestanding, nonfederal, short-term, acute care general hospitals with more than 50 beds and three years of annual cash flow data. Data were taken from the annual surveys of the American Hospital Association, the cost reports of the Centers for Medicare and Medicaid Services, and the Area Resource File of the Health Resources and Services Administration. The data were analyzed using logistic regression to identify those factors associated with a consistently positive cash flow. Freestanding hospitals with positive cash flows were found to have a greater market share and to be located in markets with a higher number of physicians and fewer acute care beds; to have fewer unoccupied beds, higher net revenues, greater liquidity, and less debt on hand; and to treat fewer Medicare patients than those without a positive cash flow. The findings suggest that these hospitals are located in resource-rich environments and that they have strong management teams.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Baird, Lance Awender; Brandvold, Timothy A.
Processes and apparatuses for washing a spent ion exchange bed and for treating biomass-derived pyrolysis oil are provided herein. An exemplary process for washing a spent ion exchange bed employed in purification of biomass-derived pyrolysis oil includes the step of providing a ion-depleted pyrolysis oil stream having an original oxygen content. The ion-depleted pyrolysis oil stream is partially hydrotreated to reduce the oxygen content thereof, thereby producing a partially hydrotreated pyrolysis oil stream having a residual oxygen content that is less than the original oxygen content. At least a portion of the partially hydrotreated pyrolysis oil stream is passed throughmore » the spent ion exchange bed. Water is passed through the spent ion exchange bed after passing at least the portion of the partially hydrotreated pyrolysis oil stream therethrough.« less
Sahu, Sudhansu Sekhar; Gunasekaran, Kasinathan; Vijayakumar, Kilakootil Narayanan; Jambulingam, Purushothaman
2017-01-01
BACKGROUND New brands of potential long lasting insecticide nets (LLINs) and LLIN treatment kits require field evaluation before they are used in a vector control programme. OBJECTIVES The aim of this study was to evaluate the bio-efficacy, usage, washing practice and physical integrity of nets treated with LLIN treatment kit, ICON MAXX in a phase III field trial in Odisha state, India. METHODS A total of 300 polyester nets treated with ICON MAXX and 140 polyester nets treated conventionally with lambda-cyhalothrin CS 2.5% ITNs were distributed. The bio-efficacy was evaluated with WHO cone bioassay. The chemical analysis of netting pieces was done at the beginning, after 12 and 36 months of the trial. FINDINGS After one year of distribution of nets, the bioassay showed 100% mortality on both ITNs and ICON MAXX treated nets. At 36 months, the overall pass rate was 58.8% and the mean lambda-cyhalothrin content of LLINs was 34.5 mg ai/m2, showing a loss of 44.4% of the original concentration. CONCLUSION ICON MAXX treated LLIN was found to retain bio-efficacy causing 97% knockdown of Anopheles stephensi up to 30 months and met the WHOPES criteria. However, the desired bio-efficacy was not sustained up to 36 months. PMID:28125134
Risk Factors for Kala-Azar in Bangladesh
Hightower, Allen W.; Chowdhury, Rajib; Ali, Mustakim; Amann, Josef; Wagatsuma, Yukiko; Haque, Rashidul; Kurkjian, Katie; Vaz, Louise E.; Begum, Moarrita; Akter, Tangin; Cetre-Sossah, Catherine B.; Ahluwalia, Indu B.; Dotson, Ellen; Secor, W. Evan; Breiman, Robert F.; Maguire, James H.
2005-01-01
Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over a 3-year period in a Bangladeshi community. By history, active case detection, and serologic screening, 155 of 2,356 residents had kala-azar with onset from 2000 to 2003. Risk was highest for persons 3–45 years of age, and no significant difference by sex was seen. In age-adjusted multivariable models, 3 factors were identified: proximity to a previous kala-azar patient (odds ratio [OR] 25.4, 95% confidence interval [CI] 15–44 within household; OR 3.2 95% CI 1.7–6.1 within 50 m), bed net use in summer (OR 0.7, 95% CI 0.53–0.93), and cattle per 1,000 m2 (OR 0.8, 95% CI 0.70–0.94]). No difference was seen by income, education, or occupation; land ownership or other assets; housing materials and condition; or keeping goats or chickens inside bedrooms. Our data confirm strong clustering and suggest that insecticide-treated nets could be effective in preventing kala-azar. PMID:15890115
6. HOT BED FOR THE AJAX MAGNETHERMIC HEAT TREATING LINE ...
6. HOT BED FOR THE AJAX MAGNETHERMIC HEAT TREATING LINE AT THE HEAT TREATMENT PLANT OF THE DUQUESNE WORKS. - U.S. Steel Duquesne Works, Heat Treatment Plant, Along Monongahela River, Duquesne, Allegheny County, PA
Mosquito Bite Prevention For Travelers
... is an insecticide that kills mosquitoes and other insects. - Do not wash bed nets or expose them ... for extra protection. Use only an EPA-registered insect repellent Consider bringing insect repellent with you. Always ...
Mosquitoes established in Lhasa city, Tibet, China
2013-01-01
Background In 2009, residents of Lhasa city, Tibet Autonomous Region (TAR), China reported large numbers of mosquitoes and bites from these insects. It is unclear whether this was a new phenomenon, which species were involved, and whether these mosquitoes had established themselves in the local circumstances. Methods The present study was undertaken in six urban sites of Chengguan district Lhasa city, Tibet. Adult mosquitoes were collected by bed net trap, labor hour method and light trap in August 2009 and August 2012. The trapped adult mosquitoes were initially counted and identified according to morphological criteria, and a proportion of mosquitoes were examined more closely using a multiplex PCR assay. Results 907 mosquitoes of the Culex pipiens complex were collected in this study. Among them, 595 were females and 312 were males. There was no significant difference in mosquito density monitored by bed net trap and labor hour method in 2009 and 2012. Of 105 mosquitoes identified by multiplex PCR, 36 were pure mosquitoes (34.29%) while 69 were hybrids (65.71%). The same subspecies of Culex pipiens complex were observed by bed net trap, labor hour method and light trap in 2009 and 2012. Conclusion The local Culex pipiens complex comprises the subspecies Cx. pipiens pipiens, Cx. pipiens pallens, Cx. pipiens quinquefasciatus and its hybrids. Mosquitoes in the Cx. pipiens complex, known to be, potentially, vectors of periodic filariasis and encephalitis, are now present from one season to the next, and appear to be established in Lhasa City, TAR. PMID:24060238
Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian
2003-01-01
OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. PMID:12764493
3. HOT BED FOR SALEMBROSIUS CONTINUOUS GASFIRED HEAT TREATING LINE ...
3. HOT BED FOR SALEM-BROSIUS CONTINUOUS GAS-FIRED HEAT TREATING LINE AT THE HEAT TREATMENT PLANT OF THE DUQUESNE WORKS. - U.S. Steel Duquesne Works, Heat Treatment Plant, Along Monongahela River, Duquesne, Allegheny County, PA
Evaluation of a clay-based acidic bedding conditioner for dairy cattle bedding.
Proietto, R L; Hinckley, L S; Fox, L K; Andrew, S M
2013-02-01
This study investigated the effects of a clay-based acidic bedding conditioner on sawdust bedding pH, dry matter (DM), environmental pathogen counts, and environmental bacterial counts on teat ends of lactating dairy cows. Sixteen lactating Holstein cows were paired based on parity, days in milk, milk yield, and milk somatic cell count, and were negative for the presence of an intramammary pathogen. Within each pair, cows were randomly assigned to 1 of 2 treatments with 3-wk periods in a crossover design. Treatment groups consisted of 9 freestalls per group bedded with either untreated sawdust or sawdust with a clay-based acidic bedding conditioner, added at 3- to 4-d intervals over each 21-d period. Bedding and teat ends were aseptically sampled on d 0, 1, 2, 7, 14, and 21 for determination of environmental bacterial counts. At the same time points, bedding was sampled for DM and pH determination. The bacteria identified in the bedding material were total gram-negative bacteria, Streptococcus spp., and coliform bacteria. The bacteria identified on the teat ends were Streptococcus spp., coliform bacteria, and Klebsiella spp. Teat end score, milk somatic cell count, and intramammary pathogen presence were measured weekly. Bedding and teat cleanliness, environmental high and low temperatures, and dew point data were collected daily. The bedding conditioner reduced the pH, but not the DM, of the sawdust bedding compared with untreated sawdust. Overall environmental bacterial counts in bedding were lower for treated sawdust. Total bacterial counts in bedding and on teat ends increased with time over both periods. Compared with untreated sawdust, the treated bedding had lower counts of total gram-negative bacteria and streptococci, but not coliform counts. Teat end bacterial counts were lower for cows bedded on treated sawdust for streptococci, coliforms, and Klebsiella spp. compared with cows bedded on untreated sawdust. The clay-based acidic bedding conditioner reduced environmental pathogens in sawdust bedding and teat ends without affecting teat end integrity. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Faulde, Michael K; Nehring, Oliver
2012-08-01
New and improved strategies for malaria control and prevention are urgently needed. As a contribution to an optimized personal protection strategy, a novel long-lasting insecticide and repellent-treated net (LLIRN) has been designed by binding combinations of permethrin plus N,N-diethyl-m-toluamide (DEET), or insect repellent 3535 (IR3535), and etofenprox plus DEET, onto fibres of bed net fabric employing a new multi-layer polymer-coating technique. Protective repellent efficacy, toxicological effectiveness and residual activity of 12 LLIRN types have been evaluated by laboratory testing against adult Aedes aegypti. The novel multi-layer LLIRN design allowed simultaneous embedding at concentrations up to 5,930 mg/m(2) for DEET, 3,408 mg/m(2) for IR3535, 2,296 mg/m(2) for permethrin and 2,349 mg/m(2) for etofenprox, respectively. IR3535 layers prevented co-binding of additional pyrethroid-containing polymer layers, thus making pyrethroids plus DEET LLIRNs an ideal combination. All LLIRNs revealed synergistic insecticidal effects which, when measured against concentration controls of the isolated compounds, were significant in all LLIRN types designed. DEET in DEET plus permethrin LLIRNs significantly (p < 0.0001) reduced the concentration-dependent permethrin 100 % knockdown (KD) time from 55 to 75 %, the corresponding 100 % kill time (p < 0.0001) from 55 to 64 %. DEET in DEET plus etofenprox LLIRNs reduced the dose-specific 100 % knockdown (KD) time of etofenprox from 42 to 50 % (p = 0.004), the 100 % kill time from 25 to 38 % (p < 0.0001). Permethrin or etofenprox did not influence spatial repellency of DEET or IR3535 on LLIRNs. Vice versa, DEET and IR3535 increased spatial and excitatory repellency and reduced landing and probing frequency on LLIRNs resulting in strongly enhanced biting protection, even at low concentrations. One hundred percent biting and probing protection of stored LLIRNs was preserved for 83 weeks with the 5,930 mg/m(2) DEET and 2,139 mg/m(2) etofenprox LLIRN, for 72 weeks with the 5,002 mg/m(2) DEET and 2,349 mg/m(2) etofenprox LLIRN, for 63 weeks with the 3,590 mg/m(2) DEET and 1,208 mg/m(2) permethrin LLRN, and for 61 weeks with the 4,711 mg/m(2) DEET and 702 mg/m(2) etofenprox LLIRN. Because 100 % bite protection with up to 75 % quicker contact toxicity of pyrethroids were documented, synergistic toxicological and repellent effects of multi-layer polymer-coating LLIRNs may overcome LLIN-triggered selection pressure for development of new kdr- and metabolic pyrethroid resistances while simultaneously increasing protective efficacy also against kdr- and metabolic pyrethroid-resistant mosquitoes substantially due to the repellent-induced effects of LLIRNs thus indicating that this approach is a promising new candidate for future bed net, curtain, and window screen impregnation aiming at optimized prevention from mosquito-borne diseases.
Pongvongsa, Tiengkham; Ha, Hoang; Thanh, Le; Marchand, Ron P; Nonaka, Daisuke; Tojo, Bumpei; Phongmany, Panom; Moji, Kazuhiko; Kobayashi, Jun
2012-08-03
In Savannakhet province, Laos and Quang Tri province, Vietnam, malaria is still an important health problem and most cases are found in the mountainous, forested border areas where ethnic minority groups live. The objectives of this study were to obtain a better joint understanding of the malaria situation along the border and, on the basis of that, improve malaria control methods through better cooperation between the two countries. Fourteen villages in Savannakhet and 22 villages in Quang Tri were randomly selected within 5 km from the border where a blood survey for microscopic diagnosis (n = 1256 and n = 1803, respectively), household interviews (n = 400, both sides) and vector surveys were conducted between August and October 2010. Satellite images were used to examine the forest density around the study villages. Malaria prevalence was significantly higher in Laos (5.2%) than in Vietnam (1.8%) and many other differences were found over the short distance across the border. Bed net coverage was high (> 90%) in both Laos and Vietnam but, while in Laos more than 60% of the nets were long-lasting insecticide-treated, Vietnam used indoor residual spraying in this area and the nets were untreated. Anopheles mosquitoes were more abundant in Laos than in Vietnam, especially many Anopheles dirus were captured in indoor light traps while none were collected in Vietnam. The forest cover was higher around the Lao than the Vietnamese villages. After this study routine exchange of malaria surveillance data was institutionalized and for the first time indoor residual spraying was applied in some Lao villages. The abundance of indoor-collected An. dirus on the Laos side raises doubts about the effectiveness of a sole reliance on long-lasting insecticide-treated nets in this area. Next to strengthening the early detection, correct diagnosis and prompt, adequate treatment of malaria infections, it is recommended to test focal indoor residual spraying and the promotion of insect repellent use in the early evening as additional vector interventions. Conducting joint malaria surveys by staff of two countries proved to be effective in stimulating better collaboration and improve cross-border malaria control.
Broken promise? Taxes and tariffs on insecticide treated mosquito nets.
Alilio, Martin; Mwenesi, Halima; Barat, Lawrence M; Payes, Roshelle M; Prysor-Jones, Suzanne; Diara, Malick; McGuire, David; Shaw, Willard
2007-12-01
Seven years ago, the removal of taxes and tariffs on insecticide treated nets (ITNs) was considered one of the easiest resolutions for most countries to implement among the targets agreed upon at the African Summit on Roll Back Malaria in Abuja, Nigeria, on April 25, 2000. However, seven years later, 24 of the 39 Abuja signatories continue to impose taxes and tariffs on this life-saving tool. Taxes and tariffs significantly increase the price of an insecticide treated net, reduce affordability, and discourage the commercial sector from importing insecticide treated net products. Consequently, Roll Back Malaria partners are engaged in advocacy efforts to remove taxes and tariffs on insecticide treated nets in malaria-endemic countries of Africa. This viewpoint summarizes key obstacles to the removal of taxes and tariffs that have been identified through a review of country situations. To achieve the goal of producing and supplying more than 160 million insecticide treated nets needed to reach the revised Roll Back Malaria Partnership targets by 2010, tax and tariff reforms are urgently needed. Such reforms must be accompanied by country-specific systems to protect the poor (e.g., through voucher systems for vulnerable groups and other forms of targeted subsidies).
Strode, Clare; Donegan, Sarah; Garner, Paul; Enayati, Ahmad Ali; Hemingway, Janet
2014-01-01
Background Pyrethroid insecticide-treated bed nets (ITNs) help contribute to reducing malaria deaths in Africa, but their efficacy is threatened by insecticide resistance in some malaria mosquito vectors. We therefore assessed the evidence that resistance is attenuating the effect of ITNs on entomological outcomes. Methods and Findings We included laboratory and field studies of African malaria vectors that measured resistance at the time of the study and used World Health Organization–recommended impregnation regimens. We reported mosquito mortality, blood feeding, induced exophily (premature exit of mosquitoes from the hut), deterrence, time to 50% or 95% knock-down, and percentage knock-down at 60 min. Publications were searched from 1 January 1980 to 31 December 2013 using MEDLINE, Cochrane Central Register of Controlled Trials, Science Citation Index Expanded, Social Sciences Citation Index, African Index Medicus, and CAB Abstracts. We stratified studies into three levels of insecticide resistance, and ITNs were compared with untreated bed nets (UTNs) using the risk difference (RD). Heterogeneity was explored visually and statistically. Included were 36 laboratory and 24 field studies, reported in 25 records. Studies tested and reported resistance inconsistently. Based on the meta-analytic results, the difference in mosquito mortality risk for ITNs compared to UTNs was lower in higher resistance categories. However, mortality risk was significantly higher for ITNs compared to UTNs regardless of resistance. For cone tests: low resistance, risk difference (RD) 0.86 (95% CI 0.72 to 1.01); moderate resistance, RD 0.71 (95% CI 0.53 to 0.88); high resistance, RD 0.56 (95% CI 0.17 to 0.95). For tunnel tests: low resistance, RD 0.74 (95% CI 0.61 to 0.87); moderate resistance, RD 0.50 (95% CI 0.40 to 0.60); high resistance, RD 0.39 (95% CI 0.24 to 0.54). For hut studies: low resistance, RD 0.56 (95% CI 0.43 to 0.68); moderate resistance, RD 0.39 (95% CI 0.16 to 0.61); high resistance, RD 0.35 (95% CI 0.27 to 0.43). However, with the exception of the moderate resistance category for tunnel tests, there was extremely high heterogeneity across studies in each resistance category (chi-squared test, p<0.00001, I 2 varied from 95% to 100%). Conclusions This meta-analysis found that ITNs are more effective than UTNs regardless of resistance. There appears to be a relationship between resistance and the RD for mosquito mortality in laboratory and field studies. However, the substantive heterogeneity in the studies' results and design may mask the true relationship between resistance and the RD, and the results need to be interpreted with caution. Our analysis suggests the potential for cumulative meta-analysis in entomological trials, but further field research in this area will require specialists in the field to work together to improve the quality of trials, and to standardise designs, assessment, and reporting of both resistance and entomological outcomes. Please see later in the article for the Editors' Summary PMID:24642791
Stephenson, Caroline J; Rossheim, Matthew E; Frankenfeld, Cara L; Boncy, Jacques; Okech, Bernard A; von Fricken, Michael E
2017-12-01
The governments of Haiti and the Dominican Republic have a binational agreement to work towards malaria elimination for the island of Hispaniola by the year 2020. Understanding malaria-related knowledge and behaviors can help inform elimination efforts. This study examined the association between social-behavioral factors, like bedtime and bed net ownership, with malaria seroconversion status among people in the Ouest and Sud-Est departments of Haiti. In 2013, cross-sectional survey data (n=377) and blood samples were collected from a convenience sample of individuals within community, clinic and school settings. Logistic regression models were constructed to examine associations between social-behavioral factors and malaria exposure, adjusting for potential confounders. Compared to people going to bed between 6 and 8 pm, those going to bed between 8 and 10 pm were 2.67 (OR, 95% CI: 1.16-6.14) times as likely to have been exposed to malaria. Participants who reported going to bed after 10 pm were 5.96 times as likely to have had previous malaria exposure (OR, 95% CI: 2.26-15.7), compared to 6-8 pm. No significant associations were found between malaria exposure and either insecticide use nor bed net ownership. These findings are consistent with suspected feeding behaviors of Anopheles albimanus, which prefers feeding at night and outdoors. Study findings may improve overall understanding of malaria transmission in Haiti and potentially guide future studies conducted in this region. Copyright © 2017 Elsevier B.V. All rights reserved.
Comparison of house spraying and insecticide-treated nets for malaria control.
Curtis, C. F.; Mnzava, A. E.
2000-01-01
The efficacies of using residual house spraying and insecticide-treated nets against malaria vectors are compared, using data from six recent comparisons in Africa, Asia and Melanesia. By all the entomological and malariological criteria recorded, pyrethroid-treated nets were at least as efficacious as house spraying with dichlorodiphenyltrichloroethane (DDT), malathion or a pyrethroid. However, when data from carefully monitored house spraying projects carried out between the 1950s and 1970s at Pare-Taveta and Zanzibar (United Republic of Tanzania), Kisumu (Kenya) and Garki (Nigeria) are compared with recent insecticide-treated net trials with apparently similar vector populations, the results with the insecticide-treated nets were much less impressive. Possible explanations include the longer duration of most of the earlier spraying projects and the use of non-irritant insecticides. Non-irritant insecticides may yield higher mosquito mortalities than pyrethroids, which tend to make insects leave the site of treatment (i.e. are excito-repellent). Comparative tests with non-irritant insecticides, including their use on nets, are advocated. The relative costs and sustainability of spraying and of insecticide-treated net operations are briefly reviewed for villages in endemic and epidemic situations and in camps for displaced populations. The importance of high population coverage is emphasized, and the advantages of providing treatment free of charge, rather than charging individuals, are pointed out. PMID:11196486
Yerkes, R.F.; Ellsworth, W.L.; Tinsley, J.C.
1983-01-01
A reverse-right-oblique surface rupture, associated with a ML 2.5 earthquake, formed in a diatomite quarry near Lompoc, California, in the northwesternmost Transverse Ranges on April 7, 1981. The 575-m-long narrow zone of ruptures formed in clay interbeds in diatomite and diatomaceous shale of the Neogene Monterey Formation. The ruptures parallel bedding, dip 39o-59oS, and trend about N84oE on the north limb of an open symmetrical syncline. Maximum net slip was 25 cm; maximum reverse dip slip was 23 cm, maximum right-lateral strike slip was about 9 cm, and average net slip was about 12 cm. The seismic moment of the earthquake is estimated at 1 to 2 X 1018 dyne/cm and the static stress drop at about 3 bar. The removal of an average of about 44 m of diatomite resulted in an average load reduction of about 5 bar, which decreased the normal stress by about 3.5 bar and increased the shear stress on the tilted bedding plane by about 2 bar. The April 7, 1981, event was a very shallow bedding-plane rupture, apparently triggered by crustal unloading. -Authors
Global Warming Potential from early phase decomposition of soil organic matter amendments
NASA Astrophysics Data System (ADS)
Mayer, A.; Silver, W. L.
2015-12-01
Organic matter amendments to soil are widely used as a method of enhancing nutrient availability for crops or grassland. Amendments such as composted manure or greenwaste also have the co-benefits of potentially increasing soil carbon (C) stocks (DeLonge et al., 2013) and diverting organic waste from landfills or manure lagoons. However, application of organic matter amendments can also stimulate emissions of greenhouse gases (GHGs). In this study we determined how the chemical quality of organic matter amendments affected soil C and N content and GHG emissions during early stage decomposition. California grassland soils were amended with six different amendments of varying C and N content including three composts and three feedstocks (goat and horse bedding and cattle manure). Amendments and soils were incubated in the laboratory for 7 weeks; GHG fluxes were measured weekly. The three feedstocks emitted significantly more GHGs than the composted materials. With the exception of cow manure, N content of the amendment was linearly correlated with global warming potential emitted (R2= 0.66, P <0.0001). C:N ratios were not a significant predictor of GHG emissions. Cow manure stimulated a net loss of C (or C equivalents) in the mineral soil, as expected. However, greenwaste compost also surprisingly resulted in net C losses, while goat bedding, horse bedding, and the other compost were either C neutral or a slight net C sink at the end of the incubation. Ongoing analyses are examining the fate of the C incorporated from the amendment to the soil as occluded or free light fraction, as well as N mineralization rates. Our data suggest that N content of organic matter amendments is a good predictor of initial GHG emissions. The study also indicates that composting greenwaste with N-rich bedding and manure can result in lower GHG emissions and C sequestration compared to the individual uncomposted components.
O'Neill, Sean M; Seresinghe, Sarah; Sharma, Arun; Russell, Tara A; Crawford, L'Orangerie; Frencher, Stanley K
2018-01-01
Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms. Staff privileging decisions were initially based only on physicians' training and experience, but this resulted in several cases that tested the boundaries of what a small community hospital was prepared to handle. A collaborative, transparent process to review physician privileges was developed. This began with physician-only review of procedure lists, followed by a larger, multidisciplinary group to assess system-level factors. Specific questions were used to guide discussion, and unanimous approval from all stakeholders was required to include a procedure. An initial list of 558 procedures across 11 specialties was reduced to 321 (57.5%). No new cases that fall outside these new boundaries have arisen. An inclusive process was crucial for obtaining buy-in and establishing cultural norms. Arranging transfer agreements remains a significant challenge. Accumulation of institutional experience continues through regular performance reviews. As this hospital's capabilities mature, a blueprint has been established for expanding surgical scope of practice based explicitly on system-level factors. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.
Natural calcium isotonic composition of urine as a marker of bone mineral balance
Skulan, J.; Bullen, T.; Anbar, A.D.; Puzas, J.E.; Shackelford, L.; LeBlanc, A.; Smith, S.M.
2007-01-01
Background: We investigated whether changes in the natural isotopic composition of calcium in human urine track changes in net bone mineral balance, as predicted by a model of calcium isotopic behavior in vertebrates. If so, isotopic analysis of natural urine or blood calcium could be used to monitor short-term changes in bone mineral balance that cannot be detected with other techniques. Methods: Calcium isotopic compositions are expressed as ??44Ca, or the difference in parts per thousand between the 44Ca/40Ca of a sample and the 44Ca/ 40Ca of a standard reference material. ??44Ca was measured in urine samples from 10 persons who participated in a study of the effectiveness of countermeasures to bone loss in spaceflight, in which 17 weeks of bed rest was used to induce bone loss. Study participants were assigned to 1 of 3 treatment groups: controls received no treatment, one treatment group received alendronate, and another group performed resistive exercise. Measurements were made on urine samples collected before, at 2 or 3 points during, and after bed rest. Results: Urine ??44Ca values during bed rest were lower in controls than in individuals treated with alendronate (P <0.05, ANOVA) or exercise (P <0.05), and lower than the control group baseline (P <0.05, Mest). Results were consistent with the model and with biochemical and bone mineral density data. Conclusion: Results confirm the predicted relationship between bone mineral balance and calcium isotopes, suggesting that calcium isotopic analysis of urine might be refined into a clinical and research tool. ?? 2007 American Association for Clinical Chemistry.
Natural calcium isotopic composition of urine as a marker of bone mineral balance.
Skulan, Joseph; Bullen, Thomas; Anbar, Ariel D; Puzas, J Edward; Shackelford, Linda; LeBlanc, Adrian; Smith, Scott M
2007-06-01
We investigated whether changes in the natural isotopic composition of calcium in human urine track changes in net bone mineral balance, as predicted by a model of calcium isotopic behavior in vertebrates. If so, isotopic analysis of natural urine or blood calcium could be used to monitor short-term changes in bone mineral balance that cannot be detected with other techniques. Calcium isotopic compositions are expressed as delta(44)Ca, or the difference in parts per thousand between the (44)Ca/(40)Ca of a sample and the (44)Ca/(40)Ca of a standard reference material. delta(44)Ca was measured in urine samples from 10 persons who participated in a study of the effectiveness of countermeasures to bone loss in spaceflight, in which 17 weeks of bed rest was used to induce bone loss. Study participants were assigned to 1 of 3 treatment groups: controls received no treatment, one treatment group received alendronate, and another group performed resistive exercise. Measurements were made on urine samples collected before, at 2 or 3 points during, and after bed rest. Urine delta(44)Ca values during bed rest were lower in controls than in individuals treated with alendronate (P <0.05, ANOVA) or exercise (P <0.05), and lower than the control group baseline (P <0.05, t-test). Results were consistent with the model and with biochemical and bone mineral density data. Results confirm the predicted relationship between bone mineral balance and calcium isotopes, suggesting that calcium isotopic analysis of urine might be refined into a clinical and research tool.
Bed Bug Education for School Maintenance
ERIC Educational Resources Information Center
Henriksen, Missy
2012-01-01
Bed bugs are a growing problem, not only in homes and hotels, but also in schools and colleges. Facility administrators and staff need to understand the bed bug resurgence and develop best practices to deal with an infestation. In this article, the author offers tips for preventing and treating bed bugs in school and university settings.
Modeling Combinations of Pre-erythrocytic Plasmodium falciparum Malaria Vaccines.
Walker, Andrew S; Lourenço, José; Hill, Adrian V S; Gupta, Sunetra
2015-12-01
Despite substantial progress in the control of Plasmodium falciparum infection due to the widespread deployment of insecticide-treated bed nets and artemisinin combination therapies, malaria remains a prolific killer, with over half a million deaths estimated to have occurred in 2013 alone. Recent evidence of the development of resistance to treatments in both parasites and their mosquito vectors has underscored the need for a vaccine. Here, we use a mathematical model of the within-host dynamics of P. falciparum infection, fit to data from controlled human malaria infection clinical trials, to predict the efficacy of co-administering the two most promising subunit vaccines, RTS,S/AS01 and ChAd63-MVA ME-TRAP. We conclude that currently available technologies could be combined to induce very high levels of sterile efficacy, even in immune-naive individuals. © The American Society of Tropical Medicine and Hygiene.
Nutrient Removal through Oyster Habitat Restoration in the Indian River Lagoon, Florida
NASA Astrophysics Data System (ADS)
Gallagher, S. M.; Schmidt, C. A.; Walters, L.; Blank, R.
2017-12-01
In 2016, an algae bloom in the Indian River Lagoon (IRL) caused a state of emergency in Florida. As with many estuaries, nutrient loading in the IRL has led to periodic eutrophication. While previous studies have shown oyster bed restoration reduces suspended organic matter in estuaries, similar reductions to net nutrient loads are not well established. In addition, previous studies have focused on seasonal variation rather than ongoing yearly effects. Here, we determine the net nitrogen and phosphorus effects of oyster restoration in the IRL over seven years. Analysis of aerial images from 1943 and 2009 showed 14.7 ha of oyster beds were destroyed by boat traffic in the IRL (40% loss). According to our measurements of restored oyster bed sediment, this equates to a maximum of 1,580,000 kg•N•yr-1 of lost denitrification potential; this is equivalent to 150% of estimated current nitrogen loading in the IRL. Oyster restoration began in the IRL in 2007 and has recovered 7.7% of the lost beds and denitrification potential (1.13 ha and 107,000 kg•N•yr-1•ha-1). In all cases, denitrification reached a maximum within two years and remained significantly higher than open sediment for at least the seven years observed. Denitrification benefits came at the cost of mobilizing a maximum of 3450 kg ha-1 of recalcitrant phosphorus from restored bed sediment. This effect was limited to the two years following restoration, whereas increased denitrification was ongoing. Overall, our results show oyster restoration achieved maximum denitrification within two years and maintained significant denitrification benefits for at least seven years. In addition, our results are useful for future oyster restoration projects since they quantify nitrogen benefits in terms of phosphorus mobilization.
An online spacecraft environment interactions information system
NASA Technical Reports Server (NTRS)
Lauriente, Michael
1990-01-01
This paper reviews the role that EnviroNET assumes as a contemporary system that scientists and engineers can use to share information on networks that are connected globally. Advantage is being taken to use this powerful communication tool for the space community to articulate the various anomalies that our space systems are experiencing. EnviroNET is being considered as a test bed for developing an expert system for diagnosing environmentally induced anomalies for spacecraft. The various offline activities in progress toward this objective are described.
Wang, Lei; Cai, Xuquan; Xu, Yijuan
2015-01-01
The recent resurgence of bed bugs (Cimex spp.) in many developed countries has drawn increasing attention worldwide. The status of urban bed bug infestations were investigated in Shenzhen and Dongguan, two major cities in southern Guangdong Province of southern China, based on pest control service records from two different companies (one during 2012 and another during 2013). The results showed that Shenzhen and Dongguan have a severe problem with bed bug infestations: the control of bed bugs is a constant concern, except during the winter. In Shenzhen, a similar number of premises were treated for bed bugs in central business districts and suburban districts. However, in Dongguan, more premises were treated for bed bugs in suburban districts than in central business districts. The treatment rate for worker sleeping quarters, apartments, hotel, and private houses in Shenzhen was 53.8, 43.0, 1.9, and 1.3%, respectively. The percentage of treated rooms was 56.1% for worker sleeping quarters and 91.1% for apartments. In Dongguan, the treatment rate for worker sleeping quarters, apartments, hotel, and private houses was 90.0, 10.0, 0.0, and 0.0%, respectively. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Schellenberg, J R; Abdulla, S; Minja, H; Nathan, R; Mukasa, O; Marchant, T; Mponda, H; Kikumbih, N; Lyimo, E; Manchester, T; Tanner, M; Lengeler, C
1999-01-01
We present a large-scale social marketing programme of insecticide-treated nets in 2 rural districts in southwestern Tanzania (population 350,000) and describe how the long-term child health and survival impact will be assessed. Formative and market research were conducted in order to understand community perceptions, knowledge, attitudes and practice with respect to the products to be socially marketed. We identified Zuia Mbu (Kiswahili for 'prevent mosquitoes') as a suitable brand name for both treated nets and single-dose insecticide treatment sachets. A mix of public and private sales outlets is used for distribution. In the first stage of a stepped introduction 31 net agents were appointed and trained in 18 villages: 15 were shop owners, 14 were village leaders, 1 was a parish priest and 1 a health worker. For net treatment 37 young people were appointed in the same villages and trained as agents. Further institutions in both districts such as hospitals, development projects and employers were also involved in distribution. Promotion for both products was intense and used a variety of channels. A total of 22,410 nets and 8072 treatments were sold during the first year: 18 months after launching, 46% of 312 families with children aged under 5 years reported that their children were sleeping under treated nets. A strong evaluation component in over 50,000 people allows assessment of the long-term effects of insecticide-treated nets on child health and survival, anaemia in pregnancy, and the costs of the intervention. This evaluation is based on cross-sectional surveys, and case-control and cohort studies.
Das, Pradeep; Ghosh, Debashis; Priyanka, Jyoti; Matlashewski, Greg; Kroeger, Axel; Upfill-Brown, Alexander
2016-01-01
Background We investigated the efficacy, safety and cost of lime wash of household walls plus treatment of sand fly breeding places with bleach (i.e. environmental management or EM), insecticide impregnated durable wall lining (DWL), and bed net impregnation with slow release insecticide (ITN) for sand fly control in the Indian sub-continent. Methods This multi-country cluster randomized controlled trial had 24 clusters in each three sites with eight clusters per high, medium or low sand fly density stratum. Every cluster included 45–50 households. Five households from each cluster were randomly selected for entomological measurements including sand fly density and mortality at one, three, nine and twelve months post intervention. Household interviews were conducted for socioeconomic information and intervention acceptability assessment. Cost for each intervention was calculated. There was a control group without intervention. Findings Sand fly mortality [mean and 95%CI] ranged from 84% (81%-87%) at one month to 74% (71%-78%) at 12 months for DWL, 75% (71%-79%) at one month to 49% (43%-55%) at twelve months for ITN, and 44% (34%-53%) at one month to 22% (14%-29%) at twelve months for EM. Adjusted intervention effect on sand fly density measured by incidence rate ratio ranged from 0.28 (0.23–0.34) at one month to 0.62 (0.51–0.75) at 12 months for DWL; 0.72 (0.62–0.85) at one month to 1.02 (0.86–1.22) at 12 months for ITN; and 0.89 (0.76–1.03) at one months to 1.49 (1.26–1.74) at 12 months for EM. Household acceptance of EM was 74% compared to 94% for both DWL and ITN. Operational cost per household in USD was about 5, 8, and 2 for EM, DWL and ITN, respectively. Minimal adverse reactions were reported for EM and ITN while 36% of households with DWL reported transient itching. Interpretation DWL is the most effective, durable and acceptable control method followed by ITN. The Visceral Leishmaniasis (VL) Elimination Program in the Indian sub-continent should consider DWL and ITN for sand fly control in addition to IRS. PMID:27533097
2013-01-01
Background Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study’s objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services. Methods A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services. Results In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of −2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval −7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective. Conclusion In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN. PMID:24119916
Barriobero-Vila, Pere; Gussone, Joachim; Haubrich, Jan; Sandlöbes, Stefanie; Da Silva, Julio Cesar; Cloetens, Peter; Schell, Norbert; Requena, Guillermo
2017-03-07
Selective laser melting is a promising powder-bed-based additive manufacturing technique for titanium alloys: near net-shaped metallic components can be produced with high resource-efficiency and cost savings [...].
Evaluation of a Reverse Gradient Garment for prevention of bed-rest deconditioning
NASA Technical Reports Server (NTRS)
Sandler, H.; Dolkas, D.; Newsom, B.; Webb, P.; Annis, J.; Pace, N.; Grunbaum, B. W.
1983-01-01
A Reverse Gradient Garment (RGG) was used to intermittently induce venous pooling in the extremities of a magnitude similar to that seen in going from a lying to standing position during the course of a 15-d period of horizontal bed rest. Venous pooling failed to improve bed-rest-induced losses in +2.5 Gz and +3.0 Gz centrifugation tolerance or to prevent increased heart-rate responses to lower-body negative pressure (LBNP). Four subjects served as controls, four were treated. Tests during the 7-d recovery period showed fluid/electrolyte and body composition values to have returned to pre-bed-rest levels with continued depression of acceleration tolerance times (56% decreased at +2.5 Gz and 74% decreased at +3.0 Gz compared to pre-bed-rest levels) and exaggerated blood insulin response on glucose tolerance testing (blood insulin for treated group increased 95% at 1 h before bed rest and 465% during recovery). This study demonstrates that the physiologic changes after bed rest persist for significant periods of time. Acceleration tolerance time proved to be a sensitive test for the deconditioning process.
Fluidized bed heat treating system
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ripley, Edward B; Pfennigwerth, Glenn L
Systems for heat treating materials are presented. The systems typically involve a fluidized bed that contains granulated heat treating material. In some embodiments a fluid, such as an inert gas, is flowed through the granulated heat treating medium, which homogenizes the temperature of the heat treating medium. In some embodiments the fluid may be heated in a heating vessel and flowed into the process chamber where the fluid is then flowed through the granulated heat treating medium. In some embodiments the heat treating material may be liquid or granulated heat treating material and the heat treating material may be circulatedmore » through a heating vessel into a process chamber where the heat treating material contacts the material to be heat treated. Microwave energy may be used to provide the source of heat for heat treating systems.« less
Msyamboza, K; Senga, E; Tetteh-Ashong, E; Kazembe, P; Brabin, B J
2007-04-01
The evaluation of the effectiveness of antimalarial drugs and bed net use in pregnant women is an important aspect of monitoring and surveillance of malaria control in pregnancy. In principle the screening method for assessing vaccine efficacy can be applied in non-vaccine settings for assessing interventions for malaria control in pregnancy. In this analysis field data on the proportion of placental malaria cases treated with two doses of sulphadoxine-pyrimethamine (SP) and the uptake of two doses of SP in the antenatal clinic was used in a case-coverage method to assess the protective effectiveness (PE) of intermittent preventive treatment with SP for malaria control in pregnancy. PE was assessed using placental malaria, low birthweight and maternal anaemia at delivery as outcome variables. The method was also applied to an evaluation of the protective effectiveness of self-reported use of impregnated bed nets (ITNs). Effectiveness was highest for reduction of low birthweight in multigravidae (87.2%, 95% CI, 83.2-91.3%). PE was lower for placental malaria (61.6% primigravidae, 28.5% multigravidae), and maternal anaemia (Hb < 8.0 g/dl, 37.8% primigravidae, 29.6% multigravidae). Estimates for PE of self-reported use of ITNs gave values for all three outcome parameters that were much lower than for SP use. For women of all parties effectiveness estimates for reduction of low birthweight were 22% (95% CI, 17.7-26.4), prevention of placental malaria (all types) 7.1% (95% CI, 4.4-9.8), prevention of active placental infection 38.9% (95% CI, 27.4-50.4), and for maternal anaemia 8.8% (95% CI, 0-20.0). The case-coverage method could provide a useful and practical approach to routine monitoring and evaluation of drug interventions to control malaria in pregnancy and has potentially wide applications. Effectiveness estimates related to reported ITN use in pregnancy may be less reliable. The method should be further evaluated using currently available data sets.
Peck, George W; Ferguson, Holly J; LePage, Jane T; Hebert, Vincent R; O'Neal, Sally D; Walsh, Douglas B
2014-01-01
Face flies, Musca autumnalis De Geer (Diptera: Muscidae), and houseflies, Musca domestica L. (Diptera: Muscidae), have a significant impact on livestock and dairy production throughout North America. Pyrethroid insecticide efficacy can be affected by exposure to direct sunlight, and the rate of photodegradation is substrate and formulation dependent. Insecticide-treated netting (ITN) is finding new applications in crop and livestock production systems. A baseline study using long-duration no-choice assays has been carried out to gauge the effectiveness of ITN treated with β-cyfluthrin, λ-cyhalothrin and bifenthrin on face flies and houseflies. After 12 weeks in direct sunlight, ITN treated with β-cyfluthrin was still highly insecticidal to face flies and houseflies, producing 100% mortality in petri dish assays. However, sunlight reduced the insecticidal activity of λ-cyhalothrin, with 3% of face flies and 50% of houseflies surviving after exposure to ITN that had been deployed for 10 weeks. Insecticidal activity was greatly reduced on bifenthrin-treated netting, with 20% of face flies and 50% of houseflies surviving in assays with netting deployed for only 3 weeks. With careful choice of the pyrethroid applied, treated netting could be an important component of livestock integrated pest management programs focused on sustainable practices. © 2013 Society of Chemical Industry.
A repellent net as a new technology to protect cabbage crops.
Martin, T; Palix, R; Kamal, A; Delétré, E; Bonafos, R; Simon, S; Ngouajio, M
2013-08-01
Floating row covers or insect-proof nets with fine mesh are effective at protecting vegetable crops against aphids but negatively impact plant health, especially under warm conditions. Furthermore, in control of cabbage insect pests, aphid parasitoids cannot enter the fine-mesh nets, leading to frequent aphid outbreaks. To surmount these difficulties, a 40-mesh-size repellent net treated with alphacypermethrin was studied in laboratory and field tests. Results showed both irritant and repellent effects of the alphacypermethrin-treated net on Myzus persicae (Sulzer) (Hemiptera: Aphididae) and its parasitoid Aphidius colemani (Haliday) (Hymenoptera: Braconidae). Under field conditions, there were no pests on cabbage protected with the repellent net. The repellent net allowed combining a visual and repellent barrier against aphids. Because of this additive effect, repellent nets allowed covering cabbage permanently with adequate protection against all pests.
Manna, Suvendu; Saha, Prosenjit; Roy, Debasis; Adhikari, Basudam; Das, Papita
2018-04-15
Fluoride has both detrimental and beneficial effects on living beings depending on the concentration and consumption periods. The study presented in this article investigated the feasibility of using neem oil phenolic resin treated lignocellulosic bio-sorbents for fluoride removal from water through fixed bed column study. Results indicated that treated bio-sorbents could remove fluoride both from synthetic and groundwater with variable bed depth, flow rate, fluoride concentration and column diameter. Data obtained from this study indicated that columns with the thickest bed, lowest flow rate, and fluoride concentration showed best column performance. Bio-sorbents used in this study are regenerable and reusable for more than five cycles. The initial materials cost needed to remove one gram of fluoride also found to be lower than the available alternatives. This makes the process more promising candidate to be used for fluoride removal. In addition, the process is also technically advantageous over the available alternatives. Copyright © 2018 Elsevier Ltd. All rights reserved.
2012-01-01
Background In Savannakhet province, Laos and Quang Tri province, Vietnam, malaria is still an important health problem and most cases are found in the mountainous, forested border areas where ethnic minority groups live. The objectives of this study were to obtain a better joint understanding of the malaria situation along the border and, on the basis of that, improve malaria control methods through better cooperation between the two countries. Methods Fourteen villages in Savannakhet and 22 villages in Quang Tri were randomly selected within 5 km from the border where a blood survey for microscopic diagnosis (n = 1256 and n = 1803, respectively), household interviews (n = 400, both sides) and vector surveys were conducted between August and October 2010. Satellite images were used to examine the forest density around the study villages. Results Malaria prevalence was significantly higher in Laos (5.2%) than in Vietnam (1.8%) and many other differences were found over the short distance across the border. Bed net coverage was high (> 90%) in both Laos and Vietnam but, while in Laos more than 60% of the nets were long-lasting insecticide-treated, Vietnam used indoor residual spraying in this area and the nets were untreated. Anopheles mosquitoes were more abundant in Laos than in Vietnam, especially many Anopheles dirus were captured in indoor light traps while none were collected in Vietnam. The forest cover was higher around the Lao than the Vietnamese villages. After this study routine exchange of malaria surveillance data was institutionalized and for the first time indoor residual spraying was applied in some Lao villages. Conclusions The abundance of indoor-collected An. dirus on the Laos side raises doubts about the effectiveness of a sole reliance on long-lasting insecticide-treated nets in this area. Next to strengthening the early detection, correct diagnosis and prompt, adequate treatment of malaria infections, it is recommended to test focal indoor residual spraying and the promotion of insect repellent use in the early evening as additional vector interventions. Conducting joint malaria surveys by staff of two countries proved to be effective in stimulating better collaboration and improve cross-border malaria control. PMID:22862795
The dental safety net in Connecticut.
Beazoglou, Tryfon; Heffley, Dennis; Lepowsky, Steven; Douglass, Joanna; Lopez, Monica; Bailit, Howard
2005-10-01
Many poor, medically disabled and geographically isolated populations have difficulty accessing private-sector dental care and are considered underserved. To address this problem, public- and voluntary-sector organizations have established clinics and provide care to the underserved. Collectively, these clinics are known as "the dental safety net." The authors describe the dental safety net in Connecticut and examine the capacity and efficiency of this system to provide care to the noninstitutionalized underserved population of the state. The authors describe Connecticut's dental safety net in terms of dentists, allied health staff members, operatories, patient visits and patients treated per dentist per year. The authors compare the productivity of safety-net dentists with that of private practitioners. They also estimate the capacity of the safety net to treat people enrolled in Medicaid and the State Children's Health Insurance Program. The safety net is made up of dental clinics in community health centers, hospitals, the dental school and public schools. One hundred eleven dentists, 38 hygienists and 95 dental assistants staff the clinics. Safety-net dentists have fewer patient visits and patients than do private practitioners. The Connecticut safety-net system has the capacity to treat about 28.2 percent of publicly insured patients. The dental safety net is an important community resource, and greater use of allied dental personnel could substantially improve the capacity of the system to care for the poor and other underserved populations.
Nyavor, Kunche Delali; Kweku, Margaret; Agbemafle, Isaac; Takramah, Wisdom; Norman, Ishmael; Tarkang, Elvis; Binka, Fred
2017-01-01
Introduction Malaria remains one of the top five killer diseases in sub-Saharan Africa (SSA) and its burden is skewed towards pregnant women and children under five. Insecticide Treated Bed-Net (ITN) usage is considered one of the most cost-effective, preventive interventions against malaria. This study sought to assess ownership, usage, effectiveness, knowledge, access and availability of ITNs among mothers with children under five in the Hohoe municipality. Methods In August 2010 a cross-sectional survey was carried out in 30 communities, selected using the WHO 30 cluster sampling technique. In the selected communities, mothers/caregivers with children under five years were selected using the snowball method. Data were collected through questionnaires and direct observation of ITN. Descriptive statistics was used to analyse the data collected. Results A total of 450 mothers/caregivers were interviewed and their mean age was 30 ± 7 years. ITN ownership was 81.3%, and usage was 66.4%. The majority (97.8%) of the mothers/caregivers said ITNs were effective for malaria prevention. Awareness about ITNs was high (98.7%) and the majority (52.9%) had heard about ITNs from Reproductive and Child Health (RCH) Clinic and antenatal care ANC clinic (33.6%). Over 60% of the ITNs were acquired through free distribution at RCH clinics, clinic and home distribution during mass immunization sessions. The majority of the mothers/caregivers (78.6%) knew the signs and symptoms of malaria, what causes malaria (82.2%) and who is most at risk (90%). Conclusion Behaviour change communication strategies on ITN use may need to be further targeted to ensure full use of available ITNs. PMID:29255537
2010-01-01
Background Malaria is a leading global cause of preventable morbidity and mortality, especially in sub-Saharan Africa, despite recent advances in treatment and prevention technologies. Scale-up and wide distribution of long-lasting insecticide-treated nets (LLINs) could rapidly decrease malarial disease in endemic areas, if used properly and continuously. Studies have shown that effective use of LLINs depends, in part, upon understanding causal factors associated with malaria. This study examined malaria beliefs, attitudes, and practices toward LLINs assessed during a large-scale integrated prevention campaign (IPC) in rural Kenya. Methods Qualitative interviews were conducted with 34 IPC participants who received LLINs as part of a comprehensive prevention package of goods and services. One month after distribution, interviewers asked these individuals about their attitudes and beliefs regarding malaria, and about their use of LLINs. Results Virtually all participants noted that mosquitoes were involved in causing malaria, though a substantial proportion of participants (47 percent) also mentioned an incorrect cause in addition to mosquitoes. For example, participants commonly noted that the weather (rain, cold) or consumption of bad food and water caused malaria. Regardless, most participants used the LLINs they were given and most mentioned positive benefits from their use, namely reductions in malarial illness and in the costs associated with its diagnosis and treatment. Conclusions Attitudes toward LLINs were positive in this rural community in Western Kenya, and respondents noted benefits with LLIN use. With improved understanding and clarification of the direct (mosquitoes) and indirect (e.g., standing water) causes of malaria, it is likely that LLIN use can be sustained, offering effective household-level protection against malaria. PMID:21118550
Nyavor, Kunche Delali; Kweku, Margaret; Agbemafle, Isaac; Takramah, Wisdom; Norman, Ishmael; Tarkang, Elvis; Binka, Fred
2017-01-01
Malaria remains one of the top five killer diseases in sub-Saharan Africa (SSA) and its burden is skewed towards pregnant women and children under five. Insecticide Treated Bed-Net (ITN) usage is considered one of the most cost-effective, preventive interventions against malaria. This study sought to assess ownership, usage, effectiveness, knowledge, access and availability of ITNs among mothers with children under five in the Hohoe municipality. In August 2010 a cross-sectional survey was carried out in 30 communities, selected using the WHO 30 cluster sampling technique. In the selected communities, mothers/caregivers with children under five years were selected using the snowball method. Data were collected through questionnaires and direct observation of ITN. Descriptive statistics was used to analyse the data collected. A total of 450 mothers/caregivers were interviewed and their mean age was 30 ± 7 years. ITN ownership was 81.3%, and usage was 66.4%. The majority (97.8%) of the mothers/caregivers said ITNs were effective for malaria prevention. Awareness about ITNs was high (98.7%) and the majority (52.9%) had heard about ITNs from Reproductive and Child Health (RCH) Clinic and antenatal care ANC clinic (33.6%). Over 60% of the ITNs were acquired through free distribution at RCH clinics, clinic and home distribution during mass immunization sessions. The majority of the mothers/caregivers (78.6%) knew the signs and symptoms of malaria, what causes malaria (82.2%) and who is most at risk (90%). Behaviour change communication strategies on ITN use may need to be further targeted to ensure full use of available ITNs.
Microlith Based Sorber for Removal of Environmental Contaminants
NASA Technical Reports Server (NTRS)
Roychoudhury, S.; Perry, J.
2004-01-01
The development of energy efficient, lightweight sorption systems for removal of environmental contaminants in space flight applications is an area of continuing interest to NASA. The current CO2 removal system on the International Space Station employs two pellet bed canisters of 5A molecular sieve that alternate between regeneration and sorption. A separate disposable charcoal bed removes trace contaminants. An alternative technology has been demonstrated using a sorption bed consisting of metal meshes coated with a sorbent, trademarked and patented as Microlith by Precision Combustion, Inc. (PCI); thesemeshes have the potential for direct electrical heating for this application. This allows the bed to be regenerable via resistive heating and offers the potential for shorter regeneration times, reduced power requirement, and net energy savings vs. conventional systems. The capability of removing both CO2 and trace contaminants within the same bed has also been demonstrated. Thus, the need for a separate trace contaminant unit is eliminated resulting in an opportunity for significant weight savings. Unlike the charcoal bed, zeolites for trace contaminant removal are amenable to periodic regeneration. This paper describes the design and performance of a prototype sorber device for simultaneous CO2 and trace contarninant removal and its attendant weight and energy savings.
Perceived Discrimination and Binge Eating Disorder; Gender Difference in African Americans.
Assari, Shervin
2018-04-24
Environmental stressors, such as perceived discrimination (PD), are linked to Binge Eating Disorder (BED). The current study investigated the association between PD and BED among African Americans, and the variation in such an association based on gender. Data of the National Survey of American Life (NSAL), 2001⁻2003, with a nationally-representative sample of African American adults, were used ( n = 3516). The independent variable in the study was PD. The dependent variable was BED, measured using the Composite International Diagnostic Interview (CIDI). Socio-demographics (age, education, employment, and marital status) were covariates, and gender was the moderator variable. Survey logistic regressions with and without gender × PD interaction terms were used for data analysis. In the pooled sample, PD was associated with higher odds of BED, net of socio-demographic factors. Models also showed a significant gender × PD interaction term suggesting a stronger association between PD and BED for women, compared to men. Gender specific models showed an association between PD and BED among female, but not male, African Americans. Although a link may exist between PD and BED among African Americans, the magnitude of this association depends on gender, with a stronger association among females than males. This finding is in line with the literature that has shown gender-specific consequences of environmental stress for African Americans.
Unuabonah, Emmanuel I; Olu-Owolabi, Bamidele I; Fasuyi, Esther I; Adebowale, Kayode O
2010-07-15
Kaolinite clay was treated with polyvinyl alcohol to produce a novel water-stable composite called polymer-clay composite adsorbent. The modified adsorbent was found to have a maximum adsorption capacity of 20,400+/-13 mg/L (1236 mg/g) and a maximum adsorption rate constant of approximately = 7.45x10(-3)+/-0.0002 L/(min mg) at 50% breakthrough. Increase in bed height increased both the breakpoint and exhaustion point of the polymer-clay composite adsorbent. The time for the movement of the Mass Transfer Zone (delta) down the column was found to increase with increasing bed height. The presence of preadsorbed electrolyte and regeneration were found to reduce this time. Increased initial Cd(2+) concentration, presence of preadsorbed electrolyte, and regeneration of polymer-clay composite adsorbent reduced the volume of effluent treated. Premodification of polymer-clay composite adsorbent with Ca- and Na-electrolytes reduced the rate of adsorption of Cd(2+) onto polymer-clay composite and lowered the breakthrough time of the adsorbent. Regeneration and re-adsorption studies on the polymer-clay composite adsorbent presented a decrease in the bed volume treated at both the breakpoint and exhaustion points of the regenerated bed. Experimental data were observed to show stronger fits to the Bed Depth Service Time (BDST) model than the Thomas model. 2010 Elsevier B.V. All rights reserved.
Cooper, Richard; Wang, Changlu; Singh, Narinderpal
2016-04-01
Two experiments were conducted to evaluate the effects of various interventions on low-level bed bug, Cimex lectularius L., populations in occupied apartments. The first experiment was conducted in occupied apartments under three intervention conditions: never treated (Group I), recently treated with no further treatment (Group II), and recently treated with continued treatment (Group III). Each apartment was monitored with pitfall-style traps (interceptors) installed at beds and upholstered furniture (sleeping and resting areas) along with ∼18 additional interceptors throughout the apartment. The traps were inspected every 2 wk. After 22 wk, bed bugs had been eliminated (zero trap catch for eight consecutive weeks and none detected in visual inspections) in 96, 87, and 100% of the apartments in Groups I, II, and III, respectively. The second experiment investigated the impact of interceptors as a control measure in apartments with low-level infestations. In the treatment group, interceptors were continuously installed at and away from sleeping and resting areas and were inspected every 2 wk for 16 wk. In the control group, interceptors were placed in a similar fashion as the treatment group but were only placed during 6–8 and 14–16 wk to obtain bed bug counts. Bed bug counts were significantly lower at 8 wk in the treatment group than in the control group. At 16 wk, bed bugs were eliminated in 50% of the apartments in the treatment group. The implications of our results in the development of bed bug management strategies and monitoring protocols are discussed.
Climate Stratosphere Pacific Islands International Desks Climate.gov Climate Test Bed (CTB) JAWF USAID FEWS-NET NWS / NCEP Aviation Weather Center Climate Prediction Center Environmental Modeling Center non-operational server hosts the redesigned web pages developed, thus far, as part of the Climate
A Tidally Averaged Sediment-Transport Model for San Francisco Bay, California
Lionberger, Megan A.; Schoellhamer, David H.
2009-01-01
A tidally averaged sediment-transport model of San Francisco Bay was incorporated into a tidally averaged salinity box model previously developed and calibrated using salinity, a conservative tracer (Uncles and Peterson, 1995; Knowles, 1996). The Bay is represented in the model by 50 segments composed of two layers: one representing the channel (>5-meter depth) and the other the shallows (0- to 5-meter depth). Calculations are made using a daily time step and simulations can be made on the decadal time scale. The sediment-transport model includes an erosion-deposition algorithm, a bed-sediment algorithm, and sediment boundary conditions. Erosion and deposition of bed sediments are calculated explicitly, and suspended sediment is transported by implicitly solving the advection-dispersion equation. The bed-sediment model simulates the increase in bed strength with depth, owing to consolidation of fine sediments that make up San Francisco Bay mud. The model is calibrated to either net sedimentation calculated from bathymetric-change data or measured suspended-sediment concentration. Specified boundary conditions are the tributary fluxes of suspended sediment and suspended-sediment concentration in the Pacific Ocean. Results of model calibration and validation show that the model simulates the trends in suspended-sediment concentration associated with tidal fluctuations, residual velocity, and wind stress well, although the spring neap tidal suspended-sediment concentration variability was consistently underestimated. Model validation also showed poor simulation of seasonal sediment pulses from the Sacramento-San Joaquin River Delta at Point San Pablo because the pulses enter the Bay over only a few days and the fate of the pulses is determined by intra-tidal deposition and resuspension that are not included in this tidally averaged model. The model was calibrated to net-basin sedimentation to calculate budgets of sediment and sediment-associated contaminants. While simulated net sedimentation in the four basins that comprise San Francisco Bay was correct, the simulations incorrectly eroded shallows while channels deposited because model surface-layer boxes span both shallows and channels, and neglect lateral variability of suspended-sediment concentration. Validation with recent (1983-2005) net sedimentation in South San Francisco Bay was poor, perhaps owing to poorly quantified sediment supply, and to invasive species that altered erosion and deposition processes. This demonstrates that deterministically predicting future sedimentation is difficult in this or any estuary for which boundary conditions are not stationary. The model would best be used as a tool for developing past and present sediment budgets, and for creating scenarios of future sedimentation that are compared to one another rather than considered a deterministic prediction.
A preliminary evaluation of the potential of Beauveria bassiana for bed bug control.
Barbarin, Alexis M; Jenkins, Nina E; Rajotte, Edwin G; Thomas, Matthew B
2012-09-15
Residual biopesticide treatments of Beauveria bassiana were tested against the bed bug Cimex lectularius. An oil formulation of conidia was applied to different substrates. Bed bugs were exposed for 1 h, transferred to an unsprayed environment and monitored for mortality. Separate bioassays evaluated the effect of bed bug strain, sex, life stage, and exposure substrate on mortality. Rapid mortality was observed in all bioassays, with bed bugs exposed to treated jersey knit cotton dying most rapidly. A further assay demonstrated efficient autodissemination of conidia from exposed bed bugs to unexposed bed bugs within artificial harborages. Copyright © 2012 Elsevier Inc. All rights reserved.
Hedman, Travis L; Chapman, Ted T; Dewey, William S; Quick, Charles D; Wolf, Steven E; Holcomb, John B
2007-01-01
Burn therapists routinely are tasked to position the lower extremities of burn patients for pressure ulcer prevention, skin graft protection, donor site ventilation, and edema reduction. We developed two durable and low-maintenance devices that allow effective positioning of the lower extremities. The high-profile and low-profile leg net devices were simple to fabricate and maintain. The frame was assembled using a three-quarter-inch diameter copper pipe and copper fittings (45 degrees, 90 degrees, and tees). A double layer of elasticized tubular netting was pulled over the frame and doubled back for leg support to complete the devices. The devices can be placed on any bed surface. The netting can be exchanged when soiled and the frame can be disinfected between patients using standard techniques. Both devices were used on approximately 250 patients for a total of 1200 treatment days. No incidence of pressure ulcer was observed, and graft take was not adversely affected. The devices have not required repairs or replacement. Medical providers reported they are easy to apply and effectively maintain proper positioning throughout application. Neither device interfered with the application of other positioning devices. Both devices were found to be an effective method of positioning lower extremities to prevent pressure ulcer, minimize graft loss and donor site morbidity, and reduce edema. The devices allowed for proper wound ventilation and protected grafted lower extremities on any bed surface. The devices are simple to fabricate and maintain. Both devices can be effectively used simultaneously with other positioning devices.
Sheet flow and suspended sediment due to wave groups in a large wave flume
Dohmen-Janssen, C. M.; Hanes, D.M.
2005-01-01
A series of sand bed experiments was carried out in the Large Wave Flume in Hannover, Germany as a component of the SISTEX99 experiment. The experiments focussed on the dynamic sediment response due to wave group forcing over a flat sand bed in order to improve understanding of cross-shore sediment transport mechanisms and determine sediment concentrations, fluxes and net transport rates under these conditions. Sediment concentrations were measured within the sheet flow layer (thickness in the order of 10 grain diameters) and in the suspension region (thickness in the order of centimetres). Within the sheet flow layer, the concentrations are highly coherent with the instantaneous near-bed velocities due to each wave within the wave group. However, in the suspension layer concentrations respond much more slowly to changes in near-bed velocity. At several centimetres above the bed, the suspended sediment concentrations vary on the time scale of the wave group, with a time delay relative to the peak wave within the wave group. The thickness of the sheet flow changes with time. It is strongly coherent with the wave forcing, and is not influenced by the history or sequence of the waves within the group. The velocity of the sediment was also measured within the sheet flow layer some of the time (during the larger wave crests of the group), and the velocity of the fluid was measured at several cm above the sheet flow layer. The grain velocity and concentration estimates can be combined to estimate the sediment flux. The estimates were found to be consistent with previous measurements under monochromatic waves. Under these conditions, without any significant mean current, the sediment flux within the sheet flow layer was found to greatly exceed the sediment flux in the suspension layer. As a result, net transport rates under wave groups are similar to those under monochromatic waves. ?? 2004 Elsevier Ltd. All rights reserved.
Evidence of man-vector contact in torn long-lasting insecticide-treated nets
2013-01-01
Background Studies indicate that physical damage to long-lasting insecticide-treated nets (LLINs) occurs at a surprisingly rapid rate following net distribution. To what extent does such damage affect the impact of LLINs? Can vectors pass a compromised LLIN barrier to bite? Do more resistant vectors enter the insecticide-treated nets (ITNs) through holes? Methods The study was carried out in three geo-locations. Two types of LLINs (polyester and polyethylene) with ‘standardized’ physical damage were compared with similarly damaged, but non-insecticidal (control) nets. The proportionate Holes Index (pHI) of each net was 276. Mosquitoes were captured inside the nets, identified taxonomically, and subjected to molecular analysis to estimate Knock-down resistance (Kdr) frequency. Results The most commonly observed species was Anopheles gambiae, accounting for approximately 70% (1,076/1,550) of the total mosquitoes collected both in LLINs and non-insecticidal nets. When compared with controls, number of vectors captured in torn LLINs was significantly reduced. Nonetheless in a night, an average of 5 An. gambiae s.l could enter the damaged LLINs to bite. Similar numbers of resistant mosquitoes were collected in both LLINs and non-insecticidal (control) nets (p > 0.05). Conclusions At a pHI of 276, man-vector contact was observed in torn LLINs. The insecticide at the surface of LLINs could only reduce the number of vectors. Resistant mosquitoes have opportunity to enter both non-insecticidal (control) nets and LLINs to bite. PMID:23941585
A mathematical model of the impact of present and future malaria vaccines.
Wenger, Edward A; Eckhoff, Philip A
2013-04-15
With the encouraging advent of new malaria vaccine candidates, mathematical modelling of expected impacts of present and future vaccines as part of multi-intervention strategies is especially relevant. The impact of potential malaria vaccines is presented utilizing the EMOD model, a comprehensive model of the vector life cycle coupled to a detailed mechanistic representation of intra-host parasite and immune dynamics. Values of baseline transmission and vector feeding behaviour parameters are identified, for which local elimination is enabled by layering pre-erythrocytic vaccines of various efficacies on top of high and sustained insecticide-treated net coverage. The expected reduction in clinical cases is further explored in a scenario that targets children by adding a pre-erythrocytic vaccine to the EPI programme for newborns. At high transmission, there is a minimal reduction in clinical disease cases, as the time to infection is only slightly delayed. At lower transmission, there is an accelerating community-level protection that has subtle dependences on heterogeneities in vector behaviour, ecology, and intervention coverage. At very low transmission, the trend reverses as many children are vaccinated to prevent few cases. The maximum-impact setting is one in which the impact of increasing bed net coverage has saturated, vector feeding is primarily outdoors, and transmission is just above the threshold where small perturbations from a vaccine intervention result in large community benefits.
Improving the quality of vascular surgical discharge planning in a hub centre
Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G
2016-01-01
Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered ‘delayed’ and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results. PMID:26924480
Improving the quality of vascular surgical discharge planning in a hub centre.
Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G
2016-04-01
Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered 'delayed' and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results.
Braithwaite, Sabina; Friedman, Bernard; Mutter, Ryan; Handrigan, Michael
2013-01-01
Objective Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009. The goal was to estimate net income and losses (nationally, and by hospital type) of a response of filling unused hospital bed capacity proportionately and postponing elective admissions (a “passive” supply response). Methods Epidemiologic assumptions were combined with assumptions from other literature (e.g., staff absenteeism, profitability by payer class), Census data on age groups by region, and baseline hospital utilization data. Hospital discharge records were available from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS). Hospital bed capacity and staffing were measured with the American Hospital Association's (AHA) Annual Survey. Results Nationwide, in a scenario of relatively severe epidemiologic assumptions, we estimated aggregate net income of $119 million for about 1 million additional influenza-related admissions, and a net loss of $37 million for 52,000 postponed elective admissions. Implications Aggregate and distributional results did not suggest that a policy of promising additional financial compensation to hospitals in anticipation of the surge in flu cases was necessary. The analysis identified needs for better information of several types to improve simulations of hospital behavior and impacts during demand surges. PMID:23398540
Angarita-Jaimes, N C; Parker, J E A; Abe, M; Mashauri, F; Martine, J; Towers, C E; McCall, P J; Towers, D P
2016-04-01
Many vectors of malaria and other infections spend most of their adult life within human homes, the environment where they bloodfeed and rest, and where control has been most successful. Yet, knowledge of peri-domestic mosquito behaviour is limited, particularly how mosquitoes find and attack human hosts or how insecticides impact on behaviour. This is partly because technology for tracking mosquitoes in their natural habitats, traditional dwellings in disease-endemic countries, has never been available. We describe a sensing device that enables observation and recording of nocturnal mosquitoes attacking humans with or without a bed net, in the laboratory and in rural Africa. The device addresses requirements for sub-millimetre resolution over a 2.0 × 1.2 × 2.0 m volume while using minimum irradiance. Data processing strategies to extract individual mosquito trajectories and algorithms to describe behaviour during host/net interactions are introduced. Results from UK laboratory and Tanzanian field tests showed that Culex quinquefasciatus activity was higher and focused on the bed net roof when a human host was present, in colonized and wild populations. Both C. quinquefasciatus and Anopheles gambiae exhibited similar behavioural modes, with average flight velocities varying by less than 10%. The system offers considerable potential for investigations in vector biology and many other fields. © 2016 The Authors.
Snyman, Katherine; Mwangwa, Florence; Bigira, Victor; Kapisi, James; Clark, Tamara D.; Osterbauer, Beth; Greenhouse, Bryan; Sturrock, Hugh; Gosling, Roly; Liu, Jenny; Dorsey, Grant
2015-01-01
Despite the use of accepted interventions to combat malaria, such as insecticide-treated bed nets and artemisinin-based combination therapy, malaria remains a leading cause of morbidity and mortality in Uganda. We investigated associations between household factors and malaria incidence in a cohort of children living in a highly endemic region of Uganda. Living in a modern house, defined as the use of non-earth floors, non-thatched roofs, and non-mud walls, was associated with approximately half malaria incidence compared with living in a traditional home (incidence rate ratio [IRR] = 0.54, P = 0.001). Other factors found to be associated with a lower incidence of malaria included living in town versus rural setting; sleeping in a room with openings to the outside (windows, eaves, and airbricks); and having an older and more educated primary caregiver. This study adds to the growing body of evidence that improved house construction may be associated with a lower risk of malaria. PMID:25870429
The investment case for folic acid fortification in developing countries
2018-01-01
Abstract There is compelling evidence that neural tube defects can be prevented through mandatory folic acid fortification. Why, then, is an investment case needed? At the core of the answer to this question is the notion that governments and individuals have limited resources for which there are many competing claims. An investment case compares the costs and benefits of folic acid fortification relative to alternative life‐saving investments and informs estimates of the financing required for implementation. Our best estimate is that the cost per death averted through mandatory folic acid fortification is $957 and the cost per disability‐adjusted life year is $14.90. Both compare favorably to recommended life‐saving interventions, such as the rotavirus vaccine and insecticide‐treated bed nets. Thus, there is a strong economic argument for mandatory folic acid fortification. Further improvements to these estimates will require better data on the costs of implementing fortification and on the costs of improving compliance where regulations are already in place. PMID:29363765
Economic analysis of microaerobic removal of H2S from biogas in full-scale sludge digesters.
Díaz, I; Ramos, I; Fdz-Polanco, M
2015-09-01
The application of microaerobic conditions during sludge digestion has been proven to be an efficient method for H2S removal from biogas. In this study, three microaerobic treatments were considered as an alternative to the technique of biogas desulfurization applied (FeCl3 dosing to the digesters) in a WWTP comprising three full-scale anaerobic reactors treating sewage sludge, depending on the reactant: pure O2 from cryogenic tanks, concentrated O2 from PSA generators, and air. These alternatives were compared in terms of net present value (NPV) with a fourth scenario consisting in the utilization of iron-sponge-bed filter inoculated with thiobacteria. The analysis revealed that the most profitable alternative to FeCl3 addition was the injection of concentrated O2 (0.0019 €/m(3) biogas), and this scenario presented the highest robustness towards variations in the price of FeCl3, electricity, and in the H2S concentration. Copyright © 2015 Elsevier Ltd. All rights reserved.
Using Decision Analysis to Improve Malaria Control Policy Making
Kramer, Randall; Dickinson, Katherine L.; Anderson, Richard M.; Fowler, Vance G.; Miranda, Marie Lynn; Mutero, Clifford M.; Saterson, Kathryn A.; Wiener, Jonathan B.
2013-01-01
Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets and artemesinin combination therapies for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision analysis can help to address and overcome these challenges. A prototype decision analysis framework for malaria control in Tanzania is presented, highlighting the key components that a decision support tool should include. Developing and applying such a framework can promote stronger and more effective linkages between research and policy, ultimately helping to reduce the burden of malaria and other vector-borne diseases. PMID:19356821
ERIC Educational Resources Information Center
Benigni, Mark D.; Moylan, Maureen
2009-01-01
This article discusses the Berlin (Connecticut) High School's NET (Non-Traditional Educational Training) program. NET is a self-contained program that is composed of three components: academics, social and emotional support, and vocational training. Rather than treat students alike, the NET program tailors their high school experience to meet…
Testing predictions of the emotion regulation model of binge-eating disorder.
Kenny, Therese E; Singleton, Christopher; Carter, Jacqueline C
2017-11-01
The emotion regulation (ER) model of binge eating posits that individuals with binge-eating disorder (BED) experience more intense emotions and greater difficulties in ER than individuals without BED, leading them to binge eat as a means of regulating emotions. According to this model, individuals with BED should report greater difficulties in ER than their non-BED counterparts, the severity of these difficulties should be positively associated with BED symptoms, and this association should be stronger when individuals experience persistent negative emotions (i.e., depression). Studies examining these hypotheses, however, have been limited. Data were collected from adults meeting the DSM 5 criteria for BED (n = 71; 93% female) and no history of an eating disorder (NED; n = 79; 83.5% female). Participants completed self-report measures of difficulties in ER, eating disorder (ED) psychopathology, and depression. Individuals with BED reported greater difficulties in ER compared to those with NED. Moreover, difficulties in ER predicted unique variance in binge frequency and ED psychopathology in BED. Depression moderated the association between ER difficulties and binge frequency such that emotion dysregulation and binge frequency were positively associated in those reporting high, but not low, depression levels. The association between difficulties in ER and ED pathology in BED suggests that treatments focusing on improving ER skills may be effective in treating this ED; however, the moderating effect of depression underscores the need for research on individual differences and treatment moderators. These findings suggest the importance of ER in understanding and treating BED. © 2017 Wiley Periodicals, Inc.
Triiodothyronine increases calcium loss in a bed rest antigravity model for space flight.
Smith, Steven R; Lovejoy, Jennifer C; Bray, George A; Rood, Jennifer; Most, Marlene M; Ryan, Donna H
2008-12-01
Bed rest has been used as a model to simulate the effects of space flight on bone metabolism. Thyroid hormones accelerate bone metabolism. Thus, supraphysiologic doses of this hormone might be used as a model to accelerate bone metabolism during bed rest and potentially simulate space flight. The objective of the study was to quantitate the changes in bone turnover after low doses of triiodothyronine (T(3)) added to short-term bed rest. Nine men and 5 women were restricted to bed rest for 28 days with their heads positioned 6 degrees below their feet. Subjects were randomly assigned to receive either placebo or oral T(3) at doses of 50 to 75 microg/d in a single-blind fashion. Calcium balance was measured over 5-day periods; and T(3), thyroxine, thyroid-stimulating hormone, immunoreactive parathyroid hormone, osteocalcin, bone alkaline phosphatase, and urinary deoxypyridinoline were measured weekly. Triiodothyronine increased 2-fold in the men and 5-fold in the women during treatment, suppressing both thyroxine and thyroid-stimulating hormone. Calcium balance was negative by 300 to 400 mg/d in the T(3)-treated volunteers, primarily because of the increased fecal loss that was not present in the placebo group. Urinary deoxypyridinoline to creatinine ratio, a marker of bone resorption, increased 60% in the placebo group during bed rest, but more than doubled in the T(3)-treated subjects (P < .01), suggesting that bone resorption was enhanced by treatment with T(3). Changes in serum osteocalcin and bone-specific alkaline phosphatase, markers of bone formation, were similar in T(3)- and placebo-treated subjects. Triiodothyronine increases bone resorption and fecal calcium loss in subjects at bed rest.
Monroe, April; Asamoah, Obed; Lam, Yukyan; Koenker, Hannah; Psychas, Paul; Lynch, Matthew; Ricotta, Emily; Hornston, Sureyya; Berman, Amanda; Harvey, Steven A
2015-01-28
Despite targeted indoor residual spraying (IRS) over a six-year period and free mass distribution of long-lasting insecticide-treated nets (ITNs), malaria rates in northern Ghana remain high. Outdoor sleeping and other night-time social, cultural and economic activities that increase exposure to infective mosquito bites are possible contributors. This study was designed to document these phenomena through direct observation, and to explore the context in which they occur. During the late dry season months of February and March 2014, study team members carried out continuous household observations from dusk to dawn in one village in Ghana's Northern Region and one in Upper West Region. In-depth interviews with health workers and community residents helped supplement observational findings. Study team members completed observations of 182 individuals across 24 households, 12 households per site. Between the two sites, they interviewed 14 health workers, six community health volunteers and 28 community residents. In early evening, nearly all study participants were observed to be outdoors and active. From 18.00-23.00 hours, socializing, night school, household chores, and small-scale economic activities were common. All-night funerals, held outdoors and attended by large numbers of community members, were commonly reported and observed. Outdoor sleeping was frequently documented at both study sites, with 42% of the study population sleeping outdoors at some time during the night. While interviewees mentioned bed net use as important to malaria prevention, observed use was low for both indoor and outdoor sleeping. Net access within households was 65%, but only 17% of those with access used a net at any time during the night. Participants cited heat as the primary barrier and reported higher net use during the rainy season. Outdoor sleeping and other night-time activities were extensive, and could significantly increase malaria risk. These findings suggest that indoor-oriented control measures such as ITNs and IRS are insufficient to eliminate malaria in this setting, especially given the low net use observed. Development and evaluation of complementary outdoor control strategies should be prioritized. A research agenda is proposed to quantify the relative risk of outdoor night-time activities and test potential vector control interventions that might reduce that risk.
Entrainment of bed sediment by debris flows: results from large-scale experiments
Reid, Mark E.; Iverson, Richard M.; Logan, Matthew; LaHusen, Richard G.; Godt, Jonathan W.; Griswold, Julie P.
2011-01-01
When debris flows grow by entraining sediment, they can become especially hazardous owing to increased volume, speed, and runout. To investigate the entrainment process, we conducted eight largescale experiments in the USGS debris-flow flume. In each experiment, we released a 6 m3 water-saturated debris flow across a 47-m long, ~12-cm thick bed of partially saturated sediment lining the 31º flume. Prior to release, we used low-intensity overhead sprinkling and real-time monitoring to control the bed-sediment wetness. As each debris flow descended the flume, we measured the evolution of flow thickness, basal total normal stress, basal pore-fluid pressure, and sediment scour depth. When debris flows traveled over relatively dry sediment, net scour was minimal, but when debris flows traveled over wetter sediment (volumetric water content > 0.22), debris-flow volume grew rapidly and flow speed and runout were enhanced. Data from scour sensors showed that entrainment occurred by rapid (5-10 cm/s), progressive scour rather than by mass failure at depth. Overriding debris flows rapidly generated high basal pore-fluid pressures when they loaded and deformed bed sediment, and in wetter beds these pressures approached lithostatic levels. Reduction of intergranular friction within the bed sediment thereby enhanced scour efficiency, entrainment, and runout.
Bed Bug Infestations in an Urban Environment
Svoboda, Tomislav J.; De Jong, Iain J.; Kabasele, Karl J.; Gogosis, Evie
2005-01-01
Until recently, bed bugs have been considered uncommon in the industrialized world. This study determined the extent of reemerging bed bug infestations in homeless shelters and other locations in Toronto, Canada. Toronto Public Health documented complaints of bed bug infestations from 46 locations in 2003, most commonly apartments (63%), shelters (15%), and rooming houses (11%). Pest control operators in Toronto (N = 34) reported treating bed bug infestations at 847 locations in 2003, most commonly single-family dwellings (70%), apartments (18%), and shelters (8%). Bed bug infestations were reported at 20 (31%) of 65 homeless shelters. At 1 affected shelter, 4% of residents reported having bed bug bites. Bed bug infestations can have an adverse effect on health and quality of life in the general population, particularly among homeless persons living in shelters. PMID:15829190
Whole-brain Irradiation Field Design: A Comparison of Parotid Dose.
Wu, Cheng-Chia; Wuu, Yen-Ruh; Jani, Ashish; Saraf, Anurag; Tai, Cheng-Hung; Lapa, Matthew E; Andrew, Jacquelyn I S; Tiwari, Akhil; Saadatmand, Heva J; Isaacson, Steven R; Cheng, Simon K; Wang, Tony J C
2017-01-01
Whole-brain radiation therapy (WBRT) plays an important role in patients with diffusely metastatic intracranial disease. Whether the extent of the radiation field design to C1 or C2 affects parotid dose and risk for developing xerostomia is unknown. The goal of this study is to examine the parotid dose based off of the inferior extent of WBRT field to either C1 or C2. Patients treated with WBRT with either 30 Gy or 37.5 Gy from 2011 to 2014 at a single institution were examined. Parotid dose constraints were compared with Radiation Therapy Oncology Group (RTOG) 0615 nasopharyngeal carcinoma for a 33-fraction treatment: mean <26 Gy, volume constraint at 20 Gy (V20) < 20 cc, and dose at 50% of the parotid volume (D50) < 30 Gy. Biologically effective dose (BED) conversions with an α/β of 3 for normal parotid were performed to compare with 10-fraction and 15-fraction treatments of WBRT. The constraints are as follows: mean < BED 32.83 Gy, V15.76 (for 10-fraction WBRT) or V17.35 (for 15-fraction WBRT) < 20 cc, and D50 < BED 39.09 Gy. Nineteen patients treated to C1 and 26 patients treated to C2 were analyzed. Comparing WBRT to C1 with WBRT to C2, the mean left, right, and both parotids' doses were lower when treated to C1. Converting mean dose to BED 3 , the parotid doses were lower than BED 3 constraint of 32.83 Gy: left (30.12 Gy), right (30.69 Gy), and both parotids (30.32 Gy). V20 to combined parotids was lower in patients treated to C1. When accounting for fractionation of WBRT received, the mean corrected V20 volume was less than 20 cc when treating to C1. D50 for C1 was lower than C2 for the left parotid, right parotid, and both parotids. BED 3 conversion for the mean D50 of the left, right, and both parotids was less than 39.09 Gy. In conclusion, WBRT to C1 limits parotid dose, and parotid dose constraints are achievable compared with inferior border at C2. A possible mean parotid dose constraint with BED 3 should be less than 32.83 Gy. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
Whole-brain Irradiation Field Design: A Comparison of Parotid Dose
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wu, Cheng-Chia; Wuu, Yen-Ruh; Jani, Ashish
Whole-brain radiation therapy (WBRT) plays an important role in patients with diffusely metastatic intracranial disease. Whether the extent of the radiation field design to C1 or C2 affects parotid dose and risk for developing xerostomia is unknown. The goal of this study is to examine the parotid dose based off of the inferior extent of WBRT field to either C1 or C2. Patients treated with WBRT with either 30 Gy or 37.5 Gy from 2011 to 2014 at a single institution were examined. Parotid dose constraints were compared with Radiation Therapy Oncology Group (RTOG) 0615 nasopharyngeal carcinoma for a 33-fraction treatment: meanmore » <26 Gy, volume constraint at 20 Gy (V20) < 20 cc, and dose at 50% of the parotid volume (D50) < 30 Gy. Biologically effective dose (BED) conversions with an α/β of 3 for normal parotid were performed to compare with 10-fraction and 15-fraction treatments of WBRT. The constraints are as follows: mean < BED 32.83 Gy, V15.76 (for 10-fraction WBRT) or V17.35 (for 15-fraction WBRT) < 20 cc, and D50 < BED 39.09 Gy. Nineteen patients treated to C1 and 26 patients treated to C2 were analyzed. Comparing WBRT to C1 with WBRT to C2, the mean left, right, and both parotids' doses were lower when treated to C1. Converting mean dose to BED{sub 3}, the parotid doses were lower than BED{sub 3} constraint of 32.83 Gy: left (30.12 Gy), right (30.69 Gy), and both parotids (30.32 Gy). V20 to combined parotids was lower in patients treated to C1. When accounting for fractionation of WBRT received, the mean corrected V20 volume was less than 20 cc when treating to C1. D50 for C1 was lower than C2 for the left parotid, right parotid, and both parotids. BED{sub 3} conversion for the mean D50 of the left, right, and both parotids was less than 39.09 Gy. In conclusion, WBRT to C1 limits parotid dose, and parotid dose constraints are achievable compared with inferior border at C2. A possible mean parotid dose constraint with BED{sub 3} should be less than 32.83 Gy.« less
2006-02-01
include Ceratophyllum demersum, Myriophyllum spicatum, and Nymphaea odorata . METHODS: In late April 2004, vertical slide gates were adjusted to...due to a shallow water column and dense N. odorata beds. Flows into Schmokers Lake could not be directly measured because it was not connected to the
Brian R. Lockhart; John D. Hodges
1994-01-01
Gas-exchange measurements, including CO2-exchange rate (net photosynthesis), stomatal conductance, and transpiration, were conducted on intact and clipped cherrybark oak (Quercus pagoda Raf.) seedlings growing inthe field and in a nursery bed. Seedlings inthe field, released frommidstory and understory woody competition, showed...
Hospital output forecasts and the cost of empty hospital beds.
Pauly, M V; Wilson, P
1986-01-01
This article investigates the cost incurred when hospitals have different levels of beds to treat a given number of patients. The cost of hospital care is affected by both the forecasted level of admissions and the actual number of admissions. When the relationship between forecasted and actual admissions is held constant, it is found that an empty hospital bed at a typical hospital in Michigan has a relatively low cost, about 13 percent or less of the cost of an occupied bed. However, empty beds in large hospitals do add significantly to cost. If hospital beds are closed, whether by closing beds at hospitals which remain in business or by closing entire hospitals, cost savings are estimated to be small. PMID:3759473
van der Mee-Marquet, Nathalie; Girard, Sophie; Lagarrigue, François; Leroux, Isabelle; Voyer, Isabelle; Bloc, Daniel; Besnier, Jean-Marc; Quentin, Roland
2006-01-01
We report a multiresistant Enterobacter cloacae outbreak in an intensive care unit, associated with mattresses and with antibacterial-treated and vapour-permeable polyurethane synthetic mattress covers of therapeutic beds. PMID:16542475
Do-it-yourself Bed Bug Control
... Contact Us Share Do-it-yourself Bed Bug Control Información relacionada disponible en español Can you treat ... all of the residents to participate. Achieving complete control can take weeks to months, depending on the ...
Lo, Yung-Chung; Lee, Kuo-Shing; Lin, Ping-Jei; Chang, Jo-Shu
2009-10-01
Anaerobic granular sludge bed (AnGSB) bioreactors were supplemented with activated carbon carriers and combined with distributors (e.g., acrylic resin board, stainless steel net and plastic net) installed at different locations to investigate the effect of distributor/carrier on biohydrogen production efficiency. The results show that plastic net stimulated the substrate/microorganisms contact and sludge granulation, thereby leading to a much better H(2) production performance when compared with those obtained from traditional CSTR. The highest H(2) production rate (7.89 L/h/L) and yield (3.42 mol H(2)/mol sucrose) were obtained when two pieces of plastic nets were installed at both 4 cm and 16 cm from the bottom of AnGSB without carrier addition and the bioreactor was operated at a HRT of 0.5h. For the AnGSB installed with two pieces of plastic net distributors, addition of carriers led to significant improvement on the H(2) production efficiency at a longer HRT (1-4h) when compared with the carrier-absent system.
Singh, Rajiv; Sinha, Saurabh; Bill, Alan; Turner-Stokes, Lynne
2017-04-01
To identify the needs for specialised rehabilitation provision in a cohort of neurosurgical patients; to determine if these were met, and to estimate the potential cost implications and cost-benefits of meeting any unmet rehabilitation needs. A prospective study of in-patient admissions to a regional neurosurgical ward. Assessment of needs for specialised rehabilitation (Category A or B needs) was made with the Patient Categorisation Tool. The number of patients who were referred and admitted for specialised rehabilitation was calculated. Data from the unit's submission to the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database 2012-2015 were used to estimate the potential mean lifetime savings generated through reduction in the costs of on-going care in the community. Of 223 neurosurgical in-patients over 3 months, 156 (70%) had Category A or B needs. Out of the 105 patients who were eligible for admission to the local specialised rehabilitation service, only 20 (19%) were referred and just 11 (10%) were actually admitted. The mean transfer time was 70.2 (range 28-127) days, compared with the national standard of 42 days. In the 3-year sample, mean savings in the cost of on-going care were £568 per week. Assuming a 10-year reduction in life expectancy, the approximate net lifetime saving for post-neurosurgical patients was estimated as at least £600K per patient. We calculated that provision of additional bed capacity in the specialist rehabilitation unit could generate net savings of £3.6M/bed-year. This preliminary single-centre study identified a considerable gap in provision of specialised rehabilitation for neurosurgical patients, which must be addressed if patients are to fulfil their potential for recovery. A 5-fold increase in bed capacity would cost £9.3m/year, but could lead to potential net savings of £24m/year. Our findings now require confirmation on a wider scale through prospective multi-centre studies.
Kariuki, Simon K; Njunge, James; Muia, Ann; Muluvi, Geofrey; Gatei, Wangeci; Ter Kuile, Feiko; Terlouw, Dianne J; Hawley, William A; Phillips-Howard, Penelope A; Nahlen, Bernard L; Lindblade, Kim A; Hamel, Mary J; Slutsker, Laurence; Shi, Ya Ping
2013-08-27
Although several studies have investigated the impact of reduced malaria transmission due to insecticide-treated bed nets (ITNs) on the patterns of morbidity and mortality, there is limited information on their effect on parasite diversity. Sequencing was used to investigate the effect of ITNs on polymorphisms in two genes encoding leading Plasmodium falciparum vaccine candidate antigens, the 19 kilodalton blood stage merozoite surface protein-1 (MSP-1(19kDa)) and the Th2R and Th3R T-cell epitopes of the pre-erythrocytic stage circumsporozoite protein (CSP) in a large community-based ITN trial site in western Kenya. The number and frequency of haplotypes as well as nucleotide and haplotype diversity were compared among parasites obtained from children <5 years old prior to the introduction of ITNs (1996) and after 5 years of high coverage ITN use (2001). A total of 12 MSP-1(19kDa) haplotypes were detected in 1996 and 2001. The Q-KSNG-L and E-KSNG-L haplotypes corresponding to the FVO and FUP strains of P. falciparum were the most prevalent (range 32-37%), with an overall haplotype diversity of > 0.7. No MSP-1(19kDa) 3D7 sequence-types were detected in 1996 and the frequency was less than 4% in 2001. The CSP Th2R and Th3R domains were highly polymorphic with a total of 26 and 14 haplotypes, respectively detected in 1996 and 34 and 13 haplotypes in 2001, with an overall haplotype diversity of > 0.9 and 0.75 respectively. The frequency of the most predominant Th2R and Th3R haplotypes was 14 and 36%, respectively. The frequency of Th2R and Th3R haplotypes corresponding to the 3D7 parasite strain was less than 4% at both time points. There was no significant difference in nucleotide and haplotype diversity in parasite isolates collected at both time points. High diversity in these two genes has been maintained overtime despite marked reductions in malaria transmission due to ITNs use. The frequency of 3D7 sequence-types was very low in this area. These findings provide information that could be useful in the design of future malaria vaccines for deployment in endemic areas with high ITN coverage and in interpretation of efficacy data for malaria vaccines based on 3D7 parasite strains.
Wang, Paul; Connor, Alison L; Joudeh, Ammar S; Steinberg, Jeffrey; Ndhlovu, Ketty; Siyolwe, Musanda; Ntebeka, Bristol; Chibuye, Benjamin; Hamainza, Busiku
2016-03-03
In 2013, the Zambian Ministry of Health through its National Malaria Control Programme distributed over two million insecticide-treated bed nets (ITNs) in four provinces using a door-to-door distribution strategy, and more than 6 million ITNs were allocated to be distributed in 2014. This study was commissioned to measure attendance rates at a community point distribution and to examine the impact of follow-up community health worker (CHW) hang-up visits on short and medium-term ITN retention and usage with a view of informing optimal ITN distribution strategy in Zambia. Households received ITNs at community point distributions conducted in three rural communities in Rufunsa District, Zambia. Households were then randomly allocated into five groups to receive CHW visits to hang any unhung ITNs at different intervals: 1-3, 5-7, 10-12, 15-17 days, and no hang-up visit. Follow-up surveys were conducted among all households at 7-11 weeks after distribution and at 5-6 months after distribution to measure short- and medium-term household retention and usage of ITNs. Of the 560 pre-registered households, 540 (96.4 %) attended the community point distribution. Self-installation of ITNs by households increased over the first 10 days after the community point distribution. Retention levels remained high over time with 90.2 % of distributed ITNs still in the household at 7-11 weeks and 85.7 % at 5-6 months. Retention did not differ between households that received a CHW visit and those that did not. At 7-11 weeks, households had an average of 73.8 % of sleeping spaces covered compared to 80.3 % at 5-6 months. On average, 65.6 % of distributed ITNs were hanging at 7-11 weeks compared to 63.1 % at 5-6 months. While a CHW hang-up visit was associated with increased usage at 7-11 weeks, this difference was no longer apparent at 5-6 months. This evaluation revealed that (1) the community point distributions achieved high attendance rates followed by acceptable rates of short-term and medium-term ITN retention and usage, as compared to reported rates achieved by door-to-door distributions in the recent past, (2) CHW hang-up visits had a modest short-term impact on ITN usage but no medium-term effect, and (3) community point distributions can yield sizeable time savings compared to door-to-door distributions.
Boggild, A; Brophy, J; Charlebois, P; Crockett, M; Geduld, J; Ghesquiere, W; McDonald, P; Plourde, P; Teitelbaum, P; Tepper, M; Schofield, S; McCarthy, A
2014-01-01
Background On behalf of the Public Health Agency of Canada, the Committee to Advise on Tropical Medicine and Travel (CATMAT) developed the Canadian Recommendations for the Prevention and Treatment of Malaria Among International Travellers for Canadian health care providers who are preparing patients for travel to malaria-endemic areas and treating travellers who have returned ill. Objective To provide guidelines on risk assessment and prevention of malaria Methods CATMAT reviewed all major sources of information on malaria prevention, as well as recent research and national and international epidemiological data, to tailor guidelines to the Canadian context. The evidence-based medicine recommendations were developed with associated rating scales for the strength and quality of the evidence. Recommendations Used together and correctly, personal protective measures (PPM) and chemoprophylaxis very effectively protect against malaria infection. PPM include protecting accommodation areas from mosquitoes, wearing appropriate clothing, using bed nets pre-treated with insecticide and applying topical insect repellant (containing 20%–30% DEET or 20% icaridin) to exposed skin. Selecting the most appropriate chemoprophylaxis involves assessment of the traveller’s itinerary to establish his/her malaria risk profile as well as potential drug resistance issues. Antimalarials available on prescription in Canada include chloroquine (or hydroxychloroquine), atovaquone-proguanil, doxycycline, mefloquine and primaquine. PMID:29769893
Onwujekwe, Obinna; Hanson, Kara; Fox-Rushby, Julia
2004-01-01
Objective To explore the equity implications of insecticide-treated nets (ITN) distribution programmes that are based on user charges. Methods A questionnaire was used to collect information on previous purchase of untreated nets and hypothetical willingness to pay (WTP) for ITNs from a random sample of householders. A second survey was conducted one month later to collect information on actual purchases of ITNs. An economic status index was used for characterizing inequity. Major findings The lower economic status quintiles were less likely to have previously purchased untreated nets and also had a lower hypothetical and actual WTP for ITNs. Conclusion ITN distribution programmes need to take account of the diversity in WTP for ITNs if they are to ensure equity in access to the nets. This could form part of the overall poverty reduction strategy. PMID:15023234
Hiring a Pest Management Professional for Bed Bugs
If you hire someone to treat your bed bug infestation, make sure they use Integrated Pest Management (IPM) techniques, check credentials, and know they may need multiple visits, to take apart furniture, and to use vacuums, heat, and pesticides.
Stay Legal and Safe in Treating for Bed Bugs
Quick fix solutions may sound appealing, but they may not be legal, safe, or effective. To avoid adverse effects such as poisoning, buy EPA-registered pesticides labeled for bed bug control, and follow all label directions and precautions.
Anderson, John F; Ferrandino, Francis J; Vasil, Michael P; Bedoukian, Robert H; Maher, Marie; McKenzie, Karen
2018-05-04
Bed bugs, Cimex lectularius L. (Hemiptera: Cimicidae), have become a major health nuisance in the past 20 ysin cities and elsewhere throughout many areas of the world. Few studies have reported on repellent compounds that could reduce their transport in luggage. We evaluated the repellency of six naturally occurring or related compounds used in flavor/fragrance applications or structurally related compounds, para-menthane-3,8-diol, and N,N-diethyl-meta-toluamide (DEET) to bed bugs in a 183 × 183-cm arena . Repellency was assessed using soft-sided polyester lunch bags serving as surrogates of luggage and barrier cloth towels upon which rested untreated lunch bags. We report for the first time repellency of delta dodecalactone, 2-(3, 7-dimethyl-2, 6-nonadien-1-yl)-cyclopentanone (a.k.a. 'methyl apritone'), gamma dodecalactone, and para-menthane-3,8-diol to bed bugs. Propyl dihydrojasmonate, 3-methyl-5-hexyl-2-cyclohexenone, gamma methyl tridecalactone, and DEET are also documented to be repellent to bed bugs. These compounds provided relatively long-term protection. Propyl dihydrojasmonate prevented bed bugs from seeking refuge in treated lunch bags 27 d after treatment, and when applied to cloth towels repelled harborage-seeking bed bugs for 146 d. Methyl apritone blended with 3-methyl-5-hexyl-2-cyclohexenone and delta dodecalactone as an individual compound applied to cloth towels repelled bed bugs for 190 and 276 d, respectively. The above-mentioned compounds, either individually or as blends, may reduce risk of bed bugs seeking harborage in treated suitcases or towels upon which untreated luggage is placed.
Recognizing Binge-Eating Disorder in the Clinical Setting: A Review of the Literature.
Kornstein, Susan G; Kunovac, Jelena L; Herman, Barry K; Culpepper, Larry
2016-01-01
Review the clinical skills needed to recognize, diagnose, and manage binge-eating disorder (BED) in a primary care setting. A PubMed search of English-language publications (January 1, 2008-December 11, 2014) was conducted using the term binge-eating disorder . Relevant articles known to the authors were also included. Publications focusing on preclinical topics (eg, characterization of receptors and neurotransmitter systems) without discussing clinical relevance were excluded. A total of 101 publications were included in this review. Although BED is the most prevalent eating disorder, it is underdiagnosed and undertreated. BED can be associated with medical (eg, type 2 diabetes and metabolic syndrome) and psychiatric (eg, depression and anxiety) comorbidities that, if left untreated, can impair quality of life and functionality. Primary care physicians may find diagnosing and treating BED challenging because of insufficient knowledge of its new diagnostic criteria and available treatment options. Furthermore, individuals with BED may be reluctant to seek treatment because of shame, embarrassment, and a lack of awareness of the disorder. Several short assessment tools are available to screen for BED in primary care settings. Pharmacotherapy and psychotherapy should focus on reducing binge-eating behavior, thereby reducing medical and psychiatric complications. Overcoming primary care physician- and patient-related barriers is critical to accurately diagnose and appropriately treat BED. Primary care physicians should take an active role in the initial recognition and assessment of suspected BED based on case-finding indicators (eg, eating habits and being overweight), the initial treatment selection, and the long-term follow-up of patients who meet DSM-5 BED diagnostic criteria.
de Aquino, Samuel; Fuess, Lucas Tadeu; Pires, Eduardo Cleto
2017-07-01
This study reports on the application of an innovative structured-bed reactor (FVR) as an alternative to conventional packed-bed reactors (PBRs) to treat high-strength solid-rich wastewaters. Using the FVR prevents solids from accumulating within the fixed-bed, while maintaining the advantages of the biomass immobilization. The long-term operation (330days) of a FVR and a PBR applied to sugarcane vinasse under increasing organic loads (2.4-18.0kgCODm -3 day -1 ) was assessed, focusing on the impacts of the different media arrangements over the production and retention of biomass. Much higher organic matter degradation rates, as well as long-term operational stability and high conversion efficiencies (>80%) confirmed that the FVR performed better than the PBR. Despite the equivalent operating conditions, the biomass growth yield was different in both reactors, i.e., 0.095gVSSg -1 COD (FVR) and 0.066gVSSg -1 COD (PBR), indicating a clear control of the media arrangement over the biomass production in fixed-bed reactors. Copyright © 2017 Elsevier Ltd. All rights reserved.
Risk factors of visceral leishmaniasis: a case control study in north-western Ethiopia.
Yared, Solomon; Deribe, Kebede; Gebreselassie, Araya; Lemma, Wessenseged; Akililu, Essayas; Kirstein, Oscar D; Balkew, Meshesha; Warburg, Alon; Gebre-Michael, Teshome; Hailu, Asrat
2014-10-14
Visceral leishmaniasis (VL, also called ''kala-azar"), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL. A case-control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL. Elevated odds of VL was associated with goat ownership (OR = 6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR = 6.4; 95% Cl: 1.6-25.6), increased family size (OR = 1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR = 1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR = 0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR = 0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR = 0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case. Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants.
Early Growth Response of Slash Pine to Double-Bedding on a Flatwoods Site in Georgia
Curtis L. VanderSchaaf; David B. South
2004-01-01
A somewhat poorly-drained site in the Georgia flatwoods was prepared with single- and double-bedding and was planted with slash pine (Pinus elliottii Engelm.) seedlings in October. Half of the plots were treated with imazypyr in March. Double-bedding increased 7 th year volume by 5 m3 per ha, but due to insufficient control of...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cook, Lawrence Leslie; Apel, William Arnold; Gostomski, P. A.
2004-04-01
In response to complaints from nearby residents, a biofilter was designed, installed, and tested for treating odors in one of three odorous emission streams from an asphalt plant producing polymer-modified asphalt. Hydrogen sulfide (H2S) was determined to be the most prevalent gaseous reduced sulfur compound and was detected in the emission stream only when polymer material was being added to raw asphalt. Emission stream H2S concentrations we requite variable, ranging from 16 to approximately 30,000 ppm (v/v) and considered the likely compound contributing most to the plant's odor complaints. The biofilter was effective in controlling odor from the production processmore » and removed an overall average of 65% of the H2S during polymer addition, and for H2S concentrations less than 400 ppmv, re m oval averaged 98%. These removal efficiencies reflect data from the biofilter operating at 2.5-minute empty bed residence time in 1996 and a 6.1-minute empty bed residence time in 1997. The biofilter's bed became increasingly acidified during the plant's 1997 operating season producing a pH gradient through the bed ranging from a high of 6.6 to a low of 3.1. The bed medium moisture content remained constant at about 60% (wet weight basis), but changes were observed in the water potential: no correlation to performance was determined. Changes in the microbial community reflected the bed acidification trend, with acidophiles becoming gene rally more numerous in the bed's deeper portions and in the mid to late season when the bed was most acidified. Bed acidification did not impact the biofilter's H2S removal efficiency. Nearby residents we resurveyed and roughly half of the respondents indicated that the odor conditions had improved, one-third felt odor conditions were unchanged and the remaining 15% felt odor conditions were worse despite the fact that only one of three of the plant's odorous emission streams were treated by the biofilter. Plans are to implement biofiltration for odor control at all of the facility's emission points.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lukens, J. Nicholas; Lin, Alexander, E-mail: alexander.lin@uphs.upenn.edu; Gamerman, Victoria
Purpose: A subset of patients with oropharyngeal squamous cell carcinoma (OP-SCC) managed with transoral robotic surgery (TORS) and postoperative radiation therapy (PORT) developed soft tissue necrosis (STN) in the surgical bed months after completion of PORT. We investigated the frequency and risk factors. Materials and Methods: This retrospective analysis included 170 consecutive OP-SCC patients treated with TORS and PORT between 2006 and 2012, with >6 months' of follow-up. STN was defined as ulceration of the surgical bed >6 weeks after completion of PORT, requiring opioids, biopsy, or hyperbaric oxygen therapy. Results: A total of 47 of 170 patients (28%) hadmore » a diagnosis of STN. Tonsillar patients were more susceptible than base-of-tongue (BOT) patients, 39% (41 of 104) versus 9% (6 of 66), respectively. For patients with STN, median tumor size was 3.0 cm (range 1.0-5.6 cm), and depth of resection was 2.2 cm (range 1.0-5.1 cm). Median radiation dose and dose of fraction to the surgical bed were 6600 cGy and 220 cGy, respectively. Thirty-one patients (66%) received concurrent chemotherapy. Median time to STN was 2.5 months after PORT. All patients had resolution of STN after a median of 3.7 months. Multivariate analysis identified tonsillar primary (odds ratio [OR] 4.73, P=.01), depth of resection (OR 3.12, P=.001), total radiation dose to the resection bed (OR 1.51 per Gy, P<.01), and grade 3 acute mucositis (OR 3.47, P=.02) as risk factors for STN. Beginning May 2011, after implementing aggressive avoidance of delivering >2 Gy/day to the resection bed mucosa, only 8% (2 of 26 patients) experienced STN (all grade 2). Conclusions: A subset of OP-SCC patients treated with TORS and PORT are at risk for developing late consequential surgical bed STN. Risk factors include tonsillar location, depth of resection, radiation dose to the surgical bed, and severe mucositis. STN risk is significantly decreased with carefully avoiding a radiation dosage of >2 Gy/day to the surgical bed.« less
NASA Astrophysics Data System (ADS)
Boschmann, Michael; Adams, Frauke; Tank, Jens; Schaller, Karin; Boese, Andrea; Heer, Martina; Klause, Susanne; Luft, Friedrich C.; Jordan, Jens
2005-08-01
Long term immobilization and reduced food intake is often associated with development of orthostatic intolerance. Blocking the norepinephrine transporter (NET) can also mimic symptoms of orthostatic intolerance. Therefore, we hypothesized that simulated microgravity (14 days bed rest at head down tilt, BR) can cause changes in postganglionic NET function and adrenoreceptor (AR) sensitivity and these changes can be aggravated by hypocaloric food intake. For testing, two microdialysis probes were inserted into subcutaneous adipose tissue of eight young healthy men at day 1 and 14 of BR and perfused with Ringer's solution and increasing doses of tyramine and isoproterenol in order to simulate NET blockade and stimulate AR, respectively. At day 14 of eucaloric diet and BR, isoproterenol induced lipolysis was greater, whereas at day 14 of hypocaloric diet and BR, tyramine induced lipolysis was greater when compared to day 1. Therefore, the nutritional state affects NET function and AR sensitivity differently during BR.
Lantos-Hyde United States Government Malaria Strategy, 2009-2014
2010-04-25
Long lasting insecticide -treated nets (LLINs); • Indoor residual spraying (IRS) with insecticides ; • Intermittent preventive treatment of...measures: insecticide -treated mosquito nets (ITNs); indoor residual spraying (IRS) of insecticides ; artemisinin-based combination therapy (ACTs); and...is national policy. Indoor residual spraying : Between 2005 and 2009, PMI supported the introduction or
Basnet, Sanjay; Kamble, Shripat T
2018-05-01
Bed bugs are one the most troublesome household pests that feed primarily on human blood. RNA interference (RNAi) is currently being pursued as a potential tool for insect population management and has shown efficacy against some phytophagous insects. We evaluated the different techniques to deliver dsRNA specific to bed bug muscle actin (dsactin) into bed bugs. Initially, stability of dsRNA in human blood was studied to evaluate the feasibility of feeding method. Adult bed bugs were injected with dsRNA between last thoracic segment and first abdominal segment on the ventral side, with a dose of 0.2 µg dsactin per insect. In addition to injection, dsactin was mixed in acetone and treated topically in the abdomens of fifth stage nymphs. We found the quick degradation of dsRNA in blood. Injection of dsactin caused significant depletion of actin transcripts and substantial reduction in oviposition and lethality in female adults. Topically treated dsRNA in fifth stage nymphs had no effect on actin mRNA expression and survival. Our results demonstrated that injection is a reliable method of dsRNA delivery into bed bugs while topical treatment was not successful. This research provides an understanding on effective delivery methods of dsRNA into bed bugs for functional genomics research and feasibility of the RNAi based molecules for pest management purposes.
Sheikh, Aziz; Hurwitz, Brian; Sibbald, Bonnie; Barnes, Greta; Howe, Maggie; Durham, Stephen
2002-06-18
The house dust mite is the most important environmental allergen implicated in the aetiology of childhood asthma in the UK. Dust mite barrier bedding is relatively inexpensive, convenient to use, and of proven effectiveness in reducing mattress house dust mite load, but no studies have evaluated its clinical effectiveness in the control of childhood asthma when dispensed in primary care. We therefore aimed to evaluate the effectiveness of house dust mite barrier bedding in children with asthma treated in primary care. Pragmatic, randomised, double-blind, placebo controlled trial conducted in eight family practices in England. Forty-seven children aged 5 to 14 years with confirmed house dust mite sensitive asthma were randomised to receive six months treatment with either house dust mite barrier or placebo bedding. Peak expiratory flow was the main outcome measure of interest; secondary outcome measures included asthma symptom scores and asthma medication usage. No difference was noted in mean monthly peak expiratory flow, asthma symptom score, medication usage or asthma consultations, between children who received active bedding and those who received placebo bedding. Treating house dust mite sensitive asthmatic children in primary care with house dust mite barrier bedding for six months failed to improve peak expiratory flow. Results strongly suggest that the intervention made no impact upon other clinical features of asthma.
Sheikh, Aziz; Hurwitz, Brian; Sibbald, Bonnie; Barnes, Greta; Howe, Maggie; Durham, Stephen
2002-01-01
Background The house dust mite is the most important environmental allergen implicated in the aetiology of childhood asthma in the UK. Dust mite barrier bedding is relatively inexpensive, convenient to use, and of proven effectiveness in reducing mattress house dust mite load, but no studies have evaluated its clinical effectiveness in the control of childhood asthma when dispensed in primary care. We therefore aimed to evaluate the effectiveness of house dust mite barrier bedding in children with asthma treated in primary care. Methods Pragmatic, randomised, double-blind, placebo controlled trial conducted in eight family practices in England. Forty-seven children aged 5 to 14 years with confirmed house dust mite sensitive asthma were randomised to receive six months treatment with either house dust mite barrier or placebo bedding. Peak expiratory flow was the main outcome measure of interest; secondary outcome measures included asthma symptom scores and asthma medication usage. Results No difference was noted in mean monthly peak expiratory flow, asthma symptom score, medication usage or asthma consultations, between children who received active bedding and those who received placebo bedding. Conclusions Treating house dust mite sensitive asthmatic children in primary care with house dust mite barrier bedding for six months failed to improve peak expiratory flow. Results strongly suggest that the intervention made no impact upon other clinical features of asthma. PMID:12079502
7. VIEW OF THE HOT BED FOR THE CONTINUOUS ELECTRIC ...
7. VIEW OF THE HOT BED FOR THE CONTINUOUS ELECTRIC FURNACE HEAT TREATING LINE AT THE HEAT TREATMENT PLANT OF THE DUQUESNE WORKS. - U.S. Steel Duquesne Works, Heat Treatment Plant, Along Monongahela River, Duquesne, Allegheny County, PA
2009-06-01
involves overseas laboratories. Repellents and pesticides used by the U.S. military at present must be U.S. Environmental Protection Agency (EPA...eucalyptus, citronella, catnip, sage, lavender, basil , thyme, and the tea tree) contain oils that repel arthropods when applied to skin, hair, or wood (that
Brian R. Lockhart; John D. Hodges
2005-01-01
Gas-exchange measurements, including C022-exchange rate (net photosynthesis), stomatal conductance, and transpiration, were conducted on intact and clipped cherrybark oak (Quercus pagoda Raf.) seedlings growing in the field and in a nursery bed. Seedlings in the field, released from midstory and understory woody competition,...
Climate Prediction Center - NCEP Global Ocean Data Assimilation System:
home page National Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Monthly in NetCDF Other formats Links NOAA Ocean Climate Observation Program (OCO) Climate Test Bed About Prediction (NCEP) are a valuable community asset for monitoring different aspects of ocean climate
Kumar, Aryavarta M S; Miller, Jonathan; Hoffer, Seth A; Mansur, David B; Coffey, Michael; Lo, Simon S; Sloan, Andrew E; Machtay, Mitchell
2018-05-10
HSRT directed to large surgical beds in patients with resected brain metastases improves local control while sparing patients the toxicity associated with whole brain radiation. We review our institutional series to determine factors predictive of local failure. In a total of 39 consecutive patients with brain metastases treated from August 2011 to August 2016, 43 surgical beds were treated with HSRT in three or five fractions. All treatments were completed on a robotic radiosurgery platform using the 6D Skull tracking system. Volumetric MRIs from before and after surgery were used for radiation planning. A 2-mm PTV margin was used around the contoured surgical bed and resection margins; these were reviewed by the radiation oncologist and neurosurgeon. Lower total doses were prescribed based on proximity to critical structures or if prior radiation treatments were given. Local control in this study is defined as no volumetric MRI evidence of recurrence of tumor within the high dose radiation volume. Statistics were calculated using JMP Pro v13. Of the 43 surgical beds analyzed, 23 were from NSCLC, 5 were from breast, 4 from melanoma, 5 from esophagus, and 1 each from SCLC, sarcoma, colon, renal, rectal, and unknown primary. Ten were treated with three fractions with median dose 24 Gy and 33 were treated with five fractions with median dose 27.5 Gy using an every other day fractionation. There were no reported grade 3 or higher toxicities. Median follow up was 212 days after completion of radiation. 10 (23%) surgical beds developed local failure with a median time to failure of 148 days. All but three patients developed new brain metastases outside of the treated field and were treated with stereotactic radiosurgery, whole brain radiation and/or chemotherapy. Five patients (13%) developed leptomeningeal disease. With a median follow up of 226 days, 30 Gy/5 fx was associated with the best local control (93%) with only 1 local failure. A lower total dose in five fractions (ie 27.5 or 25 Gy) had a local control rate of 70%. For three fraction SBRT, local control was 100% using a dose of 27 Gy in three fractions (follow up was > 600 days) and 71% if 24 Gy in three fractions was used. A higher total biologically equivalent dose (BED 10 ) was statistically significant for improved local control (p = 0.04) with a threshold BED 10 ≥ 48 associated with better local control. HSRT after surgical resection for brain metastasis is well tolerated and has improved local control with BED 10 ≥ 48 (30 Gy/5 fx and 27 Gy/3 fx). Additional study is warranted.
Near-Bed Turbulent Kinetic Energy Budget Under a Large-Scale Plunging Breaking Wave Over a Fixed Bar
NASA Astrophysics Data System (ADS)
van der Zanden, Joep; van der A, Dominic A.; Cáceres, Iván.; Hurther, David; McLelland, Stuart J.; Ribberink, Jan S.; O'Donoghue, Tom
2018-02-01
Hydrodynamics under regular plunging breaking waves over a fixed breaker bar were studied in a large-scale wave flume. A previous paper reported on the outer flow hydrodynamics; the present paper focuses on the turbulence dynamics near the bed (up to 0.10 m from the bed). Velocities were measured with high spatial and temporal resolution using a two component laser Doppler anemometer. The results show that even at close distance from the bed (1 mm), the turbulent kinetic energy (TKE) increases by a factor five between the shoaling, and breaking regions because of invasion of wave breaking turbulence. The sign and phase behavior of the time-dependent Reynolds shear stresses at elevations up to approximately 0.02 m from the bed (roughly twice the elevation of the boundary layer overshoot) are mainly controlled by local bed-shear-generated turbulence, but at higher elevations Reynolds stresses are controlled by wave breaking turbulence. The measurements are subsequently analyzed to investigate the TKE budget at wave-averaged and intrawave time scales. Horizontal and vertical turbulence advection, production, and dissipation are the major terms. A two-dimensional wave-averaged circulation drives advection of wave breaking turbulence through the near-bed layer, resulting in a net downward influx in the bar trough region, followed by seaward advection along the bar's shoreward slope, and an upward outflux above the bar crest. The strongly nonuniform flow across the bar combined with the presence of anisotropic turbulence enhances turbulent production rates near the bed.
Liu, Hui; Xu, Jian-Wei; Yang, Heng-Lin; Li, Mei; Sun, Cheng-De; Yin, Yi-Jie; Zheng, Zhi-Liang; Zhang, Guang-Yun; Yu, Ai-Shui; Yang, Yong-Hui; Li, Chun-Hui; Ai, Shui
2016-04-25
From 2007 to 2013, intensive control measures reduced malaria burden by 90 % along the China-Myanmar border. However, despite these measures a P. falciparum malaria outbreak was reported in the Shan Special Region II of Myanmar in June of 2014. Epidemiological, parasitological and entomological investigations were performed. Dihydroartemisinin piperaquine (DAPQ) was immediately administered to treat parasite positive individuals. Long lasting insecticidal nets (LLIN), indoor residual spraying (IRS) with insecticides and behavior change communication (BCC) were also provided for outbreak control. An embedded efficacy study was conducted evaluating DP. Molecular genotyping via polymerase chain reaction (PCR) was performed on the Kelch gene on chromosome 13. All infections were identified as Plasmodium falciparum by RDT and microscopy. Two fatalities resulted from the outbreak. The attack rate was 72.8 % (67/92) and the incidence density rate was 14.2 per 100 person-weeks. The positive rate of rapid diagnostic test (RDT) was 72.2 % (65/90) and microscopically-determine parasite rate 42.2 % (38/90). Adjusted odds ratio (OR) of multivariate logistic regression analysis for aged <15 years, 15-45 years, inappropriate treatment from a private healer and lack of bed nets were 13.51 (95 % confidence interval, 2.21-105.89), 7.75 (1.48-44.97), 3.78 (1.30-46.18) and 3.21(1.21-15.19) respectively. In the six surrounding communities of the outbreak site, positive RDT rate was 1.2 % (4/328) and microscopically-determine parasite rate 0.6 % (2/328). Two light traps collected a total of 110 anopheline mosquitoes including local vectors, An. minimus, An. sinensis and An. maculates. After intensive control, the detection of malaria attacks, parasites and antigen were reduced to zero between July 1 and December 1, 2014. The cure rate of P. falciparum patients at day 42 was 94.3 % (95 % CI, 80.8-99.3 %). The PCR did not detect K13-propeller mutations. Imported P. falciparum caused the outbreak. Age, seeking inappropriate treatment and lack of bed nets were risk factors for infection during the outbreak. P. falciparum was sensitive to treatment with DAPQ. The integrated measures controlled the outbreak and prevented the spread of P. falciparum effectively. The results of this study indicate that malaria control on the China-Myanmar border, especially among special populations, needs further collaboration between China, Myanmar and international societies.
Sorted bed forms as self-organized patterns: 2. complex forcing scenarios
Coco, Giovanni; Murray, A. Brad; Green, Malcom O.; Thieler, E. Robert; Hume, T.M.
2007-01-01
We employ a numerical model to study the development of sorted bed forms under a variety of hydrodynamic and sedimentary conditions. Results indicate that increased variability in wave height decreases the growth rate of the features and can potentially give rise to complicated, a priori unpredictable, behavior. This happens because the system responds to a change in wave characteristics by attempting to self-organize into a patterned seabed of different geometry and spacing. The new wavelength might not have enough time to emerge before a new change in wave characteristics occurs, leading to less regular seabed configurations. The new seabed configuration is also highly dependent on the preexisting morphology, which further limits the possibility of predicting future behavior. For the same reasons, variability in the mean current magnitude and direction slows down the growth of features and causes patterns to develop that differ from classical sorted bed forms. Spatial variability in grain size distribution and different types of net sediment aggradation/degradation can also result in the development of sorted bed forms characterized by a less regular shape. Numerical simulations qualitatively agree with observed geometry (spacing and height) of sorted bed forms. Also in agreement with observations is that at shallower depths, sorted bed forms are more likely to be affected by changes in the forcing conditions, which might also explain why, in shallow waters, sorted bed forms are described as ephemeral features. Finally, simulations indicate that the different sorted bed form shapes and patterns observed in the field might not necessarily be related to diverse physical mechanisms. Instead, variations in sorted bed form characteristics may result from variations in local hydrodynamic and/or sedimentary conditions.
Pharmacological management of binge eating disorder: current and emerging treatment options
McElroy, Susan L; Guerdjikova, Anna I; Mori, Nicole; O’Melia, Anne M
2012-01-01
Growing evidence suggests that pharmacotherapy may be beneficial for some patients with binge eating disorder (BED), an eating disorder characterized by repetitive episodes of uncontrollable consumption of abnormally large amounts of food without inappropriate weight loss behaviors. In this paper, we provide a brief overview of BED and review the rationales and data supporting the effectiveness of specific medications or medication classes in treating patients with BED. We conclude by summarizing these data, discussing the role of pharmacotherapy in the BED treatment armamentarium, and suggesting future areas for research. PMID:22654518
Christensen, Kara A.; Fettich, Karla C.; Weissman, Jessica; Berona, Johnny; Chen, Eunice Y.
2017-01-01
Emotion dysregulation has been linked to binge eating disorder (BED) and bulimia nervosa (BN) although the mechanisms by which it affects BN/BED psychopathology are unclear. This study tested loneliness as a mediator between emotion dysregulation and BN/BED psychopathology. A treatment-seeking sample of 107 women with BN or BED was assessed for loneliness (UCLA Loneliness Scale), emotion dysregulation (Difficulties in Emotion Regulation Scale), and BN/BED psychopathology (Eating Disorder Examination) before treatment. Hierarchical linear regressions and bootstrapping mediation models were run. Greater overall emotion dysregulation was associated with greater BN/BED psychopathology, mediated by loneliness (95 % CI 0.03, 0.09). Emotion dysregulation, however, did not mediate between loneliness and BN/BED psychopathology (95 % CI −0.01, 0.01). Targeting loneliness may effectively treat emotional aspects of BN/BED in women. PMID:24235091
Sundberg, C; Tonderski, K; Lindgren, P E
2007-01-01
Constructed wetlands can be used to decrease the high ammonium concentrations in landfill leachates. We investigated nitrification/denitrification activity and the corresponding bacterial communities in landfill leachate that was treated in a compact constructed wetland, Tveta Recycling Facility, Sweden. Samples were collected at three depths in a filter bed and the sediment from a connected open pond in July, September and November 2004. Potential ammonia oxidation was measured by short-term incubation method and potential denitrification by the acetylene inhibition technique. The ammonia-oxidising and the denitrifying bacterial communities were investigated using group-specific PCR primers targeting 16S rRNA genes and the functional gene nosZ, respectively. PCR products were analysed by denaturing gradient gel electrophoresis and nucleotide sequencing. The same degree of nitrification activity was observed in the pond sediment and at all levels in the filter bed, whereas the denitrification activity decreased with filter bed depth. Denitrification rates were higher in the open pond, even though the denitrifying bacterial community was more diverse in the filter bed. The ammonia-oxidising community was also more varied in the filter bed. In the filter bed and the open pond, there was no obvious relationship between the nitrification/denitrification activities and the composition of the corresponding bacterial communities.
The potential of the anaerobic, expanded bed granular activated carbon (GAC) reactor in treating a high strength waste containing RCRA semivolatile organic compounds (VOCs) was studied. Six semivolatiles, orthochlorophenol, nitrobenzene, naphthalene, para-nitrophenol, lindane, a...
DEVELOPMENT OF AEROBIC BIOFILTER DESIGN CRITERIA FOR TREATING VOCS
This paper reports preliminary results on the use of trickle bed biofilters with monolithic ceramic channelized microbial support structures for the treatment of VOCs typical of landfill leachate stripping. Toluene was used for the purpose of characterizing the trickle bed biofi...
DESIGNING FIXED-BED ADSORBERS TO REMOVE MIXTURES OF ORGANICS.
A liquid-phase granular activated carbon (GAC) pilot plant and a full-scale GAC adsorber were designed, built, and operated in order to evaluate their performance for treating a groundwater contaminated with several volatile and synthetic organic chemicals. Several empty bed con...
Natural Ca Isotope Composition of Urine as a Rapid Measure of Bone Mineral Balance
NASA Astrophysics Data System (ADS)
Skulan, J.; Gordon, G. W.; Morgan, J.; Romaniello, S. J.; Smith, S. M.; Anbar, A. D.
2011-12-01
Naturally occurring stable Ca isotope variations in urine are emerging as a powerful tool to detect changes in bone mineral balance. Bone formation depletes soft tissue of light Ca isotopes while bone resorption releases isotopically light Ca into soft tissue. Previously published work found that variations in Ca isotope composition could be detected at 4 weeks of bed rest in a 90-day bed rest study (data collected at 4, 8 and 12 weeks). A new 30-day bed rest study involved 12 patients on a controlled diet, monitored for 7 days prior to bed rest and 7 days post bed rest. Samples of urine, blood and food were collected throughout the study. Four times daily blood samples and per void urine samples were collected to monitor diurnal or high frequency variations. An improved chemical purification protocol, followed by measurement using multiple collector inductively coupled plasma mass spectrometry (MC-ICP-MS) allowed accurate and precise determinations of mass-dependent Ca isotope variations in these biological samples to better than ±0.2% (δ44/42Ca) on <25 μg of Ca. Results from this new study show that Ca isotope ratios shift in a direction consistent with net bone loss after just 7 days, long before detectible changes in bone density by X-ray measurements occur. Consistent with this interpretation, the Ca isotope variations track changes observed in N-teleopeptide, a bone resorption biomarker. Bone-specific alkaline phosphatase, a bone formation biomarker, is unchanged over this period. Ca isotopes can in principle be used to quantify net changes in bone mass. Using a mass-balance model, our results indicate an average loss of 0.62 ± 0.16 % in bone mass over the course of this 30-day study. This is consistent with the rate of bone loss in longer-term studies as seen by X-ray measurements. This Ca isotope technique should accelerate the pace of discovery of new treatments for bone disease and provide novel insights into the dynamics of bone metabolism.
Tangena, Julie-Anne A; Adiamoh, Majidah; D'Alessandro, Umberto; Jarju, Lamin; Jawara, Musa; Jeffries, David; Malik, Naiela; Nwakanma, Davis; Kaur, Harparkash; Takken, Willem; Lindsay, Steve W; Pinder, Margaret
2013-01-01
Malaria vector control is threatened by resistance to pyrethroids, the only class of insecticides used for treating bed nets. The second major vector control method is indoor residual spraying with pyrethroids or the organochloride DDT. However, resistance to pyrethroids frequently confers resistance to DDT. Therefore, alternative insecticides are urgently needed. Insecticide resistance and the efficacy of indoor residual spraying with different insecticides was determined in a Gambian village. Resistance of local vectors to pyrethroids and DDT was high (31% and 46% mortality, respectively) while resistance to bendiocarb and pirimiphos methyl was low (88% and 100% mortality, respectively). The vectors were predominantly Anopheles gambiae s.s. with 94% of them having the putative resistant genotype kdr 1014F. Four groups of eight residential compounds were each sprayed with either (1) bendiocarb, a carbamate, (2) DDT, an organochlorine, (3) microencapsulated pirimiphos methyl, an organophosphate, or (4) left unsprayed. All insecticides tested showed high residual activity up to five months after application. Mosquito house entry, estimated by light traps, was similar in all houses with metal roofs, but was significantly less in IRS houses with thatched roofs (p=0.02). Residents participating in focus group discussions indicated that IRS was considered a necessary nuisance and also may decrease the use of long-lasting insecticidal nets. Bendiocarb and microencapsulated pirimiphos methyl are viable alternatives for indoor residual spraying where resistance to pyrethroids and DDT is high and may assist in the management of pyrethroid resistance.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cook, L.L.; Gostomski, P.A.; Apel, W.A.
1999-09-30
In response to complaints from nearby residents, a biofilter was designed, installed, and tested for treating odors in one of three odorous emission streams from an asphalt plant producing polymer-modified asphalt. Hydrogen sulfide (H{sub 2}S) was determined to be the most prevalent gaseous reduced sulfur compound and was detected in the emission stream only when polymer material was being added to raw asphalt. Emission stream H{sub 2}S concentrations were quite variable, ranging from 16 to approximately 30,000 ppm (v/v) and considered the likely compound contributing most to the plant's odor complaints. The biofilter was effective in controlling odor from themore » production process and removed an overall average of 65% of the H{sub 2}S during polymer addition, and for H{sub 2}S concentrations less than 400 ppmv, removal averaged 98%. These removal efficiencies reflect data from the biofilter operating at 2.5-minute empty bed residence time in 1996 and a 6.1-minute empty bed residence time in 1997. The biofilter's bed became increasingly acidified during the plant's 1997 operating season producing a pH gradient through the bed ranging from a high of 6.6 to a low of 3.1. The bed medium moisture content remained constant at about 60% (wet weight basis), but changes were observed in the water potential: no correlation to performance was determined. Changes in the microbial community reflected the bed acidification trend, with acidophiles becoming generally more numerous in the bed's deeper portions and in the mid to late season when the bed was most acidified. Bed acidification did not impact the biofilter's H{sub 2}S removal efficiency.« less
Recognizing Binge-Eating Disorder in the Clinical Setting: A Review of the Literature
Kornstein, Susan G.; Kunovac, Jelena L.; Herman, Barry K.; Culpepper, Larry
2016-01-01
Objective: Review the clinical skills needed to recognize, diagnose, and manage binge-eating disorder (BED) in a primary care setting. Data Sources: A PubMed search of English-language publications (January 1, 2008–December 11, 2014) was conducted using the term binge-eating disorder. Relevant articles known to the authors were also included. Study Selection/Data Extraction: Publications focusing on preclinical topics (eg, characterization of receptors and neurotransmitter systems) without discussing clinical relevance were excluded. A total of 101 publications were included in this review. Results: Although BED is the most prevalent eating disorder, it is underdiagnosed and undertreated. BED can be associated with medical (eg, type 2 diabetes and metabolic syndrome) and psychiatric (eg, depression and anxiety) comorbidities that, if left untreated, can impair quality of life and functionality. Primary care physicians may find diagnosing and treating BED challenging because of insufficient knowledge of its new diagnostic criteria and available treatment options. Furthermore, individuals with BED may be reluctant to seek treatment because of shame, embarrassment, and a lack of awareness of the disorder. Several short assessment tools are available to screen for BED in primary care settings. Pharmacotherapy and psychotherapy should focus on reducing binge-eating behavior, thereby reducing medical and psychiatric complications. Conclusions: Overcoming primary care physician– and patient-related barriers is critical to accurately diagnose and appropriately treat BED. Primary care physicians should take an active role in the initial recognition and assessment of suspected BED based on case-finding indicators (eg, eating habits and being overweight), the initial treatment selection, and the long-term follow-up of patients who meet DSM-5 BED diagnostic criteria. PMID:27733955
Local Control After Stereotactic Body Radiation Therapy for Liver Tumors.
Ohri, Nitin; Tomé, Wolfgang A; Méndez Romero, Alejandra; Miften, Moyed; Ten Haken, Randall K; Dawson, Laura A; Grimm, Jimm; Yorke, Ellen; Jackson, Andrew
2018-01-06
To quantitatively evaluate published experiences with hepatic stereotactic body radiation therapy (SBRT), to determine local control rates after treatment of primary and metastatic liver tumors and to examine whether outcomes are affected by SBRT dosing regimen. We identified published articles that reported local control rates after SBRT for primary or metastatic liver tumors. Biologically effective doses (BEDs) were calculated for each dosing regimen using the linear-quadratic equation. We excluded series in which a wide range of BEDs was used. Individual lesion data for local control were extracted from actuarial survival curves, and data were aggregated to form a single dataset. Actuarial local control curves were generated using the Kaplan-Meier method after grouping lesions by disease type and BED (<100 Gy 10 vs >100 Gy 10 ). Comparisons were made using log-rank testing. Thirteen articles met all inclusion criteria and formed the dataset for this analysis. The 1-, 2-, and 3-year actuarial local control rates after SBRT for primary liver tumors (n = 431) were 93%, 89%, and 86%, respectively. Lower 1- (90%), 2- (79%), and 3-year (76%) actuarial local control rates were observed for liver metastases (n = 290, log-rank P = .011). Among patients treated with SBRT for primary liver tumors, there was no evidence that local control is influenced by BED within the range of schedules used. For liver metastases, on the other hand, outcomes were significantly better for lesions treated with BEDs exceeding 100 Gy 10 (3-year local control 93%) than for those treated with BEDs of ≤100 Gy 10 (3-year local control 65%, P < .001). Stereotactic body radiation therapy for primary liver tumors provides high rates of durable local control, with no clear evidence for a dose-response relationship among commonly utilized schedules. Excellent local control rates are also seen after SBRT for liver metastases when BEDs of >100 Gy 10 are utilized. Copyright © 2018 Elsevier Inc. All rights reserved.
Planted floating bed performance in treatment of eutrophic river water.
Bu, Faping; Xu, Xiaoyi
2013-11-01
The objective of the study was to treat eutrophic river water using floating beds and to identify ideal plant species for design of floating beds. Four parallel pilot-scale units were established and vegetated with Canna indica (U1), Accords calamus (U2), Cyperus alternifolius (U3), and Vetiveria zizanioides (U4), respectively, to treat eutrophic river water. The floating bed was made of polyethylene foam, and plants were vegetated on it. Results suggest that the floating bed is a viable alternative for treating eutrophic river water, especially for inhibiting algae growth. When the influent chemical oxygen demand (COD) varied from 6.53 to 18.45 mg/L, total nitrogen (TN) from 6.82 to 12.25 mg/L, total phosphorus (TP) from 0.65 to 1.64 mg/L, and Chla from 6.22 to 66.46 g/m(3), the removal of COD, TN, TP, and Chla was 15.3%-38.4%, 25.4%-48.4%, 16.1%-42.1%, and 29.9 %-88.1%, respectively. Ranked by removal performance, U1 was best, followed by U2, U3, and U4. In the floating bed, more than 60% TN and TP were removed by sedimentation; plant uptake was quantitatively of low importance with an average removal of 20.2% of TN and 29.4% of TP removed. The loss of TN (TP) was of the least importance. Compared with the other three, U1 exhibited better dissolved oxygen (DO) gradient distributions, higher DO levels, higher hydraulic efficiency, and a higher percentage of nutrient removal attributable to plant uptake; in addition, plant development and the volume of nutrient storage in the C. indica tissues outperformed the other three species. C. indica thus could be selected when designing floating beds for the Three Gorges Reservoir region of P. R. China.
Heat transfer to small horizontal cylinders immersed in a fluidized bed
DOE Office of Scientific and Technical Information (OSTI.GOV)
Friedman, J.; Koundakjian, P.; Naylor, D.
2006-10-15
Heat transfer to horizontal cylinders immersed in fluidized beds has been extensively studied, but mainly in the context of heat transfer to boiler tubes in coal-fired beds. As a result, most correlations in the literature have been derived for cylinders of 25-50 mm diameter in vigorously fluidizing beds. In recent years, fluidized bed heat treating furnaces fired by natural gas have become increasingly popular, particularly in the steel wire manufacturing industry. These fluidized beds typically operate at relatively low fluidizing rates and with small diameter wires (1-6 mm). Nusselt number correlations developed based on boiler tube studies do not extrapolatemore » down to these small size ranges and low fluidizing rates. In order to obtain reliable Nusselt number data for these size ranges, an experimental investigation has been undertaken using two heat treating fluidized beds; one a pilot-scale industrial unit and the other a lab-scale (300 mm diameter) unit. Heat transfer measurements were obtained using resistively heated cylindrical samples ranging from 1.3 to 9.5 mm in diameter at fluidizing rates ranging from approximately 0.5 x G{sub mf} (packed bed condition) to over 10 x G{sub mf} using aluminum oxide sand particles ranging from d{sub p}=145-330 {mu}m (50-90 grit). It has been found that for all cylinder sizes tested, the Nusselt number reaches a maximum near 2 x G{sub mf}, then remains relatively steady ({+-}5-10%) to the maximum fluidizing rate tested, typically 8-12xG{sub mf}. A correlation for maximum Nusselt number is developed.« less
The economic benefit of treating subclinical Streptococcus agalactiae mastitis in lactating cows.
Yamagata, M; Goodger, W J; Weaver, L; Franti, C
1987-12-15
The economic benefits of treating lactating cows for Streptococcus agalactiae mastitis were studied at a large (689 milking cows) central California dairy. Postcure milk production of case cows (infected, treated, and cured) was compared with production of paired control cows (uninfected) and was matched for yield, days in milk, days in gestation, and parity. A simulation was used to plot expected lactation curves for mastitic cows (infected, not treated) with characteristics similar to those of each control cow, and these curves were compared with actual case-cow lactation curves. The difference in actual and expected production was used to calculate net economic benefits of treatment. Comparison of expected with actual production indicated a net benefit from treatment of $396/cow for cows treated in early lactation and $237 for cows treated in midlactation, but a net loss of $55 for cows treated in late lactation. Lactation number did not have a significant impact on economic benefits of treatment. In contrast to other studies indicating no economic benefit from treating mastitis during lactation, this study's positive results may have been attributable to the high cure rate (98%) and the subclinical form of mastitis being treated. Streptococcus agalactiae mastitis treatment during early and midlactation would appear to be an economically justifiable option for dairy managers.
TREATMENT OF VOCS IN HIGH STRENGTH WASTES USING AN ANAEROBIC EXPANDED-BED GAS REACTOR
The potential of the expanded-bed granular activated carbon (GAC) anaerobic reactor in treating a high strength waste containing RCRA volatile organic compounds (VOCs) was studied. A total of six VOCs, methylene chloride, chlorobenzene, carbon tetrachloride, chloroform, toluene ...
Estimating the opportunity costs of bed-days.
Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark
2018-03-01
Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.
Neutrophil extracellular traps can activate alternative complement pathways.
Wang, H; Wang, C; Zhao, M-H; Chen, M
2015-09-01
The interaction between neutrophils and activation of alternative complement pathway plays a pivotal role in the pathogenesis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). ANCAs activate primed neutrophils to release neutrophil extracellular traps (NETs), which have recently gathered increasing attention in the development of AAV. The relationship between NETs and alternative complement pathway has not been elucidated. The current study aimed to investigate the relationship between NETs and alternative complement pathway. Detection of components of alternative complement pathway on NETs in vitro was assessed by immunostain and confocal microscopy. Complement deposition on NETs were detected after incubation with magnesium salt ethyleneglycol tetraacetic acid (Mg-EGTA)-treated human serum. After incubation of serum with supernatants enriched in ANCA-induced NETs, levels of complement components in supernatants were measured by enzyme-linked immunosorbent assay (ELISA). Complement factor B (Bb) and properdin deposited on NETs in vitro. The deposition of C3b and C5b-9 on NETs incubated with heat-inactivated normal human serum (Hi-NHS) or EGTA-treated Hi-NHS (Mg-EGTA-Hi-NHS) were significantly less than that on NETs incubated with NHS or EGTA-treated NHS (Mg-EGTA-NHS). NETs induced by ANCA could activate the alternative complement cascade in the serum. In the presence of EGTA, C3a, C5a and SC5b-9 concentration decreased from 800·42 ± 244·81 ng/ml, 7·68 ± 1·50 ng/ml, 382·15 ± 159·75 ng/ml in the supernatants enriched in ANCA induced NETs to 479·07 ± 156·2 ng/ml, 4·86 ± 1·26 ng/ml, 212·65 ± 44·40 ng/ml in the supernatants of DNase I-degraded NETs (P < 0·001, P = 0·008, P < 0·001, respectively). NETs could activate the alternative complement pathway, and might thus participate in the pathogenesis of AAV. © 2015 British Society for Immunology.
Cernicchiaro, Natalia; White, Brad J; Renter, David G; Babcock, Abram H
2013-02-01
To evaluate associations between economic and performance outcomes with the number of treatments after an initial diagnosis of bovine respiratory disease (BRD) in commercial feedlot cattle. 212,867 cattle arriving in a Midwestern feedlot between 2001 and 2006. An economic model was created to estimate net returns. Generalized linear mixed models were used to determine associations between the frequency of BRD treatments and other demographic variables with economic and performance outcomes. Net returns decreased with increasing number of treatments for BRD. However, the magnitude depended on the season during which cattle arrived at the feedlot, with significantly higher returns for cattle arriving during fall and summer than for cattle arriving during winter and spring. For fall arrivals, there were higher mean net returns for cattle that were never treated ($39.41) than for cattle treated once ($29.49), twice ($16.56), or ≥ 3 times (-$33.00). For summer arrivals, there were higher least squares mean net returns for cattle that were never treated ($31.83) than for cattle treated once ($20.22), twice ($6.37), or ≥ 3 times ($-42.56). Carcass traits pertaining to weight and quality grade were deemed responsible for differences in net returns among cattle receiving different numbers of treatments after an initial diagnosis of BRD. Differences in economic net returns and performance outcomes for feedlot cattle were determined on the basis of number of treatments after an initial diagnosis of BRD; the analysis accounted for the season of arrival, sex, and weight class.
Zhang, Jin-Sheng; Yuan, Xing-Zhong; Zeng, Guang-Ming; Dong, Bei-Bei; Liang, Yun-Shan
2009-11-01
In this study, the system composed with the external loop fluidized bed reactor and constructed wetland was used to treat the landfill leachate. The change of water quality for the landfill leachate treated by this system was investigated. The experimental results indicated that the COD and NH4(+) -N of the influent reduced from 4000 mg x L(-1) and 300 mg x L(-1) to 1 500 mg x L(-1) and 150 mg x L(-1) after the external loop three phase fluidized bed reactor and steady at 200 mg x L(-1) and 10 mg x L(-1) behind treated by the constructed wetland. The heavy metals of Cd, Zn, Pb were also reduced for treatment by external loop three phase fluidized bed reactor. They were steady at 0.01 mg x L(-1), 0.5 mg x L(-1), 0.1 mg x L(-1) from 0.12 mg x L(-1), 3.0 mg x L(-1), 1.4 mg x L(-1) because of the constructed wetland. We also compared the different plants for the efficiency, the results showed that whatever plants, there was little effects on the efficiency of the COD and NH4(+) -N, but the effect of heavy metal was markedness.
Packed Bed Bioreactor for the Isolation and Expansion of Placental-Derived Mesenchymal Stromal Cells
Osiecki, Michael J.; Michl, Thomas D.; Kul Babur, Betul; Kabiri, Mahboubeh; Atkinson, Kerry; Lott, William B.; Griesser, Hans J.; Doran, Michael R.
2015-01-01
Large numbers of Mesenchymal stem/stromal cells (MSCs) are required for clinical relevant doses to treat a number of diseases. To economically manufacture these MSCs, an automated bioreactor system will be required. Herein we describe the development of a scalable closed-system, packed bed bioreactor suitable for large-scale MSCs expansion. The packed bed was formed from fused polystyrene pellets that were air plasma treated to endow them with a surface chemistry similar to traditional tissue culture plastic. The packed bed was encased within a gas permeable shell to decouple the medium nutrient supply and gas exchange. This enabled a significant reduction in medium flow rates, thus reducing shear and even facilitating single pass medium exchange. The system was optimised in a small-scale bioreactor format (160 cm2) with murine-derived green fluorescent protein-expressing MSCs, and then scaled-up to a 2800 cm2 format. We demonstrated that placental derived MSCs could be isolated directly within the bioreactor and subsequently expanded. Our results demonstrate that the closed system large-scale packed bed bioreactor is an effective and scalable tool for large-scale isolation and expansion of MSCs. PMID:26660475
Osiecki, Michael J; Michl, Thomas D; Kul Babur, Betul; Kabiri, Mahboubeh; Atkinson, Kerry; Lott, William B; Griesser, Hans J; Doran, Michael R
2015-01-01
Large numbers of Mesenchymal stem/stromal cells (MSCs) are required for clinical relevant doses to treat a number of diseases. To economically manufacture these MSCs, an automated bioreactor system will be required. Herein we describe the development of a scalable closed-system, packed bed bioreactor suitable for large-scale MSCs expansion. The packed bed was formed from fused polystyrene pellets that were air plasma treated to endow them with a surface chemistry similar to traditional tissue culture plastic. The packed bed was encased within a gas permeable shell to decouple the medium nutrient supply and gas exchange. This enabled a significant reduction in medium flow rates, thus reducing shear and even facilitating single pass medium exchange. The system was optimised in a small-scale bioreactor format (160 cm2) with murine-derived green fluorescent protein-expressing MSCs, and then scaled-up to a 2800 cm2 format. We demonstrated that placental derived MSCs could be isolated directly within the bioreactor and subsequently expanded. Our results demonstrate that the closed system large-scale packed bed bioreactor is an effective and scalable tool for large-scale isolation and expansion of MSCs.
Thermal and chemical remediation of mixed waste
Nelson, P.A.; Swift, W.M.
1994-08-09
A process and system for treating organic waste materials without venting gaseous emissions to the atmosphere. A fluidized bed including lime particles is operated at a temperature of at least 500 C by blowing gas having 20%/70% oxygen upwardly through the bed particles at a rate sufficient to fluidize same. A toxic organic waste material is fed into the fluidized bed where the organic waste material reacts with the lime forming CaCO[sub 3]. The off gases are filtered and cooled to condense water which is separated. A portion of the calcium carbonate formed during operation of the fluidized bed is replaced with lime particles. The off gases from the fluidized bed after drying are recirculated until the toxic organic waste material in the bed is destroyed. 3 figs.
Thermal and chemical remediation of mixed waste
Nelson, Paul A.; Swift, William M.
1994-01-01
A process and system for treating organic waste materials without venting gaseous emissions to the atmosphere. A fluidized bed including lime particles is operated at a temperature of at least 500.degree. C. by blowing gas having 20%/70% oxygen upwardly through the bed particles at a rate sufficient to fluidize same. A toxic organic waste material is fed into the fluidized bed where the organic waste material reacts with the lime forming CaCO.sub.3. The off gases are filtered and cooled to condense water which is separated. A portion of the calcium carbonate formed during operation of the fluidized bed is replaced with lime particles. The off gases from the fluidized bed after drying are recirculated until the toxic organic waste material in the bed is destroyed.
Photo Initiated Chemical Vapour Deposition To Increase Polymer Hydrophobicity
NASA Astrophysics Data System (ADS)
Bérard, Ariane; Patience, Gregory S.; Chouinard, Gérald; Tavares, Jason R.
2016-08-01
Apple growers face new challenges to produce organic apples and now many cover orchards with high-density polyethylene (HDPE) nets to exclude insects, rather than spraying insecticides. However, rainwater- associated wetness favours the development of apple scabs, Venturia inaequalis, whose lesions accumulate on the leaves and fruit causing unsightly spots. Treating the nets with a superhydrophobic coating should reduce the amount of water that passes through the net. Here we treat HDPE and polyethylene terephthalate using photo-initiated chemical vapour deposition (PICVD). We placed polymer samples in a quartz tube and passed a mixture of H2 and CO through it while a UVC lamp (254 nm) illuminated the surface. After the treatment, the contact angle between water droplets and the surface increased by an average of 20°. The contact angle of samples placed 70 cm from the entrance of the tube was higher than those at 45 cm and 20 cm. The PICVD-treated HDPE achieved a contact angle of 124°. Nets spray coated with a solvent-based commercial product achieved 180° but water ingress was, surprisingly, higher than that for nets with a lower contact angle.
Testing a Threshold-Based Bed Bug Management Approach in Apartment Buildings.
Singh, Narinderpal; Wang, Changlu; Zha, Chen; Cooper, Richard; Robson, Mark
2017-07-26
We tested a threshold-based bed bug ( Cimex lectularius L.) management approach with the goal of achieving elimination with minimal or no insecticide application. Thirty-two bed bug infested apartments were identified. These apartments were divided into four treatment groups based on apartment size and initial bed bug count, obtained through a combination of visual inspection and bed bug monitors: I- Non-chemical only in apartments with 1-12 bed bug count, II- Chemical control only in apartments with 1-12 bed bug count, III- Non-chemical and chemical control in apartments with >12 bed bug count, and IV- Chemical control only in apartments with ≥11 bed bug count. All apartments were monitored or treated once every two weeks for a maximum of 28 wk. Treatment I eliminated bed bugs in a similar amount of time to treatment II. Time to eliminate bed bugs was similar between treatment III and IV but required significantly less insecticide spray in treatment III than that in treatment IV. A threshold-based management approach (non-chemical only or non-chemical and chemical) can eliminate bed bugs in a similar amount of time, using little to no pesticide compared to a chemical only approach.
Efficacy of three different steamers for control of bed bugs (Cimex lectularius L.).
Wang, Desen; Wang, Changlu; Wang, Guohong; Zha, Chen; Eiden, Amanda L; Cooper, Richard
2018-04-15
Bed bugs, Cimex lectularius L., have become one of the most difficult urban pests to control. Steam treatment is reported to be an effective method to kill bed bugs and is considered to be an important component of bed bug integrated pest management (IPM). We evaluated and compared the efficacy of two affordable consumer-grade commercial steamers to a commonly used professional-grade steamer for killing bed bugs. In laboratory experiments, the consumer-grade steamer at an affordable price achieved the same high control efficacy as the professional-grade steamer for treating bed bugs exposed on mattresses (100% bed bug mortality), located beneath a fabric cover (>89% bed bug mortality), or hiding in cracks (100% bed bug mortality). Bed bugs located behind a leather cover did not suffer significant mortality from steam treatment regardless of the type of steamers used and treatment duration. Proper use of steamers can kill all life stages of bed bugs. Affordable consumer-grade steamers are as effective as professional-grade steam machines for eliminating bed bugs resting on mattresses, hiding behind fabric materials, or in cracks. This article is protected by copyright. All rights reserved.
Testing a Threshold-Based Bed Bug Management Approach in Apartment Buildings
Singh, Narinderpal; Zha, Chen; Cooper, Richard; Robson, Mark
2017-01-01
We tested a threshold-based bed bug (Cimex lectularius L.) management approach with the goal of achieving elimination with minimal or no insecticide application. Thirty-two bed bug infested apartments were identified. These apartments were divided into four treatment groups based on apartment size and initial bed bug count, obtained through a combination of visual inspection and bed bug monitors: I- Non-chemical only in apartments with 1–12 bed bug count, II- Chemical control only in apartments with 1–12 bed bug count, III- Non-chemical and chemical control in apartments with >12 bed bug count, and IV- Chemical control only in apartments with ≥11 bed bug count. All apartments were monitored or treated once every two weeks for a maximum of 28 wk. Treatment I eliminated bed bugs in a similar amount of time to treatment II. Time to eliminate bed bugs was similar between treatment III and IV but required significantly less insecticide spray in treatment III than that in treatment IV. A threshold-based management approach (non-chemical only or non-chemical and chemical) can eliminate bed bugs in a similar amount of time, using little to no pesticide compared to a chemical only approach. PMID:28933720
Streambed Mobility and Dispersal of Aquatic Insect Larvae: Results from a Laboratory Study.
NASA Astrophysics Data System (ADS)
Kenworthy, S. T.
2002-12-01
Three series of flume experiments were conducted to quantify relationships between entrainment of surface layer gravels and displacement of benthic insect larvae. One series (B) utilized a sediment mixture with a median size 6.9 mm, maximum size 45 mm, and 10% < 2mm. Two other series examined the effects of locally coarsening the bed surface (Bc) and increasing the < 2mm fraction to 20% (S). Aquatic insect larvae were collected in the field and placed in an upstream segment of the flume bed. Flow rate, flume slope, and sediment transport rate were varied systematically among experiments. Displaced larvae were collected in a net at the end of the flume. The distribution of larvae remaining in the bed was obtained by sorting larvae from the sediment in 25 channel segments. Flow rate and mean boundary shear stress varied among runs by factors of 1.2 and 2.4 respectively. Proportional entrainment of >11mm surface grains ranged from <0.05 to >0.90. Displacement of insect larvae increased in a regular and consistent manner with increasing flow strength and surface sediment entrainment. Significant displacement occurred for some types of larvae (Ephemerellid mayflies) over a relatively low range of shear stress and bed surface entrainment. Other larvae (Atherix sp.) were displaced only at the highest levels of bed surface entrainment. Displacement was lower from coarsened bed surfaces in series Bc, and higher from sandier sediments in series S experiments. The differential effects of bed surface entrainment upon various types of larvae are consistent with anatomical and behavioral differences that influence exposure to near-bed flow and bedload transport. These results suggest that spatial patterns of sediment mobilization are important for understanding patterns of dispersal and disturbance of streambed communities.
Marine bacterial degradation of brominated methanes
Goodwin, K.D.; Lidstrom, M.E.; Oremland, R.S.
1997-01-01
Brominated methanes are ozone-depleting compounds whose natural sources include marine algae such as kelp. Brominated methane degradation by bacteria was investigated to address whether bacterial processes might effect net emission of these compounds to the atmosphere. Bacteria in seawater collected from California kelp beds degraded CH2Br2 but not CHBr3. Specific inhibitors showed that methanotrophs and nitrifiers did not significantly contribute to CH2Br2 removal. A seawater enrichment culture oxidized 14CH2Br2 to 14CO2 as well as 14CH3Br to 14CO2. The rates of CH2Br2 degradation in laboratory experiments suggest that bacterial degradation of CH2Br2 in a kelp bed accounts for <1% of the CH2Br2 produced by the kelp. However, the half-life of CH2Br2 due to bacterial removal appears faster than hydrolysis and within an order of magnitude of volatilization to the atmosphere.Brominated methanes are ozone-depleting compounds whose natural sources include marine algae such as kelp. Brominated methane degradation by bacteria was investigated to address whether bacterial processes might effect net emission of these compounds to the atmosphere. Bacteria in seawater collected from California kelp beds degraded CH2Br2 but not CHBr3. Specific inhibitors showed that methanotrophs and nitrifiers did not significantly contribute to CH2Br2 removal. A seawater enrichment culture oxidized 14CH2Br2 to 14CO2 as well as 14CH3Br to 14CO2. The rates of CH2Br2 degradation in laboratory experiments suggest that bacterial degradation of CH2Br2 in a kelp bed accounts for <1% of the CH2Br2 produced by the kelp. However, the half-life of CH2Br2 due to bacterial removal appears faster than hydrolysis and within an order of magnitude of volatilization to the atmosphere.
2010-01-01
Background Insecticide-treated nets (ITNs) are becoming increasingly available to vulnerable populations at risk for malaria. Their appropriate and consistent use is essential to preventing malaria, but ITN use often lags behind ITN ownership. In order to increase ITN use, it is necessary to devise strategies that accurately identify, differentiate, and target the reasons and types of non-use. Methods A simple method based on the end-user as the denominator was employed to classify each individual into one of four ITN use categories: 1) living in households not owning an ITN; 2) living in households owning, but not hanging an ITN; 3) living in households owning and hanging an ITN, but who are not sleeping under one; and 4) sleeping under an ITN. This framework was applied to survey data designed to evaluate long-lasting insecticidal nets (LLINs) distributions following integrated campaigns in five countries: Togo, Sierra Leone, Madagascar, Kenya and Niger. Results The percentage of children <5 years of age sleeping under an ITN ranged from 51.5% in Kenya to 81.1% in Madagascar. Among the three categories of non-use, children living in households without an ITN make up largest group (range: 9.4%-30.0%), despite the efforts of the integrated child health campaigns. The percentage of children who live in households that own but do not hang an ITN ranged from 5.1% to 16.1%. The percentage of children living in households where an ITN was suspended, but who were not sleeping under it ranged from 4.3% to 16.4%. Use by all household members in Sierra Leone (39.9%) and Madagascar (60.4%) indicate that integrated campaigns reach beyond their desired target populations. Conclusions The framework outlined in this paper provides a helpful tool to examine the deficiencies in ITN use. Monitoring and evaluation strategies designed to assess ITN ownership and use can easily incorporate this approach using existing data collection instruments that measure the standard indicators. PMID:20482776
NASA Technical Reports Server (NTRS)
Smith, Scott M.; Zwart, S. R.; Hargens, A. r.
2006-01-01
Dietary potassium and protein intakes predict net endogenous acid production in humans. Intracellular buffers, including exchangeable bone mineral, play a crucial role in balancing chronic acid-base perturbations in the body; subsequently, chronic acid loads can potentially contribute to bone loss. Bone is lost during space flight, and a dietary countermeasure would be desirable for many reasons. We studied the ability of diet protein and potassium to predict levels of bone resorption markers in males and females. Identical twin pairs (8 M, 7 F) were assigned to 2 groups: bed rest (sedentary, SED) or bed rest with supine treadmill exercise in a lower body negative pressure chamber (EX). Diet was controlled for 3 d before and 30 d of bed rest (BR). Urinary Ca, N-telopeptide (NTX), and pyridinium crosslinks (PYD) were measured before and on days 5, 12, 19, and 26 of BR. Data were analyzed by Pearson correlation (P<0.05). The ratio of dietary animal protein/potassium intake was not correlated with NTX before BR for males or females, but they were positively correlated in both groups of males during bed rest. Dietary animal protein/potassium and urine Ca were correlated before and during bed rest for the males, and only during bed rest for the females. Conversely, the ratio of dietary vegetable protein/potassium intake was negatively correlated with urinary calcium during bed rest for the females, but there was no relationship between vegetable protein/potassium intake and bone markers for the males. These data suggest that the ratio of animal protein/potassium intake may affect bone, particularly in bed rest subjects. These data show that the type of protein and gender may be additional factors that modulate the effect of diet on bone metabolism during bed rest. Altering this ratio may help prevent bone loss on Earth and during space flight.
Fraser-Hurt, N.; Lyimo, E. O.
1998-01-01
The Rotary Net Initiative, implemented in Kilombero District, southern United Republic of Tanzania, allowed us to explore different sales channels for the distribution of insecticide-treated nets (ITNs) and the insecticide treatment service in a rural area of very high malaria transmission. Several types of ITNs were promoted and sold through different channels in the public and private sector, i.e. hospital pharmacy, mother and child health (MCH) clinic, net committee, village health workers and retail shops. The ITNs were sold for US$ 5.0-9.2, with profit margins of 9-16%. Net treatment cost US$ 0.33, with commission fees of 75%. Net transport and treatment were partially subsidized. Some outlets established their own fund by ITN sales. Sales of nets and treatments were seasonal, and certain net types were preferred. Demand for insecticide treatment was generally low. Changes in net coverage were assessed in two villages. A range of outlet features were compared qualitatively. Our experience supports suggestions that ITN technology should be delivered through MCH care services and demonstrates that specific promotion and innovation are necessary to achieve substantial net treatment levels. A large-scale ITN project in the same area and other ITN studies should lead to better understanding of ITN implementation at the population level. PMID:10191557
Pophali, G R; Khan, R; Dhodapkar, R S; Nandy, T; Devotta, S
2007-12-01
This paper addresses the treatment of purified terephthalic acid (PTA) effluent using anaerobic and aerobic processes. Laboratory studies were carried out on flow proportionate composite wastewater generated from the manufacturing of PTA. An activated sludge process (ASP-two stage and single stage) and an upflow anaerobic fixed film fixed bed reactor (AFFFBR) were used, individually and in combination. The performance of a full-scale ETP under existing operating conditions was also studied. Full scale ETP studies revealed that the treatment of PTA effluent using a two-stage ASP alone does not meet treated effluent quality within the prescribed Indian Standards. The biomass produced in the two stage ASP was very viscous and fluffy and the sludge volume index (SVI) was very high (200-450 ml/g). However, pretreatment of PTA effluent using an upflow AFFFBR ensured substantial reduction in BOD (63%) and COD (62%) with recovery of biogas at 1.8-1.96 l/l effluent treated at a volumetric loading rate (VLR) 4-5 kg COD/m(3) d. The methane content in the biogas varied between 55% and 60%. The pretreated effluent from the upflow AFFFBR was then treated through a single stage ASP. The biomass produced in the ASP after anaerobic treatment had very good settlability (SVI: 75-90 ml/g) as compared to the two stage ASP and the treated effluent quality with respect to BOD, COD and SS was within the prescribed Indian Standards. The alternative treatment process comprising an upflow AFFFBR and a single stage ASP ensured net power saving of 257 kW and in addition generated 442 kW of power through the AFFFBR.
Repert, Deborah A.; Underwood, Jennifer C.; Smith, Richard L.; Song, Bongkeun
2014-01-01
Information on the contribution of nitrogen (N)-cycling processes in bed sediments to river nutrient fluxes in large northern latitude river systems is limited. This study examined the relationship between N-cycling processes in bed sediments and N speciation and loading in the Yukon River near its mouth at the Bering Sea. We conducted laboratory bioassays to measure N-cycling processes in sediment samples collected over distinct water cycle seasons. In conjunction, the microbial community composition in the bed sediments using genes involved in N-cycling (narG, napA, nosZ, and amoA) and 16S rRNA gene pyrosequences was examined. Temporal variation was observed in net N mineralization, nitrate uptake, and denitrification rate potentials and correlated strongly with sediment carbon (C) and extractable N content and microbial community composition rather than with river water nutrient concentrations. The C content of the bed sediment was notably impacted by the spring flood, ranging from 1.1% in the midst of an ice-jam to 0.1% immediately after ice-out, suggesting a buildup of organic material (OM) prior to scouring of the bed sediments during ice break up. The dominant members of the microbial community that explained differences in N-processing rates belonged to the genera Crenothrix,Flavobacterium, and the family of Comamonadaceae. Our results suggest that biogeochemical processing rates in the bed sediments appear to be more coupled to hydrology, nutrient availability in the sediments, and microbial community composition rather than river nutrient concentrations at Pilot Station.
A fluidized bed enhances biotreatment
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1996-03-01
Chlorinated organics such as trichloroethylene (TCE) are often difficult to treat biologically because they degrade into intermediate compounds that are toxic to most microorganisms. But recent advances in fluidized bed biotreatment by Envirex, Inc. (Waukesha, Wis.) indicate that difficult-to-treat wastes like TCE can be successfully biodegraded. The key is to add chemicals (dubbed co-metabolic substrates), which promote the growth of microbes that preferentially degrade the unwanted intermediate compounds. Preliminary field tests using phenol, toluene and methane as the co-metabolic substrate show that TCE levels can be reduced by as much as 95%.
Health and agricultural productivity: Evidence from Zambia.
Fink, Günther; Masiye, Felix
2015-07-01
We evaluate the productivity effects of investment in preventive health technology through a randomized controlled trial in rural Zambia. In the experiment, access to subsidized bed nets was randomly assigned at the community level; 516 farmers were followed over a one-year farming period. We find large positive effects of preventative health investment on productivity: among farmers provided with access to free nets, harvest value increased by US$ 76, corresponding to about 14.7% of the average output value. While only limited information was collected on farming inputs, shifts in the extensive and the intensive margins of labor supply appear to be the most likely mechanism underlying the productivity improvements observed. Copyright © 2015 Elsevier B.V. All rights reserved.
26 CFR 1.613A-7 - Definitions.
Code of Federal Regulations, 2013 CFR
2013-04-01
... an interest of a partner in property of a partnership or a net profit interest) such taxpayer's... trust was created requires all or a portion of the gross or net proceeds of any royalty or other..., royalties, overriding royalties, net profits interests, and, to the extent not treated as loans under...
Fitzgerald, S.A.; Klump, J.V.; Swarzenski, P.W.; Mackenzie, R.A.; Richards, K.D.
2001-01-01
Short-term (???monthly) sediment deposition and resuspension rates of surficial bed sediments in two PCB-laden impoundments on the Fox River, WI, were determined in the summer and fall of 1998 using 7Be, a naturally occurring radioisotope produced in the atmosphere. Decay-corrected activities and inventories of 7Be were measured in bed sediment and in suspended particles. Beryilium-7 activities generally decreased with depth in the top 5-10 cm of sediments and ranged from undetectable to ???0.9 pCi cm-3. Inventories of 7Be, calculated from the sum of activities from all depths, ranged from 0.87 to 3.74 pCi cm-2, and the values covaried between sites likely reflecting a common atmospheric input signal. Activities of 7Be did not correlate directly with rainfall. Partitioning the 7Be flux into "new" and "residual" components indicated that net deposition was occurring most of the time during the summer. Net erosion, however, was observed at the upstream site from the final collection in the fall. This erosion event was estimated to have removed 0.10 g (cm of sediment)-2, corresponding to ???0.5 cm of sediment depth, and ???6-10 kg of polychlorinated biphenyls (PCBs) over the whole deposit. Short-term accumulation rates were up to ???130 times higher than the long-term rates calculated from 137Cs profiles, suggesting an extremely dynamic sediment transport environment, even within an impounded river system.Short-term (approximately monthly) sediment deposition and resuspension rates of surficial bed sediments in two PCB-laden impoundments on the Fox River, WI, were determined in the summer and fall of 1998 using 7Be, a naturally occurring radioisotope produced in the atmosphere. Decay-corrected activities and inventories of 7Be were measured in bed sediment and in suspended particles. Beryllium-7 activities generally decreased with depth in the top 5-10 cm of sediments and ranged from undetectable to approximately 0.9 pCi cm-3. Inventories of 7Be, calculated from the sum of activities from all depths, ranged from 0.87 to 3.74 pCi cm-2, and the values covaried between sites likely reflecting a common atmospheric input signal. Activities of 7Be did not correlate directly with rainfall. Partitioning the 7Be flux into `new' and `residual' components indicated that net deposition was occurring most of the time during the summer. Net erosion, however, was observed at the upstream site from the final collection in the fall. This erosion event was estimated to have removed 0.10 g (cm of sediment)-2, corresponding to approximately 0.5 cm of sediment depth, and approximately 6-10 kg of polychlorinated biphenyls (PCBs) over the whole deposit. Short-term accumulation rates were up to approximately 130 times higher than the long-term rates calculated from 137Cs profiles, suggesting an extremely dynamic sediment transport environment, even within an impounded river system.
USDA-ARS?s Scientific Manuscript database
Bed bugs Cimex lectularius were treated with conidia of the entomopathogenic fungus Metarhizium anisopliae by topical, spray, and contact exposure. One week post-exposure, inconsistent mortalities were observed, averaging 30% across all treatment groups and replicates. Microscopic examination of top...
Xu, Y; Lin, Y M; Stark, C R; Ferket, P R; Williams, C M; Brake, J
2017-07-01
The effects of zero or 50% dietary coarsely ground corn (CC) in pelleted and screened grower and finisher diets on broilers reared on 3 bedding floor types (plastic net [NET], new pine wood shavings litter [NEW], or old pine wood shavings litter [OLD]) on broiler live performance, litter characteristics, gizzard and proventriculus weight, and apparent ileal digestibility (AID) were studied in a 2 × 3 factorial arrangement of treatments. Fine corn was produced with a hammermill (271 μm) and CC with a roller mill (1145 μm). Utilization of CC reduced milling cost by 9.47 cents per MT with similar nutrient content of screened pellets. The 50% CC treatment exhibited improved (P ≤ 0.05) feed intake at 42 d (2.5%) and 49 d (3.0%), and BW (5.4%) and FCR from 28 d (1.4%). Birds on NEW litter exhibited improved (P < 0.05) BW at 28 and 35 d and 42 d FCR as compared to NET and 49 d FCR compared to NET and OLD. The 50% CC treatment exhibited increased (P < 0.05) gizzard weight but decreased proventriculus weight at 49 d. NEW litter birds exhibited increased (P ≤ 0.05) gizzard weight at 28 d and 49 d and decreased proventriculus weight as compared to NET at 49 days. The 50% CC treatment exhibited decreased (P ≤ 0.05) litter moisture at 35 and 42 d, litter N at 35 and 49 d, and litter pH at 49 days. OLD litter birds exhibited greater (P < 0.05) litter N at 14, 35, and 49 d, as well as litter moisture, pH, and ammonia concentration at 49 days. The 50% CC group also exhibited improved AID of nitrogen (P < 0.05). Broilers fed pelleted and screened diets containing 50% CC exhibited improved live performance and reduced litter moisture while use of NEW litter resulted in a somewhat similar effect, which indicated that consumption of NEW litter also facilitated gastric development and function. © 2017 Poultry Science Association Inc.
ITN utilization among pregnant women attending ANC in Etsako West Lga, Edo State, Nigeria.
Wagbatsoma, V A; Aigbe, E E
2010-06-01
To determine the factors affecting utilization of ITN by pregnant women in Etsako West LGA, Edo State. A descriptive cross-sectional study design was employed. Using a systematic sampling method, a total of 385 respondents were selected from all ANC facilities in the LGA following a verbally obtained consent. Tool for data collection was a semi-structured, researcher administered questionnaire. The respondents' knowledge of cause of malaria was good, as 269 (69%) had good knowledge but only 9 (2.3%) knew its effects on the foetus. Meanwhile, ownership of ITN and its use were very low, 36 (9.3%) and 31 (8.0) respectively. The main factor affecting the use of the commodity in the LGA was unavailability of ITNs. Other factors included belief of the women on the effectiveness of the commodity, level of education, marital status and family sizes ofrespondents. Use of Insecticide treated bed net has been hampered by unavailability of the commodity. It is therefore recommended that efforts should be made to make the commodity available to reduce morbidity and mortality among this vulnerable group.
Dadzie, Samuel; Boakye, Daniel; Asoala, Victor; Koram, Kwadwo; Kiszewski, Anthony; Appawu, Maxwell
2013-02-01
NO MAS (NM) mosquito repellent was evaluated in two farming villages (4 km apart) in the Kassena Nankana district of northern Ghana. We determined its efficacy against local malaria vectors, degree of user acceptance, and its effect on malaria prevalence in households using insecticide-treated bed nets. The average protective efficacy of NM against Anopheles mosquitoes over 9 hours was 89.6%. Controls averaged 86 bites/person/night versus 9 bites/person/night with the use of NM. Use of repellent was associated with a decrease of absolute malaria prevalence by 19.2% in the repellent village and by 6.5% in the control village (45.5 to 26.3, and 29.5 to 23.0, respectively). The user-acceptance rate of NM repellent was 96.1%. Ten percent (10%) of repellent users reported irritation as the main adverse effect during the period. Eighty-five percent (85%) of the users found the odor of NM appealing and 87% reported no inconvenience in applying the repellent daily.
Sinha, Parul; Pipkorn, Patrik; Thorstad, Wade L; Gay, Hiram A; Haughey, Bruce H
2016-10-01
The purpose of our study is to compare oncologic and functional outcomes of p16-positive oropharyngeal squamous cell carcinoma (OPSCC) patients, in the presence and absence of planned radiation to the primary bed following transoral surgery (TOS), stratified by T-classification. Retrospective cohort study of 261, T1-T4, consecutively TOS-treated OPSCC patients. At a median follow-up of 61months, local recurrence (LR) occurred in 6 (2.3%)patients (3 each in T1-T2 and T3-T4 groups), of which 5 had tumors in the tongue base and one in the tonsil. Of patients not receiving planned primary bed radiation, LR occurred in 3% of T1-T2s versus 17% of T3-T4s. In patients with T1-T2 tumors, Absolute Risk Reduction of LR with primary bed radiation was 3.26% (95% CI: -0.37%, 7%); Number Needed to Treat to prevent one LR was 31 (95% CI: 14.5, 271). Absolute Risk Increase for gastrostomy-tube with primary bed radiation was 34.4% (95% CI: 24%, 45%); Number Needed to Harm was 3 (95% CI: 2.2, 4.2), i.e., for every three patients with T1-T2 tumors receiving primary bed radiation, one had a gastrostomy-tube. Elimination of primary bed radiation in margin-negative resected, T1-T2 p16-positive OPSCC was not associated with significant compromise of local control, and correlated with superior swallowing preservation, assessed using gastrostomy rate as a surrogate. Lack of primary bed radiation in T3-T4 tumors associated with significantly increased LR rates. Copyright © 2016 Elsevier Ltd. All rights reserved.
Erickson, Susan L.; Gandhi, Anjalika R.; Asafu-Adjei, Josephine K.; Sampson, Allan R.; Miner, LeeAnn; Blakely, Randy D.; Sesack, Susan R.
2011-01-01
Pharmacological blockade of norepinephrine (NE) reuptake is clinically effective in treating several mental disorders. Drugs that bind to the NE transporter (NET) alter both protein levels and activity of NET and also the catecholamine synthetic enzyme tyrosine hydroxylase (TH). We examined the rat prefrontal cortex (PFC) by electron microscopy to determine whether the density and subcellular distribution of immunolabeling for NET and colocalization of NET with TH within individual NE axons were altered by chronic treatment with the selective NE uptake inhibitor desipramine (DMI). Following DMI treatment (21 days, 15 mg/kg/day), NET-immunoreactive (-ir) axons were significantly less likely to colocalize TH. This finding is consistent with reports of reduced TH levels and activity in the locus coeruleus after chronic DMI and indicates a reduction of NE synthetic capacity in the PFC. Measures of NET expression and membrane localization, including the number of NET-ir profiles per tissue area sampled, the number of gold particles per NET-ir profile area, and the proportion of gold particles associated with the plasma membrane, were similar in DMI and vehicle treated rats. These findings were verified using two different antibodies directed against distinct epitopes of the NET protein. The results suggest that chronic DMI treatment does not reduce NET expression within individual NE axons in vivo or induce an overall translocation of NET protein away from the plasma membrane in the PFC as measured by ultrastructural immunogold labeling. Our findings encourage consideration of possible postranslational mechanisms for regulating NET activity in antidepressant-induced modulation of NE clearance. PMID:21208501
Measurement of coarse gravel and cobble transport using portable bedload traps
Kristin Bunte; Steven R. Abt; John P. Potyondy; Sandra E. Ryan
2004-01-01
Portable bedload traps (0.3 by 0.2 m opening) were developed for sampling coarse bedload transport in mountain gravel-bed rivers during wadable high flows. The 0.9 m long trailing net can capture about 20 kg of gravel and cobbles. Traps are positioned on ground plates anchored in the streambed to minimize disturbance of the streambed during sampling. This design...
Atkinson, Jo-An M; Fitzgerald, Lisa; Toaliu, Hilson; Taleo, George; Tynan, Anna; Whittaker, Maxine; Riley, Ian; Vallely, Andrew
2010-04-12
In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); influences on these practices including how malaria is contextualized within community health and disease priorities; and effective avenues for channelling health information. The primary protection method identified by participants was the use of bed nets, however, the frequency and motivation for their use differed between study villages on the basis of the perceived presence of malaria. Village, household and personal cleanliness were identified by participants as important for protection against malaria. Barriers and influences on bed net use included cultural beliefs and practices, travel, gender roles, seasonality of mosquito nuisance and risk perception. Health care workers and church leaders were reported to have greatest influence on malaria prevention practices. Participants preferred receiving health information through visiting community health promotion teams, health workers, church leaders and village chiefs. In low malaria transmission settings, a package for augmenting social capital and sustaining community participation for elimination will be essential and includes: 'sentinel sites' for qualitative monitoring of evolving local socio-cultural, behavioural and practical issues that impact malaria prevention and treatment; mobilizing social networks; intersectoral collaboration; integration of malaria interventions with activities addressing other community health and disease priorities; and targeted implementation of locally appropriate, multi-level, media campaigns that sustain motivation for community participation in malaria elimination.
2010-01-01
Background In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Method Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); influences on these practices including how malaria is contextualized within community health and disease priorities; and effective avenues for channelling health information. Results The primary protection method identified by participants was the use of bed nets, however, the frequency and motivation for their use differed between study villages on the basis of the perceived presence of malaria. Village, household and personal cleanliness were identified by participants as important for protection against malaria. Barriers and influences on bed net use included cultural beliefs and practices, travel, gender roles, seasonality of mosquito nuisance and risk perception. Health care workers and church leaders were reported to have greatest influence on malaria prevention practices. Participants preferred receiving health information through visiting community health promotion teams, health workers, church leaders and village chiefs. Conclusion In low malaria transmission settings, a package for augmenting social capital and sustaining community participation for elimination will be essential and includes: 'sentinel sites' for qualitative monitoring of evolving local socio-cultural, behavioural and practical issues that impact malaria prevention and treatment; mobilizing social networks; intersectoral collaboration; integration of malaria interventions with activities addressing other community health and disease priorities; and targeted implementation of locally appropriate, multi-level, media campaigns that sustain motivation for community participation in malaria elimination. PMID:20380748
Tiffany, Amanda; Moundekeno, Faya Pascal; Traoré, Alexis; Haile, Melat; Sterk, Esther; Guilavogui, Timothée; Genton, Blaise; Serafini, Micaela; Grais, Rebecca F
2016-05-28
Malaria is one of the principal causes of morbidity and mortality in the Republic of Guinea, particularly in the highly endemic regions. To assist in malaria control efforts, a multi-component malaria control intervention was implemented in the hyperendemic region of Guéckédou Prefecture. The coverage of the intervention and its impact on malaria parasite prevalence were assessed. Five cross-sectional surveys using cluster-based sampling and stratified by area were conducted from 2011 to 2013 in three sous-préfectures of Guéckédou Préfecture that received the intervention: Guéckédou City, Tékoulo and Guendembou in addition to one comparison sous-préfecture that did not receive the intervention, Koundou. Surveys were repeated every 6 months, corresponding with the dry and rainy seasons. Rapid diagnostic tests (RDT) were used to diagnose malaria infection. In each selected household, bed net use and ownership were assessed. A total of 35,123 individuals participated in the surveys. Malaria parasite prevalence declined in all intervention sous-préfectures from 2011 to 2013 (56.4-45.9 % in Guéckédou City, 64.9-54.1 % in Tékoulo and 69.4-56.9 % in Guendembou) while increasing in the comparison sous-préfecture (64.5-69 %). It was consistently higher in children 5-14 years of age followed by those 1-59 months and ≥15 years. Indicators of intervention coverage, the proportion of households reporting ownership of at least one bed net and the proportion of survey participants with fever who received treatment from a health facility or community health worker also increased significantly in the intervention areas. Implementation of the multi-component malaria control intervention significantly reduced the prevalence of malaria in the sous-préfectures of intervention while also increasing the coverage of bed nets. However, malaria prevalence remains unacceptably high and disproportionately affects children <15 years of age. In such situations additional vector control interventions and age specific interventions should be considered.
Savoie, Jennifer G.; Smith, Richard L.; Kent, Douglas B.; Hess, Kathryn M.; LeBlanc, Denis R.; Barber, Larry B.
2006-01-01
A plume of contaminated ground water extends from former disposal beds at the Massachusetts Military Reservation wastewater-treatment plant toward Ashumet Pond, and farther southward toward coastal ponds and Vineyard Sound, Cape Cod, Massachusetts. Treated sewage-derived wastewater was discharged to the rapid-infiltration beds for nearly 60 years before the disposal site was moved to a different location in December 1995. Water-quality samples were collected periodically from monitoring wells and multilevel samplers during and after the disposal period to characterize the nature and extent of the contaminated ground water and to observe the water-quality changes after the wastewater disposal ceased. Data are presented here for water samples collected from 1994 through 2004 from 16 wells (at 2 locations) and 14 multilevel samplers (at 9 locations) along a longitudinal transect that extends through one of the disposal beds. Data collected from the treated-wastewater plume are presented in tabular format. These data include field parameters; concentrations of cations, anions, nitrate, ammonium, and organic and inorganic carbon species; and ultraviolet/visible absorbance. The natural restoration of the sand and gravel aquifer after removal of the nearly 60-year-long treated-wastewater source, along with interpretations of the water quality in the treated-wastewater plume on Cape Cod, have been documented in several published reports that are listed in the references.
Arroz, Jorge A H; Mendis, Chandana; Pinto, Liliana; Candrinho, Baltazar; Pinto, João; Martins, Maria do Rosário O
2017-10-25
The universal coverage bed nets campaign is a proven health intervention promoting increased access, ownership, and use of bed nets to reduce malaria burden. This article describes the intervention and implementation strategies that Mozambique carried out recently in order to improve access and increase demand for long-lasting insecticidal nets (LLINs). A before-and-after study with a control group was used during Stage I of the implementation process. The following strategies were tested in Stage I: (1) use of coupons during household registration; (2) use of stickers to identify the registered households; (3) new LLIN ascription formula (one LLIN for every two people). In Stage II, the following additional strategies were implemented: (4) mapping and micro-planning; (5) training; and (6) supervision. Odds ratio (OR) and 95% confidence interval (CI) were used to compare and establish differences between intervened and control districts in Stage I. Main outcomes were: percentage of LLINs distributed, percentage of target households benefited. In Stage I, 87.8% (302,648) of planned LLINs were distributed in the intervention districts compared to 77.1% (219,613) in the control districts [OR: 2.14 (95% CI 2.11-2.16)]. Stage I results also showed that 80.6% (110,453) of households received at least one LLIN in the intervention districts compared to 72.8% (87,636) in the control districts [OR: 1.56 (95% CI 1.53-1.59)]. In Stage II, 98.4% (3,536,839) of the allocated LLINs were delivered, covering 98.6% (1,353,827) of the registered households. Stage I results achieved better LLINs and household coverage in districts with the newly implemented strategies. The results of stage II were also encouraging. Additional strategies adaptation is required for a wide-country LLIN campaign.
26 CFR 1.1258-1 - Netting rule for certain conversion transactions.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Netting rule for certain conversion... Losses § 1.1258-1 Netting rule for certain conversion transactions. (a) Purpose. The purpose of this... conversion transaction before determining the amount of gain treated as ordinary income under section 1258(a...
Deutz, Nicolaas E P; Pereira, Suzette L; Hays, Nicholas P; Oliver, Jeffery S; Edens, Neile K; Evans, Chris M; Wolfe, Robert R
2013-10-01
Loss of muscle mass due to prolonged bed rest decreases functional capacity and increases hospital morbidity and mortality in older adults. To determine if HMB, a leucine metabolite, is capable of attenuating muscle decline in healthy older adults during complete bed rest. A randomized, controlled, double-blinded, parallel-group design study was carried out in 24 healthy (SPPB ≥ 9) older adult subjects (20 women, 4 men), confined to complete bed rest for ten days, followed by resistance training rehabilitation for eight weeks. Subjects in the experimental group were treated with HMB (calcium salt, 1.5 g twice daily - total 3 g/day). Control subjects were treated with an inactive placebo powder. Treatments were provided starting 5 days prior to bed rest till the end rehabilitation phase. DXA was used to measure body composition. Nineteen eligible older adults (BMI: 21-33; age: 60-76 year) were evaluable at the end of the bed rest period (Control n = 8; Ca-HMB n = 11). Bed rest caused a significant decrease in total lean body mass (LBM) (2.05 ± 0.66 kg; p = 0.02, paired t-test) in the Control group. With the exclusion of one subject, treatment with HMB prevented the decline in LBM over bed rest -0.17 ± 0.19 kg; p = 0.23, paired t-test). There was a statistically significant difference between treatment groups for change in LBM over bed rest (p = 0.02, ANOVA). Sub-analysis on female subjects (Control = 7, HMB = 8) also revealed a significant difference in change in LBM over bed rest between treatment groups (p = 0.04, ANOVA). However, differences in function parameters could not be observed, probably due to the sample size of the study. In healthy older adults, HMB supplementation preserves muscle mass during 10 days of bed rest. These results need to be confirmed in a larger trial. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
2010-01-01
Background Long-lasting insecticidal nets (LLINs) are an important tool for controlling malaria. Much attention has been devoted to determine both the effect of LLINs on the reduction of Plasmodium infection rate and on clinically-confirmed malaria cases in sub-Saharan Africa. We carried out an epidemiological study to investigate whether LLINs impact on Plasmodium prevalence rate and the proportion of clinically-confirmed malaria cases, in five villages in the district of Toumodi, central Côte d'Ivoire. Methods From April 2007 to November 2008, a community-based malaria control programme was implemented in the study villages, which involved large-scale distribution of LLINs, and training and sensitization activities within the community. We determined the effect of this programme on Plasmodium prevalence rate, clinically-confirmed malaria cases and proportion of high parasitaemia rates in children aged 6-59 months through a series of cross-sectional surveys starting in April 2007 and repeated once every 6 months. Results We observed a significant decrease in the mean P. falciparum prevalence rate from April 2007 to April 2008 (p = 0.029). An opposite trend was observed from November 2007 to November 2008 when P. falciparum prevalence rate increased significantly (p = 0.003). Highly significant decreases in the proportions of clinical malaria cases were observed between April 2007 and April 2008 (p < 0.001), and between November 2007 and November 2008 (p = 0.001). Conclusions Large-scale distribution of LLINs, accompanied by training and sensitization activities, significantly reduced Plasmodium prevalence rates among young children in the first year of the project, whereas overall clinical malaria rates dropped over the entire 18-month project period. A decrease in community motivation to sleep under bed nets, perhaps along with changing patterns of malaria transmission, might explain the observed increase in the Plasmodium prevalence rate between November 2007 and November 2008. PMID:20860829
The 1990 Amendments to the Clean Air Act have stimulated strong interest in the use of biofiltration for the economical engineered control of VOCs in effluent air streams. rickle bed air biofilters (TBABS) are especially applicable for treating VOCs at high loadings. or long term...
Estimating Fuel Bed Loadings in Masticated Areas
Sharon Hood; Ros Wu
2006-01-01
Masticated fuel treatments that chop small trees, shrubs, and dead woody material into smaller pieces to reduce fuel bed depth are used increasingly as a mechanical means to treat fuels. Fuel loading information is important to monitor changes in fuels. The commonly used planar intercept method however, may not correctly estimate fuel loadings because masticated fuels...
ERIC Educational Resources Information Center
Hilbert, Anja; Saelens, Brian E.; Stein, Richard I.; Mockus, Danyte S.; Welch, R. Robinson; Matt, Georg E.; Wilfley, Denise E.
2007-01-01
The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined…
In an attempt to better understand the dynamics of subslab air flow, the report suggests that subslab air flow induced by a central suction point be treated as radial air flow through a porous bed contained between two impermeable disks. (NOTE: Many subslab depressurization syste...
DATA QUALITY OBJECTIVES FOR SELECTING WASTE SAMPLES FOR BENCH-SCALE REFORMER TREATABILITY STUDIES
DOE Office of Scientific and Technical Information (OSTI.GOV)
BANNING DL
2011-02-11
This document describes the data quality objectives to select archived samples located at the 222-S Laboratory for Bench-Scale Reforming testing. The type, quantity, and quality of the data required to select the samples for Fluid Bed Steam Reformer testing are discussed. In order to maximize the efficiency and minimize the time to treat Hanford tank waste in the Waste Treatment and Immobilization Plant, additional treatment processes may be required. One of the potential treatment processes is the fluidized bed steam reformer. A determination of the adequacy of the fluidized bed steam reformer process to treat Hanford tank waste is required.more » The initial step in determining the adequacy of the fluidized bed steam reformer process is to select archived waste samples from the 222-S Laboratory that will be used in a bench scale tests. Analyses of the selected samples will be required to confirm the samples meet the shipping requirements and for comparison to the bench scale reformer (BSR) test sample selection requirements.« less
Matoke-Muhia, Damaris; Gimnig, John E; Kamau, Luna; Shililu, Josephat; Bayoh, M Nabie; Walker, Edward D
2016-06-10
The 2La chromosomal inversion, a genetic polymorphism in An. gambiae (sensu stricto) (s.s.), is associated with adaptation to microclimatic differences in humidity and desiccation resistance and mosquito behaviors. Ownership of insecticide-treated bed nets (ITNs) for malaria control has increased markedly in western Kenya in the last 20 years. An increase in the frequency of ITNs indoors could select against house entering or indoor resting of Anopheles mosquitoes. Thus, the frequency of the 2La inversion is postulated to change in An. gambiae (s.s.) with the increase of ITN ownership over time. Anopheles gambiae mosquitoes were sampled between 1994 and 2011 using pyrethrum knockdown, bednet traps and human landing catches (HLC) from Asembo and Seme, western Kenya. The 2La inversion was detected by a PCR assay with primers designed for proximal breakpoints of the 2La/a and 2L+(a)/+(a) chromosomal conformation. Mosquitoes were tested for malaria parasite infection by sporozoite ELISA. The frequency of the 2La chromosomal inversion declined from 100 % of all chromosomes in 1994 to 17 % in 2005 and remained low through 2011 (21 %). ITN ownership increased from 0 to > 90 % of houses in the study area during this interval. The decline in the frequency of the 2La chromosomal inversion was significantly, negatively correlated with year (r = -0.93) and with increase in ITN ownership (r = -0.96). The frequency of the homo- and heterokaryotypes departed significantly from Hardy-Weinberg equilibrium, suggesting that 2La/a karyotype was under selection, earlier in its favor and later, against it. Precipitation and maximum monthly temperature did not vary over time, therefore there was no trend in climate that could account for the decline. There was no significant difference in frequency of the 2La inversion in An. gambiae (s.s.) females sampled indoors or outdoors in HCL in 2011, nor was there an association between the 2La inversion and infection with Plasmodium falciparum sporozoites. The increase in ITN ownership in the study area was negatively correlated with the frequency of 2La inversion. The decline in 2La frequency in western Kenya is postulated to be due to differential impacts of ITNs on mosquitoes with different 2La karyotypes, possibly mediated by differences in behavior associated with the 2La karyotypes. Further research is required to determine if this is a widespread phenomenon, to further determine the association of the 2La karyotypes with mosquito behavior, and to assess whether ITNs are exerting selection mediated by differences in behavior on the different karyotypes.
Gelfenbaum, G.; Noble, M.
1993-01-01
Photographs of the seabed taken from an instrumented bottom tripod located approximately 100 km east of Charleston, South Carolina, reveal bed elevation changes of over 20 cm between July and November 1978. The tripod was in 85 m of water and was equipped with two current meters at 38.7 and 100 cm from the bed, a pressure sensor, a transmissometer, which fouled early during the deployment, a temperature sensor and a camera. The sediment under the tripod was composed of poorly sorted sand, some shell debris and numerous small biological tubes. Bed roughness varied throughout the deployment from biologically-produced mounds (2-5 cm high and 5-20 cm diameter) to streaks to a smooth bed, depending upon the frequency and magnitude of the sediment transporting events. Even though these events were common, especially during the later part of the deployment, the bed was rarely rippled, and there was no evidence of large bedforms such as dunes or sand waves migrating through the field of view of the camera. Photographs did clearly show, however, a gradual net deposition of the bed of nearly 20 cm, followed by erosion of approximately 5 cm. The flow field near the bed was dominated by sub-tidal period currents. Hourly-averaged currents at 100 cm from the bed typically varied between 10 and 30 cm s-1 and occasionally were as high as 60 cm s-1. The large flow events were predominantly toward the southwest along the shelf in the opposite direction of the northeast flowing Gulf Stream. The cross-shore component of the flow near the bed was predominantly directed offshore due to a local topographic steering effect. Current, temperature and satellite data suggest that the largest flow events were associated with the advection of Gulf Stream filaments past the tripod. Erosion events, as seen from the photographs, were highly correlated with the passage of these Gulf Stream filaments past the tripod. Gradual deposition of sediment, which occurred during the first half of the deployment, appears to have been associated with the convergence of the near-bed sediment flux near the shelf break. ?? 1993.
2013-01-01
Background Jars, tanks, and drums provide favorable rearing/breeding sites for Aedes aegypti in Vietnam. However, the use of insecticides to control mosquitoes at such breeding sites has not been approved in Vietnam since they are also often sources of drinking water, making larval vector control difficult. Mosquito nets pre-treated with long-lasting insecticide treated nets (LLITNs) form an effective measure for malaria control. We examined changes in the abundance of immature Aedes aegypti to evaluate the efficacy of covering ceramic jars with lids comprising one type of LLITN, Olyset® Net, in inhibiting oviposition by adult females, and to evaluate the effect of treating other breeding containers, such as flower vases, inside and around the outside of houses with a slow-release pyriproxyfen formulation to kill pupae. Methods We selected 313 households for the trial and 363 households for the control in Tan Chanh, Long An province, Vietnam. In the trial area, Olyset® Net lids were used to cover five major types of water container (ceramic jars, cylindrical concrete tanks, other concrete tanks, plastic drums, and plastic buckets), while pyriproxyfen was used to treat flower vases and ant traps. We also monitored dengue virus transmission by measuring anti-dengue IgM and IgG levels in healthy residents in both control and trial areas to estimate the effectiveness of Olyset® Net at controlling the dengue vector, Aedes aegypti. Results The container-index and house-index for immature Ae. aegypti fell steeply one month after treatment in the trial area. Lids with Olyset® Net that fit container openings clearly seemed to reduce the presence of immature Ae. aegypti as the density of pupae decreased 1 month after treatment in the trial area. Pyriproxyfen was also effective at killing pupae in the water containers in the trial area. Although the dengue seroconversion rate was not influenced by Olyset® Net, it was lower in two-five year old children when compared to older children and adults in both control and trial areas. Conclusions Our study showed that the treatment by Olyset® Net and pyriproxyfen had a strong negative effect on the prevalence of immature Ae. aegypti, which persisted for at least 5 months after treatment. PMID:23312018
Tsunoda, Takashi; Kawada, Hitoshi; Huynh, Trang T T; Luu, Loan Le; Le, San Hoang; Tran, Huu Ngoc; Vu, Huong Thi Que; Le, Hieu Minh; Hasebe, Futoshi; Tsuzuki, Ataru; Takagi, Masahiro
2013-01-11
Jars, tanks, and drums provide favorable rearing/breeding sites for Aedes aegypti in Vietnam. However, the use of insecticides to control mosquitoes at such breeding sites has not been approved in Vietnam since they are also often sources of drinking water, making larval vector control difficult. Mosquito nets pre-treated with long-lasting insecticide treated nets (LLITNs) form an effective measure for malaria control. We examined changes in the abundance of immature Aedes aegypti to evaluate the efficacy of covering ceramic jars with lids comprising one type of LLITN, Olyset® Net, in inhibiting oviposition by adult females, and to evaluate the effect of treating other breeding containers, such as flower vases, inside and around the outside of houses with a slow-release pyriproxyfen formulation to kill pupae. We selected 313 households for the trial and 363 households for the control in Tan Chanh, Long An province, Vietnam. In the trial area, Olyset® Net lids were used to cover five major types of water container (ceramic jars, cylindrical concrete tanks, other concrete tanks, plastic drums, and plastic buckets), while pyriproxyfen was used to treat flower vases and ant traps. We also monitored dengue virus transmission by measuring anti-dengue IgM and IgG levels in healthy residents in both control and trial areas to estimate the effectiveness of Olyset® Net at controlling the dengue vector, Aedes aegypti. The container-index and house-index for immature Ae. aegypti fell steeply one month after treatment in the trial area. Lids with Olyset® Net that fit container openings clearly seemed to reduce the presence of immature Ae. aegypti as the density of pupae decreased 1 month after treatment in the trial area. Pyriproxyfen was also effective at killing pupae in the water containers in the trial area. Although the dengue seroconversion rate was not influenced by Olyset® Net, it was lower in two-five year old children when compared to older children and adults in both control and trial areas. Our study showed that the treatment by Olyset® Net and pyriproxyfen had a strong negative effect on the prevalence of immature Ae. aegypti, which persisted for at least 5 months after treatment.
Kayedi, M H; Lines, J D; Haghdoost, A A; Vatandoost, M H; Rassi, Y; Khamisabady, K
2008-08-01
Field studies were carried out in Iran to evaluate the effect of various factors (washing, sun, smoke, dust and dirt) on the residual insecticidal activity of PermaNet (a brand of long-lasting insecticidal net), and on nets conventionally treated with deltamethrin (K-O Tab), using bioassay tests. Thirty-two nets were washed five or 15 times, and eight nets were not washed at all. Nets were washed vigorously in cold tap water (17 degrees C, pH 8.9) with a detergent. Hand rubbing continued for 3min. After washing, some nets were exposed to dense smoke from a dung-hay fire for 3min and were also left exposed to the dusty wind between washes. One group of nets was exposed to the sunlight for the full 3-d interval between washes; another was exposed to sunlight for just 3h after each wash; two other groups were kept in the shade. There was a significantly greater loss of activity in nets exposed to the sun throughout the 3-d interval between washes: that is, for a total of 15 to 45 d. However, short sunlight exposure (maximum 3h between washes) during drying did not have any effect. We did not find any significant effect of exposure to dirt, dust and smoke after washing. It is concluded that the effect of sun is much smaller than that of washing, and that drying nets for a few hours in the sun is not harmful.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pokhrel, D; Sood, S; Shen, X
2016-06-15
Purpose: To present radiobiological modeling of TCP using tumor size-adjusted BED(s-BED)and PTV(D99) to lung SBRT patients treated with X-ray Voxel Monte Carlo(XVMC) algorithm, apply parameterized Lyman-NTCP model to predict grade-2 RP and subsequently, compare with clinical outcomes/observations. Methods: Dosimetric parameters and clinical follow-up for XVMC-based lung-SBRT patients were retrospectively evaluated. Patients were treated at Novalis-TX with hybrid(2 non-coplanar partial-arcs plus 3–6 static-beams)plan using HD-MLC/6MV-SRS-beam.For TCP,s-BED modelling was utilized: TCP=EXP[sBED-TCD50]/k/(1.0+EXP[sBED-TCD50]/k), where k=31Gy corresponding to TCD50=0Gy and s-BED was defined as BED10 minus 10 times the tumor diameter(in centimeters)by Ohri et al.(IJROBP,2012). For 2-yr local-control, we used more-realistic MC-computed PTVD99 as amore » predictive parameter, s-BED(D99).Due to relatively shorter median follow-up interval(12-months),Kaplan-Meier curves were generated to estimate 2-yr observed local-control and compared to predicted-rate by TCP modeling. For NTCP, we employed parameterized Lyman-NTCP model utilizing normal-lung DVH and α/β=3Gy fitted to predict grade-2 RP after lung-SBRT. Results: Total 108 patients (137 tumors) treated for 35–70Gy in 3–5 fractions, either primary-lung(n=74)or metastatic-lung(n=53)tumors were included.F or the given prescription dose with MC-computed MUs, 2-yr local-control rates with s-BED(D99) was 87±8%. Kaplan-Meier generated observed local-control rate at 2-yr was 87.5%,suggesting that PTV(D99) could be a potential predictor (p-value=0.38). Observed vs predicted TCP for primary-lung tumors and metastatic tumors were 97% vs 88±7% and 94% vs 86±9%.NTCP model predicted well for symptomatic-RP with predicted vs observed (3±5% vs 2%). Radiographic and clinically significant RP was observed in 13% and 2% of patients. Higher rates of radiographic change were observed in patients who received >50Gy compared to ≤50Gy(24% vs 10%). Conclusion: Utilizing MC-computed PTVD99, our TCP results were well correlated with clinical outcome. The predicted grade-2 RP rate was comparable to clinical observations. Clinical application of these radiobiological models may potentially allow for target dose escalation and/or lung-toxicity reduction. Further validation of these radiobiological models with longer follow up interval for large cohorts of lung-SBRT patients is anticipated.« less
O'Connor, Ben L.; Harvey, Judson W.; McPhillips, Lauren E.
2012-01-01
Storm-driven flow pulses in rivers destroy and restructure sediment habitats that affect stream metabolism. This study examined thresholds of bed disturbances that affected patch- and reach-scale sediment conditions and metabolism rates. A 4 year record of discharge and diel changes in dissolved oxygen concentrations (ΔDO) was analyzed for disturbances and recovery periods of the ΔDO signal. Disturbances to the ΔDO signal were associated with flow pulses, and the recovery times for the ΔDO signal were found to be in two categories: less than 5 days (30% of the disturbances) or greater than 15 days (70% of the disturbances). A field study was performed during the fall of 2007, which included a storm event that increased discharge from 3.1 to 6.9 m3/s over a 7 h period. During stable flow conditions before the storm, variability in patch-scale stream metabolism values were associated with sediment texture classes with values ranging from −16.4 to 2.3 g O22/d (negative sign indicates net respiration) that bounded the reach-averaged rate of −5.6 g O22/d. Hydraulic modeling of bed shear stresses demonstrated a storm-induced flow pulse mobilized approximately 25% of the bed and reach-scale metabolism rates shifted from −5 to −40 g O22/d. These results suggest that storm-induced bed disturbances led to threshold behavior with respect to stream metabolism. Small flow pulses resulted in partial-bed mobilization that disrupted stream metabolism by increased turbidity with short recovery times. Large flow pulses resulted in full-bed mobilization that disrupted stream metabolism by destroying periphyton habitats with long recovery times.
Kahn, James G; Muraguri, Nicholas; Harris, Brian; Lugada, Eric; Clasen, Thomas; Grabowsky, Mark; Mermin, Jonathan; Shariff, Shahnaaz
2012-01-01
Efficiently delivered interventions to reduce HIV, malaria, and diarrhea are essential to accelerating global health efforts. A 2008 community integrated prevention campaign in Western Province, Kenya, reached 47,000 individuals over 7 days, providing HIV testing and counseling, water filters, insecticide-treated bed nets, condoms, and for HIV-infected individuals cotrimoxazole prophylaxis and referral for ongoing care. We modeled the potential cost-effectiveness of a scaled-up integrated prevention campaign. We estimated averted deaths and disability-adjusted life years (DALYs) based on published data on baseline mortality and morbidity and on the protective effect of interventions, including antiretroviral therapy. We incorporate a previously estimated scaled-up campaign cost. We used published costs of medical care to estimate savings from averted illness (for all three diseases) and the added costs of initiating treatment earlier in the course of HIV disease. Per 1000 participants, projected reductions in cases of diarrhea, malaria, and HIV infection avert an estimated 16.3 deaths, 359 DALYs and $85,113 in medical care costs. Earlier care for HIV-infected persons adds an estimated 82 DALYs averted (to a total of 442), at a cost of $37,097 (reducing total averted costs to $48,015). Accounting for the estimated campaign cost of $32,000, the campaign saves an estimated $16,015 per 1000 participants. In multivariate sensitivity analyses, 83% of simulations result in net savings, and 93% in a cost per DALY averted of less than $20. A mass, rapidly implemented campaign for HIV testing, safe water, and malaria control appears economically attractive.
Tangena, Julie-Anne A.; Adiamoh, Majidah; D’Alessandro, Umberto; Jarju, Lamin; Jawara, Musa; Jeffries, David; Malik, Naiela; Nwakanma, Davis; Kaur, Harparkash; Takken, Willem; Lindsay, Steve W.; Pinder, Margaret
2013-01-01
Background Malaria vector control is threatened by resistance to pyrethroids, the only class of insecticides used for treating bed nets. The second major vector control method is indoor residual spraying with pyrethroids or the organochloride DDT. However, resistance to pyrethroids frequently confers resistance to DDT. Therefore, alternative insecticides are urgently needed. Methodology/Principal Findings Insecticide resistance and the efficacy of indoor residual spraying with different insecticides was determined in a Gambian village. Resistance of local vectors to pyrethroids and DDT was high (31% and 46% mortality, respectively) while resistance to bendiocarb and pirimiphos methyl was low (88% and 100% mortality, respectively). The vectors were predominantly Anopheles gambiae s.s. with 94% of them having the putative resistant genotype kdr 1014F. Four groups of eight residential compounds were each sprayed with either (1) bendiocarb, a carbamate, (2) DDT, an organochlorine, (3) microencapsulated pirimiphos methyl, an organophosphate, or (4) left unsprayed. All insecticides tested showed high residual activity up to five months after application. Mosquito house entry, estimated by light traps, was similar in all houses with metal roofs, but was significantly less in IRS houses with thatched roofs (p=0.02). Residents participating in focus group discussions indicated that IRS was considered a necessary nuisance and also may decrease the use of long-lasting insecticidal nets. Conclusion/Significance Bendiocarb and microencapsulated pirimiphos methyl are viable alternatives for indoor residual spraying where resistance to pyrethroids and DDT is high and may assist in the management of pyrethroid resistance. PMID:24058551
Removal of fluoride impurities from UF/sub 6/ gas
Beitz, J.V.
1984-01-06
A method of purifying a UF/sub 6/ gas stream containing one or more metal fluoride impurities composed of a transuranic metal, transition metal or mixtures thereof, is carried out by contacting the gas stream with a bed of UF/sub 5/ in a reaction vessel under conditions where at least one impurity reacts with the UF/sub 5/ to form a nongaseous product and a treated gas stream, and removing the treated gas stream from contact with the bed. The nongaseous products are subsequently removed in a reaction with an active fluorine affording agent to form a gaseous impurity which is removed from the reaction vessel. The bed of UF/sub 5/ is formed by the reduction of UF/sub 6/ in the presence of uv light. One embodiment of the reaction vessel includes a plurality of uv light sources as tubes on which UF/sub 5/ is formed. 2 figures.
Removal of fluoride impurities from UF.sub.6 gas
Beitz, James V.
1985-01-01
A method of purifying a UF.sub.6 gas stream containing one or more metal fluoride impurities composed of a transuranic metal, transition metal or mixtures thereof, is carried out by contacting the gas stream with a bed of UF.sub.5 in a reaction vessel under conditions where at least one impurity reacts with the UF.sub.5 to form a nongaseous product and a treated gas stream, and removing the treated gas stream from contact with the bed. The nongaseous products are subsequently removed in a reaction with an active fluorine affording agent to form a gaseous impurity which is removed from the reaction vessel. The bed of UF.sub.5 is formed by the reduction of UF.sub.6 in the presence of UV light. One embodiment of the reaction vessel includes a plurality of UV light sources as tubes on which UF.sub.5 is formed.
DATA QUALITY OBJECTIVES FOR SELECTING WASTE SAMPLES FOR THE BENCH STEAM REFORMER TEST
DOE Office of Scientific and Technical Information (OSTI.GOV)
BANNING DL
2010-08-03
This document describes the data quality objectives to select archived samples located at the 222-S Laboratory for Fluid Bed Steam Reformer testing. The type, quantity and quality of the data required to select the samples for Fluid Bed Steam Reformer testing are discussed. In order to maximize the efficiency and minimize the time to treat Hanford tank waste in the Waste Treatment and Immobilization Plant, additional treatment processes may be required. One of the potential treatment processes is the fluid bed steam reformer (FBSR). A determination of the adequacy of the FBSR process to treat Hanford tank waste is required.more » The initial step in determining the adequacy of the FBSR process is to select archived waste samples from the 222-S Laboratory that will be used to test the FBSR process. Analyses of the selected samples will be required to confirm the samples meet the testing criteria.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wanielista, M.; Charba, J.; Dietz, J.
This is the final report on the use of Granulated Active Carbon (GAC) beds of Filtrasorb 400 in series to reduce the Trihalomethane Formation Potential (THMFP) concentrations at the Lake Angel detention pond, Orange County, Florida. The detention pond accepts runoff from an interstate highway and a commercial area. Breakthrough time was estimated from laboratory analyses and used to design two beds in series at the detention pond. Breakthrough occurred in the first bed after treating 138,000 liters of water. Exhaustion of the first bed was reached after treating 1270 bed volumes with a sorption zone length of 1.70 feet.more » The TOC adsorbed per gram of GAC was 6.3 mg. The liquid flow rate averaged 0.0011 cfs. Similar breakthrough curves for Total Organic Carbon (TOC) and color were also reported. The used GAC can be disposed of by substituting it for sand in concrete mixes. An economic evaluation of the GAC system at Lake Angel demonstrated an annual cost of $4.39/1000 gallons to treat the stormwater runoff after detention and before discharge into a drainage well. The cost could be further reduced by using the stormwater to irrigate right-of-way sections of the watershed. An alternative method of pumping to another drainage basin was estimated to be more expensive. The underdrain network for the GAC system initially became clogged with the iron- and sulfur-precipitation bacteria Leptothrix, Gallionella and Thiothrix. These bacteria were substantially reduced by altering the influent GAC system pipeline to take water directly from the lake. An alternate pipe system used a clay layer to reduce ground water inputs and did not exhibit substantial bacterial growth.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Polkinghorn, William R.; Dunkel, Ira J.; Souweidane, Mark M.
2011-11-01
Purpose: We previously reported excellent local control for treating medulloblastoma with a limited boost to the tumor bed. In order to decrease ototoxicity, we subsequently implemented a tumor-bed boost using intensity-modulated radiation therapy (IMRT), the clinical results of which we report here. Patients and Methods: A total of 33 patients with newly diagnosed medulloblastoma, 25 with standard risk, and 8 with high risk, were treated on an IMRT tumor-bed boost following craniospinal irradiation (CSI). Six standard-risk patients were treated with an institutional protocol with 18 Gy CSI in conjunction with intrathecal iodine-131-labeled monoclonal antibody. The majority of patients received concurrentmore » vincristine and standard adjuvant chemotherapy. Pure-tone audiograms were graded according to National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: Median age was 9 years old (range, 4-46 years old). Median follow-up was 63 months. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) rates for standard-risk patients who received 23.4 or 36 Gy CSI (not including those who received 18 Gy CSI with radioimmunotherapy) were 81.4% and 88.4%, respectively, at 5 years; 5-year PFS and OS rates for high-risk patients were both 87.5%. There were no isolated posterior fossa failures outside of the boost volume. Posttreatment audiograms were available for 31 patients, of whom 6%, at a median follow-up of 19 months, had developed Grade 3 hearing loss. Conclusion: An IMRT tumor-bed boost results in excellent local control while delivering a low mean dose to the cochlea, resulting in a low rate of ototoxicity.« less
NASA Astrophysics Data System (ADS)
Barry, S.; Frazer, T.; Jacoby, C.
2013-05-01
Ocean acidification poses a serious threat to a broad suite of calcifying organisms. Scleractinian corals and calcareous algae that occupy shallow, tropical waters are vulnerable to global changes in ocean chemistry because they already are subject to stressful and variable carbon dynamics at the local scale. For example, net heterotrophy increases carbon dioxide concentrations, and pH varies with diurnal fluctuations in photosynthesis and respiration. Few researchers, however, have investigated the possibility that carbon dioxide consumption during photosynthesis by non-calcifying photoautotrophs, such as seagrasses, can ameliorate deleterious effects of ocean acidification on sympatric calcareous algae. Naturally occurring variations in the density of seagrasses and associated calcareous algae provide an ecologically relevant test of the hypothesis that diel fluctuations in water chemistry driven by cycles of photosynthesis and respiration within seagrass beds create microenvironments that enhance macroalgal calcification. In Grape Tree Bay off Little Cayman Island BWI, we quantified net production and characterized calcification for thalli of the calcareous green alga Halimeda incrassata growing within beds of Thalassia testudinum with varying shoot densities. Results indicated that individual H. incrassata thalli were ~6% more calcified in dense seagrass beds. On an areal basis, however, far more calcium carbonate was produced by H. incrassata in areas where seagrasses were less dense due to higher rates of production. In addition, diel pH regimes in vegetated and unvegetated areas within the lagoon were not significantly different, suggesting water exchange and mixing throughout the lagoon. These results suggest that, especially in well-mixed lagoons, carbonate production by calcareous algae may be more related to biotic interactions between seagrasses and calcareous algae than to seagrass-mediated changes in local water chemistry.
Mwandagalirwa, Melchior Kashamuka; Levitz, Lauren; Thwai, Kyaw L; Parr, Jonathan B; Goel, Varun; Janko, Mark; Tshefu, Antoinette; Emch, Michael; Meshnick, Steven R; Carrel, Margaret
2017-11-09
The Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with malaria are needed, as is an understanding of how these characteristics vary spatiotemporally and across different community-level malaria endemicities. An ongoing study in Kinshasa Province is designed to address gaps in prior malaria surveillance in the DRC by monitoring malaria across seasons, age groups and in high and low malaria sites. Across seven sites, 242 households and 1591 individuals are participating in the study. Results of the enrollment questionnaire, rapid diagnostic tests and PCR testing of dried blood spots are presented. Overall malaria prevalence in the study cohort is high, 27% by rapid diagnostic test and 31% by polymerase chain reaction, and malaria prevalence is highly varied across very small geographic distances. Malaria prevalence is highest in children aged 6-15. While the majority of households own bed nets, bed net usage is less than 50%. The study cohort will provide an understanding of how malaria persists in populations that have varying environmental exposures, varying community-level malaria, and varying access to malaria control efforts.
Gryseels, Charlotte; Peeters Grietens, Koen; Dierickx, Susan; Xuan, Xa Nguyen; Uk, Sambunny; Bannister-Tyrrell, Melanie; Trienekens, Suzan; Ribera, Joan Muela; Hausmann-Muela, Susanna; Gerrets, René; D'Alessandro, Umberto; Sochantha, Tho; Coosemans, Marc; Erhart, Annette
2015-01-01
Malaria control along the Vietnam–Cambodia border presents a challenge for both countries' malaria elimination targets as the region is forested, inhabited by ethnic minority populations, and potentially characterized by early and outdoor malaria transmission. A mixed methods study assessed the vulnerability to malaria among the Jarai population living on both sides of the border in the provinces of Ratanakiri (Cambodia) and Gia Lai (Vietnam). A qualitative study generated preliminary hypotheses that were quantified in two surveys, one targeting youth (N = 498) and the other household leaders (N = 449). Jarai male youth, especially in Cambodia, had lower uptake of preventive measures (57.4%) and more often stayed overnight in the deep forest (35.8%) compared with the female youth and the adult population. Among male youth, a high-risk subgroup was identified that regularly slept at friends' homes or outdoors, who had fewer bed nets (32.5%) that were torn more often (77.8%). The vulnerability of Jarai youth to malaria could be attributed to the transitional character of youth itself, implying less fixed sleeping arrangements in nonpermanent spaces or non-bed sites. Additional tools such as long-lasting hammock nets could be suitable as they are in line with current practices. PMID:26283747
Pirie, M D; Oliver, E G H; Mugrabi de Kuppler, A; Gehrke, B; Le Maitre, N C; Kandziora, M; Bellstedt, D U
2016-09-17
The disproportionate species richness of the world's biodiversity hotspots could be explained by low extinction (the evolutionary "museum") and/or high speciation (the "hot-bed") models. We test these models using the largest of the species rich plant groups that characterise the botanically diverse Cape Floristic Region (CFR): the genus Erica L. We generate a novel phylogenetic hypothesis informed by nuclear and plastid DNA sequences of c. 60 % of the c. 800 Erica species (of which 690 are endemic to the CFR), and use this to estimate clade ages (using RELTIME; BEAST), net diversification rates (GEIGER), and shifts in rates of diversification in different areas (BAMM; MuSSE). The diversity of Erica species in the CFR is the result of a single radiation within the last c. 15 million years. Compared to ancestral lineages in the Palearctic, the rate of speciation accelerated across Africa and Madagascar, with a further burst of speciation within the CFR that also exceeds the net diversification rates of other Cape clades. Erica exemplifies the "hotbed" model of assemblage through recent speciation, implying that with the advent of the modern Cape a multitude of new niches opened and were successively occupied through local species diversification.
NOTE: Dose area product evaluations with Gafchromic® XR-R films and a flat-bed scanner
NASA Astrophysics Data System (ADS)
Rampado, O.; Garelli, E.; Deagostini, S.; Ropolo, R.
2006-12-01
Gafchromic® XR-R films are a useful tool to evaluate entrance skin dose in interventional radiology. Another dosimetric quantity of interest in diagnostic and interventional radiology is the dose area product (DAP). In this study, a method to evaluate DAP using Gafchromic® XR-R films and a flat-bed scanner was developed and tested. Film samples were exposed to an x-ray beam of 80 kVp over a dose range of 0 10 Gy. DAP measurements with films were obtained from the digitalization of a film sample positioned over the x-ray beam window during the exposure. DAP values obtained with this method were compared for 23 cardiological interventional procedures with DAP values displayed by the equipment. The overall one-sigma dose measurement uncertainty depended on the absorbed dose, with values below 6% for doses above 1 Gy. A maximum discrepancy of 16% was found, which is of the order of the differences in the DAP measurements that may occur with different calibration procedures. Based on the results presented, after an accurate calibration procedure and a thorough inspection of the relationship between the actual dose and the direct measured quantity (net optical density or net pixel value variation), Gafchromic® XR-R films can be used to assess the DAP.
Kweka, Eliningaya J; Lyatuu, Ester E; Mboya, Michael A; Mwang’onde, Beda J; Mahande, Aneth M
2010-01-01
Background: In most of the past decades, mosquito control has been done by the use of indoor residual spray and insecticides-treated bed nets. The control of mosquitoes by targeting the breeding sites (larval habitat) has not been given priority. Disrupting the oviposition sensory detection of mosquitoes by introducing deterrents of plant origin, which are cheap resources, might be add value to integrated vector control. Such knowledge is required in order to successfully manipulate the behavior of mosquitoes for monitoring or control. Materials and Methods: Twenty gravid mosquitoes were placed in a cage measuring 30 × 30 × 30 cm for oviposition. The oviposition media were made of different materials. Experiments were set up at 6:00 pm, and eggs were collected for counting at 7:30 am. Mosquitoes were observed until they died. The comparisons of the number of eggs were made between the different treatments. Results: There was significant difference in the number of eggs found in control cups when compared with the number of eggs found in water treated with Ocimum kilimandscharicum (OK) (P=0.02) or Ocimum suave (OS) (P=0.000) and that found in water with debris treated with OK (P=0.011) or OS (P=0.002). There was no significant difference in the number of eggs laid in treated water and the number of eggs laid in water with debris treated either with OK (P=0.105) or OS (P=0.176). Oviposition activity index for both OS and OK experiments lay in a negative side and ranged from -0.19% to -1%. The results show that OS and OK deter oviposition in An.gambiae s.s. Conclusions: Further research needs to be done on the effect of secondary metabolites of these plant extracts as they decompose in the breeding sites. In the event of favorable results, the potential of these plant extracts can be harnessed on a larger scale. PMID:20927285
A Theoretical Model of Drumlin Formation Based on Observations at Múlajökull, Iceland
NASA Astrophysics Data System (ADS)
Iverson, N. R.; McCracken, R. G.; Zoet, L. K.; Benediktsson, Í. Ö.; Schomacker, A.; Johnson, M. D.; Woodard, J.
2017-12-01
The drumlin field at the surge-type glacier, Múlajökull, provides an unusual opportunity to build a model of drumlin formation based on field observations in a modern drumlin-forming environment. These observations indicate that surges deposit till layers that drape the glacier forefield, conform to drumlin surfaces, and are deposited in shear. Observations also indicate that erosion helps create drumlin relief, effective stresses in subglacial till are highest between drumlins, and during quiescent flow, crevasses on the glacier surface overlie drumlins while subglacial channels occupy intervening swales. In the model, we consider gentle undulations on the bed bounded by subglacial channels at low water pressure. During quiescent flow, slip of temperate ice across these undulations and basal water flow toward bounding channels create an effective stress distribution that maximizes till entrainment in ice on the heads and flanks of drumlins. Crevasses amplify this effect but are not necessary for it. During surges, effective stresses are uniformly low, and the bed shears pervasively. Vigorous basal melting during surges releases debris from ice and deposits it on the bed, with deposition augmented by transport in the deforming bed. As surge cycles progress, drumlins migrate downglacier and grow at increasing rates, due to positive feedbacks that depend on drumlin height. Drumlin growth can be accompanied by either net aggradation or erosion of the bed, and drumlin heights and stratigraphy generally correspond with observations. This model highlights that drumlin growth can reflect instabilities other than those of bed shear instability models, which require heuristic till transport assumptions.
Bradley, Cathy J; Dahman, Bassam; Sabik, Lindsay M
2015-02-01
We examined whether safety net hospitals reduce the likelihood of emergency colorectal cancer (CRC) surgery in uninsured and Medicaid-insured patients. If these patients have better access to care through safety net providers, they should be less likely to undergo emergency resection relative to similar patients at non- safety net hospitals. Using population-based data, we estimated the relationship between safety net hospitals, patient insurance status, and emergency CRC surgery. We extracted inpatient admission data from the Virginia Health Information discharge database and matched them to the Virginia Cancer Registry for patients aged 21 to 64 years who underwent a CRC resection between January 1, 1999, and December 31, 2005 (n = 5488). We differentiated between medically defined emergencies and those that originated in the emergency department (ED). For each definition of emergency surgery, we estimated the linear probability models of the effects of being treated at a safety net hospital on the probability of having an emergency resection. Safety net hospitals reduce emergency surgeries among uninsured and Medicaid CRC patients. When defining an emergency resection as those that involved an ED visit, these patients were 15 to 20 percentage points less likely to have an emergency resection when treated in a safety net hospital. Our results suggest that these hospitals provide a benefit, most likely through the access they afford to timely and appropriate care, to uninsured and Medicaid-insured patients relative to hospitals without a safety net mission.
Application of simplified bioclean apparatuses for treatment of acute leukemia.
Hasegawa, H; Horiuchi, A
1983-01-01
We used a portable horizontal laminar-air-flow clean bed and an open horizontal laminar-air-flow fan (clean wall unit) for treating patients with acute leukemia. The level of cleanliness as shown in the nonviable and viable particle counts was class 100 and class 1,000 at the head and foot, respectively, of the bed in the clean-bed rooms, while it was class 100 and class 10,000 respectively, in the clean-wall-unit rooms. The level of cleanliness in the open wards, on the other hand, was class 1,000,000. The incidence of infectious complications in the clean-bed rooms was 3.1/100 days when the granulocyte count was 1,000/mm3 or less, 3.9/100 days when the count was 500/mm3 or less and 6.1/100 days when it was 100/mm3 or less. In the clean-wall-unit rooms, these values were 3.1, 3.7 and 7.1, respectively, while in the open wards they were 4.6, 6.1 and 15.0. Thus, it was ascertained that, as the granulocyte count decreased, the incidence of infectious complications became significantly higher in the open wards than in the clean-bed rooms or the clean-wall-unit rooms. No complication of pneumonia was found in 37 patients with acute leukemia in the clean-bed rooms or in 40 in the clean-wall-unit rooms. Among 36 patients treated in the open wards, on the other hand, the complication of pneumonia was found in four. From the above results, it is believed that the use of clean-bed rooms or clean-wall-unit rooms is an extremely effective supplementary treatment method for preventing respiratory tract infection complications in patients with acute leukemia.
Acidification of calf bedding reduces fly development and bacterial abundance.
Calvo, M S; Gerry, A C; McGarvey, J A; Armitage, T L; Mitloehner, F M
2010-03-01
Environmental stressors, such as high fly density, can affect calf well-being. Sodium bisulfate (SBS) is an acidifier that reduces the pH of flooring and bedding, creating a medium that neither bacteria nor immature flies (also known as larvae or maggots) can thrive in. Two experiments were conducted to investigate the application of SBS to a mixture of rice hull calf bedding and calf slurry (BED) to reduce house fly (Musca domestica L.) larval density and the abundance of bacteria. In experiment 1, dish pans containing 1L of BED and 3,000 house fly eggs were treated with SBS at concentrations of 0, 8.9, 17.7, and 26.5g of SBS/0.05m(2) of BED (CON, LOW, MED, and HIGH, respectively), with each SBS concentration applied to 4 individual pans (16 pans total). Reapplication of the same SBS concentrations in each pan occurred 3 times/wk throughout the 23-d trial. Larval house fly survival was significantly reduced in all pans with SBS relative to CON pans, with lowest survival rates in the MED and HIGH pans (99% and 100% reduction, respectively). The mean pH for each treatment was inversely related to the SBS concentration. In experiment 2, pans containing 1L of BED and 3,000 house fly eggs were treated with either 0g of SBS (CON), 8.9g of SBS/0.05m(2) of BED with reapplication of the acidifier 3 times/wk (SB3x), or 8.9g of SBS/0.05m(2) of BED applied only once at 48h before the end of the 8 d-trial (SB48). Larval house fly survival and bacterial concentrations were reduced (90% larval reduction and 68% bacterial reduction) in the SB3x treatment relative to the CON. Mean pH was also reduced in SB3x pans relative to CON or SB48 pans. Overall, acidification of calf BED using the acidifier SBS resulted in a reduction of bacteria and house fly larval survival. This form of fly control might be expected to reduce adult fly production and, therefore, fly-related stress in calves.
Financial Analysis of Treating Periprosthetic Joint Infections at a Tertiary Referral Center.
Waddell, Bradford S; Briski, David C; Meyer, Mark S; Ochsner, John L; Chimento, George F
2016-05-01
Periprosthetic joint infection (PJI) is a significant challenge to the orthopedic surgeon, patient, hospital, and insurance provider. Our study compares the financial information of self-originating and referral 2-stage revision hip and knee surgeries at our tertiary referral center for hip or knee PJI over the last 4 years. We performed an in-house retrospective financial review of all patients who underwent 2-stage revision hip or knee arthroplasty for infection between January 2008 and August 2013, comparing self-originating and referral cases. We found an increasing number of referrals over the study period. There was an increased cost of treating hips over knees. All scenarios generated a positive net income; however, referral hip PJIs offered lower reimbursement and net income per case (although not statistically significant), whereas knee PJIs offered higher reimbursement and net income per case (although not statistically significant). With referral centers treating increased numbers of infected joints performed elsewhere, we show continued financial incentive in accepting referrals, although with less financial gain than when treating one's own hip PJI and an increased financial gain when treating referral knee PJIs. Copyright © 2016 Elsevier Inc. All rights reserved.
Implications of bed reduction in an acute psychiatric service.
Bastiampillai, Tarun J; Bidargaddi, Niranjan P; Dhillon, Rohan S; Schrader, Geoffrey D; Strobel, Jörg E; Galley, Philip J
2010-10-04
To evaluate the impact of psychiatric inpatient bed closures, accompanied by a training program aimed at enhancing team effectiveness and incorporating data-driven practices, in a mental health service. Retrospective comparison of the changes in services within three consecutive financial years: baseline period - before bed reduction (2006-07); observation period - after bed reduction (2007-08); and intervention period - second year after bed reduction (2008-09). The study was conducted at Cramond Clinic, Queen Elizabeth Hospital, Adelaide. Length of stay, 28-day readmission rates, discharges, bed occupancy rates, emergency department (ED) presentations, ED waiting time, seclusions, locality of treatment, and follow-up in the community within 7days. Reduced bed numbers were associated with reduced length of stay, fewer referrals from the community and subsequently shorter waiting times in the ED, without significant change in readmission rates. A higher proportion of patients was treated in the local catchment area, with improved community follow-up and a significant reduction in inpatient seclusions. Our findings should reassure clinicians concerned about psychiatric bed numbers that service redesign with planned bed reductions will not necessarily affect clinical care, provided data literacy and team training programs are in place to ensure smooth transition of patients across ED, inpatient and community services.
Yukich, Joshua O; Briët, Olivier J T; Ahorlu, Collins K; Nardini, Peter; Keating, Joseph
2017-08-07
Long-lasting insecticidal nets (LLINs) are one of the main interventions recommended by the World Health Organization for malaria vector control. LLINs are ineffective if they are not being used. Subsequent to the completion of a cluster randomized cross over trial conducted in rural Greater Accra where participants were provided with the 'Bɔkɔɔ System'-a set of solar powered net fan and light consoles with a solar panel and battery-or alternative household water filters, all trial participants were invited to participate in a Becker-DeGroot-Marschak auction to determine the mean willingness to pay (WTP) for the fan and light consoles and to estimate the demand curve for the units. Results demonstraed a mean WTP of approximately 55 Cedis (~13 USD). Demand results suggested that at a price which would support full manufacturing cost recovery, a majority of households in the area would be willing to purchase at least one such unit.
Neutrophil autophagy and extracellular DNA traps contribute to airway inflammation in severe asthma.
Pham, D L; Ban, G-Y; Kim, S-H; Shin, Y S; Ye, Y-M; Chwae, Y-J; Park, H-S
2017-01-01
Autophagy and neutrophil extracellular DNA traps (NETs) are implicated in asthma; however, their roles in asthma pathogenesis have not been elucidated. We compared autophagy and NET production levels from peripheral blood neutrophils (PBNs) of patients with severe asthma (SA) and non-severe asthma (NSA). Additionally, we investigated the inflammatory effects of NETs on human airway epithelial cells (AECs) and peripheral blood eosinophils (PBEs). Peripheral blood neutrophils from patients with SA (n = 30) and NSA (n = 38) were treated with interleukin (IL)-8 (100 ng/mL). Autophagy (light chain 3-II expression) and NET production levels were evaluated by Western blot, immunofluorescence microscopy, and PicoGreen assay. The effects of NETs on AECs were assessed by investigating cell death, cell detachment, expression of occludin and claudin-1, and IL-8 production; the effects of NETs on PBEs were examined by investigating the activation and release of eosinophil cationic protein (ECP) and eosinophil-derived neurotoxin (EDN). Untreated and IL-8-treated PBNs from the SA group produced higher autophagy and NET levels compared with those from the NSA group (P < 0.01). IL-8 increased autophagy and NET levels in PBNs from the SA group, but not from the NSA group. NET levels were correlated with autophagy levels in PBNs (P < 0.001). IL-8-induced NET production levels negatively were correlated with FEV1/FVC (r = -0.700, P = 0.016). NETs induced cell death, detachment, degradation of occludin and claudin-1, and IL-8 production from AECs. Higher levels of NET-induced ECP and EDN were released from PBEs in SA compared with NSA groups. Neutrophil autophagy and NETs could enhance asthma severity by damaging airway epithelium and triggering inflammatory responses of AECs and PBEs. Modulating neutrophil autophagy and NET production may be a new target therapy for SA. © 2016 John Wiley & Sons Ltd.
Kilian, Albert; Byamukama, Wilson; Pigeon, Olivier; Atieli, Francis; Duchon, Stephan; Phan, Chi
2008-01-01
Background In order to evaluate whether criteria for LLIN field performance (phase III) set by the WHO Pesticide Evaluation Scheme are met, first and second generations of one of these products, PermaNet®, a polyester net using the coating technology were tested. Methods A randomized, double blinded study design was used comparing LLIN to conventionally treated nets and following LLIN for three years under regular household use in rural conditions. Primary outcome measures were deltamethrin residue and bioassay performance (60 minute knock-down and 24 hour mortality after a three minute exposure) using a strain of Anopheles gambiae s.s. sensitive to pyrethroid insecticides. Results Baseline concentration of deltamethrin was within targets for all net types but was rapidly lost in conventionally treated nets and first generation PermaNet® with median of 0.7 and 2.5 mg/m2 after six months respectively. In contrast, second generation PermaNet® retained insecticide well and had 41.5% of baseline dose after 36 months (28.7 mg/m2). Similarly, vector mortality and knockdown dropped to 18% and 70% respectively for first generation LLIN after six months but remained high (88.5% and 97.8% respectively) for second generation PermaNet® after 36 months of follow up at which time 90.0% of nets had either a knockdown rate ≥ 95% or mortality rate ≥ 80%. Conclusion Second generation PermaNet® showed excellent results after three years of field use and fulfilled the WHOPES criteria for LLIN. Loss of insecticide on LLIN using coating technology under field conditions was far more influenced by factors associated with handling rather than washing. PMID:18355408
Munneke, Marten; Nijkrake, Maarten J; Keus, Samyra Hj; Kwakkel, Gert; Berendse, Henk W; Roos, Raymund Ac; Borm, George F; Adang, Eddy M; Overeem, Sebastiaan; Bloem, Bastiaan R
2010-01-01
Many patients with Parkinson's disease are treated with physiotherapy. We have developed a community-based professional network (ParkinsonNet) that involves training of a selected number of expert physiotherapists to work according to evidence-based recommendations, and structured referrals to these trained physiotherapists to increase the numbers of patients they treat. We aimed to assess the efficacy of this approach for improving health-care outcomes. Between February, 2005, and August, 2007, we did a cluster-randomised trial with 16 clusters (defined as community hospitals and their catchment area). Clusters were randomly allocated by use of a variance minimisation algorithm to ParkinsonNet care (n=8) or usual care (n=8). Patients were assessed at baseline and at 8, 16, and 24 weeks of follow-up. The primary outcome was a patient preference disability score, the patient-specific index score, at 16 weeks. Health secondary outcomes were functional mobility, mobility-related quality of life, and total societal costs over 24 weeks. Analysis was by intention to treat. This trial is registered, number NCT00330694. We included 699 patients. Baseline characteristics of the patients were comparable between the ParkinsonNet clusters (n=358) and usual-care clusters (n=341). The primary endpoint was similar for patients within the ParkinsonNet clusters (mean 47.7, SD 21.9) and control clusters (48.3, 22.4). Health secondary endpoints were also similar for patients in both study groups. Total costs over 24 weeks were lower in ParkinsonNet clusters compared with usual-care clusters (difference euro727; 95% CI 56-1399). Implementation of ParkinsonNet networks did not change health outcomes for patients living in ParkinsonNet clusters. However, health-care costs were reduced in ParkinsonNet clusters compared with usual-care clusters. ZonMw; Netherlands Organisation for Scientific Research; Dutch Parkinson's Disease Society; National Parkinson Foundation; Stichting Robuust. Copyright 2010 Elsevier Ltd. All rights reserved.
Test of an antifouling treatment on tuna fish-cages in Boston Bay, Port Lincoln, South Australia.
Svane, Ib; Cheshire, Anthony; Barnett, Jeremy
2006-01-01
A test of the antifouling properties of Wattyl NetClear was conducted on fish farms containing southern bluefin tuna (Thunnus maccoyii) during a 6-month period (February-July 2002). Wattyl NetClear is a water-based synthetic latex-based coating where the active antifouling agent is a mixture of two isothiazolinones likely to affect both biochemical conditioning and bacterial colonisation. The development of fouling was monitored using underwater stereo-photogrammetry on 3 treated and 3 untreated net cages with the main factors treatment, depth and cage nested within treatment. A significant treatment and depth effect was found but variable through time and in some instances with significant cage effects. By the end of the study, the difference in fouling load between treated and untreated nets was 14.7%. In total 72% of all free-space data points were on treated nets. The dominating fouling organisms were Enteromorpha sp. and sponges with low settlement of blue mussel and paper oysters. Passive deposition of tuna faeces contributed significantly to the cover. The largest cover of fouling was observed in April-May with a dominance of sponges in June-July. Enteromorpha sp. dominated shallow depths while sponges dominated at deeper levels. Tuna faeces were distributed independent of depth but varied with time. The results showed that fouling of fish cages consisted of both active settlement and passive deposition, the latter independent on antifouling treatment.
NASA Astrophysics Data System (ADS)
Rice, S. P.
2012-04-01
The impact on sediment transport processes and channel morphology of several relatively large, iconic animals including beaver and salmon is increasingly well understood. However, many other aquatic fauna are important zoogeomorphic agents and ecosystem engineers. These somewhat overlooked "Cinderella" species include benthic aquatic insect larvae, freshwater crustaceans and many species of fish. Despite relatively modest individual effects, the ubiquity, abundance and cumulative impact of these organisms makes them a potentially significant agency, with as yet undiscovered and unquantified impacts on channel morphology and sediment fluxes. Their actions (digging, foraging, moving, burrowing), constructions and secretions modify bed sediment characteristics (grain size distribution, interlock, imbrication, protrusion), alter bed topography (thence hydraulic roughness) and contribute to biogenic restraints on grain movement. In turn, they can affect the distribution of surface particle entrainment thresholds and bed shear stresses, with implications for bed load transport. Flume experiments have measured some of these impacts and provided direct observations of the mechanisms involved, but many of the most interesting research questions pertain to the impact of these animals at reach, catchment and even landscape scales: Not least, what is the impact of small aquatic animals on bed load flux and yield? This presentation will consider some of the challenges involved in answering this question; that is, of scaling up experimental understanding of how aquatic animals affect bed load transport processes to river scales. Pertinent themes include: (1) the potential impacts of experimental arrangements on the behaviours and activities that affect hydraulic or geomorphological processes; (2) field coincidence of the spatial and temporal distributions of (a) the animals and their behaviours with (b) the physical conditions (substrates, flows) under which those animals are understood to have an effect; (3) the magnitude of any demonstrable net field impact, relative to those other factors that control bed load transport rates.
Mechanisms of ripple migration on a natural sand bed under waves
NASA Astrophysics Data System (ADS)
Carlson, E.; Foster, D. L.
2016-02-01
In nearshore environments, the wave bottom boundary layer is of particular importance to bedform migration and evolution as it is the location of energy transfer from the water column to the bed. This effort examines the mechanisms responsible for bedform evolution and migration. In a field scale laboratory study, sand ripple dynamics were measured using particle image velocimetry. Both monotonic (T = 4 s, 8 s), bimodal (wave pair T = 3.7, 4.3 s), and solitary wave cases were examined. Bedform states included orbital and anorbital rippled beds with wavelengths ranging from 5 to 15 cm. During cases of moderately high energy, time series of instantaneous ripple migration rates oscillated with the same frequency as the surface waves. The oscillatory ripple migration signature was asymmetric, with higher amplitudes during onshore directed movement. This asymmetry leads to a net onshore migration, ranging from 0.1 to 0.6 cm/min in the wave conditions mentioned. The cyclic motion of the ripple field was compared to concomitant transfer mechanisms affecting the boundary layer dynamics including: bed shear stress, coherent structure generation, and free stream velocity. Coherent structures were identified using the swirling strength criterion, and were present during each half wave developing in the ripple troughs. Two estimates of bed shear stress were made: 1) Meyer-Peter Muller method using the bed migration to determine the necessary stress and 2) double averaging of the velocity field and partitioning into components of stress, following the methods of Rodriguez-Abudo and Foster (2014). Peak ripple migration rates occurred during strengthening onshore flow, which coincides with peak bed shear stresses and the onset of coherent structure formation. Higher energy bimodal wave groups caused periods of high suspension which were coincident with peak onshore migrations, during the low velocity periods of the bimodal forcing the bed did not migrate.
Ramanantsoa, Ambinina; Wilson-Barthes, Marta; Rahenintsoa, Rindra; Hoibak, Sarah; Ranaivoharimina, Harilala; Rahelimalala, Martha Delphine; Rakotomanga, Avotiana; Finlay, Alyssa; Muela Ribera, Joan; Peeters Grietens, Koen
2017-10-10
There is growing awareness of the likely impact increased numbers of LLINs will have on the environment, if not disposed of or recycled appropriately. As part of a World Health Organization (WHO) and United Nations Environment Programme (UNEP) pilot study to assess environmentally-sound and cost-effective LLIN recycling strategies, the USAID-Deliver Project collected 22,559 used bed nets in Madagascar. A social science study was conducted to provide data on socio-cultural factors related to collection and replacement of LLINs, including impact on primary and other net uses. Ethnographic exploratory research was carried out following the pilot USAID-Deliver net collection and recycling campaign in Betioky, Tsihombe, Fenerive Est and Ambanja districts of Madagascar, triangulating participant observation, interviewing and group discussions. Sampling was theoretical and data analysis was a continuous and iterative process concurrent to data collection. Final analysis was conducted using NVivo10. The following themes emerged as contributing to the success of collecting expired LLINs in the community for recycling purposes: (i) net adequacy and preference: characteristic differences between collected and newly distributed nets lead to communities' reticence to relinquish old nets before confirming new nets were appropriate for intended use. Where newly distributed nets failed to meet local requirements, this was expected to increase alternative uses and decrease household turn over. (ii) Net collection strategies: the net collection campaign brought net use out of the private sphere and into the public arena. Net owners reported feeling ashamed when presenting damaged nets in public for collection, leading to reduced net relinquishment. (iii) Net lifecycle: communities perceived nets as being individually owned and economic value was attributed both to good-condition nets for sleeping and to worn nets for alternative/secondary purposes. Collecting nets at the stage of waste rather than at their prescribed end of life was locally acceptable. The collection of LLINs for recycling/disposal can lead to lower coverage under certain conditions. Collecting used LLINs may be appropriate under the following conditions: (i) nets are collected at the stage of waste; (ii) new nets are in line with community preferences; and (iii) collection strategies have been agreed upon within the community prior to replacement activities. Any collection/recycling of old LLINs should be based on in-depth understanding of the local context and include participatory processes to prevent reduced coverage.
Das, Ashis; Friedman, Jed; Kandpal, Eeshani; Ramana, Gandham N V; Gupta, Rudra Kumar Das; Pradhan, Madan M; Govindaraj, Ramesh
2014-12-08
Malaria continues to be a prominent global public health challenge. This study tested the effectiveness of two service delivery models for reducing the malaria burden, e.g. supportive supervision of community health workers (CHW) and community mobilization in promoting appropriate health-seeking behaviour for febrile illnesses in Odisha, India. The study population comprised 120 villages from two purposively chosen malaria-endemic districts, with 40 villages randomly assigned to each of the two treatment arms, one with both supportive supervision and community mobilization and one with community mobilization alone, as well as an observational control arm. Outcome measures included changes in the utilization of bed nets and timely care-seeking for fever from a trained provider compared to the control group. Analysis was by intention-to-treat. Significant improvements were observed in the reported utilization of bed nets in both intervention arms (84.5% in arm A and 82.4% in arm B versus 78.6% in the control arm; p < 0.001). While overall rates of treatment-seeking were equal across study arms, treatment-seeking from a CHW was higher in both intervention arms (28%; p = 0.005 and 27.6%; p = 0.007) than in the control arm (19.2%). Fever cases were significantly more likely to visit a CHW and receive a timely diagnosis of fever in the combined interventions arm than in the control arm (82.1% vs. 67.1%; p = 0.025). Care-seeking from trained providers also increased with a substitution away from untrained providers. Further, fever cases from the combined interventions arm (60.6%; p = 0.004) and the community mobilization arm (59.3%; p = 0.012) were more likely to have received treatment from a skilled provider within 24 hours than fever cases from the control arm (50.1%). In particular, women from the combined interventions arm were more likely to have received timely treatment from a skilled provider (61.6% vs. 47.2%; p = 0.028). A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization and can be effective in improving care-seeking and preventive behaviour and may be used to strengthen the national malaria control programme.
The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi
Stevens, Warren; Wiseman, Virginia; Ortiz, Juan; Chavasse, Desmond
2005-01-01
Background Insecticide-treated nets (ITNs) are a proven intervention to reduce the burden of malaria, yet there remains a debate as to the best method of ensuring they are universally utilized. This study is a cost-effectiveness analysis of an intervention in Malawi that started in 1998, in Blantyre district, before expanding nationwide. Over the 5-year period, 1.5 million ITNs were sold. Methods The costs were calculated retrospectively through analysis of expenditure data. Costs and effects were measured as cost per treated-net year (cost/TNY) and cost per net distributed. Results The mean cost/TNY was calculated at $4.41, and the mean cost/ITN distributed at $2.63. It also shows evidence of economies of scale, with the cost/TNY falling from $7.69 in year one (72,196 ITN) to $3.44 in year five (720,577 ITN). Cost/ITN distributed dropped from $5.04 to $1.92. Conclusion Combining targeting and social marketing has the potential of being both cost-effective and capable of achieving high levels of coverage, and it is possible that increasing returns to scale can be achieved. PMID:15885143
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1993-11-01
Municipal sanitary landfills generate leachate that New York State regulations require to be collected and treated to avoid contaminating surface water and groundwater. One option for treating leachate is to haul it to municipal wastewater treatment facility. This option may be expensive, may require excessive energy for transportation, and may require pretreatment to protect the receiving facility`s processes. An alternative is on-site treatment and discharge. Personnel from the Town of Fenton, New York; Hawk Engineering, P.C.; Cornell University; and Ithaca College designed, built, and operated a pilot constructed wetland for treating leachate at the Town of Fenton`s municipal landfill. Themore » system, consisting of two overland flow beds and two subsurface flow beds has been effective for 18 months in reducing levels of ammonia (averaging 85% removal by volatilization and denitrification) and total iron (averaging 95% removal by precipitation and sedimentation), two key constituents of the Fenton landfill`s leachate. The system effects these reductions with zero chemical and energy inputs and minimal maintenance. A third key constituent of the leachate, manganese, apparently passes through the beds with minimal removal. Details and wetland considerations are described.« less
Jeffrey M. Kane; Eric E. Knapp; J. Morgan Varner
2006-01-01
The use of mechanical mastication to treat non-merchantable fuels is becoming increasingly popular, but loadings and other characteristics of masticated fuel beds are unknown. Surveys of eight recently masticated sites in northern California and southwestern Oregon indicate that significant site level differences were detected for 1 hr and 10 hr time-lag classes and...
Sediment transport on the Palos Verdes shelf over seasonal to decadal time scales
Wiberg, P.L.; Drake, D.E.; Harris, C.K.; Noble, M.
2002-01-01
We combine direct observations, longer-term wave data, and model calculations to characterize resuspension and transport of fine-grained, effluent-affected sediment on the Palos Verdes shelf. Near-bed waves, currents, and suspended sediment concentrations were monitored during the winter of 1992-93 with a bottom tripod and current-meter mooring at a 63-m-deep site. Wave conditions that winter were moderate (??? 2 year recurrence interval), and mean current was alongshelf to the northwest; currents were not significantly correlated with wave conditions. Seven wave events during the winter (December-March) produced near-bed wave orbital velocities at the study site in excess of 14 cm s-1, the observed threshold for significant resuspension. Three of these events occurred during the bottom tripod deployment and are characterized by the highest persistent suspended sediment concentrations in the tripod record. Suspended sediment flux was alongshelf to the northwest for 5 of the 6 wave events for which current data were available; one event occurred during low southeast currents. Measured suspended sediment concentration and grain size generally agree with values that were calculated using a shelf sediment transport model with no adjustment of parameters from values determined for two muddy sites on the northern California shelf. We extend our seasonal observations to a period of almost 2 decades by applying the observed thresholds for wave-driven resuspension to near-bed wave conditions calculated from NDBC Buoy 46025 surface wave data. An average of 10 resuspension events per year, with an average duration of 1.6 days, were identified at a water depth of 60 m; the number of events dropped to 3 per year at 90 m, beyond the shelf break. For the majority of these events, calculated net suspended sediment flux is toward the northwest (alongshelf) at an average rate of 140 kg m-1 h-1; about a third of the events have net southeastward flux at an average rate of 30 kg m-1 h-1. The calculated thickness of the resuspended surface layer of the bed was less than 1 cm for all events at 60 m. ?? 2002 Elsevier Science Ltd. All rights reserved.
Burch, Tucker R; Sadowsky, Michael J; LaPara, Timothy M
2013-09-03
This study investigated whether air-drying beds reduce antibiotic resistance gene (ARG) concentrations in residual municipal wastewater solids. Three laboratory-scale drying beds were operated for a period of nearly 100 days. Real-time PCR was used to quantify 16S rRNA genes, 16S rRNA genes specific to fecal bacteria (AllBac) and human fecal bacteria (HF183), the integrase gene of class 1 integrons (intI1), and five ARGs representing a cross-section of antibiotic classes and resistance mechanisms (erm(B), sul1, tet(A), tet(W), and tet(X)). Air-drying beds were capable of reducing all gene target concentrations by 1 to 5 orders of magnitude, and the nature of this reduction was consistent with both a net decrease in the number of bacterial cells and a lack of selection within the microbial community. Half-lives varied between 1.5 d (HF183) and 5.4 d (tet(X)) during the first 20 d of treatment. After the first 20 d of treatment, however, half-lives varied between 8.6 d (tet(X)) and 19.3 d (AllBac), and 16S rRNA gene, intI1, and sul1 concentrations did not change (P > 0.05). These results demonstrate that air-drying beds can reduce ARG and intI1 concentrations in residual municipal wastewater solids within timeframes typical of operating practices.
Omudu, E A; Kuse, C N
2010-12-01
The common bedbug Cimex lectularius Linnaeus 1758 (Hemiptera: Cimicidae) is a globally re-emerging pest of serious public health concern. We investigated bedbug infestation in randomly selected apartments in Gbajimba community in Guma Local Government area in Benue state, Nigeria. Beddings and furniture (bed frames, pillows, mattresses, cushion chairs, mats, mosquito nets and bamboo beds) were thoroughly inspected for bedbug infestation using the hand-picking technique. Data were analysed using chi- square analysis for differences in the infestation levels in harbourages and sampling locations. Only 16% of the apartments investigated showed no evidence of bedbug infestation as egg cases and faecal marks were sighted in 62.2% of apartments surveyed. The highest infestation rate was observed in Angwan Jukun area and infestation here was higher compared to other study locations within the town though the difference was not statistically significant (x2 = 7.92, df = 6, p >0.05). Bamboo beds harboured the highest number of bedbugs collected, accounting for 35.8%, while other harbourages like iron bed frames and sleeping mats had 23 and 22.7% infestation rates respectively. The infestation rates in these household items were significantly higher than other items inspected (x2 = 11.8, df = 4, p > 0.05). This study demonstrates the urgent need for identification of evidences of infestation and bedbug management involving community participation in inspection, detection and education, including physical removal and exclusion as well as pesticide application.
NASA Astrophysics Data System (ADS)
Sheppard, Jill N.; James, Nicola C.; Whitfield, Alan K.; Cowley, Paul D.
2011-11-01
Habitat variability is one of the factors influencing species richness within estuarine systems, and a loss of habitat can result in a restructuring of the estuarine ichthyofaunal assemblage, particularly if these conditions persist over long time periods. The potential effects of the loss of extensive submerged macrophyte beds ( Ruppia cirrhosa and Potamogeton pectinatus) on an estuarine fish assemblage were investigated through an analysis of a long-term seine net catch dataset from the temporarily open/closed East Kleinemonde Estuary, South Africa. Catch data for a 12-year period, encompassing six years of macrophyte presence and six years of macrophyte senescence, indicated that the loss of this habitat did not influence species richness but changes in the relative abundance of certain species were evident. A shift in dominance from vegetation-associated species to those associated with sandy environments ( e.g. members of the family Mugilidae) was observed. However, species wholly dependent on macrophytes such as the critically endangered estuarine pipefish Syngnathus watermeyeri were only recorded during years when macrophyte beds were present, while vegetation-associated species such as the sparid Rhabdosargus holubi persisted at lower levels of relative abundance. The reduced abundance of all vegetation-associated fish species during years of macrophyte senescence was probably reflective of declining food resources resulting from the loss of macrophyte beds and/or increased vulnerability to predation. Submerged beds of aquatic plants are therefore important habitats within temporarily open/closed estuaries, South Africa's dominant estuary type.
NASA Astrophysics Data System (ADS)
Asmus, H.; Asmus, R.
2000-07-01
Material exchange, biodiversity and trophic transfer within the food web were investigated in two different types of intertidal seagrass beds: a sheltered, dense Zostera marina bed and a more exposed, sparse Z. noltii bed, in the Northern Wadden Sea. Both types of Zostera beds show a seasonal development of above-ground biomass, and therefore measurements were carried out during the vegetation period in summer. The exchange of particles and nutrients between seagrass beds and the overlying water was measured directly using an in situ flume. Particle sedimentation [carbon (C), nitrogen (N) and phosphorus (P) constituents] from the water column prevailed in dense seagrass beds. In the sheltered, dense seagrass bed, a net particle uptake was found even on windy days (7-8 Beaufort). Dissolved inorganic N and orthophosphate were mainly taken up by the dense seagrass bed. At times of strong winds, nutrients were released from the benthic community to tidal waters. In a budget calculation of total N and total P, the dense seagrass beds were characterised as a material sink. The seagrass beds with sparse Z. noltii were a source of particles even during calm weather. The uptake of dissolved inorganic N in the sparse seagrass bed was low but significant, while the uptake of inorganic phosphate and silicate by seagrasses and their epiphytes was exceeded by release processes from the sediment into the overlying water. Estimates at the ecosystem level showed that material fluxes of seagrass beds in the Sylt-Rømø Bight are dominated by the dense type of Zostera beds. Therefore, seagrass beds act as a sink for particles and for dissolved inorganic nutrients. During storms, seagrass beds are distinct sources for inorganic nutrients. The total intertidal area of the Sylt-Rømø Bight could be described as a sink for particles and a source for dissolved nutrients. This balance of the material budget was estimated by either including or excluding seagrass beds. Including the subtidal part, the function of the ecosystem as a source for particles increased, supposing that all seagrass beds were lost from the area. During the vegetation period, seagrass beds act as a storage compartment for material accumulated in the living biomass of the community. There was great biodiversity among the plant and animal groups found in intertidal seagrass beds of the Sylt-Rømø Bay, representing 50-86% of the total number of species investigated, depending on the particular group. Since most species are not exclusively seagrass residents, the loss of intertidal seagrass beds would be of minor importance for biodiversity at the ecosystem level. Food web structure in seagrass beds is different from other intertidal communities. Primary production and detritus input is high, but secondary production is similar to that of unvegetated areas, although the relative importance of the trophic guilds is different. The loss of seagrass beds leads to profound alterations in the food web of the total ecosystem. Historical as well as recent changes in material fluxes and energy flow due to man-made alterations to the ecosystem are discussed.
Effects of wave shape on sheet flow sediment transport
Hsu, T.-J.; Hanes, D.M.
2004-01-01
A two-phase model is implemented to study the effects of wave shape on the transport of coarse-grained sediment in the sheet flow regime. The model is based on balance equations for the average mass, momentum, and fluctuation energy for both the fluid and sediment phases. Model simulations indicate that the responses of the sheet flow, such as the velocity profiles, the instantaneous bed shear stress, the sediment flux, and the total amount of the mobilized sediment, cannot be fully parameterized by quasi-steady free-stream velocity and may be correlated with the magnitude of local horizontal pressure gradient (or free-stream acceleration). A net sediment flux in the direction of wave advance is obtained for both skewed and saw-tooth wave shapes typical of shoaled and breaking waves. The model further suggests that at critical values of the horizontal pressure gradient, there is a failure event within the bed that mobilizes more sediment into the mobile sheet and enhances the sediment flux. Preliminary attempts to parameterize the total bed shear stress and the total sediment flux appear promising. Copyright 2004 by the American Geophysical Union.
NASA Technical Reports Server (NTRS)
Fox, E. C.; Kiefel, E. R.; Mcintosh, G. L.; Sharpe, J. B.; Sheahan, D. R.; Wakefield, M. E.
1993-01-01
The development of a test bed tank and system for evaluating cryogenic fluid management technologies in a simulated upper stage liquid hydrogen tank is covered. The tank is 10 ft long and is 10 ft in diameter, and is an ASME certified tank constructed of 5083 aluminum. The tank is insulated with a combination of sprayed on foam insulation, covered by 45 layers of double aluminized mylar separated by dacron net. The mylar is applied by a continuous wrap system adapted from commercial applications, and incorporates variable spacing between the mylar to provide more space between those layers having a high delta temperature, which minimizes heat leak. It also incorporates a unique venting system which uses fewer large holes in the mylar rather than the multitude of small holes used conventionally. This significantly reduces radiation heat transfer. The test bed consists of an existing vacuum chamber at MSFC, the test bed tank and its thermal control system, and a thermal shroud (which may be heated) surrounding the tank. Provisions are made in the tank and chamber for inclusion of a variety of cryogenic fluid management experiments.
Distribution and stability of eelgrass beds at Izembek Lagoon, Alaska
Ward, David H.; Markon, Carl J.; Douglas, David C.
1997-01-01
Spatial change in eelgrass meadows, Zostera marina L., was assessed between 1978 and 1987 and between 1987 and 1995 at Izembek Lagoon, Alaska. Change in total extent was evaluated through a map to map comparison of data interpreted from a 1978 Landsat multi-spectral scanner image and 1987 black and white aerial photographs. A ground survey in 1995 was used to assess spatial change from 1987. Eelgrass beds were the predominant vegetation type in the lagoon, comprising 44-47% (15000-16000 ha) of the total area in 1978 and 1987. Izembek Lagoon contains the largest bed of seagrass along the Pacific Coast of North America and largest known single stand of eelgrass in the world. There was a high degree of overlap in the spatial distribution of eelgrass among years of change detection. The overall net change was a 6% gain between, 1978 and 1987 and a <1% gain between 1987 and 1995. The lack of significant change in eelgrass cover suggests that eelgrass meadows in Izembek Lagoon have been stable during the 17-year period of our study.
Vanden Eng, Jodi L; Mathanga, Don P; Landman, Keren; Mwandama, Dyson; Minta, Anna A; Shah, Monica; Sutcliffe, James; Chisaka, Joseph; Lindblade, Kim A; Steinhardt, Laura
2017-10-10
Measuring the physical condition of long-lasting insecticidal nets (LLINs) under field conditions is of great importance for malaria control programmes to guide decisions on how frequently to replace LLINs. Current guidelines by the World Health Organization Pesticide Evaluation Scheme (WHOPES) propose a proportionate hole index (pHI) for assessing LLIN condition by counting the number of holes the size of a thumb, fist, head, and larger than a head. However, this method does not account for irregular hole shapes or exact hole sizes which could result in inaccurate decisions about when to replace LLINs. LLINs were collected during a 2013 health facility-based malaria case control study in Machinga District, Malawi. To evaluate the accuracy of the pHI, the physical condition of 277 LLINs was estimated by the WHOPES method and then compared with two more thorough measurement methods: image analysis of digital photographs of each LLIN side; and for 10 nets, ruler measurements of the length, width, and location of each hole. Total hole counts and areas per net were estimated by each method, and detailed results of hole shapes and composite pictures of hole locations were generated using image analysis. The WHOPES method and image analysis resulted in similar estimates of total hole counts, each with a median of 10 (inter-quartile range (IQR) 4-24 and 4-23, respectively; p = 0.004); however, estimated hole areas were significantly larger using the WHOPES method (median 162 cm 2 , IQR 28-793) than image analysis (median 13 cm 2 , IQR 3-101; p < 0.0001). The WHOPES method classified fewer LLINs in 'good condition' compared to image analysis (42% vs 74%). The ruler method detected significantly more holes than image analysis did (p = 0.002) in 10 LLINs; however, total hole area was not significantly different (p = 0.16). Most holes were not circular but roughly 2-5 times longer in one direction. The lower quarter of LLIN sides was found to have the most holes. The WHOPES method overestimated total hole area, likely because holes are elongated rather than circular, suggesting further adjustments to the pHI formula may be warranted when considering LLIN replacement strategies.
Fluidized bed selective pyrolysis of coal
Shang, J.Y.; Cha, C.Y.; Merriam, N.W.
1992-12-15
The present invention discloses a process for the pyrolysis of coal which comprises the effective utilization of two zonal inclined fluidized beds, where said zones can be selectively controlled as to temperature and heating rate. The first zonal inclined fluidized bed serves as a dryer for crushed coal and additionally is controlled to selectively pyrolyze said coal producing substantially carbon dioxide for recycle use. The second zonal inclined fluidized bed further pyrolyses the coal to gaseous, liquid and char products under controlled temperature and heating rate zones designed to economically integrate the product mix. The gas and liquid products are recovered from the gaseous effluent stream while the char which remains can be further treated or utilized in a subsequent process step. 9 figs.
Fluidized bed selective pyrolysis of coal
Shang, Jer Y.; Cha, Chang Y.; Merriam, Norman W.
1992-01-01
The present invention discloses a process for the pyrolysis of coal which comprises the effective utilization of two zonal inclined fluidized beds, where said zones can be selectively controlled as to temperature and heating rate. The first zonal inclined fluidized bed serves as a dryer for crushed coal and additionally is controlled to selectively pyrolyze said coal producing substantially carbon dioxide for recycle use. The second zonal inclined fluidized bed further pyrolyzes the coal to gaseous, liquid and char products under controlled temperature and heating rate zones designed to economically integrate the product mix. The gas and liquid products are recovered from the gaseous effluent stream while the char which remains can be further treated or utilized in a subsequent process step.
Overcrowding and diversion in the emergency department: the health care safety net unravels.
Velianoff, George D
2002-03-01
Emergency department overcrowding and diversion of patients are serious problems that are symptomatic of larger health care system issues. Downsizing, government regulations, managed care, increased numbers of uninsured, and reimbursement decreases are issues that have created the overcrowding and diversion issues. The Emergency Medical Treatment and Active Labor Act (EMTALA), poor operations and hospital processes, unavailable inpatient beds and closures, consolidations and workforce shortages are also contributors to the overcrowding and diversion issues. Options and solutions are proposed to alleviate the problem, however, greater collaboration, changed work environments, and reimbursement structures need to be developed and instituted. The safety net of the US health system is unraveling, and without intervention, the emergency department will not be able to provide services to the public at any level of quality and efficiency.
Whisnant, Joshua A.; Hansen, Cristi V.; Eslick, Patrick J.
2015-10-01
Groundwater levels from January 2014 to January 2015 in the central part of the study area rose about 3 feet in some places, probably because Wichita reduced its withdrawals from the aquifer in 2014 by more than 50 percent. Groundwater levels probably recovered less than anticipated because of decreased recharge and net groundwater flow and increased agricultural pumpage. A volumetric water budget for the central part of the study area between 2013 and 2014 showed that the substantial decrease in total pumping (10,412 acre-feet) did not result in an increase in storage volume because it was more than offset by decreased recharge (6,502 acre-feet; artificial and from precipitation) and an even greater decrease in net groundwater flow (11,710 acre-feet).
Effects of health insurance on non-working married women’s medical care use and bed days at home
2013-01-01
Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements. PMID:23816313
Effects of health insurance on non-working married women's medical care use and bed days at home.
Lee, Changwoo; Shin, Euichul
2013-07-01
This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual's health insurance status. This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. In contrast to previous studies' findings indicating that absences from work and medical care use among working males may be complements, this study's results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements.
Consonni, S; Giugliano, M; Grosso, M
2005-01-01
This two-part paper assesses four strategies for energy recovery from Municipal Solid Waste (MSW) by dedicated Waste-To-Energy (WTE) plants. In strategy 1, the residue of Material Recovery (MR) is fed directly to a grate combustor, while in strategy 2 the grate combustor comes downstream of light mechanical treatment. In strategies 3 and 4, the MR residue is converted into Refuse Derived Fuel (RDF), in a fluidized cumbuster bed. The results of Part A, devoted to mass and energy balances, clearly show that pre-treating the MR residue in order to increase the heating value of the feedstock fed to the WTE plant has marginal effects on the energy efficiency of the WTE plant. When considering the efficiency of the whole strategy of waste management, the energy balances show that the more thorough the pre-treatment, the smaller the amount of energy recovered per unit of MR residue. Starting from the heat/mass balances illustrated in Part A, Part B examines the environmental impacts and economics of the various strategies by means of a Life Cycle Assessment (LCA). Results show that treating the MR residues ahead of the WTE plant does not provide environmental or economic benefits. RDF production worsens almost all impact indicators because it reduces net electricity production and thus the displacement of power plant emissions; it also increases costs, because the benefits of improving the quality of the material fed to the WTE plant do not compensate the cost of such improvement.
Evaluation of a model community-wide bed bug management program in affordable housing.
Cooper, Richard A; Wang, Changlu; Singh, Narinderpal
2016-01-01
Low-income apartment communities in the United States are suffering from disproportionally high bed bug, Cimex lectularius L., infestations owing to lack of effective monitoring and treatment. Studies examining the effectiveness of integrated pest management (IPM) for the control of bed bugs in affordable housing have been limited to small subsets of bed-bug-infested apartments, rather than at the apartment community level. We developed, implemented and evaluated a complex-wide IPM program for bed bugs in an affordable housing community. Proactive inspections and biweekly treatments using a combination of non-chemical and chemical methods until bed bugs were not detected for three biweekly monitoring visits were key elements of the IPM program. A total of 55 bed-bug-infested apartments were identified during the initial inspection. Property management was unaware of 71% of these infestations. Over the next 12 months, 14 additional infested apartments were identified. The IPM program resulted in a 98% reduction in bed bug counts among treated apartments and reduced infestation rates from 15 to 2.2% after 12 months. Adopting a complex-wide bed bug IPM program, incorporating proactive monitoring, and biweekly treatments of infested apartments utilizing non-chemical and chemical methods can successfully reduce infestation rates to very low levels. © 2015 Society of Chemical Industry.
Sorbent-Based Atmosphere Revitalization System
NASA Technical Reports Server (NTRS)
Knox, James C (Inventor); Miller, Lee A. (Inventor)
2017-01-01
The present invention is a sorbent-based atmosphere revitalization (SBAR) system using treatment beds each having a bed housing, primary and secondary moisture adsorbent layers, and a primary carbon dioxide adsorbent layer. Each bed includes a redirecting plenum between moisture adsorbent layers, inlet and outlet ports connected to inlet and outlet valves, respectively, and bypass ports connected to the redirecting plenums. The SBAR system also includes at least one bypass valve connected to the bypass ports. An inlet channel connects inlet valves to an atmosphere source. An outlet channel connects the bypass valve and outlet valves to the atmosphere source. A vacuum channel connects inlet valves, the bypass valve and outlet valves to a vacuum source. In use, one bed treats air from the atmosphere source while another bed undergoes regeneration. During regeneration, the inlet, bypass, and outlet valves sequentially open to the vacuum source, removing accumulated moisture and carbon dioxide.
NASA Astrophysics Data System (ADS)
Azhikodan, Gubash; Yokoyama, Katsuhide
2018-03-01
The erosion and deposition dynamics of fine sediment in a highly turbid estuarine channel were successfully surveyed during the period from August 29 to September 12, 2009 using an echo sounder in combination with a high-resolution acoustic Doppler current profiler. Field measurements were conducted focusing on the tide driven dynamics of suspended sediment concentration (SSC), and fluid mud at the upstream of the macrotidal Chikugo river estuary during semidiurnal and fortnightly tidal cycles. Morphological evolution was observed especially during the spring tide over a period of two weeks. The elevation of the channel bed was stable during neap tide, but it underwent fluctuations when the spring tide occurred owing to the increase in the velocity and shear stress. Two days of time lag were observed between the maximum SSC and peak tidal flow, which resulted in the asymmetry between neap-to-spring and spring-to-neap transitions. During the spring tide, a hysteresis loop was observed between shear stress and SSC, and its direction was different during flood and ebb tides. Although both fine sediments and flocs were dominant during flood tides, only fine sediments were noticed during ebb tides. Hence, the net elevation change in the bed was positive, and sedimentation took place during the semilunar tidal cycle. Finally, a bed of consolidated mud was deposited on the initial bed, and the height of the channel bed increased by 0.9 m during the two-week period. The observed hysteretic effect between shear stress and SSC during the spring tides, and the asymmetrical neap-spring-neap tidal cycle influenced the near-bed sediment dynamics of the channel, and led to the formation of a fluid mud layer at the bottom of the river.
David Frankman; Brent W. Webb; Bret W. Butler
2007-01-01
Thermal radiation emission from a simulated black flame surface to a fuel bed is analyzed by a ray-tracing technique, tracking emission from points along the flame to locations along the fuel bed while accounting for absorption by environmental water vapor in the intervening medium. The Spectral Line Weighted-sum-of-gray-gases approach was adopted for treating the...
Dittmer, D. K.; Teasell, R.
1993-01-01
Prolonged bed rest and immobilization inevitably lead to complications. Such complications are much easier to prevent than to treat. Musculoskeletal complications include loss of muscle strength and endurance, contractures and soft tissue changes, disuse osteoporosis, and degenerative joint disease. Cardiovascular complications include an increased heart rate, decreased cardiac reserve, orthostatic hypotension, and venous thromboembolism. Images Figures 1-2 Figures 3-4 PMID:8324411
Pinto-Gouveia, José; Carvalho, Sérgio A; Palmeira, Lara; Castilho, Paula; Duarte, Cristiana; Ferreira, Cláudia; Duarte, Joana; Cunha, Marina; Matos, Marcela; Costa, Joana
2017-09-01
Binge eating disorder (BED) is associated with several psychological and medical problems, such as obesity. Approximately 30% of individuals seeking weight loss treatments present binge eating symptomatology. Moreover, current treatments for BED lack efficacy at follow-up assessments. Developing mindfulness and self-compassion seem to be beneficial in treating BED, although there is still room for improvement, which may include integrating these different but complimentary approaches. BEfree is the first program integrating psychoeducation-, mindfulness-, and compassion-based components for treating women with binge eating and obesity. To test the acceptability and efficacy up to 6-month postintervention of a psychological program based on psychoeducation, mindfulness, and self-compassion for obese or overweight women with BED. A controlled longitudinal design was followed in order to compare results between BEfree (n = 19) and waiting list group (WL; n = 17) from preintervention to postintervention. Results from BEfree were compared from preintervention to 3- and 6-month follow-up. BEfree was effective in eliminating BED; in diminishing eating psychopathology, depression, shame and self-criticism, body-image psychological inflexibility, and body-image cognitive fusion; and in improving obesity-related quality of life and self-compassion when compared to a WL control group. Results were maintained at 3- and 6-month follow-up. Finally, participants rated BEfree helpful for dealing with impulses and negative internal experiences. These results seem to suggest the efficacy of BEfree and the benefit of integrating different components such as psychoeducation, mindfulness, and self-compassion when treating BED in obese or overweight women. The current study provides evidence of the acceptability of a psychoeducation, mindfulness, and compassion program for binge eating in obesity (BEfree); Developing mindfulness and self-compassionate skills is an effective way of diminishing binge eating, eating psychopathology and depression, and increasing quality of life in women with obesity; Integrating psychoeducation, mindfulness, and compassion seem to be effective in diminishing binge eating, with results maintained up to 6-month postintervention. Copyright © 2017 John Wiley & Sons, Ltd.
Haque, Ubydul; Overgaard, Hans J; Clements, Archie C A; Norris, Douglas E; Islam, Nazrul; Karim, Jahirul; Roy, Shyamal; Haque, Waziul; Kabir, Moktadir; Smith, David L; Glass, Gregory E
2014-02-01
Malaria is endemic in 13 of 64 districts in Bangladesh. About 14 million people are at risk. Some evidence suggests that the prevalence of malaria in Bangladesh has decreased since the the Global Fund to Fight AIDS, Tuberculosis and Malaria started to support the National Malaria Control Program (NMCP) in 2007. We did an epidemiological and economic assessment of malaria control in Bangladesh. We obtained annually reported, district-level aggregated malaria case data and information about disbursed funds from the NMCP. We used a Poisson regression model to examine the associations between total malaria, severe malaria, malaria-attributable mortality, and insecticide-treated net coverage. We identified and mapped malaria hotspots using the Getis-Ord Gi* statistic. We estimated the cost-effectiveness of the NMCP by estimating the cost per confirmed case, cost per treated case, and cost per person of insecticide-treated net coverage. During the study period (from Jan 1, 2008, to Dec 31, 2012) there were 285,731 confirmed malaria cases. Malaria decreased from 6.2 cases per 1000 population in 2008, to 2.1 cases per 1000 population in 2012. Prevalence of all malaria decreased by 65% (95% CI 65-66), severe malaria decreased by 79% (78-80), and malaria-associated mortality decreased by 91% (83-95). By 2012, there was one insecticide-treated net for every 2.6 individuals (SD 0.20). Districts with more than 0.5 insecticide-treated nets per person had a decrease in prevalence of 21% (95% CI 19-23) for all malaria, 25% (17-32) for severe malaria, and 76% (35-91) for malaria-associated mortality among all age groups. Malaria hotspots remained in the highly endemic districts in the Chittagong Hill Tracts. The cost per diagnosed case was US$0.39 (SD 0.02) and per treated case was $0.51 (0.27); $0.05 (0.04) was invested per person per year for health education and $0.68 (0.30) was spent per person per year for insecticide-treated net coverage. Malaria elimination is an achievable prospect in Bangladesh and failure to push for elimination nearly ensures a resurgence of disease. Consistent financing is needed to avoid resurgence and maintain elimination goals. None. Copyright © 2014 Haque et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.
Disrupting Mosquito Reproduction and Parasite Development for Malaria Control
Gabrieli, Paolo; Buckee, Caroline O.; Catteruccia, Flaminia
2016-01-01
The control of mosquito populations with insecticide treated bed nets and indoor residual sprays remains the cornerstone of malaria reduction and elimination programs. In light of widespread insecticide resistance in mosquitoes, however, alternative strategies for reducing transmission by the mosquito vector are urgently needed, including the identification of safe compounds that affect vectorial capacity via mechanisms that differ from fast-acting insecticides. Here, we show that compounds targeting steroid hormone signaling disrupt multiple biological processes that are key to the ability of mosquitoes to transmit malaria. When an agonist of the steroid hormone 20-hydroxyecdysone (20E) is applied to Anopheles gambiae females, which are the dominant malaria mosquito vector in Sub Saharan Africa, it substantially shortens lifespan, prevents insemination and egg production, and significantly blocks Plasmodium falciparum development, three components that are crucial to malaria transmission. Modeling the impact of these effects on Anopheles population dynamics and Plasmodium transmission predicts that disrupting steroid hormone signaling using 20E agonists would affect malaria transmission to a similar extent as insecticides. Manipulating 20E pathways therefore provides a powerful new approach to tackle malaria transmission by the mosquito vector, particularly in areas affected by the spread of insecticide resistance. PMID:27977810
Art and theatre for health in rural Cambodia.
Nguon, Chea; Dysoley, Lek; Davoeung, Chan; Sovann, Yok; Sanann, Nou; Sareth, Ma; Kunthea, Pich; Vuth, San; Sovann, Kem; Kol, Kayna; Heng, Chhouen; Sary, Rouen; Peto, Thomas J; Tripura, Rupam; Lim, Renly; Cheah, Phaik Yeong
2018-01-01
This article describes our experience using art and theatre to engage rural communities in western Cambodia to understand malaria and support malaria control and elimination. The project was a pilot science-arts initiative to supplement existing engagement activities conducted by local authorities. In 2016, the project was conducted in 20 villages, involved 300 community members and was attended by more than 8000 people. Key health messages were to use insecticide-treated bed-nets and repellents, febrile people should attend village malaria workers, and to raise awareness about the risk of forest-acquired malaria. Building on the experience and lessons learnt in the year prior, the 2017 project which was conducted in 15 villages involved 600 community members and attracted more than 12,000 people. In addition to the malaria theme, upon discussion with local health authorities, secondary theme (infant vaccination) was added to the 2017 project. We learnt the following lessons from our experience in Cambodia: involving local people including children from the beginning of the project and throughout the process is important; messages should be kept simple; it is necessary to take into consideration practical issues such as location and timing of the activities; and that the project should offer something unique to communities.
Analysis of cash flow in academic medical centers in the United States.
McCue, Michael J; Thompson, Jon M
2011-09-01
To examine cash flow margins in academic medical centers (AMCs; i.e., teaching hospitals) in an effort both to determine any significant differences in a set of operational and financial factors known to influence cash flow for high- and low-cash-flow AMCs and to discuss how these findings affect AMC operations. The authors sampled the Medicare cost report data of 103 AMCs for fiscal years 2005, 2006, and 2007, and then they applied the t test to test for significant mean differences between the two cash flow groups across operational and financial variables (e.g., case mix, operating margin). Compared with low-cash-flow AMCs, high-cash-flow AMCs were larger-bed-size facilities, treated cases of greater complexity, generated higher net patient revenue per adjusted discharge, served a significantly lower percentage of Medicaid patients, had significantly higher average operating profit margins and cash flow margin ratios, possessed a higher number of days of cash on hand, and collected their receivables more quickly. Study findings imply that high-cash-flow AMCs were earning higher cash flow returns than low-cash-flow AMCs, which may be because high-cash-flow AMCs generate higher patient revenues while serving fewer lower-paying Medicaid patients.
Climbing Ability of the Common Bed Bug (Hemiptera: Cimicidae).
Hottel, B A; Pereira, R M; Gezan, S A; Qing, R; Sigmund, W M; Koehler, P G
2015-05-01
Little is known about what factors influence the climbing ability of bed bugs, Cimex lectularius L. (Hemiptera: Cimicidae), in relation to the various surfaces they encounter. We examined how sex, time since last fed, and what surfaces the bed bugs were in contact with affected their climbing performance. The effects of sex and time since fed were tested by counting the number of bed bugs able to climb a 45° slope. The pulling force was recorded using an analytical balance technique that captured the sequential vertical pulling force output of bed bugs attached to various surfaces. Recently fed female bed bugs were found to have the most difficulty in climbing smooth surfaces in comparison with males. This difference can be explained by the larger weight gained from bloodmeals by female bed bugs. A variety of vertical pulling forces were observed on surfaces ranging from sandpaper to talc powder-covered glass. For surfaces not treated with talc powder, bed bugs generated the least amount of vertical pulling force from synthetically created 0.6-µm plastron surfaces. This vast range in the ability of bed bugs to grip onto various surfaces may have implications on limiting bed bugs dispersal and hitchhiking behaviors. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Wang, Changlu; Singh, Narinderpal; Cooper, Richard
2014-11-05
Bed bugs (Cimex lectularius L. and Cimex hemipterus F.) are among the most difficult urban pests to manage. Many essential oil-based bed bug control products that are considered reduced risk to mammals compared to synthetic insect neurotoxins have become commercially available, but their effectiveness as a stand-alone control method is unknown. This study assessed the field efficacy of an essential oil-based bed bug control product (EcoRaider; a.i. 1% geraniol + 1% cedar oil + 2% sodium lauryl sulfate) compared to a pyrethroid and neonicotinoid mixture spray (0.075% Temprid SC; a.i. beta-cyfluthrin + imidacloprid). After 12 weeks, the three treatments-EcoRaider, Temprid SC, and EcoRaider + Temprid SC caused 92.5 ± 2.7, 92.9 ± 3.0, and 91.7% ± 2.7% bed bug count reduction, respectively. No significant differences existed in the bed bug reduction among the treatments. Bed bugs were eliminated from only 22% of the treated apartments. Among those still with bed bugs, 76% of the residents did not know bed bugs were present. We documented the residents' self-control practices and discussed the potential of using essential oil-based insecticides in bed bug management programs to minimize the health risks to building occupants and pets and to slow down the development of insecticide resistance.
Wang, Changlu; Singh, Narinderpal; Cooper, Richard
2014-01-01
Bed bugs (Cimex lectularius L. and Cimex hemipterus F.) are among the most difficult urban pests to manage. Many essential oil-based bed bug control products that are considered reduced risk to mammals compared to synthetic insect neurotoxins have become commercially available, but their effectiveness as a stand-alone control method is unknown. This study assessed the field efficacy of an essential oil-based bed bug control product (EcoRaider; a.i. 1% geraniol + 1% cedar oil + 2% sodium lauryl sulfate) compared to a pyrethroid and neonicotinoid mixture spray (0.075% Temprid SC; a.i. beta-cyfluthrin + imidacloprid). After 12 weeks, the three treatments—EcoRaider, Temprid SC, and EcoRaider + Temprid SC caused 92.5 ± 2.7, 92.9 ± 3.0, and 91.7% ± 2.7% bed bug count reduction, respectively. No significant differences existed in the bed bug reduction among the treatments. Bed bugs were eliminated from only 22% of the treated apartments. Among those still with bed bugs, 76% of the residents did not know bed bugs were present. We documented the residents’ self-control practices and discussed the potential of using essential oil-based insecticides in bed bug management programs to minimize the health risks to building occupants and pets and to slow down the development of insecticide resistance. PMID:26462944
Davison, L; Headley, T; Pratt, K
2005-01-01
Reed beds (horizontal subsurface flow constructed wetlands) have been employed as secondary treatment devices in on-site and decentralised wastewater management systems in the northeast of the Australian state of New South Wales (NSW) for over a decade. This paper summarises some of the practical and research findings that have come to light in that time. Experience with various aspects of reed bed structure is discussed. A study of the evaporative performance of four small beds planted with Phragmites australis yielded an annual crop factor of 2.6. A total of 28 studies on reed beds treating a variety of commonly encountered wastewater streams yielded the following mean pollutant removal efficiencies: total suspended solids (TSS) 83%, biochemical oxygen demand (BOD) 81%, total nitrogen (TN) 57%, total phosphorus (TP) 35% and faecal coliforms (FC) 1.9 logs. The reed bed is becoming the preferred on-site technology for removing TN and BOD and polishing TSS from primary settled domestic wastewater. Sizing beds for a residence time of approximately five days has become standard practice. A study of six reed beds found six different species of earthworm present, mainly Perionyx excavatus (Indian Blue). A mesocosm experiment subsequently showed that the worms were translocating clogging material from the substrate interstices to the surface of the bed thereby indicating a possible method for prolonging reed bed life.
Kroiss, A; Putzer, D; Decristoforo, C; Uprimny, C; Warwitz, B; Nilica, B; Gabriel, M; Kendler, D; Waitz, D; Widmann, G; Virgolini, I J
2013-04-01
We wanted to establish the range of (68)Ga-DOTA-TOC uptake in liver and bone metastases of patients with neuroendocrine tumours (NET) and to establish the range of its uptake in pancreatic NET. This would allow differentiation between physiological uptake and tumour-related somatostatin receptor expression in the pancreas (including the uncinate process), liver and bone. Finally, we wanted to test for differences in patients with NET, either treated or not treated with peptide receptor radionuclide therapy (PRRT). In 249 patients, 390 (68)Ga-DOTA-TOC PET/CT studies were performed. The clinical indications for PET/CT were gastroenteropancreatic NET (194 studies), nongastroenteropancreatic NET (origin in the lung and rectum; 46 studies), NET of unknown primary (111 studies), phaeochromocytoma/glomus tumours (18 studies), and radioiodine-negative metastatic thyroid carcinoma (21 studies). SUVmax (mean ± standard deviation) values of (68)Ga-DOTA-TOC were 29.8 ± 16.5 in 162 liver metastases, 19.8 ± 18.8 in 89 bone metastases and 34.6 ± 17.1 in 43 pancreatic NET (33.6 ± 14.3 in 30 tumours of the uncinate process and 36.3 ± 21.5 in 13 tumours of the pancreatic tail). A significant difference in SUVmax (p < 0.02) was found in liver metastases of NET patients treated with PRRT. There were significant differences in SUVmax between nonmalignant and malignant tissue for both bone and liver metastases and for pancreatic NET including the uncinate process (p < 0.0001). At a cut-off value of 17.1 the specificity and sensitivity of SUVmax for differentiating tumours in the uncinate process were 93.6 % and 90.0 %, respectively (p < 0.0001). (68)Ga-DOTA-TOC is an excellent tracer for the imaging of tumours expressing somatostatin receptors on the tumour cell surface, facilitating the detection of even small tumour lesions. The noninvasive PET/CT approach by measurement of regional SUVmax can offer important clinical information to distinguish between physiological and pathological somatostatin receptor expression, especially in the uncinate process. PRRT does not significantly influence SUVmax, except in liver metastases of patients with NET.
Ziegler, D.L.
1975-12-01
A system is described for treating or cleaning incinerator flue gas containing acid gases and radioactive and fissionable contaminants. Flue gas and a quench solution are fed into a venturi and then tangentially into the lower portion of a receptacle for restricting volumetric content of the solution. The upper portion of the receptacle contains a scrub bed to further treat or clean the flue gas.
Microwave heat treating of manufactured components
Ripley, Edward B.
2007-01-09
An apparatus for heat treating manufactured components using microwave energy and microwave susceptor material. Heat treating medium such as eutectic salts may be employed. A fluidized bed introduces process gases which may include carburizing or nitriding gases. The process may be operated in a batch mode or continuous process mode. A microwave heating probe may be used to restart a frozen eutectic salt bath.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stahl, John M.; Ross, Rudi; Harder, Eileen M.
Purpose: To determine the effect of biologically effective dose (BED{sub 10}) and radiation treatment schedule on overall survival (OS) in patients with early-stage non-small cell lung cancer (NSCLC) undergoing stereotactic body radiation therapy (SBRT). Methods and Materials: Using data from 65 treatment centers in the United States, we retrospectively reviewed the records of T1-2 N0 NSCLC patients undergoing SBRT alone from 2006 to 2014. Biologically relevant covariates, including dose per fraction, number of fractions, and time between fractions, were used to quantify BED{sub 10} and radiation treatment schedule. The linear-quadratic equation was used to calculate BED{sub 10} and to generatemore » a dichotomous dose variable of <105 Gy versus ≥105 Gy BED{sub 10}. The primary outcome was OS. We used the Kaplan-Meier method, the log–rank test, and Cox proportional hazards regression with propensity score matching to determine whether prescription BED{sub 10} was associated with OS. Results: We identified 747 patients who met inclusion criteria. The median BED{sub 10} was 132 Gy, and 59 (7.7%) had consecutive-day fractions. Median follow-up was 41 months, and 452 patients (60.5%) had died by the conclusion of the study. The 581 patients receiving ≥105 Gy BED{sub 10} had a median survival of 28 months, whereas the 166 patients receiving <105 Gy BED{sub 10} had a median survival of 22 months (log–rank, P=.01). Radiation treatment schedule was not a significant predictor of OS on univariable analysis. After adjusting for T stage, sex, tumor histology, and Eastern Cooperative Oncology Group performance status, BED{sub 10} ≥105 Gy versus <105 Gy remained significantly associated with improved OS (hazard ratio 0.78, 95% confidence interval 0.62-0.98, P=.03). Propensity score matching on imbalanced variables within high- and low-dose cohorts confirmed a survival benefit with higher prescription dose. Conclusions: We found that dose escalation to 105 Gy BED{sub 10} and beyond may improve survival in NSCLC patients treated with SBRT.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Connolly, J.R.; Keil, K.; Mansker, W.L.
1984-10-01
This report summarizes the detailed geologic characterization of samples of bed-contact zones and surrounding nonwelded bedded tuffs, both within Tunnel Bed 5, that are exposed in the G-Tunnel complex beneath Rainier Mesa on the Nevada Test Site (NTS). Original planning studies treated the bed-contact zones in Tunnel Bed 5 as simple planar surfaces of relatively high permeability. Detailed characterization, however, indicates that these zones have a finite thickness, are depositional in origin, vary considerably over short vertical and horizontal distances, and are internally complex. Fluid flow in a sequence of nonwelded zeolitized ash-flow or bedded tuffs and thin intervening reworkedmore » zones appears to be a porous-medium phenomenon, regardless of the presence of layering. There are no consistent differences in either bulk composition or detailed mineralogy between bedded tuffs and bed-contact zones in Tunnel Bed 5. Although the original bulk composition of Tunnel Bed 5 was probably peralkaline, extensive zeolitization has resulted in a present peraluminous bulk composition of both bedded tuffs and bed-contact zones. The major zeolite present, clinoptilolite, is intermediate (Ca:K:Na = 26:35:39) and effectively uniform in composition. This composition is similar to that of clinoptilolite from the tuffaceous beds of Calico Hills above the static water level in hole USW G-1, but somewhat different from that reported for zeolites from below the static water level in USW G-2. Tunnel Bed 5 also contains abundant hydrous manganese oxides. The similarity in composition of the clinoptilolites from Tunnel Bed 5 and those above the static water level at Yucca Mountain indicates that many of the results of nuclide-migration experiments in Tunnel Bed 5 would be transferrable to zeolitized nonwelded tuffs above the static water level at Yucca Mountain.« less
Shimizu, Yasuyuki; Giri, Sanjay; Yamaguchi, Satomi; Nelson, Jonathan M.
2009-01-01
This work presents recent advances on morphodynamic modeling of bed forms under unsteady discharge. This paper includes further development of a morphodynamic model proposed earlier by Giri and Shimizu (2006a). This model reproduces the temporal development of river dunes and accurately replicates the physical properties associated with bed form evolution. Model results appear to provide accurate predictions of bed form geometry and form drag over bed forms for arbitrary steady flows. However, accurate predictions of temporal changes of form drag are key to the prediction of stage‐discharge relation during flood events. Herein, the model capability is extended to replicate the dune–flat bed transition, and in turn, the variation of form drag produced by the temporal growth or decay of bed forms under unsteady flow conditions. Some numerical experiments are performed to analyze hysteresis of the stage‐discharge relationship caused by the transition between dune and flat bed regimes during rising and falling stages of varying flows. The numerical model successfully simulates dune–flat bed transition and the associated hysteresis of the stage‐discharge relationship; this is in good agreement with physical observations but has been treated in the past only using empirical methods. A hypothetical relationship for a sediment parameter (the mean step length) is proposed to a first level of approximation that enables reproduction of the dune–flat bed transition. The proposed numerical model demonstrates its ability to address an important practical problem associated with bed form evolution and flow resistance in varying flows.
Experimental Applications of the Modular Acoustic System for the Submersible ALVIN
1975-08-01
surface. Data comparlsoIs can be made with results from other on-site instrumental packages, such as rock hammers and drills , and plankton nets...Massachusetts, and Long Island Sound," J. Sedimentary Petrology 33:723-727. Rhoads, D.C. and 1). J. Stanley (1965). "Biogenic Graded Bedding," J...Sedimentary Petrology 35:956-963. Rhoads, D.C. (1967). "Biogenic Reworking of Intertidal and Sub- tidal Sediments in Barnstable Harbor and Buzzards Bay, Massa
Property Investigation of Laser Cladded, Laser Melted and Electron Beam Melted Ti-Al6-V4
2006-05-01
UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Figure 3: Examples of electron beam melted net shape parts; powder bed [3]. 1.4 Laser Cladding ...description, www.arcam.com. [4] K.-H. Hermann, S. Orban, S. Nowotny, Laser Cladding of Titanium Alloy Ti6242 to Restore Damaged Blades, Proceedings...Property Investigation of Laser Cladded , Laser Melted and Electron Beam Melted Ti-Al6-V4 Johannes Vlcek EADS Deutschland GmbH Corporate Research
Sistrom, Christopher Lee; McKay, Niccie L
2005-06-01
This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services. Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices. The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size. Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.
Repellency of selected chemicals against the bed bug (Hemiptera: Cimicidae).
Wang, Changlu; Lü, Lihua; Zhang, Aijun; Liu, Chaofeng
2013-12-01
In recent years, the common bed bug, Cimex lectularius L. (Hemiptera: Cimicidae), became a major public health concern in urban communities. Bed bugs are notoriously difficult to control, and their bites are not tolerated by most people. The public has an urgent need for materials and methods to reduce bed bug introduction and bites during work, travel, or sleep. A repellent product will help achieve these goals by discouraging and preventing bed bugs from moving to a protected area. We evaluated the repellency of three commercially available insect repellent or control materials and five nonregistered materials with the goal of identifying safe and effective bed bug repellents. The two commercial repellent products that contained 7% picaridin or 0.5% permethrin had little repellency against bed bugs. N,N-diethyl-m-toluamide (DEET), the most commonly used insect repellent, provided a high level of repellency against bed bugs. When a host cue (carbon dioxide) was present, the minimum DEET concentration to repel > or = 94% of the bed bugs for a9-h period was 10%. The longevity of repellency of DEET was concentration dependent. At 25% concentration, DEET-treated fabric surface remained highly repellent to bed bugs for a 14-d period. However, DEET has a strong smell and dissolves certain plastic materials. Therefore, we evaluated several odorless, noncorrosive, and potentially effective repellents. Isolongifolenone and isolongifolanone, two natural products and recently reported insect repellents, exhibited strong repellent property against bed bugs but at significantly lower levels than DEET. Three novel potential repellent compounds discovered by Bedoukian Research Inc. (Danbury, CT) exhibited similar level of repellency and longevity as DEET for repelling bed bugs. These nonirritant and odorless compounds are promising candidates as alternatives to DEET for reducing the spread of bed bugs and bed bug bites.
Pawaskar, Manjiri; Solo, Kirk; Valant, Jason; Schmitt, Emily; Nwankwo, Millicent; Herman, Barry K
2016-10-27
Characterize the frequency, duration, and severity of binge-eating behaviors in adults meeting DSM-5 criteria for binge-eating disorder (BED) in a large US community sample. A representative sample of US adults from the National Health and Wellness Survey was recruited from an online panel and asked to respond to an Internet survey (conducted in October 2013) that included questions designed to assess binge-eating behaviors in relation to DSM-5 BED diagnostic criteria. Of 22,397 respondents, 344 self-reported meeting DSM-5 BED criteria (BED respondents). Most BED respondents reported that binge-eating episodes had occurred for the past 7-12 months (61.0%), and 93.6% reported ≥ 2-3 binge-eating episodes/wk. All BED respondents reported that "extreme" (52.6%) or "great" (47.4%) distress levels were associated with binge-eating episodes. Among BED respondents who agreed to provide detailed binge-eating behavior data after being invited to respond to additional survey questions, 40.6% reported binge eating on average > 1 time/d, and 59.2% reported binge eating 2-3 times/d. For 44.5% of BED respondents, binge-eating duration was 31-60 minutes. BED respondents reported that they "very often" (36.6%) or "often" (34.0%) had urges to binge eat between 7-10 pm. "Feeling disgusted with oneself, depressed, or guilty afterward" was the most bothersome symptom of binge eating for BED respondents (extremely bothersome: 41.9%). Binge-eating frequency among BED respondents averaged once daily. Most BED respondents exhibited binge-eating behavior for 7-12 months, often with severe symptoms. These findings highlight the disease burden of BED and have potential implications for diagnosing and treating BED. © Copyright 2016 Physicians Postgraduate Press, Inc.
Comparing Biofouling Control Treatments for Use on Aquaculture Nets
Swain, Geoffrey; Shinjo, Nagahiko
2014-01-01
Test panels comprised of uncoated, copper coated and silicone coated 7/8'' (22 mm) mesh knitted nylon net were evaluated to compare their properties and the effectiveness to prevent biofouling. This paper describes test procedures that were developed to quantify the performance in terms of antifouling, cleanability, drag and cost. The copper treatment was the most effective at controlling fouling, however, the silicone treated nets were the easiest to clean. The drag forces on the net were a function of twine diameter, twine roughness and fouling. After immersion, the uncoated nets had the most drag followed by the silicone and copper treatments. The cost of applying silicone to nets is high; however, improved formulations may provide a non-toxic alternative to control fouling. PMID:25474085
Rousson, Valentin; Zumbrunn, Thomas
2011-06-22
Decision curve analysis has been introduced as a method to evaluate prediction models in terms of their clinical consequences if used for a binary classification of subjects into a group who should and into a group who should not be treated. The key concept for this type of evaluation is the "net benefit", a concept borrowed from utility theory. We recall the foundations of decision curve analysis and discuss some new aspects. First, we stress the formal distinction between the net benefit for the treated and for the untreated and define the concept of the "overall net benefit". Next, we revisit the important distinction between the concept of accuracy, as typically assessed using the Youden index and a receiver operating characteristic (ROC) analysis, and the concept of utility of a prediction model, as assessed using decision curve analysis. Finally, we provide an explicit implementation of decision curve analysis to be applied in the context of case-control studies. We show that the overall net benefit, which combines the net benefit for the treated and the untreated, is a natural alternative to the benefit achieved by a model, being invariant with respect to the coding of the outcome, and conveying a more comprehensive picture of the situation. Further, within the framework of decision curve analysis, we illustrate the important difference between the accuracy and the utility of a model, demonstrating how poor an accurate model may be in terms of its net benefit. Eventually, we expose that the application of decision curve analysis to case-control studies, where an accurate estimate of the true prevalence of a disease cannot be obtained from the data, is achieved with a few modifications to the original calculation procedure. We present several interrelated extensions to decision curve analysis that will both facilitate its interpretation and broaden its potential area of application.
2011-01-01
Background Decision curve analysis has been introduced as a method to evaluate prediction models in terms of their clinical consequences if used for a binary classification of subjects into a group who should and into a group who should not be treated. The key concept for this type of evaluation is the "net benefit", a concept borrowed from utility theory. Methods We recall the foundations of decision curve analysis and discuss some new aspects. First, we stress the formal distinction between the net benefit for the treated and for the untreated and define the concept of the "overall net benefit". Next, we revisit the important distinction between the concept of accuracy, as typically assessed using the Youden index and a receiver operating characteristic (ROC) analysis, and the concept of utility of a prediction model, as assessed using decision curve analysis. Finally, we provide an explicit implementation of decision curve analysis to be applied in the context of case-control studies. Results We show that the overall net benefit, which combines the net benefit for the treated and the untreated, is a natural alternative to the benefit achieved by a model, being invariant with respect to the coding of the outcome, and conveying a more comprehensive picture of the situation. Further, within the framework of decision curve analysis, we illustrate the important difference between the accuracy and the utility of a model, demonstrating how poor an accurate model may be in terms of its net benefit. Eventually, we expose that the application of decision curve analysis to case-control studies, where an accurate estimate of the true prevalence of a disease cannot be obtained from the data, is achieved with a few modifications to the original calculation procedure. Conclusions We present several interrelated extensions to decision curve analysis that will both facilitate its interpretation and broaden its potential area of application. PMID:21696604
Britch, Seth C; Linthicum, Kenneth J; Wynn, Wayne W; Walker, Todd W; Farooq, Muhammad; Smith, Vincent L; Robinson, Cathy A; Lothrop, Branka B; Snelling, Melissa; Gutierrez, Arturo; Lothrop, Hugh D
2010-08-01
Treating perimeters of vegetation with residual insecticides for protection from mosquito vectors has potential for U.S. military force health protection. However, for current U.S. military operations in hot-arid environments with little or no vegetation, residual applications on portable artificial materials may be a viable alternative. We evaluated bifenthrin residual treatments of U.S. military camouflage netting under hot-arid field conditions in a desert area in southern California exposed to abundant wild Culex tarsalis mosquitoes. We assessed the ability of the treatment to reduce the numbers of mosquitoes penetrating perimeters of netting and reaching CO2-baited mosquito traps. Treated camouflage netting barriers reduced mosquitoes by > or = 50% for 7-14 days and by 20-35% for 21-28 days compared to untreated barriers. Although reductions may be translated into reductions in risk of exposure to mosquito-borne diseases, we emphasize that barrier treatments should be a component in a suite of insect control measures to be effective.
JAFARI, Jalil; MESDAGHINIA, Alireza; NABIZADEH, Ramin; FARROKHI, Mehrdad; MAHVI, Amir Hossein
2013-01-01
Background: Anaerobic treatment methods are more suitable for the treatment of concentrated wastewater streams, offer lower operating costs, the production of usable biogas product. The aim of this study was to investigate the performance of an Anaerobic Fluidized Bed Reactor (AFBR)-Aerobic Moving Bed Bio Reactor (MBBR) in series arrangement to treat Currant wastewater. Methods: The bed materials of AFBR were cylindrical particles made of PVC with a diameter of 2–2.3 mm, particle density of 1250 kg/m3. The volume of all bed materials was 1.7 liter which expanded to 2.46 liters in fluidized situation. In MBBR, support media was composed of 1.5 liters Bee-Cell 2000 having porosity of 87% and specific surface area of 650m2/m3. Results: When system operated at 35 ºC, chemical oxygen demand (COD) removal efficiencies were achieved to 98% and 81.6% for organic loading rates (OLR) of 9.4 and 24.2 g COD/l.d, and hydraulic retention times (HRT) of 48 and 18 h, in average COD concentration feeding of 18.4 g/l, respectively. Conclusion: The contribution of AFBR in total COD removal efficiency at an organic loading rate (OLR) of 9.4 g COD/l.d was 95%, and gradually decreased to 76.5% in OLR of 24.2 g COD/l.d. Also with increasing in organic loading rate the contribution of aerobic reactor in removing COD gradually decreased. In this system, the anaerobic reactor played the most important role in the removal of COD, and the aerobic MBBR was actually needed to polish the anaerobic treated wastewater. PMID:26056640
Characteristics of sedimentary structures in coarse-grained alluvial rivers
NASA Astrophysics Data System (ADS)
Ackerley, David; Powell, Mark
2013-04-01
The characteristics of coarse-grained alluvial surfaces have important implications for the estimation of flow resistance, entrainment thresholds and sediment transport rates in gravel-bed rivers. This area of research has, thus, demanded attention from geomorphologists, sedimentologists, and river engineers. The majority of research has focused towards understanding the characteristics and adjustments in surface grain size. Bed stability, however, is not ultimately defined by particle size but how grains are arranged within the bed surface. For example, by the organisation of particles into a variety of grain and form scale sedimentary structures and bedforms (e.g. imbrication; pebble clusters, stone nets, transverse ribs). While it is widely acknowledged sedimentary structuring must be considered within estimates of flow resistance and sediment transport, relatively little is known about the structural properties of water-worked river gravels. As a consequence, we remain woefully ignorant of this important aspect of gravel-bed river sedimentology. The aim of this poster is to present some preliminary results of a study designed to characterise the morphodynamics of sedimentary structures in coarse-grained alluvial rivers and their implications upon entrainment thresholds and sediment transport rates. The poster focuses on investigating the variability in grain and form scale sedimentary structuring across a number of field sites. Representative patches of three gravel bars on the Rivers Wharfe, Manifold and Afon Elan, UK, have been surveyed using a Leica HDS 3000 Terrestrial Laser Scanner. The resultant raw point-cloud data, recorded at a 4mm resolution, has been registered, filtered, and interpolated to produce highly detailed 2½D digital elevation models of gravel-bed surface topography. These surfaces have been analysed using a number of structural parameters including bed elevation probability distribution function statistics (standard deviation, skewness, kurtosis), semivariograms, and inclination indices. This research enhances our understanding of alluvial bed surface structures and lays the foundations for developing a more detailed understanding of their morphodynamics.
Paleocene-eocene lignite beds of southwest Alabama: Parasequence beds in highstand systems tracts
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mancini, E.A.; Tew, B.H.; Carroll, R.E.
1993-09-01
In southwest Alabama, lignite beds are present in at least four stratigraphic intervals that span approximately 8 m.y. of geologic time. Lignite is found in the Paleocene Oak Hill Member and Coal Bluff Member of the Naheola Formation of the Midway Group and the Paleocene Tuscahoma Sand and the Eocene Hatchetigbee Formation of the Wilcox Group. Lignite beds range in thickness from 0.5 to 11 ft and consist of 32-53% moisture, 13-39% volatile matter, 4-36% fixed carbon, and 5-51% ash. These Paleocene and Eocene lignite beds occur as parasequence deposits in highstand systems tracts of four distinct third-order depositional sequences.more » The lignite beds are interpreted as strata within highstand systems tract parasequences that occur in mud-dominated regressive intervals. Lignite beds were deposited in coastal marsh and low-lying swamp environments as part of deltaic systems that prograded into southwestern Alabama from the west. As sediment was progressively delivered into the basin from these deltas, the effects of relative sea level rise during an individual cycle were overwhelmed, producing a net loss of accommodation and concomitant overall basinward progradation of the shoreline (regression). Small-scale fluctuations in water depth resulting from the interaction of eustasy, sediment yield, and subsidence led to cyclical flooding of the low-lying coastal marshes and swamps followed by periods of progradational and regression. Highstand systems tract deposition within a particular depositional sequence culminated with a relative sea level fall that resulted in a lowering of base level and an abrupt basinward shift in coastal onlap. Following sea level fall and the subsequent accumulation of the lowstand deposits, significant relative sea level rise resulted in the marine inundation of the area previously occupied by coastal marshes and swamps and deposition of the transgressive systems tract of the overlying sequence.« less
Leonard, Christina M.; Legleiter, Carl; Overstreet, Brandon T.
2017-01-01
This study examined the effects of natural and anthropogenic changes in confining margin width by applying remote sensing techniques – fusing LiDAR topography with image-derived bathymetry – over a large spatial extent: 58 km of the Snake River, Wyoming, USA. Fused digital elevation models from 2007 and 2012 were differenced to quantify changes in the volume of stored sediment, develop morphological sediment budgets, and infer spatial gradients in bed material transport. Our study spanned two similar reaches that were subject to different controls on confining margin width: natural terraces versus artificial levees. Channel planform in reaches with similar slope and confining margin width differed depending on whether the margins were natural or anthropogenic. The effects of tributaries also differed between the two reaches. Generally, the natural reach featured greater confining margin widths and was depositional, whereas artificial lateral constriction in the leveed reach produced a sediment budget that was closer to balanced. Although our remote sensing methods provided topographic data over a large area, net volumetric changes were not statistically significant due to the uncertainty associated with bed elevation estimates. We therefore focused on along-channel spatial differences in bed material transport rather than absolute volumes of sediment. To complement indirect estimates of sediment transport derived by morphological sediment budgeting, we collected field data on bed mobility through a tracer study. Surface and subsurface grain size measurements were combined with bed mobility observations to calculate armoring and dimensionless sediment transport ratios, which indicated that sediment supply exceeded transport capacity in the natural reach and vice versa in the leveed reach. We hypothesize that constriction by levees induced an initial phase of incision and bed armoring. Because levees prevented bank erosion, the channel excavated sediment by migrating rapidly across the restricted braidplain and eroding bars and islands.
Yang, Gi-geun; Pham, Anh
2018-01-01
Long-lasting insecticidal nets (LLINs) have been widely used as an effective alternative to conventional insecticide-treated nets (ITNs) for over a decade. Due to the growing number of field trials and interventions reporting the effectiveness of LLINs in controlling malaria, there is a need to systematically review the literature on LLINs and ITNs to examine the relative effectiveness and characteristics of both insecticide nettings. A systematic review of over 2000 scholarly articles published since the year 2000 was conducted. The odds ratios (ORs) of insecticidal net effectiveness in reducing malaria were recorded. The final dataset included 26 articles for meta-regression analysis, with a sample size of 154 subgroup observations. While there is substantial heterogeneity in study characteristics and effect size, we found that the overall OR for reducing malaria by LLIN use was 0.44 (95% CI = 0.41–0.48, p < 0.01) indicating a risk reduction of 56%, while ITNs were slightly less effective with an OR of 0.59 (95% CI = 0.57–0.61, p <0.01). A meta-regression model confirms that LLINs are significantly more effective than ITNs in the prevention of malaria, when controlling for other covariates. For both types of nets, protective efficacy was greater in high transmission areas when nets were used for an extended period. However, cross-sectional studies may overestimate the effect of the nets. The results surprisingly suggest that nets are less effective in protecting children under the age of five, which may be due to differences in child behavior or inadequate coverage. Compared to a previous meta-analysis, insecticide-treated nets appear to have improved their efficacy despite the risks of insecticide resistance. These findings have practical implications for policymakers seeking effective malaria control strategies. PMID:29562673
Surplus activated sludge dewatering in pilot-scale sludge drying reed beds.
Stefanakis, A I; Akratos, C S; Melidis, P; Tsihrintzis, V A
2009-12-30
A pilot-scale experiment on dewatering of surplus activated sludge (SAS) is presented, where two pilot-scale vertical flow, sludge drying reed beds (SDRBs), planted with Phragmites australis are used. The bottom of the beds is filled with cobbles, connected to the atmosphere through perforated PVC ventilation tubes, in order to achieve oxygen diffusion through the overlying porous medium that is colonized by roots and an abundant nitrifying biomass. Two layers of gravel, of decreasing size from bottom to top, make the drainage layer where the reeds are planted. The two beds were fed according to the following cycle: one week feeding with SAS at rates one 30 kg/m(2)/year and the other 75 kg/m(2)/year, and resting for three weeks. The results show that planted SDRBs can effectively dewater SAS from domestic sewage, the produced residual sludge presents a high dry weight content, the degree of volume reduction depends upon the initial SAS concentration and can be of the order of 90%, and decomposition of organic matter and high levels of mineralization can be achieved. Furthermore, the percolating water is not septic. The fertilizer value of the treated SAS, which contains no added chemicals, is comparable to that of SAS treated by other methods.
Reif, R; Besancon, A; Le Corre, K; Jefferson, B; Lema, J M; Omil, F
2011-01-01
The presence in the aquatic environment of xenobiotics such as Pharmaceutical and Personal Care Products (PPCPs) has emerged as an issue of concern. Upgrading sewage treatment quality with modern technologies such as Membrane Bioreactors (MBRs) and/or implementing a further posttreatment might mitigate the release of xenobiotics into surface waters. The performance of two processes treating municipal sewage, a MBR and an Activated Sludge (AS) unit, have been compared in terms of PPCPs removal. Moreover, their effluents were treated using vertical flow reed beds. Both systems were operated under similar conditions, more specifically Hydraulic Retention Time (HRT), maintained at 8 hours, and Sludge Retention Time (SRT) set at 6 and 20 days. Pharmaceuticals belong to therapeutic groups such as antiepileptics (carbamazepine) and analgesics (ibuprofen, naproxen, diclofenac), whereas the personal care products are musk fragrances (galaxolide and tonalide). Xenobiotics removals achieved in the MBR showed better results, particularly for the acidic drugs ibuprofen (87% vs. 50%) and naproxen (56% vs. 6%) operating at low SRT. After filtration through vertical flow reed-beds, PPCPs content in effluents was decreased, below 1 ppb in most cases, improving the effluent quality and confirming reed-beds as an interesting low cost alternative in order to attenuate xenobiotics contamination.
Recer, G M
2004-02-01
Sensitization and exposure to dust-mite antigens are causative factors in the development and exacerbation of asthma. Impermeable bedding encasements are considered a first-line treatment to reduce dust-mite antigen exposure in clinical asthma-management guidelines. Public-health recommendations for environmental asthma treatments should be based on the weight of evidence supporting the reliability of environmental interventions so that uncertainties regarding their effectiveness can be accurately communicated to patients, and so that limited public-health resources can be most effectively utilized. To evaluate the strength of a clinical-trial evidence supporting the efficacy of bedding encasements as an asthma treatment. A narrative review was conducted of all clinical trials involving bedding encasement for the treatment of asthma. Collective statistical analyses were also performed to characterize the quantitative effect of bedding encasement on dust-mite allergen exposure and bronchial hyper-responsiveness (BHR) when used by asthma patients. Over 30 clinical trials were reviewed. Of those studies reporting adequate exposure and BHR results, four reported significant reduction in dust-mite allergen exposure and concomitant BHR reduction in active-treatment groups using bedding encasements. In 10 studies, mite-allergen exposure was reportedly decreased during the study, but BHR was not changed in the active-treatment group or was reduced to a similar degree in the active-treatment and control groups. Five other studies reported a lack of significant effect of the intervention on exposure and BHR. Collective paired analyses found that the effect of bedding encasement on allergen exposure and BHR tended toward only a modest, non-significant improvement. Collectively, effects of bedding encasement on BHR and dust-mite allergen exposure were modestly correlated only when the baseline exposure was above 2 microg Type 1 antigen per gram settled dust. Although bedding encasement might be an effective asthma treatment under some conditions, when implemented in clinical trials by asthma patients, its effectiveness is inconsistent and appears to be, at best, modest. Therefore, its significance as a reliable asthma management modality for any individual asthma patient is uncertain. Where resource constraints are significant, targeting the use of variably effective interventions such as bedding encasements toward those patient sub-populations most likely to derive substantial benefit may gain the largest net public-health benefit.
Ying, Xiao-Ming; Jiang, Yong-Liang; Xu, Peng; Wang, Peng; Zhu, Bo; Guo, Shao-Qing
2016-08-25
To conduct a meta analysis of studies comparing theapeutic effect and safety of microendoscopic discectomy to conventional open discectomy in the treatment of lumbar disc herniation in China. A systematic literature retrieval was conducted in the Chinese Bio medicine Database, CNKI database, Chongqin VIP database and Wangfang database. The statistical analysis was performed using a RevMan 4.2 software. The comparison included excellent rate, operation times, blood loss, periods of bed rest and resuming daily activities, hospital stay or hospital stay after surgery, and complications of microendoscopic discectomy versus conventional open discectomy. The search yielded 20 reports, which included 2 957 cases treated by microendoscopic discectomy and 2 130 cases treated by conventional open discectomy. There were 12, 11, 7, 5, 4 and 4 reports which had comparison of operation times, blood loss, period of bed rest, periods of resuming daily activities, hospital stay and hospital stay after surgery respectively. Complications were mentioned in 10 reports. Compared to patients treated by open discectomy, patients treated by microendoscopic discectomy had a higher excellent rates [OR=1.29, 95%CI (1.03, 1.62)], less blood loss[OR=-63.67, 95%CI (-86.78, -40.55)], less period of bed rest[OR=-15.33, 95%CI (-17.76, -12.90)], less period of resumption of daily activities [OR=-24.41, 95%CI (-36.86, -11.96)], less hospital stay [OR=-5.00, 95%CI (-6.94, -3.06)] or hospital stay after surgery [OR=-7.47, 95%CI (-9.17, -5.77) respectively. However, incidence of complications and operation times were proved no significant different between microendoscopic discectomy and open discectomy. Microendoscopic discectomy and conventional open discectomy in treatment of lumbar disc herniation are both safe, effective; incidence of complications are nearly. Patients with lumbar disc herniation treated by microendoscopic discectomy have fewer blood loss, shorter periods of bed rest and hospital stay, and resume daily activities faster. Techniques are selected according to indications, microendoscopic discectomy should be carried out when conjunct indications occur.
Fluidized bed combustor and tube construction therefor
De Feo, Angelo; Hosek, William
1981-01-01
A fluidized bed combustor comprises a reactor or a housing which has a windbox distributor plate adjacent the lower end thereof which contains a multiplicity of hole and air discharge nozzles for discharging air and coal into a fluidized bed which is maintained above the distributor plate and below a take-off connection or flue to a cyclone separator in which some of the products of combustion are treated to remove the dust which is returned into the fluidized bed. A windbox is spaced below the fluidized bed and it has a plurality of tubes passing therethrough with the passage of combustion air and fluidizing air which passes through an air space so that fluidizing air is discharged into the reaction chamber fluidized bed at the bottom thereof to maintain the bed in a fluidized condition. A fluid, such as air, is passed through the tubes which extend through the windbox and provide a preheating of the combustion air and into an annular space between telescoped inner and outer tubes which comprise heat exchanger tubes or cooling tubes which extend upwardly through the distributor plate into the fluidized bed. The heat exchanger tubes are advantageously arranged so that they may be exposed in groups within the reactor in a cluster which is arranged within holding rings.
Tube construction for fluidized bed combustor
De Feo, Angelo; Hosek, William
1984-01-01
A fluidized bed combustor comprises a reactor or a housing which has a windbox distributor plate adjacent the lower end thereof which contains a multiplicity of hole and air discharge nozzles for discharging air and coal into a fluidized bed which is maintained above the distributor plate and below a take-off connection or flue to a cyclone separator in which some of the products of combustion are treated to remove the dust which is returned into the fluidized bed. A windbox is spaced below the fluidized bed and it has a plurality of tubes passing therethrough with the passage of combustion air and fluidizing air which passes through an air space so that fluidizing air is discharged into the reaction chamber fluidized bed at the bottom thereof to maintain the bed in a fluidized condition. A fluid, such as air, is passed through the tubes which extend through the windbox and provide a preheating of the combustion air and into an annular space between telescoped inner and outer tubes which comprise heat exchanger tubes or cooling tubes which extend upwardly through the distributor plate into the fluidized bed. The heat exchanger tubes are advantageously arranged so that they may be exposed in groups within the reactor in a cluster which is arranged within holding rings.
[Magnetotherapy in obliterating vascular diseases of the lower extremities].
Kirillov, Iu B; Shval'b, P G; Lastushkin, A V; Baranov, V M; Sigaev, A A; Zueva, G V; Karpov, E I
1992-01-01
The investigators have developed a polymagnetic system "Avrora-MK-01" employing running impulse magnetic field to treat diseases of the leg vessels by the action on peripheral capillary bed. At a pregangrene stage a positive effect on peripheral capillaries was achieved in 75-82% of the patients treated.
Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port
Mori, Hirohito; Kobayashi, Nobuya; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Chiyo, Taiga; Ayaki, Maki; Nagase, Takashi; Masaki, Tsutomu
2016-01-01
AIM: To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or not. METHODS: Two dogs (11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port. RESULTS: The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one port. CONCLUSION: We are sure of great feasibility of endoscopic cholecystectomy via single port for human. PMID:27053847
Yoon, Jangho
2011-02-01
There is a strong connection between the mental health and criminal justice systems. This research empirically tested whether the privatization of the inpatient mental health system alters this relationship, contributing to jail population growth. Using state-level panel data on U.S. states and the District of Columbia for the years 1985-1998, this study analyzed the relationship between the size of jail populations and private share of hospital psychiatric beds, first for overall private beds and then separately by private for-profit and nonprofit. Empirical models controlled for changes in mental health financing and resources, variations in criminal justice practice, and demographic and socio-economic factors as well as state and year fixed effects. A method of instrumental variables was employed to make a stronger case for causal inference. Results show that a one-percentage point increase in the private for-profit share of psychiatric beds contributes to the growth of jail inmates by approximately 2.3% annually. A greater private nonprofit share of psychiatric beds does not appear to influence the size of jail populations. These findings suggest that the increased private for-profit share of inpatient psychiatric resources undermines the safety-net and some control function of the mental health system and leads to a greater number of jail inmates. Copyright © 2010 Elsevier Ltd. All rights reserved.
Hatzinger, Paul B; Lewis, Celeste; Webster, Todd S
2017-12-01
The ex situ treatment of N-nitrosodimethylamine (NDMA) and N-nitrodimethylamine (NTDMA) in groundwater was evaluated in a field-scale fluidized bed bioreactor (FBR). Both of these compounds, which originally entered groundwater at the test site from the use of liquid rocket propellant, are suspected human carcinogens. The objective of this research was to examine the application of a novel field-scale propane-fed fluidized bed bioreactor as an alternative to ultraviolet irradiation (UV) for treating NDMA and NTDMA to low part-per-trillion (ng/L) concentrations. Previous laboratory studies have shown that the bacterium Rhodococcus ruber ENV425 can biodegrade NDMA and NTDMA during growth on propane as a primary substrate and that the strain can effectively reduce NDMA concentrations in propane-fed bench-scale bioreactors of different design. R. ruber ENV425 was used as a seed culture for the FBR, which operated at a fluidization flow of ∼19 L-per-min (LPM) and received propane, oxygen, and inorganic nutrients in the feed. The reactor effectively treated ∼1 μg/L of influent NDMA to effluent concentrations of less than 10 ng/L at a hydraulic residence time (HRT) of only 10 min. At a 20 min HRT, the FBR reduced NDMA to <4.2 ng/L in the effluent, which was the discharge limit at the test site where the study was conducted. Similarly, NTDMA was consistently treated in the FBR from ∼0.5 μg/L to <10 ng/L at an HRT of 10 min or longer. Based on these removal rates, the average NDMA and NTDMA elimination capacities achieved were 2.1 mg NDMA treated/m 3 of expanded bed/hr of operation and 1.1 mg NTDMA treated/m 3 of expanded bed/hr of operation, respectively. The FBR system was highly resilient to upsets including power outages. Treatment of NDMA, but not NTDMA, was marginally affected when trace co-contaminants including trichloroethene (TCE) and trichlorofluoromethane (Freon 11) were initially added to feed groundwater, but performance recovered over a few weeks in the continued presence of these compounds. Strain ENV425 appeared to be replaced by native propanotrophs over time based on qPCR analysis, but contaminant treatment was not diminished. The results suggest that a FBR can be a viable alternative to UV treatment for removing NDMA from groundwater. Copyright © 2017 Elsevier Ltd. All rights reserved.
Lake bed classification using acoustic data
Yin, Karen K.; Li, Xing; Bonde, John; Richards, Carl; Cholwek, Gary
1998-01-01
As part of our effort to identify the lake bed surficial substrates using remote sensing data, this work designs pattern classifiers by multivariate statistical methods. Probability distribution of the preprocessed acoustic signal is analyzed first. A confidence region approach is then adopted to improve the design of the existing classifier. A technique for further isolation is proposed which minimizes the expected loss from misclassification. The devices constructed are applicable for real-time lake bed categorization. A mimimax approach is suggested to treat more general cases where the a priori probability distribution of the substrate types is unknown. Comparison of the suggested methods with the traditional likelihood ratio tests is discussed.
Grabowsky, Mark; Nobiya, Theresa; Ahun, Mercy; Donna, Rose; Lengor, Miata; Zimmerman, Drake; Ladd, Holly; Hoekstra, Edward; Bello, Aliu; Baffoe-Wilmot, Aba; Amofah, George
2005-01-01
OBJECTIVE: To achieve high and equitable coverage of insecticide-treated bednets by integrating their distribution into a measles vaccination campaign. METHODS: In December 2002 in the Lawra district in Ghana, a measles vaccination campaign lasting 1 week targeted all children aged 9 months-15 years. Families with one or more children less than five years old were targeted to receive a free insecticide-treated bednet. The Ghana Health Service, with support from the Ghana Red Cross and UNICEF, provided logistical support, volunteer workers and social mobilization during the campaign. Volunteers visited homes to inform caregivers about the campaign and encourage them to participate. We assessed pre-campaign coverage of bednets by interviewing caregivers leaving vaccination and distribution sites. Five months after distribution, a two-stage cluster survey using population-proportional sampling assessed bednet coverage, retention and use. Both the pre-campaign and post-campaign survey assessed household wealth using an asset inventory. FINDINGS: At the campaign exit interview 636/776 (82.0%) caregivers reported that they had received a home visit by a Red Cross volunteer before the campaign and that 32/776 (4.1%) of the youngest children in each household who were less than 5 years of age slept under an insecticide-treated bednet. Five months after distribution caregivers reported that 204/219 (93.2%) of children aged 9 months to 5 years had been vaccinated during the campaign; 234/248 (94.4%) of households were observed to have an insecticide-treated bednet; and 170/249 (68.3%) were observed to have a net hung over a bed. Altogether 222/248 (89.5%) caregivers reported receiving at least one insecticide-treated bednet during the campaign, and 153/254 (60.2%) said that on the previous night their youngest child had slept under a bednet received during the campaign. For households in the poorest quintile, post-campaign coverage of insecticide-treated bednets was 10 times higher than pre-campaign coverage of households in the wealthiest quintile (46/51 (90.2%) versus 14/156 (9.0%)). The marginal operational cost was 0.32 US dollars per insecticide-treated bednet delivered. CONCLUSION: These findings suggest that linking bednet distribution to measles vaccination campaigns may provide an important opportunity for achieving high and equitable coverage of bednets. PMID:15798843
[Chemotherapy for GI and pancreatic NETs].
Doi, Toshihiko
2013-07-01
Neuroendocrine tumors(NETs)describe a heterogeneous group of tumors with a wide range of morphologic, functional, and behavioral characteristics. Pancreatic neuroendocrine tumors(pNET)are a subset of NETs which are increasing in incidence and prevalence. These tumors are generally slow growing and behave in an indolent fashion. However, when these tumors spread they can be life threatening and difficult to treat with current modalities. Recently, the basic treatment for pNET was changed with the approval of two targeted agents, sunitinib and everolimus. Clinical trials conducting various combinations of somatostatin analogues, mTOR inhibitors, tyrosine kinase inhibitors, and cytotoxic agents are ongoing under-evaluation, and a multitargeted approach to therapy will translate into improved patient outcomes.
Methane production by attached film
Jewell, William J.
1981-01-01
A method for purifying wastewater of biodegradable organics by converting the organics to methane and carbon dioxide gases is disclosed, characterized by the use of an anaerobic attached film expanded bed reactor for the reaction process. Dilute organic waste material is initially seeded with a heterogeneous anaerobic bacteria population including a methane-producing bacteria. The seeded organic waste material is introduced into the bottom of the expanded bed reactor which includes a particulate support media coated with a polysaccharide film. A low-velocity upward flow of the organic waste material is established through the bed during which the attached bacterial film reacts with the organic material to produce methane and carbon dioxide gases, purified water, and a small amount of residual effluent material. The residual effluent material is filtered by the film as it flows upwardly through the reactor bed. In a preferred embodiment, partially treated effluent material is recycled from the top of the bed to the bottom of the bed for further treatment. The methane and carbon dioxide gases are then separated from the residual effluent material and purified water.
Reducing grain storage losses in developing countries
USDA-ARS?s Scientific Manuscript database
We investigated the use of insecticide-treated material and modified atmosphere storage for reducing insect damage in stored maize. Results showed that insecticide treated netting and insecticide treated seed bags protected grain from insect damage for up to nine months if the grain was free from i...
Kristin Bunte; Kurt W. Swingle; Steven R. Abt
2007-01-01
A bedload trap is a portable sampler designed specifically for collecting gravel and cobble bedload (4 to 180 mm in diameter) in wadeable streams. Bedload traps consist of an aluminum frame with a 12 by 8 inch (0.3 by 0.2 m) opening to which a 3- to 5.5-ft (0.9 to 1.65 m) long trailing net is attached. Bedload traps are installed on ground plates that are anchored to...
2006-05-01
welding power sources are not totally efficient at converting power drawn from the wall into heat energy used for the welding process . TIG sources are...Powder bed + Laser • Wire + Laser • Wire + Electron Beam • Wire + TIG Each system has its own unique attributes in terms of process variables...relative economics of producing a near net shape by Additive Manufacturing (AM) processes compared with traditional machine from solid processes (MFS
Turbidity Currents With Equilibrium Basal Driving Layers: A Mechanism for Long Runout
NASA Astrophysics Data System (ADS)
Luchi, R.; Balachandar, S.; Seminara, G.; Parker, G.
2018-02-01
Turbidity currents run out over 100 km in lakes and reservoirs, and over 1,000 km in the ocean. They do so without dissipating themselves via excess entrainment of ambient water. Existing layer-averaged formulations cannot capture this. We use a numerical model to describe the temporal evolution of a turbidity current toward steady state under condition of zero net sediment flux at the bed. The flow self-partitions itself into two layers. The lower "driving layer" approaches an invariant flow thickness, velocity profile, and suspended sediment concentration profile that sequesters nearly all of the suspended sediment. This layer can continue indefinitely at steady state over a constant bed slope. The upper "driven layer" contains a small fraction of the suspended sediment. The devolution of the flow into these two layers likely allows the driving layer to run out long distances.
NASA Astrophysics Data System (ADS)
Przybyłek, Jan; Dragon, Krzysztof; Kaczmarek, Piotr Michał Jan
2017-12-01
River bank filtration (RBF) is a system that enriches groundwater resources by induced infiltration of river water to an aquifer. Problematic during operation of RBF systems is the deterioration of infiltration effectiveness caused by river bed clogging. This situation was observed in the Krajkowo well field which supplies fresh water to the city of Poznań (Poland) during and after the long hydrological drought between the years 1989 and 1992. The present note discusses results of specific hydrogeological research which included drilling of a net of boreholes to a depth of 10 m below river bottom (for sediment sampling as well as for hydrogeological measurements), analyses of grain size distribution and relative density studies. The results obtained have allowed the recognition of the origin of the clogging processes, as well as the documentation of the clogged parts of the river bottom designated for unclogging activities.
Cravotta, C.A.
2008-01-01
This paper demonstrates the use of dissolution-rate data obtained in the laboratory to indicate the potential quality of effluent from a field-scale oxic limestone drain (OLD) treatment system for neutralization of dilute acidic mine drainage (AMD). Effluent from the Reevesdale Mine South Dip Tunnel, a large source of AMD and base flow to the Wabash Creek and Little Schuylkill River in the Southern Anthracite Coalfield of east-central Pennsylvania, is representative of AMD with low concentrations but high loadings of dissolved Fe, Al and other metals because of a high flow rate. In January 2003, rapid neutralization of the AMD from the Reevesdale Mine was achieved in laboratory tests of its reaction rate with crushed limestone in closed, collapsible containers (Cubitainers). The tests showed that net-alkaline effluent could be achieved with retention times greater than 3 h and that effluent alkalinities and associated dissolution rates were equivalent for Fe(OH)3-coated and uncoated limestone. On the basis of the laboratory results, a flushable OLD containing 1450 metric tons of high-purity calcitic limestone followed by two 0.7-m deep wetlands were constructed at the Reevesdale Mine. During the first year of operation, monthly data at the inflow, outflow and intermediate points within the treatment system were collected (April 2006-2007). The inflow to the treatment system ranged from 6.8 to 27.4 L/s, with median pH of 4.7, net acidity of 9.1 mg/L CaCO3, and concentrations of dissolved Al, Fe and Mn of 1.0, 1.9 and 0.89 mg/L, respectively. The corresponding effluent from the OLD had computed void-volume retention times of 4.5-18 h, with median pH of 6.6, net acidity of -93.2 mg/L CaCO3, and concentrations of dissolved Al, Fe and Mn of <0.1, 0.08 and 0.52 mg/L, respectively. The wetlands below the OLD were effective for retaining metal-rich solids flushed at monthly or more frequent intervals from the OLD, but otherwise had little effect on the effluent quality. During the first year of operation, approximately 43 metric tons of limestone were dissolved and 2 metric tons of Al, Fe and Mn were precipitated within the OLD. However, because of the accumulation of these metals within the OLD and possibly other debris from the mine, the effectiveness of the treatment system declined. Despite the installation of a flush-pipe network at the base of the OLD to remove precipitated solids, the limestone bed clogged near the inflow. Consequently, a large fraction of the AMD bypassed the treatment system. To promote flow through the OLD, the flush pipes were open continuously during the last 4 months of the study; however, this effluent was only partially treated because short-circuiting through the pipes decreased contact between the effluent and limestone. A reconfiguration of the flow path through the limestone bed from horizontal to vertical upward could increase the limestone surface area exposed to the metal-laden influent, increase the cross-sectional area perpendicular to flow, decrease the flow path for solids removal, and, consequently, decrease potential for clogging.
NETosis Delays Diabetic Wound Healing in Mice and Humans.
Fadini, Gian Paolo; Menegazzo, Lisa; Rigato, Mauro; Scattolini, Valentina; Poncina, Nicol; Bruttocao, Andrea; Ciciliot, Stefano; Mammano, Fabio; Ciubotaru, Catalin Dacian; Brocco, Enrico; Marescotti, Maria Cristina; Cappellari, Roberta; Arrigoni, Giorgio; Millioni, Renato; Vigili de Kreutzenberg, Saula; Albiero, Mattia; Avogaro, Angelo
2016-04-01
Upon activation, neutrophils undergo histone citrullination by protein arginine deiminase (PAD)4, exocytosis of chromatin and enzymes as neutrophil extracellular traps (NETs), and death. In diabetes, neutrophils are primed to release NETs and die by NETosis. Although this process is a defense against infection, NETosis can damage tissue. Therefore, we examined the effect of NETosis on the healing of diabetic foot ulcers (DFUs). Using proteomics, we found that NET components were enriched in nonhealing human DFUs. In an independent validation cohort, a high concentration of neutrophil elastase in the wound was associated with infection and a subsequent worsening of the ulcer. NET components (elastase, histones, neutrophil gelatinase-associated lipocalin, and proteinase-3) were elevated in the blood of patients with DFUs. Circulating elastase and proteinase-3 were associated with infection, and serum elastase predicted delayed healing. Neutrophils isolated from the blood of DFU patients showed an increased spontaneous NETosis but an impaired inducible NETosis. In mice, skin PAD4 activity was increased by diabetes, and FACS detection of histone citrullination, together with intravital microscopy, showed that NETosis occurred in the bed of excisional wounds. PAD4 inhibition by Cl-amidine reduced NETting neutrophils and rescued wound healing in diabetic mice. Cumulatively, these data suggest that NETosis delays DFU healing. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
Biological evaluation of pearl millet protein: effect of different treatments and storage.
Kapoor, R; Kapoor, A C
1990-07-01
Whole grain flour of one variety (HC-4) of pearl millet (Pennisetum americanum L. Leeke) after giving different treatments (defatting, butylated hydroxyanisole, ascorbic acid and thermal) was stored in earthen pots at prevailing room temperature (28-34 degrees C) and relative humidity (70-80%) for 30 days. The flour samples were evaluated for protein quality using rats. Storage of flour for 30 days markedly reduced the protein quality. The values of protein efficiency ratio, true digestibility, biological value, net protein retention and net protein utilisation were significantly (P less than 0.05) higher in fresh and treated flour than untreated flour. Among treated flours, defatted flour showed best growth followed by butylated hydroxyanisole, thermal and ascorbic acid treated flour.
Citrome, Leslie
2017-01-01
Many patients with symptoms of binge-eating disorder (BED) are not diagnosed. Perhaps the biggest obstacles are the failure of physicians to recognize BED as a distinct disorder and the lack of awareness among patients that binge-eating is a well-studied abnormal behavior that is amenable to treatment. In addition, patients may avoid seeking treatment because they feel a general sense of shame over their eating habits and do not want to bring up these symptoms during visits with their physicians. In general, negative attitudes and biases regarding overweight and obesity are common. The presence of medical and psychiatric comorbidities also contributes to the challenge of diagnosis, as many doctors focus on treating those comorbidities, thereby delaying treatment for the BED and leading to suboptimal care. Once BED is diagnosed along with any comorbid conditions, medications for the treatment of the comorbidities must be carefully considered so that BED symptoms are not exacerbated. © Copyright 2017 Physicians Postgraduate Press, Inc.
NASA Astrophysics Data System (ADS)
Lea, Devin M.; Legleiter, Carl J.
2016-01-01
Stream power represents the rate of energy expenditure along a river and can be calculated using topographic data acquired via remote sensing or field surveys. This study sought to quantitatively relate temporal changes in the form of Soda Butte Creek, a gravel-bed river in northeastern Yellowstone National Park, to stream power gradients along an 8-km reach. Aerial photographs from 1994 to 2012 and ground-based surveys were used to develop a locational probability map and morphologic sediment budget to assess lateral channel mobility and changes in net sediment flux. A drainage area-to-discharge relationship and DEM developed from LiDAR data were used to obtain the discharge and slope values needed to calculate stream power. Local and lagged relationships between mean stream power gradient at median peak discharge and volumes of erosion, deposition, and net sediment flux were quantified via spatial cross-correlation analyses. Similarly, autocorrelations of locational probabilities and sediment fluxes were used to examine spatial patterns of sediment sources and sinks. Energy expended above critical stream power was calculated for each time period to relate the magnitude and duration of peak flows to the total volumetric change in each time increment. Collectively, we refer to these methods as the stream power gradient (SPG) framework. The results of this study were compromised by methodological limitations of the SPG framework and revealed some complications likely to arise when applying this framework to small, wandering, gravel-bed rivers. Correlations between stream power gradients and sediment flux were generally weak, highlighting the inability of relatively simple statistical approaches to link sub-budget cell-scale sediment dynamics to larger-scale driving forces such as stream power gradients. Improving the moderate spatial resolution techniques used in this study and acquiring very-high resolution data from recently developed methods in fluvial remote sensing could help improve understanding of the spatial organization of stream power, sediment transport, and channel change in dynamic natural rivers.
Jesús, A Gómez-De; Romano-Baez, F J; Leyva-Amezcua, L; Juárez-Ramírez, C; Ruiz-Ordaz, N; Galíndez-Mayer, J
2009-01-30
For the aerobic biodegradation of the fungicide and defoliant 2,4,6-trichlorophenol (2,4,6-TCP), a bench-scale packed-bed bioreactor equipped with a net draft tube riser for liquid circulation and oxygenation (PB-ALR) was constructed. To obtain a high packed-bed volume relative to the whole bioreactor volume, a high A(D)/A(R) ratio was used. Reactor's downcomer was packed with a porous support of volcanic stone fragments. PB-ALR hydrodynamics and oxygen mass transfer behavior was evaluated and compared to the observed behavior of the unpacked reactor operating as an internal airlift reactor (ALR). Overall gas holdup values epsilon(G), and zonal oxygen mass transfer coefficients determined at various airflow rates in the PB-ALR, were higher than those obtained with the ALR. When comparing mixing time values obtained in both cases, a slight increment in mixing time was observed when reactor was operated as a PB-ALR. By using a mixed microbial community, the biofilm reactor was used to evaluate the aerobic biodegradation of 2,4,6-TCP. Three bacterial strains identified as Burkholderia sp., Burkholderia kururiensis and Stenotrophomonas sp. constituted the microbial consortium able to cometabolically degrade the 2,4,6-TCP, using phenol as primary substrate. This consortium removed 100% of phenol and near 99% of 2,4,6-TCP. Mineralization and dehalogenation of 2,4,6-TCP was evidenced by high COD removal efficiencies ( approximately 95%), and by the stoichiometric release of chloride ions from the halogenated compound ( approximately 80%). Finally, it was observed that the microbial consortium was also capable to metabolize 2,4,6-TCP without phenol as primary substrate, with high removal efficiencies (near 100% for 2,4,6-TCP, 92% for COD and 88% for chloride ions).
NASA Astrophysics Data System (ADS)
Flindt, M. R.; Pedersen, C. B.; Amos, C. L.; Levy, A.; Bergamasco, A.; Friend, P. L.
2007-05-01
The study of plant-bound nutrient transport has been largely neglected in estuaries. Lately however, it has been shown that nutrients bound to macroalgae and seagrasses can constitute a major part of the nutrient transport in shallow tidal estuaries. Organic detritus in estuaries comes from various sources. This paper looks into the source of detritus from sloughing, and the transport behaviour of plant detritus under unidirectional flows. In order to determine the extent of the sloughing of macrophytes, the threshold current velocities for the traction and resuspension of the most common submersed macrophytes in Venice Lagoon ( Ulva lactuca, Enteromorpha sp., Ceramium rubrum, Cladophora sp., and Chaetomorpha linum) were studied in a laboratory flume. It was found that all macrophytes subjected to flows of 1.5-3.0 cm s -1 move initially as bed load. The threshold for suspension of the macrophyte tissue was at current speeds >3 cm s -1. The exception was the filamentous macroalgae, C. linum, which moved as bed load at all current speeds. This implies that the advection of plant-bound nutrients in Venice Lagoon is widespread and takes place over virtually all stages of the tide. Initial experiments were carried out on unattached macroalgae. A second study focused on the sloughing of attached macroalgae by steady currents. The threshold current speeds at which sloughing commenced varied between different types of algae, and sloughing rate was related largely to current speed. The resuspension rates were uniform between the different macrophyte groups. Our results help explain why plant matter has been trapped in nets close to the bed of Venice Lagoon on ebbing tides. It shows that a major component of the bedload is organic in origin. The results verify that a large proportion of the net nutrient export from estuaries is bound in macrophyte tissue. These findings need to be included in future ecological models that describe the resuspension, sloughing and settling of macrophytes.
Lee, Joo Eun; Kim, Tae Hyun; Cho, Kyoung Hee; Han, Kyu-Tae; Park, Eun-Cheol
2017-06-08
There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013. Pneumonia admissions to acute care hospitals among 7446 inpatients older than 65 were examined. We conducted a multivariate Cox proportional hazard model to analyze the association between the number of doctors per bed and 30-day readmission, as well as that of pneumonia-specific 30-day readmission with the combined effects of number of doctors per bed and number of beds. Overall, 1421 (19.1%) patients were readmitted within 30 days and 756 (11.2%) patients were readmitted for pneumonia within 30 days. Patients with pneumonia treated by very low or low number of doctors per bed showed higher readmission (pneumonia-specific readmission: hazard ratio [HR] = 1. 406, 95% confidence interval [CI] = 1.072-1.843 for low number of doctors per bed; all-cause readmissions: HR = 1.276, 95% CI = 1.026-1.587 for very low number of doctors per bed, and HR = 1.280, 95% CI = 1.064-1.540 for low number of doctors per bed). This empirical study showed that patients with pneumonia cared for in hospitals with more doctors were less likely to be readmitted. Pneumonia-specific 30-day readmission was also significantly associated with the combined effect of the number of doctors and the number of hospital beds.
Binge-eating disorder in the Swedish national registers: Somatic comorbidity.
Thornton, Laura M; Watson, Hunna J; Jangmo, Andreas; Welch, Elisabeth; Wiklund, Camilla; von Hausswolff-Juhlin, Yvonne; Norring, Claes; Herman, Barry K; Larsson, Henrik; Bulik, Cynthia M
2017-01-01
To evaluate associations between binge-eating disorder (BED) and somatic illnesses and determine whether medical comorbidities are more common in individuals who present with BED and comorbid obesity. Cases (n = 850) were individuals with a BED diagnosis in the Swedish eating disorders quality registers. Ten community controls were matched to each case on sex, and year, month, and county of birth. Associations of BED status with neurologic, immune, respiratory, gastrointestinal, skin, musculoskeletal, genitourinary, circulatory, and endocrine system diseases were evaluated using conditional logistic regression models. We further examined these associations by adjusting for lifetime psychiatric comorbidity. Amongst individuals with BED, we explored whether comorbid obesity was associated with risk of somatic disorders. BED was associated with most classes of diseases evaluated; strongest associations were with diabetes [odds ratio (95% confidence interval) = 5.7 (3.8; 8.7)] and circulatory systems [1.9 (1.3; 2.7)], likely indexing components of metabolic syndrome. Amongst individuals with BED, those with comorbid obesity were more likely to have a lifetime history of respiratory [1.5 (1.1; 2.1)] and gastrointestinal [2.6 (1.7; 4.1)] diseases than those without comorbid obesity. Increased risk of some somatic disease classes in individuals with BED was not simply due to obesity or other lifetime psychiatric comorbidity. The association of BED with many somatic illnesses highlights the morbidity experienced by individuals with BED. Clinicians treating patients with BED should be vigilant for medical comorbidities. Nonpsychiatric providers may be the first clinical contact for those with BED underscoring the importance of screening in primary care. © 2016 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:58-65). © 2016 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc.
Rönnbäck, Patrik; Kautsky, Nils; Pihl, Leif; Troell, Max; Söderqvist, Tore; Wennhage, Håkan
2007-11-01
Coastal areas are exposed to a variety of threats due to high population densities and rapid economic development. How will this affect human welfare and our dependence on nature's capacity to provide ecosystem goods and services? This paper is original in evaluating this concern for major habitats (macroalgae, seagrasses, blue mussel beds, and unvegetated soft bottoms) in a temperate coastal setting. More than 40 categories of goods and services are classified into provisional, regulating, and cultural services. A wide variety of Swedish examples is described for each category, including accounts of economic values and the relative importance of different habitats. For example, distinguishing characteristics would be the exceptional importance of blue mussels for mitigation of eutrophication, sandy soft bottoms for recreational uses, and seagrasses and macroalgae for fisheries production and control of wave and current energy. Net changes in the provision of goods and services are evaluated for three cases of observed coastal ecosystem shifts: i) seagrass beds into unvegetated substrate; ii) unvegetated shallow soft bottoms into filamentous algal mat dominance; and iii) macroalgae into mussel beds on hard substrate. The results are discussed in a management context including accounts of biodiversity, interconnectedness of ecosystems, and potential of economic valuation.
Forces on a segregating particle
NASA Astrophysics Data System (ADS)
Lueptow, Richard M.; Shankar, Adithya; Fry, Alexander M.; Ottino, Julio M.; Umbanhowar, Paul B.
2017-11-01
Size segregation in flowing granular materials is not well understood at the particle level. In this study, we perform a series of 3D Discrete Element Method (DEM) simulations to measure the segregation force on a single spherical test particle tethered to a spring in the vertical direction in a shearing bed of particles with gravity acting perpendicular to the shear. The test particle is the same size or larger than the bed particles. At equilibrium, the downward spring force and test particle weight are offset by the upward buoyancy-like force and a size ratio dependent force. We find that the buoyancy-like force depends on the bed particle density and the Voronoi volume occupied by the test particle. By changing the density of the test particle with the particle size ratio such that the buoyancy force matches the test particle weight, we show that the upward size segregation force is a quadratic function of the particle size ratio. Based on this, we report an expression for the net force on a single particle as the sum of a size ratio dependent force, a buoyancy-like force, and the weight of the particle. Supported by NSF Grant CBET-1511450 and the Procter and Gamble Company.
2010-01-01
Background Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. Methods A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. Results ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Conclusions Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance. PMID:20682050
Chandre, Fabrice; Dabire, Roch K; Hougard, Jean-Marc; Djogbenou, Luc S; Irish, Seth R; Rowland, Mark; N'guessan, Raphael
2010-08-03
Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance.
Neuroendocrine tumor imaging with 68Ga-DOTA-NOC: physiologic and benign variants.
Kagna, Olga; Pirmisashvili, Natalia; Tshori, Sagi; Freedman, Nanette; Israel, Ora; Krausz, Yodphat
2014-12-01
Imaging with (68)Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotide analogs has become an important modality in patients with neuroendocrine tumors (NETs). In addition to high uptake in NET lesions, prominent physiologic radiotracer activity has been reported in the pituitary gland, pancreas, adrenal glands, liver, and spleen, and faint activity has been reported in the thyroid and gastrointestinal tract. This article describes previously unknown sites of 68Ga-DOTA-1-NaI3-octreotide (NOC) uptake unrelated to NETs. One hundred eighty-two patients (96 female and 86 male patients; age range, 4-89 years) with documented (n=156) or suspected (n=26) NETs underwent 207 68Ga-DOTA-NOC PET/CT studies. Studies were retrospectively reviewed for the presence, intensity, and localization of foci of increased uptake that were further correlated with findings on additional imaging studies and clinical follow-up for a period of 4-32 months. Uptake of 68Ga-DOTA-NOC not identified as NET or known physiologic activity was detected in 297 sites with confirmation in 149 of 207 studies (72%). The most common location of non-NET-related 68Ga-DOTA-NOC-avid sites was in small lymph nodes, followed by prostate, uterus, breasts, lungs, brown fat, musculoskeletal system, and other sites, including oropharynx, pineal body, thymus, aortic plaque, genitalia, surgical bed, and subcutaneous granuloma. Intensity of uptake in non-NET-related 68Ga-DOTA-NOC-avid sites ranged in maximum standardized uptake value from 0.8 to 10.5. Previously unreported benign sites of 68Ga-DOTA-NOC uptake were found in the majority of studies, suggesting the presence of somatostatin receptors in physiologic variants or processes with no evidence of tumor. Knowledge of increased tracer uptake in non-NET-related sites is important for accurate interpretation and for avoiding potential pitfalls of 68Ga-DOTA-NOC PET/CT.
Threats to the health care safety net.
Taylor, T B
2001-11-01
The American health care safety net is threatened due to inadequate funding in the face of increasing demand for services by virtually every segment of our society. The safety net is vital to public safety because it is the sole provider for first-line emergency care, as well as for routine health care of last resort, through hospital emergency departments (ED), emergency medical services providers (EMS), and public/free clinics. Despite the perceived complexity, the causes and solutions for the current crisis reside in simple economics. During the last two decades health care funding has radically changed, yet the fundamental infrastructure of the safety net has change little. In 1986, the Emergency Medical Treatment and Active Labor Act established federally mandated safety net care that inadvertently encouraged reliance on hospital EDs as the principal safety net resource. At the same time, decreasing health care funding from both private and public sources resulted in declining availability of services necessary to support this shift in demand, including hospital inpatient beds, EDs, EMS providers, on-call specialists, hospital-based nurses, and public hospitals/clinics. The result has been ED/hospital crowding and resource shortages that at times limit the ability to provide even true emergency care and threaten the ability of the traditional safety net to protect public health and safety. This paper explores the composition of the American health care safety net, the root causes for its disintegration, and offers short- and long-term solutions. The solutions discussed include restructuring of disproportionate share funding; presumed (deemed) eligibility for Medicaid eligibility; restructuring of funding for emergency care; health care for foreign nationals; the nursing shortage; utilization of a "health care resources commission"; "episodic (periodic)" health care coverage; best practices and health care services coordination; and government and hospital providers' roles. There is a base amount of funding that must be available to the American health care safety net to maintain its infrastructure and provide appropriate growth, research, development, and expansion of services. Fall below this level and the infrastructure will eventually crumble. America must patch the safety net with short-term funding and repair it with long-term health care policy and environmental changes.
Modeling Test and Treatment Strategies for Presymptomatic Alzheimer Disease
Burke, James F.; Langa, Kenneth M.; Hayward, Rodney A.; Albin, Roger L.
2014-01-01
Objectives In this study, we developed a model of presymptomatic treatment of Alzheimer disease (AD) after a screening diagnostic evaluation and explored the circumstances required for an AD prevention treatment to produce aggregate net population benefit. Methods Monte Carlo simulation methods were used to estimate outcomes in a simulated population derived from data on AD incidence and mortality. A wide variety of treatment parameters were explored. Net population benefit was estimated in aggregated QALYs. Sensitivity analyses were performed by individually varying the primary parameters. Findings In the base-case scenario, treatment effects were uniformly positive, and net benefits increased with increasing age at screening. A highly efficacious treatment (i.e. relative risk 0.6) modeled in the base-case is estimated to save 20 QALYs per 1000 patients screened and 221 QALYs per 1000 patients treated. Conclusions Highly efficacious presymptomatic screen and treat strategies for AD are likely to produce substantial aggregate population benefits that are likely greater than the benefits of aspirin in primary prevention of moderate risk cardiovascular disease (28 QALYS per 1000 patients treated), even in the context of an imperfect treatment delivery environment. PMID:25474698
Robjant, Katy; Roberts, Jackie; Katona, Cornelius
2017-01-01
Human trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD) have been found. Narrative exposure therapy (NET) is an evidence-based treatment for PTSD. In this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD. All 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment. Although limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population.
Scarano, Antonio
The immediate placement of single postextractive implants is increasing in the everyday clinical practice. Due to insufficient bone tissue volume, proper primary stability, essential for subsequent osseointegration, is sometimes not reached. The aim of this work was to compare two different approaches: implant bed preparation before and after root extraction. Twenty-two patients of both sexes were selected who needed an implant-prosthetic rehabilitation of the fractured first mandibular molar or presented an untreatable endodontic pathology. The sites were randomly assigned to the test group (treated with implant bed preparation before molar extractions) or control group (treated with implant bed preparation after molar extractions) by a computer-generated table. All implants were placed by the same operator, who was experienced in both traditional and ultrasonic techniques. The implant stability quotient (ISQ) and the position of the implant were evaluated. Statistical analysis was carried out. In the control group, three implants were placed in the central portion of the bone septum, while eight implants were placed with a tilted axis in relation to the septum; in the test group, all implants were placed in ideal positions within the root extraction sockets. The different position of the implants between the two procedures was statistically significant. This work presented an innovative approach for implant placement at the time of mandibular molar extraction. Preparing the implant bed with an ultrasonic device before root extraction is a simple technique and also allows greater stability to be reached in a selective case.
Dussol, Anne-Sophie; Joly, Marie-Odile; Vercherat, Cecile; Forestier, Julien; Hervieu, Valérie; Scoazec, Jean-Yves; Lombard-Bohas, Catherine; Walter, Thomas
2015-10-01
The alkylating agents (ALKYs) streptozotocin, dacarbazine, and temozolomide currently are the main drugs used in systemic chemotherapy for neuroendocrine tumors (NETs). The promising activity shown by gemcitabine and oxaliplatin (GEMOX) in previous studies prompted this study 1) to confirm the use of GEMOX in a larger population of NET patients, 2) to compare its efficacy with that of ALKYs, and 3) to explore whether the O(6) -methylguanine-DNA methyltransferase (MGMT) status could help in selecting the chemotherapy regimen. One hundred four patients with metastatic NETs (37 pancreatic NETs, 33 gastrointestinal NETs, 23 bronchial NETs, and 11 NETs of other/unknown origin) were treated with GEMOX between 2004 and 2014. Among these patients, 63 also received ALKYs. MGMT promoter gene methylation was assessed via pyrosequencing in 42 patients. Patients received a median of 6 courses of GEMOX. Twenty-four (23%) had an objective response (OR). The median progression-free survival (PFS) and overall survival were 7.8 and 31.6 months, respectively. In the 63 patients treated with both ALKYs and GEMOX, the ORs (22% and 22%) and the PFSs (7.5 and 7.3 months) were similar. The response was concordant in 53% of the patients. Promoter gene methylation of MGMT was associated with better outcomes with ALKYs (P = .03 for OR and P = .04 for PFS) but not GEMOX. GEMOX is effective against NETs; its activity is comparable to that of ALKYs, and it is not influenced by the MGMT status. Our data suggest that GEMOX might be preferred for patients with unmethylated MGMT tumors. Cancer 2015;121:3435-43. © 2015 American Cancer Society. © 2015 American Cancer Society.
Corrosion Behavior of Heat-Treated AlSi10Mg Manufactured by Laser Powder Bed Fusion.
Cabrini, Marina; Calignano, Flaviana; Fino, Paolo; Lorenzi, Sergio; Lorusso, Massimo; Manfredi, Diego; Testa, Cristian; Pastore, Tommaso
2018-06-21
This experimental work is aimed at studying the effect of microstructural modifications induced by post-processing heat treatments on the corrosion behavior of silicon-aluminum alloys produced by means of laser powder bed fusion (LPBF). The manufacturing technique leads to microstructures characterized by the presence of melt pools, which are quite different compared to casting alloys. In this study, the behavior of an AlSi10Mg alloy was evaluated by means of intergranular corrosion tests according to ISO 11846 standard on heat-treated samples ranging from 200 to 500 °C as well as on untreated samples. We found that temperatures above 200 °C reduced microhardness of the alloy, and different corrosion morphologies occurred due to the modification of both size and distribution of silicon precipitates. Selective penetrating attacks occurred at melt pool borders. The intergranular corrosion phenomena were less intense for as-produced specimens without heat treatments compared to the heat-treated specimens at 200 and 300 °C. General corrosion morphologies were noticed for specimens heat treated at temperatures exceeding 400 °C.
Xing, W; Ngo, H H; Guo, W S; Listowski, A; Cullum, P
2011-05-01
An integrated fluidized bed bioreactor (iFBBR) was designed to incorporate an aerobic sponge FBBR (ASB-FBBR) into an anoxic granular activated carbon FBBR (GAC-FBBR). This iFBBR was operated with and without adding a new starch based flocculant (NSBF) to treat synthetic primary treated sewage effluent (PTSE). The NSBF contains starch based cationic flocculants and trace nutrients. The results indicate that the iFBBR with NSBF addition could remove more than 93% dissolved organic carbon (DOC), 61% total nitrogen (T-N) and 60% total phosphorus (T-P) at just a very short hydraulic retention time of 50 min. The optimum frequency of adding NSBF to the iFFBR is four times per day. As a pretreatment to microfiltration, the iFFBR could increase 5L/m(2)h of critical flux thus reducing the membrane fouling. In addition, better microbial activity was also observed with high DO consumption (>66%) and specific oxygen uptake rate (>35 mg O(2)/g VSS h). Copyright © 2010 Elsevier Ltd. All rights reserved.
Value of neonicotinoid seed treatments to US soybean farmers.
Hurley, Terrance; Mitchell, Paul
2017-01-01
The benefits of neonicotinoid seed treatment to soybean farmers have received increased scrutiny. Rather than use data from small-plot experiments, this research uses survey data from 500 US farmers to estimate the benefit of neonicotinoid seed treatments to them. As seed treatment users, farmers are familiar with their benefits in the field and have economic incentives to only use them if they provide value. Of the surveyed farmers, 51% used insecticide seed treatments, averaging 87% of their soybean area. Farmers indicated that human and environmental safety is an important consideration affecting their pest management decisions and reported aphids as the most managed and important soybean pest. Asking farmers who used seed treatments to state how much value they provided gives an estimate of $US 28.04 ha -1 treated in 2013, net of seed treatment costs. Farmer-reported average yields provided an estimated average yield gain of 128.0 kg ha -1 treated in 2013, or about $US 42.20 ha -1 treated, net of seed treatment costs. These estimates using different data and methods are consistent and suggest the value of insecticide seed treatments to the US soybean farmers who used them in 2013 was around $US 28-42 ha -1 treated, net of seed treatment costs. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.
NASA Astrophysics Data System (ADS)
Frings, Roy M.; Gehres, Nicole; Promny, Markus; Middelkoop, Hans; Schüttrumpf, Holger; Vollmer, Stefan
2014-01-01
The river bed of the Rhine River is subject to severe erosion and sedimentation. Such high geomorphological process rates are unwanted for economical, ecological, and safety reasons. The objectives of this study were (1) to quantify the geomorphological development of the Rhine River between 1985 and 2006; (2) to investigate the bed erosion process; and (3) to distinguish between tectonic, hydrological, and human controls. We used a unique data set with thousands of bedload and suspended-load measurements and quantified the fluxes of gravel, sand, silt, and clay through the northern Upper Rhine Graben and the Rhenish Massif. Furthermore, we calculated bed level changes and evaluated the sediment budget of the channel. Sediment transport rates were found to change in the downstream direction: silt and clay loads increase because of tributary supply; sand loads increase because of erosion of sand from the bed; and gravel loads decrease because of reduced sediment mobility caused by the base-level control exerted by the uplifting Rhenish Massif. This base-level control shows tectonic setting, in addition to hydrology and human interventions, to represent a major control on morphodynamics in the Rhine. The Rhine bed appears to be in a state of disequilibrium, with an average net bed degradation of 3 mm/a. Sand being eroded from the bed is primarily washed away in suspension, indicating a rapid supply of sand to the Rhine delta. The degradation is the result of an increased sediment transport capacity caused by nineteenth and twentieth century's river training works. In order to reduce degradation, huge amounts of sediment are fed into the river by river managers. Bed degradation and artificial sediment feeding represent the major sources of sand and gravel to the study area; only small amounts of sediment are supplied naturally from upstream or by tributaries. Sediment sinks include dredging, abrasion, and the sediment output to the downstream area. Large uncertainties exist about the amounts of sediment deposited on floodplains and in groyne fields. Compared to the natural situation during the middle Holocene, the present-day gravel and sand loads seem to be lower, whereas the silt and clay loads seem to be higher. This is probably caused by the present-day absence of meander migration, the deforestation, and the reduced sediment trapping efficiency of the floodplains. Even under natural conditions no equilibrium bed level existed.
2013-01-01
Background Connectivity map (cMap) is a recent developed dataset and algorithm for uncovering and understanding the treatment effect of small molecules on different cancer cell lines. It is widely used but there are still remaining challenges for accurate predictions. Method Here, we propose BRCA-MoNet, a network of drug mode of action (MoA) specific to breast cancer, which is constructed based on the cMap dataset. A drug signature selection algorithm fitting the characteristic of cMap data, a quality control scheme as well as a novel query algorithm based on BRCA-MoNet are developed for more effective prediction of drug effects. Result BRCA-MoNet was applied to three independent data sets obtained from the GEO database: Estrodial treated MCF7 cell line, BMS-754807 treated MCF7 cell line, and a breast cancer patient microarray dataset. In the first case, BRCA-MoNet could identify drug MoAs likely to share same and reverse treatment effect. In the second case, the result demonstrated the potential of BRCA-MoNet to reposition drugs and predict treatment effects for drugs not in cMap data. In the third case, a possible procedure of personalized drug selection is showcased. Conclusions The results clearly demonstrated that the proposed BRCA-MoNet approach can provide increased prediction power to cMap and thus will be useful for identification of new therapeutic candidates. Website: The web based application is developed and can be access through the following link http://compgenomics.utsa.edu/BRCAMoNet/ PMID:24564956
NASA Astrophysics Data System (ADS)
Khosronejad, Ali; Sotiropoulos, Fotis
2012-11-01
We develop and validate a 3D numerical model for coupled simulations of turbulence and sand-bed morphodynamics in natural waterways under live bed conditions. We employ the Fluid-Structure Interaction Curvilinear Immersed Boundary (FSI-CURVIB) method of Khosronejad et al. (Adv. in Water Res., 2011). The mobile channel bed is discretized with an unstructured triangular grid and treated as the sharp-interface immersed boundary embedded in a background curvilinear mesh. Transport of bed load and suspended load sediments are combined in the non-equilibrium from of the Exner-Poyla for the bed surface elevation, which evolves due to the spatio-temporally varying bed shear stress and velocity vector induced by the turbulent flow field. Both URANS and LES models are implemented to simulate the effects of turbulence. Simulations are carried out for a wide range of waterways, from small scale streams to large-scale rivers, and the simulated sand-waves are quantitatively compared to available measurements. It is shown that the model can accurately capture sand-wave formation, growth, and migration processes observed in nature. The simulated bed-forms are found to have amplitude and wave length scales ranging from the order of centimeters up to several meters. This work was supported by NSF Grants EAR-0120914 and EAR-0738726, and National Cooperative Highway Research Program Grant NCHRP-HR 24-33. Computational resources were provided by the University of Minnesota Supercomputing Institute.
Determinants of malaria infection in Dembia district, Northwest Ethiopia: a case-control study.
Agegnehu, Fisseha; Shimeka, Alemayehu; Berihun, Firnus; Tamir, Melkamu
2018-04-11
Despite the progress in reducing malaria infections and related deaths, the disease remains a major global public health problem. The problem is among the top five leading causes of outpatient visits in Dembia district of the northwest Ethiopia. Therefore, this study aimed to assess the determinants of malaria infections in the district. An institution-based case-control study was conducted in Dembia district from October to November 2016. Out of the ten health centers in the district, four were randomly selected for the study in which 370 participants (185 cases and 185 controls) were enrolled. Data were collected using a pretested structured questionnaire. Factors associated with malaria infections were determined using logistic regression analysis. Odds ratio with 95% CI was used as a measure of association, and variables with a p-value of ≤0.05 were considered as statistically significant. The median age of all participants was 26 years, while that of cases and controls was 22 and 30 with a range of 1 to 80 and 2 to 71, respectively. In the multivariable logistic regression, over 15 years of age adjusted odds ratio(AOR) and confidence interval (CI) of (AOR = 18; 95% CI: 2.1, 161.5), being male (AOR = 2.2; 95% CI: 1.2, 3.9), outdoor activities at night (AOR = 5.7; 95% CI: 2.5, 12.7), bed net sharing (AOR = 3.9; 95% CI: 2.0, 7.7), and proximity to stagnant water sources (AOR = 2.7; 95% CI: 1.3, 5.4) were independent predictors. Being in over 15 years of age group, male gender, night time activity, bed net sharing and proximity to stagnant water sources were determinant factors of malaria infection in Dembia district. Additional interventions and strategies which focus on men, outdoor work at night, household net utilization, and nearby stagnant water sources are essential to reduce malaria infections in the area.
Paduch, Jan-Hendrik; Mohr, Elmar; Krömker, Volker
2013-05-01
Several mastitis-causing pathogens are able to colonize the bovine teat canal. The objective of this study was to investigate the association between the treatment of sawdust bedding with a commercial alkaline conditioner and the bacterial counts on teat skin and in the teat canal. The study used a crossover design. Ten lactating Holstein cows that were free of udder infections and mastitis were included in the study. The animals were bedded on either untreated sawdust or sawdust that had been treated with a hydrated lime-based conditioner. Once a day, fresh bedding material was added. After 3 weeks, the bedding material was removed from the cubicles, fresh bedding material was provided, and the cows were rotated between the two bedding material groups. Teat skin and teat canals were sampled using the wet and dry swab technique after weeks 1, 2, 3, 4, 5 and 6. Staphylococcus aureus, Streptococcus uberis, Escherichia coli and other coliform bacteria were detected in the resulting agar plate cultures. The treatment of the bedding material was associated with the teat skin bacterial counts of Str. uberis, Esch. coli and other coliform bacteria. An association was also found between the bedding material and the teat canal bacterial counts of coliform bacteria other than Esch. coli. For Staph. aureus, no associations with the bedding material were found. In general, the addition of a hydrated lime-based conditioner to sawdust reduces the population sizes of environmental pathogens on teat skin and in teat canals.
Knowledge of binge eating disorder: a cross-sectional survey of physicians in the United States.
Supina, Dylan; Herman, Barry K; Frye, Carla B; Shillington, Alicia C
2016-01-01
Binge eating disorder (BED)--now a designated disorder in the DSM-5--is the most prevalent eating disorder (ED), affecting 2-3% of the US population. This survey of US physicians assesses how BED is diagnosed, treated and referred. Internists, family practitioners, obstetrics/gynecologist (OB/GYNs) and psychiatrists were randomly selected from a nationally-representative panel. Participants completed an online survey and reviewed case vignettes consistent with DSM-5-defined BED, then answered questions to elicit whether they would assess for psychiatric conditions including EDs. Those reporting they would screen and who correctly identified BED in vignettes received additional questions about BED diagnosis, treatment, and referral patterns. Of 278 physicians surveyed, 96% were board-certified and 87% had practiced >10 years. 23% were psychiatrists, 27% family practitioners, 31% internists and 19% OB/GYNs. 92% were 'somewhat likely' to screen for ED after reviewing DSM-5-consistent vignettes. 206 (74%) correctly identified BED. Of these, 33% and 68% reported they proactively screen eating habits for all patients and obese patients, respectively. 10% reported not screening eating habits even in the presence of ED symptoms. Fewer than half reported using DSM criteria in Diagnosing BED, and 56 (27%) did not recognize BED to be a discreet ED. Although ED awareness is improving, understanding BED as a distinct ED is lacking, which may result in low rates of screening and diagnosis. This study illustrates how taking a complete patient history (including probing BED characteristics) may be an effective first-line strategy for clinicians to facilitate optimal care for these patients.
Soria, José; Gauthier, Daniel; Flamant, Gilles; Rodriguez, Rosa; Mazza, Germán
2015-09-01
Municipal Solid Waste Incineration (MSWI) in fluidized bed is a very interesting technology mainly due to high combustion efficiency, great flexibility for treating several types of waste fuels and reduction in pollutants emitted with the flue gas. However, there is a great concern with respect to the fate of heavy metals (HM) contained in MSW and their environmental impact. In this study, a coupled two-scale CFD model was developed for MSWI in a bubbling fluidized bed. It presents an original scheme that combines a single particle model and a global fluidized bed model in order to represent the HM vaporization during MSW combustion. Two of the most representative HM (Cd and Pb) with bed temperatures ranging between 923 and 1073K have been considered. This new approach uses ANSYS FLUENT 14.0 as the modelling platform for the simulations along with a complete set of self-developed user-defined functions (UDFs). The simulation results are compared to the experimental data obtained previously by the research group in a lab-scale fluid bed incinerator. The comparison indicates that the proposed CFD model predicts well the evolution of the HM release for the bed temperatures analyzed. It shows that both bed temperature and bed dynamics have influence on the HM vaporization rate. It can be concluded that CFD is a rigorous tool that provides valuable information about HM vaporization and that the original two-scale simulation scheme adopted allows to better represent the actual particle behavior in a fluid bed incinerator. Copyright © 2015 Elsevier Ltd. All rights reserved.
Aderibigbe, Sunday Adedeji; Olatona, Foluke Adenike; Sogunro, Oluremi; Alawode, Gafar; Babatunde, Oluwole Adeyemi; Onipe, Ambrose Itopa; Bolarinwa, Oladimeji Akeem; Ameen, Hafsat Abolore; Osagbemi, Gordon Kayode; Sanya, Emmanuel Olatunde; Olarinoye, Adebunmi Oyeladun; Akande, Tanimola Makanjuola
2014-01-01
Malaria has proven to be the most horrendous and intractable amongst the health problems confronting countries in the sub-Saharan Africa. This study aims to determine the ownership and utilisation of long lasting insecticide treated nets following free distribution campaign in a state in South West Nigeria. Multi-stage sampling technique was used to recruit 2560 households spread across the 16 LGAs of the state. Interviewer administered standardized questionnaire was used for the survey. Data analysis was done using Stata 10 software. Sixty eight point six percent (68.6%) of the households had at least one under-five child living in the household while 32.6% had at least one pregnant woman living in the household. A total of 2440 (95.3%) households received LLIN during the campaign. Overall, the utilization rate for all respondents was 58.5%. Despite the fact that 2440 households received LLINs during the campaign, only 84.3% of them were seen to have hung theirs during the survey. Coverage and ownership of LLINs increased significantly following the free distribution campaign. There was a discrepancy between net possession and net use with rate of use lower than possession. Post distribution educational campaign should be incorporated into future distribution campaigns to help increase net utilisation.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Howe, Daniel T.; Taasevigen, Danny; Garcia-Perez, Manuel
Efficient conversion of all components in lignocellulosic biomass is essential to realizing economic feasibility of biorefineries. However, when utilizing biochemical pathways, lignin cannot be fermented. Furthermore, the high lignin and high ash residue resulting from simultaneous saccharification and fermentation (SSF) reactors is difficult to thermochemically process due to feed line plugging and bed agglomeration. In this study a corn stover SSF digester residue was thermally pretreated at 300°C for 22.5 minutes (min) and then gasified in a bubbling fluidized bed gasifier to study the effect of thermal pretreatment on its processing behavior. Untreated, pelletized SSF residue was gasified at themore » same conditions to establish the baseline processing behavior. Results indicate that the thermal pretreatment process removes a substantial portion of the polar and non-polar extractives, with a resultant increase in the concentration of lignin, cellulose, and ash. Feed line plugging was not observed, although bed agglomeration was occurring at similar rates for both feedstocks, suggesting that overall ash content is the most important factor affecting bed agglomeration. Benzene, phenol, and polyaromatic hydrocarbons in the tar were present at higher concentrations in the treated material, with higher tar loading in the product gas. Total product gas generation is lower for the treated material, although the overall gas composition does not change.« less
Doe, John E.; Lander, Deborah R.; Doerrer, Nancy G.; Heard, Nina; Hines, Ronald N.; Lowit, Anna B.; Pastoor, Timothy; Phillips, Richard D.; Sargent, Dana; Sherman, James H.; Young Tanir, Jennifer; Embry, Michelle R.
2016-01-01
Abstract The HESI-coordinated RISK21 roadmap and matrix are tools that provide a transparent method to compare exposure and toxicity information and assess whether additional refinement is required to obtain the necessary precision level for a decision regarding safety. A case study of the use of a pyrethroid, “pseudomethrin,” in bed netting to control malaria is presented to demonstrate the application of the roadmap and matrix. The evaluation began with a problem formulation step. The first assessment utilized existing information pertaining to the use and the class of chemistry. At each stage of the step-wise approach, the precision of the toxicity and exposure estimates were refined as necessary by obtaining key data which enabled a decision on safety to be made efficiently and with confidence. The evaluation demonstrated the concept of using existing information within the RISK21 matrix to drive the generation of additional data using a value-of-information approach. The use of the matrix highlighted whether exposure or toxicity required further investigation and emphasized the need to address the default uncertainty factor of 100 at the highest tier of the evaluation. It also showed how new methodology such as the use of in vitro studies and assays could be used to answer the specific questions which arise through the use of the matrix. The matrix also serves as a useful means to communicate progress to stakeholders during an assessment of chemical use. PMID:26517449
Killeen, G F; McKenzie, F E; Foy, B D; Schieffelin, C; Billingsley, P F; Beier, J C
2000-05-01
We have used a relatively simple but accurate model for predicting the impact of integrated transmission control on the malaria entomologic inoculation rate (EIR) at four endemic sites from across sub-Saharan Africa and the southwest Pacific. The simulated campaign incorporated modestly effective vaccine coverage, bed net use, and larval control. The results indicate that such campaigns would reduce EIRs at all four sites by 30- to 50-fold. Even without the vaccine, 15- to 25-fold reductions of EIR were predicted, implying that integrated control with a few modestly effective tools can meaningfully reduce malaria transmission in a range of endemic settings. The model accurately predicts the effects of bed nets and indoor spraying and demonstrates that they are the most effective tools available for reducing EIR. However, the impact of domestic adult vector control is amplified by measures for reducing the rate of emergence of vectors or the level of infectiousness of the human reservoir. We conclude that available tools, including currently neglected methods for larval control, can reduce malaria transmission intensity enough to alleviate mortality. Integrated control programs should be implemented to the fullest extent possible, even in areas of intense transmission, using simple models as decision-making tools. However, we also conclude that to eliminate malaria in many areas of intense transmission is beyond the scope of methods which developing nations can currently afford. New, cost-effective, practical tools are needed if malaria is ever to be eliminated from highly endemic areas.
Fixed-bed operation for manganese removal from water using chitosan/bentonite/MnO composite beads.
Muliwa, Anthony M; Leswifi, Taile Y; Maity, Arjun; Ochieng, Aoyi; Onyango, Maurice S
2018-04-24
In the present study, a new composite adsorbent, chitosan/bentonite/manganese oxide (CBMnO) beads, cross-linked with tetraethyl-ortho-silicate (TEOS) was applied in a fixed-bed column for the removal of Mn (II) from water. The adsorbent was characterised by scanning electron microscopy (SEM), Fourier transform infra-red (FT-IR), N 2 adsorption-desorption and X-ray photoelectron spectroscopy (XPS) techniques, and moreover the point of zero charge (pH pzc ) was determined. The extend of Mn (II) breakthrough behaviour was investigated by varying bed mass, flow rate and influent concentration, and by using real environmental water samples. The dynamics of the column showed great dependency of breakthrough curves on the process conditions. The breakthrough time (t b ), bed exhaustion time (t s ), bed capacity (q e ) and the overall bed efficiency (R%) increased with an increase in bed mass, but decreased with the increase in both influent flow rate and concentration. Non-linear regression suggested that the Thomas model effectively described the breakthrough curves while large-scale column performance could be estimated by the bed depth service time (BDST) model. Experiments with environmental water revealed that coexisting ions had little impact on Mn (II) removal, and it was possible to achieve 6.0 mg/g breakthrough capacity (q b ), 4.0 L total treated water and 651 bed volumes processed with an initial concentration of 38.5 mg/L and 5.0 g bed mass. The exhausted bed could be regenerated with 0.001 M nitric acid solution within 1 h, and the sorbent could be reused twice without any significant loss of capacity. The findings advocate that CBMnO composite beads can provide an efficient scavenging pathway for Mn (II) in polluted water.
Asidi, Alex N; N' Guessan, Raphael; Koffi, Alphonsine A; Curtis, Christopher F; Hougard, Jean-Marc; Chandre, Fabrice; Corbel, Vincent; Darriet, Frédéric; Zaim, Morteza; Rowland, Mark W
2005-01-01
Background Pyrethroid resistant mosquitoes are becoming increasingly common in parts of Africa. It is important to identify alternative insecticides which, if necessary, could be used to replace or supplement the pyrethroids for use on treated nets. Certain compounds of an earlier generation of insecticides, the organophosphates may have potential as net treatments. Methods Comparative studies of chlorpyrifos-methyl (CM), an organophosphate with low mammalian toxicity, and lambdacyhalothrin (L), a pyrethroid, were conducted in experimental huts in Côte d'Ivoire, West Africa. Anopheles gambiae and Culex quinquefasciatus mosquitoes from the area are resistant to pyrethroids and organophosphates (kdr and insensitive acetylcholinesterase Ace.1R). Several treatments and application rates on intact or holed nets were evaluated, including single treatments, mixtures, and differential wall/ceiling treatments. Results and Conclusion All of the treatments were effective in reducing blood feeding from sleepers under the nets and in killing both species of mosquito, despite the presence of the kdr and Ace.1R genes at high frequency. In most cases, the effects of the various treatments did not differ significantly. Five washes of the nets in soap solution did not reduce the impact of the insecticides on A. gambiae mortality, but did lead to an increase in blood feeding. The three combinations performed no differently from the single insecticide treatments, but the low dose mixture performed encouragingly well indicating that such combinations might be used for controlling insecticide resistant mosquitoes. Mortality of mosquitoes that carried both Ace.1R and Ace.1S genes did not differ significantly from mosquitoes that carried only Ace.1S genes on any of the treated nets, indicating that the Ace.1R allele does not confer effective resistance to chlorpyrifos-methyl under the realistic conditions of an experimental hut. PMID:15918909
A multiscale cerebral neurochemical connectome of the rat brain
Schöttler, Judith; Ercsey-Ravasz, Maria; Cosa-Linan, Alejandro; Varga, Melinda; Toroczkai, Zoltan; Spanagel, Rainer
2017-01-01
Understanding the rat neurochemical connectome is fundamental for exploring neuronal information processing. By using advanced data mining, supervised machine learning, and network analysis, this study integrates over 5 decades of neuroanatomical investigations into a multiscale, multilayer neurochemical connectome of the rat brain. This neurochemical connectivity database (ChemNetDB) is supported by comprehensive systematically-determined receptor distribution maps. The rat connectome has an onion-type structural organization and shares a number of structural features with mesoscale connectomes of mouse and macaque. Furthermore, we demonstrate that extremal values of graph theoretical measures (e.g., degree and betweenness) are associated with evolutionary-conserved deep brain structures such as amygdala, bed nucleus of the stria terminalis, dorsal raphe, and lateral hypothalamus, which regulate primitive, yet fundamental functions, such as circadian rhythms, reward, aggression, anxiety, and fear. The ChemNetDB is a freely available resource for systems analysis of motor, sensory, emotional, and cognitive information processing. PMID:28671956
Tataw, David B
2014-01-01
This article describes and assesses the implications of policy decisions affecting health provider capacity in the Los Angeles County municipal safety-net health system from 1980 to 2000. Although never articulated in law or a county ordinance, the county pursued a sustained and discernable policy of cost reductions that affected capacity at King/Drew Medical Center from 1980 to 2000 without the input of beneficiaries or their advocates. Year after year, the county reduced personnel, supplies, and available beds either by reducing formal budgets or through operative actions of facility administrators that prevented the implementation of formally approved expenditures. This policy appears to have undermined the hospital system's mission of providing health services to at-risk populations with nowhere else to go. Decision making during the two decades under study revealed a decision-making pattern that challenged traditional models of policy decision making.
Marton, E.; Elston, D.P.
1987-01-01
Palaeomagnetic studies were carried out in Permian red beds of the Balaton Highlands, the Mecsek Mountains and the Bu??kk Mountains of Hungary. Statistically well defined directions were obtained from six localities in the Balaton Highlands and two localities in the Mecsek Mountains. No meaningful results were obtained from the Bu??kk Mountains. Three magnetic components were identified from red beds of the Balaton Highlands: (1) in haematite with a very high unblocking temperature (700??C), interpreted as a Permian magnetization (Dc= 79??, Ic=-11??, k = 24, ??95 = 13.6 ??), in six samples from three beds in a single locality (2) a secondary but ancient component residing mainly inmaghemite (D = 314??, I = 49??, k = 48, ??95 = 10.0??), in 84 samples from six localities with a within-locality scatter increasing on unfolding; and (3) a direction parallel to the present field (D = 7??, I = 62??, k = 46, ??95 = 7.7 ??), in nine samples from a single locality. For the Balaton Highlands, the component 1 direction agrees with directions obtained from Permian red beds and volcanics in the eastern part of the Southern and Eastern Alps and the Inner West Carpathians. All show large, apparent rotations relative to stable Europe since the Permian. Component 2 is of post-folding (post-Aptian) age. Its direction agrees with known Late Cretaceous directions from the Transdanubian Central Mountains, which also show significant counterclockwise rotation relative to stable Europe. The characteristic magnetization for the Mecsek Mountains resides in haematite and may be primary. The directions indicate only a slight net counterclockwise rotation of the Mecsek Mountains with respect to stable Europe since the Permian. ?? 1987.
Bichai, Françoise; Barbeau, Benoit; Dullemont, Yolanda; Hijnen, Wim
2010-02-01
The significance of zooplankton in the transport and fate of pathogenic organisms in drinking water is poorly understood, although many hints of the role of predation in the persistence of microorganisms through water treatment processes can be found in literature. The objective of this study was to assess the impact of predation by natural zooplankton on the transport and fate of protozoan (oo)cysts in granular activated carbon (GAC) filtration process. UV-irradiated unlabelled Cryptosporidium parvum and Giardia lamblia (oo)cysts were seeded into two pilot-scale GAC filtration columns operated under full-scale conditions. In a two-week period after seeding, a reduction of free (oo)cysts retained in the filter bed was observed. Zooplankton was isolated from the filter bed and effluent water on a 30 microm net before and during the two-week period after seeding; it was enumerated and identified. Rotifers, which are potential predators of (oo)cysts, accounted for the major part of the isolated zooplankton. Analytical methods were developed to detect (oo)cysts internalized in natural zooplankton isolated from the filter bed and effluent water. Sample sonication was optimized to disrupt zooplankton organisms and release internalized microorganisms. (Oo)cysts released from zooplankton after sonication were isolated by IMS and stained (EasyStain) for microscopic counting. Both Cryptosporidium and Giardia (oo)cysts were detected in association with zooplankton in the filter bed samples as well as in the effluent of GAC filters. The results of this study suggest that predation by zooplankton can play a role in the remobilization of persistent pathogens such as Cryptosporidium and Giardia (oo)cysts retained in GAC filter beds, and consequently in the transmission of these pathogens in drinking water. Copyright 2009 Elsevier Ltd. All rights reserved.
Magris, M; Rubio-Palis, Y; Alexander, N; Ruiz, B; Galván, N; Frias, D; Blanco, M; Lines, J
2007-03-01
We conducted a community-randomized controlled trial in an area of moderate malaria transmission in the Amazon region, southern Venezuela, home of the Yanomami indigenous ethnic group. The aim was to compare the malaria incidence rate in villages with lambdacyhalothrin-treated hammock nets (ITHN) or with placebo-treated hammock nets (PTHN). In both arms of the study, intensive surveillance for early case detection was maintained and prompt malaria treatment was administered. Baseline data were collected before the intervention and a population of around 924 Yanomami was followed for 2 years. Despite the recent introduction of nets in the Yanomami villages and the adverse natural conditions in the area, the nets were accepted enthusiastically by the study population, used conscientiously and looked after carefully. The malaria incidence rate per thousand person-years at risk was 114.6 in the IHTN group and 186.8 in the PTHN group. The adjusted rate ratios indicated that ITHN prevent 56% [IRR: 0.44, 95% confidence interval (CI): 52-59%] of new malaria cases. ITHN reduced the prevalence of parasitaemia by 83% [relative risks (RR): 0.17, 95% CI: 47-100%], according to a cross-sectional survey carried out during the high transmission season. The prevalence of splenomegaly and anaemia was too low to detect any possible reduction as a result of ITHN. The main conclusion of the present study is that ITHN can reduce malaria incidence in the area and it is the most feasible method for malaria control in a forested area where indigenous villages are scattered over a large territory. This is the first community-level epidemiological trial to show that ITHN are highly effective against malaria transmitted by Anopheles darlingi.
Costs and consequences of large-scale vector control for malaria
Yukich, Joshua O; Lengeler, Christian; Tediosi, Fabrizio; Brown, Nick; Mulligan, Jo-Ann; Chavasse, Des; Stevens, Warren; Justino, John; Conteh, Lesong; Maharaj, Rajendra; Erskine, Marcy; Mueller, Dirk H; Wiseman, Virginia; Ghebremeskel, Tewolde; Zerom, Mehari; Goodman, Catherine; McGuire, David; Urrutia, Juan Manuel; Sakho, Fana; Hanson, Kara; Sharp, Brian
2008-01-01
Background Five large insecticide-treated net (ITN) programmes and two indoor residual spraying (IRS) programmes were compared using a standardized costing methodology. Methods Costs were measured locally or derived from existing studies and focused on the provider perspective, but included the direct costs of net purchases by users, and are reported in 2005 USD. Effectiveness was estimated by combining programme outputs with standard impact indicators. Findings Conventional ITNs: The cost per treated net-year of protection ranged from USD 1.21 in Eritrea to USD 6.05 in Senegal. The cost per child death averted ranged from USD 438 to USD 2,199 when targeting to children was successful. Long-lasting insecticidal nets (LLIN) of five years duration: The cost per treated-net year of protection ranged from USD 1.38 in Eritrea to USD 1.90 in Togo. The cost per child death averted ranged from USD 502 to USD 692. IRS: The costs per person-year of protection for all ages were USD 3.27 in KwaZulu Natal and USD 3.90 in Mozambique. If only children under five years of age were included in the denominator the cost per person-year of protection was higher: USD 23.96 and USD 21.63. As a result, the cost per child death averted was higher than for ITNs: USD 3,933–4,357. Conclusion Both ITNs and IRS are highly cost-effective vector control strategies. Integrated ITN free distribution campaigns appeared to be the most efficient way to rapidly increase ITN coverage. Other approaches were as or more cost-effective, and appeared better suited to "keep-up" coverage levels. ITNs are more cost-effective than IRS for highly endemic settings, especially if high ITN coverage can be achieved with some demographic targeting. PMID:19091114
Manios, T; Stentiford, E I; Millner, P
2003-06-01
Subsurface horizontal flow experimental wetlands (reed beds), were designed and built based on a combination of two design methodologies, that of the WRc and Severn Trent Water plc (1996) and that of the USA, EPA (1988). Four different growing media were used with a combination of top soil, gravel, river sand, and mature sewage sludge compost, to determine the best substrate for total suspended solids (TSS) removal. Eight units were constructed, two for each growing media. One bed for each pair was planted with Typha latifolia plants commonly known as cattails. Primary treated domestic wastewater, was continuously fed to the beds for more than six months. All eight beds performed very well. The best performance was achieved by the gravel reed beds with an almost constant removal rate above 95% and an average effluent concentration of less than 10 mg/L. Soil based beds containing top soil and sand, managed to reach values of removal around 90%. The wetlands containing compost in their substrate, produced an effluent with average concentration of less than 30 mg/L and a percentage removal between 80% and 90%. As expected, there was no significant difference in the performance of planted and unplanted wetlands.
Wongnoi, Rachbordin; Songkasiri, Warinthorn; Phalakornkule, Chantaraporn
2007-02-01
The objective of this study was to investigate the influence of a three-phase separator configuration on the performance of an upflow anaerobic sludge bed (USAB) treating wastewater from a fruit canning factory. The performances of two 30-L UASB reactors--one with a modified three-phase separator giving a spiral flow pattern and the other with a conventional configuration-were investigated in parallel. Wastewater, with a chemical oxygen demand (COD) concentration between 2000 and 7000 mg/L, was obtained from a fruit-canning factory. Based on the effluent data of the first 100 operation days, the UASB with the three-phase separator giving spiral flow patterns yielded up to 25% lower biomass washout. It also showed better efficiencies in treating wastewater--up to 60% lower effluent COD, up to 20% higher COD percent removal, and up to 29% higher biogas production. This work presents evidence of an improvement on the conventional physical design of a UASB.
Batzias, F A; Sidiras, D K
2007-10-01
Batch and column kinetics of methylene blue adsorption on calcium chloride, zinc chloride, magnesium chloride and sodium chloride treated beech sawdust were simulated, using untreated beech sawdust as control, in order to explore its potential use as a low-cost adsorbent for wastewater dye removal. The adsorption capacity, estimated according to Freundlich's model, the Langmuir constant K(L) and the adsorption capacity coefficient values, determined using the Bohart and Adams' bed depth service model indicate that salts treatment enhanced the adsorption properties of the original material. Since sawdust is an industrial waste/byproduct and the salts used can be recovered as spent liquids from various chemical operations, this process of adsorbent upgrading/modification might be considered to take place within an 'Industrial Ecology' framework.
NASA Technical Reports Server (NTRS)
Stapleton, Thomas J. (Inventor)
2015-01-01
A concentric split flow filter may be configured to remove odor and/or bacteria from pumped air used to collect urine and fecal waste products. For instance, filter may be designed to effectively fill the volume that was previously considered wasted surrounding the transport tube of a waste management system. The concentric split flow filter may be configured to split the air flow, with substantially half of the air flow to be treated traveling through a first bed of filter media and substantially the other half of the air flow to be treated traveling through the second bed of filter media. This split flow design reduces the air velocity by 50%. In this way, the pressure drop of filter may be reduced by as much as a factor of 4 as compare to the conventional design.
Unsteady seepage flow over sloping beds in response to multiple localized recharge
NASA Astrophysics Data System (ADS)
Bansal, Rajeev K.
2017-05-01
New generalized solutions of linearized Boussinesq equation are derived to approximate the dynamic behavior of subsurface seepage flow induced by multiple localized time-varying recharges over sloping ditch-drain aquifer system. The mathematical model is based on extended Dupuit-Forchheimer assumption and treats the spatial location of recharge basins as additional parameter. Closed form analytic expressions for spatio-temporal variations in water head distribution and discharge rate into the drains are obtained by solving the governing flow equation using eigenvalue-eigenfunction method. Downward and zero-sloping aquifers are treated as special cases of main results. A numerical example is used for illustration of combined effects of various parameters such as spatial coordinates of the recharge basin, aquifer's bed slope, and recharge rate on the dynamic profiles of phreatic surface.
Ma, Chifeng; Chen, Hung-I; Flores, Mario; Huang, Yufei; Chen, Yidong
2013-01-01
Connectivity map (cMap) is a recent developed dataset and algorithm for uncovering and understanding the treatment effect of small molecules on different cancer cell lines. It is widely used but there are still remaining challenges for accurate predictions. Here, we propose BRCA-MoNet, a network of drug mode of action (MoA) specific to breast cancer, which is constructed based on the cMap dataset. A drug signature selection algorithm fitting the characteristic of cMap data, a quality control scheme as well as a novel query algorithm based on BRCA-MoNet are developed for more effective prediction of drug effects. BRCA-MoNet was applied to three independent data sets obtained from the GEO database: Estrodial treated MCF7 cell line, BMS-754807 treated MCF7 cell line, and a breast cancer patient microarray dataset. In the first case, BRCA-MoNet could identify drug MoAs likely to share same and reverse treatment effect. In the second case, the result demonstrated the potential of BRCA-MoNet to reposition drugs and predict treatment effects for drugs not in cMap data. In the third case, a possible procedure of personalized drug selection is showcased. The results clearly demonstrated that the proposed BRCA-MoNet approach can provide increased prediction power to cMap and thus will be useful for identification of new therapeutic candidates.
Hinkle, S.R.; Böhlke, J.K.; Fisher, L.H.
2008-01-01
Septic tank systems are an important source of NO3- to many aquifers, yet characterization of N mass balance and isotope systematics following septic tank effluent discharge into unsaturated sediments has received limited attention. In this study, samples of septic tank effluent before and after transport through single-pass packed-bed filters (sand filters) were evaluated to elucidate mass balance and isotope effects associated with septic tank effluent discharge to unsaturated sediments. Chemical and isotopic data from five newly installed pairs and ten established pairs of septic tanks and packed-bed filters serving single homes in Oregon indicate that aqueous solute concentrations are affected by variations in recharge (precipitation, evapotranspiration), NH4+ sorption (primarily in immature systems), nitrification, and gaseous N loss via NH3 volatilization and(or) N2 or N2O release during nitrification/denitrification. Substantial NH4+ sorption capacity was also observed in laboratory columns with synthetic effluent. Septic tank effluent ??15N-NH4+ values were almost constant and averaged + 4.9??? ?? 0.4??? (1 ??). In contrast, ??15N values of NO3- leaving mature packed-bed filters were variable (+ 0.8 to + 14.4???) and averaged + 7.2??? ?? 2.6???. Net N loss in the two networks of packed-bed filters was indicated by average 10-30% decreases in Cl--normalized N concentrations and 2-3??? increases in ??15N, consistent with fractionation accompanying gaseous N losses and corroborating established links between septic tank effluent and NO3- in a local, shallow aquifer. Values of ??18O-NO3- leaving mature packed-bed filters ranged from - 10.2 to - 2.3??? (mean - 6.4??? ?? 1.8???), and were intermediate between a 2/3 H2O-O + 1/3 O2-O conceptualization and a 100% H2O-O conceptualization of ??18O-NO3- generation during nitrification.
Evaluating Effects of Floodplain Constriction Along a High Energy Gravel-Bed River: Snake River, WY
NASA Astrophysics Data System (ADS)
Leonard, Christina M.
This study examined approximately 66 km of the Snake River, WY, USA, spanning a natural reach within Grand Teton National Park and a reach immediately downstream that is confined by artificial levees. We linked the channel adjustments observed within these two reaches between 2007 and 2012 to sediment transport processes by developing a morphological sediment budget. A pair of digital elevation models (DEMs) was generated by fusing LiDAR topography with depth estimates derived from optical image data within wetted channels. Errors for both components of the DEMs (LiDAR and optical bathymetry) were propagated through the DEM of difference and sediment budget calculations. Our results indicated that even with the best available methods for acquiring high resolution topographic data over large areas, the uncertainty associated with bed elevation estimates implied that net volumetric changes were not statistically significant. In addition to the terrain analysis, we performed a tracer study to assess the mobility of different grain size classes in different morphological units. Grain sizes, hydraulic conditions, and flow resistance characteristics along cross-sections were used to calculate critical discharges for entrainment, but this bulk characterization of fluid driving forces failed to predict bed mobility. Our results indicated that over seasonal timescales specific grain classes were not preferentially entrained. Surface and subsurface grain size data were used to calculate armoring and dimensionless sediment transport ratios for both reaches; sediment supply exceeded transport capacity in the natural reach and vice versa in the confined reach. We used a conceptual model to describe channel adjustments to lateral constriction by levees. Initially we suggest levees focused flow energy and incised the bed, resulting in bed armoring. Bed armoring promoted channel widening, but levees prevented this and instead the channel migrated more rapidly within the constricted braidplain, eroding vegetated islands and bars and excavating sediment from the reach.
Evaluation of Uncertainty in Bedload Transport Estimates in a Southern Appalachian Stream
NASA Astrophysics Data System (ADS)
Schwartz, J. S.
2016-12-01
Capacity estimates of bed-material transport rates are generally derived using empirical formulae as a function of bed material gradation and composition, and hydraulic shear stress. Various field techniques may be used to sample and characterize bed material gradation; some techniques assume the existing bar material is representative of that in transport. Other methods use Helly-Smith samplers, pit traps, and net traps. Very few large, complete cross-section pit traps fully instrumented to collect continuous bedload transport have been constructed, and none in the eastern United States to our knowledge. A fully-instrumented bedload collection station was constructed on Little Turkey Creek (LTC) in Farragut, Tennessee. The aim of the research was to characterize bed material transport during stormflows for a southern Appalachian stream in the Ridge and Valley Providence. Bedload transport data from LTC was compared with classic datasets including Oak Creek (Oregon), East Fork River (Wyoming), and Clearwater and Snake rivers (Idaho). In addition, data were evaluated to assess the potential accuracy of both calibrated and uncalibrated bedload transport models using bedload transport data from LTC. Uncalibrated models were assessed with regard to their estimated range of uncertainty according to Monte Carlo uncertainty analyses. Models calibrated using reference shear values determined according to station measurements are evaluated in the same manner. Finally, models calibrated using the small scale, short-term, low rate bedload sampling techniques promoted in the literature for the spreadsheet based Bedload Assessment in Gravel-bedded Streams (BAGS) software for determining the reference shear stress are compared to results of both uncalibrated models and those calibrated using data from the bedload station. This research supports design and construction of dynamically stable alluvial stream restoration projects where stream channels are largely dependent on reach-scale hydraulic geometry that provides a long-term balance between bed-material sediment supply and transport capacity.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Soria, José, E-mail: jose.soria@probien.gob.ar; Gauthier, Daniel; Flamant, Gilles
2015-09-15
Highlights: • A CFD two-scale model is formulated to simulate heavy metal vaporization from waste incineration in fluidized beds. • MSW particle is modelled with the macroscopic particle model. • Influence of bed dynamics on HM vaporization is included. • CFD predicted results agree well with experimental data reported in literature. • This approach may be helpful for fluidized bed reactor modelling purposes. - Abstract: Municipal Solid Waste Incineration (MSWI) in fluidized bed is a very interesting technology mainly due to high combustion efficiency, great flexibility for treating several types of waste fuels and reduction in pollutants emitted with themore » flue gas. However, there is a great concern with respect to the fate of heavy metals (HM) contained in MSW and their environmental impact. In this study, a coupled two-scale CFD model was developed for MSWI in a bubbling fluidized bed. It presents an original scheme that combines a single particle model and a global fluidized bed model in order to represent the HM vaporization during MSW combustion. Two of the most representative HM (Cd and Pb) with bed temperatures ranging between 923 and 1073 K have been considered. This new approach uses ANSYS FLUENT 14.0 as the modelling platform for the simulations along with a complete set of self-developed user-defined functions (UDFs). The simulation results are compared to the experimental data obtained previously by the research group in a lab-scale fluid bed incinerator. The comparison indicates that the proposed CFD model predicts well the evolution of the HM release for the bed temperatures analyzed. It shows that both bed temperature and bed dynamics have influence on the HM vaporization rate. It can be concluded that CFD is a rigorous tool that provides valuable information about HM vaporization and that the original two-scale simulation scheme adopted allows to better represent the actual particle behavior in a fluid bed incinerator.« less
Millar, William T.; Lindquist, Christer; Nordström, Håkan; Lidberg, Pär; Gårding, Jonas
2013-01-01
In the application of stereotactic radiosurgery, using the Gamma Knife, there are large variations in the overall treatment time for the same prescription dose, given in a single treatment session, for different patients. This is due to not only changes in the activity of the Cobolt-60 sources, but also to variations in the number of iso-centers used, the collimator size for a particular iso-center, and the time gap between the different iso-centers. Although frequently viewed as a single dose treatment the concept of biologically effective dose (BED), incorporating concurrent fast and a slow components of repair of sublethal damage, would imply potential variations in BED because of the influence of these different variables associated with treatment. This was investigated in 26 patients, treated for Vestibular Schwannomas, using the Series B Gamma-Knife, between 1999 and 2005. The iso-center number varied between 2 and 13, and the overall treatment time from 25.4–129.58 min. The prescription doses varied from 10–14 Gy. To obtain physical dose and dose-rates from each iso-center, in a number of locations in the region of interest, a prototype version of the Leksell GammaPlan® was used. For an individual patient, BED values varied by up to 15% for a given physical iso-dose. This was due to variation in the dose prescription at different locations on that iso-dose. Between patients there was a decline in the range of BED values as the overall treatment time increased. This increased treatment time was partly a function of the slow decline in the activity of the sources with time but predominantly due to changes in the number of iso-centers used. Thus, variations in BED values did not correlate with prescription dose but was modified by the overall treatment time. PMID:29296371
Alves, Alcione Aparecida de Almeida; Ruiz, Giselle Louise de Oliveira; Nonato, Thyara Campos Martins; Müller, Laura Cecilia; Sens, Maurício Luiz
2018-02-26
The application of a fixed bed adsorption column of granular activated carbon (FBAC-GAC), in the removal of carbaryl, methomyl and carbofuran at a concentration of 25 μg L -1 for each carbamate, from the public water supply was investigated. For the determination of the presence of pesticides in the water supply, the analytical technique of high-performance liquid chromatography with post-column derivatization was used. Under conditions of constant diffusivity, the FBAC-GAC was saturated after 196 h of operation on a pilot scale. The exhaust rate of the granular activated carbon (GAC) in the FBAC-GAC until the point of saturation was 0.02 kg GAC m -3 of treated water. By comparing a rapid small-scale column test and FBAC-GAC, it was confirmed that the predominant intraparticle diffusivity in the adsorption column was constant diffusivity. Based on the results obtained on a pilot scale, it was possible to estimate the values to be applied in the FBAC-GAC (full scale) to remove the pesticides, which are particle size with an average diameter of 1.5 mm GAC; relationship between the internal diameter of the column and the average diameter of GAC ≥50 in order to avoid preferential flow near the adsorption column wall; surface application rate 240 m 3 m -2 d -1 and an empty bed contact time of 3 min. BV: bed volume; CD: constant diffusivity; EBCT: empty bed contact time; FBAC-GAC: fixed bed adsorption column of granular activated carbon; GAC: granular activated carbon; MPV: maximum permitted values; NOM: natural organic matter; PD: proportional diffusivity; pH PCZ : pH of the zero charge point; SAR: surface application rate; RSSCT: rapid small-scale column test; WTCS: water treated conventional system.
Characterization of biofilm in 200W fluidized bed reactors
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lee, Michelle H.; Saurey, Sabrina D.; Lee, Brady D.
2014-09-29
Contaminated groundwater beneath the 200 West Area at the Hanford Site in Southeast Washington is currently being treated using a pump and treat system to remove organics, inorganics, radionuclides, and metals. A granular activated carbon-based fluidized bed reactor (FBR) has been added to remove nitrate, hexavalent chromium and carbon tetrachloride. Initial analytical results indicated the microorganisms effectively reduced many of the contaminants to less than cleanup levels. However shortly thereafter operational upsets of the FBR include carbon carry over, over production of microbial extracellular polymeric substance (biofilm) materials, and over production of hydrogen sulfide. As a result detailed investigations weremore » undertaken to understand the functional diversity and activity of the microbial community present in the FBR over time. Molecular analyses including terminal restriction fragment length polymorphism analysis, quantitative polymerase chain reaction and fluorescent in situ hybridization analyses were performed on the microbial community extracted from the biofilm within the bed and from the inoculum, to determine functional dynamics of the FBR bed over time and following operational changes. Findings from these analyses indicated: 1) the microbial community within the bed was completely different than community used for inoculation, and was likely from the groundwater; 2) analyses early in the testing showed an FBR community dominated by a few Curvibacter and Flavobacterium species; 3) the final sample taken indicated that the microbial community in the FBR bed had become more diverse; and 4) qPCR analyses indicated that bacteria involved in nitrogen cycling, including denitrifiers and anaerobic ammonia oxidizing bacteria, were dominant in the bed. These results indicate that molecular tools can be powerful for determining functional diversity within FBR type reactors. Coupled with micronutrient, influent and effluent chemistry evaluations, a more complete understanding of the balance between system additions (nutrients, groundwater) and biology can be achieved, thus increasing long-term predictions of performance. These analyses uniquely provide information that can be used in optimizing the overall performance, efficiency, and stability of the system both in real time as well as over the long-term, as the system design is altered or improved and/or new streams are added.« less
UltraNet Target Parameters. Chapter 1
NASA Technical Reports Server (NTRS)
Kislitzin, Katherine T.; Blaylock, Bruce T. (Technical Monitor)
1992-01-01
The UltraNet is a high speed network capable of rates up to one gigabit per second. It is a hub based network with four optical fiber links connecting each hub. Each link can carry up to 256 megabits of data, and the hub backplane is capable of one gigabit aggregate throughput. Host connections to the hub may be fiber, coax, or channel based. Bus based machines have adapter boards that connect to transceivers in the hub, while channel based machines use a personality module in the hub. One way that the UltraNet achieves its high transfer rates is by off-loading the protocol processing from the hosts to special purpose protocol engines in the UltraNet hubs. In addition, every hub has a PC connected to it by StarLAN for network management purposes. Although there is hub resident and PC resident UltraNet software, this document treats only the host resident UltraNet software.
Chemical quality of surface waters in Devils Lake basin North Dakota, 1952-60
Mitten, Hugh T.; Scott, C.H.; Rosene, Philip G.
1968-01-01
Above-normal precipitation in 1954, 1956, and 1957 caused the water surface of Devils Lake to rise to an altitude of 1,419.3 feet, its highest in 40 years. Nearly all the water entering the lake flowed through Big Coulee, and about three-fourths of that inflow was at rates greater than 100 cubic feet per second. At these rates, the inflow contained less than 600 ppm (parts per million) dissolved solids and was of the calcium bicarbonate type.Because the inflow was more dilute than the lake water, the dissolved solids in the lake decreased from 8,680 ppm in 1952 to about 6,000 ppm in 1956 and 1957. Subsequently, however, they increased to slightly more than 8,000 ppm and averaged 6,800 ppm for the 1954-60 period. Sodium and sulfate were the principal dissolved constituents in the lake water. Although the concentration of dissolved solids varied significantly from time to time, the relative proportions of the chief constituents remained nearly the same.Water flowed from Devils Lake to Mission Bay in 1956,1957, and 1958, and some flowed from Mission Bay into East Bay. However, no water moved between East Devils Lake, western Stump Lake, and eastern Stump Lake during 1952-60; these lakes received only local runoff, and the variations in their water volume caused only minor variations in dissolved solids. For the periods sampled, concentrations averaged 60,700 ppm for East Devils Lake, 23,100 ppm for western Stump Lake, and 127,000 ppm for eastern Stump Lake.Sodium and sulfate were the chief dissolved constituents in all the lakes of the Devils Lake chain. Water in eastern Stump Lake was saturated with sodium sulfate and precipitated large quantities of granular, hydrated sodium sulfate crystals on the lakebed and shore in fall and winter. A discontinuous layer of consolidated sodium sulfate crystals formed a significant part of the bed throughout the year.Measured concentrations! of zinc, iron, manganese, fluoride, arsenic, boron, copper, and lead were not high enough to harm fish. Data on alpha and beta particle activities in Devils Lake were insufficient to determine if present activities are less than, equal to, or more than activities before nuclear tests began.Miscellaneous surface waters not in the Devils Lake chain contained dissolved solids that ranged from 239 to 61,200 ppm. The lakes that spill infrequently and have little or no ground-water inflow and outflow generally contain high concentrations of dissolved solids.Salt balance computations for Devils Lake for 1952-60 indicate that a net of as much as 89,000 tons of salts was removed from the bed by the water in some years and as much as 35,000 tons was added to the bed in other years. For the 9-year period, the tons removed exceeded the tons added; the net removed averaged 2.7 tons per acre per year. Pickup of these salts from the bed increased the dissolved solids in the lake water an average of 193 ppni per year. Between 1952 and 1960, 201,000 tons of salt was added to the bed of East Devils Lake, 15,100 tons to the bed of western Stump Lake, and 421,000 tons to the bed of eastern Stump Lake.Laboratory examination of shore and bed material indicated that the shore contained less weight of salt per unit weight of dry, inorganic material than the bed. Calcium and bicarbonate were the chief constituents dissolved from bed material of Devils Lake, whereas sodium and sulfate were the chief constituents dissolved from bed material of East Bay, East Devils Lake, and eastern and western Stump Lakes. Generally, calcium and bicarbonate were the chief constitutents dissolved from shore material of all these lakes.Evidence indicates that not more than 20 percent of the salt that "disappeared" from the water of Devils Lake west of State Route 20 as the lake altitudes decreased years ago will redissolve if the lake altitude is restored.
Efficacy of mosquito netting for sustainable small holders' cabbage production in Africa.
Martin, T; Assogba-Komlan, F; Houndete, T; Hougard, J M; Chandre, F
2006-04-01
The efficacy of a mosquito netting to protect cabbages, Brassica oleracea L., against pests was investigated in field trials in Benin, West Africa. A polyester net covered the plants at night by using a wood armature. The net was removed during the day to prevent overheating and excessive shade, both problems of insect-proof screens used under tropical conditions. The number of all lepidopteran larvae with netting protection and foliar insecticide sprays was significantly lower than the unprotected control. The number of diamondback moth, Plutella xylostella (L.), was significantly lower with netting protection compared with foliar insecticide sprays and control. Netting treated with deltamethrin gave total protection of young plants against the aphid Lipaphis erysimi (Kaltenbach). At harvest, the number of marketable cabbages protected with untreated netting was significantly higher compared with the production with foliar insecticide sprays. The protection of cabbages with netting can be an economically viable method. Considering the price of cabbages on local markets (US dollars 1/unit), the net returns per 100 m2 were US dollars 247 by using netting, US dollars 149 by using insecticides, and US dollars 117 for controls. The net returns for using netting are based on replacing the netting each crop cycle. But netting can be reused several times, depending upon conditions, increasing the profit margin. The netting protection may be an alternative to the growing unsustainable practices of vegetable cropping in peri-urban areas of tropical countries.
Benelli, Giovanni; Murugan, Kadarkarai; Panneerselvam, Chellasamy; Madhiyazhagan, Pari; Conti, Barbara; Nicoletti, Marcello
2015-02-01
Mosquitoes (Diptera: Culicidae) represent an important threat to millions of people worldwide, since they act as vectors for important pathogens, such as malaria, yellow fever, dengue and West Nile. Control programmes mainly rely on chemical treatments against larvae, indoor residual spraying and insecticide-treated bed nets. In recent years, huge efforts have been carried out to propose new eco-friendly alternatives, with a special focus on the evaluation of plant-borne mosquitocidal compounds. Major examples are neem-based products (Azadirachta indica A. Juss, Meliaceae) that have been proven as really effective against a huge range of pests of medical and veterinary importance, including mosquitoes. Recent research highlighted that neem cake, a cheap by-product from neem oil extraction, is an important source of mosquitocidal metabolites. In this review, we examined (i) the latest achievements about neem cake metabolomics with special reference to nor-terpenoid and related content; (ii) the neem cake ovicidal, larvicidal and pupicidal toxicity against Aedes, Anopheles and Culex mosquito vectors; (iii) its non-target effects against vertebrates; and (iv) its oviposition deterrence effects on mosquito females. Overall, neem cake can be proposed as an eco-friendly and low-cost source of chemicals to build newer and safer control tools against mosquito vectors.
Efficiency Evaluation of Nozawa-Style Black Light Trap for Control of Anopheline Mosquitoes
Lee, Hee Il; Seo, Bo Youl; Shin, E-Hyun; Burkett, Douglas A.; Lee, Jong-Koo
2009-01-01
House-residual spraying and insecticide-treated bed nets have achieved some success in controlling anthropophilic and endophagic vectors. However, these methods have relatively low efficacy in Korea because Anopheles sinensis, the primary malaria vector, is highly zoophilic and exophilic. So, we focused our vector control efforts within livestock enclosures using ultraviolet black light traps as a mechanical control measure. We found that black light traps captured significantly more mosquitoes at 2 and 2.5 m above the ground (P < 0.05). We also evaluated the effectiveness of trap spacing within the livestock enclosure. In general, traps spaced between 4 and 7 m apart captured mosquitoes more efficiently than those spaced closer together (P > 0.05). Based on these findings, we concluded that each black light trap in the livestock enclosures killed 7,586 female mosquitoes per trap per night during the peak mosquito season (July-August). In May-August 2003, additional concurrent field trials were conducted in Ganghwa county. We got 74.9% reduction (P < 0.05) of An. sinensis in human dwellings and 61.5% reduction (P > 0.05) in the livestock enclosures. The black light trap operation in the livestock enclosures proved to be an effective control method and should be incorporated into existing control strategies in developed countries. PMID:19488423
From Livingstone to ecotourism. What's new in travel medicine?
Houston, S
2000-01-01
To review recent developments in the field of travel medicine and to outline the knowledge and resources family physicians need for providing health advice to travelers headed for tropical or developing countries. Personal files; references from review articles and from a recent textbook of travel medicine; current guidelines on pretravel advice; and a review of the 1996 to 1999 MEDLINE database using "travel medicine" as a term and subject heading, "trave(l)lers' diarrhea" as a text word and subject heading, "immunization + travel," and "malaria + chemo prevention" were used as information sources. Priority was given to randomized controlled trials and recommendations of expert or national bodies. Some elements of travel medicine, such as malaria chemoprophylaxis, have become more complex. Some valuable new preventive measures, such as hepatitis A vaccine, treated bed nets, and antimalarial drugs, have become available. Some health risks, such as cholera, have been overemphasized in the past, whereas others, such as tuberculosis and sexually transmitted diseases, have been underemphasized. Information sources relevant for providing travel health advice have improved and expanded. Canadian evidence-based guidelines addressing most important travel health issues are now available. Travel medicine is a rapidly evolving field. Physicians intending to provide health advice to travelers to high-risk parts of the world should be well prepared and have access to good, up-to-date information.
Leahy, P.P.
1982-01-01
The Trescott computer program for modeling groundwater flow in three dimensions has been modified to (1) treat aquifer and confining bed pinchouts more realistically and (2) reduce the computer memory requirements needed for the input data. Using the original program, simulation of aquifer systems with nonrectangular external boundaries may result in a large number of nodes that are not involved in the numerical solution of the problem, but require computer storage. (USGS)
Fixed-bed adsorption study of methylene blue onto pyrolytic tire char
NASA Astrophysics Data System (ADS)
Makrigianni, Vassiliki; Giannakas, Aris; Papadaki, Maria; Albanis, Triantafyllos; Konstantinou, Ioannis
2016-04-01
In this work, the adsorption efficiency of acid treated pyrolytic tire char to cationic methylene blue (MB) dye adsorption from aqueous solutions was investigated by fixed-bed adsorption column experiments. The effects of the initial dye concentration (10 - 40 mg L-1) and feed flow rate (50 - 150 mL min -1) with a fixed bed height (15 cm) were studied in order to determine the breakthrough characteristics of the adsorption system. The Adams-Bohart, Yoon-Nelson and Thomas model were applied to the adsorption of MB onto char at different operational conditions to predict the breakthrough curves and to determine the characteristic parameters of the column. The results showed that the maximum adsorbed quantities decreased with increasing flow rate and increased with increasing initial MB concentration. Breakthrough time and exhaustion time increased with decreasing inlet dye concentration and flow rate. In contrast with Adams-Bohart model, Yoon-Nelson model followed by Thomas model were found more suitable to describe the fixed-bed adsorption of methylene blue by char. The correlation coefficient values R2 for both models at different operating conditions are higher than 0.9 and the low average relative error values provided very good fittings of experimental data at different operating conditions. Higher adsorption capacity of 3.85 mg g -1 was obtained at 15 cm of adsorbent bed height, flow rate of 100 mL min -1and initial MB concentration of 40 mg L-1. Although that activated carbons exhibited higher adsorption capacities in the literature, acid-treated pyrolytic tire char was found to be considerably efficient adsorbent for the removal of MB dye column taking into account the advantages of the simpler production process compared to activated carbons, as well as, the availability of waste tire feedstock and concurrent waste tire management.