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Sample records for children receiving artemether-lumefantrine

  1. Effectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trial

    OpenAIRE

    Achan, J.; Tibenderana, J. K.; Kyabayinze, D.; Mangen, F. W.; Kamya, M. R.; Dorsey, G.; D'Alessandro, U; Rosenthal, P. J.; Talisuna, A O

    2009-01-01

    OBJECTIVE: To compare the effectiveness of oral quinine with that of artemether-lumefantrine in treating uncomplicated malaria in children. DESIGN: Randomised, open label effectiveness study. SETTING: Outpatient clinic of Uganda's national referral hospital in Kampala. PARTICIPANTS: 175 children aged 6 to 59 months with uncomplicated malaria. INTERVENTIONS: Participants were randomised to receive oral quinine or artemether-lumefantrine administered by care givers at home. MAIN OUTCOME MEASURE...

  2. Clinical Efficacy of Artemether-Lumefantrine in Congolese Children with Acute Uncomplicated Falciparum Malaria in Brazzaville

    OpenAIRE

    Mathieu Ndounga; Rachida Tahar; Prisca N. Casimiro; Dieudonné Loumouamou; Basco, Leonardo K.

    2012-01-01

    The Republic of the Congo adopted artemisinin-based combination therapies (ACTs) in 2006: artesunate-amodiaquine and artemether-lumefantrine as the first-line and second-line drugs, respectively. The baseline efficacy of artemether-lumefantrine was evaluated between March and July 2006 in Brazzaville, the capital city of Congo. Seventy-seven children aged between 6 months and 10 years were enrolled in a nonrandomized study. The children were treated under supervision with 6 doses of artemethe...

  3. Evaluation of Recurrent Parasitemia after Artemether-Lumefantrine Treatment for Uncomplicated Malaria in Children in Western Kenya

    OpenAIRE

    Woodring, Joseph V.; Ogutu, Bernhards; Schnabel, David; John N Waitumbi; Olsen, Cara H; Walsh, Douglas S.; Heppner, D. Gray; Polhemus, Mark E.

    2010-01-01

    From April 2005 to April 2006, a phase 2 malaria vaccine trial in Kenya enrolled 400 children aged 12–47 months. Each received mixed supervised and unsupervised artemether-lumefantrine for uncomplicated malaria, using a standard six-dose regimen, by weight. Children were followed for detection of parasitemia and clinical malaria. A median of two negative malaria blood films occurred during every recurrent parasitemia (RP) episode, suggesting reinfection over late recrudescence. Median time to...

  4. Pyronaridine-artesunate granules versus artemether-lumefantrine crushed tablets in children with Plasmodium falciparum malaria: a randomized controlled trial

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    Kayentao Kassoum

    2012-10-01

    Full Text Available Abstract Background Children are most vulnerable to malaria. A pyronaridine-artesunate pediatric granule formulation is being developed for the treatment of uncomplicated Plasmodium falciparum malaria. Methods This phase III, multi-center, comparative, open-label, parallel-group, controlled clinical trial included patients aged ≤12 years, bodyweight ≥5 to P. falciparum malaria. Patients were randomized (2:1 to pyronaridine-artesunate granules (60/20 mg once daily or artemether-lumefantrine crushed tablets (20/120 mg twice daily, both dosed by bodyweight, orally (liquid suspension for three days. Results Of 535 patients randomized, 355 received pyronaridine-artesunate and 180 received artemether-lumefantrine. Day-28 adequate clinical and parasitological response (ACPR, corrected for re-infection using polymerase chain reaction (PCR genotyping (per-protocol population was 97.1% (329/339; 95% CI 94.6, 98.6 for pyronaridine-artesunate; 98.8% (165/167; 95% CI 95.7, 99.9 for artemether-lumefantrine. The primary endpoint was achieved: pyronaridine-artesunate PCR-corrected day-28 ACPR was statistically significantly >90% (P 3 times the upper limit of normal (ULN and peak total bilirubin >2xULN (i.e. within the Hy’s law definition. Conclusions The pyronaridine-artesunate pediatric granule formulation was efficacious and was non-inferior to artemether-lumefantrine. The adverse event profile was similar for the two comparators. Pyronaridine-artesunate should be considered for inclusion in paediatric malaria treatment programmes. Trial registration ClinicalTrials.gov: identifier NCT00541385

  5. A randomized, open-label, comparative efficacy trial of artemether-lumefantrine suspension versus artemether-lumefantrine tablets for treatment of uncomplicated Plasmodium falciparum malaria in children in western Kenya

    OpenAIRE

    Akhwale Willis S; Obonyo Charles O; Juma Elizabeth A; Ogutu Bernhards R

    2008-01-01

    Abstract Background Artemether/lumefantrine (AL) has been adopted as the treatment of choice for uncomplicated malaria in Kenya and other countries in the region. Six-dose artemether/lumefantrine tablets are highly effective and safe for the treatment of infants and children weighing between five and 25 kg with uncomplicated Plasmodium falciparum malaria. However, oral paediatric formulations are urgently needed, as the tablets are difficult to administer to young children, who cannot swallow...

  6. A randomized, open-label, comparative efficacy trial of artemether-lumefantrine suspension versus artemether-lumefantrine tablets for treatment of uncomplicated Plasmodium falciparum malaria in children in western Kenya

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    Akhwale Willis S

    2008-12-01

    Full Text Available Abstract Background Artemether/lumefantrine (AL has been adopted as the treatment of choice for uncomplicated malaria in Kenya and other countries in the region. Six-dose artemether/lumefantrine tablets are highly effective and safe for the treatment of infants and children weighing between five and 25 kg with uncomplicated Plasmodium falciparum malaria. However, oral paediatric formulations are urgently needed, as the tablets are difficult to administer to young children, who cannot swallow whole tablets or tolerate the bitter taste of the crushed tablets. Methods A randomized, controlled, open-label trial was conducted comparing day 28 PCR corrected cure-rates in 245 children aged 6–59 months, treated over three days with either six-dose of artemether/lumefantrine tablets (Coartem® or three-dose of artemether/lumefantrine suspension (Co-artesiane® for uncomplicated falciparum malaria in western Kenya. The children were followed-up with clinical, parasitological and haematological evaluations over 28 days. Results Ninety three percent (124/133 and 90% (121/134 children in the AL tablets and AL suspension arms respectively completed followed up. A per protocol analysis revealed a PCR-corrected parasitological cure rate of 96.0% at Day 28 in the AL tablets group and 93.4% in the AL suspension group, p = 0.40. Both drugs effectively cleared gametocytes and were well tolerated, with no difference in the overall incidence of adverse events. Conclusion The once daily three-dose of artemether-lumefantrine suspension (Co-artesiane® was not superior to six-dose artemether-lumefantrine tablets (Coartem® for the treatment of uncomplicated malaria in children below five years of age in western Kenya. Trial registration ClinicalTrials.gov NCT00529867

  7. Dispersible formulation of artemether/lumefantrine: specifically developed for infants and young children

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    Sagara Issaka

    2009-10-01

    Full Text Available Abstract Infants and children under five years of age are the most vulnerable to malaria with over 1,700 deaths per day from malaria in this group. However, until recently, there were no WHO-endorsed paediatric anti-malarial formulations available. Artemisinin-based combination therapy is the current standard of care for patients with uncomplicated falciparum malaria in Africa. Artemether/lumefantrine (AL meets WHO pre-qualification criteria for efficacy, safety and quality. Coartem®, a fixed dose combination of artemether and lumefantrine, has consistently achieved cure rates of >95% in clinical trials. However, AL tablets are inconvenient for caregivers to administer as they need to be crushed and mixed with water or food for infants and young children. Further, in common with other anti-malarials, they have a bitter taste, which may result in children spitting the medicine out and not receiving the full therapeutic dose. There was a clear unmet medical need for a formulation of AL specifically designed for children. Ahead of a call from WHO for child-friendly medicines, Novartis, working in partnership with Medicines for Malaria Venture (MMV, started the development of a new formulation of AL for infants and young children: Coartem® Dispersible. The excellent efficacy, safety and tolerability already demonstrated by AL tablets were confirmed with dispersible AL in a large trial comparing the crushed tablets with dispersible tablets in 899 African children with falciparum malaria. In the evaluable population, 28-day PCR-corrected cure rates of >96% were achieved. Further, its sweet taste means that it is palatable for children, and the dispersible formulation makes it easier for caregivers to administer than bitter crushed tablets. Easing administration may foster compliance, hence improving therapeutic outcomes in infants and young children and helping to preserve the efficacy of ACT.

  8. Efficacy of artemether-lumefantrine and artesunateamodiaquine for treating uncomplicated falciparum malaria in children

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    Tri Faranita

    2012-09-01

    Full Text Available Background Artsunate-amodiaquine (ASAQ has been used as a first-line treatment for uncomplicated falciparum malaria in Indonesia since 2004. Its efficacy depends on amodiaquine resistance of the infecting parasites. Artemether-lumefantrine (AL has been shown to be highly efficacious in treating uncomplicated falciparum malaria in several countries. However, there have been few studies on these anti-malarial medications in Indonesia. Objective To compare the efficacy of AL to ASAQ for treating uncomplicated falciparum malaria in children. Methods An open, randomized, controlled trial was conducted in school-aged children in the Mandailing Natal Regency, North Sumatera Province, Indonesia, from October falciparum malaria patients were randomly assigned to receive either AL or ASAQ for 3 days. Participants were followed-up on days 1, 2, 3, 7, 14, 28 and 42 following the first medication dose. The outcomes noted were adequate clinical and parasitological response (ACPR, parasite reduction, parasite clearance time, fever clearance time and adverse events. Analysis was based on intention-to-treat. Results In this study, ACPRs on day 42 were 86.4% and 90.7% for the ASAQ and AL groups, respectively (P=0.260. On days 7 and 14, the AL group had higher cure rates than that of the ASAQ parasitological failure for both groups were similar. We also found faster parasite clearance time and higher parasite reduction in the AL group than in the ASAQ group, However, fever clearance time was shorter in the ASAQ group, The incidence of adverse events such as nausea, vomiting, malaise, and pruritus were similar between the two groups (P=0.441. Conclusion AL had higher efficacy than ASAQ for the treatment of uncomplicated falciparum malaria in children.

  9. Artemether-lumefantrine: an oral antimalarial for uncomplicated malaria in children

    DEFF Research Database (Denmark)

    Adjei, George O; Goka, Bamenla Q; Binka, Fred;

    2009-01-01

    Artemether-lumefantrine (AL; Coartem, Riamet) is the first fixed-dose artemisinin combination therapy (ACT) regimen to be manufactured under Good Manufacturing Practice conditions, and is the most widely adopted ACT regimen used in malaria control programs. AL is approved for the treatment of...... uncomplicated malaria in adults, children and infants, and as treatment of uncomplicated malaria in nonimmune travelers returning from malarious areas. AL is efficacious for treating uncomplicated malaria in children and the frequency of associated adverse events is not higher than other available ACT regimens....... In this review, available evidence on efficacy and safety of AL in the treatment of uncomplicated malaria, with emphasis on children where appropriate, and focusing on characteristics that are potentially important for malaria control policy decisions, are presented and discussed....

  10. Comparative safety of artemether-lumefantrine and other artemisinin-based combinations in children: a systematic review

    OpenAIRE

    Egunsola, Oluwaseun; Oshikoya, Kazeem A

    2013-01-01

    Background The purpose of the study was to compare the safety of artemether-lumefantrine (AL) with other artemisinin-based combinations in children. Methods A search of EMBASE (from 1974 to April 2013), MEDLINE (from 1946 to April 2013) and the Cochrane library of registered controlled trials for randomized controlled trials (RCTs) which compared AL with other artemisinin-based combinations was done. Only studies involving children ≤ 17 years old in which safety of AL was an outcom...

  11. Dihydroartemisinin-piperaquine and artemether-lumefantrine for treating uncomplicated malaria in African children: a randomised, non-inferiority trial.

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    Quique Bassat

    Full Text Available BACKGROUND: Artemisinin combination therapies (ACTs are currently the preferred option for treating uncomplicated malaria. Dihydroartemisinin-piperaquine (DHA-PQP is a promising fixed-dose ACT with limited information on its safety and efficacy in African children. METHODOLOGY/PRINCIPAL FINDINGS: The non-inferiority of DHA-PQP versus artemether-lumefantrine (AL in children 6-59 months old with uncomplicated P. falciparum malaria was tested in five African countries (Burkina Faso, Kenya, Mozambique, Uganda and Zambia. Patients were randomised (2:1 to receive either DHA-PQP or AL. Non-inferiority was assessed using a margin of -5% for the lower limit of the one-sided 97.5% confidence interval on the treatment difference (DHA-PQP vs. AL of the day 28 polymerase chain reaction (PCR corrected cure rate. Efficacy analysis was performed in several populations, and two of them are presented here: intention-to-treat (ITT and enlarged per-protocol (ePP. 1553 children were randomised, 1039 receiving DHA-PQP and 514 AL. The PCR-corrected day 28 cure rate was 90.4% (ITT and 94.7% (ePP in the DHA-PQP group, and 90.0% (ITT and 95.3% (ePP in the AL group. The lower limits of the one-sided 97.5% CI of the difference between the two treatments were -2.80% and -2.96%, in the ITT and ePP populations, respectively. In the ITT population, the Kaplan-Meier estimate of the proportion of new infections up to Day 42 was 13.55% (95% CI: 11.35%-15.76% for DHA-PQP vs 24.00% (95% CI: 20.11%-27.88% for AL (p<0.0001. CONCLUSIONS/SIGNIFICANCE: DHA-PQP is as efficacious as AL in treating uncomplicated malaria in African children from different endemicity settings, and shows a comparable safety profile. The occurrence of new infections within the 42-day follow up was significantly lower in the DHA-PQP group, indicating a longer post-treatment prophylactic effect. TRIAL REGISTRATION: Controlled-trials.com ISRCTN16263443.

  12. Pharmacokinetic and Pharmacodynamic Characteristics of a new Pediatric Formulation of Artemether-Lumefantrine in African Children with Uncomplicated Plasmodium Falciparum Malaria.

    OpenAIRE

    Djimdé, Abdoulaye A.; Tekete, Mamadou; Abdulla, Salim; Lyimo, John; Bassat, Quique; Mandomando, Inacio; Lefèvre, Gilbert; Borrmann, Steffen

    2011-01-01

    The pharmacokinetic and pharmacodynamic properties of a new pediatric formulation of artemether-lumefantrine, dispersible tablet, were determined within the context of a multicenter, randomized, parallel-group study. In an exploratory approach, we compared a new pediatric formulation with the tablet formulation administered crushed in the treatment of African children with uncomplicated Plasmodium falciparum malaria. Patients were randomized to 3 different dosing groups (weights of 5 to

  13. Surveillance of the efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated Plasmodium falciparum among children under five in Togo, 2005-2009

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    Dorkenoo Monique A

    2012-10-01

    Full Text Available Abstract Background Malaria remains a major public health problem in Togo. The national malaria control programme in Togo changed the anti-malarial treatment policy from monotherapy to artemisinin combination therapy in 2004. This study reports the results of therapeutic efficacy studies conducted on artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Togo, between 2005 and 2009. Methods Children between 6 and 59 months of age, who were symptomatically infected with P. falciparum, were treated with either artemether-lumefantrine or artesunate-amodiaquine. The primary end-point was the 28-day cure rate, PCR-corrected for reinfection and recrudescence. Studies were conducted according to the standardized WHO protocol for the assessment of the efficacy of anti-malarial treatment. Differences between categorical data were compared using the chi-square test or the Fisher’s exact test where cell counts were ≤ 5. Differences in continuous data were compared using a t-test. Results A total of 16 studies were conducted in five sentinel sites, with 459, 505 and 332 children included in 2005, 2007 and 2009, respectively. The PCR-corrected 28-day cure rates using the per-protocol analysis were between 96%-100% for artemether-lumefantrine and 94%-100% for artesunate-amodiaquine. Conclusions Both formulations of artemisinin-based combination therapy were effective over time and no severe adverse events related to the treatment were reported during the studies.

  14. Significant pharmacokinetic interactions between artemether/lumefantrine and efavirenz or nevirapine in HIV-infected Ugandan adults

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    Byakika-Kibwika, Pauline; Lamorde, Mohammed; Mayito, Jonathan; Nabukeera, Lillian; Namakula, Rhoda; Mayanja-Kizza, Harriet; Katabira, Elly; Ntale, Muhammad; Pakker, Nadine; Ryan, Mairin; Hanpithakpong, Warunee; Tarning, Joel; Lindegardh, Niklas; de Vries, Peter J; Khoo, Saye

    2012-01-01

    Objectives Co-administration of artemether/lumefantrine with antiretroviral therapy has potential for pharmacokinetic drug interactions. We investigated drug–drug interactions between artemether/lumefantrine and efavirenz or nevirapine. Methods We performed a cross-over study in which HIV-infected adults received standard six-dose artemether/lumefantrine 80/480 mg before and at efavirenz or nevirapine steady state. Artemether, dihydroartemisinin, lumefantrine, efavirenz and nevirapine plasma ...

  15. Artemether-Lumefantrine Exposure in HIV-Infected Nigerian Subjects on Nevirapine-Containing Antiretroviral Therapy.

    Science.gov (United States)

    Parikh, Sunil; Fehintola, Fatai; Huang, Liusheng; Olson, Alexander; Adedeji, Waheed A; Darin, Kristin M; Morse, Gene D; Murphy, Robert L; Taiwo, Babafemi O; Akinyinka, Olusegun O; Adewole, Isaac F; Aweeka, Francesca T; Scarsi, Kimberly K

    2015-12-01

    Coadministration of nevirapine-based antiretroviral therapy (ART) and artemether-lumefantrine is reported to result in variable changes in lumefantrine exposure. We conducted an intensive pharmacokinetic study with 11 HIV-infected adults who were receiving artemether-lumefantrine plus nevirapine-based ART, and we compared the results with those for 16 HIV-negative adult historical controls. Exposure to artemether and lumefantrine was significantly lower and dihydroartemisinin exposure was unchanged in subjects receiving nevirapine-based ART, compared with controls. Nevirapine exposure was unchanged before and after artemether-lumefantrine administration. PMID:26392500

  16. Therapeutic efficacy of artemether-lumefantrine combination in the treatment of uncomplicated malaria among children under five years of age in three ecological zones in Ghana

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    Abuaku Benjamin

    2012-11-01

    Full Text Available Abstract Background In 2008, artemether - lumefantrine (AL and dihydroartemisinin - piperaquine (DHAP were added to artesunate - amodiaquine (AS-AQ as first-line drugs for uncomplicated malaria in Ghana. The introduction of new drugs calls for continuous monitoring of these drugs to provide timely information on trends of their efficacy and safety to enhance timely evidence-based decision making by the National Malaria Control Programme. In this regard, the therapeutic efficacy of AL was monitored from September 2010 to April 2011 in four sentinel sites representing the three main ecological zones of the country. Methods The study was a one-arm prospective evaluation of clinical and parasitological responses to directly observed treatment for uncomplicated malaria among children aged 6 months to 59 months using the 2009 WHO protocol for surveillance of anti-malarial drug efficacy. Children recruited into the study received weight-based 20/120 mg AL at 0, 8, 24, 36, 48, and 60 hrs. Parasitaemia levels were assessed on days 2, 3, 7, 14, 21, 28, and at any time a study child was brought to the clinic with fever. Results A total of 175 children were enrolled into the study: 56 in the savanna zone, 78 in the forest zone and 41 in the coastal zone. Per-protocol analysis showed that the overall PCR-corrected cure rates on day 14 and day 28 were 96.5% (95% CI: 92.1, 98.6 and 95.4% (95% CI: 90.3, 98.0, respectively, with statistically significant differences between the ecological zones. The 90.4% day-28 cure rate observed in the savannah zone (95% CI: 78.2, 96.4 was significantly the lowest compared with 100% (95% CI: 93.2, 99.9 in the forest zone and 93.8% (95% CI: 77.8, 98.9 in the coastal zone (P = 0.017. Fever and parasite clearance were slower among children enrolled in the savannah zone. Gametocytaemia after day-3 post-treatment was rare in all the zones. Conclusions The study has shown that AL remains efficacious in Ghana with

  17. Amodiaquine-Artesunate versus Artemether-Lumefantrine against Uncomplicated Malaria in Children Less Than 14 Years in Ngaoundere, North Cameroon: Efficacy, Safety, and Baseline Drug Resistant Mutations in pfcrt, pfmdr1, and pfdhfr Genes

    OpenAIRE

    Ali, Innocent M.; Netongo, Palmer M; Barbara Atogho-Tiedeu; Eric-Olivier Ngongang; Anthony Ajua; Achidi, Eric A.; Mbacham, Wilfred F.

    2013-01-01

    Background. In Cameroon, both Artesunate-amodiaquine (AS/AQ) and artemether-lumefantrine (AL) are used as first-line treatment against uncomplicated malaria in line with the WHO recommendations. We compared the efficacy and safety of both therapeutic combinations and determined the prevalence of drug resistance conferring mutations in three parasite genes. Methods. One hundred and fifty acute malaria patients between six months and 14 years of age were randomized to receive standard doses of ...

  18. Artemether-Lumefantrine Exposure in HIV-Infected Nigerian Subjects on Nevirapine-Containing Antiretroviral Therapy

    OpenAIRE

    Parikh, Sunil; Fehintola, Fatai; Huang, Liusheng; Olson, Alexander; Adedeji, Waheed A.; Darin, Kristin M.; Morse, Gene D.; Robert L Murphy; Taiwo, Babafemi O; Akinyinka, Olusegun O; Adewole, Isaac F.; Aweeka, Francesca T.; Scarsi, Kimberly K.

    2015-01-01

    Coadministration of nevirapine-based antiretroviral therapy (ART) and artemether-lumefantrine is reported to result in variable changes in lumefantrine exposure. We conducted an intensive pharmacokinetic study with 11 HIV-infected adults who were receiving artemether-lumefantrine plus nevirapine-based ART, and we compared the results with those for 16 HIV-negative adult historical controls. Exposure to artemether and lumefantrine was significantly lower and dihydroartemisinin exposure was unc...

  19. Primacy of effective communication and its influence on adherence to artemether-lumefantrine treatment for children under five years of age: a qualitative study

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    Simba Daudi O

    2012-06-01

    Full Text Available Abstract Background Prompt access to artemesinin-combination therapy (ACT is not adequate unless the drug is taken according to treatment guidelines. Adherence to the treatment schedule is important to preserve efficacy of the drug. Although some community based studies have reported fairly high levels of adherence, data on factors influencing adherence to artemether-lumefantrine (AL treatment schedule remain inadequate. This study was carried-out to explore the provider’s instructions to caretakers, caretakers’ understanding of the instructions and how that understanding was likely to influence their practice with regard to adhering to AL treatment schedule. Methods A qualitative study was conducted in five villages in Kilosa district, Tanzania. In-depth interviews were held with providers that included prescribers and dispensers; and caretakers whose children had just received AL treatment. Information was collected on providers’ instructions to caretakers regarding dose timing and how to administer AL; and caretakers’ understanding of providers’ instructions. Results Mismatch was found on providers’ instructions as regards to dose timing. Some providers’ (dogmatists instructions were based on strict hourly schedule (conventional which was likely to lead to administering some doses in awkward hours and completing treatment several hours before the scheduled time. Other providers (pragmatists based their instruction on the existing circumstances (contextual which was likely to lead to delays in administering the initial dose with serious treatment outcomes. Findings suggest that, the national treatment guidelines do not provide explicit information on how to address the various scenarios found in the field. A communication gap was also noted in which some important instructions on how to administer the doses were sometimes not provided or were given with false reasons. Conclusions There is need for a review of the national malaria

  20. A comparative, randomized clinical trial of artemisinin/naphtoquine twice daily one day versus artemether/lumefantrine six doses regimen in children and adults with uncomplicated falciparum malaria in Côte d'Ivoire

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    Toure Walamtchin

    2009-07-01

    Full Text Available Abstract Background Drug resistance in Plasmodium falciparum poses a major threat to malaria control. Combination anti-malarial therapy, including artemisinins, has been advocated to improve efficacy and limit the spread of resistance. The fixed combination of oral artemether-lumefantrine (AL is highly effective and well-tolerated. Artemisinin/naphtoquine (AN is a fixed-dose ACT that has recently become available in Africa. The objectives of the study were to compare the efficacy and safety of AN and AL for the treatment of uncomplicated falciparum malaria in a high transmission-intensity site in Ivory Coast. Methods We enrolled 122 participants aged 6 months or more with uncomplicated falciparum malaria. Participants were randomized to receive either artemisinin/naphtoquine or artemether/lumefantrine with variable dose according to their weight. Primary endpoints were the risks of treatment failure within 28 days, either unadjusted or adjusted by genotyping to distinguish recrudescence from new infection. Results Among 125 participants enrolled, 123 (98.4% completed follow-up. Clinical evaluation of the 123 participants showed that cumulative PCR-uncorrected cure rate on day 28 was 100% for artemisinin/naphtoquine and 98.4% for artemether/lumefantrine. Both artemisinin-based combinations effected rapid fever and parasite clearance. Interpretation These data suggest that Arco® could prove to be suitable for use as combination antimalarial therapy. Meanwhile, pharmacokinetic studies and further efficacy assessment should be conducted before its widespread use can be supported.

  1. Adherence to a Six-Dose Regimen of Artemether-Lumefantrine for Treatment of Uncomplicated Plasmodium Falciparum Malaria in Uganda.

    OpenAIRE

    Fogg, Carole; Bajunirwe, Francis; Piola, Patrice; Biraro, Samuel; Checchi, Francesco; Kiguli, James; Namiiro, Proscovia; Musabe, Joy; Kyomugisha, Agnes; Guthmann, Jean-Paul

    2004-01-01

    Measuring baseline levels of adherence and identifying risk factors for non-adherence are important steps before the introduction of new antimalarials. In Mbarara in southwestern Uganda, we assessed adherence to artemether-lumefantrine (Coartem) in its latest World Health Organization blister formulation. Patients with uncomplicated Plasmodium falciparum malaria were prescribed artemether-lumefantrine and received an explanation of how to take the following five doses at home. A tablet count ...

  2. Evaluation of the efficacy and safety of artemether-lumefantrine in the treatment of acute uncomplicated Plasmodium falciparum malaria in Nigerian infants and children

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    de Palacios Patricia

    2008-11-01

    Full Text Available Abstract Background The six-dose regimen of artemether-lumefantrine (AL is now considered the gold standard for the treatment of uncomplicated Plasmodium falciparum malaria. There are few reports evaluating co-artemether in very young Nigerian infants and children. Results of the evaluation of the six-dose regimen in very young infants and children in Nigeria are presented in this report. Methods As part of a larger African study, this open label, non-comparative trial, assessed the efficacy and safety of six-dose regimen of AL tablets in 103 Nigerian infants and children weighing between five and 25 kg suffering from acute uncomplicated malaria. Treatment was administered under supervision over three days with children as in-patients. 12-lead ECG tracings were taken pre-treatment and at day 3. Results Ninety-three infants and children completed the study as stipulated by the protocol. Mean fever and parasite clearance times for the intent to treat population (ITT were 24.9 h ± (1.28 and 26 h ± (4.14 and the corresponding figures for the per-protocol population (PP were 19.24 h ± 13.9 and 25.62 h ± 11.25 respectively. Day 14 cure rates for the ITT and PP were 95.1% and 100% respectively while day 28 cure rates were 91.3% and 95.7% respectively. The overall PCR corrected day 28 cure rate was 95.1% for the ITT. The six-dose regimen of AL was well tolerated with no drug-related serious adverse events. Although six patients recorded a QTc prolongation of > 60 ms on D3 over D0 recording, no patient recorded a QTc interval > 500 ms. Conclusion The six-dose regimen of AL tablets is safe and effective for the treatment of acute uncomplicated malaria in Nigerian infants and children weighing between five and 25 kg. Trial registration NCT00709969

  3. Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania: an open label prospective study

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    Blessborn Daniel

    2011-03-01

    Full Text Available Abstract Background Home-management of malaria (HMM strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL, presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs and administered unsupervised by parents or guardians at home. Methods An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5% patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%. The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10 compared with reinfections (205 ng/mL [114-390]; n = 92, or no parasite reappearance (217 [121-374] ng/mL; n = 70; p ≤ 0.046. Conclusions Provision of AL by CHWs for unsupervised malaria treatment at home

  4. Access to subsidized artemether-lumefantrine from the private sector among febrile children in rural setting in Kilosa, Tanzania.

    Science.gov (United States)

    Simba, Daudi; Kakoko, Deodatus

    2012-04-01

    The World Health Organization aims at universal access to effective antimalarial treatment by the year 2015. Consequently, an enormous financial resource has been invested on Artemisinin Combination Therapy (ACT) subsidy. In Tanzania, strategies to increase access of artemether-lumufantrine (ALu) rural areas, where the burden is highest, includes subsidy to the Faith-based Organisations (FBO) facilities and accredited drug dispensing outlets (ADDOs). This study was done to assess the extent to which children suffering from malaria access ALu from the private sector in rural areas. A total of 1,235 under fives randomly selected from 12 rural villages were followed up at home on weekly basis for six months in Kilosa district in 2008. Using a structured questionnaire, caretakers were interviewed about the child's history of fever in the past 7 days; type of treatment given and the source. Baseline data were obtained on demographic characteristics, caretakers' knowledge about malaria and social economic indicators of the household. Of the 1,235 children followed-up, 740 care-seeking visits were recorded, of which, 264 (35.7%) were made at government health facilities and nearly a quarter (24.1%; 178/740) at ordinary shops that sell general merchandize including rice and sugar. Only 22% of the caretakers sought care from FBO and ADDOs. While 686 (86.6%) of the episodes were treated with antimalarials, only 319 (43%) received ALu, the recommended antimalarial. Majority (83%) of the visits made at government facilities were prescribed with ALu compared to less than half who went to FBO facilities (40.0%) and ADDOs (25.0%). In conclusion, this study has shown that less than a quarter of fever episodes suspected to be malaria in rural areas were made at FBO facilities and ADDOs, of which, less than half were treated with ALu. This shows that ALu subsidy to formal private sector does not adequately reach children in rural areas, where the malaria burden is highest. This cast

  5. Artemether-lumefantrine treatment of uncomplicated Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Kofoed, Poul-Erik

    2015-01-01

    BACKGROUND: Achieving adequate antimalarial drug exposure is essential for curing malaria. Day 7 blood or plasma lumefantrine concentrations provide a simple measure of drug exposure that correlates well with artemether-lumefantrine efficacy. However, the 'therapeutic' day 7 lumefantrine......-lumefantrine for uncomplicated Plasmodium falciparum malaria, to define therapeutic day 7 lumefantrine concentrations and identify patient factors that substantially alter these concentrations. A systematic review of PubMed, Embase, Google Scholar, ClinicalTrials.gov and conference proceedings identified all...... achieve day 7 lumefantrine concentrations ≥200 ng/ml and high cure rates in most uncomplicated malaria patients. Three groups are at increased risk of treatment failure: very young children (particularly those underweight-for-age); patients with high parasitemias; and patients in very low transmission...

  6. Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

    OpenAIRE

    James Prah; Elvis Ofori Ameyaw; Richmond Afoakwah; Patrick Fiawoyife; Ernest Oppong-Danquah; Johnson Nyarko Boampong

    2016-01-01

    Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and...

  7. Prolonged Selection of pfmdr1 Polymorphisms After Treatment of Falciparum Malaria With Artemether-Lumefantrine in Uganda

    OpenAIRE

    Baliraine, Frederick N.; Rosenthal, Philip J

    2011-01-01

    We compared the prevalence of key pfmdr1 alleles between pretreatment Plasmodium falciparum parasite isolates and parasites that emerged after treatment of uncomplicated malaria in a longitudinal cohort of Ugandan children. The pfmdr1 86N, 184F, and 1246D alleles were selected after treatment with artemether-lumefantrine, but not after artesunate-amodiaquine or amodiaquine-sulfadoxine-pyrimethamine. Remarkably, selection persisted in infections presenting up to about 60 days after treatment w...

  8. Therapeutic efficacy of Artemether/Lumefantrine (Coartem® against Plasmodium falciparum in Kersa, South West Ethiopia

    Directory of Open Access Journals (Sweden)

    Animut Abebe

    2010-01-01

    Full Text Available Abstract Background Artemether/Lumefantrine (Coartem® has been used as a first-line treatment for uncomplicated Plasmodium falciparum infection since 2004 in Ethiopia. In the present study the therapeutic efficacy of artemether/lumefantrine for the treatment of uncomplicated P. falciparum infection at Kersa, Jima zone, South-west Ethiopia, has been assessed. Methods A 28 day therapeutic efficacy study was conducted between November 2007 and January 2008, in accordance with the 2003 WHO guidelines. Outcomes were classified as early treatment failure (ETF, late clinical failure (LCF, late parasitological failure (LPF and adequate clinical and parasitological response (ACPR. Results 90 patients were enrolled and completed the 28 day follow-up period after treatment with artemether/lumefantrine. Cure rate was very high, 96.3%, with 95% CI of 0.897-0.992 (PCR uncorrected. Age-stratified data showed adequate clinical and parasitological response (ACPR to be 100% for children under 5 and 97.4% and 87.3% for children aged 5-14, and adults, respectively. There was no early treatment failure (ETF in all age groups. Fever was significantly cleared on day 3 (P 0.05. No major side effect was observed in the study except the occurrence of mouth ulcers in 7% of the patients. Conclusions The current study proved the excellent therapeutic efficacy of artemether/lumefantrine in the study area and the value of using it. However, the proper dispensing and absorption of the drug need to be emphasized in order to utilize the drug for a longer period of time. This study recommends further study on the toxicity of the drug with particular emphasis on the development of oral ulcers in children.

  9. Efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Northeast Ethiopia

    Directory of Open Access Journals (Sweden)

    Assefa Mulu

    2015-06-01

    Conclusions: In general, this study discovered good clinical and parasitological response of P. falciparum to artemether/lumefantrine. Further polymeric chain reaction and plasma drug concentration based effectiveness study of artemether/lumefantrine should be conducted throughout the country. [Int J Basic Clin Pharmacol 2015; 4(3.000: 492-496

  10. Amodiaquine-artesunate vs artemether-lumefantrine for uncomplicated malaria in Ghanaian children: a randomized efficacy and safety trial with one year follow-up

    DEFF Research Database (Denmark)

    Adjei, George O; Kurtzhals, Jorgen A L; Rodrigues, Onike P;

    2008-01-01

    -L were efficacious for treatment of children with uncomplicated malaria in Ghana and drug-related adverse events were rare in treated subjects during one year of follow-up. The high prevalence of potentially AQ resistant parasites raises questions about the utility of AQ as a partner drug for ACT in...... days, or on the safety of repeated treatments. METHODS: Children aged six months to 14 years with uncomplicated malaria were randomly assigned to treatment with AS+AQ (n = 116), or AM-L (n = 111). Recruited subjects were followed-up, initially for 28 days, and then monthly for up to one year. All...... subsequent attacks of uncomplicated malaria after 28 days were treated with the same regimen as at randomization. Investigations aimed at determining efficacy and side effects were conducted. RESULTS: Adequate clinical and parasitological response in subjects with evaluable end-points were, 97.1% (100...

  11. Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

    Directory of Open Access Journals (Sweden)

    James Prah

    2016-01-01

    Full Text Available Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%−104.70% of stated content by manufacturer. The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%–111.87%. Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market.

  12. Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis.

    Science.gov (United States)

    Prah, James; Ameyaw, Elvis Ofori; Afoakwah, Richmond; Fiawoyife, Patrick; Oppong-Danquah, Ernest; Boampong, Johnson Nyarko

    2016-01-01

    Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%-104.70% of stated content by manufacturer). The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%-111.87%). Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market. PMID:27006665

  13. Artemether-Lumefantrine Combination Therapy for Treatment of Uncomplicated Malaria: The Potential for Complex Interactions with Antiretroviral Drugs in HIV-Infected Individuals

    OpenAIRE

    Pauline Byakika-Kibwika; Mohammed Lamorde; Harriet Mayanja-Kizza; Saye Khoo; Concepta Merry; Jean-Pierre Van geertruyden

    2011-01-01

    Treatment of malaria in HIV-infected individuals receiving antiretroviral therapy (ART) poses significant challenges. Artemether-lumefantrine (AL) is one of the artemisisnin-based combination therapies recommended for treatment of malaria. The drug combination is highly efficacious against sensitive and multidrug resistant falciparum malaria. Both artemether and lumefantrine are metabolized by hepatic cytochrome P450 (CYP450) enzymes which metabolize the protease inhibitors (PIs) and nonnucle...

  14. Interaction between Artemether-Lumefantrine and Nevirapine-Based Antiretroviral Therapy in HIV-1-Infected Patients▿

    OpenAIRE

    Kredo, T.; Mauff, K.; Van der Walt, J. S.; Wiesner, L.; G. Maartens; Cohen, K.; Smith, P.; Barnes, K. I.

    2011-01-01

    Artemether-lumefantrine and nevirapine-based antiretroviral therapy (ART) are the most commonly recommended first-line treatments for malaria and HIV, respectively, in Africa. Artemether, lumefantrine, and nevirapine are metabolized by the cytochrome P450 3A4 enzyme system, which nevirapine induces, creating potential for important drug interactions. In a parallel-design pharmacokinetic study, concentration-time profiles were obtained in two groups of HIV-infected patients: ART-naïve patients...

  15. Efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Northeast Ethiopia

    OpenAIRE

    Assefa Mulu; Berhanu Geresu; Yeshiwork Beyene; Muluneh Ademe

    2015-01-01

    Background: The impact of resistance to antimalarials is insidious and unless efficacy studies are conducted, resistance may go unrecognized. The aim of this study was to assess the efficacy of artemether/lumefantrine, for the treatment of uncomplicated Plasmodium falciparum infections in Kemisie Health Center, Northeast Ethiopia. Methods: Artemether/lumefantrine efficacy study was conducted in Kemisie Health Center, Northeast Ethiopia from September, 2012 to May, 2013. The study participa...

  16. Artemether-Lumefantrine Pharmacokinetics and Clinical Response Are Minimally Altered in Pregnant Ugandan Women Treated for Uncomplicated Falciparum Malaria

    OpenAIRE

    Nyunt, Myaing M.; Nguyen, Vy K.; Kajubi, Richard; Huang, Liusheng; Ssebuliba, Joshua; Kiconco, Sylvia; Mwima, Moses W.; Achan, Jane; Aweeka, Francesca; Parikh, Sunil; Mwebaza, Norah

    2016-01-01

    Artemether-lumefantrine is a first-line regimen for the treatment of uncomplicated malaria during the second and third trimesters of pregnancy. Previous studies have reported changes in the pharmacokinetics and clinical outcomes following treatment with artemether-lumefantrine in pregnant women compared to nonpregnant adults; however, the results are inconclusive. We conducted a study in rural Uganda to compare the pharmacokinetics of artemether-lumefantrine and the treatment responses betwee...

  17. Efficacy of artemether-lumefantrine as a treatment for uncomplicated Plasmodium vivax malaria in eastern Sudan

    Directory of Open Access Journals (Sweden)

    Abdallah Tajeldin M

    2012-12-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT is the treatment of choice for uncomplicated Plasmodium falciparum malaria in most areas of the world, where malaria is endemic, including Sudan. However, few published data are available on the use of ACT for treatment of P. vivax malaria. Methods This study was conducted at a health centre in Kassala, eastern Sudan, from October to December 2011. Patients with uncomplicated P. vivax malaria received artemether-lumefantrine (AL tablets (containing 20mg artemether and 120 mg lumefantrine and were monitored for 28 days. Results Out of the 43 cases enrolled in this study, 38 completed the 28-day follow-up. Their mean age was 25.1 years (SD: 1.5. On day 3 following AL treatment, all of the patients were afebrile and aparasitaemic. By day 28, all 38 patients exhibited adequate clinical and parasitological responses to AL treatment. The cure rate was 100% and 88.4% for the per protocol analysis andfor the intention to treat analysis, respectively. Mild adverse effects (nausea, vomiting, abdominal pain, dizziness and/or rash that resolved spontaneously were observed in four (10.5% of the patients. Conclusion AL combination therapy was fully effective for treatment of P. vivax malaria in the study in eastern Sudan. Trial registration Trial. Gov: NCT01625871

  18. No hearing loss associated with the use of artemether-lumefantrine to treat experimental human malaria.

    NARCIS (Netherlands)

    McCall, M.B.B.; Beynon, A.J.; Mylanus, E.A.M.; Ven, A.J.A.M. van der; Sauerwein, R.W.

    2006-01-01

    Artemisinin derivatives are becoming the first-line treatment for uncomplicated malaria in areas with widespread resistance to chloroquine. Although generally safe and well tolerated, it has been suggested from animal experiments, and more recently from one human study with artemether-lumefantrine,

  19. Possible treatment failure of artemether-lumefantrine in an Italian traveler with uncomplicated falciparum malaria.

    OpenAIRE

    Ernestina Carla Repetto; Claudio Giacomazzi; Antonio Traverso

    2011-01-01

    Artemisinin-combination therapies (ACTs) are recommended for the treatment of uncomplicated malaria in endemic areas with multidrug resistant Plasmodium falciparum. We report a case of possible artemether-lumefantrine failure in an Italian traveler with uncomplicated P. falciparum malaria imported from Democratic Republic of Congo.

  20. Possible Clinical Failure of Artemether-Lumefantrine in an Italian Traveler with Uncomplicated Falciparum Malaria.

    OpenAIRE

    Repetto, Ernestina C.; Traverso, Antonio; Giacomazzi, Claudio G.

    2011-01-01

    Artemisinin-combination therapies (ACTs) are recommended for the treatment of uncomplicated malaria in endemic areas with multidrug resistant Plasmodium falciparum. We report a case of possible artemether-lumefantrine clinical failure in an Italian traveler with uncomplicated P. falciparum malaria imported from Democratic Republic of Congo.

  1. The effect of dose on the antimalarial efficacy of artemether-lumefantrine

    DEFF Research Database (Denmark)

    Anstey, N. M.; Davis, T. M E; Karunajeewa, H. A.;

    2015-01-01

    Background: Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic sett...

  2. Pharmacokinetics of artemether and dihydroartemisinin in healthy Pakistani male volunteers treated with artemether-lumefantrine.

    OpenAIRE

    Tarning Joel; Najmi Muzammil H; Ali Shabana; Lindegardh Niklas

    2010-01-01

    Abstract Background Artemether-lumefantrine is one of the most widely used anti-malarial drug combinations in the world with excellent tolerability and cure rates in adult and paediatric patients with uncomplicated falciparum malaria. The aim of this study was to evaluate the pharmacokinetics of artemether and its active metabolite, dihydroartemisinin, in healthy Pakistani volunteers. Methods Twelve healthy male Pakistani subjects, aged 20 to 50, were recruited into the study. A fixed oral co...

  3. Ototoxicity of artemether/lumefantrine in the treatment of falciparum malaria: a randomized trial

    OpenAIRE

    Krause Eike; Girma Tsinuel; Mamo Yoseph; Berens-Riha Nicole; Miranda Isabel; Eshetu Teferi; Gürkov Robert; Schmidt Michael; Hempel John-Martin; Löscher Thomas

    2008-01-01

    Abstract Background Due to increasing drug resistance, artemisinin-based combination chemotherapy (ACT) has become the first-line treatment of falciparum malaria in many endemic countries. However, irreversible ototoxicity associated with artemether/lumefantrine (AL) has been reported recently and suggested to be a serious limitation in the use of ACT. The aim of the study was to compare ototoxicity, tolerability, and efficacy of ACT with that of quinine and atovaquone/proguanil in the treatm...

  4. Enhanced Antimalarial Activity by a Novel Artemether-Lumefantrine Lipid Emulsion for Parenteral Administration

    OpenAIRE

    Ma, Yufan; Lu, Tingli; Zhao, Wen; Wang, Ying(School of Physics, Shandong University, Jinan, 250100, PR China); Chen, Ting; Mei, Qibing; Chen, Tao

    2014-01-01

    Artemether and lumefantrine (also known as benflumetol) are difficult to formulate for parenteral administration because of their low aqueous solubility. Cremophor EL as an emulsion excipient has been shown to cause serious side effects. This study reports a method of preparation and the therapeutic efficacies of novel lipid emulsion (LE) delivery systems with artemether, lumefantrine, or artemether in combination with lumefantrine, for parenteral administration. Their physical and chemical s...

  5. Selection of Plasmodium falciparum pfmdr1 Alleles following Therapy with Artemether-Lumefantrine in an Area of Uganda where Malaria Is Highly Endemic

    OpenAIRE

    Dokomajilar, Christian; Nsobya, Samuel L.; Greenhouse, Bryan; Rosenthal, Philip J; Dorsey, Grant

    2006-01-01

    Polymorphisms in the Plasmodium falciparum pfmdr1 gene were assayed in pretreatment samples and in samples from patients reinfected following therapy with artemether-lumefantrine. The pfmdr1 alleles 86N, 184F, and 1246D significantly increased in prevalence after treatment. All samples had a single pfmdr1 copy. Treatment with artemether-lumefantrine selects for polymorphisms that may alter antimalarial drug response.

  6. A cost-effectiveness analysis of artemether lumefantrine for treatment of uncomplicated malaria in Zambia

    Directory of Open Access Journals (Sweden)

    Hawela Moonga

    2007-02-01

    Full Text Available Abstract Background Malaria remains a leading cause of morbidity, mortality and non-fatal disability in Zambia, especially among children, pregnant women and the poor. Data gathered by the National Malaria Control Centre has shown that recently observed widespread treatment failure of SP and chloroquine precipitated a surge in malaria-related morbidity and mortality. As a result, the Government has recently replaced chloroquine and SP with combination therapy as first-line treatment for malaria. Despite the acclaimed therapeutic advantages of ACTs over monotherapies with SP and CQ, the cost of ACTs is much greater, raising concerns about affordability in many poor countries such as Zambia. This study evaluates the cost-effectiveness analysis of artemether-lumefantrine, a version of ACTs adopted in Zambia in mid 2004. Methods Using data gathered from patients presenting at public health facilities with suspected malaria, the costs and effects of using ACTs versus SP as first-line treatment for malaria were estimated. The study was conducted in six district sites. Treatment success and reduction in demand for second line treatment constituted the main effectiveness outcomes. The study gathered data on the efficacy of, and compliance to, AL and SP treatment from a random sample of patients. Costs are based on estimated drug, labour, operational and capital inputs. Drug costs were based on dosages and unit prices provided by the Ministry of Health and the manufacturer (Norvatis. Findings The results suggest that AL produces successful treatment at less cost than SP, implying that AL is more cost-effective. While it is acknowledged that implementing national ACT program will require considerable resources, the study demonstrates that the health gains (treatment success from every dollar spent are significantly greater if AL is used rather than SP. The incremental cost-effectiveness ratio is estimated to be US$4.10. When the costs of second line

  7. Can Rapid Diagnostic Testing for Malaria Increase Adherence to Artemether-Lumefantrine?: A Randomized Controlled Trial in Uganda.

    Science.gov (United States)

    Saran, Indrani; Yavuz, Elif; Kasozi, Howard; Cohen, Jessica

    2016-04-01

    Most patients with suspected malaria do not receive diagnostic confirmation before beginning antimalarial treatment. We investigated the extent to which uncertainty about malaria diagnosis contributes to patient nonadherence to artemether-lumefantrine (AL) treatment through a randomized controlled trial in central Uganda. Among 1,525 patients purchasing a course of AL at private drug shops, we randomly offered 37.6% a free malaria rapid diagnostic test (RDT) and then assessed adherence through home visits 3 days later. Of these subjects, 68.4% tested positive for malaria and 65.8% adhered overall. Patients who tested positive did not have significantly higher odds of adherence than those who were not offered the test (adjusted odds ratio [OR]: 1.07, 95% confidence interval [CI]: 0.734-1.57,P= 0.719). Patients who received a positive malaria test had 0.488 fewer pills remaining than those not offered the test (95% CI: -1.02 to 0.043,P= 0.072). We found that patients who felt relatively healthy by the second day of treatment had lower odds of completing treatment (adjusted OR: 0.532, 95% CI: 0.394-0.719,P< 0.001). Our results suggest that diagnostic testing may not improve artemisinin-based combination therapy adherence unless efforts are made to persuade patients to continue taking the full course of drugs even if symptoms have resolved. PMID:26928828

  8. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence.

    Science.gov (United States)

    Premji, Zulfiqarali G; Abdulla, Salim; Ogutu, Bernhards; Ndong, Alice; Falade, Catherine O; Sagara, Issaka; Mulure, Nathan; Nwaiwu, Obiyo; Kokwaro, Gilbert

    2008-01-01

    A fixed-dose combination of artemether-lumefantrine (AL, Coartem(R)) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat.As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals) supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans) and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30-60 g/person/day across the whole population (average 43 g/person/day). Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15-30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat) or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5-59 months have shown similar high cure rates to those observed in

  9. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Sagara Issaka

    2008-11-01

    Full Text Available Abstract A fixed-dose combination of artemether-lumefantrine (AL, Coartem® has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat. As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat. African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30–60 g/person/day across the whole population (average 43 g/person/day. Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15–30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5–59 months have shown similar high cure

  10. Randomized, prospective, three-arm study to confirm the auditory safety and efficacy of artemether-lumefantrine in Colombian patients with uncomplicated Plasmodium falciparum malaria.

    Science.gov (United States)

    Carrasquilla, Gabriel; Barón, Clemencia; Monsell, Edwin M; Cousin, Marc; Walter, Verena; Lefèvre, Gilbert; Sander, Oliver; Fisher, Laurel M

    2012-01-01

    The safety of artemether-lumefantrine in patients with acute, uncomplicated Plasmodium falciparum malaria was investigated prospectively using the auditory brainstem response (ABR) and pure-tone thresholds. Secondary outcomes included polymerase chain reaction-corrected cure rates. Patients were randomly assigned in a 3:1:1 ratio to either artemether-lumefantrine (N = 159), atovaquone-proguanil (N = 53), or artesunate-mefloquine (N = 53). The null hypothesis (primary outcome), claiming that the percentage of patients with a baseline to Day-7 ABR Wave III latency increase of > 0.30 msec is ≥ 15% after administration of artemether-lumefantrine, was rejected; 2.6% of patients (95% confidence interval: 0.7-6.6) exceeded 0.30 msec, i.e., significantly below 15% (P 95% to Day 42. The results support the continued safe and efficacious use of artemether-lumefantrine in uncomplicated falciparum malaria. PMID:22232454

  11. Artemether-lumefantrine treatment failure despite adequate lumefantrine day 7 concentration in a traveller with Plasmodium falciparum malaria after returning from Tanzania.

    OpenAIRE

    Färnert Anna; Ursing Johan; Tolfvenstam Thomas; Rono Josea; Karlsson Lillemor; Sparrelid Elda; Lindegårdh Niklas

    2012-01-01

    Abstract Artemether-lumefantrine is currently first-line therapy of Plasmodium falciparum malaria in many countries. This report describes a treatment failure despite adequate drug concentrations in a traveller returning from sub-Saharan Africa. Genotyping confirmed recrudescence and suggested reduced sensitivity. Potential sub-optimal effect of artemether-lumefantrine highlights the need to follow non-immune individuals the weeks after treatment.

  12. Randomized, Prospective, Three-Arm Study to Confirm the Auditory Safety and Efficacy of Artemether-Lumefantrine in Colombian Patients with Uncomplicated Plasmodium falciparum Malaria

    OpenAIRE

    Carrasquilla, Gabriel; Barón, Clemencia; Monsell, Edwin M; Cousin, Marc; Walter, Verena; Lefèvre, Gilbert; Sander, Oliver; Fisher, Laurel M.

    2012-01-01

    The safety of artemether-lumefantrine in patients with acute, uncomplicated Plasmodium falciparum malaria was investigated prospectively using the auditory brainstem response (ABR) and pure-tone thresholds. Secondary outcomes included polymerase chain reaction-corrected cure rates. Patients were randomly assigned in a 3:1:1 ratio to either artemether-lumefantrine (N = 159), atovaquone-proguanil (N = 53), or artesunate-mefloquine (N = 53). The null hypothesis (primary outcome), claiming that t...

  13. Similar Efficacy and Tolerability of Double-Dose Chloroquine and Artemether-Lumefantrine for Treatment of Plasmodium falciparum Infection in Guinea-Bissau: A Randomized Trial

    OpenAIRE

    Ursing, Johan; Kofoed, Poul-Erik; Rodrigues, Amabelia; Blessborn, Daniel; Thoft-Nielsen, Rikke; Björkman, Anders; Rombo, Lars

    2011-01-01

    Background. In 2008, Guinea-Bissau introduced artemether-lumefantrine for treatment of uncomplicated malaria. Previously, 3 times the standard dose of chloroquine, that was probably efficacious against Plasmodium falciparum with the resistance-associated chloroquine-resistance transporter (pfcrt) 76T allele, was routinely used. The present study compared the efficacy and tolerability of a double standard dose of chloroquine with the efficacy and tolerability of artemether-lumefantrine.

  14. Surveillance of artemether-lumefantrine associated Plasmodium falciparum multidrug resistance protein-1 gene polymorphisms in Tanzania

    DEFF Research Database (Denmark)

    Kavishe, Reginald A; Paulo, Petro; Kaaya, Robert D;

    2014-01-01

    recommended first-line drug in treatment of uncomplicated malaria. This study surveyed the distribution of the Plasmodium falciparum multidrug resistance protein-1 single nucleotide polymorphisms (SNPs) associated with increased parasite tolerance to ALu, in Tanzania. METHODS: A total of 687 Plasmodium......BACKGROUND: Resistance to anti-malarials is a major public health problem worldwide. After deployment of artemisinin-based combination therapy (ACT) there have been reports of reduced sensitivity to ACT by malarial parasites in South-East Asia. In Tanzania, artemether-lumefantrine (ALu) is the...... in all regions, ranging from 17% - 26%. CONCLUSION: This is the first country-wide survey on Pfmdr1 mutations associated with ACT resistance. Distribution of individual Pfmdr1 mutations at codons 86, 184 and 1246 varies throughout Tanzanian regions. There is a general homogeneity in distribution of...

  15. Artemether-Lumefantrine Pharmacokinetics and Clinical Response Are Minimally Altered in Pregnant Ugandan Women Treated for Uncomplicated Falciparum Malaria.

    Science.gov (United States)

    Nyunt, Myaing M; Nguyen, Vy K; Kajubi, Richard; Huang, Liusheng; Ssebuliba, Joshua; Kiconco, Sylvia; Mwima, Moses W; Achan, Jane; Aweeka, Francesca; Parikh, Sunil; Mwebaza, Norah

    2016-03-01

    Artemether-lumefantrine is a first-line regimen for the treatment of uncomplicated malaria during the second and third trimesters of pregnancy. Previous studies have reported changes in the pharmacokinetics and clinical outcomes following treatment with artemether-lumefantrine in pregnant women compared to nonpregnant adults; however, the results are inconclusive. We conducted a study in rural Uganda to compare the pharmacokinetics of artemether-lumefantrine and the treatment responses between 30 pregnant women and 30 nonpregnant adults with uncomplicated Plasmodium falciparum malaria. All participants were uninfected with HIV, treated with a six-dose regimen of artemether-lumefantrine, and monitored clinically for 42 days. The pharmacokinetics of artemether, its metabolite dihydroartemisinin, and lumefantrine were evaluated for 21 days following treatment. We found no significant differences in the overall pharmacokinetics of artemether, dihydroartemisinin, or lumefantrine in a direct comparison of pregnant women to nonpregnant adults, except for a statistically significant but small difference in the terminal elimination half-lives of both dihydroartemisinin and lumefantrine. There were seven PCR-confirmed reinfections (5 pregnant and 2 nonpregnant participants). The observation of a shorter terminal half-life for lumefantrine may have contributed to a higher frequency of reinfection or a shorter posttreatment prophylactic period in pregnant women than in nonpregnant adults. While the comparable overall pharmacokinetic exposure is reassuring, studies are needed to further optimize antimalarial efficacy in pregnant women, particularly in high-transmission settings and because of emerging drug resistance. (This study is registered at ClinicalTrials.gov under registration no. NCT01717885.). PMID:26666942

  16. Therapeutic Efficacy of Artemether-Lumefantrine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Northern Ethiopia

    OpenAIRE

    Gebremedhin Kinfu; Solomon Gebre-Selassie; Nigus Fikrie

    2012-01-01

    Introduction. Multidrug resistance of Plasmodium falciparum is spreading throughout Africa. This has posed major challenges to malaria control in sub-Saharan Africa. Objective. The aim of the study was to evaluate the efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in North Ethiopia. Methods. This prospective study was undertaken during August–November 2009 on 71 malaria patients that fulfilled the inclusion criteria set by the WHO. Patient...

  17. Lopinavir/ritonavir significantly influences pharmacokinetic exposure of artemether/lumefantrine in HIV-infected Ugandan adults

    OpenAIRE

    Byakika-Kibwika, Pauline; Lamorde, Mohammed; Okaba-Kayom, Violet; Mayanja-Kizza, Harriet; Katabira, Elly; Hanpithakpong, Warunee; Pakker, Nadine; Dorlo, Thomas P. C.; Tarning, Joel; Lindegardh, Niklas; de Vries, Peter J; Back, David; Khoo, Saye; Merry, Concepta

    2012-01-01

    Background Treatment of HIV/malaria-coinfected patients with antiretroviral therapy (ART) and artemisinin-based combination therapy has potential for drug interactions. We investigated the pharmacokinetics of artemether, dihydroartemisinin and lumefantrine after administration of a single dose of 80/480 mg of artemether/lumefantrine to HIV-infected adults, taken with and without lopinavir/ritonavir. Methods A two-arm parallel study of 13 HIV-infected ART-naive adults and 16 HIV-infected adult...

  18. Unsweetened Natural Cocoa Powder Has the Potential to Attenuate High Dose Artemether-Lumefantrine-Induced Hepatotoxicity in Non-Malarious Guinea Pigs.

    Science.gov (United States)

    Asiedu-Gyekye, Isaac Julius; Edem Kukuia, Kennedy Kwami; Seidu, Abdulai Mahmood; Antwi-Boasiako, Charles; N'guessan, Benoit Banga; Frimpong-Manso, Samuel; Adjei, Samuel; Zobi, Jonathan; Tettey, Abraham Terkpertey; Nyarko, Alexander Kwadwo

    2016-01-01

    Objective. This study investigated the elemental composition of unsweetened natural cocoa powder (UNCP), its effect on nitric oxide, and its hepatoprotective potential during simultaneous administration with high-dose artemether/lumefantrine (A/L). Method. Macro- and microelements in UNCP were analyzed with EDXRF spectroscopy. Thirty (30) male guinea-pigs were then divided into five groups. For groups 3 (low-dose), 4 (medium-dose), and 5 (high-dose), the animals received oral UNCP prophylactically for 14 days. Group 1 received distilled water (14 days) and group 2 A/L for the last 3 days (days 12 to 14). After euthanisation, biochemical and histopathological examinations were carried out in all groups. Results. Phytochemical analysis of UNCP showed the presence of saponins, flavonoids, tannins, and cardiac glycosides. Thirty-eight (38) macro- and microelements were found. UNCP produced significant decreases in ALT, ALP, GGT, and AST levels. A significant increase in total protein levels was observed during A/L+UNCP administration in comparison to 75 mg/kg A/L group. Histopathological examinations buttressed the protective effects of cocoa administration. UNCP administration increased nitric oxide levels 149.71% (P < 0.05) compared to controls. Conclusion. UNCP increases nitric oxide levels and has hepatoprotective potential during A/L administration. A high level of copper was observed which may be detrimental during high daily consumptions of UNCP. PMID:27493672

  19. Unsweetened Natural Cocoa Powder Has the Potential to Attenuate High Dose Artemether-Lumefantrine-Induced Hepatotoxicity in Non-Malarious Guinea Pigs

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    Isaac Julius Asiedu-Gyekye

    2016-01-01

    Full Text Available Objective. This study investigated the elemental composition of unsweetened natural cocoa powder (UNCP, its effect on nitric oxide, and its hepatoprotective potential during simultaneous administration with high-dose artemether/lumefantrine (A/L. Method. Macro- and microelements in UNCP were analyzed with EDXRF spectroscopy. Thirty (30 male guinea-pigs were then divided into five groups. For groups 3 (low-dose, 4 (medium-dose, and 5 (high-dose, the animals received oral UNCP prophylactically for 14 days. Group 1 received distilled water (14 days and group 2 A/L for the last 3 days (days 12 to 14. After euthanisation, biochemical and histopathological examinations were carried out in all groups. Results. Phytochemical analysis of UNCP showed the presence of saponins, flavonoids, tannins, and cardiac glycosides. Thirty-eight (38 macro- and microelements were found. UNCP produced significant decreases in ALT, ALP, GGT, and AST levels. A significant increase in total protein levels was observed during A/L+UNCP administration in comparison to 75 mg/kg A/L group. Histopathological examinations buttressed the protective effects of cocoa administration. UNCP administration increased nitric oxide levels 149.71% (P<0.05 compared to controls. Conclusion. UNCP increases nitric oxide levels and has hepatoprotective potential during A/L administration. A high level of copper was observed which may be detrimental during high daily consumptions of UNCP.

  20. Artemether-Lumefantrine Combination Therapy for Treatment of Uncomplicated Malaria: The Potential for Complex Interactions with Antiretroviral Drugs in HIV-Infected Individuals

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    Pauline Byakika-Kibwika

    2011-01-01

    Full Text Available Treatment of malaria in HIV-infected individuals receiving antiretroviral therapy (ART poses significant challenges. Artemether-lumefantrine (AL is one of the artemisisnin-based combination therapies recommended for treatment of malaria. The drug combination is highly efficacious against sensitive and multidrug resistant falciparum malaria. Both artemether and lumefantrine are metabolized by hepatic cytochrome P450 (CYP450 enzymes which metabolize the protease inhibitors (PIs and nonnucleoside reverse transcriptase inhibitors (NNRTIs used for HIV treatment. Coadministration of NNRTIs and PIs with AL could potentially cause complex pharmacokinetic drug interactions. NNRTI by inducing CYP450 3A4 enzyme and PIs by inhibiting CYP450 3A4 enzymes could influence both artemether and lumefantrine concentrations and their active metabolites dihydroartemisinin and desbutyl-lumefantrine, predisposing patients to poor treatment response, toxicity, and risk for development of resistance. There are scanty data on these interactions and their consequences. Pharmacokinetic studies to evaluate these interactions in the target populations are urgently needed.

  1. Similar efficacy and tolerability of double-dose chloroquine and artemether-lumefantrine for treatment of Plasmodium falciparum infection in Guinea-Bissau: a randomized trial

    DEFF Research Database (Denmark)

    Ursing, Johan; Kofoed, Poul-Erik; Rodrigues, Amabelia;

    2011-01-01

    In 2008, Guinea-Bissau introduced artemether-lumefantrine for treatment of uncomplicated malaria. Previously, 3 times the standard dose of chloroquine, that was probably efficacious against Plasmodium falciparum with the resistance-associated chloroquine-resistance transporter (pfcrt) 76T allele...

  2. Rational dispensing and use of artemether-lumefantrine during pregnancy in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Kamuhabwa, Appolinary R; Mnyusiwalla, Fatema

    2011-04-01

    Artemether-Lumefantrine (ALu) is widely used for uncomplicated malaria during the second and third trimester of pregnancy. Because of the suspected teratogenic effects of artemether during the first trimester, quinine is used in early pregnancy unless the risks outweigh the benefits. The aim of this study was to assess dispensing practice of ALu in private pharmacies and knowledge of pregnant women regarding the use of ALu. This was a prospective-descriptive study involving visits to 200 private retail pharmacies (using a mystery shopper) and interviewing pregnant women at the municipal public hospitals in Dar es Salaam, Tanzania. Among the drug dispensers, 60 (30%) were pharmacists, 71(35.5%) nurse assistants, 34 (17%) pharmaceutical technicians and 35 (17.5%) sales persons with no formal education on drug dispensing. Among the dispensers, 14.5% had high knowledge, 38.0% had medium knowledge and 47.5% had low knowledge on the use of ALu during pregnancy. About thirty three percent of the drug dispensers were willing to dispense ALu during the first trimester of pregnancy. Sixty two percent of the drug dispensers indicated that ALu is the drug of choice for uncomplicated malaria after the first trimester of pregnancy. However, 36% indicated that ALu could not be used during pregnancy. A total of 200 pregnant women were interviewed. Among them, 16.5% were aware that ALu should not be taken during the first trimester of pregnancy. Only 17% of pregnant women were given information on the importance of taking food when using ALu, but none of them was given information on the importance of fatty meals when using ALu. In conclusion, the results show that most drug dispensers have inadequate knowledge about good dispensing practice of ALu in pregnancy. There is therefore a need for continuing training of drug dispensers regarding antimalarial drugs use in pregnancy. PMID:25566607

  3. Physical and chemical stability of expired fixed dose combination artemether-lumefantrine in uncontrolled tropical conditions

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    Hess Kimberly

    2009-02-01

    Full Text Available Abstract Background New artemisinin combination therapies pose difficulties of implementation in developing and tropical settings because they have a short shelf-life (two years relative to the medicines they replace. This limits the reliability and cost of treatment, and the acceptability of this treatment to health care workers. A multi-pronged investigation was made into the chemical and physical stability of fixed dose combination artemether-lumefantrine (FDC-ALU stored under heterogeneous, uncontrolled African conditions, to probe if a shelf-life extension might be possible. Methods Seventy samples of expired FDC-ALU were collected from private pharmacies and malaria researchers in seven African countries. The samples were subjected to thin-layer chromatography (TLC, disintegration testing, and near infrared Raman spectrometry for ascertainment of active ingredients, tablet integrity, and chemical degradation of the tablet formulation including both active ingredients and excipients. Results Seventy samples of FDC-ALU were tested in July 2008, between one and 58 months post-expiry. 68 of 70 (97% samples passed TLC, disintegration and Raman spectrometry testing, including eight samples that were post-expiry by 20 months or longer. A weak linear association (R2 = 0.33 was observed between the age of samples and their state of degradation relative to brand-identical samples on Raman spectrometry. Sixty-eight samples were retested in February 2009 using Raman spectrometry, between eight and 65 months post-expiry. 66 of 68 (97% samples passed Raman spectrometry retesting. An unexpected observation about African drug logistics was made in three batches of FDC-ALU, which had been sold into the public sector at concessional pricing in accordance with a World Health Organization (WHO agreement, and which were illegally diverted to the private sector where they were sold for profit. Conclusion The data indicate that FDC-ALU is chemically and

  4. In vivo efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria in Central Ethiopia

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    Jima Daddi

    2011-07-01

    Full Text Available Abstract Background In vivo efficacy assessments of the first-line treatments for Plasmodium falciparum malaria are essential for ensuring effective case management. In Ethiopia, artemether-lumefantrine (AL has been the first-line treatment for uncomplicated P. falciparum malaria since 2004. Methods Between October and November 2009, we conducted a 42-day, single arm, open label study of AL for P. falciparum in individuals >6 months of age at two sites in Oromia State, Ethiopia. Eligible patients who had documented P. falciparum mono-infection were enrolled and followed according to the standard 2009 World Health Organization in vivo drug efficacy monitoring protocol. The primary and secondary endpoints were PCR uncorrected and corrected cure rates, as measured by adequate clinical and parasitological response on days 28 and 42, respectively. Results Of 4426 patients tested, 120 with confirmed falciparum malaria were enrolled and treated with AL. Follow-up was completed for 112 patients at day 28 and 104 patients at day 42. There was one late parasitological failure, which was classified as undetermined after genotyping. Uncorrected cure rates at both day 28 and 42 for the per protocol analysis were 99.1% (95% CI 95.1-100.0; corrected cure rates at both day 28 and 42 were 100.0%. Uncorrected cure rates at day 28 and 42 for the intention to treat analysis were 93.3% (95% CI 87.2-97.1 and 86.6% (95% CI 79.1-92.1, respectively, while the corrected cure rates at day 28 and 42 were 94.1% (95% CI 88.2-97.6 and 87.3% (95% CI 79.9-92.7, respectively. Using survival analysis, the unadjusted cure rate was 99.1% and 100.0% adjusted by genotyping for day 28 and 42, respectively. Eight P. falciparum patients (6.7% presented with Plasmodium vivax infection during follow-up and were excluded from the per protocol analysis. Only one patient had persistent parasitaemia at day 3. No serious adverse events were reported, with cough and nausea/vomiting being the

  5. From chloroquine to artemether-lumefantrine: the process of drug policy change in Zambia

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    Snow Robert W

    2008-01-01

    Full Text Available Abstract Background Following the recognition that morbidity and mortality due to malaria had dramatically increased in the last three decades, in 2002 the government of Zambia reviewed its efforts to prevent and treat malaria. Convincing evidence of the failing efficacy of chloroquine resulted in the initiation of a process that eventually led to the development and implementation of a new national drug policy based on artemisinin-based combination therapy (ACT. Methods All published and unpublished documented evidence dealing with the antimalarial drug policy change was reviewed. These data were supplemented by the authors' observations of the policy change process. The information has been structured to capture the timing of events, the challenges encountered, and the resolutions reached in order to achieve implementation of the new treatment policy. Results A decision was made to change national drug policy to artemether-lumefantrine (AL in the first quarter of 2002, with a formal announcement made in October 2002. During this period, efforts were undertaken to identify funding for the procurement of AL and to develop new malaria treatment guidelines, training materials, and plans for implementation of the policy. In order to avoid a delay in implementation, the policy change decision required a formal adoption within existing legislation. Starting with donated drug, a phased deployment of AL began in January 2003 with initial use in seven districts followed by scaling up to 28 districts in the second half of 2003 and then to all 72 districts countrywide in early 2004. Conclusion Drug policy changes are not without difficulties and demand a sustained international financing strategy for them to succeed. The Zambian experience demonstrates the need for a harmonized national consensus among many stakeholders and a political commitment to ensure that new policies are translated into practice quickly. To guarantee effective policies requires

  6. A randomised controlled trial of artemether-lumefantrine versus artesunate for uncomplicated plasmodium falciparum treatment in pregnancy.

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    Rose McGready

    2008-12-01

    Full Text Available BACKGROUND: To date no comparative trials have been done, to our knowledge, of fixed-dose artemisinin combination therapies (ACTs for the treatment of Plasmodium falciparum malaria in pregnancy. Evidence on the safety and efficacy of ACTs in pregnancy is needed as these drugs are being used increasingly throughout the malaria-affected world. The objective of this study was to compare the efficacy, tolerability, and safety of artemether-lumefantrine, the most widely used fixed ACT, with 7 d artesunate monotherapy in the second and third trimesters of pregnancy. METHODS AND FINDINGS: An open-label randomised controlled trial comparing directly observed treatment with artemether-lumefantrine 3 d (AL or artesunate monotherapy 7 d (AS7 was conducted in Karen women in the border area of northwestern Thailand who had uncomplicated P. falciparum malaria in the second and third trimesters of pregnancy. The primary endpoint was efficacy defined as the P. falciparum PCR-adjusted cure rates assessed at delivery or by day 42 if this occurred later than delivery, as estimated by Kaplan-Meier survival analysis. Infants were assessed at birth and followed until 1 y of life. Blood sampling was performed to characterise the pharmacokinetics of lumefantrine in pregnancy. Both regimens were very well tolerated. The cure rates (95% confidence interval for the intention to treat (ITT population were: AS7 89.2% (82.3%-96.1% and AL 82.0% (74.8%-89.3%, p = 0.054 (ITT; and AS7 89.7% (82.6%-96.8% and AL 81.2% (73.6%-88.8%, p = 0.031 (per-protocol population. One-third of the PCR-confirmed recrudescent cases occurred after 42 d of follow-up. Birth outcomes and infant (up to age 1 y outcomes did not differ significantly between the two groups. The pharmacokinetic study indicated that low concentrations of artemether and lumefantrine were the main contributors to the poor efficacy of AL. CONCLUSION: The current standard six-dose artemether-lumefantrine regimen was well

  7. Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treating uncomplicated malaria: a randomized trial to guide policy in Uganda.

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    Adoke Yeka

    Full Text Available BACKGROUND: Uganda recently adopted artemether-lumefantrine (AL as the recommended first-line treatment for uncomplicated malaria. However, AL has several limitations, including a twice-daily dosing regimen, recommendation for administration with fatty food, and a high risk of reinfection soon after therapy in high transmission areas. Dihydroartemisinin-piperaquine (DP is a new alternative artemisinin-based combination therapy that is dosed once daily and has a long post-treatment prophylactic effect. We compared the efficacy and safety of AL with DP in Kanungu, an area of moderate malaria transmission. METHODOLOGY/PRINCIPAL FINDINGS: Patients aged 6 months to 10 years with uncomplicated falciparum malaria were randomized to therapy and followed for 42 days. Genotyping was used to distinguish recrudescence from new infection. Of 414 patients enrolled, 408 completed follow-up. Compared to patients treated with artemether-lumefantrine, patients treated with dihydroartemisinin-piperaquine had a significantly lower risk of recurrent parasitaemia (33.2% vs. 12.2%; risk difference = 20.9%, 95% CI 13.0-28.8% but no statistically significant difference in the risk of treatment failure due to recrudescence (5.8% vs. 2.0%; risk difference = 3.8%, 95% CI -0.2-7.8%. Patients treated with dihydroartemisinin-piperaquine also had a lower risk of developing gametocytaemia after therapy (4.2% vs. 10.6%, p = 0.01. Both drugs were safe and well tolerated. CONCLUSIONS/SIGNIFICANCE: DP is highly efficacious, and operationally preferable to AL because of a less intensive dosing schedule and requirements. Dihydroartemisinin-piperaquine should be considered for a role in the antimalarial treatment policy of Uganda. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN75606663.

  8. Artesunate + amodiaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in the Colombian Pacific region: a noninferiority trial

    OpenAIRE

    Fernando De la Hoz Restrepo; Alexandra Porras Ramírez; Alejandro Rico Mendoza; Freddy Córdoba; Diana Patricia Rojas

    2012-01-01

    INTRODUCTION: In Colombia, there are no published studies for the treatment of uncomplicated Plasmodium falciparum malaria comparing artemisinin combination therapies. Hence, it is intended to demonstrate the non-inferior efficacy/safety profiles of artesunate + amodiaquine versus artemether-lumefantrine treatments. METHODS: A randomized, controlled, open-label, noninferiority (Δ≤5%) clinical trial was performed in adults with uncomplicated P. falciparum malaria using the 28‑day World Health ...

  9. Efficacy and safety of artemether-lumefantrine compared with quinine in pregnant women with uncomplicated Plasmodium falciparum malaria: an open-label, randomised, non-inferiority trial

    OpenAIRE

    Piola, Patrice; Nabasumba, Carolyn; Turyakira, Eleanor; Dhorda, Mehul; Lindegardh, Niklas; Nyehangane, Dan; Snounou, Georges; Ashley, Elizabeth A.; McGready, Rose; Nosten, Francois; Guerin, Philippe J

    2010-01-01

    BACKGROUND: Malaria in pregnancy is associated with maternal and fetal morbidity and mortality. In 2006, WHO recommended use of artemisinin-based combination treatments during the second or third trimesters, but data on efficacy and safety in Africa were scarce. We aimed to assess whether artemether-lumefantrine was at least as efficacious as oral quinine for the treatment of uncomplicated falciparum malaria during the second and third trimesters of pregnancy in Mbarara, Uganda. METHODS: We d...

  10. An Economic Evaluation of the Posttreatment Prophylactic Effect of Dihydroartemisinin-Piperaquine Versus Artemether-Lumefantrine for First-Line Treatment of Plasmodium falciparum Malaria Across Different Transmission Settings in Africa.

    Science.gov (United States)

    Pfeil, Johannes; Borrmann, Steffen; Bassat, Quique; Mulenga, Modest; Talisuna, Ambrose; Tozan, Yesim

    2015-11-01

    Malaria disproportionately affects young children. Clinical trials in African children showed that dihydroartemisinin-piperaquine (DP) is an effective antimalarial and has a longer posttreatment prophylactic (PTP) effect against reinfections than other artemisinin-based combination therapies, including artemether-lumefantrine (AL). Using a previously developed Markov model and individual patient data from a multicenter African drug efficacy trial, we assessed the economic value of the PTP effect of DP versus AL in pediatric malaria patients from health-care provider's perspective in low-to-moderate and moderate-to-high transmission settings under different drug co-payment scenarios. In low-to-moderate transmission settings, first-line treatment with DP was highly cost-effective with an incremental cost-effectiveness ratio of US$5 (95% confidence interval [CI] = -76 to 196) per disability-adjusted life year (DALY) averted. In moderate-to-high transmission settings, DP first-line treatment led to a mean cost saving of US$1.09 (95% CI = -0.88 to 3.85) and averted 0.05 (95% CI = -0.08 to 0.22) DALYs per child per year. Our results suggested that DP might be superior to AL for first-line treatment of uncomplicated childhood malaria across a range of transmission settings in Africa. PMID:26240155

  11. Comparative study of the efficacy and tolerability of dihydroartemisinin - piperaquine - trimethoprim versus artemether - lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Cameroon, Ivory Coast and Senegal

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    Yavo William

    2011-07-01

    Full Text Available Abstract Background The ACT recommended by WHO is very effective and well-tolerated. However, these combinations need to be administered for three days, which may limit adherence to treatment. The combination of dihydroartemisinin - piperaquine phosphate - trimethoprim (Artecom®, Odypharm Ltd, which involves treatment over two days, appears to be a good alternative, particularly in malaria-endemic areas. This study intends to compare the efficacy and tolerability of the combination dihydroartemisinin - piperaquine phosphate - trimethoprim (DPT versus artemether - lumefantrine (AL in the treatment of uncomplicated Plasmodium falciparum malaria in Cameroon, Ivory Coast and Senegal. Methods This was a randomized, controlled, open-label clinical trial with a 28-day follow-up period comparing DPT to AL as the reference drug. The study involved patients of at least two years of age, suffering from acute, uncomplicated Plasmodium falciparum malaria with fever. The WHO 2003 protocol was used. Results A total of 418 patients were included in the study and divided into two treatment groups: 212 in the DPT group and 206 in the AL group. The data analysis involved the 403 subjects who correctly followed the protocol (per protocol analysis, i.e. 206 (51.1% in the DPT group and 197 (48.9% in the AL group. The recovery rate at D14 was 100% in both treatment groups. The recovery rate at D28 was 99% in the DPT and AL groups before and after PCR results with one-sided 97.5% Confidence Interval of the rates difference > -1.90%. More than 96% of patients who received DPT were apyrexial 48 hours after treatment compared to 83.5% in the AL group (p Conclusion The overall efficacy and tolerability of DPT are similar to those of AL. The ease of taking DPT and its short treatment course (two days may help to improve adherence to treatment. Taken together, these findings make this medicinal product a treatment of choice for the effective management of malaria in Africa.

  12. Artemether-lumefantrine nanostructured lipid carriers for oral malaria therapy: Enhanced efficacy at reduced dose and dosing frequency.

    Science.gov (United States)

    Prabhu, Priyanka; Suryavanshi, Shital; Pathak, Sulabha; Sharma, Shobhona; Patravale, Vandana

    2016-09-10

    Artemether-lumefantrine (ARM-LFN) is a World Health Organization (WHO) approved fixed-dose combination having low solubility and poor oral bioavailability. Nanostructured lipid carriers (NLC) were developed to enhance the oral efficacy of this combination using the microemulsion template technique. They were characterized for drug content, entrapment efficiency, size distribution, in vitro release, antimalarial efficacy, and toxicity. The NLC showed sustained drug release. The recommended adult therapeutic dose is 80mg ARM and 480mg LFN (4 tablets) twice a day, which amounts to 160mg ARM and 960mg LFN daily. ARM-LFN NLC given once a day at 1/5 of therapeutic dose (16mg ARM and 96mg LFN) showed complete parasite clearance and 100% survival in Plasmodium berghei-infected mice. 33% of the mice treated with marketed tablets twice a day at the therapeutic dose showed late-stage recrudescence. Thus, NLC showed enhanced efficacy at 1/10 of the daily dose of ARM-LFN. The 10-fold reduced daily dose was formulated in two soft gelatin capsules thus reducing the number of units to be taken at a time by the patient. The capsules showed good stability at room temperature for a year. The NLC were found to be safe in rats. The biocompatible NLC developed using an industrially feasible technique offer a promising solution for oral malaria therapy. PMID:27421912

  13. In vitro hemolytic effect of sulfadoxine/pyrimethamine and artemether/lumefantrine on malaria parasitized erythrocytes of female patients.

    Science.gov (United States)

    Anaba, Festus Chinyereugo; Ahiante, Blessing Osemengbe; Pepple, Dagogo John

    2012-10-01

    G6PD is an X-linked gene enzyme that protects erythrocytes from hemolysis when they are exposed to antimalarial drugs because of the effects of the free radicals generated by these drugs. We investigated the effects of Fansidar ™ (Sulfatoxine/Pyrimethamine) and Coartem ™ (Artemether/Lumefantrine) on the hemolysis of malaria parasitized female erythrocytes. Twelve (12) malarious patients attending the University of Benin Teaching Hospital, Benin City, Nigeria, were used in this study. Ten (10) apparently healthy female students from the Medical School, University of Benin, acted as control. Low, normal (the recommended adult dose) and high doses of Fansidar ™ and Coartem ™ were used to determine the percentage hemolysis by checking the absorbance of the various samples. Data was analyzed by the Student's t-test and ANOVA with p<0.05 indicating the level of significance. At low doses of Fansidar ™ and Coartem ™, no hemolysis occurred, while at normal doses, Fansidar ™ showed no hemolysis but significant hemolysis (p<0.05) was observed in the Coartem ™ group. At high doses, both FansidarTM and CoartemTM caused significant (p<0.05) hemolysis. High doses of both drugs and normal dose of CoartemTM caused significant hemolysis. There was no hemolysis observed in the normal dose of FansidarTM and low doses for both drugs, similar to the trend reported for male subjects. PMID:23010004

  14. In Vivo Efficacy and Parasite Clearance of Artesunate + Sulfadoxine-Pyrimethamine Versus Artemether-Lumefantrine in Mali.

    Science.gov (United States)

    Niaré, Karamoko; Dara, Antoine; Sagara, Issaka; Sissoko, Mahamadou S; Guindo, Cheick Oumar; Cissé, Nana H; Coulibaly, Cheick Oumar; Ringwald, Pascal; Benoit-Vical, Françoise; Berry, Antoine; Djimdé, Abdoulaye A; Doumbo, Ogobara K

    2016-03-01

    Although artemisinin resistance has yet to be reported in Africa, surveillance of the efficacy of artemisinin-based combination therapies (ACTs) is warranted. Here, the efficacy of artesunate + sulfadoxine-pyrimethamine (AS + SP) and artemether-lumefantrine (AL) was evaluated in Mali. Randomized open-label comparative in vivo assay of AS + SP versus AL were carried out using the 28-day follow-up World Health Organization protocol. Patients with uncomplicated falciparum malaria and at least 6 months of age were recruited between October 2010 and January 2014. A subset of these patients was selected to measure Plasmodium falciparum clearance time. Polymerase chain reaction-corrected adequate clinical and parasitological responses were 100% for AS + SP and 98.2% for AL with no significant difference (P = 0.06). The reinfection rates were comparable (P = 0.63) with 8.0% for AS + SP and 12.6% for AL. Individuals under 8 years were more susceptible to treatment failure (relative risk = 1.9; 95% confidence interval = 1.2, 3.3). Median parasite clearance half-life was 1.7 hours (interquartile range [IQR] = 1.3-2.2) for AS + SP and 1.9 hours (IQR = 1.5-2.5) for AL with no statistically significant difference (P = 0.24). Efficacy of AS + SP and AL was high. This study provides baseline information on parasite clearance half-lives after ACT treatment, particularly AS + SP, in Mali. PMID:26811430

  15. Efficacy and safety of the six-dose regimen of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in adolescents and adults: A pooled analysis of individual patient data from randomized clinical trials

    NARCIS (Netherlands)

    E.A. Mueller; M. van Vugt; W. Kirch; K. Andriano; P. Hunt; P.I. de Palacios

    2006-01-01

    To demonstrate the superiority of the six-dose over the four-dose regimen of artemether-lumefantrine (co-artemether, Coartem (R)) in patients > 12 years, data from 11 randomized clinical trials were pooled and analyzed. A total of 1368 patients with uncomplicated Plasinodium falciparum malaria (six-

  16. Safety of artemether-lumefantrine in pregnant women with malaria: results of a prospective cohort study in Zambia

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    Manyando Christine

    2010-09-01

    Full Text Available Abstract Background Safety data regarding exposure to artemisinin-based combination therapy in pregnancy are limited. This prospective cohort study conducted in Zambia evaluated the safety of artemether-lumefantrine (AL in pregnant women with malaria. Methods Pregnant women attending antenatal clinics were assigned to groups based on the drug used to treat their most recent malaria episode (AL vs. sulphadoxine-pyrimethamine, SP. Safety was assessed using standard and pregnancy-specific parameters. Post-delivery follow-up was six weeks for mothers and 12 months for live births. Primary outcome was perinatal mortality (stillbirth or neonatal death within seven days after birth. Results Data from 1,001 pregnant women (AL n = 495; SP n = 506 and 933 newborns (AL n = 466; SP n = 467 showed: perinatal mortality (AL 4.2%; SP 5.0%, comprised of early neonatal mortality (each group 2.3%, stillbirths (AL 1.9%; SP 2.7%; preterm deliveries (AL 14.1%; SP 17.4% of foetuses; and gestational age-adjusted low birth weight (AL 9.0%; SP 7.7%. Infant birth defect incidence was 1.8% AL and 1.6% SP, excluding umbilical hernia. Abortions prior to antenatal care could not be determined: abortion occurred in 4.5% of women treated with AL during their first trimester; none were reported in the 133 women exposed to SP and/or quinine during their first trimester. Overall development (including neurological assessment was similar in both groups. Conclusions These data suggest that exposure to AL in pregnancy, including first trimester, is not associated with particular safety risks in terms of perinatal mortality, malformations, or developmental impairment. However, more data are required on AL use during the first trimester.

  17. A systematic review of the safety and efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria during pregnancy

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    Manyando Christine

    2012-05-01

    Full Text Available Abstract Malaria during pregnancy, particularly Plasmodium falciparum malaria, has been linked to increased morbidity and mortality, which must be reduced by both preventive measures and effective case management. The World Health Organization (WHO recommends artemisinin-based combination therapy (ACT to treat uncomplicated falciparum malaria during the second and third trimesters of pregnancy, and quinine plus clindamycin during the first trimester. However, the national policies of many African countries currently recommend quinine throughout pregnancy. Therefore, the aim of this article is to provide a summary of the available data on the safety and efficacy of artemether-lumefantrine (AL in pregnancy. An English-language search identified 16 publications from 1989 to October 2011 with reports of artemether or AL exposure in pregnancy, including randomized clinical trials, observational studies and systematic reviews. Overall, there were 1,103 reports of AL use in pregnant women: 890 second/third trimester exposures; 212 first trimester exposures; and one case where the trimester of exposure was not reported. In the second and third trimesters, AL was not associated with increased adverse pregnancy outcomes as compared with quinine or sulphadoxine-pyrimethamine, showed improved tolerability relative to quinine, and its efficacy was non-inferior to quinine. There is evidence to suggest that the pharmacokinetics of anti-malarial drugs may change in pregnancy, although the impact on efficacy and safety needs to be studied further, especially since the majority of studies report high cure rates and adequate tolerability. As there are fewer reports of AL safety in the first trimester, additional data are required to assess the potential to use AL in the first trimester. Though the available safety and efficacy data support the use of AL in the second and third trimesters, there is still a need for further information. These findings reinforce the

  18. Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa.

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    Karen I Barnes

    2005-11-01

    Full Text Available BACKGROUND: Between 1995 and 2000, KwaZulu-Natal province, South Africa, experienced a marked increase in Plasmodium falciparum malaria, fuelled by pyrethroid and sulfadoxine-pyrimethamine resistance. In response, vector control was strengthened and artemether-lumefantrine (AL was deployed in the first Ministry of Health artemisinin-based combination treatment policy in Africa. In South Africa, effective vector and parasite control had historically ensured low-intensity malaria transmission. Malaria is diagnosed definitively and treatment is provided free of charge in reasonably accessible public-sector health-care facilities. METHODS AND FINDINGS: We reviewed four years of malaria morbidity and mortality data at four sentinel health-care facilities within KwaZulu-Natal's malaria-endemic area. In the year following improved vector control and implementation of AL treatment, malaria-related admissions and deaths both declined by 89%, and outpatient visits decreased by 85% at the sentinel facilities. By 2003, malaria-related outpatient cases and admissions had fallen by 99%, and malaria-related deaths had decreased by 97%. There was a concomitant marked and sustained decline in notified malaria throughout the province. No serious adverse events were associated causally with AL treatment in an active sentinel pharmacovigilance survey. In a prospective study with 42 d follow up, AL cured 97/98 (99% and prevented gametocyte developing in all patients. Consistent with the findings of focus group discussions, a household survey found self-reported adherence to the six-dose AL regimen was 96%. CONCLUSION: Together with concurrent strengthening of vector control measures, the antimalarial treatment policy change to AL in KwaZulu-Natal contributed to a marked and sustained decrease in malaria cases, admissions, and deaths, by greatly improving clinical and parasitological cure rates and reducing gametocyte carriage.

  19. Efficacy of fixed-dose combination artesunate-amodiaquine versus artemether-lumefantrine for uncomplicated childhood Plasmodium falciparum malaria in Democratic Republic of Congo: a randomized non-inferiority trial

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    Espié Emmanuelle

    2012-05-01

    Full Text Available Abstract Background In 2005, the Democratic Republic of Congo (DRC adopted artesunate and amodiaquine (ASAQ as first-line anti-malarial treatment. In order to compare the efficacy of the fixed-dose formulation ASAQ versus artemether-lumefantrine (AL, a randomized, non-inferiority open-label trial was conducted in Katanga. Methods Children aged six and 59 months with uncomplicated Plasmodium falciparum malaria were enrolled and randomly allocated into one of the two regimens. The risk of recurrent parasitaemia by day 42, both unadjusted and adjusted by PCR genotyping to distinguish recrudescence from new infection, was analysed. Results Between April 2008 and March 2009, 301 children were included: 156 with ASAQ and 145 with AL. No early treatment failures were reported. Among the 256 patients followed-up at day 42, 32 patients developed late clinical or parasitological failure (9.9% (13/131 in the ASAQ group and 15.2% (19/125 in the AL group. After PCR correction, cure rates were 98.3% (95%CI, 94.1-99.8 in the ASAQ group and 99.1% (95%CI, 94.9-99.9 in the AL group (difference −0.7%, one sided 95% CI −3.1. Kaplan-Meier PCR-adjusted cure rates were similar. Both treatment regimens were generally well tolerated. Conclusion Both ASAQ and AL are highly effective and currently adequate as the first-line treatment of uncomplicated falciparum malaria in this area of Katanga, DRC. However, in a very large country, such as DRC, and because of possible emergence of resistance from other endemic regions, surveillance of efficacy of artemisinin-based combination treatments, including other evaluations of the resistance of ASAQ, need to be done in other provinces. Trial registration The protocol was registered with the clinicaltrials.gov, open clinical trial registry under the identifier number NCT01567423.

  20. Efficacy and safety of a fixed dose artesunate-sulphamethoxypyrazine-pyrimethamine compared to artemether-lumefantrine for the treatment of uncomplicated falciparum malaria across Africa: a randomized multi-centre trial

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    Djimdé Abdoulaye

    2009-04-01

    Full Text Available Abstract Background The efficacy of artemisinin-based combination therapy has already been demonstrated in a number of studies all over the world, and some of them can be regarded as comparably effective. Ease of administration of anti-malarial treatments with shorter courses and fewer tablets may be key determinant of compliance. Methods Patients with uncomplicated falciparum malaria and over six months of age were recruited in Cameroon, Mali, Rwanda and Sudan. 1,384 patients were randomly assigned to receive artesunate-sulphamethoxypyrazine-pyrimethamine (AS-SMP three-day (once daily for 3 days regimen (N = 476 or AS-SMP 24-hour (0 h, 12 h, 24 h regimen (N = 458 or artemether-lumefantrine (AL, the regular 6 doses regimen (N = 450. The primary objective was to demonstrate non-inferiority (using a margin of -6% of AS-SMP 24 hours or AS-SMP three days versus AL on the PCR-corrected 28-day cure rate. Results The PCR corrected 28-day cure rate on the intention to treat (ITT analysis population were: 96.0%(457/476 in the AS-SMP three-day group, 93.7%(429/458 in the AS-SMP 24-hour group and 92.0%(414/450 in the AL group. Likewise, the cure rates on the PP analysis population were high: 99.3%(432/437 in the AS-SMP three-day group, 99.5%(416/419 in the AS-SMP 24-hour group and 99.7(391/394% in the AL group. Most common drug-related adverse events were gastrointestinal symptoms (such as vomiting and diarrhea which were slightly higher in the AS-SMP 24-hour group. Conclusion AS-SMP three days or AS-SMP 24 hours are safe, are as efficacious as AL, and are well tolerated. Trial registration NCT00484900 http://www.clinicaltrials.gov.

  1. Malaria transmission after artemether-lumefantrine and dihydroartemisinin-piperaquine: a randomized trial

    NARCIS (Netherlands)

    Sawa, P.; Shekalaghe, S.; Drakeley, C.; Sutherland, C.J.; Mweresa, C.K.; Baidjoe, A.Y.; Manjurano, A.; Kavishe, R.A.; Beshir, K.B.; Yussuf, R.U.; Omar, S.A.; Hermsen, C.C.; Okell, L.; Schallig, H.D.; Sauerwein, R.W.; Hallett, R.L.; Bousema, T.

    2013-01-01

    BACKGROUND: Artemisinin-based combination therapy (ACT) reduces the potential for malaria transmission, compared with non-ACTs. It is unclear whether this effect differs between ACTs. METHODS: A total of 298 children (age, 6 months to 10 years) with uncomplicated falciparum malaria were randomized t

  2. The role of molecular markers in emerging artemether-lumefantrine resistant Plasmodium falciparum

    OpenAIRE

    Malmberg, Maja

    2013-01-01

    Malaria is a devastating disease which kills ~1 million people yearly. The vast majority of lives lost due to malaria are children and pregnant women in sub-Saharan Africa. Although malaria is a treatable disease it continues to be one of the major causes of death, especially in poor settings. Chemotherapy is the key to control the disease, decrease the burden of malaria and save lives. The malaria parasites ability to develop resistance towards antimalarial drugs is therefore a major concern...

  3. Polymorphisms in Plasmodium falciparum Chloroquine Resistance Transporter and Multidrug Resistance 1 Genes: Parasite Risk Factors that Affect Treatment Outcomes for P. falciparum Malaria after Artemether-Lumefantrine and Artesunate-Amodiaquine

    OpenAIRE

    Venkatesan, Meera; Gadalla, Nahla B; Stepniewska, Kasia; Dahal, Prabin; Nsanzabana, Christian; Moriera, Clarissa; Price, Ric N; Mårtensson, Andreas; Rosenthal, Philip J.; Dorsey, Grant; Sutherland, Colin J.; Guérin, Philippe; Davis, Timothy M. E.; Ménard, Didier; Adam, Ishag

    2014-01-01

    Adequate clinical and parasitologic cure by artemisinin combination therapies relies on the artemisinin component and the partner drug. Polymorphisms in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) genes are associated with decreased sensitivity to amodiaquine and lumefantrine, but effects of these polymorphisms on therapeutic responses to artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) have not been clea...

  4. Therapeutic Efficacy of Artemether-Lumefantrine (Coartem®) in Treating Uncomplicated P. falciparum Malaria in Metehara, Eastern Ethiopia: Regulatory Clinical Study

    Science.gov (United States)

    Assefa, Ashenafi; Mohamed, Hussein; Solomon, Hiwot; Woyessa, Adugna; Assefa, Yibeltal; Kebede, Amha; Kassa, Moges

    2016-01-01

    Background As per the WHO recommendation, the development of resistance by P. falciparum to most artemisinin combination therapies (ACTs) triggered the need for routine monitoring of the efficacy of the drugs every two years in all malaria endemic countries. Hence, this study was carried out to assess the therapeutic efficacy of Artemether-Lumefantrine (Coartem®) in treating the uncomplicated falciparum malaria, after 9 years of its introduction in the Metehara, Eastern Ethiopia. Method This is part of the therapeutic efficacy studies by the Federal Ministry of Health Ethiopia, which were conducted in regionally representative sentinel sites in the country from October 2014 to January 2015. Based on the study criteria set by WHO, febrile and malaria suspected outpatients in the health center were consecutively recruited to study. A standard six-dose regimen of AL was administered over three days and followed up for measuring therapeutic responses over 28 days. Data entry and analysis was done by using the WHO designed Excel spreadsheet and SPSS version 20 for Windows. Statistical significant was considered for P-value less than 0.05. Result Of the 91 patients enrolled, the day-28 analysis showed 83 adequate clinical and parasitological responses (ACPRs). Per protocol analysis, PCR-uncorrected & corrected cure rates of Coartem® among the study participants were 97.6% (95%CI: 93.6–99.5) and 98.8% (CI: 93.5–100%), respectively. No parasite detected on day 3 and onwards. Fever clearance was above 91% on day-3. Mean hemoglobin was significantly increased (Pdrug reactions were observed among the study participants. Conclusion This study showed high efficacy of AL in the study area, which suggests the continuation of AL as first line drug for the treatment of uncomplicated P. falciparum malaria in the study area. This study recommends further studies on drug toxicity, particularly on repeated cough and oral ulceration. PMID:27128799

  5. Access to Subsidized Artemether-Lumefantrine from the Private Sector Among Febrile Children in Rural Setting in Kilosa, Tanzania

    OpenAIRE

    Simba, Daudi; Kakoko, Deodatus

    2012-01-01

    The World Health Organization aims at universal access to effective antimalarial treatment by the year 2015. Consequently, an enormous financial resource has been invested on Artemisinin Combination Therapy (ACT))) subsidy. In Tanzania, strategies to increase access of artemether-lumufantrine (ALu) rural areas, where the burden is highest, includes subsidy to the Faith-based Organisations (FBO) facilities and accredited drug dispensing outlets (ADDOs). This study was done to assess the ext...

  6. Electrocardiographic study in Ghanaian children with uncomplicated malaria, treated with artesunate-amodiaquine or artemether-lumefantrine

    DEFF Research Database (Denmark)

    Adjei, George O; Oduro-Boatey, Collins; Rodrigues, Onike P;

    2012-01-01

    Several anti-malarial drugs are associated with adverse cardiovascular effects. These effects may be exacerbated when different anti-malarials are used in combination. There has been no report yet on the potential cardiac effects of the combination artesunate-amodiaquine....

  7. Open-label trial on efficacy of artemether/lumefantrine against the uncomplicated Plasmodium falciparum malaria in Metema district, Northwestern Ethiopia

    Science.gov (United States)

    Wudneh, Feven; Assefa, Ashenafi; Nega, Desalegn; Mohammed, Hussien; Solomon, Hiwot; Kebede, Tadesse; Woyessa, Adugna; Assefa, Yibeltal; Kebede, Amha; Kassa, Moges

    2016-01-01

    Purpose Following the increased Plasmodium falciparum resistance to chloroquine and sulfadoxine/pyrimethamine, Ethiopia adopted artemether/lumefantrine (AL) as the first-line treatment for uncomplicated P. falciparum in 2004. According to the recommendation of the World Health Organization, this study was carried out for regular monitoring of the efficacy of AL in treating the uncomplicated P. falciparum malaria in Metema district, Gondar Zone, Northwest Ethiopia. Patients and methods This is a one-arm prospective 28-day in vivo therapeutic efficacy study among the uncomplicated P. falciparum malaria patients aged 6 months and older. The study was conducted from October 2014 to January 2015, based on the revised World Health Organization protocol of 2009 for surveillance of antimalarial drug therapeutic efficacy study. Standard six-dose regimen of AL was given twice daily for 3 days, and then the treatment outcomes were assessed on days 0, 1, 2, 3, 7, 14, 21, 28, and any other unscheduled day for emergency cases. Results There were 91 study subjects enrolled in this study, of whom 80 study subjects completed the full follow-up schedules and showed adequate clinical and parasitological responses on day 28, with no major adverse event. Per protocol analysis, the unadjusted cure rate of Coartem® was 98.8% (95% confidence interval: 93.3%–100%) in the study area. Recurrence of one P. falciparum case was detected on day 28, with a late parasitological failure rate of 1.2%. No early treatment failure occurred. Complete parasite and fever clearance was observed on day 3. Gametocyte carriage was 4.4% at enrollment that cleared on day 21. Although the difference is statistically not significant, a slight increase in the level of mean hemoglobin from baseline to day 28 was observed. Conclusion The study showed high efficacy and tolerability of Coartem® against uncomplicated P. falciparum malaria, suggesting the continuation as a first-line drug in the study district

  8. Community screening and treatment of asymptomatic carriers of Plasmodium falciparum with artemether-lumefantrine to reduce malaria disease burden: a modelling and simulation analysis

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    Ubben David

    2011-07-01

    Full Text Available Abstract Background Asymptomatic carriers of Plasmodium falciparum serve as a reservoir of parasites for malaria transmission. Identification and treatment of asymptomatic carriers within a region may reduce the parasite reservoir and influence malaria transmission in that area. Methods Using computer simulation, this analysis explored the impact of community screening campaigns (CSC followed by systematic treatment of P. falciparum asymptomatic carriers (AC with artemether-lumefantrine (AL on disease transmission. The model created by Okell et al (originally designed to explore the impact of the introduction of treatment with artemisinin-based combination therapy on malaria endemicity was modified to represent CSC and treatment of AC with AL, with the addition of malaria vector seasonality. The age grouping, relative distribution of age in a region, and degree of heterogeneity in disease transmission were maintained. The number and frequency of CSC and their relative timing were explored in terms of their effect on malaria incidence. A sensitivity analysis was conducted to determine the factors with the greatest impact on the model predictions. Results The simulation showed that the intervention that had the largest effect was performed in an area with high endemicity (entomological inoculation rate, EIR > 200; however, the rate of infection returned to its normal level in the subsequent year, unless the intervention was repeated. In areas with low disease burden (EIR Conclusions Community screening and treatment of asymptomatic carriers with AL may reduce malaria transmission significantly. The initial level of disease intensity has the greatest impact on the potential magnitude and duration of malaria reduction. When combined with other interventions (e.g. long-lasting insecticide-treated nets, rapid diagnostic tests, prompt diagnosis and treatment, and, where appropriate, indoor residual spraying the effect of this intervention can be

  9. Temporal trends in prevalence of Plasmodium falciparum molecular markers selected for by artemether-lumefantrine treatment in pre-ACT and post-ACT parasites in western Kenya.

    Science.gov (United States)

    Achieng, Angela O; Muiruri, Peninah; Ingasia, Luicer A; Opot, Benjamin H; Juma, Dennis W; Yeda, Redemptah; Ngalah, Bidii S; Ogutu, Bernhards R; Andagalu, Ben; Akala, Hoseah M; Kamau, Edwin

    2015-12-01

    Artemether-lumefantrine (AL) became the first-line treatment for uncomplicated malaria in Kenya in 2006. Studies have shown AL selects for SNPs in pfcrt and pfmdr1 genes in recurring parasites compared to the baseline infections. The genotypes associated with AL selection are K76 in pfcrt and N86, 184F and D1246 in pfmdr1. To assess the temporal change of these genotypes in western Kenya, 47 parasite isolates collected before (pre-ACT; 1995-2003) and 745 after (post-ACT; 2008-2014) introduction of AL were analyzed. In addition, the associations of parasite haplotype against the IC50 of artemether and lumefantrine, and clearance rates were determined. Parasite genomic DNA collected between 1995 and 2014 was analyzed by sequencing or PCR-based single-base extension on Sequenom MassARRAY. IC50s were determined for a subset of the samples. One hundred eighteen samples from 2013 to 2014 were from an efficacy trial of which 68 had clearance half-lives. Data revealed there were significant differences between pre-ACT and post-ACT genotypes at the four codons (chi-square analysis; p < 0.0001). The prevalence of pfcrt K76 and N86 increased from 6.4% in 1995-1996 to 93.2% in 2014 and 0.0% in 2002-2003 to 92.4% in 2014 respectively. Analysis of parasites carrying pure alleles of K + NFD or T + YYY haplotypes revealed that 100.0% of the pre-ACT parasites carried T + YYY and 99.3% of post-ACT parasites carried K + NFD. There was significant correlation (p = 0.04) between lumefantrine IC50 and polymorphism at pfmdr1 codon 184. There was no difference in parasite clearance half-lives based on genetic haplotype profiles. This study shows there is a significant change in parasite genotype, with key molecular determinants of AL selection almost reaching saturation. The implications of these findings are not clear since AL remains highly efficacious. However, there is need to closely monitor parasite genotypic, phenotypic and clinical dynamics in response to continued use

  10. Multicentric assessment of the efficacy and tolerability of dihydroartemisinin-piperaquine compared to artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Yavo William

    2011-07-01

    Full Text Available Abstract Background The choice of appropriate artemisinin-based combination therapy depends on several factors (cost, efficacy, safety, reinfection rate and simplicity of administration. To assess whether the combination dihydroartemisinin-piperaquine (DP could be an alternative to artemether-lumefantrine (AL, the efficacy and the tolerability of the two products for the treatment of uncomplicated falciparum malaria in sub-Saharan Africa have been compared. Methods A multicentric open randomized controlled clinical trial of three-day treatment of DP against AL for the treatment of two parallel groups of patients aged two years and above and suffering from uncomplicated falciparum malaria was carried out in Cameroon, Côte d'Ivoire and Senegal. Within each group, patients were randomly assigned supervised treatment. DP was given once a day for three days and AL twice a day for three days. Follow-up visits were performed on day 1 to 4 and on day 7, 14, 21, 28 to evaluate clinical and parasitological results. The primary endpoint was the recovery rate by day 28. Results Of 384 patients enrolled, 197 were assigned DP and 187 AL. The recovery rates adjusted by genotyping, 99.5% in the DP group and 98.9% in the AL group, were not statistically different (p = 0.538. No Early Therapeutic Failure (ETF was observed. At day 28, two patients in the DP group and five in AL group had recurrent parasitaemia with Plasmodium falciparum. In the DP group, after PCR genotyping, one of the two recurrences was classified as a new infection and the other as recrudescence. In AL group, two recurrences were classified after correction by PCR as recrudescence. All cases of recrudescence were classified as Late Parasitological Failure (LPF. In each group, a rapid recovery from fever and parasitaemia was noticed. More than 90% of patients did no longer present fever or parasitaemia 48 hours after treatment. Both drugs were well tolerated. Indeed, no serious adverse events

  11. A Randomised Controlled Trial of Artemether-Lumefantrine Versus Artesunate for Uncomplicated Plasmodium falciparum Treatment in Pregnancy

    OpenAIRE

    Rose McGready; Saw Oo Tan; Ashley, Elizabeth A; Mupawjay Pimanpanarak; Jacher Viladpai-Nguen; Lucy Phaiphun; Katja Wüstefeld; Marion Barends; Natthapon Laochan; Lily Keereecharoen; Niklas Lindegardh; Pratap Singhasivanon; White, Nicholas J.; François Nosten

    2008-01-01

    Editors' Summary Background. Plasmodium falciparum, a mosquito-borne parasite that causes malaria, kills nearly one million people every year. Although most deaths occur among young children, malaria during pregnancy is also an important public-health problem. In areas where malaria transmission is high (stable transmission), women acquire a degree of immunity. Although less symptomatic than women who lack natural protection, their babies are often small and sickly because malaria-related ane...

  12. Prescribing practice for malaria following introduction of artemether-lumefantrine in an urban area with declining endemicity in West Africa

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    Conway David J

    2010-06-01

    Full Text Available Abstract Background The decline in malaria coinciding with the introduction of newer, costly anti-malarials has prompted studies into the overtreatment for malaria mostly in East Africa. The study presented here describes prescribing practices for malaria at health facilities in a West African country. Methods Cross-sectional surveys were carried out in two urban Gambian primary health facilities (PHFs during and outside the malaria transmission season. Facilities were comparable in terms of the staffing compliment and capability to perform slide microscopy. Patients treated for malaria were enrolled after consultations and blood smears collected and read at a reference laboratory. Slide reading results from the PHFs were compared to the reference readings and the proportion of cases treated but with a negative test result at the reference laboratory was determined. Results Slide requests were made for 33.2% (173 of those enrolled, being more frequent in children (0-15 yrs than adults during the wet season (p = 0.003. In the same period, requests were commoner in under-fives compared to older children (p = 0.022; however, a positive test result was 4.4 times more likely in the latter group (p = 0.010. Parasitaemia was confirmed for only 4.7% (10/215 and 12.5% (37/297 of patients in the dry and wet seasons, respectively. The negative predictive value of a PHF slide remained above 97% in both seasons. Conclusions The study provides evidence for considerable overtreatment for malaria in a West African setting comparable to reports from areas with similar low malaria transmission in East Africa. The data suggest that laboratory facilities may be under-used, and that adherence to negative PHF slide results could significantly reduce the degree of overtreatment. The "peak prevalence" in 5-15 year olds may reflect successful implementation of malaria control interventions in under-fives, but point out the need to extend such interventions to older

  13. Rapid selection of Plasmodium falciparum chloroquine resistance transporter gene and multidrug resistance gene-1 haplotypes associated with past chloroquine and present artemether-lumefantrine use in Inhambane District, southern Mozambique

    DEFF Research Database (Denmark)

    Thomsen, Thomas T; Madsen, Laura B; Hansson, Helle H;

    2013-01-01

    Chloroquine (CQ) use in Mozambique was stopped in 2002 and artemether-lumefantrine (AL) was implemented in 2008. In light of no use of CQ and extensive use of AL, we determined the frequency of molecular markers of Plasmodium falciparum drug resistance/tolerance to CQ and AL in persons living in...... Linga-Linga, an isolated peninsula and in Furvela village, which is located 8 km inland. The P. falciparum chloroquine resistance transporter gene CVMNK wild type increased in frequency from 43.9% in 2009 to 66.4% in 2010 (P = 0.001), and combined P. falciparum multidrug resistance gene 1 N86-184F-D1246...... haplotype increased significantly between years (P = 0.039). The combination of P. falciparum chloroquine resistance transporter gene CVMNK and P. falciparum multidrug resistance gene NFD increased from 24.3% (2009) to 45.3% in (2010, P = 0.017). The rapid changes observed may largely be caused by decreased...

  14. Efficacy and Safety of Artesunate-Amodiaquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium falciparum Malaria in Sentinel Sites across Côte d’Ivoire

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    William Yavo

    2015-01-01

    Full Text Available Two years after the introduction of free Artesunate-Amodiaquine (ASAQ and Artemether-Lumefantrine (AL for the treatment of uncomplicated malaria in public health facilities in Côte d’Ivoire, we carried out this study to compare their efficacy and tolerability in three surveillance sites. It was a multicentre open randomised clinical trial of 3-day ASAQ treatment against AL for the treatment of 2 parallel groups of patients aged 2 years and above. The endpoints were (1 Adequate Clinical and Parasitological Response (ACPR at day 28 and (2 the clinical and biological tolerability. Of the 300 patients who were enrolled 289, with 143 (49.5% and 146 (50.5% in the ASAQ and AL groups, respectively, correctly followed the WHO 2003 protocol we used. The PCR-corrected ACPR was 99.3% for each group. More than 94% of patients no longer showed signs of fever, 48 hours after treatment. Approximately 78% of the people in the ASAQ group had a parasite clearance time of 48 hours or less compared to 81% in the AL group (p=0.496. Both drugs were found to be well tolerated by the patients. This study demonstrates the effectiveness and tolerability of ASAQ and AL supporting their continuous use for the treatment of uncomplicated P. falciparum malaria infection in Côte d’Ivoire.

  15. Randomized trial of safety and effectiveness of chlorproguanil-dapsone and lumefantrine-artemether for uncomplicated malaria in children in the Gambia.

    Directory of Open Access Journals (Sweden)

    Samuel Dunyo

    Full Text Available BACKGROUND: Chlorproguanil-dapsone (Lapdap, developed as a low-cost antimalarial, was withdrawn in 2008 after concerns about safety in G6PD deficient patients. This trial was conducted in 2004 to evaluate the safety and effectiveness of CD and comparison with artemether-lumefantrine (AL under conditions of routine use in G6PD normal and G6PD deficient patients with uncomplicated malaria in The Gambia. We also examined the effects of a common genetic variant that affects chlorproguanil metabolism on risk of treatment failure. METHODS: 1238 children aged 6 months to 10 years with uncomplicated malaria were randomized to receive CD or artemether-lumefantrine (AL and followed for 28 days. The first dose was supervised, subsequent doses given unsupervised at home. G6PD genotype was determined to assess the interaction between treatment and G6PD status in their effects on anaemia. The main endpoints were clinical treatment failure by day 28, incidence of severe anaemia (Hb<5 g/dL, and haemoglobin concentration on day 3. FINDINGS: One third of patients treated with AL, and 6% of patients treated with CD, did not complete their course of medication. 18% (109/595 of children treated with CD and 6.1% (36/587 with AL required rescue medication within 4 weeks, risk difference 12% (95%CI 8.9%-16%. 23 children developed severe anaemia (17 (2.9% treated with CD and 6 (1.0% with AL, risk difference 1.8%, 95%CI 0.3%-3.4%, P = 0.02. Haemoglobin concentration on day 3 was lower among children treated with CD than AL (difference 0.43 g/dL, 95% CI 0.24 to 0.62, and within the CD group was lower among those children who had higher parasite density at enrollment. Only 17 out of 1069 children who were typed were G6PD A- deficient, of these 2/9 treated with CD and 1/8 treated with AL developed severe anaemia. 5/9 treated with CD had a fall of 2 g/dL or more in haemoglobin concentration by day 3. INTERPRETATION: AL was well tolerated and highly effective and when

  16. Pharmacokinetics of a Novel Sublingual Spray Formulation of the Antimalarial Drug Artemether in African Children with Malaria

    Science.gov (United States)

    Salman, Sam; Bendel, Daryl; Lee, Toong C.; Templeton, David

    2015-01-01

    The pharmacokinetics of sublingual artemether (ArTiMist) was investigated in 91 young African children with severe malaria or who could not tolerate oral antimalarial therapy. Each received 3.0 mg/kg of body weight of artemether at 0, 8, 24, 36, 48, and 60 h or until the initiation of oral treatment. Few blood samples were drawn postdose. Plasma artemether and dihydroartemisinin (DHA) levels were measured using liquid chromatography-mass spectrometry, and the data were analyzed using established population compartmental pharmacokinetic models. Parasite clearance was prompt (median parasite clearance time, 24 h), and there were no serious adverse events. Consistent with studies in healthy adults (S. Salman, D. Bendel, T. C. Lee, D. Templeton, and T. M. E. Davis, Antimicrob Agents Chemother 59:3197–3207, 2015, http://dx.doi.org/10.1128/AAC.05013-14), the absorption of sublingual artemether was biphasic, and multiple dosing was associated with the autoinduction of the metabolism of artemether to DHA (which itself has potent antimalarial activity). In contrast to studies using healthy volunteers, pharmacokinetic modeling indicated that the first absorption phase did not avoid first-pass metabolism, suggesting that the drug is transferred to the upper intestine through postdose fluid/food intake. Simulations using the present data and those from an earlier study in older Melanesian children with uncomplicated malaria treated with artemether-lumefantrine tablets suggested that the bioavailability of sublingual artemether was at least equivalent to that after conventional oral artemether-lumefantrine (median [interquartile range] areas under the concentration-time curve for artemether, 3,403 [2,471 to 4,771] versus 3,063 [2,358 to 4,514] μg · h/liter, respectively; and for DHA, 2,958 [2,146 to 4,278] versus 2,839 [1,812 to 3,488] μg · h/liter, respectively; P ≥ 0.42). These findings suggest that sublingual artemether could be used as prereferral treatment for sick

  17. Randomized trials of artemisinin-piperaquine, dihydroartemisinin-piperaquine phosphate and artemether-lumefantrine for the treatment of multi-drug resistant falciparum malaria in Cambodia-Thailand border area

    Directory of Open Access Journals (Sweden)

    Song Jianping

    2011-08-01

    Full Text Available Abstract Background Drug resistance of falciparum malaria is a global problem. Sulphadoxine/pyrimethamine-resistant and mefloquine-resistant strains of falciparum malaria have spread in Southeast Asia at lightning speed in 1980s-1990s, and the Cambodia-Thailand border is one of the malaria epidemic areas with the most severe forms of multi-drug resistant falciparum malaria. Methods Artemisinin-piperaquine (AP, dihydroartemisinin-piperaquine phosphate (DHP and artemether-lumefantrine (AL were used to treat 110, 55 and 55 uncomplicated malaria patients, respectively. The total dosage for adults is 1,750 mg (four tablets, twice over 24 hours of AP, 2,880 mg (eight tablets, four times over two days of DHP, and 3,360 mg (24 tablets, six times over three days of AL. The 28-day cure rate, parasite clearance time, fever clearance time, and drug tolerance of patients to the three drugs were compared. All of the above methods were consistent with the current national guidelines. Results The mean parasite clearance time was similar in all three groups (66.7 ± 21.9 hrs, 65.6 ± 27.3 hrs, 65.3 ± 22.5 hrs in AP, DHP and AL groups, respectively, and there was no remarkable difference between them; the fever clearance time was also similar (31.6 ± 17.7 hrs, 34.6 ± 21.8 hrs and 36.9 ± 15.4 hrs, respectively. After following up for 28-days, the cure rate was 95.1%(97/102, 98.2%(54/55 and 82.4%(42/51; and the recrudescence cases was 4.9%(5/102, 1.8%(1/55 and 17.6%(9/51, respectively. Therefore, the statistical data showed that 28-day cure rate in AP and DHP groups was superior to AL group obviously. The patients had good tolerance to all the three drugs, and some side effects (anoxia, nausea, vomiting, headache and dizziness could be found in every group and they were self-limited; patients in control groups also had good tolerance to DHP and AL, there was no remarkable difference in the three groups. Conclusions AP, DHP and AL all remained efficacious

  18. Antiretroviral Choice for HIV Impacts Antimalarial Exposure and Treatment Outcomes in Ugandan Children

    Science.gov (United States)

    Parikh, Sunil; Kajubi, Richard; Huang, Liusheng; Ssebuliba, Joshua; Kiconco, Sylvia; Gao, Qin; Li, Fangyong; Were, Moses; Kakuru, Abel; Achan, Jane; Mwebaza, Norah; Aweeka, Francesca T.

    2016-01-01

    Background. The optimal treatment of malaria in human immunodeficiency virus (HIV)–infected children requires consideration of critical drug–drug interactions in coinfected children, as these may significantly impact drug exposure and clinical outcomes. Methods. We conducted an intensive and sparse pharmacokinetic/pharmacodynamic study in Uganda of the most widely adopted artemisinin-based combination therapy, artemether-lumefantrine. HIV-infected children on 3 different first-line antiretroviral therapy (ART) regimens were compared to HIV-uninfected children not on ART, all of whom required treatment for Plasmodium falciparum malaria. Pharmacokinetic sampling for artemether, dihydroartemisinin, and lumefantrine exposure was conducted through day 21, and associations between drug exposure and outcomes through day 42 were investigated. Results. One hundred forty-five and 225 children were included in the intensive and sparse pharmacokinetic analyses, respectively. Compared with no ART, efavirenz (EFV) reduced exposure to all antimalarial components by 2.1- to 3.4-fold; lopinavir/ritonavir (LPV/r) increased lumefantrine exposure by 2.1-fold; and nevirapine reduced artemether exposure only. Day 7 concentrations of lumefantrine were 10-fold lower in children on EFV vs LPV/r-based ART, changes that were associated with an approximate 4-fold higher odds of recurrent malaria by day 28 in those on EFV vs LPV/r-based ART. Conclusions. The choice of ART in children living in a malaria-endemic region has highly significant impacts on the pharmacokinetics and pharmacodynamics of artemether-lumefantrine treatment. EFV-based ART reduces all antimalarial components and is associated with the highest risk of recurrent malaria following treatment. For those on EFV, close clinical follow-up for recurrent malaria following artemether-lumefantrine treatment, along with the study of modified dosing regimens that provide higher exposure, is warranted. PMID:27143666

  19. A randomized trial of artesunate-amodiaquine versus artemether-lumefantrine in Ghanaian paediatric sickle cell and non-sickle cell disease patients with acute uncomplicated malaria

    DEFF Research Database (Denmark)

    Adjei, George O; Goka, Bamenla Q; Enweronu-Laryea, Christabel C;

    2014-01-01

    BACKGROUND: Sickle cell disease (SCD) is a genetic disorder common in malaria endemic areas. In endemic areas, malaria is a major cause of morbidity and mortality among SCD patients. This suggests the need for prompt initiation of efficacious anti-malarial therapy in SCD patients with acute malaria....... However, there is no information to date, on the efficacy or safety of artemisinin combination therapy when used for malaria treatment in SCD patients. METHODS: Children with SCD and acute uncomplicated malaria (n = 60) were randomized to treatment with artesunate-amodiaquine (AA), or artemether....../57) in the SCD group and 96.4% (53/55) in the non-SCD group. The fractional changes in haemoglobin, platelets and white blood cell counts between baseline (day 0) and endpoint (day 42) were 16.9, 40.6 and 92.3%, respectively, for the SCD group, and, 12.3, 48.8 and 7.5%, respectively, for the non...

  20. Reversible audiometric threshold changes in children with uncomplicated malaria

    DEFF Research Database (Denmark)

    Adjei, George O; Goka, Bamenla Q; Kitcher, Emmanuel;

    2013-01-01

    is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n = 37), artemether-lumefantrine (n = 35), or amodiaquine (n = 8) in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds......Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs) with hearing...... were compared with those of a control group of children (n = 57) from the same area. Findings. During the acute stage, hearing threshold levels of treated children were significantly elevated compared with controls (P <0.001). The threshold elevations persisted up to 28 days, but no differences in...

  1. A qualitative study of the feasibility and community perception on the effectiveness of artemether-lumefantrine use in the context of home management of malaria in south-west Nigeria

    Directory of Open Access Journals (Sweden)

    Happi Christian

    2008-06-01

    Full Text Available Abstract Background In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use. Methods A before and after qualitative study using key informant interviews (KII and focus group discussions (FGDs was conducted in selected villages in Ona-Ara local government area. At baseline, 14 FGDs and 14 KIIs were conducted. Thereafter, community medicine distributors (CMDs were trained in each village to dispense artemeter-lumenfantrine (AL to febrile children aged 6–59 months presumed to have uncomplicated malaria. After one year of drug distribution, nine KIIs and 10 FGDs were conducted. Participants and key informants were mothers and fathers with children under five years, traditional heads of communities, opinion leaders and health workers. Results None of the participants have heard of AL prior to study. Participants were favourably disposed to introduction of AL into the community. Mothers/caregivers were said to have used AL in place of the orthodox drugs and herbs reported commonly used prior to study after commencement of AL distribution. The use of CMDs for drug distribution was acceptable to the participants and they were judged to be efficient as they were readily available, distributed correct dose of AL and mobilised the community effectively. AL was perceived to be very effective and no significant adverse event was reported. Major concerns to the sustainability of the program were the negative attitudes of health workers towards discharge of their duties, support to the CMDs and the need to provide CMDs incentives. In addition regular supply of drugs and adequate supervision of CMDs were advised. Conclusion Our findings showed

  2. Adherence of community caretakers of children to pre-packaged antimalarial medicines (HOMAPAK® among internally displaced people in Gulu district, Uganda

    Directory of Open Access Journals (Sweden)

    Opwonya John

    2006-05-01

    Full Text Available Abstract Background In 2002, home-based management of fever (HBMF was introduced in Uganda, to improve access to prompt, effective antimalarial treatment of all fevers in children under 5 years. Implementation is through community drug distributors (CDDs who distribute pre-packaged chloroquine plus sulfadoxine-pyrimethamine (HOMAPAK® free of charge to caretakers of febrile children. Adherence of caretakers to this regimen has not been studied. Methods A questionnaire-based survey combined with inspection of blister packaging was conducted to investigate caretakers' adherence to HOMAPAK®. The population surveyed consisted of internally displaced people (IDPs from eight camps. Results A total of 241 caretakers were interviewed. 95.0% (CI: 93.3% – 98.4% of their children had received the correct dose for their age and 52.3% of caretakers had retained the blister pack. Assuming correct self-reporting, the overall adherence was 96.3% (CI: 93.9% – 98.7%. The nine caretakers who had not adhered had done so because the child had improved, had vomited, did not like the taste of the tablets, or because they forgot to administer the treatment. For 85.5% of cases treatment had been sought within 24 hours. Blister packaging was considered useful by virtually all respondents, mainly because it kept the drugs clean and dry. Information provided on, and inside, the package was of limited use, because most respondents were illiterate. However, CDDs had often told caretakers how to administer the treatment. For 39.4% of respondents consultation with the CDD was their reported first action when their child has fever and 52.7% stated that they consult her/him if the child does not get better. Conclusion In IDP camps, the HBMF strategy forms an important component of medical care for young children. In case of febrile illness, most caretakers obtain prompt and adequate antimalarial treatment, and adhere to it. A large proportion of malaria episodes are thus

  3. Reversible Audiometric Threshold Changes in Children with Uncomplicated Malaria

    Directory of Open Access Journals (Sweden)

    George O. Adjei

    2013-01-01

    Full Text Available Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs with hearing is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n=37, artemether-lumefantrine (n=35, or amodiaquine (n=8 in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared with those of a control group of children (n=57 from the same area. Findings. During the acute stage, hearing threshold levels of treated children were significantly elevated compared with controls (P<0.001. The threshold elevations persisted up to 28 days, but no differences in hearing thresholds were evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels during the acute illness, a finding that has implications for learning and development in areas of intense transmission, as well as for evaluating potential ototoxicity of new antimalarial drugs.

  4. MRI in children receiving total parenteral nutrition

    International Nuclear Information System (INIS)

    Cranial MRI was obtained in 13 of a group of 57 children receiving long-term parenteral nutrition, who were being investigated for hypermanganasaemia. Increased signal intensity on T1-weighted images has been reported in adult patients on long-term parenteral nutrition and with encephalopathy following chronic manganese exposure in arc welding. It has been postulated that these changes are due to deposition of the paramagnetic trace element manganese. In excess manganese is hepato- and neurotoxic and we present the correlation of whole blood manganese levels with imaging findings. The age range of our patients was 6 months to 10 years, and the duration of therapy 3 months to 10 years. In 7 children we found characteristic increased signal intensity on T1-weighted images, with no abnormality on T2-weighted images. All patients had elevated whole blood manganese levels, suggesting that the basis for this abnormality is indeed deposition of manganese within the tissues. (orig.). With 3 figs

  5. Strategies for understanding and reducing the Plasmodium vivax and Plasmodium ovale hypnozoite reservoir in Papua New Guinean children: a randomised placebo-controlled trial and mathematical model.

    Directory of Open Access Journals (Sweden)

    Leanne J Robinson

    2015-10-01

    Full Text Available The undetectable hypnozoite reservoir for relapsing Plasmodium vivax and P. ovale malarias presents a major challenge for malaria control and elimination in endemic countries. This study aims to directly determine the contribution of relapses to the burden of P. vivax and P. ovale infection, illness, and transmission in Papua New Guinean children.From 17 August 2009 to 20 May 2010, 524 children aged 5-10 y from East Sepik Province in Papua New Guinea (PNG participated in a randomised double-blind placebo-controlled trial of blood- plus liver-stage drugs (chloroquine [CQ], 3 d; artemether-lumefantrine [AL], 3 d; and primaquine [PQ], 20 d, 10 mg/kg total dose (261 children or blood-stage drugs only (CQ, 3 d; AL, 3 d; and placebo [PL], 20 d (263 children. Participants, study staff, and investigators were blinded to the treatment allocation. Twenty children were excluded during the treatment phase (PQ arm: 14, PL arm: 6, and 504 were followed actively for 9 mo. During the follow-up time, 18 children (PQ arm: 7, PL arm: 11 were lost to follow-up. Main primary and secondary outcome measures were time to first P. vivax infection (by qPCR, time to first clinical episode, force of infection, gametocyte positivity, and time to first P. ovale infection (by PCR. A basic stochastic transmission model was developed to estimate the potential effect of mass drug administration (MDA for the prevention of recurrent P. vivax infections. Targeting hypnozoites through PQ treatment reduced the risk of having at least one qPCR-detectable P. vivax or P. ovale infection during 8 mo of follow-up (P. vivax: PQ arm 0.63/y versus PL arm 2.62/y, HR = 0.18 [95% CI 0.14, 0.25], p < 0.001; P. ovale: 0.06 versus 0.14, HR = 0.31 [95% CI 0.13, 0.77], p = 0.011 and the risk of having at least one clinical P. vivax episode (HR = 0.25 [95% CI 0.11, 0.61], p = 0.002. PQ also reduced the molecular force of P. vivax blood-stage infection in the first 3 mo of follow-up (PQ arm 1.90/y

  6. Plasmodium falciparum gametocyte carriage, sex ratios and asexual parasite rates in Nigerian children before and after a treatment protocol policy change instituting the use of artemisinin-based combination therapies

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    Grace Olusola Gbotosho

    2011-09-01

    Full Text Available The effects of artemisinin-based combination therapies (ACTs on transmission of Plasmodium falciparum were evaluated after a policy change instituting the use of ACTs in an endemic area. P. falciparum gametocyte carriage, sex ratios and inbreeding rates were examined in 2,585 children at presentation with acute falciparum malaria during a 10-year period from 2001-2010. Asexual parasite rates were also evaluated from 2003-2010 in 10,615 children before and after the policy change. Gametocyte carriage declined significantly from 12.4% in 2001 to 3.6% in 2010 (@@χ2 for trend = 44.3, p < 0.0001, but sex ratios and inbreeding rates remained unchanged. Additionally, overall parasite rates remained unchanged before and after the policy change (47.2% vs. 45.4%, but these rates declined significantly from 2003-2010 (@@χ2 for trend 35.4, p < 0.0001. Chloroquine (CQ and artemether-lumefantrine (AL were used as prototype drugs before and after the policy change, respectively. AL significantly shortened the duration of male gametocyte carriage in individual patients after treatment began compared with CQ (log rank statistic = 7.92, p = 0.005. ACTs reduced the rate of gametocyte carriage in children with acute falciparum infections at presentation and shortened the duration of male gametocyte carriage after treatment. However, parasite population sex ratios, inbreeding rates and overall parasite rate were unaffected.

  7. Availability and utilization of the WHO recommended priority lifesaving medicines for under five-year old children in public health facilities in Uganda

    DEFF Research Database (Denmark)

    Nsabagasani, Xavier; Ogwal-Okeng, Jasper; Mbonye, Anthony;

    2015-01-01

    IIs and 40% of the HC IVs. The most uncommon were child-friendly priority medicines for malaria with: Artesunate injection in only 6% of HC IIs, 14% of HC IIIs and 20% of HC IVs; Artemether lumefantrine dispersible tablets and rectal artesunate were missing in all the 32 HCs. Less than a third of the...... health workers reported prescribing zinc sulphate and ORS for diarrhea, 86% reported procaine benzyl penicillin injection powder for sepsis, and 57% reported amoxicillin dispersible tablets for pneumonia. None reported prescribing Artemether lumefantrine dispersible tablets and rectal artesunate for...

  8. Improving child support enforcement for children receiving SSI.

    Science.gov (United States)

    Wilschke, S

    Less than half of all children who receive Supplemental Security Income (SSI) benefits and live in a single-parent home receive child support services. Although filing for child support is a condition of eligibility for income assistance programs such as Temporary Assistance for Needy Families (TANF), it is not a condition of eligibility for SSI benefits. Requiring single custodial parents applying for SSI on behalf of their children to pursue child support payments might result in more children on SSI receiving child support, and since the Social Security Administration (SSA) excludes one-third of child support when determining benefit amounts, increased receipt of child support would enhance the financial well-being of SSI children. Improving access to data on child support would enhance the integrity of the SSI program by reducing overpayments to children receiving child support. This article looks at the child support provisions in SSI and other means-tested programs and discusses policy options for improving receipt of child support and access to related data. Requiring cooperation with child support enforcement agencies would be consistent with the philosophy that the SSI program should serve as a program of last resort. Whenever possible, both parents should take primary responsibility for their children. While such a requirement has the potential to improve the financial status of children receiving SSI, factors such as their low-income status and their involvement with the TANF program raise questions about how much those children will actually benefit from such a requirement. Even if many additional children do not receive child support, the requirement demonstrates SSA's dedication to the stewardship of the SSI program. However, if custodial parents fail to comply with the requirement, children may be worse off as a result of the requirement. SSA should carefully pursue a requirement to induce cooperation while protecting children to the greatest extent

  9. Should children with inherited metabolic disorders receive varicella vaccination?

    LENUS (Irish Health Repository)

    Varghese, M

    2011-01-01

    The aim was to determine the rate of varicella infection and complications in children with disorders of intermediary metabolism (IEM) between the ages of 1 and 16 years attending our national metabolic referral centre. Of 126 children identified, a response was received from 122. A history of previous varicella infection was identified in 64 cases (53%) and of varicella vaccination in 5 (4%). Fifty-three (43%) patients apparently did not have a history of clinical varicella infection. Of the 64 children with a history of varicella infection, five required hospitalisation for complications, including life-threatening lactic acidosis in one patient with mitochondrial disease and metabolic decompensation in four patients. In conclusion, varicella infection may cause an increased risk of metabolic decompensation in patients with IEMs. We propose that a trial of varicella vaccination be considered for this cohort of patients with monitoring of its safety and efficacy.

  10. Pharmacovigilance of artemether-lumefantrine in pregnant women followed until delivery in Rwanda

    OpenAIRE

    Rulisa Stephen; Kaligirwa Nadine; Agaba Steven; Karema Corine; Mens Petra F; de Vries Peter J

    2012-01-01

    Abstract Background The World Health Organization presently recommends Artemisinin-based combination therapy (ACT) as first-line therapy for uncomplicated P. falciparum malaria. Many malaria-endemic countries, including Rwanda, have adopted these treatment guidelines. The Artemisinin derivative Artemether, in combination with lumefantrine, is currently used in Rwanda for malaria during the second and third trimesters of pregnancy. Safety data on the use of ACT in pregnancy are still limited t...

  11. Parameters of anesthesia/sedation in children receiving radiotherapy

    International Nuclear Information System (INIS)

    Previous reports establish low risk of complications in pediatric treatments under anesthesia/sedation (A/S) in the outpatient setting. Here, we present our institutional experience with A/S by age and gender in children receiving daily proton RT. After Institutional Review Board approval, we reviewed our center’s records between 9/9/2004 and 6/30/2013 with respect to age and gender of A/S requirement in our pediatric patients (defined as patients ≤18 years of age). Of 390 patients treated in this era, 182 were girls. Children aged ≤3 invariably required A/S; and by age 7–8, approximately half of patients do not. For pediatric patients ≥ 12 years of age, approximately 10% may require A/S for different reasons. There was no difference by gender. Beyond age 3, the requirement for A/S decreases in an age-dependent fashion, with a small cadre of older children having difficulty enough with sustained immobilization that A/S is necessary. In our experience, there is no difference in A/S requirement by gender

  12. 25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and...

  13. The Impact of an Intervention to Improve Malaria Care in Public Health Centers on Health Indicators of Children in Tororo, Uganda (PRIME): A Cluster-Randomized Trial.

    Science.gov (United States)

    Staedke, Sarah G; Maiteki-Sebuguzi, Catherine; DiLiberto, Deborah D; Webb, Emily L; Mugenyi, Levi; Mbabazi, Edith; Gonahasa, Samuel; Kigozi, Simon P; Willey, Barbara A; Dorsey, Grant; Kamya, Moses R; Chandler, Clare I R

    2016-08-01

    Optimizing quality of care for malaria and other febrile illnesses is a complex challenge of major public health importance. To evaluate the impact of an intervention aiming to improve malaria case management on the health of community children, a cluster-randomized trial was conducted from 2010-2013 in Tororo, Uganda, where malaria transmission is high. Twenty public health centers were included; 10 were randomized in a 1:1 ratio to intervention or control. Households within 2 km of health centers provided the sampling frame for the evaluation. The PRIME intervention included training in fever case management using malaria rapid diagnostic tests (mRDTs), patient-centered services, and health center management; plus provision of mRDTs and artemether-lumefantrine. Cross-sectional community surveys were conducted at baseline and endline (N = 8,766), and a cohort of children was followed for approximately 18 months (N = 992). The primary outcome was prevalence of anemia (hemoglobin < 11.0 g/dL) in children under 5 years of age in the final community survey. The intervention was delivered successfully; however, no differences in prevalence of anemia or parasitemia were observed between the study arms in the final community survey or the cohort. In the final survey, prevalence of anemia in children under 5 years of age was 62.5% in the intervention versus 63.1% in control (adjusted risk ratio = 1.01; 95% confidence interval = 0.91-1.13; P = 0.82). The PRIME intervention, focusing on training and commodities, did not produce the expected health benefits in community children in Tororo. This challenges common assumptions that improving quality of care and access to malaria diagnostics will yield health gains. PMID:27273646

  14. Incidence of malaria and efficacy of combination antimalarial therapies over 4 years in an urban cohort of Ugandan children.

    Directory of Open Access Journals (Sweden)

    Tamara D Clark

    Full Text Available BACKGROUND: Combination therapies are now recommended to treat uncomplicated malaria. We used a longitudinal design to assess the incidence of malaria and compare the efficacies of 3 combination regimens in Kampala, Uganda. METHODOLOGY/PRINCIPAL FINDINGS: Children aged 1-10 years were enrolled from randomly selected households in 2004-05 and 2007, and were followed at least monthly through 2008. Insecticide-treated bednets (ITNs were provided in 2006. Children were randomized upon their first episode, and then treated for all episodes of uncomplicated malaria with amodiaquine/sulfadoxine-pyrimethamine (AQ/SP, artesunate/amodiaquine (AS/AQ, or artemether/lumefantrine (AL. Risks of parasitological failure were determined for each episode of uncomplicated malaria and clinical parameters were followed. A total of 690 children experienced 1464 episodes of malaria. 96% of these episodes were uncomplicated malaria and treated with study drugs; 94% were due to Plasmodium falciparum. The rank order of treatment efficacy was AL > AS/AQ > AQ/SP. Failure rates increased over time for AQ/SP, but not the artemisinin-based regimens. Over the 4-year course of the study the prevalence of asymptomatic parasitemia decreased from 11.8% to 1.4%, the incidence of malaria decreased from 1.55 to 0.32 per person year, and the prevalence of anemia (hemoglobin <10 gm/dL decreased from 5.9% to 1.0%. No episodes of severe malaria (based on WHO criteria and no deaths were seen. CONCLUSIONS/SIGNIFICANCE: With ready access to combination therapies and distribution of ITNs, responses were excellent for artemisinin-containing regimens, severe malaria was not seen, and the incidence of malaria and prevalence of parasitemia and anemia decreased steadily over time. TRIAL REGISTRATION: isrctn.org ISRCTN37517549.

  15. Treatment guided by rapid diagnostic tests for malaria in Tanzanian children: safety and alternative bacterial diagnoses

    Directory of Open Access Journals (Sweden)

    Sykes Alma

    2011-10-01

    Full Text Available Abstract Background WHO guidelines for the treatment of young children with suspected malaria have recently changed from presumptive treatment to anti-malarial treatment guided by a blood slide or malaria rapid diagnostic test (RDT. However, there is limited evidence of the safety of this policy in routine outpatient settings in Africa. Methods Children 3-59 months of age with a non-severe febrile illness and no obvious cause were enrolled over a period of one year in a malaria endemic area of Tanzania. Treatment was determined by the results of a clinical examination and RDT result, and blood culture and serum lactate were also collected. RDT-negative children were followed up over 14 days. Results Over the course of one year, 965 children were enrolled; 158 (16.4% were RDT-positive and treated with artemether-lumefantrine and 807 (83.4% were RDT-negative and treated with non-anti-malarial medicines. Compared with RDT-positives, RDT-negative children were on average younger with a lower axillary temperature and more likely to have a history of cough or difficulty in breathing. Six (0.6% children became RDT-positive after enrolment, all of whom were PCR-negative for Plasmodium falciparum DNA at enrolment. In addition, 12 (1.2% children were admitted to hospital, one with possible malaria, none of whom died. A bacterial pathogen was identified in 9/965 (0.9% children, eight of whom were RDT-negative and one was RDT-positive, but slide-negative. Excluding three children with Salmonella typhi, all of the children with bacteraemia were ≤12 months of age. Compared to double-read research slide results RDTs had a sensitivity of 97.8% (95%CI 96.9-98.7 and specificity of 96.3% (95%CI 96.3-98.4. Conclusions Use of RDTs to direct the use of anti-malarial drugs in young children did not result in any missed diagnoses of malaria although new infections soon after a consultation with a negative RDT result may undermine confidence in results. Invasive

  16. Brief Report: Adherence to Fluid Recommendations in Children Receiving Treatment for Retentive Encopresis

    OpenAIRE

    Kuhl, Elizabeth S.; Felt, Barbara T.; Patton, Susana R

    2009-01-01

    Objective Limited data are available regarding whether children being treated for retentive encopresis are adherent to recommendations to increase their daily fluid intake. The purpose of this study was to examine fluid adherence in children who received treatment for retentive encopresis. Methods A retrospective chart review was performed using diet diary data for 26 children (ages 3–12) who completed a group behavioral intervention for retentive encopresis. Results Mean daily intake of clea...

  17. The majority of sick children receive paracetamol during the winter

    DEFF Research Database (Denmark)

    Ertmann, Ruth Kirk; Møller, Janne Julie; Waldorff, Frans Boch;

    2012-01-01

    INTRODUCTION: Even though fever is a common symptom in childhood, it often worries parents and they may try to reduce discomfort by giving the child paracetamol, which is currently the most commonly sold over-the-counter medicine. The objective of this study was to investigate parent-administered......INTRODUCTION: Even though fever is a common symptom in childhood, it often worries parents and they may try to reduce discomfort by giving the child paracetamol, which is currently the most commonly sold over-the-counter medicine. The objective of this study was to investigate parent......-administered paracetamol in toddlers during a winter-period in relation to symptoms, doctor contacts and severity-rated illness. MATERIAL AND METHODS: The study was conducted as a prospective diary study covering a three-month winter-period. It comprised a cohort of 183 infants born in February 2001 in a district of the...... capital area in Denmark. RESULTS: According to the parents, a total of 119 toddlers (65%) received paracetamol at least once during the study period; 9.3% of the toddlers received paracetamol for more than ten days. The administration of paracetamol rose as the number of symptoms increased. Paracetamol...

  18. 42 CFR 435.110 - Individuals receiving aid to families with dependent children.

    Science.gov (United States)

    2010-10-01

    ... essential to the well-being of a recipient (see 45 CFR 233.20(a)(2)(vi)) and who could be a recipient under... with dependent children. (a) A Medicaid agency must provide Medicaid to individuals receiving AFDC. (b) For purposes of this section, an individual is receiving AFDC if his needs are included in...

  19. Prescribing practice for malaria following introduction of artemether-lumefantrine in an urban area with declining endemicity in West Africa

    OpenAIRE

    Conway David J; Schellenberg David; Drammeh Silaba; Bojang Kawsu; Walther Brigitte; Okebe Joseph U; Walther Michael

    2010-01-01

    Abstract Background The decline in malaria coinciding with the introduction of newer, costly anti-malarials has prompted studies into the overtreatment for malaria mostly in East Africa. The study presented here describes prescribing practices for malaria at health facilities in a West African country. Methods Cross-sectional surveys were carried out in two urban Gambian primary health facilities (PHFs) during and outside the malaria transmission season. Facilities were comparable in terms of...

  20. Artesunate-Amodiaquine and Artemether-Lumefantrine Therapies and Selection of Pfcrt and Pfmdr1 Alleles in Nanoro, Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Paul Sondo

    Full Text Available The adoption of Artemisinin based combination therapies (ACT constitutes a basic strategy for malaria control in sub-Saharan Africa. Moreover, since cases of ACT resistance have been reported in South-East Asia, the need to understand P. falciparum resistance mechanism to ACT has become a global research goal. The selective pressure of ACT and the possibility that some specific Pfcrt and Pfmdr1 alleles are associated with treatment failures was assessed in a clinical trial comparing ASAQ to AL in Nanoro. Dried blood spots collected on Day 0 and on the day of recurrent parasitaemia during the 28-day follow-up were analyzed using the restriction fragments length polymorphism (PCR-RFLP method to detect single nucleotide polymorphisms (SNPs in Pfcrt (codon76 and Pfmdr1 (codons 86, 184, 1034, 1042, and 1246 genes. Multivariate analysis of the relationship between the presence of Pfcrt and Pfmdr1 alleles and treatment outcome was performed. AL and ASAQ exerted opposite trends in selecting Pfcrt K76T and Pfmdr1-N86Y alleles, raising the potential beneficial effect of using diverse ACT at the same time as first line treatments to reduce the selective pressure by each treatment regimen. No clear association between the presence of Pfcrt and Pfmdr1 alleles carried at baseline and treatment failure was observed.

  1. Prospective evaluation of artemether-lumefantrine for the treatment of non-falciparum and mixed-species malaria in Gabon

    OpenAIRE

    Mombo-Ngoma Ghyslain; Kleine Christian; Basra Arti; Würbel Heike; Diop Daisy A; Capan Mesküre; Adegnika Ayola A; Kurth Florian; Mordmüller Benjamin; Joanny Fanny; Kremsner Peter G; Ramharter Michael; Bélard Sabine

    2012-01-01

    Abstract Background The recommendation of artemisinin combination therapy (ACT) as first-line treatment for uncomplicated falciparum malaria is supported by a plethora of high quality clinical trials. However, their recommendation for the treatment of mixed-species malaria and the large-scale use for the treatment of non-falciparum malaria in endemic regions is based on anecdotal rather than systematic clinical evidence. Methods This study prospectively observed the efficacy of artemether-lum...

  2. Artesunate-Amodiaquine and Artemether-Lumefantrine Therapies and Selection of Pfcrt and Pfmdr1 Alleles in Nanoro, Burkina Faso.

    Science.gov (United States)

    Sondo, Paul; Derra, Karim; Diallo Nakanabo, Seydou; Tarnagda, Zekiba; Kazienga, Adama; Zampa, Odile; Valéa, Innocent; Sorgho, Hermann; Owusu-Dabo, Ellis; Ouédraogo, Jean-Bosco; Guiguemdé, Tinga Robert; Tinto, Halidou

    2016-01-01

    The adoption of Artemisinin based combination therapies (ACT) constitutes a basic strategy for malaria control in sub-Saharan Africa. Moreover, since cases of ACT resistance have been reported in South-East Asia, the need to understand P. falciparum resistance mechanism to ACT has become a global research goal. The selective pressure of ACT and the possibility that some specific Pfcrt and Pfmdr1 alleles are associated with treatment failures was assessed in a clinical trial comparing ASAQ to AL in Nanoro. Dried blood spots collected on Day 0 and on the day of recurrent parasitaemia during the 28-day follow-up were analyzed using the restriction fragments length polymorphism (PCR-RFLP) method to detect single nucleotide polymorphisms (SNPs) in Pfcrt (codon76) and Pfmdr1 (codons 86, 184, 1034, 1042, and 1246) genes. Multivariate analysis of the relationship between the presence of Pfcrt and Pfmdr1 alleles and treatment outcome was performed. AL and ASAQ exerted opposite trends in selecting Pfcrt K76T and Pfmdr1-N86Y alleles, raising the potential beneficial effect of using diverse ACT at the same time as first line treatments to reduce the selective pressure by each treatment regimen. No clear association between the presence of Pfcrt and Pfmdr1 alleles carried at baseline and treatment failure was observed. PMID:27031231

  3. Artemether-Lumefantrine Concentrations in Tablets and Powders from Ghana Measured by a New High-Performance Liquid Chromatography Method.

    Science.gov (United States)

    Debrah, Philip; Nettey, Henry; Miltersen, Katja Kjeldgaard; Ayeh-Kumi, Patrick; Brock, Birgitte; Sarkodie, Joseph Adusei; Akwo-Kretchy, Irene; Owusu-Danso, Patrick; Adjei, Samuel; Petersen, Eskild; Hardlei, Tore Forsingdal

    2016-07-01

    We developed and validated a new analytical method for the simultaneous quantification of artemether and lumefantrine in fixed-dose tablets and powders for reconstitution into pediatric suspensions (PSs). The method showed linearity (r(2) > 0.9947), precision (coefficient of variation 99%). The validated method was used to analyze 24 batches of fixed-dose tablets and PSs of artemether and lumefantrine. Of the samples, 23 were obtained using convenience sampling of commonly available brands within Accra in Ghana and one was obtained from Aarhus University Hospital. In all, 83.3% (confidence interval: 80-120%) passed for both artemether and lumefantrine contents, 16.7% failed by the U.S. Pharmacopoeia standards, 8.3% failed for one content, and 8.3% failed for both contents. All four products (16.7%) that failed were PSs, and two (8.3%) showed higher levels of artemether than prescribed (222% and 756%). PMID:27139437

  4. Impact of intermittent screening and treatment for malaria among school children in Kenya: a cluster randomised trial.

    Directory of Open Access Journals (Sweden)

    Katherine E Halliday

    2014-01-01

    Full Text Available BACKGROUND: Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement. However, there is limited experimental evidence of the benefits of alternative school-based malaria interventions or how the impacts of interventions vary according to intensity of malaria transmission. We investigated the effect of intermittent screening and treatment (IST for malaria on the health and education of school children in an area of low to moderate malaria transmission. METHODS AND FINDINGS: A cluster randomised trial was implemented with 5,233 children in 101 government primary schools on the south coast of Kenya in 2010-2012. The intervention was delivered to children randomly selected from classes 1 and 5 who were followed up for 24 months. Once a school term, children were screened by public health workers using malaria rapid diagnostic tests (RDTs, and children (with or without malaria symptoms found to be RDT-positive were treated with a six dose regimen of artemether-lumefantrine (AL. Given the nature of the intervention, the trial was not blinded. The primary outcomes were anaemia and sustained attention. Secondary outcomes were malaria parasitaemia and educational achievement. Data were analysed on an intention-to-treat basis. During the intervention period, an average of 88.3% children in intervention schools were screened at each round, of whom 17.5% were RDT-positive. 80.3% of children in the control and 80.2% in the intervention group were followed-up at 24 months. No impact of the malaria IST intervention was observed for prevalence of anaemia at either 12 or 24 months (adjusted risk ratio [Adj.RR]: 1.03, 95% CI 0.93-1.13, p = 0.621 and Adj.RR: 1.00, 95% CI 0.90-1.11, p = 0.953 respectively, or on prevalence of P. falciparum infection or scores of classroom attention. No effect of IST was observed on educational achievement in the older class, but an apparent negative

  5. Study of the factors associated with dental caries in children who receive early dental care

    OpenAIRE

    FRAIZ Fabian Calixto; Luiz Reynaldo de Figueiredo WALTER

    2001-01-01

    The present study investigated the factors associated with the development of dental caries in preschool children who receive regular dental care and follow-up. The research was carried out at the Baby Clinic, Londrina State University, and comprised two hundred preschool children, whose ages ranged from 24 to 48 months, as well as their mothers, who had already taken part in a dental program at the Baby Clinic during, at least, the previous twelve months. Regarding oral hygiene habits, there...

  6. Caregiver Participation in Community-based Mental Health Services for Children Receiving Outpatient Care

    OpenAIRE

    Fawley-King, Kya; Haine-Schlagel, Rachel; Trask, Emily V.; Zhang, Jinjin; Garland, Ann F

    2013-01-01

    Caregiver participation in child mental health treatment has been associated with better youth outcomes, but little is known about the amount and type of caregiver participation in usual care services for children. This study examined 1255 caregivers’ reports of their participation in the outpatient services their children received through a large, public mental health system in the Southwest. The majority of the caregivers reported that they participated in their child's services. Extent of ...

  7. The effect of chewing gum on oral mucositis in children receiving chemotherapy

    OpenAIRE

    Ocakcı, Ayşe Ferda; Ayverdi, Didem; Ekim, Ayfer

    2014-01-01

    Abstract Background: Oral mucositis is an important clinical problem, resulting in significant patient morbidity, a change in health-related quality of life, and supportive care. The purpose of this study was to assess the efficiency of chewing gum on children, who are receiving chemotherapy regimens, for prevention and treatment of oral mucositis. Method and Material: The study sample consisted of 60 children (30 study group-30 control group) between the ages 6-...

  8. A Comparison of Concept Development and Human Figure Drawings of Children Who Receive Preschool Education vs Those Who Do Not

    Science.gov (United States)

    Balat, Gulden Uyanik

    2010-01-01

    This study evaluated from a developmental point of view the basic concept knowledge and human figure drawings of children who did and did not attend preschool. A total of 118 children who received preschool education and 147 children who did not do so participated in the study. The mean age of children was 75.4 months. Their concept knowledge was…

  9. Impact of effective nursing interventions to the fatigue syndrome in children who receive chemotherapy.

    Science.gov (United States)

    Ekti Genc, Rabia; Conk, Zeynep

    2008-01-01

    This experimental, randomized controlled study was conducted for children with cancer who are 7 to 12 years of age and receiving chemotherapy treatment to detect the impact of appropriate nursing interventions on decreasing the fatigue syndrome. The research sample is composed of a total of 60 children with cancer, with 30 children being included in the experimental group and 30 children included in the control group with their mothers. In the experimental group, after the 7th to 10th day of the chemotherapy treatment, throughout a week, the researcher conducted the effective nursing interventions every day for 45 to 60 minutes. In the control group, routine nursing interventions were carried out. The experimental and control group children's mean scores for the Fatigue Scale-Child and those of mothers for Fatigue Scale-Parent were compared. A statistically significant difference was found between the Fatigue Scale-Child and Fatigue Scale-Parent mean scores of the experimental and the control group children (P < .00). These results suggest that fatigue of children with cancer can be reduced by implementing appropriate nursing interventions. PMID:18600119

  10. Risk factors for Plasmodium falciparum and Plasmodium vivax gametocyte carriage in Papua New Guinean children with uncomplicated malaria.

    Science.gov (United States)

    Karl, Stephan; Laman, Moses; Moore, Brioni R; Benjamin, John M; Salib, Mary; Lorry, Lina; Maripal, Samuel; Siba, Peter; Robinson, Leanne J; Mueller, Ivo; Davis, Timothy M E

    2016-08-01

    There are limited data on gametocytaemia risk factors before/after treatment with artemisinin combination therapy in children from areas with transmission of multiple Plasmodium species. We utilised data from a randomised trial comparing artemether-lumefantrine (AL) and artemisinin-naphthoquine (AN) in 230 Papua New Guinean children aged 0.5-5 years with uncomplicated malaria in whom determinants of gametocytaemia by light microscopy were assessed at baseline using logistic regression and during follow-up using multilevel mixed effects modelling. Seventy-four (32%) and 18 (8%) children presented with P. falciparum and P. vivax gametocytaemia, respectively. Baseline P. falciparum gametocytaemia was associated with Hackett spleen grade 1 (odds ratio (95% CI) 4.01 (1.60-10.05) vs grade 0; P<0.001) and haemoglobin (0.95 (0.92-0.97) per 1g/L increase; P<0.001), and P. falciparum asexual parasitaemia in slide-positive cases (0.36 (0.19-0.68) for a 10-fold increase; P=0.002). Baseline P. vivax gametocytaemia was associated with Hackett grade 2 (12.66 (1.31-122.56); P=0.028), mixed P. falciparum/vivax infection (0.16 (0.03-1.00); P=0.050), P. vivax asexual parasitaemia (5.68 (0.98-33.04); P=0.053) and haemoglobin (0.94 (0.88-1.00); P=0.056). For post-treatment P. falciparum gametocytaemia, independent predictors were AN vs AL treatment (4.09 (1.43-11.65)), haemoglobin (0.95 (0.93-0.97)), presence/absence of P. falciparum asexual forms (3.40 (1.66-0.68)) and day post-treatment (0.086 (0.82-0.90)) (P<0.001). Post-treatment P. vivax gametocytaemia was predicted by presence of P. vivax asexual forms (596 (12-28,433); P<0.001). Consistent with slow P. falciparum gametocyte maturation, low haemoglobin, low asexual parasite density and higher spleen grading, markers of increased prior infection exposure/immunity, were strong associates of pre-treatment gametocyte positivity. The persistent inverse association between P. falciparum gametocytaemia and haemoglobin during follow

  11. Impact of combining intermittent preventive treatment with home management of malaria in children less than 10 years in a rural area of Senegal: a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Tine Roger CK

    2011-12-01

    Full Text Available Abstract Background Current malaria control strategies recommend (i early case detection using rapid diagnostic tests (RDT and treatment with artemisinin combination therapy (ACT, (ii pre-referral rectal artesunate, (iii intermittent preventive treatment and (iv impregnated bed nets. However, these individual malaria control interventions provide only partial protection in most epidemiological situations. Therefore, there is a need to investigate the potential benefits of integrating several malaria interventions to reduce malaria prevalence and morbidity. Methods A randomized controlled trial was carried out to assess the impact of combining seasonal intermittent preventive treatment in children (IPTc with home-based management of malaria (HMM by community health workers (CHWs in Senegal. Eight CHWs in eight villages covered by the Bonconto health post, (South Eastern part of Senegal were trained to diagnose malaria using RDT, provide prompt treatment with artemether-lumefantrine for uncomplicated malaria cases and pre-referral rectal artesunate for complicated malaria occurring in children under 10 years. Four CHWs were randomized to also administer monthly IPTc as single dose of sulphadoxine-pyrimethamine (SP plus three doses of amodiaquine (AQ in the malaria transmission season, October and November 2010. Primary end point was incidence of single episode of malaria attacks over 8 weeks of follow up. Secondary end points included prevalence of malaria parasitaemia, and prevalence of anaemia at the end of the transmission season. Primary analysis was by intention to treat. The study protocol was approved by the Senegalese National Ethical Committee (approval 0027/MSP/DS/CNRS, 18/03/2010. Results A total of 1,000 children were enrolled. The incidence of malaria episodes was 7.1/100 child months at risk [95% CI (3.7-13.7] in communities with IPTc + HMM compared to 35.6/100 child months at risk [95% CI (26.7-47.4] in communities with only HMM (a

  12. Transient occult cardiotoxicity in children receiving continuous beta-agonist therapy

    Institute of Scientific and Technical Information of China (English)

    Christopher L Carroll; Melinda Coro; Allison Cowl; Kathleen A Sala; Craig M Schramm

    2014-01-01

    Background: Continuous beta-agonist therapy, typically in the form of inhaled albuterol, is the first line therapy for the treatment of acute and severe bronchospasm in children. Although this treatment is commonly used, concerns about cardiotoxicity have been raised. We aimed to investigate the cardiotoxic effects of continuous beta-agonist therapy in children. Methods: We conducted a retrospective review of children admitted to the intensive care unit (ICU) between May 2008 and April 2009, who were treated with continuous beta-agonist therapy (intravenous and nebulized). Results: Twenty of the 36 children treated with continuous albuterol had repeated serum troponin-T and lactate levels measured. Eleven patients (55%) were also treated with continuous intravenous terbutaline. Elevated levels of troponin-T levels were found in 25% of children, and elevated lactate levels were found in 60%. However, all returned to normal levels within 48 hours of ICU admission, despite continued beta-agonist therapy. No children experienced arrhythmias during therapy. There was no association between intravenous terbutaline use and elevated troponin-T [odds ratio (OR), 1.3; 95% CI, 0.2-10.3] or with elevated serum lactate (OR, 0.6; 95% CI, 0.1-3.7). There was also no association between elevated troponin-T or lactate and ICU or hospital length of stay. Conclusions: In this small study, a significant proportion of children had elevated serum troponin-T and lactate levels while receiving inhaled continuous beta-agonist therapy, irrespective of intravenous therapy. However, these abnormal values all returned to normal within 48 hours of ICU admission and were not associated with increased duration of hospitalization.

  13. Reducing the Digital Divide among Children Who Received Desktop or Hybrid Computers for the Home

    Directory of Open Access Journals (Sweden)

    Gila Cohen Zilka

    2016-06-01

    Full Text Available Researchers and policy makers have been exploring ways to reduce the digital divide. Parameters commonly used to examine the digital divide worldwide, as well as in this study, are: (a the digital divide in the accessibility and mobility of the ICT infrastructure and of the content infrastructure (e.g., sites used in school; and (b the digital divide in literacy skills. In the present study we examined the degree of effectiveness of receiving a desktop or hybrid computer for the home in reducing the digital divide among children of low socio-economic status aged 8-12 from various localities across Israel. The sample consisted of 1,248 respondents assessed in two measurements. As part of the mixed-method study, 128 children were also interviewed. Findings indicate that after the children received desktop or hybrid computers, changes occurred in their frequency of access, mobility, and computer literacy. Differences were found between the groups: hybrid computers reduce disparities and promote work with the computer and surfing the Internet more than do desktop computers. Narrowing the digital divide for this age group has many implications for the acquisition of skills and study habits, and consequently, for the realization of individual potential. The children spoke about self improvement as a result of exposure to the digital environment, about a sense of empowerment and of improvement in their advantage in the social fabric. Many children expressed a desire to continue their education and expand their knowledge of computer applications, the use of software, of games, and more. Therefore, if there is no computer in the home and it is necessary to decide between a desktop and a hybrid computer, a hybrid computer is preferable.

  14. Prevalence of molecular markers of Plasmodium falciparum drug resistance in Dakar, Senegal.

    OpenAIRE

    Wurtz Nathalie; Fall Bécaye; Pascual Aurélie; Diawara Silmane; Sow Kowry; Baret Eric; Diatta Bakary; Fall Khadidiatou B; Mbaye Pape S; Fall Fatou; Diémé Yaya; Rogier Christophe; Bercion Raymond; Briolant Sébastien; Wade Boubacar

    2012-01-01

    Abstract Background As a result of the widespread resistance to chloroquine and sulphadoxine-pyrimethamine, artemisinin-based combination therapy (ACT) (including artemether-lumefantrine and artesunate-amodiaquine) has been recommended as a first-line anti-malarial regimen in Senegal since 2006. Intermittent preventive treatments with anti-malarial drugs based on sulphadoxine-pyrimethamine are also given to children or pregnant women once per month during the transmission season. Since 2006, ...

  15. The challenge to avoid anti-malarial medicine stock-outs in an era of funding partners: the case of Tanzania

    OpenAIRE

    Mikkelsen-Lopez, Inez; Shango, Winna; Barrington, Jim; Ziegler, Rene; Smith, Tom; de Savigny, Don

    2014-01-01

    Background Between 2007 and 2013, the Tanzanian public sector received 93.1 million doses of first-line anti-malarial artemisinin-based combination therapy (ACT) in the form of artemether-lumefantrine entirely supplied by funding partners. The introduction of a health facility ACT stock monitoring system using SMS technology by the National Malaria Control Programme in mid 2011 revealed a high frequency of stock-outs of ACT in primary care public health facilities. The objective of this study...

  16. Linking Employment Status, Maternal Psychological Well-Being, Parenting, and Children's Attributions about Poverty in Families Receiving Government Assistance.

    Science.gov (United States)

    Murry, Velma McBride; Brody, Gene H.; Brown, Anita; Wisenbaker, Joseph; Cutrona, Carolyn E.; Simons, Ronald L.

    2002-01-01

    Using an ecological risk-protection perspective, explores functional changes in single African American mothers (N=96) receiving government assistance. Examines links among maternal employment, mothers' physical and psychological health, and children's attributions about causes of poverty. Maternal psychological distress was linked with children's…

  17. Percentage of Children Aged 5--17 Years Ever Receiving a Diagnosis of Learning Disability, United States, 2007--2009

    Science.gov (United States)

    ... 5--17 Years Ever Receiving a Diagnosis of Learning Disability,* by Race/Ethnicity † and Family Income Group § --- National ... professional ever told you that [child] had a learning disability?" † White and black children are non-Hispanic children ...

  18. Metabolic and Hormonal Changes of Severely Burned Children Receiving Long-Term Oxandrolone Treatment

    Science.gov (United States)

    Przkora, Rene; Jeschke, Marc G.; Barrow, Robert E.; Suman, Oscar E.; Meyer, Walter J.; Finnerty, Celeste C.; Sanford, Arthur P.; Lee, Jong; Chinkes, David L.; Mlcak, Ronald P.; Herndon, David N.

    2005-01-01

    Objective: When given to children for 1 year after a severe burn, oxandrolone significantly improves lean body mass, bone mineral content, and muscle strength. The beneficial effects of oxandrolone on height and weight were observed 1 year after treatment was discontinued. To study the efficacy of oxandrolone in severely burned children for 12 months after burn and 12 months after the drug was discontinued. Summary Background Data: Oxandrolone attenuates body catabolism during the acute phase after burn. It is unclear whether oxandrolone would have any beneficial effects during long-term treatment or if there were any effects after the drug was stopped. Methods: Sixty-one children with 40% total body surface area burns were enrolled in this study. Patients were randomized into those to receive oxandrolone (n = 30) or placebo (n = 31) for the first 12 months. Treatment was discontinued after 12 months, and the patients were studied without the drug for the following 12 months. At discharge and 6, 12, 18, and 24 months after burn, height, weight, body composition, resting energy expenditure, muscle strength, and serum human growth hormone, insulin-like growth factor-I (IGF-1), IGF binding protein-3, insulin, cortisol, parathyroid hormone, tri-iodothyronine uptake (T3 uptake), and free thyroxine index (FTI) were measured. Statistical analysis used Tukey multiple comparison test. Significance was accepted at P < 0.05. Results: Oxandrolone improved lean body mass, bone mineral content and muscle strength compared with controls during treatment, P < 0.05. Serum IGF-1, T3 uptake, and FTI were significantly higher during drug treatment compared with controls, P < 0.05. Significant increases in height and weight with oxandrolone were observed after the end of treatment. Conclusions: Oxandrolone improved body composition and strength in severely burned children during the 12 months of treatment. Its effect on height and weight continued after treatment was discontinued. PMID

  19. Health worker performance in the management of paediatric fevers following in-service training and exposure to job aids in Kenya

    Directory of Open Access Journals (Sweden)

    Bruce Jane

    2010-09-01

    Full Text Available Abstract Background Improving the way artemether-lumefantrine (AL is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. Methods An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. Results At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1 no health facility or health worker was exposed to all components of the intervention; 2 the proportion of health workers who received the enhanced in-service training was 67%; 3 the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL, at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1 to 87.6% (95% CI: 82.5, 91.5; 4 there were modest but non-significant improvements in dispensing and counseling practices; and 5 when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. Conclusion In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and

  20. Thyroid dysfunction and neoplasia in children receiving neck irradiation for cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, I.D.; Black, T.L.; Thompson, E.I.; Pratt, C.; Rao, B.; Hustu, O.

    1985-03-15

    The reported relationship of radiation exposure and thyroid carcinoma stimulated this retrospective study of 298 patients treated at St. Jude Children's Hospital with radiation therapy to the neck for childhood cancer to identify patients who developed subsequent thyroid abnormalities. This series includes 153 patients with Hodgkin's disease, 95 with acute lymphocytic leukemia, 28 with lymphoepithelioma, and 22 with miscellaneous tumors. Inclusion in the study required 5 years of disease-free survival following therapy for their original tumor, which included thyroid irradiation. Follow-up has been 100%. Most patients also received chemotherapy. Seventeen patients were found to have decreased thyroid reserve with normal levels of free triiodothyroxine (T3) or free thyroxin, (T4) and an elevated level of thyroid-stimulating hormone (TSH). In nine patients hypothyroidism developed, with decreased T3 or T4 levels and an elevated level of TSH. One hyperthyroid patient was identified. Two patients had thyroiditis, and seven had thyroid neoplasms: (carcinoma in two, adenoma in two, colloid nodule in one, and undiagnosed nodules in two). This survey has demonstrated an increased incidence of thyroid dysfunction and thyroid neoplasia when compared to the general population. The importance of long-term follow-up for thyroid disease is emphasized in patients who have received thyroid irradiation. The possible role of subclinical hypothyroidism with TSH elevation coupled with radiation damage to the thyroid gland as a model for the development of neoplastic disease is discussed.

  1. Prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results

    International Nuclear Information System (INIS)

    As survival rates have risen for children with malignant primary brain tumors, so has the concern that many survivors have significant permanent cognitive deficits. Cranial irradiation (CRT) has been implicated as the major cause for cognitive dysfunction. To clarify the etiology, incidence, and severity of intellectual compromise in children with brain tumors after CRT, a prospective study was undertaken comparing the neuropsychological outcome in 18 consecutive children with malignant brain tumors treated with CRT to outcome in 14 children harboring brain tumors in similar sites in the nervous system who had not received CRT. Children with cortical or subcortical brain tumors were not eligible for study. Neuropsychological testing was performed after surgery prior to radiotherapy, after radiotherapy, and at 1- and 2-year intervals thereafter. Children who had received CRT had a mean full-scale intelligence quotient (FSIQ) of 105 at diagnosis which fell to 91 by Year 2. Similar declines were noted in their performance intelligence quotient (IQ) and verbal IQ. After CRT, patients demonstrated a statistically significant decline from baseline in FSIQ (p less than 0.02) and verbal IQ (p less than 0.04). Children who had not received CRT did not demonstrate a fall in any cognitive parameter over time. The decline between baseline testing and testing performed at Year 2 in patients who had CRT was inversely correlated with age (p less than 0.02), as younger children demonstrated the greatest loss of intelligence. Children less than 7 years of age at diagnosis had a mean decline in FSIQ of 25 points 2 years posttreatment. No other clinical parameter correlated with the overall IQ or decline in IQ. After CRT, children demonstrated a wide range of dysfunction including deficits in fine motor, visual-motor, and visual-spatial skills and memory difficulties

  2. Assessment of the efficacy of first-line antimalarial drugs after 5 years of deployment by the National Malaria Control Programme in Côte d'Ivoire

    Directory of Open Access Journals (Sweden)

    Offianan AT

    2011-11-01

    Full Text Available Andre T Offianan1, Serge B Assi2, Aristide MA Coulibaly1, Landry T N'guessan1, Aristide A Ako1, Florence K Kadjo2, Moïse K San2, Louis K Penali2 1Malariology Department, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire; 2National Malaria Control Programme, Abidjan, Côte d'Ivoire Background: The emergence of artemisinin resistance has raised concerns that the most potent antimalarial drug may be under threat. Artesunate + amodiaquine (ASAQ and artemether-lumefantrine (AL are respectively the first- and second-line treatments for uncomplicated falciparum malaria in Côte d'Ivoire. A comparison of the efficacy and safety of these two drug combinations was necessary to make evidence-based drug treatment policies. Methods: In an open-label, non inferiority, randomized, controlled clinical trial, children aged 6–59 months were randomized to receive ASAQ or AL. Both drug regimens were given for 3 days, and follow-up was for 28 days. The primary endpoint was the 28-day cure rates and was defined as proportion of patients with polymerase chain reaction (PCR-corrected cure rate after 28 days of follow-up. Findings: A total of 251 patients who were attending the Ayame and Dabakala hospitals and presenting with symptomatic acute uncomplicated falciparum malaria were randomized to receive ASAQ (128 and AL (123. The intention-to-treat analysis showed effectiveness rates of 94.5% and 93.5% for ASAQ and AL, respectively on day 28. After adjustment for PCR results, these rates were 96.1% and 96.8%, respectively. On day 28, the per-protocol analysis showed effectiveness rates of 98.4% and 96.6% for ASAQ and AL, respectively. After adjustment by PCR for reinfection, these rates were 100% for each drug, and both regimens were well tolerated. Conclusion: ASAQ and AL remain efficacious treatments of uncomplicated falciparum malaria in Ivorian children 5 years after adoption. The efficacy of ASAQ and AL in Côte d'Ivoire requires, therefore, continuous

  3. The Importance of Efficacy: Using the Extended Parallel Process Model to Examine Factors Related to Preschool-Age Children Enrolled in Medicaid Receiving Preventive Dental Visits

    Science.gov (United States)

    Askelson, Natoshia M.; Chi, Donald L.; Momany, Elizabeth T.; Kuthy, Raymond A.; Carter, Knute D.; Field, Kathryn; Damiano, Peter C.

    2015-01-01

    Early preventive dental visits are vital to the oral health of children. Yet many children, especially preschool-age children enrolled in Medicaid, do not receive early visits. This study attempts to uncover factors that can be used to encourage parents to seek preventive dental care for preschool-age children enrolled in Medicaid. The extended…

  4. 7 CFR 245.8 - Nondiscrimination practices for children eligible to receive free and reduced price meals and...

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Nondiscrimination practices for children eligible to receive free and reduced price meals and free milk. 245.8 Section 245.8 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS DETERMINING ELIGIBILITY...

  5. Increasing Daily Water Intake and Fluid Adherence in Children Receiving Treatment for Retentive Encopresis

    OpenAIRE

    Kuhl, Elizabeth S.; Hoodin, Flora; Rice, Jennifer; Felt, Barbara T.; Rausch, Joseph R.; Patton, Susana R

    2010-01-01

    Objective To examine the efficacy of an enhanced intervention (EI) compared to standard care (SC) in increasing daily water intake and fluid goal adherence in children seeking treatment for retentive encopresis. Methods Changes in beverage intake patterns and fluid adherence were examined by comparing 7-week diet diary data collected during participation in the EI to achieved data for families who had previously completed the SC. Results Compared to children in SC (n = 19), children in the EI...

  6. Comparison of Environmental Attitudes and Experiences of Five-Year-Old Children Receiving Preschool Education in the Village and City Centre

    Science.gov (United States)

    Durkan, Nazmi; Güngör, Hande; Fetihi, Leyla; Erol, Ahmet; Gülay Ogelman, Hülya

    2016-01-01

    The purpose of the study is to compare environmental attitudes and experiences of five-year-old children receiving preschool education in the village and city centre. The first group comprised 54 five-year-old children who received preschool education and attended kindergartens of two primary schools in the Karateke and Kocabas villages of Honaz…

  7. Accuracy of Knowledge of Child Development in Mothers of Children Receiving Early Intervention Services

    Science.gov (United States)

    Zand, Debra H.; Pierce, Katherine J.; Bultas, Margaret W.; McMillin, Stephen Edward; Gott, Rolanda Maxim; Wilmott, Jennifer

    2015-01-01

    Parents' involvement in early intervention (EI) services fosters positive developmental trajectories in young children. Although EI research on parenting skills has been abundant, fewer data are available on parents' knowledge of normative child development. Sixty-seven mothers of children participating in a Midwestern city's EI program completed…

  8. Outcome for Children Receiving the Early Start Denver Model before and after 48 Months

    Science.gov (United States)

    Vivanti, Giacomo; Dissanayake, Cheryl

    2016-01-01

    The Early Start Denver Model (ESDM) is an intervention program recommended for pre-schoolers with autism ages 12-48 months. The rationale for this recommendation is the potential for intervention to affect developmental trajectories during early sensitive periods. We investigated outcomes of 32 children aged 18-48 months and 28 children aged…

  9. Asking, Giving, Receiving: Friendship as Survival Strategy among Accra's Street Children

    Science.gov (United States)

    Mizen, Phillip; Ofosu-Kusi, Yaw

    2010-01-01

    This article considers friendship among street children in Accra. Drawing upon the findings of a three-year qualitative research project, the article argues that friendship is a neglected element of research yet cooperation, mutuality and exchange between friends are essential to street children's survival. Living within the extremities of the…

  10. Dyslipidemia in a Cohort of HIV-infected Latin American Children Receiving Highly Active Antiretroviral Therapy*

    OpenAIRE

    Brewinski, Margaret; Megazzini, Karen; Freimanis Hance, Laura; Cruz, Miguel Cashat; Pavia-Ruz, Noris; Della Negra, Marinella; Ferreira, Flavia Gomes Faleiro; Marques, Heloisa; Hazra, Rohan

    2010-01-01

    In order to describe the prevalence of hypercholesterolemia and hypertriglyceridemia in a cohort of HIV-infected children and adolescents in Latin America and to determine associations with highly active antiretroviral therapy (HAART), we performed this cross-sectional analysis within the NICHD International Site Development Initiative pediatric cohort study. Eligible children had to be at least 2 years of age and be on HAART. Among the 477 eligible HIV-infected youth, 98 (20.5%) had hypercho...

  11. Carnitine levels and cardiac functions in children with solid malignancies receiving doxorubicin therapy

    OpenAIRE

    Anant Khositseth; Suwadee Jirasakpisarn; Samart Pakakasama; Lulin Choubtuym; Duangrurdee Wattanasirichaigoon

    2011-01-01

    Aim: Previous studies demonstrated l-carnitine decreasing doxorubicin-induced cardiotoxicity. Our objectives were to study carnitine levels and cardiac functions in children treated with doxorubicin and the effect of short-term l-carnitine supplements. Materials and Methods: Serial carnitine levels and cardiac functions were obtained in children with newly diagnosed solid malignancies before doxorubicin, after cumulative doses of ≥150 mg/m 2 and ≥300 mg/m 2 , respectively. Oral l-carnitine 10...

  12. Survival and secondary tumors in children with medulloblastoma receiving radiotherapy and adjuvant chemotherapy: results of Children's Oncology Group trial A9961

    OpenAIRE

    PACKER, ROGER J.; Zhou, Tianni; Holmes, Emi; Vezina, Gilbert; Gajjar, Amar

    2012-01-01

    The purpose of the trial was to determine the survival and incidence of secondary tumors in children with medulloblastoma receiving radiotherapy plus chemotherapy. Three hundred seventy-nine eligible patients with nondisseminated medulloblastoma between the ages of 3 and 21 years were treated with 2340 cGy of craniospinal and 5580 cGy of posterior fossa irradiation. Patients were randomized between postradiation cisplatin and vincristine plus either CCNU or cyclophosphamide. Survival, pattern...

  13. Which Sexual Abuse Victims Receive a Forensic Medical Examination?: The Impact of Children's Advocacy Centers

    Science.gov (United States)

    Walsh, Wendy A.; Cross, Theodore P.; Jones, Lisa M.; Simone, Monique; Kolko, David J.

    2007-01-01

    Objective: This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. Methods: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of…

  14. Family Perceptions of Participation in Educational Planning for Children Receiving Mental Health Services

    Science.gov (United States)

    Jivanjee, Pauline; Kruzich, Jean M.; Friesen, Barbara J.; Robinson, Adjoa

    2007-01-01

    Family participation in educational planning for children with disabilities is believed to result in plans that are more responsive to the child's needs and that lead to better social, emotional, and educational outcomes. Participation in educational planning is also a fundamental right of parents and a cornerstone of special education…

  15. Effects of ketamine and midazolam on emergence agitation after sevoflurane anaesthesia in children receiving caudal block: a randomized trial

    Directory of Open Access Journals (Sweden)

    Ayse Ozcan

    2014-12-01

    Full Text Available Background and objectives: Emergence agitation is a common postanaesthetic problem in children after sevoflurane anaesthesia. We aimed to compare the effects of ketamine and midazolam administered intravenously, before the end of surgery, for prevention of emergence agitation in children who received caudal block for pain relief under sevoflurane anaesthesia. Methods: 62 American Society of Anesthesiologists patient classification status I children, aged 2–7 years, scheduled for inguinal hernia repair, circumcision or orchidopexy were enrolled to the study. Anaesthesia was induced with sevoflurane 8% in a mixture of 50% oxygen and nitrous oxide. After achieving adequate depth of anaesthesia, a laryngeal mask was placed and then caudal block was performed with 0.75 mL kg−1, 0.25% bupivacaine. At the end of the surgery, ketamine 0.25 mg kg−1, midazolam 0.03 mg kg−1 and saline were given to ketamine, midazolam and control groups, respectively. Agitation was assessed using Paediatric Anaesthesia Emergence Delirium scale and postoperative pain was evaluated with modified Children's Hospital of Eastern Ontario Pain Scale. Results and conclusions: Modified Children's Hospital of Eastern Ontario Pain Scale scores were found higher in control group than in ketamine and midazolam groups. Paediatric Anaesthesia Emergence Delirium scores were similar between groups. Modified Children's Hospital of Eastern Ontario Pain Scale and Paediatric Anaesthesia Emergence Delirium scores showed a significant decrease by time in all groups during follow-up in postanaesthesia care unit. The present study resulted in satisfactory Paediatric Anaesthesia Emergence Delirium scores which are below 10 in all groups. As a conclusion, neither ketamine nor midazolam added to caudal block under sevoflurane anaesthesia did show further effect on emergence agitation. In addition, pain relief still seems to be the major factor in preventing emergence agitation after

  16. Use of deuterium oxide to measure breast-milk intake in children aged 7 to 12 months receiving complementary foods

    International Nuclear Information System (INIS)

    The present study is being conducted to pilot the use of the deuterium oxide method for the measurement of breast-milk intake in children 7 - 12 months of age receiving complementary foods. This will be applied to a community efficacy study to determine the effects on total energy and nutrient intake and on breast-milk consumption of an intensive education intervention using locally available, culturally acceptable complementary foods. In order to apply the methodology to this evaluation the washout period of deuterium from the mother and the child after the administration of a dose to the mother is being determined and the comparison of this methodology with the test weighing technique for breast-milk intake. The measurement of deuterium oxide using the infrared spectrometer of the Instituto de Investigacion Nutricional [IIN] is being compared with the IR Mass Spectrometer of INTA Chile. During the present period we have conducted a pilot study to measure breast-milk intake using deuterium oxide in 9 mother-child pairs of children aged 7 - 11 months of age; samples of saliva have been taken for analyses. One child has completed the 28 days of the study and 8 children are in process. Test weighing for 48 hours has been conducted on 5 children; unadjusted breast-milk intake ranges from 589 to 682 g per 24 hours. The samples are awaiting analysis for deuterium oxide. (author)

  17. Use of deuterium oxide to measure breast milk intake in children aged 7-12 months receiving complementary foods

    International Nuclear Information System (INIS)

    In the present study we performed a pilot study using deuterium oxide method to determine the breast-milk intake in children 7-12 months of age receiving complementary food. This is applied to a community efficacy study to determine the effects on total energy and nutrient intake and on breast-milk consumption of an intensive education intervention using locally available, culturally acceptable complementary foods. We determined the washout period for the deuterium finding a value of 21 days for the mother and child. This measurement was performed using the infrared spectrometer of the Instituto de Investigacion Nutricional and compared with the values obtained with the IR Mass Spectrometer of INTA Chile. The test weighing was conduced on 14 children and compared with the values obtained using the deuterium methodology. Our result suggest that the breast milk intake determined by the weighing test was lower with regard to the value obtained with the deuterium methodology. (author)

  18. PREVALENCE OF CYTOMEGALOVIRUS IN CHILDREN WHO RECEIVE BONE MARROW TRANSPLANTATION BY MEANS OF REAL-TIME POLYMERASE CHAIN REACTION

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    López-Montanero Edith Elizabeth

    2015-01-01

    Full Text Available Introduction: The citomegalovirus (CMV is an important virus worldwide. The early and mass-produced detection of the viral load for CMV helps to treat in an early way the infection and to avoid the disease in immunodeficient patients that in several cases could be lethal. Objective: To determine the prevalence of CMV in immunodeficient children who received bone marrow transplantation by means of real-time polymerase chain reaction. Methods: Retrospective, descriptive and cross-sectional study. The viral load was determined in plasma samples recollected since 2009 to 2012 in children who received bone marrow transplantation in the Hospital de la Sociedad de Lucha contra el Cáncer (SOLCA in Guayaquil, Ecuador. Results: 38 samples were analyzed. The average age was 7.2 years, and 57.9% (n=22 were men and 42.1% (n=16 women, with a male-female relationship 1:4. Of the analyzed samples, five patients presented positive results in the mentioned technique, who were the 80% of the female gender. And the population with the higher number of cases with positive results were Los Ríos, Guayas and Esmeraldas. The patients who were transplanted due to acute lymphoblastic leukemia and lymphoma with leukemization to acute lymphoblastic leukemia had positive results for active infection by CMV, 80% and 20%, respectively. Conclusion: The prevalence of CMV in children who received bone marrow transplantation by means of real-time polymerase chain reaction was of 13%, higher in the female gender. Rev.cienc.biomed. 2015;6(1:53-59 KEYWORDS Cytomegalovirus; Cytomegalovirus Infections; Transplant Recipients; Polymerase Chain Reaction.

  19. Evaluation of Adverse Events Noted in Children Receiving Continuous Infusions of Dexmedetomidine in the Intensive Care Unit

    Science.gov (United States)

    Honey, Brooke L.; Harrison, Donald L.; Gormley, Andrew K.; Johnson, Peter N.

    2010-01-01

    OBJECTIVES Dexmedetomidine is an α2-adrenergic receptor agonist with sedative and analgesic effects in mechanically ventilated adults and children. Safety and efficacy data are limited in children. The purpose of this study is to retrospectively identify the incidence and types of adverse events noted in children receiving continuous infusions of dexmedetomidine and evaluate potential risk factors for adverse events. METHODS Between July 1, 2006, and July 31, 2007, data were collected on all children (< 18 years) who received continuous infusions of dexmedetomidine. Data collection included demographics, dexmedetomidine regimen, and type/number of adverse events. The primary endpoint was the total number of adverse events noted, including: transient hypertension, hypotension, neurological manifestations, apnea, and bradycardia. Secondary endpoints included categorization of each type of adverse event and an assessment of risk factors. A logistic regression model was used to assess the relationship of adverse events with independent variables including length of ICU stay, cumulative dose, peak infusion rate, duration of therapy, PRISM III score, and bolus dose. RESULTS Thirty-six patients received dexmedetomidine representing 41 infusions. The median age was 16 months (range, 0.1–204 months) and median PRISM III score was 2 (range, 0–18). Eighteen (43.9%) patients received a bolus dose of dexmedetomidine. The median cumulative dose (mcg/kg) and peak dose (mcg/kg/hr) were 8.5 (range, 2.2–193.7) and 0.5 (range, 0.2–0.7), respectively. Dexmedetomidine was continued for a median of 20 (range, 3–263) hours. Six (14.6%) patients were slowly tapered off the continuous infusions. Twenty-one adverse events were noted in 17 patients, including 4 neurologic manifestations. Fourteen patients required interventions for adverse events. ICU length of stay was the only independent risk factor (p=0.036) for development of adverse events. CONCLUSIONS Several potential

  20. Trained, generalized, and collateral behavior changes of preschool children receiving gross-motor skills training.

    OpenAIRE

    Kirby, K C; Holborn, S W

    1986-01-01

    Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary...

  1. PLASMA AND ERYTHROCYTE NITRIC OXIDE LEVELS IN EPILEPTIC CHILDREN RECEIVING LONG-TERM SODIUM VALPROATE THERAPY

    OpenAIRE

    ÖZEROL, Elif; ÖZEROL, İbrahim; Aslan, Mehmet; GÜLEÇ, Mukaddes; YAKINCI, Cengiz; AKYOL, ÖMER

    2003-01-01

    Valproate (VPA) is a widely used drug as the first-line treatment for epilepsy in children. Nitric oxide (NO) is an important intercellular physiological messenger capable of evoking a number of cellular responses. It is generally believed that the erytrocyte membrane is highly permeable to NO. It has been claimed that VPA may show its antiepileptic effect throughout NO. Therefore, the aim of our study were to evaluate whether differences exist in the plasma and erythrocyte NO concentrati...

  2. Parent Perceptions of Care Received by Children With an Autism Spectrum Disorder.

    Science.gov (United States)

    Russell, Sarah; McCloskey, Cynthia Ricci

    2016-01-01

    Research in the post-genomic era has provided substantial contributions toward identification of medical, genetic and environmental heritability factors associated with autism spectrum disorder (ASD). A specific etiology related to the diagnosis remains unclear, although prevalence statistics continue to rise with profound impact on families and their primary care providers (PCPs). Support professionals encounter significant challenges delivering comprehensive management for this complex neurobehavioral and developmental disorder. Children with ASD experience significantly higher risk for unmet healthcare needs, and parents report less satisfaction with their care although current literature does not fully explain why this issue persists. This study sought parent insight for the missing answers needed to inform practice. Eleven parents of children with an ASD participated in the study. Parent perceptions of care were examined utilizing Interpretive Phenomenological Analysis (IPA) and the Measure of Process of Care (MPOC-20) to illuminate and describe their lived experiences raising children with ASD, and interactions with their PCPs. Most parents utilized their child's PCP for general health maintenance, and many felt their PCP was unable to manage issues specifically related to their child's ASD. Most did not have an expectation for support with behavioral management in the home and school setting or identification of community and mental health resources, although many struggled with unaddressed needs in both of these realms. Utilizing parent perceptions to highlight practice deficiencies can build a foundation for care models that are more comprehensive and family centered. PMID:26724967

  3. Carnitine levels and cardiac functions in children with solid malignancies receiving doxorubicin therapy

    Directory of Open Access Journals (Sweden)

    Anant Khositseth

    2011-01-01

    Full Text Available Aim: Previous studies demonstrated l-carnitine decreasing doxorubicin-induced cardiotoxicity. Our objectives were to study carnitine levels and cardiac functions in children treated with doxorubicin and the effect of short-term l-carnitine supplements. Materials and Methods: Serial carnitine levels and cardiac functions were obtained in children with newly diagnosed solid malignancies before doxorubicin, after cumulative doses of ≥150 mg/m 2 and ≥300 mg/m 2 , respectively. Oral l-carnitine 100 mg/kg/day for 3 days were given to the children treated with doxorubicin at cumulative doses of ≥150 mg/m 2 and ≥300 mg/m 2 . Carnitine levels and cardiac functions were also obtained in those children before and after short-term oral l-carnitine at each cumulative dose of doxorubicin. Results: Five children (3 females, median age of 9.1 years (range 1.5-13 years with newly diagnosed solid malignancies were enrolled in the study. Free carnitine (FC tended to decrease while acyl-carnitine (AC increased making AC/FC ratio increased after cumulative dose of ≥150 and ≥300 mg/m 2 but the statistics was not significant. Left ventricular (LV systolic function was not significantly changed. Interestingly, LV global function (LV myocardial performance index was significantly increased after 150 mg/m 2 (median 0.39, 0.27-0.51 and 300 mg/m 2 (median 0.46, 0.27-0.50 when compared to baseline (median 0.28, 0.14-0.48 (P=0.05. Carnitine levels and cardiac functions were not significantly changed after oral l-carnitine supplement at cumulative dose of ≥150 mg/m 2 (n=6 and ≥300 mg/m 2 (n=9. Conclusions: Carnitine levels tended to decrease after doxorubicin treatment. LV global dysfunction was documented early after doxorubicin. However, short-term l-carnitine supplement did not improve cardiac function.

  4. The Development of Cognitive, Language, and Cultural Skills from Age 3 to 6: A Comparison between Children of Turkish Origin and Children of Native-Born German Parents and the Role of Immigrant Parents' Acculturation to the Receiving Society

    Science.gov (United States)

    Becker, Birgit; Klein, Oliver; Biedinger, Nicole

    2013-01-01

    This article analyzes the longitudinal development of differences in academic skills between children of Turkish origin and children of native-born German parents from age 3 to 6 in Germany with a focus on the role of immigrant parents' acculturation to the receiving society. Growth curve models show that Turkish-origin children start with lower…

  5. Antibody responses to Hepatitis B and measles-mumps-rubella vaccines in children who received chemotherapy for acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Simone Santana Viana

    2012-01-01

    Full Text Available OBJECTIVE: To evaluate viral vaccine antibody levels in children with acute lymphoblastic leukemia after chemotherapy and after vaccine booster doses. METHODS: Antibody levels against hepatitis B, rubella, measles and mumps vaccine antigens were evaluated in 33 children after completing chemotherapy (before and after vaccine booster doses and the results were compared to the data of 33 healthy children matched for gender, age and social class. RESULTS: After chemotherapy, 75.9%, 67.9%, 59.3% and 51.7% of the patients showed low antibody titers that would be unlikely to protect against exposure to measles, rubella, hepatitis B and mumps, respectively. After receiving a vaccine booster dose for these antigens the patients had high antibody levels consistent with potential protection against measles, mumps and hepatitis B, but not against rubella. CONCLUSION: Extra doses of measles-mumps-rubella plus hepatitis B vaccines are recommended in acute lymphoblastic leukemia patients submitted to treatment after hematologic recovery. After this, viral vaccine antibody levels should be verified to define the individual's protective status.

  6. Detection of TT Virus Among Thalassaemic Children With Chronic Viral Hepatitis B and C Receiving Irradiated and Non Irradiated RBCs

    International Nuclear Information System (INIS)

    TTV was first identified in the serum of a patient with post transfusion hepatitis of unknown etiology in 1997.As a consequence of the high prevalence of TTV in blood donors, thalassemia patients frequently acquire various genotypes of this virus through therapeutic blood transfusions.TTV as a cause of chronic hepatitis has not yet determined . Ten healthy and twenty-eight poly-transfused thalassemia children were evolved in this study where ten patients were receiving irradiated RBCs and eighteen receiving non irradiated ones.TTV was detected in serum samples by semi-nested polymerase chain reaction (PCR) using TTV-specific primer. Transaminases levels, hepatitis B and C virus markers were interpreted for possible association with TTV infection. As a result, TTV was found in 50% of thalassemia patients and in 20 % of the controls. Among thalassemia patients, isolated HBsAG, isolated HCV-AB, HBsAG and TTV-DNA and HCV-AB and TTV-DNA distributions were: 6 (21.43%) ,8 ( 28.57%) , 4 ( 14.29%) and 10 (35.7%) respectively. Regarding thalassemia patients receiving irradiated RBCs, the frequency of viral infections were 8(80%), 2(20%) and 0% for TTV co-infections, isolated HBV and isolated HCV, respectively. On the other hand, the prevalence of viral infections among patients receiving non irradiated RBCs were 6(33.3%), 4(22.2%) and 8(44.5%) for TTV co-infection, isolated HBV and isolated HCV, respectively. These data may give evidence that radiation raises the levels of blood safety especially regarding HCV. Furthermore, liver transaminase levels were significantly higher in all patients versus the controls, meanwhile, transaminase values were not different in HBsAG-positive subjects as compared with subjects who had both HBsAG and TTV-DNA positive. Also, there was no significant difference between isolated HCV infection and HCV and TTV co-infection. So, no convincing evidence was found to support TTV involvement in the D. F. EL-MAGHRABY, et al. / J. Rad. Res. Appl. Sci

  7. Perceived and desired weight, weight related eating and exercising behaviours, and advice received from parents among thin, overweight, obese or normal weight Australian children and adolescents

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    Amy Nancy K

    2011-06-01

    Full Text Available Abstract Background Thin children are less muscular, weaker, less active, and have lower performance in measures of physical fitness than their normal weight peers. Thin children are also more frequently subjected to teasing and stigmatization. Little is known about thin children's weight perceptions, desired weight and attitudes and behaviours towards food and exercise. The study aimed to compare perceived weight status, desired weight, eating and exercise behaviours and advice received from parents among thin, overweight, obese or normal weight Australian children and adolescents. Methods The sample included 8550 school children aged 6 to 18 years selected from every state and territory of Australia. The children were weighed, measured and classified as thin, normal, overweight or obese using international standards. The main outcome measures were perceived and desired weight, weight related eating and exercising behaviours, and advice received from parents. Results The distribution of weight status was - thin 4.4%; normal weight 70.7%; overweight 18.3%; and obese 6.6%. Thin children were significantly shorter than normal weight, overweight or obese children and they were also more likely to report regularly consuming meals and snacks. 57.4% of thin children, 83.1% of normal weight children, 63.7% of overweight and 38.3% of obese children perceived their weight as "about right". Of the thin children, 53.9% wanted to be heavier, 36.2% wanted to stay the same weight, and 9.8% wanted to weigh less. Thin children were significantly less likely than obese children to respond positively to statements such as "I am trying to get fitter" or "I need to get more exercise." Parents were significantly less likely to recommend exercise for thin children compared with other weight groups. Conclusions Thin children, as well as those who are overweight or obese, are less likely than normal weight children to consider their weight "about right'. Thin children

  8. Safety profile of Coartem®: the evidence base

    OpenAIRE

    Falade, Catherine; Manyando, Christine

    2009-01-01

    This article reviews the comprehensive data on the safety and tolerability from over 6,300 patients who have taken artemether/lumefantrine (Coartem®) as part of Novartis-sponsored or independently-sponsored clinical trials. The majority of the reported adverse events seen in these studies are mild or moderate in severity and tend to affect the gastrointestinal or nervous systems. These adverse events, which are common in both adults and children, are also typical of symptoms of malaria or con...

  9. An open-label trial of enhanced brief interpersonal psychotherapy in depressed mothers whose children are receiving psychiatric treatment.

    Science.gov (United States)

    Swartz, Holly A; Zuckoff, Allan; Frank, Ellen; Spielvogle, Heather N; Shear, M Katherine; Fleming, M A Dana; Scott, John

    2006-01-01

    Major depression affects one out of five women during her lifetime. Depressed mothers with psychiatrically ill children represent an especially vulnerable population. Challenged by the demands of caring for ill children, these mothers often put their own needs last; consequently, their depressions remain untreated. This population is especially difficult to engage in treatment. We have developed a nine-session intervention, an engagement session followed by eight sessions of brief interpersonal psychotherapy designed to increase maternal participation in their own psychotherapy, resolve symptoms of maternal depression, and enhance relationships (IPT-MOMS). This open-label trial assesses the feasibility and acceptability of providing this treatment to depressed mothers. Thirteen mothers meeting DSM-IV criteria for major depression were recruited from a pediatric mental health clinic where their school-age children were receiving psychiatric treatment. Subjects (mothers) were treated openly with IPT-MOMS. Eighty-five percent (11/13) completed the study. Subjects were evaluated with the Hamilton Rating Scale for Depression, and completed self-report measures of quality of life and functioning at three time points: baseline, after treatment completion, and 6-months posttreatment. A signed rank test was used to compare measurement changes between assessment time points. Subjects showed significant improvement from baseline to posttreatment on measures of maternal symptoms and functioning. These gains were maintained at 6-month follow-up. Therapy was well tolerated and accepted by depressed mothers, who are typically difficult to engage in treatment. A high proportion of subjects completed treatment and experienced improvements in functioning. Future randomized clinical trials are needed to establish the efficacy of this approach. PMID:16841341

  10. Caregiver perceptions and motivation for disclosing or concealing the diagnosis of HIV infection to children receiving HIV care in Mbarara, Uganda: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Julius Kiwanuka

    Full Text Available BACKGROUND: Disclosure of the diagnosis of HIV to HIV-infected children is challenging for caregivers. Despite current recommendations, data suggest that levels of disclosure of HIV status to HIV-infected children receiving care in resource-limited settings are very low. Few studies describe the disclosure process for children in these settings, particularly the motivators, antecedent goals, and immediate outcomes of disclosure to HIV-infected children. This study examined caregivers' perception of the disclosure concept prior to disclosure, their motivation towards or away from disclosure, and their short- and long-term intentions for disclosure to their HIV-infected children. METHODS: In-depth interviews were conducted with primary caregivers of 40 HIV-infected children (ages 5-15 years who were receiving HIV care but did not know their HIV status. RESULTS: Caregivers of HIV-infected children mainly perceived disclosure as a single event rather than a process of gradual delivery of information about the child's illness. They viewed disclosure as potentially beneficial both to children and themselves, as well as an opportunity to explain the parents' role in the transmission of HIV to the children. Caregivers desired to personally conduct the disclosure; however, most reported being over-whelmed with fear of negative outcomes and revealed a lack of self-efficacy towards managing the disclosure process. Consequently, most cope by deception to avoid or delay disclosure until they perceive their own readiness to disclose. CONCLUSIONS: Interventions for HIV disclosure should consider that caregivers may desire to be directly responsible for disclosure to children under their care. They, however, need to be empowered with practical skills to recognize opportunities to initiate the disclosure process early, as well as supported to manage it in a phased, developmentally appropriate manner. The potential role for peer counselors in the disclosure

  11. Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland.

    LENUS (Irish Health Repository)

    O'Sullivan, K

    2015-06-01

    To examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries.

  12. Iodine status of young Burkinabe children receiving small-quantity lipid-based nutrient supplements and iodised salt: a cluster-randomised trial.

    Science.gov (United States)

    Hess, Sonja Y; Abbeddou, Souheila; Yakes Jimenez, Elizabeth; Ouédraogo, Jean-Bosco; Brown, Kenneth H

    2015-12-14

    The objective of the present study was to assess the impact of providing small-quantity lipid-based nutrient supplements (SQ-LNS) on the I status of young Burkinabe children. In total, thirty-four communities were assigned to intervention (IC) or non-intervention cohorts (NIC). IC children were randomly assigned to receive 20 g lipid-based nutrient supplements (LNS)/d containing 90 µg I with 0 or 10 mg Zn from 9 to 18 months of age, and NIC children received no SQ-LNS. All the children were exposed to iodised salt through the national salt iodization programme. Spot urinary iodine (UI), thyroid-stimulating hormone (TSH) and total thyroxine (T4) in dried blood spots as well as plasma thyroglobulin (Tg) concentrations were assessed at 9 and 18 months of age among 123 IC and fifty-six NIC children. At baseline and at 18 months, UI, TSH and T4 did not differ between cohorts. Tg concentration was higher in the NIC v. IC at baseline, but this difference did not persist at 18 months of age. In both cohorts combined, the geometric mean of UI was 339·2 (95% CI 298·6, 385·2) µg/l, TSH 0·8 (95% CI 0·7, 0·8) mU/l, T4 118 (95 % CI 114, 122) nmol/l and Tg 26·0 (95% CI 24·3, 27·7) µg/l at 18 months of age. None of the children had elevated TSH at 18 months of age. Marginally more children in NIC (8·9%) had low T4 (15 ppm). A reduction of SQ-LNS I content could be considered in settings with similarly successful salt iodisation programmes. PMID:26411504

  13. High rates of virological failure and drug resistance in perinatally HIV-1-infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in Togo

    Directory of Open Access Journals (Sweden)

    Mounerou Salou

    2016-04-01

    Full Text Available Introduction: Antiretroviral treatment (ART has been scaled up over the last decade but compared to adults, children living with HIV are less likely to receive ART. Moreover, children and adolescents are more vulnerable than adults to virological failure (VF and emergence of drug resistance. In this study we determined virological outcome in perinatally HIV-1-infected children and adolescents receiving ART in Togo. Methods: HIV viral load (VL testing was consecutively proposed to all children and adolescents who were on ART for at least 12 months when attending HIV healthcare services for their routine follow-up visit (June to September 2014. Plasma HIV-1 VL was measured using the m2000 RealTime HIV-1 assay (Abbott Molecular, Des Plaines, IL, USA. Genotypic drug resistance was done for all samples with VL>1000 copies/ml. Results and discussion: Among 283 perinatally HIV-1-infected children and adolescents included, 167 (59% were adolescents and 116 (41% were children. The median duration on ART was 48 months (interquartile range: 28 to 68 months. For 228 (80.6%, the current ART combination consisted of two nucleoside reverse transcriptase inhibitors (NRTIs (zidovudine and lamivudine and one non-nucleoside reverse transcriptase inhibitor (NNRTI (nevirapine or efavirenz. Only 28 (9.9% were on a protease inhibitor (PI-based regimen. VL was below the detection limit (i.e. 40 copies/ml for 102 (36%, between 40 and 1000 copies/ml for 35 (12.4% and above 1000 copies/ml for 146 (51.6%. Genotypic drug-resistance testing was successful for 125/146 (85.6%; 110/125 (88.0% were resistant to both NRTIs and NNRTIs, 1/125 (0.8% to NRTIs only, 4/125 (3.2% to NNRTIs only and three harboured viruses resistant to reverse transcriptase and PIs. Overall, 86% (108/125 of children and adolescents experiencing VF and successfully genotyped, corresponding thus to at least 38% of the study population, had either no effective ART or had only a single effective drug in

  14. THE USE OF SUPEROXIDE DISMUTASE IN ACCELERATING SYMPTOM RELIEF IN ASTHMATIC AND HOUSE DUST MITE ALLERGIC CHILDREN RECEIVING HOUSE DUST MITE IMMUNOTHERAPY: DOUBLE BLIND RANDOMIZED CONTROLLED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Anang Endaryanto

    2015-09-01

    Full Text Available Objective: To evaluate the efficacy of superoxide dismutase (SOD in lung function (FEV1 reversibility and respiratory symptoms (drug scores, symptoms scores in asthmatic and house dust mite allergic children receiving house dust mites immunotherapy. Methods: Forty subjects aged 6–17 years old with asthma, tested positive for house dust mite allergy on skin prick test, and received immunotherapy were enrolled in this study. All subjects completed clinical based assessments and diary-based assessments for drug and symptom scores. Following a four-week baseline assessment, all subjects were randomized to receive SOD or placebo. Respiratory symptoms (drug and symptoms score and FEV1 were evaluated at the end of the 1st, 2nd, 3rd, and 4th weeks after randomization. Drug score, symptoms score, and FEV1 reversibility test results were analyzed using a Paired t test and repeated measure of ANOVA. Results: There was a significant difference in drug scores, symptoms score, and FEV1 reversibility test outcomes between SOD and placebo. SOD group showed a significant decrease in all outcome measures compared to those in placebo group. Conclusions: The use of SOD as antioxidants is effective in accelerating symptom relief for children with asthma and house dust mite allergy receiving house dust mite immunotherapy.

  15. NIH Research: Children Research Volunteers Receive Care and Help Advance Knowledge | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... hereditary illness found in fewer than 1,000 children worldwide. It used to be a death sentence for kids before they reached age 10. But thanks to her mother, who wouldn’t accept that scenario, at age ...

  16. A randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation.

    OpenAIRE

    Naidu, Sinuba; Loughlin, Pat; Coldwell, Susan E.; Noonan, Carolyn J.; Milgrom, Peter

    2004-01-01

    The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing th...

  17. Measuring coverage in MNCH: challenges in monitoring the proportion of young children with pneumonia who receive antibiotic treatment.

    Directory of Open Access Journals (Sweden)

    Harry Campbell

    Full Text Available Pneumonia remains a major cause of child death globally, and improving antibiotic treatment rates is a key control strategy. Progress in improving the global coverage of antibiotic treatment is monitored through large household surveys such as the Demographic and Health Surveys (DHS and the Multiple Indicator Cluster Surveys (MICS, which estimate antibiotic treatment rates of pneumonia based on two-week recall of pneumonia by caregivers. However, these survey tools identify children with reported symptoms of pneumonia, and because the prevalence of pneumonia over a two-week period in community settings is low, the majority of these children do not have true pneumonia and so do not provide an accurate denominator of pneumonia cases for monitoring antibiotic treatment rates. In this review, we show that the performance of survey tools could be improved by increasing the survey recall period or by improving either overall discriminative power or specificity. However, even at a test specificity of 95% (and a test sensitivity of 80%, the proportion of children with reported symptoms of pneumonia who truly have pneumonia is only 22% (the positive predictive value of the survey tool. Thus, although DHS and MICS survey data on rates of care seeking for children with reported symptoms of pneumonia and other childhood illnesses remain valid and important, DHS and MICS data are not able to give valid estimates of antibiotic treatment rates in children with pneumonia.

  18. A Study of Messages Received by Children Who Viewed an Episode of "The Harlem Globetrotters Popcorn Machine".

    Science.gov (United States)

    Child Research Service, Inc., New York, NY.

    A total of 687 children, aged 7 through 11, was interviewed in fall, 1974 to determine the extent to which the Harlem Globetrotters Popcorn Machine television programs communicated "pro-social" messages to its audience. Viewers of four different episodes of the Globetrotters were questioned about the program they had seen. Among the findings were:…

  19. Patching the gaps towards the 90–90–90 targets: outcomes of Nigerian children receiving antiretroviral treatment who are co-infected with tuberculosis

    Directory of Open Access Journals (Sweden)

    Dick D Chamla

    2015-12-01

    Full Text Available Introduction: Nigeria has a high burden of children living with HIV and tuberculosis (TB. This article examines the magnitude of TB among children receiving antiretroviral treatment (ART, compares their ART outcomes with their non-TB counterparts and argues that addressing TB among children on ART is critical for achieving the 90–90–90 targets. Methods: This was a facility-based, retrospective analysis of medical records of children aged <15 years who were newly initiated on ART between 2011 and 2012. Structured tools were used to collect data. STATA software was used to perform descriptive, survival and multivariate analyses. Results: A total of 1142 children with a median age of 3.5 years from 20 selected facilities were followed for 24 months. Of these, 95.8% were assessed for TB at ART initiation and 14.7% had TB. Children on ART were more likely to have TB if they were aged 5 years or older (p<0.01 and had delayed ART initiation (p<0.05. The cotrimoxazole and isoniazid prophylaxes were provided to 87.9 and 0.8% of children, respectively. The rate of new TB cases was 3 (2.2–4.0 per 100 person-years at six months and declined to 0.2 (0.06–1.4 per 100 person-years at 24 months. TB infection [adjusted hazard ratio (aHR: 4.3; 2.3–7.9], malnutrition (aHR: 5.1; 2.6–9.8, delayed ART initiation (aHR: 3.2; 1.5–6.7 and age less than 1 year at ART initiation (aHR: 4.0; 1.4–12.0 were associated with death. Additionally, patients with TB (aHR: 1.3; 1.1–1.6 and children below the age of 1 at ART initiation (aHR: 2.9; 1.7–5.2 were more likely to be lost to follow-up (LFU. Conclusions: Children on ART with TB are less likely to survive and more likely to be LFU. These risks, along with low isoniazid uptake and delayed ART initiation, present a serious challenge to achieving the 90–90–90 targets and underscore an urgent need for inclusion of childhood TB/HIV in global plans and reporting mechanisms.

  20. The descriptive statistics and health implications of occupational radiation doses received by men at the Sellafield nuclear installation before the conception of their children

    International Nuclear Information System (INIS)

    From a database of a quarter of a million births in Cumbria during 1950-1989, 10 363 children have been positively linked to paternal employment at the Sellafield nuclear installation in West Cumbria at, or before, the conception of the child. 9256 children have been associated with paternal preconceptional radiation exposure. The doses of external whole-body radiation received by fathers prior to conception have been estimated from annual recorded doses, and the detailed distributions of these preconceptional doses are presented. The collective paternal total preconceptional dose is 539 person-Sv, a mean individual preconceptional dose per paternally exposed child of 58 mSv. The number of serious hereditary effects predicted to be induced by this collective dose among these first generation children is less than two, and these will not be discernible against the much larger number of background cases. There is no evidence of an excess of hereditary disorders in the immediate vicinity of Sellafield, although comprehensive studies have not, as yet, been carried out. The suggestion advanced by Gardner et al (1990b) that paternal preconceptional irradiation is sufficient to account for the excess of childhood leukaemia cases in the West Cumbrian village of Seascale is highly unlikely to be correct because, inter alia, of the absence of a comparable excess among children born outside Seascale who are associated with the great majority (93%) of the collective paternal preconceptional dose. (Author)

  1. Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children--United States, July 9, 2014-January 4, 2015.

    Science.gov (United States)

    Goodman, Alyson B; Meites, Elissa; Anstey, Erica H; Fullerton, Kathleen E; Jayatilleke, Achala; Ruben, Wendy; Koumans, Emily; Oster, Alexandra M; Karwowski, Mateusz P; Dziuban, Eric; Kirkcaldy, Robert D; Glover, Maleeka; Lowe, Luis; Peacock, Georgina; Mahon, Barbara; Griese, Stephanie E

    2015-09-18

    The 2014–2015 Ebola virus disease (Ebola) epidemic is the largest in history and represents the first time Ebola has been diagnosed in the United States. On July 9, 2014, CDC activated its Emergency Operations Center and established an Ebola clinical consultation service to assist U.S. state and local public health officials and health care providers with the evaluation of suspected cases. CDC reviewed all 89 inquiries received by the consultation service during July 9, 2014– January 4, 2015, about children (persons aged ≤18 years). Most (56 [63%]) children had no identifiable epidemiologic risk factors for Ebola; among the 33 (37%) who did have an epidemiologic risk factor, in every case this was travel from an Ebola-affected country. Thirty-two of these children met criteria for a person under investigation (PUI) because of clinical signs or symptoms. Fifteen PUIs had blood samples tested for Ebola virus RNA by reverse transcription–polymerase chain reaction; all tested negative. Febrile children who have recently traveled from an Ebola-affected country can be expected to have other common diagnoses, such as malaria and influenza, and in the absence of epidemiologic risk factors for Ebola, the likelihood of Ebola is extremely low. Delaying evaluation and treatment for these other more common illnesses might lead to poorer clinical outcomes. Additionally, many health care providers expressed concerns about whether and how parents should be allowed in the isolation room. While maintaining an appropriate level of vigilance for Ebola, public health officials and health care providers should ensure that pediatric PUIs receive timely triage, diagnosis, and treatment of other more common illnesses, and care reflecting best practices in supporting children’s psychosocial needs. PMID:26390343

  2. Motor outcome differences between two groups of children with spastic diplegia who received different intensities of early onset physiotherapy followed for 5 years.

    Science.gov (United States)

    Kanda, Toyoko; Pidcock, Frank S; Hayakawa, Katumi; Yamori, Yuriko; Shikata, Yuko

    2004-03-01

    The objective of this study is to determine the clinical effectiveness of early onset long-term intensive physiotherapy on motor development in children with spastic diplegic cerebral palsy (CP). The study was a non-randomized cohort study with 62 months (mean) follow-up. The participants were ten infants who were first examined before 3 months of age corrected for prematurity. All had a gestational age of less than 33 weeks and a birth weight of less than 2000 g. Brain magnetic resonance imaging revealed periventricular white matter injury in nine subjects and moderate grade bilateral porencephaly in one. Five completed a full course of training of 52 months (mean), two did not receive therapy, and three received an insufficient course of therapy. The study was conducted at the Regional Center for Children with Disabilities including outpatient clinics and a school for children with special needs. The Vojta Method was used, which is an extensive family oriented physiotherapy program which uses isometric strengthening of muscles with tactile stimulation. Subjects were evaluated for the highest motor developmental level at the outcome evaluation 59 months (mean) after initiation of therapy. Four of the five who completed training could either stand still for 5 s or walk at the time of the outcome evaluation 52 months after the beginning of the therapy program. None of the five subjects with no training or insufficient training could accomplish this task when evaluated 64 months following therapy initiation. This was a statistically significant difference (P = 0.0278). A consistently applied physiotherapy program resulted in better motor outcomes in this group of children at risk for developing spastic diplegic CP. PMID:15036431

  3. Older white people's experiences of giving care to or receiving care from their children / Sonia S. Howes

    OpenAIRE

    Howes, Sonia S

    2013-01-01

    Social and demographic changes have a tremendous effect on the care for older people to the effect that caring for older people might have become a rare commodity. Increased life expectancy during the past century has prolonged the period in which older people need care and has made family care giving an increasingly recurrent activity for adult children. After the demolition of the apartheid area in South Africa, most research focused on previously disadvantaged groups, namely Black and Brow...

  4. Retention in care and outpatient costs for children receiving antiretroviral therapy in Zambia: a retrospective cohort analysis.

    Directory of Open Access Journals (Sweden)

    Callie A Scott

    Full Text Available BACKGROUND: There are few published estimates of the cost of pediatric antiretroviral therapy (ART in Africa. Our objective was to estimate the outpatient cost of providing ART to children remaining in care at six public sector clinics in Zambia during the first three years after ART initiation, stratified by service delivery site and time on treatment. METHODS: Data on resource utilization (drugs, diagnostics, outpatient visits, fixed costs and treatment outcomes (in care, died, lost to follow up were extracted from medical records for 1,334 children at six sites who initiated ART at 50% at four sites. At the two remaining sites, outpatient visits and fixed costs together accounted for >50% of outpatient costs. The distribution of costs is slightly skewed, with median costs 3% to 13% lower than average costs during the first year after ART initiation depending on site. CONCLUSIONS: Outpatient costs for children initiating ART in Zambia are low and comparable to reported outpatient costs for adults. Outpatient costs and retention in care vary widely by site, suggesting opportunities for efficiency gains. Taking advantage of such opportunities will help ensure that targets for pediatric treatment coverage can be met.

  5. Oral manifestations of HIV infection in children and adults receiving highly active anti-retroviral therapy [HAART] in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Mikx Frans HM

    2006-08-01

    Full Text Available Abstract Background The aim of the study was to compare the prevalence and types of HIV-related oral lesions between children and adult Tanzanian patients on HAART with those not on HAART and to relate the occurrence of the lesions with anti-HIV drug regimen, clinical stage of HIV disease and CD4+ cell count. Methods Participants were 532 HIV infected patients, 51 children and 481 adults, 165 males and 367 females. Children were aged 2–17 years and adults 18 and 67 years. Participants were recruited consecutively at the Muhimbili National Hospital (MNH HIV clinic from October 2004 to September 2005. Investigations included; interviews, physical examinations, HIV testing and enumeration of CD4+ T cells. Results A total of 237 HIV-associated oral lesions were observed in 210 (39.5% patients. Oral candidiasis was the commonest (23.5%, followed by mucosal hyperpigmentation (4.7%. There was a significant difference in the occurrence of oral candidiasis (χ2 = 4.31; df = 1; p = 0.03 and parotid enlargement (χ2 = 36.5; df = 1; p = 0.04 between children and adults. Adult patients who were on HAART had a significantly lower risk of; oral lesions (OR = 0.32; 95% CI = 0.22 – 0.47; p = 0.005, oral candidiasis (OR = 0.28; 95% CI = 0.18 – 0.44; p = 0.003 and oral hairy leukoplakia (OR = 0.18; 95% CI = 0.04 – 0.85; p = 0.03. There was no significant reduction in occurrence of oral lesions in children on HAART (OR = 0.35; 95% CI = 0.11–1.14; p = 0.15. There was also a significant association between the presence of oral lesions and CD4+ cell count 3 (χ2 = 52.4; df = 2; p = 0.006 and with WHO clinical stage (χ2 = 121; df = 3; p = 0.008. Oral lesions were also associated with tobacco smoking (χ2 = 8.17; df = 2; p = 0.04. Conclusion Adult patients receiving HAART had a significantly lower prevalence of oral lesions, particularly oral candidiasis and oral hairy leukoplakia. There was no significant change in occurrence of oral lesions in children

  6. Secondary Neoplasms in Children with Hodgkin’s Lymphoma Receiving C-MOPP and Radiotherapy: Presentation of Four Cases

    OpenAIRE

    Sevgi Gözdaşoğlu; İsmail Haluk Gökçora; Ömer Uluoğlu

    2016-01-01

    Patients who survive Hodgkin lymphoma (HL) are at increased risk of secondary neoplasms (SNs). A wide variety of SNs have been reported, including leukemias, non-Hodgkin’s lymphomas, and solid tumors, specifically breast and thyroid cancers. Herein we report subsequent neoplasms in four patients with HL receiving chemoradiotherapy. It is interesting that three SNs, fibrosarcoma, thyroid carcinoma, and retrobulbar meningioma, were observed in the radiation area in one of o...

  7. Exploratory study describing 6 month outcomes for young children with autism who receive treatment as usual in Italy

    Directory of Open Access Journals (Sweden)

    Muratori F

    2014-04-01

    Full Text Available Filippo Muratori,1,2 Antonio Narzisi1IDIA group 1Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy; 2University of Pisa, Calambrone, Pisa, Italy Background: In the last few years, the results of different studies have confirmed, in different ways, the importance of early intervention for autism. This study aims to evaluate the role of early "as usual" interventions in the outcome of toddlers diagnosed with autism spectrum disorder (ASD. Method: Seventy children with ASD aged between 24 and 48 months were recruited at different centers in Italy. They were evaluated by blind researchers at baseline and after 6 months of using Autism Diagnostic Observation Schedule-Generic (ADOS-G, Griffiths Mental Developmental Scales, and Vineland Adaptive Behavior scales. Parents filled out the MacArthur Inventory, Social Communication Questionnaire, and Child Behavior Check List. All children were referred to community providers for available interventions. Results: At the endpoint, most of the children were still classified as having an ADOS-G classification of ASD. However, 21 (34.2% passed from autism to autism spectrum, and 3 (4.2% passed from autism spectrum to no spectrum. Treatment effects were obtained for cognitive functioning, language, adaptive behavior, and child behavior without differences between development-oriented and behavior-oriented interventions. Parent involvement was a mediator for the best clinical outcome. Baseline low impairments of communication, language comprehension, and gesture were predictors of positive outcome. Conclusion: Treatment as usual, composed of individual therapy plus school-supported inclusion, may be an effective intervention in ASD. Better initial levels of communication in child and parent involvement during treatment have an important role for a positive outcome. Keywords: autism, preschoolers, treatment as usual, early intervention

  8. Prevention of oral mucositis in children receiving cancer therapy: a systematic review and evidence-based analysis.

    Science.gov (United States)

    Qutob, Akram F; Gue, Sumant; Revesz, Tamas; Logan, Richard M; Keefe, Dorothy

    2013-02-01

    This systematic review investigated, critically appraised, and rated the evidence on agents used to prevent oral mucositis in children. A comprehensive search of the relevant literature was performed up to December 2011. Articles were included according to the inclusion/exclusion criteria and were critically appraised for validation and quality assessment using a checklist consisting of 18 categories. Each article was then rated for its strength of evidence. 16,471 articles were retrieved from 19 different databases and then reduced to 27 articles that fit the inclusion criteria. Five articles on oral care protocols supported their use to prevent oral mucositis in children. Seven articles on chlorhexidine mouthwash and three on laser therapy had conflicting evidence of its use. The preventative agents that were supported by one or two articles included: benzydamine mouthwash, iseganan mouthwash, granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash, oral/enteral glutamine, oral propantheline and cryotherapy, oral cryotherapy, oral sucralfate suspension, prostaglandin E2 tablets, and chewing gum. The reduction in the rates of occurrence of oral mucositis when using agents of fair (B) to good (A) evidence ranged from 22% to 52%. In conclusion, this review suggests the use of oral care protocols to prevent oral mucositis in children because of their strength of evidence (fair to good). The authors suggest avoiding agents with fair to good evidence against their use (oral sucralfate suspension, prostaglandin E2 tablets, and GM-CSF mouthwash). Agents with conflicting evidence (chlorhexidine mouthwash (used solely), laser therapy, and glutamine) should also be avoided until further research confirms their efficacy. PMID:22959949

  9. Peer Victimization of Children with Disabilities: Examining Prevalence and Early Risk and Protective Factors among a National Sample of Children Receiving Special Education Services

    Science.gov (United States)

    Son, Esther

    2011-01-01

    Peer victimization is a serious social problem that can negatively affect a child's psychosocial development and school adjustment, and may have lasting effects for victims. Previous studies on peer victimization have suggested that children with disabilities (CWD) are likely to be more frequent targets of peer victimization. This longitudinal…

  10. Secondary Neoplasms in Children with Hodgkin's Lymphoma Receiving C-MOPP and Radiotherapy: Presentation of Four Cases.

    Science.gov (United States)

    Gözdaşoğlu, Sevgi; Pamir, Ali; Ünal, Emel; Gökçora, İsmail Haluk; Uluoğlu, Ömer; Ceyhan, Koray; Deda, Haluk; Işıkman, Erdoğan; Yavuz, Gülsan; Taçyıldız, Nurdan; Çavdar, Ayhan

    2016-03-01

    Patients who survive Hodgkin lymphoma (HL) are at increased risk of secondary neoplasms (SNs). A wide variety of SNs have been reported, including leukemias, non-Hodgkin's lymphomas, and solid tumors, specifically breast and thyroid cancers. Herein we report subsequent neoplasms in four patients with HL receiving chemoradiotherapy. It is interesting that three SNs, fibrosarcoma, thyroid carcinoma, and retrobulbar meningioma, were observed in the radiation area in one of our patients. A hypopharyngeal epithelioid malignant peripheral nerve sheath tumor as an unusual secondary malignant neoplasm developed in another patient, while a benign thyroid nodule and invasive ductal breast carcinoma were observed at different times in the female patient. Follicular adenoma of the thyroid gland developed in one of our patients. PMID:26377258

  11. Secondary Neoplasms in Children with Hodgkin’s Lymphoma Receiving C-MOPP and Radiotherapy: Presentation of Four Cases

    Directory of Open Access Journals (Sweden)

    Sevgi Gözdaşoğlu

    2016-03-01

    Full Text Available Patients who survive Hodgkin lymphoma (HL are at increased risk of secondary neoplasms (SNs. A wide variety of SNs have been reported, including leukemias, non-Hodgkin’s lymphomas, and solid tumors, specifically breast and thyroid cancers. Herein we report subsequent neoplasms in four patients with HL receiving chemoradiotherapy. It is interesting that three SNs, fibrosarcoma, thyroid carcinoma, and retrobulbar meningioma, were observed in the radiation area in one of our patients. A hypopharyngeal epithelioid malignant peripheral nerve sheath tumor as an unusual secondary malignant neoplasm developed in another patient, while a benign thyroid nodule and invasive ductal breast carcinoma were observed at different times in the female patient. Follicular adenoma of the thyroid gland developed in one of our patients.

  12. Pharmaco-Epidemiology of Artemisinin-Based Combination Therapy in the Context of Impact Evaluation of Artemether-Lumefantrine on Malaria Morbidity and Mortality During Programmatic Implementation in Rural Tanzania

    OpenAIRE

    Kabanywanyi, Abdunoor Mulokozi

    2012-01-01

    In sub-Saharan Africa previous efforts to control malaria have proved less successful mostly due to prolonged use of less efficacious mono-therapy drugs to which Plasmodium falciparum has developed drug resistance. In most parts of malaria endemic regions chloroquine (CQ) was found to be poorly effective for several decades but it was still being prescribed until recently. In Tanzania, for instance, P.falciparum was already resistant to CQ in more than 60% of all P. falciparum ...

  13. Direct contrast enhanced Venography MR in the study of central venous accesses in children receiving total parenteral nutrition

    International Nuclear Information System (INIS)

    Purpose. To present direct contrast enhanced Magnetic Resonance Venography, a recently developed method for the study of central venous accesses. Materials and methods. Six patients (4 males and 2 females; age range 15-18 Years) with severe intestinal failure treated with indwelling central Venous catheter since childhood were studied by MR-angiography. The examination was carried out with a 1.5 Philips Gyroscan Intera Magnet, sequences during the simultaneous injection of about 60 ml/limb paramagnetic contrast material, Gd DTPA, diluted with saline solution at a ratio of 1:12. The images were processed with maximum intensity coronal projections and compared with the phlebographic images obtained earlier. Results. In 4 cases the method demonstrated superior vena cava occlusion, in 2 cases inferior vena cava occlusion. The examination was well tolerated by all patients and image quality was very similar to that of the gold standard Study, conventional phlebography. Conclusions. We believe direct contrast-enhanced MR-venography to be a minimally invasive, panoramic and diagnostically reliable method, which should be considered the first choice in the study of central venous accesses of patients receiving total parental nutrition for the medical treatment of intestinal failure. The method does not expose the patients to ionizing radiation or require iodinated contrast material, and is relatively short with a room lime of about 30-40 minutes

  14. Radio receivers

    Science.gov (United States)

    Bankov, V. N.; Barulin, L. G.; Zhodzishskii, M. I.; Malyshev, I. V.; Petrusinskii, V. V.

    The book is concerned with the design of microelectronic radio receivers and their components based on semiconductor and hybrid integrated circuits. Topics discussed include the hierarchical structure of radio receivers, the synthesis of structural schemes, the design of the principal functional units, and the design of radio receiver systems with digital signal processing. The discussion also covers the integrated circuits of multifunctional amplifiers, analog multipliers, charge-transfer devices, frequency filters, piezoelectronic devices, and microwave amplifiers, filters, and mixers.

  15. A trial of intermittent preventive treatment and home-based management of malaria in a rural area of The Gambia

    Directory of Open Access Journals (Sweden)

    Webb Emily L

    2011-01-01

    Full Text Available Abstract Background Individual malaria interventions provide only partial protection in most epidemiological situations. Thus, there is a need to investigate whether combining interventions provides added benefit in reducing mortality and morbidity from malaria. The potential benefits of combining IPT in children (IPTc with home management of malaria (HMM was investigated. Methods During the 2008 malaria transmission season, 1,277 children under five years of age resident in villages within the rural Farafenni demographic surveillance system (DSS in North Bank Region, The Gambia were randomized to receive monthly IPTc with a single dose of sulphadoxine/pyrimethamine (SP plus three doses of amodiaquine (AQ or SP and AQ placebos given by village health workers (VHWs on three occasions during the months of September, October and November, in a double-blind trial. Children in all study villages who developed an acute febrile illness suggestive of malaria were treated by VHWs who had been taught how to manage malaria with artemether-lumefantrine (Coartem™. The primary aims of the project were to determine whether IPTc added significant benefit to HMM and whether VHWs could effectively combine the delivery of both interventions. Results The incidence of clinical attacks of malaria was very low in both study groups. The incidence rate of malaria in children who received IPTc was 0.44 clinical attacks per 1,000 child months at risk while that for control children was 1.32 per 1,000 child months at risk, a protective efficacy of 66% (95% CI -23% to 96%; p = 0.35. The mean (standard deviation haemoglobin concentration at the end of the malaria transmission season was similar in the two treatment groups: 10.2 (1.6 g/dL in the IPTc group compared to 10.3 (1.5 g/dL in the placebo group. Coverage with IPTc was high, with 94% of children receiving all three treatments during the study period. Conclusion Due to the very low incidence of malaria, no firm

  16. Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites

    Directory of Open Access Journals (Sweden)

    Munguti Kaendi

    2008-01-01

    Full Text Available Abstract Background The Home Management of Malaria (HMM strategy was developed using chloroquine, a now obsolete drug, which has been replaced by artemisinin-based combination therapy (ACT in health facility settings. Incorporation of ACT in HMM would greatly expand access to effective antimalarial therapy by the populations living in underserved areas in malaria endemic countries. The feasibility and acceptability of incorporating ACT in HMM needs to be evaluated. Methods A multi-country study was performed in four district-size sites in Ghana (two sites, Nigeria and Uganda, with populations ranging between 38,000 and 60,000. Community medicine distributors (CMDs were trained in each village to dispense pre-packaged ACT to febrile children aged 6–59 months, after exclusion of danger signs. A community mobilization campaign accompanied the programme. Artesunate-amodiaquine (AA was used in Ghana and artemether-lumefantrine (AL in Nigeria and Uganda. Harmonized qualitative and quantitative data collection methods were used to evaluate CMD performance, caregiver adherence and treatment coverage of febrile children with ACTs obtained from CMDs. Results Some 20,000 fever episodes in young children were treated with ACT by CMDs across the four study sites. Cross-sectional surveys identified 2,190 children with fever in the two preceding weeks, of whom 1,289 (59% were reported to have received ACT from a CMD. Coverage varied from 52% in Nigeria to 75% in Ho District, Ghana. Coverage rates did not appear to vary greatly with the age of the child or with the educational level of the caregiver. A very high proportion of children were reported to have received the first dose on the day of onset or the next day in all four sites (range 86–97%, average 90%. The proportion of children correctly treated in terms of dose and duration was also high (range 74–97%, average 85%. Overall, the proportion of febrile children who received prompt treatment and the

  17. Study of the factors associated with dental caries in children who receive early dental care Estudo de fatores associados à cárie dental em crianças que recebem atendimento odontológico precoce

    OpenAIRE

    FRAIZ Fabian Calixto; Luiz Reynaldo de Figueiredo WALTER

    2001-01-01

    The present study investigated the factors associated with the development of dental caries in preschool children who receive regular dental care and follow-up. The research was carried out at the Baby Clinic, Londrina State University, and comprised two hundred preschool children, whose ages ranged from 24 to 48 months, as well as their mothers, who had already taken part in a dental program at the Baby Clinic during, at least, the previous twelve months. Regarding oral hygiene habits, there...

  18. Hypercholesterolemia is associated with the apolipoprotein C-III (APOC3 genotype in children receiving HAART: an eight-year retrospective study.

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    Carlos A Rocco

    Full Text Available Polymorphisms in apolipoprotein genes have shown to be predictors of plasma lipid levels in adult cohorts receiving highly active antiretroviral therapy (HAART. Our objective was to confirm the association between the APOC3 genotype and plasma lipid levels in an HIV-1-infected pediatric cohort exposed to HAART. A total of 130 HIV-1-infected children/adolescents that attended a reference center in Argentina were selected for an 8-year longitudinal study with retrospective data collection. Longitudinal measurements of plasma triglycerides, total cholesterol, HDL-C and LDL-C were analyzed under linear or generalized linear mixed models. The contribution of the APOC3 genotype at sites -482, -455 and 3238 to plasma lipid levels prediction was tested after adjusting for potential confounders. Four major APOC3 haplotypes were observed for sites -482/-455/3238, with estimated frequencies of 0.60 (C/T/C, 0.14 (T/C/C, 0.11 (C/C/C, and 0.11 (T/C/G. The APOC3 genotype showed a significant effect only for the prediction of total cholesterol levels (p<0.0001. However, the magnitude of the differences observed was dependent on the drug combination (p = 0.0007 and the drug exposure duration at the time of the plasma lipid measurement (p = 0.0002. A lower risk of hypercholesterolemia was predicted for double and triple heterozygous individuals, mainly at the first few months after the initiation of Ritonavir-boosted protease inhibitor-based regimens. We report for the first time a significant contribution of the genotype to total cholesterol levels in a pediatric cohort under HAART. The genetic determination of APOC3 might have an impact on a large portion of HIV-1-infected children at the time of choosing the treatment regimens or on the counter-measures against the adverse effects of drugs.

  19. Preliminary studies of radiation port in children receiving cranial irradiation for preventing central nervous system (CNS) disease of acute lymphoblastic leukemia (ALL)

    International Nuclear Information System (INIS)

    For preventing CNS leukemia in children with ALL, simple whole skull irradiation that included only retro-orbital spaces and not anterior part of the cribriform plate and first two cervical vertebrae had been given until March 1982 to patients who had remission after drug therapy. Since March 1982, however, such patients have received new modified cranial irradiation of Pinkel's method of preventive CNS therapy to include the cribriform plate. Pinkel's method usually includes first two cervical vertebrae in radiation port, but sometimes his method of radiation fails to reach the brain and the meninges on the anterior parts of the lamina cribrosa. In this study, a comparison of CNS-relapes ratio between these two methods of preventive CNS therapy was carried out. The frequency of CNS leukemia was remarkably high in patients given the simple whole skull irradiation. Of 18 patients, 7 developed CNS leukemia. Among these 7, 5 patients (71 %) had occurence of CNS-relapse within 1 year 7 months with the other one patient, making a total of 86 %, having CNS-relapse within 1 year 11 months. On the other hand, 17 of 39 patients who received new modified cranial irradiation were followed up for more than 1 year 9 months, and all patient had no CNS-relapse to date. This result showed that the irradiation of whole circulation areas of cerebrospinal fluid of the brain and the spine at first two cervical vertebra levels had great importance in preventing CNS-relapse after achievement of drug-induced remission. (author)

  20. An assessment of the dose received by children from CT examinations along with the quality control parameters from a conventional CT system

    International Nuclear Information System (INIS)

    In 2000, the UNSCEAR reported that CT constitutes 5% of all the medical x-ray examinations and it contributes 34% of the resultant collective dose worldwide. Children are more sensitive to the ionizing radiations than adults. So, routine quality control tests are expected to be carried out periodically on the CT scanners. The aim of this research was to estimate the effective doses received by the children below two years of age from routine CT examinations carried out at an educational imaging center in Tehran. It was also aimed to evaluate the quality control parameters of the mentioned CT scanner at the same time. Materials and Methods: In this study, the Computed Tomography Dose Index were measured at the central axis of the CT gantry in air and in the standard quality control phantoms of the head and body (as recommended by the FDA) using a pencil ionization chamber and LiF TLD pellets for a single scan. By using the measured Computed Tomography Dose Index values and the IrnPACT software, the effective doses were calculated for every routine CT examination protocol. In this study, the quality control parameters such as noise, CT number calibration, high and low contrast resolution and the flatness of the CT image were also evaluated. These parameters were also measured using standard procedures and test objects. Results: The effective dose estimated in this research ranged from 2.05 to 21.45 and 2.05 to 15.7 mSv for the female and male children, respectively. The measured values of the Computed Tomography Dose Index in the standard head and body phantoms were 20.6) 2.01 and 11.13 f 1.04 mGy1100 mAs, respectively. The high and low contrast resolution was estimated to be 0.8 mm and 1.0 rnm, respectively. Conclusion: The estimated values of the effective doses in this research were less than the values reported for the Netherlands, the USA, Germany and were comparable with the values reported in the UK. The measured Computed Tomography Dose Index values were 11

  1. Immune Activation and Viral Replication after Vaccination with an Influenza A H1N1 2009 Vaccine in HIV-Infected Children Receiving Antiretroviral Therapy

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    Nattawat Onlamoon

    2013-01-01

    Full Text Available Immunization with a pandemic influenza A H1N1 2009 was recommended for HIV-infected patients. However, there is limited information concerning the impact of immunization with this vaccine on immune activation and HIV viral replication. In this study, 45 HIV-infected children and adolescents receiving antiretroviral therapy were immunized with a 2-dose series of nonadjuvated monovalent influenza A H1N1 2009 vaccine upon enrollment and approximately 1 month later. Immunogenicity was determined by haemagglutination inhibition assay. The level of immune activation was determined by identification of CD38 and HLA-DR on CD8+ T cells. Patients were divided into 2 groups which include patients who had an undetectable HIV viral load (HIV detectable group and patients who show virological failure (HIV nondetectable group. The results showed seroconversion rate of 55.2% in HIV nondetectable group, whereas 31.3% was found in HIV detectable group. Both groups of patients showed no major increase in immune activation after immunization. Interestingly, a decrease in the frequency of CD8+ T cells that coexpressed CD38 and HLA-DR was observed after immunization in both groups of patients. We suggested that immunization with influenza A H1N1 2009 vaccine can induce immune response to the pandemic virus without major impact on HIV viral replication and immune activation.

  2. Measles virus antibody responses in children randomly assigned to receive standard-titer edmonston-zagreb measles vaccine at 4.5 and 9 months of age, 9 months of age, or 9 and 18 months of age

    DEFF Research Database (Denmark)

    Martins, Cesario; Garly, May-Lill; Bale, Carlitos;

    2014-01-01

    The World Health Organization recommends administration of measles vaccine (MV) at age 9 months in low-income countries. We tested the measles virus antibody response at 4.5, 9, 18, and 24 months of age for children randomly assigned to receive standard-titer Edmonston-Zagreb MV at 4.5 and 9 months...... levels at 24 months of age. In addition, the response at both 9 and 24 months of age was inversely correlated with the antibody level at receipt of the first dose of MV, and the second dose of MV, received at 9 months of age, provided a significant boost in antibody level to children who had low antibody...... levels. In the group of 318 children who received MV at 9 months of age, with or without a second dose at 18 months of age, 99% (314) had protective levels at 24 months of age. The geometric mean titer at 24 months of age was significantly lower in the group that received MV at 4.5 and 9 months of age...

  3. Breastfeeding and the anthropometric profile of children with sickle cell anemia receiving follow-up in a newborn screening reference service

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    Zeni Drubi Nogueira

    2015-06-01

    Full Text Available OBJECTIVE: To study the breastfeeding history (BF and the anthropometric status of children with Sickle Cell Disease (SCD. METHODS: A cross-sectional study of 357 children with SCD aged between 2 and 6 years, regularly followed at a Newborn Screening Reference Service (NSRS between November 2007 and January 2009. The outcome was anthropometric status and the exposures were: BF pattern, type of hemoglobinopathy and child's age and gender. RESULTS: The mean (SD age was 3.7 (1.1 years, 52.9% were boys and 53.5% had SCA (hemoglobin SS. The prevalence of exclusive breastfeeding (EBR up to six months of age was 31.5%, the median EBR times (p25-p75 was 90.0 (24.0-180.0 days and the median weaning ages (p25-p75 was 360.0 (90.0-720.0 days respectively. Normal W/H children experienced EBR for a mean duration almost four times longer than malnourished children (p=0.01, and were weaned later (p<0.05. Height deficit was found in 5.0% of children, while all the children with severe short stature had had SCA (hemoglobin SS and were older than 4 years of age. CONCLUSIONS: EBF time and weaning age were greater than that found in the literature, which is a possible effect of the multidisciplinary follow-up. Duration of EBF and later weaning were associated with improved anthropometric indicators.

  4. Breastfeeding and the anthropometric profile of children with sickle cell anemia receiving follow-up in a newborn screening reference service

    OpenAIRE

    Zeni Drubi Nogueira; Ney Boa-Sorte; Maria Efigênia de Queiroz Leite; Márcia Miyuki Kiya; Tatiana Amorim; Silvana Fahel da Fonseca

    2015-01-01

    OBJECTIVE: To study the breastfeeding history (BF) and the anthropometric status of children with Sickle Cell Disease (SCD). METHODS: A cross-sectional study of 357 children with SCD aged between 2 and 6 years, regularly followed at a Newborn Screening Reference Service (NSRS) between November 2007 and January 2009. The outcome was anthropometric status and the exposures were: BF pattern, type of hemoglobinopathy and child's age and gender. RESULTS: The mean (SD) age was 3.7 (1.1) years, 52.9...

  5. Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis

    DEFF Research Database (Denmark)

    Batwala, Vincent; Magnussen, Pascal; Hansen, Kristian S.;

    2011-01-01

    ABSTRACT: BACKGROUND: Current Uganda National Malaria treatment guidelines recommend parasitological confirmation either by microscopy or rapid diagnostic test (RDT) before treatment with artemether-lumefantrine (AL). However, the cost-effectiveness of these strategies has not been assessed at...

  6. Reduction of anti-malarial consumption after rapid diagnostic tests implementation in Dar es Salaam: a before-after and cluster randomized controlled study

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    Swai Ndeniria

    2011-04-01

    Full Text Available Abstract Background Presumptive treatment of all febrile patients with anti-malarials leads to massive over-treatment. The aim was to assess the effect of implementing malaria rapid diagnostic tests (mRDTs on prescription of anti-malarials in urban Tanzania. Methods The design was a prospective collection of routine statistics from ledger books and cross-sectional surveys before and after intervention in randomly selected health facilities (HF in Dar es Salaam, Tanzania. The participants were all clinicians and their patients in the above health facilities. The intervention consisted of training and introduction of mRDTs in all three hospitals and in six HF. Three HF without mRDTs were selected as matched controls. The use of routine mRDT and treatment upon result was advised for all patients complaining of fever, including children under five years of age. The main outcome measures were: (1 anti-malarial consumption recorded from routine statistics in ledger books of all HF before and after intervention; (2 anti-malarial prescription recorded during observed consultations in cross-sectional surveys conducted in all HF before and 18 months after mRDT implementation. Results Based on routine statistics, the amount of artemether-lumefantrine blisters used post-intervention was reduced by 68% (95%CI 57-80 in intervention and 32% (9-54 in control HF. For quinine vials, the reduction was 63% (54-72 in intervention and an increase of 2.49 times (1.62-3.35 in control HF. Before-and-after cross-sectional surveys showed a similar decrease from 75% to 20% in the proportion of patients receiving anti-malarial treatment (Risk ratio 0.23, 95%CI 0.20-0.26. The cluster randomized analysis showed a considerable difference of anti-malarial prescription between intervention HF (22% and control HF (60% (Risk ratio 0.30, 95%CI 0.14-0.70. Adherence to test result was excellent since only 7% of negative patients received an anti-malarial. However, antibiotic

  7. A Comparison of the Cognitive Development of 3-6 Year-Old Children Who Receive Family-Supported Preschool Education, Institutional Education and No Education

    Science.gov (United States)

    Zembat, Rengin; Kuday, Fatma Servet

    2010-01-01

    This study aims to examine the effects of Family Supported Preschool Education programs on the development of preschool children. By measuring the effects of family-supported preschool education on cognitive development, this study helps support alternative methods of making preschool education more widespread. The study uses the experimental…

  8. Artemether–lumefantrine treatment failure despite adequate lumefantrine day 7 concentration in a traveller with Plasmodium falciparum malaria after returning from Tanzania

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    Färnert Anna

    2012-05-01

    Full Text Available Abstract Artemether-lumefantrine is currently first-line therapy of Plasmodium falciparum malaria in many countries. This report describes a treatment failure despite adequate drug concentrations in a traveller returning from sub-Saharan Africa. Genotyping confirmed recrudescence and suggested reduced sensitivity. Potential sub-optimal effect of artemether-lumefantrine highlights the need to follow non-immune individuals the weeks after treatment.

  9. Temporal and seasonal changes of genetic polymorphisms associated with altered drug susceptibility to chloroquine, lumefantrine and quinine in Guinea-Bissau between 2003 and 2012

    DEFF Research Database (Denmark)

    Jovel, Irina Tatiana; Kofoed, Poul-Erik; Rombo, Lars;

    2015-01-01

    BACKGROUND: Guinea-Bissau, West-Africa introduced artemether-lumefantrine in 2008 but quinine has also been commonly prescribed for treatment of uncomplicated Plasmodium falciparum malaria. An efficacious high-dose chloroquine treatment regimen was used previously. Temporal and seasonal changes of.......001). CONCLUSIONS: Following the discontinuation of an effective chloroquine regimen highly artemether-lumefantrine susceptible P. falciparum (with pfcrt 76T) accumulated possibly due to suboptimal use of quinine and despite a fitness cost linked to 76T....

  10. Plasmodium falciparum clearance with artemisinin-based combination therapy (ACT in patients with glucose-6-phosphate dehydrogenase deficiency in Mali

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    Djimde Abdoulaye

    2010-11-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT is currently the most effective medicine for the treatment of uncomplicated malaria. Artemisinin has previously been shown to increase the clearance of Plasmodium falciparum in malaria patients with haemoglobin E trait, but it did not increase parasite inhibition in an in vitro study using haemoglobin AS erythrocytes. The current study describes the efficacy of artemisinin derivatives on P. falciparum clearance in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD, a haemoglobin enzyme deficiency, not yet studied in the same context, but nonetheless is a common in malaria endemic areas, associated with host protection against uncomplicated and severe malaria. The impact of G6PD deficiency on parasite clearance with ACT treatment was compared between G6PD-deficient patients and G6PD-normal group. Methods Blood samples from children and adults participants (1 to 70 years old with uncomplicated P. falciparum malaria residing in Kambila, Mali were analysed. Study participants were randomly assigned to receive either artemether-lumefantrine (Coartem® or artesunate plus mefloquine (Artequin™. A restriction-fragment length polymorphism analysis of PCR-amplified DNA samples was used to identify the (A- allele of the gene mutation responsible for G6PD deficiency (G6PD*A-. 470 blood samples were thus analysed and of these, DNA was extracted from 315 samples using the QIAamp kit for PCR to identify the G6PD*A- gene. Results The DNA amplified from 315 samples using PCR showed that G6PD*A- deficiency was present in 56 participants (17.8%. The distribution of the specific deficiency was 1%, 7% and, 9.8% respectively for homozygous, hemizygous, and heterozygous genotypes. Before treatment, the median parasitaemia and other baseline characteristics (mean haemoglobin, sex and age groups between G6PD deficiency (hemizygous, heterozygous, and homozygous and G6PD-normal participants

  11. Repeated treatment of recurrent uncomplicated Plasmodium falciparum malaria in Senegal with fixed-dose artesunate plus amodiaquine versus fixed-dose artemether plus lumefantrine: a randomized, open-label trial

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    Barry Aichatou

    2011-08-01

    Full Text Available Abstract Background The use of artemisinin-based combination therapy (ACT is currently recommended for treating uncomplicated malaria. The objective was to assess the efficacy and safety of repeated administrations of two fixed-dose presentations of ACT - artesunate plus amodiaquine (ASAQ and artemether-lumefantrine (AL - in subsequent episodes of Plasmodium falciparum malaria. Methods A randomized comparative study was conducted in a rural community of central Senegal from August 2007 to January 2009. Children and adults with uncomplicated P. falciparum malaria were randomized to receive open-label ASAQ once daily or AL twice daily for three days. Drug doses were given according to body weight. Treatments for first episodes were supervised. For subsequent episodes, only the first intake of study drug was supervised. ECGs and audiograms were performed in patients ≥12 years of age. Primary outcome was adequate clinical and parasitological response rate (ACPR after polymerase chain reaction (PCR correction on day 28 for the first episode. Results A total of 366 patients were enrolled in the two groups (ASAQ 184, AL 182 and followed up during two malaria transmission seasons. In the intent-to-treat population, PCR-corrected ACPRs at day 28 for the first episode were 98.4% and 96.2%, respectively, in the ASAQ and AL groups. For the per-protocol population (ASAQ 183, AL 182, PCR-corrected ACPRs at day 28 for the first episode were 98.9% and 96.7%, respectively. A 100% ACPR rate was obtained at day 28 in the 60 and four patients, respectively, who experienced second and third episodes. Treatment-related adverse events were reported in 11.7% of the patients, without significant differences between the two groups. A better improvement of haemoglobin at day 28 was noted in the ASAQ versus the AL group (12.2 versus 11.8 g/dL; p = 0.03. No sign of ototoxicity was demonstrated. A prolongation of the QTc interval was observed in both groups during

  12. Accessibility, availability and affordability of anti-malarials in a rural district in Kenya after implementation of a national subsidy scheme

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    Simiyu Chrispinus

    2011-10-01

    Full Text Available Abstract Background Poor access to prompt and effective treatment for malaria contributes to high mortality and severe morbidity. In Kenya, it is estimated that only 12% of children receive anti-malarials for their fever within 24 hours. The first point of care for many fevers is a local medicine retailer, such as a pharmacy or chemist. The role of the medicine retailer as an important distribution point for malaria medicines has been recognized and several different strategies have been used to improve the services that these retailers provide. Despite these efforts, many mothers still purchase ineffective drugs because they are less expensive than effective artemisinin combination therapy (ACT. One strategy that is being piloted in several countries is an international subsidy targeted at anti-malarials supplied through the retail sector. The goal of this strategy is to make ACT as affordable as ineffective alternatives. The programme, called the Affordable Medicines Facility - malaria was rolled out in Kenya in August 2010. Methods In December 2010, the affordability and accessibility of malaria medicines in a rural district in Kenya were evaluated using a complete census of all public and private facilities, chemists, pharmacists, and other malaria medicine retailers within the Webuye Demographic Surveillance Area. Availability, types, and prices of anti-malarials were assessed. There are 13 public or mission facilities and 97 medicine retailers (registered and unregistered. Results The average distance from a home to the nearest public health facility is 2 km, but the average distance to the nearest medicine retailer is half that. Quinine is the most frequently stocked anti-malarial (61% of retailers. More medicine retailers stocked sulphadoxine-pyramethamine (SP; 57% than ACT (44%. Eleven percent of retailers stocked AMFm subsidized artemether-lumefantrine (AL. No retailers had chloroquine in stock and only five were selling artemisinin

  13. Electronic warfare receivers and receiving systems

    CERN Document Server

    Poisel, Richard A

    2014-01-01

    Receivers systems are considered the core of electronic warfare (EW) intercept systems. Without them, the fundamental purpose of such systems is null and void. This book considers the major elements that make up receiver systems and the receivers that go in them.This resource provides system design engineers with techniques for design and development of EW receivers for modern modulations (spread spectrum) in addition to receivers for older, common modulation formats. Each major module in these receivers is considered in detail. Design information is included as well as performance tradeoffs o

  14. Predictors of treatment failure and time to detection and switching in HIV-infected Ethiopian children receiving first line anti-retroviral therapy

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    Bacha Tigist

    2012-08-01

    Full Text Available Abstract Background The emergence of resistance to first line antiretroviral therapy (ART regimen leads to the need for more expensive and less tolerable second line drugs. Hence, it is essential to identify and address factors associated with an increased probability of first line ART regimen failure. The objective of this article is to report on the predictors of first line ART regimen failure, the detection rate of ART regime failure, and the delay in switching to second line ART drugs. Methods A retrospective cohort study was conducted from 2005 to 2011. All HIV infected children under the age of 15 who took first line ART for at least six months at the four major hospitals of Addis Ababa, Ethiopia were included. Data were collected, entered and analyzed using Epi info/ENA version 3.5.1 and SPSS version 16. The Cox proportional-hazard model was used to assess the predictors of first line ART failure. Results Data of 1186 children were analyzed. Five hundred seventy seven (48.8% were males with a mean age of 6.22 (SD = 3.10 years. Of the 167(14.1% children who had treatment failure, 70 (5.9% had only clinical failure, 79 (6.7% had only immunologic failure, and 18 (1.5% had both clinical and immunologic failure. Patients who had height for age in the third percentile or less at initiation of ART were found to have higher probability of ART treatment failure [Adjusted Hazard Ratio (AHR, 3.25 95% CI, 1.00-10.58]. Patients who were less than three years old [AHR, 1.85 95% CI, 1.24-2.76], chronic diarrhea after initiation of antiretroviral treatment [AHR, 3.44 95% CI, 1.37-8.62], ART drug substitution [AHR, 1.70 95% CI, 1.05-2.73] and base line CD4 count below 50 cells/mm3 [AHR, 2.30 95% CI, 1.28-4.14] were also found to be at higher risk of treatment failure. Of all the 167 first line ART failure cases, only 24 (14.4% were switched to second line ART with a mean delay of 24 (SD = 11.67 months. The remaining 143 (85.6% cases were diagnosed

  15. Developing Children's Awareness of the Human-Animal Bond: An Assessment of the Experiences and Benefits that Children Receive in the United Animal Nation's Humane Education Ambassador Readers (HEAR) Program

    Science.gov (United States)

    Stokes, Laura

    2009-01-01

    In 2007, the United Animal Nations (UAN) launched the Humane Education Ambassador Readers (HEAR), an innovation that focused on mitigation of animal suffering through education. In the HEAR program, adult volunteers read carefully selected story books to children in grades 3-6 in schools or other educational settings, and hold discussions with the…

  16. 儿童髓母细胞瘤34例三维适形放射治疗的疗效分析%The follow-up of 34 children with medulloblastoma who received 3-dimensional conformal radiation therapy

    Institute of Scientific and Technical Information of China (English)

    Dongfeng He; Siheng Ha; Changsheng Wang

    2009-01-01

    Objective: In our investigation, we studied the patients with medulloblastoma who received 3-dimensional con- formal radiation therapy (3DCRT) and recorded their effects, side effects and failure reasons. Methods: From August 2001 to August 2007, 34 children with medulloblastoma were treated in our hospital. The age at diagnosis was 3-16 years old, and the mean age at diagnosis was 9.5 years old. Among all the patients, 16 cases were included in the high risk group and 18cases were included in the low risk group. All the patients were performed total resection or subtotal resection and no patientsreceived radiotherapy or chemotherapy before operation. All patients received 3DCRT within 3 weeks after resection. The dose of 30 Gy were given to the whole brain and whole spine, followed by 20-25 Gy boosted to the posterior brain fossa. The median fraction dose was 180 cGy. Every patient received the chemotherapy scheme of the Lomustine, Cisplatinum and Vincristine. Nobody received intrathecal chemotherapy. The tests of the complete blood count, blood biochemistry, hepatic and renal functions were required before every cycle of chemotherapy. Results: 5-year overall survival (OS) and 5-year disease free survival (DFS) were 71% and 62% respectively. The median follow-up time was 36.5 months. The 5-year OS of the high risk group was 71% compared to 62% of the low risk group. There were significant difference between the two groups (P = 0.01). There were 13 failure cases in all the patients. Of these 13 patients, 10 were dead and the other 3 were alive with tumor. The complete remission (CR) rate was 70.5% and the partial remission (PR) rate was 14%. Among the failure patients, there were 3 patients (8.8%) with the recurrences located in the brain of cribriform region. The 5-year OS of the patients with preoperative metastases was 12.5% (1/8), and which of the patients with residual tumor volume > 1.5 cm3 was 0% (0/5). Through the statistic analysis, it was found that both

  17. What parents of children who have received emergency care think about deferring consent in randomised trials of emergency treatments: postal survey.

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    Carrol Gamble

    Full Text Available OBJECTIVE: To investigate parents' views about deferred consent to inform management of trial disclosure after a child's death. METHODS: A postal questionnaire survey was sent to members of the Meningitis Research Foundation UK charity, whose child had suffered from bacterial meningitis or meningococcal septicaemia within the previous 5 years. Main outcome measures were acceptability of deferred consent; timing of requesting consent; and the management of disclosure of the trial after a child's death. RESULTS: 220 families were sent questionnaires of whom 63 (29% were bereaved. 68 families responded (31%, of whom 19 (28% were bereaved. The majority (67% was willing for their child to be involved in the trial without the trial being explained to them beforehand; 70% wanted to be informed about the trial as soon as their child's condition had stabilised. In the event of a child's death before the trial could be discussed the majority of bereaved parents (66% 12/18 anticipated wanting to be told about the trial at some time. This compared with 37% (18/49 of non-bereaved families (p = 0.06. Parents' free text responses indicated that the word 'trial' held strongly negative connotations. A few parents regarded gaps in the evidence base about emergency treatments as indicating staff lacked expertise to care for a critically ill child. Bereaved parents' free text responses indicated the importance of individualised management of disclosure about a trial following a child's death. DISCUSSION: Deferred consent is acceptable to the majority of respondents. Parents whose children had recovered differed in their views compared to bereaved parents. Most bereaved parents would want to be informed about the trial in the aftermath of a child's death, although a minority strongly opposed such disclosure. Distinction should be drawn between the views of bereaved and non-bereaved parents when considering the acceptability of different consent processes.

  18. Optimizing the interval between G-CSF therapy and F-18 FDG PET imaging in children and young adults receiving chemotherapy for sarcoma

    International Nuclear Information System (INIS)

    Granulocyte colony-stimulating factors (G-CSF) speed recovery from chemotherapy-induced myelosuppression but the marrow stimulation they cause can interfere with interpretation of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) exams. To assess the frequency of interfering G-CSF-induced bone marrow activity on FDG PET imaging in children and young adults with Ewing sarcoma and rhabdomyosarcoma and to define an interval between G-CSF administration and FDG PET imaging that limits marrow interference. Blinded, retrospective review of FDG PET exams performed in patients treated with long-acting G-CSF as part of their chemotherapeutic regimen. Exams were subjectively scored by two reviewers (R1 and R2) who assessed the level of marrow uptake of FDG and measured standardized uptake values in the marrow, liver, spleen and blood pool. FDG PET findings were correlated with time since G-CSF administration and with blood cell counts. Thirty-eight FDG PET exams performed in 17 patients were reviewed with 47.4% (18/38) of exams having marrow uptake of FDG sufficient to interfere with image interpretation. Primary predictors of marrow uptake of FDG were patient age (P = 0.0037) and time since G-CSF exposure (P = 0.0028 for subjective marrow uptake of FDG, P = 0.008 [R1] and P = 0.004 [R2] for measured maximum standardized uptake value (SUVmax)). The median interval between G-CSF administration and PET imaging in cases with marrow activity considered normal or not likely to interfere was 19.5 days (range: 7-55 days). In pediatric and young adult patients with Ewing sarcoma and rhabdomyosarcoma, an interval of 20 days between administration of the long-acting form of G-CSF and FDG PET imaging should limit interference by stimulated marrow. (orig.)

  19. Optimizing the interval between G-CSF therapy and F-18 FDG PET imaging in children and young adults receiving chemotherapy for sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Trout, Andrew T.; Sharp, Susan E.; Gelfand, Michael J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Turpin, Brian K. [Cincinnati Children' s Hospital Medical Center, Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH (United States)

    2015-07-15

    Granulocyte colony-stimulating factors (G-CSF) speed recovery from chemotherapy-induced myelosuppression but the marrow stimulation they cause can interfere with interpretation of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) exams. To assess the frequency of interfering G-CSF-induced bone marrow activity on FDG PET imaging in children and young adults with Ewing sarcoma and rhabdomyosarcoma and to define an interval between G-CSF administration and FDG PET imaging that limits marrow interference. Blinded, retrospective review of FDG PET exams performed in patients treated with long-acting G-CSF as part of their chemotherapeutic regimen. Exams were subjectively scored by two reviewers (R1 and R2) who assessed the level of marrow uptake of FDG and measured standardized uptake values in the marrow, liver, spleen and blood pool. FDG PET findings were correlated with time since G-CSF administration and with blood cell counts. Thirty-eight FDG PET exams performed in 17 patients were reviewed with 47.4% (18/38) of exams having marrow uptake of FDG sufficient to interfere with image interpretation. Primary predictors of marrow uptake of FDG were patient age (P = 0.0037) and time since G-CSF exposure (P = 0.0028 for subjective marrow uptake of FDG, P = 0.008 [R1] and P = 0.004 [R2] for measured maximum standardized uptake value (SUVmax)). The median interval between G-CSF administration and PET imaging in cases with marrow activity considered normal or not likely to interfere was 19.5 days (range: 7-55 days). In pediatric and young adult patients with Ewing sarcoma and rhabdomyosarcoma, an interval of 20 days between administration of the long-acting form of G-CSF and FDG PET imaging should limit interference by stimulated marrow. (orig.)

  20. Musical therapy for children receiving venous transfusion in outpatient department%浅析音乐治疗在儿内科门诊静脉穿刺输液治疗患儿中的应用

    Institute of Scientific and Technical Information of China (English)

    段建华; 张婧雯; 张倩丽

    2013-01-01

    目的 通过分析患儿在北京新世纪儿童医院儿内科门诊静脉穿刺输液治疗时接受音乐治疗前后行为及言语紧张度数据,积累音乐治疗在儿科静脉穿刺输液治疗中的应用经验.方法 北京新世纪儿童医院门诊接受静脉穿刺输液治疗同时接受音乐治疗的患儿23名,采取行为评价量表和家长问卷评价患儿接受音乐治疗前后的行为和语言指标.结果 在儿内科门诊静脉穿刺输液治疗时接受音乐治疗可以使患儿语言恐惧表达率和紧张性肢体动作出现率降低,差异有统计学意义.结论 音乐治疗可以减轻静脉穿刺输液治疗对儿童的不良情绪刺激.%Objective To share the experience of musical therapy for children who receive venous transfusion in outpatient department. Methods Behavior scales and parents questionnaire were developed to obtain data before and after musical therapy for children receiving venous transfusion. Results Musical therapy could significantly reduce fearful language expression and tonic limb action. Conclusion Musical therapy was effective in reducing anxiety and distress.

  1. What Teachers Perceive--Children Receive?

    Science.gov (United States)

    Algozzine, Robert

    1976-01-01

    Reports a study designed to ascertain the relationship between teacher perceived attractiveness and classroom interactions and suggests that "main effects" such as facial attractiveness of youngsters acts to determine individual potential for interactions with others. (MH)

  2. Percepción y expectativas de cuidadoras de niños con gran discapacidad: Sobre la atención sanitaria recibida Perception and expectations of mothers with seriously disable children on received sanitary attention

    Directory of Open Access Journals (Sweden)

    María Isabel Cruz-Escobosa

    2006-11-01

    Full Text Available Objetivos: (1 Conocer la percepción que tienen las cuidadoras principales de niños con Gran Discapacidad respecto a la atención recibida dentro del Sistema Sanitario Público de Andalucía. (2 Identificar propuestas de mejora para la atención integral tanto de los niños, como de sus cuidadoras. Metodología: estudio cualitativo mediante Grupo Focal con madres/padres de niños y niñas diagnosticados de patologías crónicas que generan gran dependencia con edades comprendidas entre 4 y 12 años. Resultados: las repercusiones de la enfermedad de sus hijos en sus familias y en ellas supusieron un impacto total. Expresan una falta de apoyo familiar efectivo y de tiempo para su autocuidado. Perciben un trato y una atención mejorable por parte de algunos de los profesionales de Atención Especializada. En el Centro de Salud ven muy positivo el trato de los profesionales, la accesibilidad, las facilidades que encuentran ante cualquier problema que les surge y ahora el plan de atención a cuidadoras de grandes discapacitados. Conclusiones: es necesario tener en cuenta la visión de las madres en el tratamiento de la enfermedad de sus hijos. Asumirla por los profesionales como una información valiosa va a producir una mejora en la calidad prestada. Valoran que se les informe con claridad y no técnicamente. Cualquier intervención del sistema socio-sanitario debe abarcar al paciente, a la cuidadora y a la familia, aumentar las prestaciones ofrecidas, especialmente el tratamiento rehabilitador y facilitar recursos para minimizar la sobrecarga económica y emocional.Objectives: (1 To know the perception which they have the main nursemaids of children with seriously disabilities about the attention received within the Public System Sanitary of Andalusia, identifying strong and weak points. (2 To as much identify proposals of improvement for the integral attention of the children, as of its nursemaids. Methodology: qualitative study by means of Focal

  3. Optical communication receiver design

    CERN Document Server

    Alexander, Stephen B

    2006-01-01

    Copublished with IEE. This Tutorial Text provides an overview of design principles for receivers used in optical communication systems, intended for practicing engineers. The author reviews technologies used to construct optical links and illustrates the flow of system performance specifications into receiver requirements. Photodetector fundamentals, associated statistics, characteristics and performance issues are presented, together with a tutorial on noise analysis and the specific techniques needed to model optical receivers.

  4. Delphi Accounts Receivable Module

    Data.gov (United States)

    Department of Transportation — Delphi accounts receivable module contains the following data elements, but are not limited to customer information, cash receipts, line of accounting details, bill...

  5. Study of the factors associated with dental caries in children who receive early dental care Estudo de fatores associados à cárie dental em crianças que recebem atendimento odontológico precoce

    Directory of Open Access Journals (Sweden)

    Fabian Calixto FRAIZ

    2001-09-01

    Full Text Available The present study investigated the factors associated with the development of dental caries in preschool children who receive regular dental care and follow-up. The research was carried out at the Baby Clinic, Londrina State University, and comprised two hundred preschool children, whose ages ranged from 24 to 48 months, as well as their mothers, who had already taken part in a dental program at the Baby Clinic during, at least, the previous twelve months. Regarding oral hygiene habits, there was no significant difference between the preschool children who presented with caries and those who did not present with caries. However, the presence of visible bacterial plaque on the upper incisors was strongly associated with the presence of dental caries. Other factors associated with the presence of caries were: period of formal education of the father or of both parents equal or inferior to 8 years, high sugar consumption and bottle-feeding during sleep. In the studied population, the dietary pattern is still the main cause of carious lesions. In addition, the presence of visible bacterial plaque on the labial surface of the upper incisors must be considered as an important clinical sign, often associated with inadequate patterns of diet and oral hygiene.Esta pesquisa estudou os fatores associados com o desenvolvimento de cárie dentária em pré-escolares que recebem acompanhamento e intervenção odontológica. O estudo abrangeu 200 crianças, de 24 a 48 meses de idade, que participavam do programa da Bebê-Clínica (Universidade Estadual de Londrina havia pelo menos 12 meses. A comparação entre as crianças com cárie e sem cárie não apresentou diferenças estatisticamente significantes com relação aos hábitos de higiene bucal. No entanto, a presença de placa visível nos incisivos superiores esteve fortemente associada com a presença de cárie dentária. Outros fatores relacionados à presença de cárie foram a educação formal

  6. Ceramic Solar Receiver

    Science.gov (United States)

    Robertson, C., Jr.

    1984-01-01

    Solar receiver uses ceramic honeycomb matrix to absorb heat from Sun and transfer it to working fluid at temperatures of 1,095 degrees and 1,650 degrees C. Drives gas turbine engine or provides heat for industrial processes.

  7. Receiver Gain Modulation Circuit

    Science.gov (United States)

    Jones, Hollis; Racette, Paul; Walker, David; Gu, Dazhen

    2011-01-01

    A receiver gain modulation circuit (RGMC) was developed that modulates the power gain of the output of a radiometer receiver with a test signal. As the radiometer receiver switches between calibration noise references, the test signal is mixed with the calibrated noise and thus produces an ensemble set of measurements from which ensemble statistical analysis can be used to extract statistical information about the test signal. The RGMC is an enabling technology of the ensemble detector. As a key component for achieving ensemble detection and analysis, the RGMC has broad aeronautical and space applications. The RGMC can be used to test and develop new calibration algorithms, for example, to detect gain anomalies, and/or correct for slow drifts that affect climate-quality measurements over an accelerated time scale. A generalized approach to analyzing radiometer system designs yields a mathematical treatment of noise reference measurements in calibration algorithms. By treating the measurements from the different noise references as ensemble samples of the receiver state, i.e. receiver gain, a quantitative description of the non-stationary properties of the underlying receiver fluctuations can be derived. Excellent agreement has been obtained between model calculations and radiometric measurements. The mathematical formulation is equivalent to modulating the gain of a stable receiver with an externally generated signal and is the basis for ensemble detection and analysis (EDA). The concept of generating ensemble data sets using an ensemble detector is similar to the ensemble data sets generated as part of ensemble empirical mode decomposition (EEMD) with exception of a key distinguishing factor. EEMD adds noise to the signal under study whereas EDA mixes the signal with calibrated noise. It is mixing with calibrated noise that permits the measurement of temporal-functional variability of uncertainty in the underlying process. The RGMC permits the evaluation of EDA by

  8. Incidencia de bacteriemia asociada a catéter en niños hospitalizados que reciben nutrición parenteral Blood-stream catheter related infection in inpatient children receiving parenteral nutrition

    Directory of Open Access Journals (Sweden)

    E. Vaquero Sosa

    2011-02-01

    Full Text Available Las infecciones relacionadas con el catéter son la complicación más grave en los pacientes portadores de un catéter venoso central. Se considera que la nutrición parenteral (NP constituye un factor de riesgo de desarrollar una infección relacionada con el catéter (IRCat. Material y métodos: para conocer la tasa de infección y poder establecer estrategias de prevención de la infección nosocomial, se revisaron todas las historias de los 120 pacientes que recibieron NP a lo largo de 2008. Todas las historias de los pacientes con un episodio fiebre y hemocultivo positivo fueron consideradas. La tasa de infección se definió como número de episodios por cada 1000 días de NP. Resultados: Se obtuvieron 48 hemocultivos positivos. La tasa global de bacteriemia asociada a catéter fue de 37,8/1000 días de NP. La incidencia fue significativamente mayor en lactantes menores de 2 años de edad. Los gérmenes que se encontraron con mayor frecuencia fueron Estafilococo coagulasa negativo (56,8%, seguidos de bacilos Gram (20,8%, Staph aureus (12,5% y los hongos (12,5%. No encontramos diferencias en la tasa de infección cuando ajustamos por la enfermedad de base o la duración de la NP. Conclusiones: La tasa de infección en niños con NP en el hospital es considerablemente elevada. La NP parece constituir un factor de riesgo de desarrollar IRCat. Es necesario establecer políticas adecuadas y continuadas para conseguir disminuir la tasa de infección nosocomial.Blood-stream catheter related infection is the most severe complication in patients carrying a central venous catheter. Parenteral nutrition (PN use seems to be a risk factor for developing a catheter-related infection (CRI. Material & methods: In order to know the incidence of CRI in children to further implement policies to reduce nosocomial infection, we review all charts of children (1 month to 17 years who received parenteral nutrition while in hospital. All episodes of fever

  9. Solar thermal central receivers

    International Nuclear Information System (INIS)

    Market issues, environmental impact, and technology issues related to the Solar Central Receiver concept are addressed. The rationale for selection of the preferred configuration and working fluid are presented as the result of a joint utility-industry analysis. A $30 million conversion of Solar One to an external molten salt receiver would provide the intermediate step to a commercial demonstration plant. The first plant in this series could produce electricity at 11.2 cents/kWhr and the seventh at 8.2 cents/kWhr, completely competitive with projected costs of new utility plants in 1992

  10. Wideband CMOS receivers

    CERN Document Server

    Oliveira, Luis

    2015-01-01

    This book demonstrates how to design a wideband receiver operating in current mode, in which the noise and non-linearity are reduced, implemented in a low cost single chip, using standard CMOS technology.  The authors present a solution to remove the transimpedance amplifier (TIA) block and connect directly the mixer’s output to a passive second-order continuous-time Σ∆ analog to digital converter (ADC), which operates in current-mode. These techniques enable the reduction of area, power consumption, and cost in modern CMOS receivers.

  11. Pressure difference receiving ears

    DEFF Research Database (Denmark)

    Michelsen, Axel; Larsen, Ole Næsbye

    2007-01-01

    Directional sound receivers are useful for locating sound sources, and they can also partly compensate for the signal degradations caused by noise and reverberations. Ears may become inherently directional if sound can reach both surfaces of the eardrum. Attempts to understand the physics of such...

  12. Olympus beacon receiver

    Science.gov (United States)

    Ostergaard, Jens

    1988-01-01

    A medium-size Beacon Receiving System for reception and processing of the B1 (20 GHz) and B2 (30 GHz) beacons from Olympus has been developed. Integration of B1 and B2 receiving equipment into one system using one antenna and a common computer for control and data processing provides the advantages of a compact configuration and synchronization of the two receiver chains. Range for co-polar signal attenuation meaurement is about 30 dB for both beacons, increasing to 40 dB for B2 if the receivers are synchronized to B1. The accuracy is better than 0.5 dB. Cross-polarization discriminations of the order of 10 to 30 dB may be determined with an accuracy of 1 to 2 dB. A number of radiometers for complementary measurements of atmospheric attenuation of 13 to 30 GHz has also been constructed. A small multi-frequency system for operation around 22 GHz and 31 GHz is presently under development.

  13. Receiving Pseudorandom PSK

    OpenAIRE

    Janson, Thomas; Schindelhauer, Christian

    2015-01-01

    Pseudorandom PSK [1] enables parallel communication on the same carrier frequency and at the same time. We propose different signal processing methods to receive data modulated with pseudorandom PSK. This includes correlation with the carrier frequency which can be applied to signals in the kHz to MHz range and signal processing in the intermediate frequency where the correlation with the carrier frequency is performed analogous in the RF front end. We analyze the computation complexity for s...

  14. Primaquine plus artemisinin combination therapy for reduction of malaria transmission: promise and risk.

    Science.gov (United States)

    John, Chandy C

    2016-01-01

    Reduction of gametocyte transmission from humans to mosquitoes is a key component of malaria elimination. The study by Gonçalves and colleagues provides valuable new data on how the addition of low-dose primaquine to artemether-lumefantrine affects reduction of gametocytemia and transmission of gametocytes to mosquitoes in asymptomatically Plasmodium falciparum-infected children without G6PD deficiency, and on the degree to which low-dose primaquine affects hemoglobin levels in these children. The study sets the stage for future research required for consideration of an artemisinin combination therapy (ACT)-primaquine regimen in mass drug administration campaigns. Future studies will need to evaluate toxicity in adults and G6PD deficient persons, assess gametocyte transmission from adults, evaluate different ACT drugs with primaquine, and assess the implications of "rare" toxicities in large treatment populations, such as hemolysis requiring blood transfusion. The study highlights both the promise and the potential risk of ACT-primaquine treatment in malaria elimination campaigns.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0581-y . PMID:27039396

  15. Digital Receiver Phase Meter

    Science.gov (United States)

    Marcin, Martin; Abramovici, Alexander

    2008-01-01

    The software of a commercially available digital radio receiver has been modified to make the receiver function as a two-channel low-noise phase meter. This phase meter is a prototype in the continuing development of a phase meter for a system in which radiofrequency (RF) signals in the two channels would be outputs of a spaceborne heterodyne laser interferometer for detecting gravitational waves. The frequencies of the signals could include a common Doppler-shift component of as much as 15 MHz. The phase meter is required to measure the relative phases of the signals in the two channels at a sampling rate of 10 Hz at a root power spectral density digital receiver. The input RF signal is first fed to the input terminal of an analog-to-digital converter (ADC). To prevent aliasing errors in the ADC, the sampling rate must be at least twice the input signal frequency. The sampling rate of the ADC is governed by a sampling clock, which also drives a digital local oscillator (DLO), which is a direct digital frequency synthesizer. The DLO produces samples of sine and cosine signals at a programmed tuning frequency. The sine and cosine samples are mixed with (that is, multiplied by) the samples from the ADC, then low-pass filtered to obtain in-phase (I) and quadrature (Q) signal components. A digital signal processor (DSP) computes the ratio between the Q and I components, computes the phase of the RF signal (relative to that of the DLO signal) as the arctangent of this ratio, and then averages successive such phase values over a time interval specified by the user.

  16. Adaptive antennas and receivers

    CERN Document Server

    Weiner, Melvin M

    2005-01-01

    In our modern age of remote sensing, wireless communication, and the nearly endless list of other antenna-based applications, complex problems require increasingly sophisticated solutions. Conventional antenna systems are no longer suited to high-noise or low-signal applications such as intrusion detection. Detailing highly effective approaches to non-Gaussian weak signal detection, Adaptive Antennas and Receivers provides an authoritative introduction to state-of-the-art research on the modeling, testing, and application of these technologies.Edited by innovative researcher and eminent expert

  17. Solar thermal energy receiver

    Science.gov (United States)

    Baker, Karl W. (Inventor); Dustin, Miles O. (Inventor)

    1992-01-01

    A plurality of heat pipes in a shell receive concentrated solar energy and transfer the energy to a heat activated system. To provide for even distribution of the energy despite uneven impingement of solar energy on the heat pipes, absence of solar energy at times, or failure of one or more of the heat pipes, energy storage means are disposed on the heat pipes which extend through a heat pipe thermal coupling means into the heat activated device. To enhance energy transfer to the heat activated device, the heat pipe coupling cavity means may be provided with extensions into the device. For use with a Stirling engine having passages for working gas, heat transfer members may be positioned to contact the gas and the heat pipes. The shell may be divided into sections by transverse walls. To prevent cavity working fluid from collecting in the extensions, a porous body is positioned in the cavity.

  18. GNSS Software Receiver for UAVs

    DEFF Research Database (Denmark)

    Olesen, Daniel Madelung; Jakobsen, Jakob; von Benzon, Hans-Henrik;

    2016-01-01

    This paper describes the current activities of GPS/GNSS Software receiver development at DTU Space. GNSS Software receivers have received a great deal of attention in the last two decades and numerous implementations have already been presented. DTU Space has just recently started development of ...... our own GNSS software-receiver targeted for mini UAV applications, and we will in in this paper present our current progress and briefly discuss the benefits of Software Receivers in relation to our research interests....

  19. CYP2B6*6 genotype and high efavirenz plasma concentration but not nevirapine are associated with low lumefantrine plasma exposure and poor treatment response in HIV-malaria-coinfected patients.

    Science.gov (United States)

    Maganda, B A; Minzi, O M S; Ngaimisi, E; Kamuhabwa, A A R; Aklillu, E

    2016-02-01

    We investigated the influence of efavirenz (EFV)- or nevirapine (NVP)-based antiretroviral therapy (ART) on lumefantrine plasma exposure in HIV-malaria-coinfected patients and implication of pharmacogenetic variations. A total of 269 HIV patients with uncomplicated falciparum malaria on NVP-based ART (NVP-arm), EFV-based ART (EFV-arm) or not receiving ART (control-arm) were enrolled and treated with artemether-lumefantrine. Day-7 lumefantrine, baseline EFV and NVP plasma concentrations, and CYP2B6*6,*18, CYP3A4*1B, CYP3A5*3,*6,*7, ABCB1 c.3435C>T and ABCB1 c.4036A>G genotypes were determined. The median day-7 lumefantrine plasma concentration was significantly lower in the EFV-arm compared with that in NVP- and control-arm. High EFV plasma concentrations and CYP2B6*6/*6 genotype significantly correlated with low lumefantrine plasma concentrations and high rate of recurrent parasitemia. No significant effect of NVP-based ART on lumefantrine exposure was observed. In conclusion, owing to long-term CYP3A induction, EFV-based ART cotreatment significantly reduces lumefantrine plasma exposure leading to poor malaria treatment response, which is more pronounced in CYP2B6 slow metabolizers. PMID:25963334

  20. CERN apprentice receives award

    CERN Multimedia

    2008-01-01

    Another CERN apprentice has received an award for the quality of his work. Stéphane Küng (centre), at the UIG ceremony last November, presided over by Geneva State Councillor Pierre-François Unger, Head of the Department of Economics and Health. Electronics technician Stéphane Küng was honoured in November by the Social Foundation of the Union Industrielle Genevoise (UIG) as one of Geneva’s eight best apprentices in the field of mechatronics. The 20-year-old Genevan obtained his Federal apprentice’s certificate (Certificat fédéral de capacité - CFC) in June 2007, achieving excellent marks in his written tests at the Centre d’Enseignement Professionnel Technique et Artisanal (CEPTA). Like more than 200 youngsters before him, Stéphane Küng spent part of his four-year sandwich course working at CERN, where he followed many practical training courses and gained valuable hands-on experience in various technical groups and labs. "It’ always very gr...

  1. Advanced solar thermal receiver technology

    Science.gov (United States)

    Kudirka, A. A.; Leibowitz, L. P.

    1980-01-01

    Development of advanced receiver technology for solar thermal receivers designed for electric power generation or for industrial applications, such as fuels and chemical production or industrial process heat, is described. The development of this technology is focused on receivers that operate from 1000 F to 3000 F and above. Development strategy is mapped in terms of application requirements, and the related system and technical requirements. Receiver performance requirements and current development efforts are covered for five classes of receiver applications: high temperature, advanced Brayton, Stirling, and Rankine cycle engines, and fuels and chemicals.

  2. Reflux solar receiver design considerations

    Science.gov (United States)

    Diver, R. B.

    Reflux heat-pipe and pool-boiler receivers are being developed to improve upon the performance and life of directly-illuminated tube receiver technology used in previous successful demonstrations of dish-Stirling systems. The design of a reflux receiver involves engineering tradeoffs. In this paper, on-sun performance measurements of the Sandia pool-boiler receiver are compared with results from the reflux receiver thermal analysis model, AEETES. Flux and performance implications of various design options are analyzed and discussed.

  3. RFI receiver. [deep space network

    Science.gov (United States)

    Lay, R.

    1980-01-01

    An S-band radio frequency interference (RFI) receiver to analyze and identify sources of RFI problems in the Deep Space Network DSN tracking stations is described. The RFI receiver is a constant gain, double conversion, open loop receiver with dual sine/cosine channel outputs, providing a total of 20 MHZ monitoring capability. This receiver is computer controlled using a MODCOMP II miniprocessor. The RFI receiver has been designed to operate at a 150 Kelvin system noise temperature accomplished by cascading two low noise field effect transistor (FET) amplifiers for the receiver front-end. The first stage low noise FET amplifier is mounted at the feed horn to minimize any cable losses to achieve a lower system noise temperature. The receiver is tunable over the frequency range of 2150 to 2450 MHz in both sine/cosine output channels with a resolution of 100 kHz.

  4. Immune Responses to Circulating and Vaccine Viral Strains in HIV-Infected and Uninfected Children and Youth Who Received the 2013/2014 Quadrivalent Live-Attenuated Influenza Vaccine

    Science.gov (United States)

    Weinberg, Adriana; Curtis, Donna; Ning, Mariangeli Freitas; Claypool, David Jeremy; Jalbert, Emilie; Patterson, Julie; Frank, Daniel N.; Ir, Diana; Armon, Carl

    2016-01-01

    The live-attenuated influenza vaccine (LAIV) has generally been more efficacious than the inactivated vaccine in children. However, LAIV is not recommended for HIV-infected children because of insufficient data. We compared cellular, humoral, and mucosal immune responses to the 2013–2014 LAIV quadrivalent (LAIV4) in HIV-infected and uninfected children 2–25 years of age (yoa). We analyzed the responses to the vaccine H1N1 (H1N1-09), to the circulating H1N1 (H1N1-14), which had significant mutations compared to H1N1-09 and to B Yamagata (BY), which had the highest effectiveness in 2013–2014. Forty-six HIV-infected and 56 uninfected participants with prior influenza immunization had blood and nasal swabs collected before and after LAIV4 for IFNγ T and IgG/IgA memory B-cell responses (ELISPOT), plasma antibodies [hemagglutination inhibition (HAI) and microneutralization (MN)], and mucosal IgA (ELISA). The HIV-infected participants had median CD4+ T cells = 645 cells/μL and plasma HIV RNA = 20 copies/mL. Eighty-four percent were on combination anti-retroviral therapy. Regardless of HIV status, significant increases in T-cell responses were observed against BY, but not against H1N1-09. H1N1-09 T-cell immunity was higher than H1N1-14 both before and after vaccination. LAIV4 significantly increased memory IgG B-cell immunity against H1N1-14 and BY in uninfected, but not in HIV-infected participants. Regardless of HIV status, H1N1-09 memory IgG B-cell immunity was higher than H1N1-14 and lower than BY. There were significant HAI titer increases after vaccination in all groups and against all viruses. However, H1N1-14 MN titers were significantly lower than H1N1-09 before and after vaccination overall and in HIV-uninfected vaccinees. Regardless of HIV status, LAIV4 increased nasal IgA concentrations against all viruses. The fold-increase in H1N1-09 IgA was lower than BY. Overall, participants HIV-infected and uninfected children and youth had comparable

  5. Should a hospitalized child receive empiric treatment with acyclovir?

    Directory of Open Access Journals (Sweden)

    Kulik Dina M

    2012-12-01

    Full Text Available Abstract Background Herpes simplex encephalitis is associated with substantial morbidity and mortality and may be related to timely diagnosis and treatment. While awaiting the results of testing, hospitalization and empiric treatment with acyclovir is recommended, though the direct and indirect costs associated with this management are substantial. We sought to examine children hospitalized for possible herpes simplex encephalitis, following clinical and laboratory assessment in the emergency department, and empiric treatment with acyclovir, in order to describe the proportion receiving a complete course of treatment; and to identify the clinical variables which are associated with receiving a complete course, as compared with an incomplete course of acyclovir. Methods Hospitalized children prescribed acyclovir were included in this case control study. Clinical, laboratory and diagnostic variables were abstracted for children prescribed a complete (≥ 14 days or an incomplete course ( Results 289 children met eligibility criteria, 30 (10% received a complete course and 259 (90% received an incomplete course. A history of mucocutaneous herpes simplex virus infection (p  Conclusions Many children did not complete a full course of therapy. Unnecessary testing and treatment is burdensome to families and the health care system. Possible predictive variables include abnormal Glascow Coma Scale, focal neurologic findings and cerebrospinal fluid pleocytosis.

  6. Clinical Factors Associated with Long-Term Complete Remission versus Poor Response to Chemotherapy in HIV-Infected Children and Adolescents with Kaposi Sarcoma Receiving Bleomycin and Vincristine: A Retrospective Observational Study

    Science.gov (United States)

    El-Mallawany, Nader Kim; Kamiyango, William; Slone, Jeremy S.; Villiera, Jimmy; Kovarik, Carrie L.; Cox, Carrie M.; Dittmer, Dirk P.; Ahmed, Saeed; Schutze, Gordon E.; Scheurer, Michael E.; Kazembe, Peter N.; Mehta, Parth S.

    2016-01-01

    Kaposi sarcoma (KS) is the most common HIV-associated malignancy in children and adolescents in Africa. Pediatric KS is distinct from adult disease. We evaluated the clinical characteristics associated with long-term outcomes. We performed a retrospective observational analysis of 70 HIV-infected children and adolescents with KS less than 18 years of age diagnosed between 8/2010 and 6/2013 in Lilongwe, Malawi. Local first-line treatment included bleomycin and vincristine plus nevirapine-based highly active anti-retroviral therapy (HAART). Median age was 8.6 years (range 1.7–17.9); there were 35 females (50%). Most common sites of presentation were: lymph node (74%), skin (59%), subcutaneous nodules (33%), oral (27%), woody edema (24%), and visceral (16%). Eighteen (26%) presented with lymphadenopathy only. Severe CD4 suppression occurred in 28%. At time of KS diagnosis, 49% were already on HAART. Overall, 28% presented with a platelet count < 100 x 109/L and 37% with hemoglobin < 8 g/dL. The 2-year event-free (EFS) and overall survival (OS) were 46% and 58% respectively (median follow-up 29 months, range 15–50). Multivariable analysis of risk of death and failure to achieve EFS demonstrated that visceral disease (odds ratios [OR] 19.08 and 11.61, 95% CI 2.22–163.90 and 1.60–83.95 respectively) and presenting with more than 20 skin/oral lesions (OR 9.57 and 22.90, 95% CI 1.01–90.99 and 1.00–524.13 respectively) were independent risk factors for both. Woody edema was associated with failure to achieve EFS (OR 7.80, 95% CI 1.84–33.08) but not death. Univariable analysis revealed that lymph node involvement was favorable for EFS (OR 0.28, 95% CI 0.08–0.99), while T1 TIS staging criteria, presence of cytopenias, and severe immune suppression were not associated with increased mortality. Long-term complete remission is achievable in pediatric KS, however outcomes vary according to clinical presentation. Based on clinical heterogeneity, treatment according

  7. Solar advanced internal film receiver

    International Nuclear Information System (INIS)

    In a Solar Central Internal Film Receiver, the heat absorbing fluid (a molten nitrate salt) flows in a thin film down over the non illuminated side of an absorber panel. Since the molten salt working fluid is not contained in complicated tube manifolds, the receiver design is simples than a conventional tube type-receiver resulting in a lower cost and a more reliable receiver. The Internal Film Receiver can be considered as an alternative to the Direct Absorption Receiver, in the event that the current problems of the last one can not be solved. It also describes here the test facility which will be used for its solar test, and the test plans foreseen. (Author) 17 refs

  8. Immigration: perspectives from receiving countries.

    Science.gov (United States)

    Weiner, M

    1990-01-01

    The author examines the issue of international migration from the standpoint of receiving countries. He attempts "to understand how and why migrant-receiving countries respond as they do, and to suggest some of the new issues in international migration that arise in a world in which the supply of would-be migrants and refugees is now greater than receiving countries are willing to accept." PMID:12283227

  9. Monitoring the efficacy of antimalarial medicines in India via sentinel sites: Outcomes and risk factors for treatment failure

    Directory of Open Access Journals (Sweden)

    Neelima Mishra

    2016-01-01

    Interpretation & conclusion: Till 2012, India′s national antimalarial drug resistance monitoring system proved highly efficacious and safe towards first-line antimalarials used in the country, except in Northeastern region where a decline in efficacy of AS+SP has been observed. This led to change in first-line treatment for P. falciparum to artemether-lumefantrine in Northeastern region.

  10. High Rates of Asymptomatic, Sub-microscopic Plasmodium vivax Infection and Disappearing Plasmodium falciparum Malaria in an Area of Low Transmission in Solomon Islands

    OpenAIRE

    Waltmann, Andreea; Darcy, Andrew W.; Harris, Ivor; Koepfli, Cristian; Lodo, John; Vahi, Ventis; Piziki, David; Shanks, G. Dennis; Barry, Alyssa E; Whittaker, Maxine; Kazura, James W.; Mueller, Ivo

    2015-01-01

    INTRODUCTION: Solomon Islands is intensifying national efforts to achieve malaria elimination. A long history of indoor spraying with residual insecticides, combined recently with distribution of long lasting insecticidal nets and artemether-lumefantrine therapy, has been implemented in Solomon Islands. The impact of these interventions on local endemicity of Plasmodium spp. is un...

  11. Measurement of lumefantrine and its metabolite in plasma by high performance liquid chromatography with ultraviolet detection

    DEFF Research Database (Denmark)

    Khalil, Insaf F; Abildrup, Ulla; Alifrangis, Lene H;

    2011-01-01

    Artemether-lumefantrine (ARM-LUM) has in recent years become the first-line treatment for uncomplicated malaria in many Sub-Saharan African countries. Vigorous monitoring of the therapeutic efficacy of this treatment is needed. This requires high-quality studies following standard protocols...

  12. Performance of interferon-gamma and IP-10 release assays for diagnosing latent tuberculosis infections in patients with concurrent malaria in Tanzania

    DEFF Research Database (Denmark)

    Drabe, Camilla H; Vestergaard, Lasse S; Helleberg, Marie;

    2016-01-01

    -infected patients without malaria infection. Malaria was treated with artemether-lumefantrine (Coartem(®)). QFT testing was performed before initiation of malaria treatment and at days 7 and 42. In total, 172 patients completed follow-up. IFN-γ and IP-10 was measured in QFT supernatants. We found that during...

  13. Prevalence of Single Nucleotide Polymorphisms in the Plasmodium falciparum Multidrug Resistance Gene (Pfmdr-1) in Korogwe District in Tanzania Before and After Introduction of Artemisinin-Based Combination Therapy

    DEFF Research Database (Denmark)

    Thomsen, Thomas T; Ishengoma, Deus S; Mmbando, Bruno P;

    2011-01-01

    Abstract. Tanzania implemented artemether-lumefantrine (AL) as the first-line treatment for uncomplicated malaria in November of 2006 because of resistance to sulfadoxine-pyrimethamine. AL remains highly efficacious, but widespread use may soon facilitate emergence of artemisinin tolerance...

  14. A partitioned central solar receiver

    International Nuclear Information System (INIS)

    Else of solar energy as substitute for conventional fuels at a competitive cost requires efficient conversion from solar radiation to usable forms of energy. In solar thermal or thermochemical applications, high efficiency usually re- quires high temperature and high concentration of incoming radiation. The main form of energy loss from high temperature solar central receivers is thermal emission ('re radiation'), at an effective temperature close to the maximum receiver temperature. This loss is reduced if the aperture is divided into segments, most of which are maintained at lower temperatures. A two-stage partitioned receiver demonstrating this concept is under construction at the Weizman Solar Tower. The high-temperature stage is the DIAPR (Directly Irradiated Annular Pressurized Receiver). The low-temperature stage is made of tubular cavity receivers of simpler design. Preliminary optical and thermal design of the partitioned receiver is presented. For the design exit temperature of 1500 K, the aperture size of the partitioned receiver is about 60% of the equivalent single-stage receiver, indicating a significant increase of conversion efficiency. The exit temperature of the low-temperature stage is around 1100 K, allowing simpler design and inexpensive construction. (authors)

  15. Customizable Digital Receivers for Radar

    Science.gov (United States)

    Moller, Delwyn; Heavey, Brandon; Sadowy, Gregory

    2008-01-01

    Compact, highly customizable digital receivers are being developed for the system described in 'Radar Interferometer for Topographic Mapping of Glaciers and Ice Sheets' (NPO-43962), NASA Tech Briefs, Vol. 31, No. 7 (August 2007), page 72. The receivers are required to operate in unison, sampling radar returns received by the antenna elements in a digital beam-forming (DBF) mode. The design of these receivers could also be adapted to commercial radar systems. At the time of reporting the information for this article, there were no commercially available digital receivers capable of satisfying all of the operational requirements and compact enough to be mounted directly on the antenna elements. A provided figure depicts the overall system of which the digital receivers are parts. Each digital receiver includes an analog-to-digital converter (ADC), a demultiplexer (DMUX), and a field-programmable gate array (FPGA). The ADC effects 10-bit band-pass sampling of input signals having frequencies up to 3.5 GHz. The input samples are demultiplexed at a user-selectable rate of 1:2 or 1:4, then buffered in part of the FPGA that functions as a first-in/first-out (FIFO) memory. Another part of the FPGA serves as a controller for the ADC, DMUX, and FIFO memory and as an interface between (1) the rest of the receiver and (2) a front-panel data port (FPDP) bus, which is an industry-standard parallel data bus that has a high data-rate capability and multichannel configuration suitable for DBF. Still other parts of the FPGA in each receiver perform signal-processing functions. The digital receivers can be configured to operate in a stand-alone mode, or in a multichannel mode as needed for DBF. The customizability of the receiver makes it applicable to a broad range of system architectures. The capability for operation of receivers in either a stand-alone or a DBF mode enables the use of the receivers in an unprecedentedly wide variety of radar systems.

  16. Morphine sulphation in children.

    OpenAIRE

    Choonara, I; Ekbom, Y; Lindström, B; Rane, A.

    1990-01-01

    The metabolism of morphine was studied in nine children and seven preterm neonates receiving a continuous infusion of morphine. All the neonates and three children had detectable concentrations of morphine-3-sulphate (M3S) in urine. None of the neonates or the children had detectable concentrations of morphine-6-sulphate (M6S) in urine. None of the children had detectable concentrations of M3S in plasma. The M3S/morphine ratios were significantly higher in neonates than children (P less than ...

  17. Perioperative nursing of 4 children receiving contralateral healthy cervical seventh nerve root transfer for brachial plexus injury%4例儿童臂丛神经损伤健侧C(7)椎体前移位直接修复术的护理

    Institute of Scientific and Technical Information of China (English)

    黄天雯; 何翠环; 戚剑; 顾立强; 陈晓玲; 刘巧梨; 桂自珍; 刘回芬

    2011-01-01

    总结了4例儿童臂丛神经损伤健侧C(7)椎体前移位直接修复术围手术期的护理体会.术前通过心理护理、预防再损伤及功能锻炼、疼痛护理及术前体位训练等,患者情绪稳定,患者及家属对患者的伤残接受程度提高,患肢未出现再损伤.术后做好体位护理、病情观察、功能锻炼及出院指导,患儿术后康复过程顺利,切口Ⅰ级愈合,能够配合进行功能锻炼.%This paper summarizes the experience of perioperative nursing for 4 children receiving contralateral healthy cervical seventh nerve root transfer for brachial plexus injury. Before the operation,nursing care focused on psychological nursing,prevention from re-injury,functional training,pain management and posture training. The children and parents could face up the state of injury and keep calm in mood,and no re-injury occurred. The postoperative care included posture care,disease observation,functional training and discharge instruction. As a result,the children had a smooth recovery period after the operation. They could cooperate with physical therapy and the wounds healed well.

  18. 恩丹西酮联合维生素B6防治儿童化疗呕吐的疗效观察%Study on the antiemetic effects of ondansetron plus vitamin B6 in children receiving chemotherapy

    Institute of Scientific and Technical Information of China (English)

    李玉齐; 秦鑫添; 温宗秋

    2009-01-01

    目的 观察恩丹西酮联合维生素B6对儿童实体瘤化疗所致呕吐的疗效.方法 42例化疗患者采用自身随机对照,分为AB组与BA组.AB组第一疗程为A方案,止吐治疗为每天化疗前静脉注射恩丹西酮5 mg/m2配合维生素B64mg/kg静脉滴注;第二疗程为B方案,化疗前单纯静脉注射恩丹西酮5 mgB6m2.BA组则相反.均使用含顺铂方案化疗,A、B两疗程化疗方案一致.结果 A方案化疗后控制急性呕吐和延迟性呕吐的有效率分别为90.5%,92.9%.B方案化疗后控制急性呕吐和延迟性呕吐的有效率分别为69.0%,73.8%.A方案止吐疗效明显优干B方案(P<0.05).副作用主要为便秘,两组发生率相似.结论 恩丹西酮配合维生素B6对儿童实体瘤化疗所致呕吐有协同防治的作用.%Objective: To assess the efficacy of ondansetron plus vitamin B6 on chemotherapy induced vomiting in chil-dren with solid tumors. Methods: We conducted a randomized, self-controlled trial comparing ondansetron plus vitamin B6 with ondansetron monotherapy in 42 children receiving chemotherapy for solid tumors. Patients in AB group were treated with intravenous injection of 5mg/m2 ondansetron combined with intravenous infusion of 4mg/kg vitamin B6 as the A treat-ment regimen, and intravenous injection of 5mg/m2 ondansetron monotherapy as the B treatment regimen; whereas children in BA group received the B treatment regimen at first, followed by the A treatment regimen. All patients received the same cisplatin chemotherapy throughout the trial. Results: The combination therapy resulted in a 90.5% and 92.9% response rate to acute and delayed vomiting, respectively, which were significant lower with the monotherapy (69.0% and 73.8%, respectively). Therefore ondansetron plus vitamin B6 regimen was significant better than ondansetron concerning the antie-metic effects(P<0.05). Constipation was the primary adverse reaction, and its incidence was comparable across the two groups

  19. Children's access to medicines

    OpenAIRE

    Alkahtani, Saad Ahmed

    2013-01-01

    Access to health care for children is important. It is dependent on access to health professionals and also parental attitudes towards illness. Children have the right to receive medicines that are scientifically evaluated for both efficacy and safety. Counterfeit and substandard medicines unfortunately result in the death of many children worldwide. There have been particular problems with diethylene glycol which has been used as a solvent in counterfeit medicines. It has also been foun...

  20. Solar dynamic heat receiver technology

    Science.gov (United States)

    Sedgwick, Leigh M.

    1991-01-01

    A full-size, solar dynamic heat receiver was designed to meet the requirements specified for electrical power modules on the U.S. Space Station, Freedom. The heat receiver supplies thermal energy to power a heat engine in a closed Brayton cycle using a mixture of helium-xenon gas as the working fluid. The electrical power output of the engine, 25 kW, requires a 100 kW thermal input throughout a 90 minute orbit, including when the spacecraft is eclipsed for up to 36 minutes from the sun. The heat receiver employs an integral thermal energy storage system utilizing the latent heat available through the phase change of a high-temperature salt mixture. A near eutectic mixture of lithium fluoride and calcium difluoride is used as the phase change material. The salt is contained within a felt metal matrix which enhances heat transfer and controls the salt void distribution during solidification. Fabrication of the receiver is complete and it was delivered to NASA for verification testing in a simulated low-Earth-orbit environment. This document reviews the receiver design and describes its fabrication history. The major elements required to operate the receiver during testing are also described.

  1. Brain tumor - children

    Science.gov (United States)

    Glioblastoma multiforme - children; Ependymoma - children; Glioma - children; Astrocytoma - children; Medulloblastoma - children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children)

  2. Comparação entre os questionários IT-MAIS e MUSS com vídeo-gravação para avaliação de crianças candidatas ao implante coclear Comparison between the IT-MAIS and MUSS questionnaires with video-recording for evaluation of children who may receive a cochlear implantation

    Directory of Open Access Journals (Sweden)

    Elaine Soares Monteiro Pinto

    2008-02-01

    Full Text Available Existe uma grande dificuldade para determinar precocemente crianças que se beneficiariam ou não com o implante coclear, até porque devido à pouca idade são muito sutis as respostas apresentadas. OBJETIVO: Comparar os resultados obtidos através da vídeo-gravação de situações de interação de crianças candidatas ao implante coclear com os resultados obtidos através de protocolos de avaliação. MÉTODO: Fizeram parte da amostra 7 crianças com idade média de 39,7 meses, portadores de perda auditiva neurossensorial profunda. Foram aplicados os questionários IT-MAIS e MUSS aos pais e os resultados foram comparados com a observação da vídeo-gravação destas crianças. RESULTADOS: Foi possível observar que os dados são compatíveis no que se refere às etapas auditivas. No entanto, no que se refere ao questionário MUSS, os dados obtidos na observação lúdica são bastante diferentes. O questionário leva em consideração apenas a uso da linguagem oral e, portanto, a maioria das crianças apresentou um escore muito baixo. CONCLUSÃO: A observação lúdica permitiu traçar um perfil mais amplo do comportamento lingüístico e de aspectos relativos à linguagem apresentando diferenças do questionário.There is a great difficulty in determining earlier on which children would benefit or not from cochlear implants, especially because of their young age, the responses they give are very subtle. AIM: To compare results obtained through video-recording of the interactions of children who may receive a cochlear implant with the results obtained through evaluation protocols. METHOD: Seven children, with an average age of 39.7 months, with profound hearing loss were selected for the study. IT-MAIS and MUSS questionnaires were given to their parents/guardians of these children and the results were compared with the observation of the video-recordings. RESULTS: It was possible to observe that the data is compatible with the auditory

  3. Desempenho de pais de crianças em dieta de exclusão do leite de vaca na identificação de alimentos industrializados com e sem leite vaca The performance of parents of children receiving cow's milk free diets at indentification of commercial food products with and without cows's milk

    Directory of Open Access Journals (Sweden)

    Thabata Koester Weber

    2007-10-01

    of children on exclusion diets (4.0 was greater than for the control group (3.0; p = 0.005. Reading at least one label was associated with a greater chance of correctly identifying more than five of the 10 products (odds ratio = 8.0. CONCLUSIONS: Despite having received guidance, the parents of children on exclusion diets were not fully prepared to manage these diets, indicating a need for improvements to the instruction provided when indicating exclusion diets.

  4. UWB communication receiver feedback loop

    Science.gov (United States)

    Spiridon, Alex; Benzel, Dave; Dowla, Farid U.; Nekoogar, Faranak; Rosenbury, Erwin T.

    2007-12-04

    A novel technique and structure that maximizes the extraction of information from reference pulses for UWB-TR receivers is introduced. The scheme efficiently processes an incoming signal to suppress different types of UWB as well as non-UWB interference prior to signal detection. Such a method and system adds a feedback loop mechanism to enhance the signal-to-noise ratio of reference pulses in a conventional TR receiver. Moreover, sampling the second order statistical function such as, for example, the autocorrelation function (ACF) of the received signal and matching it to the ACF samples of the original pulses for each transmitted bit provides a more robust UWB communications method and system in the presence of channel distortions.

  5. Software Defined DCF77 Receiver

    OpenAIRE

    F. Zaplata; M. Kasal

    2013-01-01

    This paper shows the solution of time stamp software defined receiver integration into low cost com-mercial devices. The receiver is based on a general pur-pose processor and its analog to digital converter. The amplified signal from a narrow-band antenna is connected to the converter and no complicated filtration has to be used. All signal processing is digitally provided by the processor. During signal reception, the processor stays available for its main tasks and signal processing con-sum...

  6. Software Defined DCF77 Receiver

    Directory of Open Access Journals (Sweden)

    F. Zaplata

    2013-12-01

    Full Text Available This paper shows the solution of time stamp software defined receiver integration into low cost com-mercial devices. The receiver is based on a general pur-pose processor and its analog to digital converter. The amplified signal from a narrow-band antenna is connected to the converter and no complicated filtration has to be used. All signal processing is digitally provided by the processor. During signal reception, the processor stays available for its main tasks and signal processing con-sumes only a small part of its computational power.

  7. Ordinal Position Differences in Children's Family Interactions.

    Science.gov (United States)

    Baskett, Linda Musun

    1984-01-01

    Compares the interactions of 20 firstborn and 17 lastborn children with their parents and siblings. Children were observed at home for five 45-minute sessions. Oldest children differed from youngest children in emitting more behaviors to parents than to siblings and in receiving more negative responses from parents and siblings. (Author/CB)

  8. RFID receiver apparatus and method

    Science.gov (United States)

    Scott, Jeffrey Wayne

    2006-12-26

    An RFID backscatter interrogator for transmitting data to an RFID tag, generating a carrier for the tag, and receiving data from the tag modulated onto the carrier, the interrogator including a single grounded-coplanar wave-guide circuit board and at least one surface mount integrated circuit supported by the circuit board.

  9. Converting accounts receivable into cash.

    Science.gov (United States)

    Folk, M D; Roest, P R

    1995-09-01

    In recent years, increasing numbers of healthcare providers have converted their accounts receivable into cash through a process called securitization. This practice has gained popularity because it provides a means to raise capital necessary to healthcare organizations. Although securitization transactions can be complex, they may provide increased financial flexibility to providers as they prepare for continuing change in the healthcare industry. PMID:10145096

  10. The majority of sick children receive paracetamol during the winter

    DEFF Research Database (Denmark)

    Ertmann, R.; Møller, J.J.; Waldorff, F.B.;

    2012-01-01

    Even though fever is a common symptom in childhood, it often worries parents and they may try to reduce discomfort by giving the child paracetamol, which is currently the most commonly sold over-the-counter medicine. The objective of this study was to investigate parent-administered paracetamol in...

  11. Immunization Schedules for Infants and Children

    Science.gov (United States)

    ... Immunization Schedules Recommended Child and Adolescent Immunization Schedules History of the Vaccine Schedule Children's Hospital of Philadelphia's Vaccine Education Center Get Email Updates To receive email updates ...

  12. Femtosecond Photon-Counting Receiver

    Science.gov (United States)

    Krainak, Michael A.; Rambo, Timothy M.; Yang, Guangning; Lu, Wei; Numata, Kenji

    2016-01-01

    An optical correlation receiver is described that provides ultra-precise distance and/or time/pulse-width measurements even for weak (single photons) and short (femtosecond) optical signals. A new type of optical correlation receiver uses a fourth-order (intensity) interferometer to provide micron distance measurements even for weak (single photons) and short (femtosecond) optical signals. The optical correlator uses a low-noise-integrating detector that can resolve photon number. The correlation (range as a function of path delay) is calculated from the variance of the photon number of the difference of the optical signals on the two detectors. Our preliminary proof-of principle data (using a short-pulse diode laser transmitter) demonstrates tens of microns precision.

  13. The GBT 4mm Receiver

    Science.gov (United States)

    Frayer, David T.; White, S.; Watts, G.; Stennes, M.; Maddalena, R. J.; Simon, R.; Pospieszalski, M.; Bryerton, E.

    2013-01-01

    The new 4mm receiver (67--93 GHz) for the Robert C. Byrd Green Bank Telescope (GBT) was built to take advantage of the improved surface accuracy of the dish. The low frequency end of the 3mm atmospheric window is not available with ALMA (National Radio Astronomy Observatory is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc.

  14. Customer experiences receiving investment services

    OpenAIRE

    Szepe, Sanna

    2015-01-01

    Today the customers are able to compare the products of the different services available easily and between service companies, the experience the customer receives has become more and more important. Banking services have experienced the same evolution than the other surrounding service companies, and the importance of more complicated advisory services is sought after, when simpler transactions are taken care by the customers themselves. Investment services are one of the highest profiti...

  15. SPREE: Spoofing Resistant GPS Receiver

    OpenAIRE

    Ranganathan, Aanjhan; Ólafsdóttir, Hildur; Capkun, Srdjan

    2016-01-01

    Global Positioning System (GPS) is used ubiquitously in a wide variety of applications ranging from navigation and tracking to modern smart grids and communication networks. However, it has been demonstrated that modern GPS receivers are vulnerable to signal spoofing attacks. For example, today it is possible to change the course of a ship or force a drone to land in an hostile area by simply spoofing GPS signals. Several countermeasures have been proposed in the past to detect GPS spoofing a...

  16. Diversity of MMSE MIMO Receivers

    CERN Document Server

    Mehana, Ahmed Hesham

    2011-01-01

    In most MIMO systems, the family of waterfall error curves, calculated at different spectral efficiencies, are asymptotically parallel at high SNR. In other words, most MIMO systems exhibit a single diversity value for all {\\em fixed} rates. The MIMO MMSE receiver does not follow this pattern and exhibits a varying diversity in its family of error curves. This effect cannot be captured by DMT analysis, due to the fact that all fixed rates correspond to the same multiplexing gain, thus they cannot be differentiated within DMT analysis. This work analyzes this interesting behavior of the MMSE MIMO receiver and produces the MMSE MIMO diversity at each rate. The diversity of the quasi-static flat-fading MIMO channel consisting of any arbitrary number of transmit and receive antennas is fully characterized, showing that full spatial diversity is possible for all antenna configurations if and only if the rate is within a certain bound which is a function of the number of antennas. For other rate brackets, the avail...

  17. Prevalence of Youth with Autism Who Received Vocational Rehabilitation Services. Data Note. Number 42

    Science.gov (United States)

    Migliore, Alberto; Zalewska, Agnieszka

    2012-01-01

    In 2002, about six children aged eight years per every 1000 people in the general population received a diagnosis of autism spectrum disorder (ASD). The corresponding figure in 2008 was about 11 children, a 78% increase in just six years. To better understand how the increasing population of people with autism may impact adult programs, the…

  18. 42 CFR 435.115 - Individuals deemed to be receiving AFDC.

    Science.gov (United States)

    2010-10-01

    ... preclude eligibility under 45 CFR 233.20(a)(14) or section 1925 of the Social Security Act (which was added... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals deemed to be receiving AFDC. 435.115... Coverage of Families and Children § 435.115 Individuals deemed to be receiving AFDC. (a) The...

  19. Vertebrate pressure-gradient receivers

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob

    2011-01-01

    . Recent vertebrates form a continuum from perfect interaural transmission (0 dB in a certain frequency band) and pronounced eardrum directionality (30-40 dB) in the lizards, over somewhat attenuated transmission and limited directionality in birds and frogs, to the strongly attenuated interaural...... transmission and functionally isolated pressure receiver ears in the mammals. Since some of the binaural interaction already takes place at the eardrum in animals with strongly coupled ears, producing enhanced interaural time and level differences, the subsequent neural processing may be simpler. In robotic...

  20. Andrea Ghez Receives Crafoord Prize

    OpenAIRE

    Sher, Ben

    2012-01-01

    The Royal Swedish Academy of Scienceshas selected Andrea Ghez, a professor of physics and astronomy at UCLA, to receive the 2012 Crafoord Prize in Astronomy. She is being honored by the Academy for “observations of stars orbiting the Galactic center, indicating the presence of a supermassive black hole.” The Crafoord Prize, which includes an accompanying award of 4 million Swedish krona, is considered one of the world’s largest scientific prizes. Ghez is the first woman to win the award since...

  1. Stennis group receives NESC award

    Science.gov (United States)

    2009-01-01

    The NASA Engineering & Safety Center recently presented its Group Achievement Award to a Stennis team in recognition of technical excellence in evaluating the operational anomalies and reliability improvements associated with the space shuttle engine cut-off system. Stennis employees receiving the award were: (standing, l to r) Freddie Douglas (NASA), George Drouant (Jacobs Technology Inc.), Fred Abell (Jacobs), Robert Drackett (Jacobs) and Mike Smiles (NASA); (seated, l to r): Binh Nguyen (Jacobs), Stennis Director Gene Goldman and Joseph Lacker (NASA). Phillip Hebert of NASA is not pictured.

  2. Absorption Efficiency of Receiving Antennas

    DEFF Research Database (Denmark)

    Andersen, Jørgen Bach; Frandsen, Aksel

    2005-01-01

    A receiving antenna with a matched load will always scatter some power. This paper sets an upper and a lower bound on the absorption efficiency (absorbed power over sum of absorbed and scattered powers), which lies between 0 and 100% depending on the directivities of the antenna and scatter...... patterns. It can approach 100% as closely as desired, although in practice this may not be an attractive solution. An example with a small endfire array of dipoles shows an efficiency of 93%. Several examples of small conical horn antennas are also given, and they all have absorption efficiencies less than...

  3. Communication received from South Africa

    International Nuclear Information System (INIS)

    The document reproduces the press release with a statement by Dr. J.W.L. de Villiers, Executive Chairman of the Atomic Energy Corporation of South Africa Limited, issued on 31 January 1984 and included in the letter received by the Director General of the IAEA from the Resident Representative of South Africa to the Agency on 31 January 1984. This statement refers to the transfer of nuclear material equipment and technology by South Africa to other countries and the Non-Proliferation Treaty

  4. Broadband direct RF digitization receivers

    CERN Document Server

    Jamin, Olivier

    2014-01-01

    This book discusses the trade-offs involved in designing direct RF digitization receivers for the radio frequency and digital signal processing domains.  A system-level framework is developed, quantifying the relevant impairments of the signal processing chain, through a comprehensive system-level analysis.  Special focus is given to noise analysis (thermal noise, quantization noise, saturation noise, signal-dependent noise), broadband non-linear distortion analysis, including the impact of the sampling strategy (low-pass, band-pass), analysis of time-interleaved ADC channel mismatches, sampling clock purity and digital channel selection. The system-level framework described is applied to the design of a cable multi-channel RF direct digitization receiver. An optimum RF signal conditioning, and some algorithms (automatic gain control loop, RF front-end amplitude equalization control loop) are used to relax the requirements of a 2.7GHz 11-bit ADC. A two-chip implementation is presented, using BiCMOS and 65nm...

  5. Solar receiver with integrated optics

    Science.gov (United States)

    Jiang, Lun; Winston, Roland

    2012-10-01

    The current challenge for PV/Thermal (PV/T) systems is the reduction of radiation heat loss. Compared to solar thermal selective coating, the solar cells cannot be used as an efficient thermal absorber due to their large emissivity of the encapsulation material. Many commercial PV/T products therefore require a high concentration (more than 10x) to reach an acceptable thermal efficiency for their receivers. Such a concentration system inevitably has to track or semi-track, which induces additional cost and collects only the direct radiation from the sun. We propose a new PV/T design using a vacuum encapsulated thin film cell to solve this problem. The proposed design also collects the diffuse sun light efficiently by using an external compound parabolic concentrator (XCPC). Since the transparent electrode (TCO) of thin film cell is inherently transparent in visible light and reflective beyond infrared, this design uses this layer instead of the conventional solar cell encapsulation as the outmost heat loss surface. By integrating such a vacuum design with a tube shaped absorber, we reduce the complexity of conducting the heat energy and electricity out of the device. A low concentration standalone non-tracking solar collector is proposed in this paper. We also analyzed the thermosyphon system configuration using heat transfer and ray tracing models. The economics of such a receiver are presented.

  6. Sleep Disruption in Young Foster Children

    OpenAIRE

    Tininenko, Jennifer R.; Fisher, Philip A.; Bruce, Jacqueline; Pears, Katherine C.

    2010-01-01

    In the current study, sleep actigraphy and parent-report measures were used to investigate differences in sleeping behavior among four groups of 3- to 7-year-olds (N = 79): children in regular foster care (n = 15); children receiving a therapeutic intervention in foster care (n = 17); low income community children (n = 18); and upper middle income community children (n = 29). The children in therapeutic foster care exhibited longer sleep latency and increased variability of sleep duration tha...

  7. Do health workers’ preferences influence their practices? Assessment of providers’ attitude and personal use of new treatment recommendations for management of uncomplicated malaria, Tanzania

    Directory of Open Access Journals (Sweden)

    Masanja Irene M

    2012-11-01

    Full Text Available Abstract Background Due to growing antimalarial drug resistance, Tanzania changed malaria treatment policies twice within a decade. First in 2001 chloroquine (CQ was replaced by sulfadoxine-pyrimethamine (SP for management of uncomplicated malaria and by late 2006, SP was replaced by artemether-lumefantrine (AL. We assessed health workers’ attitudes and personal practices following the first treatment policy change, at six months post-change and two years later. Methods Two cross-sectional surveys were conducted in 2002 and 2004 among healthcare workers in three districts in South-East Tanzania using semi-structured questionnaires. Attitudes were assessed by enquiring which antimalarial was considered most suitable for the management of uncomplicated malaria for the three patient categories: i children below 5; ii older children and adults; and iii pregnant women. Practice was ascertained by asking which antimalarial was used in the last malaria episode by the health worker him/herself and/or dependants. Univariate and multivariate logistic regression was used to identify factors associated with reported attitudes and practices towards the new treatment recommendations. Results A total of 400 health workers were interviewed; 254 and 146 in the first and second surveys, respectively. SP was less preferred antimalarial in hospitals and private health facilities (p Conclusion Following changes in malaria treatment recommendations, most health workers did not prefer the new antimalarial drug, and their preferences worsened over time. However, many of them still used the newly recommended drug for management of their own or family members’ malaria episode. This indicates that, other factors than providers’ attitude may have more influence in their personal treatment practices.

  8. Efficacy of non-artemisinin- and artemisinin-based combination therapies for uncomplicated falciparum malaria in Cameroon

    Directory of Open Access Journals (Sweden)

    Thalabard Jean-Christophe

    2010-02-01

    Full Text Available Abstract Background The use of drug combinations, including non-artemisinin-based and artemisinin-based combination therapy (ACT, is a novel strategy that enhances therapeutic efficacy and delays the emergence of multidrug-resistant Plasmodium falciparum. Its use is strongly recommended in most sub-Saharan African countries, namely Cameroon, where resistance to chloroquine is widespread and antifolate resistance is emerging. Methods Studies were conducted in Cameroonian children with acute uncomplicated P. falciparum malaria according to the standard World Health Organization protocol at four sentinel sites between 2003 and 2007. A total of 1,401 children were enrolled, of whom 1,337 were assigned to randomized studies and 64 were included in a single non-randomized study. The proportions of adequate clinical and parasitological response (PCR-uncorrected on day 14 and PCR-corrected on day 28 were the primary endpoints to evaluate treatment efficacy on day 14 and day 28. The relative effectiveness of drug combinations was compared by a multi-treatment Bayesian random-effect meta-analysis. Findings The results based on the meta-analysis suggested that artesunate-amodiaquine (AS-AQ is as effective as other drugs (artesunate-sulphadoxine-pyrimethamine [AS-SP], artesunate-chlorproguanil-dapsone [AS-CD], artesunate-mefloquine [AS-MQ], dihydroartemisinin-piperaquine [DH-PP], artemether-lumefantrine [AM-LM], amodiaquine, and amodiaquine-sulphadoxine-pyrimethamine [AQ-SP]. AM-LM appeared to be the most effective with no treatment failure due to recrudescence, closely followed by DH-PP. Conclusion Although AM-LM requires six doses, rather than three doses for other artemisinin-based combinations, it has potential advantages over other forms of ACT. Further studies are needed to evaluate the clinical efficacy and tolerance of these combinations in different epidemiological context.

  9. CERN physicist receives Einstein Medal

    CERN Multimedia

    2006-01-01

    On 29 June the CERN theorist Gabriele Veneziano was awarded the prestigious Albert Einstein Medal for significant contributions to the understanding of string theory. This award is given by the Albert Einstein Society in Bern to individuals whose scientific contributions relate to the work of Einstein. Former recipients include exceptional physicists such as Murray Gell-Mann last year, but also Stephen Hawking and Victor Weisskopf. Gabriele Veneziano, a member of the integrated CERN Theory Team since 1977, led the Theory Division from 1994 to 1997 and has already received many prestigious prizes for his outstanding work, including the Enrico Fermi Prize (see CERN Courier, November 2005), the Dannie Heineman Prize for mathematical physics of the American Physical Society in 2004 (see Bulletin No. 47/2003), and the I. Ya. Pomeranchuk Prize of the Institute of Theoretical and Experimental Physics (Moscow) in 1999.

  10. Dental Awareness among Parents and Oral Health of Paediatric Cancer Patients Receiving Chemotherapy

    Science.gov (United States)

    Marwaha, Mohita; Bansal, Kalpana; Sachdeva, Anupam; Gupta, Ajay

    2016-01-01

    Introduction Dental care is often overlooked by the parents of children receiving treatment for cancer including chemotherapy who are in a phase of severe immunosuppression. Aim (i) To study dental attitudes of parents of children receiving chemotherapy towards importance of dental care. (ii) To evaluate oral hygiene status and compare it with healthy controls. Materials and Methods A questionnaire assessing the awareness towards dental care was given to the parents of 47 paediatric patients suffering from cancer receiving chemotherapy and to parents of 47 paediatric patients reporting to outpatient Department of Pedodontics at SGT Dental College. Oral examination was also carried out for both the groups and DMFT/dmft, plaque and gingival index were noted. Results Parents had a varying opinion regarding dental health of their child. The caries status of children in the control group was greater than children in the study group. The mean plaque index of children in the control group (1.40) was greater than children in the study group (1.34) which was statistically significant according to Mann-Whitney U test. The gingival health of children in the study group was better than children in the control group which was also not statistically significant. Conclusion This study highlights need for a periodic referral of the child cancer patients to the paediatric dental clinic in hospitals for the timely dental care. PMID:27437369

  11. Stimulant Treatment of Elementary School Children: Implications for School Counselors.

    Science.gov (United States)

    Bramlett, Ronald K.; Nelson, Patricia; Reeves, Betty

    1997-01-01

    Determines the percentage of elementary children in the United States who are currently receiving stimulant medication at school. Forty-six states and 246,707 children were represented in the survey. Approximately 3% of children were receiving stimulant medication at school with Ritalin the stimulant most widely used. Explores assessment issues…

  12. Fluid absorption solar energy receiver

    Science.gov (United States)

    Bair, Edward J.

    1993-01-01

    A conventional solar dynamic system transmits solar energy to the flowing fluid of a thermodynamic cycle through structures which contain the gas and thermal energy storage material. Such a heat transfer mechanism dictates that the structure operate at a higher temperature than the fluid. This investigation reports on a fluid absorption receiver where only a part of the solar energy is transmitted to the structure. The other part is absorbed directly by the fluid. By proportioning these two heat transfer paths the energy to the structure can preheat the fluid, while the energy absorbed directly by the fluid raises the fluid to its final working temperature. The surface temperatures need not exceed the output temperature of the fluid. This makes the output temperature of the gas the maximum temperature in the system. The gas can have local maximum temperatures higher than the output working temperature. However local high temperatures are quickly equilibrated, and since the gas does not emit radiation, local high temperatures do not result in a radiative heat loss. Thermal radiation, thermal conductivity, and heat exchange with the gas all help equilibrate the surface temperature.

  13. School for beggars' children.

    Science.gov (United States)

    Eferaro, S; Uloko, S D

    1993-01-01

    The children of blind beggars lead their parents around to beg for alms instead of going to school. 5 years of research however, supported by the Human Development Foundation in Nigeria found that adult beggars want their children to get educated, but did not think it possible. A special school for beggars' children was established by the foundation in 1990 with 30 children aged 6-12 years. The children attend school daily from 2 to 5 P.M. and help their blind parents in the mornings and evenings. Students receive free uniforms, writing materials and books, and are fed free during school hours. This school has attracted the attention of UNICEF which has been offering aid in the form of technical and teaching materials. The program has proved so successful, however, that demand is outpacing the supply of available teachers and teaching space. More room and more teachers are needed. Fund-raisers are being organized to that end. PMID:12318634

  14. Morphine sulphation in children.

    Science.gov (United States)

    Choonara, I; Ekbom, Y; Lindström, B; Rane, A

    1990-01-01

    The metabolism of morphine was studied in nine children and seven preterm neonates receiving a continuous infusion of morphine. All the neonates and three children had detectable concentrations of morphine-3-sulphate (M3S) in urine. None of the neonates or the children had detectable concentrations of morphine-6-sulphate (M6S) in urine. None of the children had detectable concentrations of M3S in plasma. The M3S/morphine ratios were significantly higher in neonates than children (P less than 0.01), suggesting that morphine sulphation decreases after the neonatal period. The amount of M3S formed, even in neonates, is low suggesting that this is a minor metabolic pathway. PMID:2288836

  15. Increasing use of artemisinin-based combination therapy for treatment of malaria infection in Nigerian hospitals

    Directory of Open Access Journals (Sweden)

    Igboeli NU

    2010-12-01

    Full Text Available Objectives: This study aimed at describing the pattern of outpatient antimalarial drug prescribing in a secondary and a tertiary hospital, and to assess adherence to the National Antimalarial Treatment Guideline (ATG. Methods: An audit of antimalarial prescription files from the two health facilities for a period of six months in 2008 was conducted. Semi structured questionnaires were used to collect information from the doctors and pharmacists on their awareness and knowledge of the National Antimalarial Treatment Guideline. Results: Artemisinin-based combination therapies (ACTs were the most prescribed antimalarials. Overall, 81.4% of the total prescriptions contained ACTs, out of which 56.8% were artemether-lumefantrine. However, adherence to the drugs indicated by national guideline within the DU90% was 38.5% for the tertiary and 66.7 % for the secondary hospital. The standard practice of prescribing with generic name was still not adhered to as evidenced in the understudied hospitals. The percentage of health care providers that were aware of the ATG was 88.2% for doctors and 85.1% for pharmacists. However, 13.3% and 52.2% of doctors and pharmacists respectively could not properly list the drugs specified in the guideline. Amodiaquine was the most commonly preferred option for managing children aged 0 – 3 months with malaria infection against the indicated oral quinine.Conclusion: This study showed an increased use of artemisinin-based combination therapy for the treatment of uncomplicated malaria compared previous reports in Nigeria. This study also highlights the need for periodic in-service quality assurance among health professionals with monitoring of adherence to and assessment of knowledge of clinical guidelines to ensure the practice of evidence based medicine.

  16. Modeling the cost effectiveness of malaria control interventions in the highlands of western Kenya.

    Directory of Open Access Journals (Sweden)

    Erin M Stuckey

    Full Text Available INTRODUCTION: Tools that allow for in silico optimization of available malaria control strategies can assist the decision-making process for prioritizing interventions. The OpenMalaria stochastic simulation modeling platform can be applied to simulate the impact of interventions singly and in combination as implemented in Rachuonyo South District, western Kenya, to support this goal. METHODS: Combinations of malaria interventions were simulated using a previously-published, validated model of malaria epidemiology and control in the study area. An economic model of the costs of case management and malaria control interventions in Kenya was applied to simulation results and cost-effectiveness of each intervention combination compared to the corresponding simulated outputs of a scenario without interventions. Uncertainty was evaluated by varying health system and intervention delivery parameters. RESULTS: The intervention strategy with the greatest simulated health impact employed long lasting insecticide treated net (LLIN use by 80% of the population, 90% of households covered by indoor residual spraying (IRS with deployment starting in April, and intermittent screen and treat (IST of school children using Artemether lumefantrine (AL with 80% coverage twice per term. However, the current malaria control strategy in the study area including LLIN use of 56% and IRS coverage of 70% was the most cost effective at reducing disability-adjusted life years (DALYs over a five year period. CONCLUSIONS: All the simulated intervention combinations can be considered cost effective in the context of available resources for health in Kenya. Increasing coverage of vector control interventions has a larger simulated impact compared to adding IST to the current implementation strategy, suggesting that transmission in the study area is not at a level to warrant replacing vector control to a school-based screen and treat program. These results have the potential to

  17. Memory strategy training in children with cerebral infarcts related to sickle cell disease.

    Science.gov (United States)

    Yerys, Benjamin E; White, Desirée A; Salorio, Cynthia F; McKinstry, Robert; Moinuddin, Asif; DeBaun, Michael

    2003-06-01

    Cerebral infarcts occur in approximately 30% of children with sickle cell disease (SCD), but little information exists regarding remediation of associated cognitive deficits. The authors examined the benefits of training children with infarcts to use memory strategies. Six children with SCD-related infarcts received academic tutoring; three of these children received additional training in memory strategies (silent rehearsal to facilitate short-term memory and semantic organization to facilitate long-term memory). The performance of children receiving strategy training appeared to improve more than that of children receiving only tutoring. Memory in children with SCD-related infarcts may be enhanced through strategy training. PMID:12794531

  18. Parental and aloparental care received by children in public and private schools in Vitória, ES / Cuidados parentais e aloparentais recebidos por crianças de escolas públicas e particulares de Vitória – ES

    Directory of Open Access Journals (Sweden)

    Lara Wright Silva

    2008-01-01

    Full Text Available We investigated the participation of parents and other adults in the caretaking of children in two socio-economic contexts. We found the caretaking is predominant whith participation of related and non that parental related aloparents in all the caretaking tasks assessed. There were differences due to the contexts. Parents of children attending public schools shared more caretaking tasks than parents of children attending private schools. Related aloparents were more frequently responsible for the caretaking of children from public schools while employees were more frequently responsible for children from private schools. Our results show that the socio-economic context is an important factor in the variation of caretaking of children, both for parents and aloparents.

  19. Sleep Disruption in Young Foster Children

    Science.gov (United States)

    Tininenko, Jennifer R.; Fisher, Philip A.; Bruce, Jacqueline; Pears, Katherine C.

    2010-01-01

    In the current study, sleep actigraphy and parent-report measures were used to investigate differences in sleeping behavior among four groups of 3- to 7-year-olds (N = 79): children in regular foster care (n = 15); children receiving a therapeutic intervention in foster care (n = 17); low income community children (n = 18); and upper middle income…

  20. Take Our Children to Work Day

    Science.gov (United States)

    2008-01-01

    Hundreds of children participated in the annual Take Our Children to Work Day at Stennis Space Center on July 29. During the day, children of Stennis employees received a tour of facilities and took part in various activities, including demonstrations in cryogenics and robotics.

  1. Adherence and uptake of artemisinin-based combination treatments for uncomplicated malaria: a qualitative study in northern Ghana.

    Directory of Open Access Journals (Sweden)

    Samuel Chatio

    Full Text Available Based on the recommendations of the World Health Organization in 2004, Ghana changed her antimalarial drug policy from mono-therapy to Artemisinin-based Combination Therapy (ACTs. The country is currently using three first line drugs artesunate-amodiaquine, artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated malaria. Despite this policy, little or no qualitative studies have been conducted to establish the factors influencing adherence to the new treatment for malaria. This study explored factors influencing adherence to the use of ACTs in northern Ghana.This was a qualitative study comprising forty (40 in-depth interviews with patients with malaria who visited selected public and private health facilities and received ACTs. Systematic sampling technique was used to select participants who were given ACTs for the interviews. Nvivo 9 software was used to code the data into themes for further analysis.The study revealed very important differences in knowledge about ACTs. As expected, the less or illiterates could not mention the type of ACT they would prefer to use for treating their malaria. The educated ones had a good knowledge on ACTs and preferred artemether-lumefantrinee in treating their malaria. The reason was that the drug was good and it had minimal or no side effects. Individual attitudes toward the use of medications and the side effects associated with the use of these ACTs were found to be the main factors affecting adherence to the use of ACTs. Perceived cure of illness after the initial dose greatly affected adherence. Other factors such as forgetfulness and lack of information also influenced patient adherence to ACTs use.Individual knowledge, attitudes and behaviors greatly influence patients' adherence to ACTs use. Since ACTs take a number of days to complete, continuous education by health professionals could improve on adherence to ACTs use by patients with malaria.

  2. Structuring a sound securitization of healthcare receivables.

    Science.gov (United States)

    Spradling, Mark

    2003-02-01

    Securitization of receivables allows healthcare providers to obtain an additional funding source by selling their accounts receivables to investors. A double-lock-box structure allows providers to securitize Medicare and Medicaid receivables without violating federal laws. A 2001 revision to the Uniform Commercial Code facilitates providers' securitization of private healthcare insurance receivables by underscoring rights of a purchaser of those receivables. HIPAA privacy standards appear to permit the use and disclosure of protected health information in crafting a securitization program. The securitization should be structured to shield the value of the receivables to be transferred from the potential backruptcies of the originator and the purchaser. PMID:12602313

  3. Microwave receivers with electronic warfare applications

    CERN Document Server

    Tsui, James

    2005-01-01

    This book by the author of Digital Techniques for Wideband Receivers willbe like no other one on your book shelf as the definitive word on electronicwarfare (EW) receiver design and performance. Whether you are an EWscientist involved in the test and evaluation of EW receivers or a designerof RWR's and other EW-related receivers, Microwave Receivers withElectronic Warfare Applications is a handy reference through which you canperfect your technical art. Lucidly written, this book is a treatise on EWreceivers that is relevant to you if you are just looking for a top-levelinsight into EW receive

  4. Práticas alimentares e estado nutricional de crianças no segundo semestre de vida atendidas na rede pública de saúde Feeding practices and nutritional status of children in the second semester of life who receive care in public health facilities

    Directory of Open Access Journals (Sweden)

    Simone Paula Modesto

    2007-08-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional e as práticas alimentares de crianças no segundo semestre de vida atendidas na rede pública de saúde do município de Taboão da Serra, SP. MÉTODOS: Estudo de corte transversal conduzido em Unidades Básicas de Saúde, classificadas em dois agrupamentos (região central e região periférica. A amostra foi constituída por 180 crianças, sendo 90 de cada agrupamento. O consumo alimentar foi registrado pelo método recordatório de 24 horas. Foram tomadas medidas de peso e dosagem de hemoglobina por punção capilar. RESULTADOS: A prevalência de anemia encontrada foi de 30,5% sem diferença entre os grupos. Os valores das medianas do escore-Z (peso/idade foram: 0,02 e 0,03, para os agrupamentos central e periférico, respectivamente. A utilização de suplemento de ferro apresentou diferença entre os grupos (p=0,001, sendo mais presente no agrupamento periférico, enquanto que para a vitamina A, a suplementação foi significantemente maior no agrupamento central (p=0,044. Verificou-se introdução precoce de alimentos distintos do leite materno na dieta infantil e diferença significante entre os grupos na idade de introdução de chá, suco de fruta, sopa e sopa com carne no esquema alimentar. Em relação à ingestão de nutrientes verificou-se consumo adequado de energia e proteínas, mas quanto aos micronutrientes estudados, há grande probabilidade de inadequação do consumo de ferro e vitamina C. CONCLUSÃO: A prevalência de anemia é relativamente reduzida, comparada com os dados obtidos em outros locais, e o esquema de introdução de alimentos complementares é inadequado, frente às recomendações atuais. A utilização de suplementos de nutrientes deve ser revista.OBJECTIVE: To assess the nutritional status and feeding practices of children in the second semester of life who receive care in public health facilities of the city of Taboão da Serra, SP. METHODS: This is a cross

  5. Um estudo com egressos de instituições para crianças em situação de rua: percepção acerca da situação atual de vida e do atendimento recebido A study on street children who have left institutions: perceptions of current life situations and received treatment

    Directory of Open Access Journals (Sweden)

    Normanda Araújo de Morais

    2012-12-01

    Full Text Available Este artigo objetiva identificar a situação atual de vida de egressos de uma instituição de atendimento para crianças e adolescentes em situação de rua, a avaliação que fazem do momento atual de vida, bem como compreender a sua percepção acerca da referida instituição e do atendimento recebido. Participaram nove adolescentes do sexo masculino (18-20 anos. Utilizou-se uma entrevista semi-estruturada, a qual foi analisada a partir do procedimento de análise de conteúdo. Os resultados mostraram uma variedade de situações de vida. O momento atual de vida foi descrito como satisfatório e a instituição frequentada no passado também foi avaliada de forma positiva. Os resultados são discutidos à luz da trajetória de vinculação institucional (TVI, das modalidades de saída da rua descritas na literatura e da importância da vinculação educador - criança/adolescente. Implicações para as políticas públicas de atendimento a essa população são discutidas.This article aims to identify the life situations of street children and adolescents after leaving care institutions; note how they evaluate their current life; and understand how they perceive the institution in which they stayed and the treatment they received there. Nine male adolescents participated (18-20 years old. A semi-structured interview script, evaluated through content analysis, was used. The results revealed a variety of life situations. The participants tended to describe their current life situation as satisfactory and they also positively evaluated the institution in which they stayed. The results are discussed in the context of Institutional Tie Trajectory (ITT; the modalities for leaving the streets as described in the literature; and the importance of the relationship between educator and child/adolescent. The implications for public policies treating this population are discussed.

  6. Putting Children First.

    Science.gov (United States)

    Galston, William A.

    1992-01-01

    Disadvantaged children's problems receive little if no attention by intellectuals and policymakers because of broad forces such as racial conflict, feminism, and the culture of individual rights. Personal responsibility and social and economic policies that support the family are strategies for helping economically, educationally, and emotionally…

  7. Trough Receiver Heat Loss Testing (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Lewandowski, A.; Feik, C.; Hansen, R.; Phillips, S.; Bingham, C.; Netter, J.; Forristal, R.; Burkholder, F.; Meglan, B.; Wolfrum, E.

    2006-02-01

    This presentation describes the design, fabrication, and qualification of an experimental capability for thermal loss testing of full-size trough receiver elements; and the testing on a variety of receivers.

  8. AUDIT PROCEDURES – RECEIVABLE AND SALES

    OpenAIRE

    Ștefan Zuca

    2013-01-01

    The overall objective of the audit of accounts receivable and sales is to determine if they are fairly presented in the context of the financial statements as a whole. The sales account is closely tied to accounts receivable; therefore, evidence supporting accounts receivable tends to support sales. For example, having determined that an account receivable is valid, the auditor has thereby supported the validity of the sale. Analytical procedures can often be used to test the sales account. A...

  9. 49 CFR 393.88 - Television receivers.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Television receivers. 393.88 Section 393.88... NECESSARY FOR SAFE OPERATION Miscellaneous Parts and Accessories § 393.88 Television receivers. Any motor vehicle equipped with a television viewer, screen or other means of visually receiving a...

  10. Emotion Understanding in Deaf Children with a Cochlear Implant

    Science.gov (United States)

    Wiefferink, Carin H.; Rieffe, Carolien; Ketelaar, Lizet; De Raeve, Leo; Frijns, Johan H. M.

    2013-01-01

    It is still largely unknown how receiving a cochlear implant affects the emotion understanding in deaf children. We examined indices for emotion understanding and their associations with communication skills in children aged 2.5-5 years, both hearing children (n = 52) and deaf children with a cochlear implant (n = 57). 2 aspects of emotion…

  11. More Efficient Solar Thermal-Energy Receiver

    Science.gov (United States)

    Dustin, M. O.

    1987-01-01

    Thermal stresses and reradiation reduced. Improved design for solar thermal-energy receiver overcomes three major deficiencies of solar dynamic receivers described in literature. Concentrator and receiver part of solar-thermal-energy system. Receiver divided into radiation section and storage section. Concentrated solar radiation falls on boiling ends of heat pipes, which transmit heat to thermal-energy-storage medium. Receiver used in number of applications to produce thermal energy directly for use or to store thermal energy for subsequent use in heat engine.

  12. Astronomical Receiver Modelling Using Scattering Matrices

    CERN Document Server

    King, O G; Copley, C; Davis, R J; Leahy, J P; Leech, J; Muchovej, S J C; Pearson, T J; Taylor, Angela C

    2014-01-01

    Proper modelling of astronomical receivers is vital: it describes the systematic errors in the raw data, guides the receiver design process, and assists data calibration. In this paper we describe a method of analytically modelling the full signal and noise behaviour of arbitrarily complex radio receivers. We use electrical scattering matrices to describe the signal behaviour of individual components in the receiver, and noise correlation matrices to describe their noise behaviour. These are combined to produce the full receiver model. We apply this approach to a specified receiver architecture: a hybrid of a continous comparison radiometer and correlation polarimeter designed for the C-Band All-Sky Survey. We produce analytic descriptions of the receiver Mueller matrix and noise temperature, and discuss how imperfections in crucial components affect the raw data. Many of the conclusions drawn are generally applicable to correlation polarimeters and continuous comparison radiometers.

  13. Comparison between children dilated computer and retinoscopy

    OpenAIRE

    Li-Li Qi; Li-Li Sun; Ji Li

    2015-01-01

    AIM: To investigate the dilation effect of computer optometry and retinoscopy optometry before and after mydriasis in children and to understand whether the application of computer refractor in children.METHODS: Therelated data of 500 children cases(1 000 eyes)with ametropia in our hospital were analyzed. The children firstly received computer optometry, and then use the 10g/L atropine sulfate eye gel drops, respectively. After 3d, they were performed computer optometry and retinoscopy, and c...

  14. Cryptographic Defence against Misbehaving TCP Receivers

    CERN Document Server

    Chan, Aldar C-F

    2008-01-01

    The congestion control algorithm in TCP relies on {\\em correct} feedback from the receiver to determine the rate at which packets should be sent into the network. Hence, correct receiver feedback (in the form of acknowledgements in TCP) is essential to the goal of sharing the scarce bandwidth resources fairly and avoiding congestion collapse in the Internet. However, the assumption that a TCP receiver can always be trusted (to generate feedback correctly) no longer holds as there are plenty of incentives for a receiver to deviate from the protocol. In fact, it has been shown that a misbehaving receiver (whose aim is to bring about congestion collapse) can easily generate acknowledgements to conceal loss and drive a number of honest, innocent senders arbitrary fast to create a significant number of non-responsive packet flows leading to denial of service to other Internet users. We give two efficient, provably secure mechanisms to force a receiver to generate feedback correctly; any incorrect acknowledgement w...

  15. Enforcing accounts receivable through public auctions

    OpenAIRE

    Kinkor, Jiří

    2012-01-01

    This Bachelor's thesis focuses on the legal ways of enforcing accounts receivable in public auctions within the Czech law. An important part of the thesis is dedicated to a description of accounts receivable formation process and the ways of debt securing. The crucial part refers to the legal framework identification and comparison of the receivables enforcement under obcansky soudni rad and zakon o verejenych drazbach. The entire process of the public auction from the auction proposal to the...

  16. MANAGEMENT OF ACCOUNTS RECEIVABLE IN A COMPANY

    OpenAIRE

    Kontuš, Eleonora

    2013-01-01

    Accounts receivable management directly impacts the profitability of a company. Firstly, the purpose of the empirical part of the study is to analyze accounts receivable and to demonstrate a correlation between the accounts receivable level and profitability expressed in terms of Retun on Assets (ROA) of sample companies. Secondly, the aim of theoretical research is to explore cost and benefits of changes in credit policy, determine the independent variables which have an impact on net savi...

  17. Interference Channels with Correlated Receiver Side Information

    OpenAIRE

    Liu, Nan; Gunduz, Deniz; Goldsmith, Andrea J.; Poor, H. Vincent

    2008-01-01

    The problem of joint source-channel coding in transmitting independent sources over interference channels with correlated receiver side information is studied. When each receiver has side information correlated with its own desired source, it is shown that source-channel code separation is optimal. When each receiver has side information correlated with the interfering source, sufficient conditions for reliable transmission are provided based on a joint source-channel coding scheme using the ...

  18. High-stability detectors for radioastronomical receivers

    Science.gov (United States)

    Teuber, Ute; Schmidt, Axel

    The increased bandwidths of radioastronomical receivers has increased the detector stability requirements. A detector with a short-term stability of 0.01 percent, required in a receiver with a 9 mm wavelength receiver, could not be achieved using previously available detectors and dc amplifiers. This paper describes a switched detector which meets these requirements, and presents resulting rms values as a function of integration time.

  19. Drug procurement, the Global Fund and misguided competition policies

    Directory of Open Access Journals (Sweden)

    Hess Kimberly

    2009-12-01

    Full Text Available Abstract In an effort to increase competition and decrease price, the Global Fund to Fight AIDS, Tuberculosis and Malaria recently began asking some grant recipients to use international competitive bidding processes for certain drug purchases. Unfortunately, for countries like Kenya, this request has caused more harm than good. After awarding the tender for its annual supply of the anti-malarial artemether-lumefantrine to the lowest bidder, Ajanta Pharma, Kenya experienced wide stock-outs in part due to the company's inability to supply the order in full and on time. Similar problems could arise in Uganda. Despite Kenya's experience, Uganda has awarded its next tender for artemether-lumefantrine to Ajanta Pharma. Uganda is already facing wide stock-outs and risks exacerbating an already dire situation the longer it takes to fulfil the procurement contract. A tender process based primarily on price cannot account for a company's ability to consistently supply sufficient product in time.

  20. Special design topics in digital wideband receivers

    CERN Document Server

    Tsui, James B Y

    2009-01-01

    Offering engineers a thorough examination of special, more advanced aspects of digital wideband receiver design, this practical book builds on fundamental resources on the topic, helping you gain a more comprehensive understanding of the subject. This in-depth volume presents a detailed look at a complete receiver design, including the encoder. Moreover, it discusses the detection of exotic signals and provides authoritative guidance on designing receivers used in electronic warfare. From frequency modulation and biphase shifting keys, to parameter encoders in electronic warfare receivers and

  1. Receivers for the Microwave Radiometer on Juno

    Science.gov (United States)

    Maiwald, F.; Russell, D.; Dawson, D.; Hatch, W.; Brown, S.; Oswald, J.; Janssen, M.

    2009-01-01

    Six receivers for the MicroWave Radiometer (MWR) are currently under development at JPL. These receivers cover a frequency range of 0.6 to 22 GHz in approximately octave steps, with 4 % bandwidth. For calibration and diagnosis three noise diodes and a Dicke switch are integrated into each receiver. Each receiver is connected to its own antenna which is mounted with its bore sights perpendicular to the spin axis of the spacecraft. As the spacecraft spins at 2 RPM, the antenna field of view scans Jupiter's atmosphere from limb to nadir to limb, measuring microwave emission down to 1000-bar.

  2. Hybrid Microoptical WDM Receiver for PON Communication

    Directory of Open Access Journals (Sweden)

    Vitezslav Jerabek

    2012-01-01

    Full Text Available The paper presents the design, simulation and construction results of the wavelength division multiplex (WDM optical hybrid receiver module for the passive optical network (PON. The optical WDM receiver was constructed using system of three micromodules in the new circle topology. The optical micromodule contains multimode fiber pigtail 50/125 µm, VHGT filter with collimation lens and two microwave optoelectronics receiver micromodules (OE receiver micromodules. OE receiver micromodules were designed by use small signal equivalent electrical circuit model and noise model, from which the mathematically solved the transmittance function, which was used for calculation and simulation of the optimal frequency characteristics and signal to noise ratio. For determine the limit frequency of OE receiver micromodule, the transcendent equation with transmittance function was numerically solved. OE receiver micromodule was composed of decollimation lenses and microwave optoelectronics receivers with bandwidth 2,5 GHz and alternatively in SMD technology with bandwidth 1,25 GHz, using the thin layer hybrid technology. WDM receiver use radiation 1490 nm for internet and 1550 nm for digital TV signals download information.

  3. Compressive Sensing for Spread Spectrum Receivers

    DEFF Research Database (Denmark)

    Fyhn, Karsten; Jensen, Tobias Lindstrøm; Larsen, Torben; Jensen, Søren Holdt

    2013-01-01

    With the advent of ubiquitous computing there are two design parameters of wireless communication devices that become very important: power efficiency and production cost. Compressive sensing enables the receiver in such devices to sample below the Shannon-Nyquist sampling rate, which may lead to a...... Compressive Spread Spectrum (CSS), allows for a simple, effective receiver design. Furthermore, we numerically evaluate the proposed receiver in terms of bit error rate under different signal to noise ratio conditions and compare it with other receiver structures. These numerical experiments show that though...

  4. Nursing process approach improves receivables management.

    Science.gov (United States)

    Dias, K; Stockamp, D

    1992-09-01

    The "nursing process" is a systematic decision-making approach to problem solving based on open-system theory. This theory assumes that there is an on-going interchange between all system components. Components cannot be viewed in isolation, because decisions regarding one component will affect other components. Receivables management is similar to the nursing process, in that it involves constant diagnosis, assessment, and intervention in the work in process during all phases of the receivables cycle. In experiments that applied the nursing process concept to the management of accounts receivable in several hospitals, gross days in accounts receivable were reduced and cash flow was increased. PMID:10145682

  5. Design and implementation of the CAPS receiver

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    In this paper, based on analyses of the Chinese Area Positioning System (CAPS) satellite (GEO satellite) resources and signal properties, the signal power at the port of the receiver antenna is estimated, and the implementation projects are presented for a switching band C to band L CAPS C/A code receiver integrated with GPS receiver suite and for a CAPS dual frequency P code receiver. A microstrip receiving antenna is designed with high sensitivity and wide beam orientation, the RF front end of the C/A code and P code receivers, and a processor is designed for the navigation baseband. A single frequency CAPS C/A code receiver and a CAPS dual frequency P code receiver are built at the same time. A software process flow is provided, and research on relatively key techniques is also conducted, such as signal searching, code loop and carrier loop algorithms, a height assistant algorithm, a dual frequency difference speed measurement technique, a speed measurement technique using a single frequency source with frequency assistance, and a CAPS time correcting algorithm, according to the design frame of the receiver hardware. Research results show that the static plane positioning accuracy of the CAPS C/A code receiver is 20.5-24.6 m, height accuracy is 1.2-12.8 m, speed measurement accuracy is 0.13-0.3 m/s, dynamic plane positioning accuracy is 24.4 m, height accuracy is 3.0 m, and speed measurement accuracy is 0.24 m/s. In the case of C/A code, the timing accuracy is 200 ns, and it is also shown that the positioning accuracy of the CAPS precise code receiver (1σ ) is 5 m from south to north, and 0.8 m from east to west. Finally, research on positioning accuracy is also conducted.

  6. Going to School with Madame Curie and Mr. Einstein: Gender Roles in Children's Science Biographies

    Science.gov (United States)

    Owens, Trevor

    2009-01-01

    One of the first places children encounter science and scientists is children's literature. Children's books about science and scientists have, however, received limited scholarly attention. By exploring the history of children's biographies of Marie Curie and Albert Einstein, the two most written about scientist in children's literature, this…

  7. Therapeutic efficacy trial of artemisinin-based combination therapy for the treatment of uncomplicated malaria and investigation of mutations in k13 propeller domain in Togo, 2012–2013

    OpenAIRE

    Dorkenoo, Améyo M.; Yehadji, Degninou; Agbo, Yao M.; Layibo, Yao; Agbeko, Foli; Adjeloh, Poukpessi; Yakpa, Kossi; Sossou, Efoe; Awokou, Fantchè; Ringwald, Pascal

    2016-01-01

    Background Since 2005, the Togo National Malaria Control Programme has recommended two different formulations of artemisinin-based combination therapy (ACT), artesunate–amodiaquine (ASAQ) and artemether-lumefantrine (AL), for the treatment of uncomplicated malaria. Regular efficacy monitoring of these two combinations is conducted every 2 or 3 years. This paper reports the latest efficacy assessment results and the investigation of mutations in the k13 propeller domain. Methods The study was ...

  8. Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective

    OpenAIRE

    Dillip Angel; Goodman Catherine; Hetzel Manuel W; Alba Sandra; Liana Jafari; Mshinda Hassan; Lengeler Christian

    2010-01-01

    Abstract Background To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO) was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. Methods The study ...

  9. AHP Approach for Supplier Evaluation and Selection in a Pharmaceutical Manufacturing Firm in Ghana

    OpenAIRE

    David Asamoah; Jonathan Annan; Samuel Nyarko

    2012-01-01

    In today’s highly competitive environment, improper evaluation and selection of the right suppliers can hinder anorganizations supply chain performance. The aim of this study is to present a suitable methodology for theevaluation and selection of suppliers in a pharmaceutical manufacturing firm in Ghana. Specifically, the studysought to use the Analytic Hierarchy Process methodology to select the most appropriate raw material suppliersof the artemether-lumefantrine anti-malarial drug for the ...

  10. The Impact of Inventory Management on Stock-Outs of Essential Drugs in Sub-Saharan Africa: Secondary Analysis of a Field Experiment in Zambia

    OpenAIRE

    Leung, Ngai-Hang Z.; Ana Chen; Prashant Yadav; Jérémie Gallien

    2016-01-01

    Objective To characterize the impact of widespread inventory management policies on stock-outs of essential drugs in Zambia’s health clinics and develop related recommendations. Methods Daily clinic storeroom stock levels of artemether-lumefantrine (AL) products in 2009–2010 were captured in 145 facilities through photography and manual transcription of paper forms, then used to determine historical stock-out levels and estimate demand patterns. Delivery lead-times and estimates of monthly fa...

  11. Saleability of anti-malarials in private drug shops in Muheza, Tanzania: a baseline study in an era of assumed artemisinin combination therapy (ACT)

    OpenAIRE

    Ringsted Frank M; Massawe Isolide S; Lemnge Martha M; Bygbjerg Ib C

    2011-01-01

    Abstract Background Artemether-lumefantrine (ALu) replaced sulphadoxine-pymimethamine (SP) as the official first-line anti-malarial in Tanzania in November 2006. So far, artemisinin combination therapy (ACT) is contra-indicated during pregnancy by the national malaria treatment guidelines, and pregnant women depend on SP for Intermittent Preventive Treatment (IPTp) during pregnancy. SP is still being dispensed by private drug stores, but it is unknown to which extent. If significant, it may u...

  12. Determination of artemether and lumefantrine in anti-malarial fixed-dose combination tablets by microemulsion electrokinetic chromatography with short-end injection procedure

    OpenAIRE

    Amin, N’Cho Christophe; Fabre, Huguette; Blanchin, Marie-Dominique; Montels, Jérôme; Aké, Michèle

    2013-01-01

    Background Artemether-lumefantrine (AL) combination therapy is now the most used anti-malarial treatment in the world. Quality control of AL formulations is still a major challenge in developing countries. Until now, only liquid chromatographic methods have been reported in the literature for their analysis. Capillary electrophoretic methods, which present various advantages (low price of capillary, low volumes of electrolyte consumption), may be an alternative to liquid chromatography method...

  13. 17 CFR 256.143 - Accounts receivable.

    Science.gov (United States)

    2010-04-01

    ... COMPANY ACT OF 1935 3. Current and Accrued Assets § 256.143 Accounts receivable. This account shall... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Accounts receivable. 256.143 Section 256.143 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED)...

  14. Cashier/Accounts Receivable Clerk Exploration.

    Science.gov (United States)

    Portsmouth City School Board, VA.

    The student materials present exercises designed to simulate the job performed by a cashier/accounts receivable clerk. The content of the course covers job instructions, writing receipts, proving cash, customer accounts, preparing statements, and schedule of accounts receivable. Also included in the document are a pretest and post test for the…

  15. 21 CFR 1020.10 - Television receivers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Television receivers. 1020.10 Section 1020.10 Food...) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING PRODUCTS § 1020.10 Television receivers. (a) Applicability. The provisions of this section are applicable to television...

  16. Heat-Energy Analysis for Solar Receivers

    Science.gov (United States)

    Lansing, F. L.

    1982-01-01

    Heat-energy analysis program (HEAP) solves general heat-transfer problems, with some specific features that are "custom made" for analyzing solar receivers. Can be utilized not only to predict receiver performance under varying solar flux, ambient temperature and local heat-transfer rates but also to detect locations of hotspots and metallurgical difficulties and to predict performance sensitivity of neighboring component parameters.

  17. An SDR based AIS receiver for satellites

    DEFF Research Database (Denmark)

    Larsen, Jesper Abildgaard; Mortensen, Hans Peter; Nielsen, Jens Frederik Dalsgaard

    2011-01-01

    For a few years now, there has been a high interest in monitoring the global ship traffic from space. A few satellite, capable of listening for ship borne AIS transponders have already been launched, and soon the AAUSAT3, carrying two different types of AIS receivers will also be launched. One of...... the AIS receivers onboard AAUSAT3 is an SDR based AIS receiver. This paper serves to describe the background of the AIS system, and how the SDR based receiver has been integrated into the AAUSAT3 satellite. Amongst some of the benefits of using an SDR based receiver is, that due to its versatility......, new detection algorithms are easily deployed, and it is easily adapted the new proposed AIS transmission channels....

  18. Interference Channels with Correlated Receiver Side Information

    CERN Document Server

    Liu, Nan; Goldsmith, Andrea J; Poor, H Vincent

    2008-01-01

    The problem of joint source-channel coding in transmitting independent sources over interference channels with correlated receiver side information is studied. When each receiver has side information correlated with its own desired source, it is shown that source-channel code separation is optimal. When each receiver has side information correlated with the interfering source, sufficient conditions for reliable transmission are provided based on a joint source-channel coding scheme using the superposition encoding and partial decoding idea of Han and Kobayashi. When the receiver side information is a deterministic function of the interfering source, source-channel code separation is again shown to be optimal. As a special case, for a class of Z-interference channels, when the side information of the receiver facing interference is a deterministic function of the interfering source, necessary and sufficient conditions for reliable transmission are provided in the form of single letter expressions. As a byprodu...

  19. Temperature influences in receiver clock modelling

    Science.gov (United States)

    Wang, Kan; Meindl, Michael; Rothacher, Markus; Schoenemann, Erik; Enderle, Werner

    2016-04-01

    In Precise Point Positioning (PPP), hardware delays at the receiver site (receiver, cables, antenna, …) are always difficult to be separated from the estimated receiver clock parameters. As a result, they are partially or fully contained in the estimated "apparent" clocks and will influence the deterministic and stochastic modelling of the receiver clock behaviour. In this contribution, using three years of data, the receiver clock corrections of a set of high-precision Hydrogen Masers (H-Masers) connected to stations of the ESA/ESOC network and the International GNSS Service (IGS) are firstly characterized concerning clock offsets, drifts, modified Allan deviations and stochastic parameters. In a second step, the apparent behaviour of the clocks is modelled with the help of a low-order polynomial and a known temperature coefficient (Weinbach, 2013). The correlations between the temperature and the hardware delays generated by different types of antennae are then analysed looking at daily, 3-day and weekly time intervals. The outcome of these analyses is crucial, if we intend to model the receiver clocks in the ground station network to improve the estimation of station-related parameters like coordinates, troposphere zenith delays and ambiguities. References: Weinbach, U. (2013) Feasibility and impact of receiver clock modeling in precise GPS data analysis. Dissertation, Leibniz Universität Hannover, Germany.

  20. Fundamentals of GPS Receivers A Hardware Approach

    CERN Document Server

    Doberstein, Dan

    2012-01-01

    While much of the current literature on GPS receivers is aimed at those intimately familiar with their workings, this volume summarizes the basic principles using as little mathematics as possible, and details the necessary specifications and circuits for constructing a GPS receiver that is accurate to within 300 meters. Dedicated sections deal with the features of the GPS signal and its data stream, the details of the receiver (using a hybrid design as exemplar), and more advanced receivers and topics including time and frequency measurements. Later segments discuss the Zarlink GPS receiver chip set, as well as providing a thorough examination of the TurboRogue receiver, one of the most accurate yet made. Guiding the reader through the concepts and circuitry, from the antenna to the solution of user position, the book’s deployment of a hybrid receiver as a basis for discussion allows for extrapolation of the core ideas to more complex, and more accurate designs. Digital methods are used, but any analogue c...

  1. Terahertz Array Receivers with Integrated Antennas

    Science.gov (United States)

    Chattopadhyay, Goutam; Llombart, Nuria; Lee, Choonsup; Jung, Cecile; Lin, Robert; Cooper, Ken B.; Reck, Theodore; Siles, Jose; Schlecht, Erich; Peralta, Alessandro; Thomas, Bertrand; Mehdi, Imran

    2011-01-01

    Highly sensitive terahertz heterodyne receivers have been mostly single-pixel. However, now there is a real need of multi-pixel array receivers at these frequencies driven by the science and instrument requirements. In this paper we explore various receiver font-end and antenna architectures for use in multi-pixel integrated arrays at terahertz frequencies. Development of wafer-level integrated terahertz receiver front-end by using advanced semiconductor fabrication technologies has progressed very well over the past few years. Novel stacking of micro-machined silicon wafers which allows for the 3-dimensional integration of various terahertz receiver components in extremely small packages has made it possible to design multi-pixel heterodyne arrays. One of the critical technologies to achieve fully integrated system is the antenna arrays compatible with the receiver array architecture. In this paper we explore different receiver and antenna architectures for multi-pixel heterodyne and direct detector arrays for various applications such as multi-pixel high resolution spectrometer and imaging radar at terahertz frequencies.

  2. Hearing Loss in Children: Data and Statistics

    Science.gov (United States)

    ... territories, such as the percent screened for hearing loss or receiving diagnostic testing. Transition Into Adulthood A CDC study that followed school-aged children identified with hearing loss into young ...

  3. The Submillimeter Array Antennas and Receivers

    Science.gov (United States)

    Blundell, R.

    The Submillimeter Array (SMA) was conceived at the Smithsonian Astrophysical Observatory in 1984 as a six element interferometer to operate in the major atmospheric windows from about 200 to 900 GHz. In 1996, the Academica Sinica Institute of Astronomy and Astrophysics of Taiwan joined the project and agreed to provide additional hardware to expand the interferometer to eight elements. All eight antennas are now operating at the observatory site on Mauna Kea, and astronomical observations have been made in the 230, 345, and 650 GHz bands. The SMA antennas have a diameter of 6 m, a surface accuracy of better than 25 micron rms, and can be reconfigured to provide spatial resolutions down to about 0.5" at 200 GHz and, eventually, 0.1" at 850 GHz. Coupling to the receiver package within each antenna is achieved via a beam waveguide, in a bent Nasmyth configuration, comprised of a flat tertiary mirror and two ellipsoidal mirrors that form a secondary pupil used for receiver calibration. An additional fixed mirror and a rotating wire grid polarizer are then used for receiver selection. Each antenna houses a single cryostat, with an integrated cryocooler capable of cooling up to eight receivers to 4 K. In the current configuration only three receiver bands are available: 175-255 GHz, 250-350 GHz, and 600-720 GHz, and simultaneous operation of the 650 GHz receiver with either of the lower frequency receivers is possible. Eventually dual polarization will be available from 325-350 GHz, and dual frequency operation will be possible, pairing either of the lower frequency receivers with any of the high frequency units: 325-425 GHz, 425-510 GHz, 600-720 GHz, and 800-900 GHz. Each receiver currently uses a single superconductor-insulator-superconductor junction as the mixing element, and has first stage intermediate frequency amplification at 4 K with an instantaneous bandwidth of 2.5 GHz, centered at 5 GHz. The mixers are of a fixed-tuned waveguide design, are inherently broad

  4. Software Receiver Design for Galileo Signals.

    OpenAIRE

    Lezaeta Collazos, Roberto de; Martínez Rodríguez-Osorio, Ramón

    2010-01-01

    The article presents a new concept of software-based GNSS receivers because of its advantages in flexibility and possibility of reconfiguration. The aim is to develop a receiver for navigation signals of the Galileo system testbed, the Giove-A and Giove-B. The receiver must be able to acquire, track and demodulate signals "BOC" system. For this test different techniques, both in the acquisition and follow-up. Also developed a configurable signal generator for testing and a graphical user inte...

  5. Children's Places

    DEFF Research Database (Denmark)

    Using a cross-cultural approach the book investigates children's places in different societies. "Children's Places" examines the ways in which children and adults, from their different vantage-points in society, negotiate proper places of children in both social and spatial terms. It looks at some...... of the recognised constructions of children, as well as examining contexts for them, from schools and kindergartens to inner cities and war-zones. The result gives insight into the notions of inclusion and exclusion, the placement and displacement of children within generational ranks and orders, and...... the kinds of places that children create for themselves....

  6. Research utilization among children's mental health providers

    OpenAIRE

    Ferguson H Bruce; Stasiulis Elaine; Boydell Katherine M; Barwick Melanie A; Blase Karen; Fixsen Dean

    2008-01-01

    Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider org...

  7. Percentage of Surgical Patients Receiving Recommended Care

    Science.gov (United States)

    ... view charts and maps. State Percentage of Surgical Patients Receiving Recommended Care by ... U.S. Department of Health & Human Services — 200 Independence Avenue, S.W. — Washington, D.C. 20201

  8. Digital Signal Processing Based Biotelemetry Receivers

    Science.gov (United States)

    Singh, Avtar; Hines, John; Somps, Chris

    1997-01-01

    This is an attempt to develop a biotelemetry receiver using digital signal processing technology and techniques. The receiver developed in this work is based on recovering signals that have been encoded using either Pulse Position Modulation (PPM) or Pulse Code Modulation (PCM) technique. A prototype has been developed using state-of-the-art digital signal processing technology. A Printed Circuit Board (PCB) is being developed based on the technique and technology described here. This board is intended to be used in the UCSF Fetal Monitoring system developed at NASA. The board is capable of handling a variety of PPM and PCM signals encoding signals such as ECG, temperature, and pressure. A signal processing program has also been developed to analyze the received ECG signal to determine heart rate. This system provides a base for using digital signal processing in biotelemetry receivers and other similar applications.

  9. Metal Mesh Filters for Terahertz Receivers Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The best low-noise receiver solutions for frequencies above about 800 GHz rely on either a low-noise bolometric direct detector or a hot electron bolometric mixer....

  10. List of Nuclear Materials Licensing Actions Received

    Data.gov (United States)

    Nuclear Regulatory Commission — A catalog of all Materials Licensing Actions received for review. The catalog lists the name of the entity submitting the license application, their city and state,...

  11. Metal Mesh Filters for Terahertz Receivers Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The technical objective of this SBIR program is to develop and demonstrate metal mesh filters for use in NASA's low noise receivers for terahertz astronomy and...

  12. Development of an ATSC multimedia datacasting receiver

    Science.gov (United States)

    Gagnon, Gilles; Liu, Hong; Li, Wei

    2003-11-01

    This paper presents the development of an ATSC terrestrial data receiver to be used in multimedia datacasting for remote and rural communities. In the context of a project put forward at the Communications Research Centre Canada to deliver interactive multimedia to remote and rural areas in Canada, a receiver capable of extracting Internet Packets (IP) as well as video and audio transport streams (TS) based on the Advanced Television Systems Committee (ATSC) terrestrial digital television system is developed. This paper describes the design, implementation, functionality, as well as several applications of this receiver which plays an important role in the interactive multimedia datacasting system. The ATSC terrestrial transmission chain from the server at the transmitter site to the receiver (client) at the end-user's premise is presented. A number of possible implementations for a return channel are proposed. Preliminary results of laboratory trials as well as plans for field trials are presented.

  13. Design and implementation of the CAPS receiver

    Institute of Scientific and Technical Information of China (English)

    HU YongHui; HUA Yu; HOU Lei; WEI JingFa; WU JianFeng

    2009-01-01

    In this paper,baaed on analyses of the Chinese Area Positioning System (CAPS) satellite (GEO satellite) resources and signal properties,the signal power at the port of the receiver antenna is estimated,and the implementation projects are presented for a switching band C to band L CAPS C/A code receiver integrated with GPS receiver suite and for a CAPS dual frequency P code receiver.A microstrip receiving antenna is designed with high sensitivity and wide beam orientation,the RF front end of the C/A code and P code receivers,and a processor is designed for the navigation baseband.A single frequency CAPS C/A code receiver and a CAPS dual frequency P code receiver are built at the same time.A software process flow is provided,and research on relatively key techniques is also conducted,such as signal searching,code loop and carrier loop algorithms,a height assistant algorithm,a dual frequency difference speed measurement technique,a speed measurement technique using a single frequency source with frequency assistance,and a CAPS time correcting algorithm,according to the design frame of the receiver hardware.Research results show that the static plane positioning accuracy of the CAPS C/A code receiver is 20.5-24.6 m,height accuracy is 1.2-12.8 m,speed measurement accuracy is 0.13-0.3 m/s,dynamic plane positioning accuracy is 24.4 m,height accuracy is 3.0 m,and speed measurement accuracy is 0.24 m/s.In the case of C/A code,the timing accuracy is 200 ha,and it is also shown that the positioning accuracy of the CAPS precise code receiver (1σ) is 5 m from south to north,and 0.8 m from east to west.Finally,research on positioning accuracy is also conducted.

  14. Anatomy of a digital coherent receiver

    DEFF Research Database (Denmark)

    Borkowski, Robert; Zibar, Darko; Tafur Monroy, Idelfonso

    2014-01-01

    Digital coherent receivers have gained significant attention in the last decade. The reason for this is that coherent detection, along with digital signal processing (DSP) allows for substantial increase of the channel capacity by employing advanced detection techniques. In this paper, we first......, orthonormaliation, chromatic dispersion compensation/nonlinear compensation, resampling a nd timing recovery, polarization demultiplexing and equalization, frequency and phase recovery, digital demodulation. We also describe novel subsystems of a digital coherent receiver: modulation format recognition and...

  15. Development of Receiver Stimulator for Auditory Prosthesis

    OpenAIRE

    K. Raja Kumar; P. Seetha Ramaiah

    2010-01-01

    The Auditory Prosthesis (AP) is an electronic device that can provide hearing sensations to people who are profoundly deaf by stimulating the auditory nerve via an array of electrodes with an electric current allowing them to understand the speech. The AP system consists of two hardware functional units such as Body Worn Speech Processor (BWSP) and Receiver Stimulator. The prototype model of Receiver Stimulator for Auditory Prosthesis (RSAP) consists of Speech Data Decoder, DAC, ADC, constant...

  16. Flexible receiver adapter formal design review

    International Nuclear Information System (INIS)

    This memo summarizes the results of the Formal (90%) Design Review process and meetings held to evaluate the design of the Flexible Receiver Adapters, support platforms, and associated equipment. The equipment is part of the Flexible Receiver System used to remove, transport, and store long length contaminated equipment and components from both the double and single-shell underground storage tanks at the 200 area tank farms

  17. Nonuniform bandpass sampling in radio receivers

    OpenAIRE

    Sun, Yi-Ran

    2004-01-01

    As an interface between radio receiver front-ends and digital signal processing blocks, sampling devices play a dominant role in digital radio communications. As an interface between radio receiver front-ends and digital signal processing blocks, sampling devices play a dominant role in digital radio communications. Based on different sampling theorems (e.g., classic Shannon’s sampling theorem, Papoulis’ Generalized sampling theorem, bandpass sampling theory), signals are processed by the sam...

  18. Compressed Sensing-Based Direct Conversion Receiver

    OpenAIRE

    Pierzchlewski, Jacek; Arildsen, Thomas; Larsen, Torben

    2012-01-01

    Due to the continuously increasing computational power of modern data receivers it is possible to move more and more processing from the analog to the digital domain. This paper presents a compressed sensing approach to relaxing the analog filtering requirements prior to the ADCs in a direct conversion receiver. In the presented solution, the filtered down-convertedradio signals are randomly sampled with an average sampling frequency lower than its Nyquist rate, and then reconstructed in a DS...

  19. ITERATIVE RECEIVER FOR OFDM-SDMA SYSTEM

    Institute of Scientific and Technical Information of China (English)

    Shan Shuwei; Luo Hanwen; Song Wentao

    2004-01-01

    An iterative receiver is proposed based on the EM (Expectation-Maximization)algorithm for an OFDM-SDMA (Orthogonal Frequency Division Multiplexing-Space Division Multiple Access) system. By using a few pilots in every OFDM symbol, both channel estimation and multiuser detection can be simultaneously obtained by iteration. The computer simulation results show this receiver can track channel variations and detect multiuser symbols for different number of users under time-varying multipath channels.

  20. Single-Receiver GPS Phase Bias Resolution

    Science.gov (United States)

    Bertiger, William I.; Haines, Bruce J.; Weiss, Jan P.; Harvey, Nathaniel E.

    2010-01-01

    Existing software has been modified to yield the benefits of integer fixed double-differenced GPS-phased ambiguities when processing data from a single GPS receiver with no access to any other GPS receiver data. When the double-differenced combination of phase biases can be fixed reliably, a significant improvement in solution accuracy is obtained. This innovation uses a large global set of GPS receivers (40 to 80 receivers) to solve for the GPS satellite orbits and clocks (along with any other parameters). In this process, integer ambiguities are fixed and information on the ambiguity constraints is saved. For each GPS transmitter/receiver pair, the process saves the arc start and stop times, the wide-lane average value for the arc, the standard deviation of the wide lane, and the dual-frequency phase bias after bias fixing for the arc. The second step of the process uses the orbit and clock information, the bias information from the global solution, and only data from the single receiver to resolve double-differenced phase combinations. It is called "resolved" instead of "fixed" because constraints are introduced into the problem with a finite data weight to better account for possible errors. A receiver in orbit has much shorter continuous passes of data than a receiver fixed to the Earth. The method has parameters to account for this. In particular, differences in drifting wide-lane values must be handled differently. The first step of the process is automated, using two JPL software sets, Longarc and Gipsy-Oasis. The resulting orbit/clock and bias information files are posted on anonymous ftp for use by any licensed Gipsy-Oasis user. The second step is implemented in the Gipsy-Oasis executable, gd2p.pl, which automates the entire process, including fetching the information from anonymous ftp

  1. Integrated Circuits for Linear and Efficient Receivers

    OpenAIRE

    Östman, Kim

    2014-01-01

    This dissertation presents original research contributions in the form of five integrated circuit (IC) implementations and seven scientific publications. They present advances related to high-Q resonators, DC-DC converters, and programmable RF front-ends for integrated wireless receivers. Because these three building blocks have traditionally required implementations that are partly external to the IC, the ultimate target is to reduce system size, cost, and complexity. Wireless receivers u...

  2. A handbook for solar central receiver design

    Energy Technology Data Exchange (ETDEWEB)

    Falcone, P.K.

    1986-12-01

    This Handbook describes central receiver technology for solar thermal power plants. It contains a description and assessment of the major components in a central receiver system configured for utility scale production of electricity using Rankine-cycle steam turbines. It also describes procedures to size and optimize a plant and discussed examples from recent system analyses. Information concerning site selection criteria, cost estimation, construction, and operation and maintenance is also included, which should enable readers to perform design analyses for specific applications.

  3. Approximation equation for EW receiver sensitivity

    International Nuclear Information System (INIS)

    A set of equations is presented for the calculation of the signal-to-noise ratio in decibels for required operational sensitivity of a microwave receiver. Given RF bandwidth and video bandwidth for an EW receiver, along with probability of detection and false alarm rate, S/N in decibels may be obtained. The method is less time-consuming than calculating sensitivity from curves, and the results obtained are within 1 dB of values obtained from curves. 8 references

  4. 34 CFR 303.4 - Limitation on eligible children.

    Science.gov (United States)

    2010-07-01

    ... eligible children. This part 303 does not apply to any child with disabilities receiving a free appropriate public education, in accordance with 34 CFR part 300, with funds received under 34 CFR part 301... 34 Education 2 2010-07-01 2010-07-01 false Limitation on eligible children. 303.4 Section...

  5. Dividing Attention Lowers Children's but Increases Adults' False Memories

    Science.gov (United States)

    Otgaar, Henry; Peters, Maarten; Howe, Mark L.

    2012-01-01

    The present study examined the impact of divided attention on children's and adults' neutral and negative true and false memories in a standard Deese/Roediger-McDermott paradigm. Children (7- and 11-year-olds; n = 126) and adults (n = 52) received 5 neutral and 5 negative Deese/Roediger-McDermott word lists; half of each group also received a…

  6. Sustained attention in intellectually gifted children assessed using a continuous performance test.

    Science.gov (United States)

    Shi, Jiannong; Tao, Ting; Chen, Wei; Cheng, Li; Wang, Long; Zhang, Xingli

    2013-01-01

    This study aimed to investigate two aspects of sustained attention in intellectually gifted children: first, the differences to intellectually average children; second, the differences between receiving standard education and enrichment education. Study 1 compared sustained attention between 24 intellectually gifted and 26 intellectually average children. The results showed that intellectually gifted children had better performance than their average peers, not only for the whole task but also on all indices. Study 2 compared sustained attention between 24 intellectually gifted children who received standard education and 24 intellectually gifted children who received enrichment education. The results showed that intellectually gifted children who received enrichment education performed better than those who received standard education. These findings are consistent with previous work and provide support for the implementation of enrichment education for intellectually gifted children. PMID:23451224

  7. When children affect parents: Children's academic performance and parental investment.

    Science.gov (United States)

    Yurk Quadlin, Natasha

    2015-07-01

    Sociologists have extensively documented the ways that parent resources predict children's achievement. However, less is known about whether and how children's academic performance shapes parental investment behaviors. I use data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) and longitudinal fixed effects models to examine how changes in teacher assessments are related to changes in the conferral of various parent resources. Overall, I find that the relationship between achievement and investment varies based on the directionality in children's achievement and the type of resource at hand. Children whose performance improves receive a broad range of enrichment resources, while declines in performance are met with corrective educational resources. Results are largely consistent whether language or math assessments are used to predict investment, and also among children whose achievement does not change over time. I discuss these patterns, along with implications for the use of parent resources in education and family research. PMID:26004488

  8. Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças com doença falciforme usando penicilina profilática Nasopharyngeal colonization by Streptococcus pneumoniae in children with sickle cell disease receiving prophylactic penicillin

    Directory of Open Access Journals (Sweden)

    Patricia B. Blum Fonseca

    2005-04-01

    Full Text Available OBJETIVOS: Determinar a prevalência de colonização nasofaríngea pelo pneumococo em crianças com doença falciforme, em uso de profilaxia com penicilina; identificar fatores de risco para colonização; sorotipar as cepas isoladas e avaliar a resistência antimicrobiana. METODOLOGIA: Foram colhidos 188 suabes de nasofaringe de 98 crianças com doença falciforme em acompanhamento no Hospital São Paulo, da Universidade Federal de São Paulo, no período de 09 de abril de 2002 a 28 de fevereiro de 2003. O isolamento e a identificação dos pneumococos seguiram procedimentos padronizados. A concentração inibitória mínima para penicilina foi determinada pelo método do E-test. A sorotipagem foi realizada pela reação de Neufeld-Quellung com anti-soros para 46 sorotipos. RESULTADOS: A idade variou de 4 meses a 17 anos (média e desvio padrão de 6,8±4,7 anos. Das 98 crianças do estudo, 13 apresentaram colonização pelo pneumococo (prevalência de 13,3%. O maior risco de colonização ocorreu em menores de 2 anos de idade (p = 0,02. A prevalência de cepas com resistência intermediária à penicilina foi de 21,4%, não sendo evidenciada resistência plena. Também não houve cepas resistentes à eritromicina, ceftriaxona e vancomicina. Os sorotipos isolados mais freqüentes foram o 18C e o 23F. CONCLUSÕES: O uso profilático de penicilina diminuiu a colonização nasofaríngea pelo pneumococo e não determinou aumento da resistência a esse antimicrobiano nas crianças com doença falciforme. A penicilina ainda pode ser usada na profilaxia e no tratamento dos episódios febris dessas crianças.OBJECTIVES: To determine the prevalence of nasopharyngeal pneumococcus colonization in children with sickle cell disease undergoing penicillin prophylaxis, to identify risk factors for colonization and to serotype and determine antibiotic resistance in pneumococci obtained from those children. METHODS: Between April 9, 2002 and February 28, 2003

  9. Preventive Care Delivery to Young Children With Sickle Cell Disease.

    Science.gov (United States)

    Bundy, David G; Muschelli, John; Clemens, Gwendolyn D; Strouse, John J; Thompson, Richard E; Casella, James F; Miller, Marlene R

    2016-05-01

    Preventive services can reduce the morbidity of sickle cell disease (SCD) in children but are delivered unreliably. We conducted a retrospective cohort study of children aged 2 to 5 years with SCD, evaluating each child for 14 months and expecting that he/she should receive ≥75% of days covered by antibiotic prophylaxis, ≥1 influenza immunization, and ≥1 transcranial Doppler ultrasound (TCD). We used logistic regression to quantify the relationship between ambulatory generalist and hematologist visits and preventive services delivery. Of 266 children meeting the inclusion criteria, 30% consistently filled prophylactic antibiotic prescriptions. Having ≥2 generalist, non-well child care visits or ≥2 hematologist visits was associated with more reliable antibiotic prophylaxis. Forty-one percent of children received ≥1 influenza immunizations. Children with ≥2 hematologist visits were most likely to be immunized (62% vs. 35% among children without a hematologist visit). Only 25% of children received ≥1 TCD. Children most likely to receive a TCD (42%) were those with ≥2 hematologist visits. One in 20 children received all 3 preventive services. Preventive services delivery to young children with SCD was inconsistent but associated with multiple visits to ambulatory providers. Better connecting children with SCD to hematologists and strengthening preventive care delivery by generalists are both essential. PMID:26950087

  10. Functional Decline in Children Undergoing Selective Dorsal Rhizotomy after Age 10

    Science.gov (United States)

    MacWilliams, Bruce A.; Johnson, Barbara A.; Shuckra, Amy L.; D'Astous, Jacques L.

    2011-01-01

    Aim: To compare function and gait in a group of children older than most children who received selective dorsal rhizotomy (SDR) with age- and function-matched peers who received either orthopedic surgery or no surgical intervention. Method: A retrospective study examined ambulatory children with diplegic cerebral palsy, aged between 10 years and…

  11. How Important Is Teaching Phonemic Awareness to Children Learning to Read in Spanish?

    Science.gov (United States)

    Goldenberg, Claude; Tolar, Tammy D.; Reese, Leslie; Francis, David J.; Bazán, Antonio Ray; Mejía-Arauz, Rebeca

    2014-01-01

    This comparative study examines relationships between phonemic awareness and Spanish reading skill acquisition among three groups of Spanish-speaking first and second graders: children in Mexico receiving reading instruction in Spanish and children in the United States receiving reading instruction in either Spanish or English. Children were…

  12. The Influence of Juggling on Mental Rotation Performance in Children with Spina Bifida

    Science.gov (United States)

    Lehmann, Jennifer; Jansen, Petra

    2012-01-01

    This study examined the influence of juggling training on mental rotation ability in children with spina bifida. Children between the ages of 8 and 12 solved a chronometric mental rotation test. Half of the children received juggling training (EG) over an 8 week time period; the other half did not receive training (CG). Afterwards, all…

  13. 7 CFR 1400.101 - Minor children.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Minor children. 1400.101 Section 1400.101 Agriculture... SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Limitation § 1400.101 Minor children. (a) Except as provided in paragraph (b) of this section, payments received by a child under 18 years of age as of April...

  14. School-Based Counseling of Abused Children

    Science.gov (United States)

    Brassard, Marla R.; Rivelis, Erin; Diaz, Vielka

    2009-01-01

    Abused children experience high rates of behavior, emotional, and learning problems but infrequently receive treatment. Most services provided to abused children and their families are not based on any clear evidence that they work. A number of evidence-based treatments (EBTs), demonstrated to be safe and effective in treating a range of…

  15. Performance outlook of the SCRAP receiver

    Science.gov (United States)

    Lubkoll, Matti; von Backström, Theodor W.; Harms, Thomas M.

    2016-05-01

    A combined cycle (CC) concentrating solar power (CSP) plant provides significant potential to achieve an efficiency increase and an electricity cost reduction compared to current single-cycle plants. A CC CSP system requires a receiver technology capable of effectively transferring heat from concentrated solar irradiation to a pressurized air stream of a gas turbine. The small number of pressurized air receivers demonstrated to date have practical limitations, when operating at high temperatures and pressures. As yet, a robust, scalable and efficient system has to be developed and commercialized. A novel receiver system, the Spiky Central Receiver Air Pre-heater (SCRAP) concept has been proposed to comply with these requirements. The SCRAP system is conceived as a solution for an efficient and robust pressurized air receiver that could be implemented in CC CSP concepts or standalone solar Brayton cycles without a bottoming Rankine cycle. The presented work expands on previous publications on the thermal modeling of the receiver system. Based on the analysis of a single heat transfer element (spike), predictions for its thermal performance can be made. To this end the existing thermal model was improved by heat transfer characteristics for the jet impingement region of the spike tip as well as heat transfer models simulating the interaction with ambient. While the jet impingement cooling effect was simulated employing a commercial CFD code, the ambient heat transfer model was based on simplifying assumptions in order to employ empirical and analytical equations. The thermal efficiency of a spike under design conditions (flux 1.0 MW/m2, air outlet temperature just below 800 °C) was calculated at approximately 80 %, where convective heat losses account for 16.2 % of the absorbed radiation and radiative heat losses for a lower 2.9 %. This effect is due to peak surface temperatures occurring at the root of the spikes. It can thus be concluded that the geometric

  16. Screening Rastafarian children for nutritional rickets.

    OpenAIRE

    James, J A; Clark, C; Ward, P. S.

    1985-01-01

    We examined 42 Rastafarian children under 5 years of age who were registered with a single inner city general practice to determine the prevalence of nutritional rickets. Twenty children were receiving a strict vegan(I-tal) diet and were considered to be at high risk of developing rickets and were referred for biochemical and radiological investigation. Seven of 20 children investigated had rickets, giving an overall prevalence of 7/42. Treatment with oral cholecalciferol was successful in al...

  17. Viral infections in children with cancer

    OpenAIRE

    Lindblom, Anna

    2009-01-01

    Viral infections are the most common cause of infection morbidity in children. Nevertheless, few studies have been devoted to exploring the viral panorama in children receiving chemotherapy for cancer. The present thesis aims to study viral infections in children with cancer with special focus on Parvovirus B19 (B19) and viral infections during episodes of neutropenic fever. B19 was for many years, believed to be a lytic virus cleared by the humoral response. However, su...

  18. Chiral Receiving Antenna With Low Backscattering Levels

    CERN Document Server

    Karilainen, Antti O

    2011-01-01

    Receiving antennas absorb power from incident waves, but they also re-radiate some power into surrounding space. If a receiving antenna is to be used as a sensor which should not disturb the object under study, it should scatter as little power as possible in the receiving direction. We propose to use a chiral element composed of two orthogonal chiral particles as a low-scattering sensor.The element can transmit and receive circular polarization in all directions with the Huygens' pattern. We derive the vector effective length for the antenna using the small dipole approximation for the chiral particles. We observe that the element does not backscatter, regardless of the polarization, when the incidence direction is normal to the plane of the particles. Scattered fields, scattered axial ratio, and the scattering cross section are presented. We show that the zero-backscattering property holds also for the antenna element when it is capable to receive all the available power with conjugate loading. The approxim...

  19. Schottky Heterodyne Receivers With Full Waveguide Bandwidth

    Science.gov (United States)

    Hesler, Jeffrey; Crowe, Thomas

    2011-01-01

    Compact THz receivers with broad bandwidth and low noise have been developed for the frequency range from 100 GHz to 1 THz. These receivers meet the requirements for high-resolution spectroscopic studies of planetary atmospheres (including the Earth s) from spacecraft, as well as airborne and balloon platforms. The ongoing research is significant not only for the development of Schottky mixers, but also for the creation of a receiver system, including the LO chain. The new receivers meet the goals of high sensitivity, compact size, low total power requirement, and operation across complete waveguide bands. The exceptional performance makes these receivers ideal for the broader range of scientific and commercial applications. These include the extension of sophisticated test and measurement equipment to 1 THz and the development of low-cost imaging systems for security applications and industrial process monitoring. As a particular example, a WR-1.9SHM (400-600 GHz) has been developed (see Figure 1), with state-of-the-art noise temperature ranging from 1,000-1,800 K (DSB) over the full waveguide band. Also, a Vector Network Analyzer extender has been developed (see Figure 2) for the WR1.5 waveguide band (500 750 GHz) with 100-dB dynamic range.

  20. Palm Reversal Errors in Native-Signing Children with Autism

    Science.gov (United States)

    Shield, Aaron; Meier, Richard P.

    2012-01-01

    Children with autism spectrum disorder (ASD) who have native exposure to a sign language such as American Sign Language (ASL) have received almost no scientific attention. This paper reports the first studies on a sample of five native-signing children (four deaf children of deaf parents and one hearing child of deaf parents; ages 4;6 to 7;5)…

  1. Ink and Wash Painting for Children with Visual Impairment

    Science.gov (United States)

    Shih, Chih-Ming; Chao, Hsin-Yi

    2010-01-01

    Five children with visual impairments received instruction in drawing, using ink and wash painting and calligraphy techniques. A special system developed by a blind Taiwanese Chinese calligrapher, Tsann-Cherng Liaw, was used to help the children orient and refine their work. Children's performance on simple drawing tasks was compared before and…

  2. Preschool Children's Sleep and Wake Behavior: Effects of Massage Therapy.

    Science.gov (United States)

    Field, Tiffany; And Others

    1996-01-01

    Preschool children received twice-weekly massages for five weeks. Compared to control children, the massaged children had better behavior ratings on mood state, vocalization, activity, and cooperation following massage on day one and throughout the study. Teachers rated their behavior more optimally, and their parents rated them as having less…

  3. Neurofeedback Improves Executive Functioning in Children with Autism Spectrum Disorders

    Science.gov (United States)

    Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Congedo, Marco; van Schie, Hein T.

    2009-01-01

    Seven autistic children diagnosed with autism spectrum disorders (ASD) received a neurofeedback treatment that aimed to improve their level of executive control. Neurofeedback successfully reduced children's heightened theta/beta ratio by inhibiting theta activation and enhancing beta activation over sessions. Following treatment, children's…

  4. 34 CFR 200.91 - SEA counts of eligible children.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false SEA counts of eligible children. 200.91 Section 200.91... Prevention and Intervention Programs for Children and Youth Who are Neglected, Delinquent, or At-Risk of Dropping Out § 200.91 SEA counts of eligible children. To receive an allocation under part D, subpart 1...

  5. Impaired glucose absorption in children with severe malnutrition

    NARCIS (Netherlands)

    Bandsma, Robert H. J.; Spoelstra, Martijn N.; Mari, Andrea; Mendel, Marijke; van Rheenen, Patrick F.; Senga, Edward; van Dijk, Theo; Heikens, Geert Tom

    2011-01-01

    Objective To quantify intestinal glucose absorption in children with two types of severe malnutrition, kwashiorkor and marasmus, compared with healthy children. Study design Children with kwashiorkor (n = 6) and marasmus (n = 9) and control subjects (n = 3) received a primed (13 mg/kg), constant inf

  6. Adult Children's Divorce and Intergenerational Relationships.

    Science.gov (United States)

    Spitze, Glenna; And Others

    1994-01-01

    Examined effects of adult children's divorce on their relationships with parents, using local probability sample of 905 parents. In general, divorced daughters with child custody had more contact than married daughters and received more help from parents. Sons received more babysitting help when they were married than in other situations. Divorce…

  7. Impulsivity and Psychoeducational Intervention in Hyperactive Children.

    Science.gov (United States)

    Brown, Ronald T.

    1980-01-01

    Two psychoeducational procedures were investigated for their effects on impulsivity in 120 hyperactive children in two groups: those receiving stimulant drug therapy and those not receiving stimulant drug therapy. Results indicated that the use of psychoeducational treatment approaches are of value in altering the impulsive responses of…

  8. Randomized transmit and receive ultrasound tomography

    CERN Document Server

    Clement, Gregory T

    2015-01-01

    A tomographic method is considered that forms images from sets of spatially randomized source signals and receiver sensitivities. The method is designed to allow image reconstruction for an extended number of transmitters and receivers in the presence noise and without plane wave approximation or otherwise approximation on the size or regularity of source and receiver functions. An overdetermined set of functions are formed from the Hadamard product between a Gaussian function and a uniformly distributed random number set. It is shown that this particular type of randomization tends to produce well-conditioned matrices whose pseudoinverses may be determined without implementing relaxation methods. When the inverted sets are applied to simulated first-order scattering from a Shepp-Logan phantom, successful image reconstructions are achieved for signal-to-noise ratios (SNR) as low as 1. Evaluation of the randomization approach is conducted by comparing condition numbers with other forms of signal randomization....

  9. The Communication Between Designer and Design Receiver

    DEFF Research Database (Denmark)

    Dai, Zheng; Dai, Yan

    2009-01-01

    When people think about a product,the first impression always mainly influences the result.Product is the medium of communication between designer and designer receiver.Because both of them have varied different experience and background,the information would be biased during the transferring...... process.The common symbols which can be recognized by both of designer and receiver are the key tools for communication.In some case,the same symbol in one product would be leads to different receiver impression.Generally,impression includes 3 aspects:aesthetics,function, and emotion.Designer needs to...... create an attractive and accurate impression in product from these 3 aspects.For facing the dilemma of communication,some experimental approaches can help designer deal with unique and diversity situations.Solving the detail problem in each step could keep the original meaning of designer....

  10. Receiver Functions Analysis across the Northen Apennines

    Science.gov (United States)

    Di Bona, M.; Lucente, F. P.; Piana Agostinetti, N.; Selvaggi, G.; Levin, V.; Park, J.

    2001-12-01

    The syn-collisional extension of the Northern Apennines is well established mainly from tomographic images, active faulting and geological data. A step forward in understanding how this process began, and how is going on, is the modelling of dynamic processes causing syn-collision extension. This requires the knowledge of several, still lacking, geometric characteristics of the deep structure. Among these, crustal structure, depth and geometry of main discontinuities is priority for dynamic modelling. For this reason, we deployed 10 continuosly recording broad-band seismic stations from Corsica to the Adriatic coast for five months during the past millennium, with the aim to apply receiver function analysis, to gain refined tomographic images, and to explore anisotropic characteristics of the upper mantle. We recorded several tens of teleseismic events with magnitude larger than 5.0 (up to Mw=8.3) with a good azimuthal coverage. Receiver functions are performed for teleseisms in the epicentral distance interval between 30° and 100° through classical frequency-domain deconvolution. Following the approach developed by Di Bona (1998), we could provide a variance estimate for single receiver function, assessing the statistical accuracy of amplitudes. This procedure allows us to use small magnitude events (Mb=5.0) generally excluded from receiver function analyses. Results show that individual converted arrivals have a large consistency for each station. The best receiver functions will be inverted for fine crustal structure following the inversion scheme proposed by Sambridge (1998). Finally, the dataset has been provided to the Dept. Of Geology and Geophysics (Yale University) with the aim to compare independent estimate of receiver functions (see Levin et al., this session).

  11. Thyroid function after treatment of brain tumors in children.

    Science.gov (United States)

    Ogilvy-Stuart, A L; Shalet, S M; Gattamaneni, H R

    1991-11-01

    In 134 children who had been treated for a brain tumor not involving the hypothalamic-pituitary axis, thyroid function was assessed up to 24 years after treatment with cranial or craniospinal irradiation. In addition, 78 children received up to 2 years of cytotoxic chemotherapy. Of 85 children who received craniospinal irradiation, 30 (35%) had abnormalities of thyroid function, and 10 (20%) of 49 who received cranial irradiation had such abnormalities. Frank hypothyroidism developed in three children and thyrotoxicosis in one. Thirty-six children had an elevated thyroid-stimulating hormone level in the presence of a normal thyroxine level; in 16 of them the thyroid-stimulating hormone level subsequently returned to normal. Twenty-eight children who were treated between 1960 and 1970 were excluded from the analysis. Of 34 children who received cranial irradiation, five had thyroid dysfunction and 24 of 72 who received craniospinal irradiation had such dysfunction (p = 0.013). Thyroid dysfunction was present in 4 of 35 children who received no chemotherapy and in 25 of 71 who received chemotherapy (p = 0.014). Direct irradiation plus chemotherapy was more damaging than irradiation alone. These data confirm the high incidence of thyroid dysfunction when the thyroid gland is included in the radiation field. However, in a high proportion, the thyroid abnormalities are minor and revert to normal with time; life-long replacement therapy with thyroxine may be unnecessary. PMID:1941379

  12. Children's Health

    Science.gov (United States)

    Your child's health includes physical, mental and social well-being. Most parents know the basics of keeping children healthy, like offering ... for children to get regular checkups with their health care provider. These visits are a chance to ...

  13. [Health-related problems in adopted children].

    Science.gov (United States)

    Laubjerg, Merete; Petersson, Birgit H

    2006-10-01

    International research shows that the standard of health among children adopted from abroad, especially those adopted by single parents, is not as good as that of other children. Danish studies indicate similar problems. The causes could be several, such as poor development in the embryonic and fetal stages, low birth weight, starvation, neglect, infections, and the lack of the natural bonds between mother and child. Surveys indicate that many adoptive parents, single parents in particular, receive children with health problems. There is no Danish research available, but it is important to be aware of these issues in order for both adoptees and adoptants to receive the most support. PMID:17059801

  14. Performance Driven Six-Port Receiver and Its Advantages over Low-IF Receiver Architecture

    OpenAIRE

    Abul Hasan; Mohamed Helaoui

    2014-01-01

    This paper provides an extensive analysis of the performance of a six-port based direct conversion receiver (SPR) in terms of signal quality, dynamic range, noise figure, ports matching, isolation, bandwidth, and cost. Calibration technique using multimemory polynomials has been adopted in order to improve the signal quality of the six-port receiver. The performances of the calibrated receiver are then compared with the performances of a commercially available I-Q demodulator used as a low-IF...

  15. TV Children

    Institute of Scientific and Technical Information of China (English)

    费沃尔

    2003-01-01

    Many children act in TV shows.They work several hours everyday, 1 they cannot go to regular(正规的) 2.How dothey get their schooling?In Hollywood,about forty, 3 give lessons for the children.Theirwork iS very 4 .They make sure that the children 5 many differ-ent subjects.They make sure, 6 ,that the children get enough 7and play.

  16. Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Nyato Daniel J

    2010-02-01

    Full Text Available Abstract Background New malaria treatment guidelines in Tanzania have led to the large-scale deployment of artemether-lumefantrine (Coartem®, popularly known as ALu or dawa mseto. Very little is known about how people in malaria endemic areas interpret policy makers' decision to replace existing anti-malarials, such as sulphadoxine-pyrimethamine (SP with "new" treatment regimens, such as ALu or other formulations of ACT. This study was conducted to examine community level understandings and interpretations of ALu's efficacy and side-effects. The paper specifically examines the perceived efficacy of ALu as articulated by the mothers of young children diagnosed with malaria and prescribed ALu. Methods Participant observation, six focus group discussions in two large villages, followed by interviews with a random sample of 110 mothers of children less than five years of age, who were diagnosed with malaria and prescribed ALu. Additionally, observations were conducted in two village dispensaries involving interactions between mothers/caretakers and health care providers. Results While more than two-thirds of the mothers had an overall negative disposition toward SP, 97.5% of them spoke favourably about ALu, emphasizing it's ability to help their children to rapidly recover from malaria, without undesirable side-effects. 62.5% of the mothers reported that they were spending less money dealing with malaria than previously when their child was treated with SP. 88% of the mothers had waited for 48 hours or more after the onset of fever before taking their child to the dispensary. Mothers' knowledge and reporting of ALu's dosage was, in many cases, inconsistent with the recommended dosage schedule for children. Conclusion Deployment of ALu has significantly changed community level perceptions of anti-malarial treatment. However, mothers continue to delay seeking care before accessing ALu, limiting the impact of highly subsidized rollout of the drug

  17. Virginia Tech receives NIH funds brucellosis research

    OpenAIRE

    Trulove, Susan

    2004-01-01

    Virginia Tech researchers from Virginia Bioinformatics Institute (VBI) and Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM) have received $300,000 from the National Institutes of Health (NIH) to study brucellosis. Caused by Brucella bacteria, a potential bioterrorism agent, brucellosis is common to animals and some strains infect humans.

  18. Professor Romesh Batra receives Engineering Science Medal

    OpenAIRE

    Nystrom, Lynn A.

    2009-01-01

    Clifton C. Garvin Professor of Engineering Science and Mechanics Romesh C. Batra received the Engineering Science Medal of the Society of Engineering Science (SES) at the recent meeting of the 2009 Joint American Society of Civil Engineers-American Society of Mechanical Engineers-SES Conference on Mechanics and Materials that was held in Blacksburg, Va.

  19. Compare benefits before entering receivables financing.

    Science.gov (United States)

    Ferconio, S; Lane, M R

    1991-02-01

    Financing accounts receivables is becoming a popular strategy in the healthcare industry. Factoring and securitization are two financing methods available to hospitals. Patient accounts managers who understand the programs' structures, incentives, and costs will be able to achieve the maximum benefit for their hospitals when choosing one of these transactions. PMID:10109699

  20. Howard Feiertag receives hospitality industry award

    OpenAIRE

    Ho, Sookhan

    2004-01-01

    Howard Feiertag, of Blacksburg, an instructor in hospitality and tourism management at Virginia Tech's Pamplin College of Business, received the inaugural Excellence in Sales and Marketing Strategy Award at the Hospitality Sales and Marketing Association/New York University Strategy Conference in New York recently.

  1. Signal Processing for Improved Wireless Receiver Performance

    DEFF Research Database (Denmark)

    Christensen, Lars P.B.

    2007-01-01

    This thesis is concerned with signal processing for improving the performance of wireless communication receivers for well-established cellular networks such as the GSM/EDGE and WCDMA/HSPA systems. The goal of doing so, is to improve the end-user experience and/or provide a higher system capacity...

  2. Richard W. Ziolkowski Receives Honorary Doctorate

    DEFF Research Database (Denmark)

    Breinbjerg, Olav

    2012-01-01

    At the annual Commemoration of the Technical University of Denmark (DTU) on April 27, 2012, Prof. Richard W. Ziolkowski, University of Arizona (UoA), received DTU's highest academic degree, the Honorary Doctor degree: Doctor Technices Honoris Causa (Figure 1). Prof. Ziolkowski has been a close...

  3. Imatinib induces hypothyroidism in patients receiving levothyroxinc

    NARCIS (Netherlands)

    de Groot, JWB; Zonnenberg, BA; Plukker, JTM; van Der Graaf, WTA; Links, TP

    2005-01-01

    Interactions of imatinib with other drugs have been scarcely reported. We report a previously unknown effect of imatinib on levothyroxine therapy. Eleven patients (1 with gastrointestinal stromal tumor and 10 with medullary thyroid carcinoma) received imatinib. Eight had undergone thyroidectomy and

  4. A 24GHz Radar Receiver in CMOS

    NARCIS (Netherlands)

    Kwok, K.C.

    2015-01-01

    This thesis investigates the system design and circuit implementation of a 24GHz-band short-range radar receiver in CMOS technology. The propagation and penetration properties of EM wave offer the possibility of non-contact based remote sensing and through-the-wall imaging of distance stationary or

  5. A GPS Receiver for Lunar Missions

    Science.gov (United States)

    Bamford, William A.; Heckler, Gregory W.; Holt, Greg N.; Moreau, Michael C.

    2008-01-01

    Beginning with the launch of the Lunar Reconnaissance Orbiter (LRO) in October of 2008, NASA will once again begin its quest to land humans on the Moon. This effort will require the development of new spacecraft which will safely transport people from the Earth to the Moon and back again, as well as robotic probes tagged with science, re-supply, and communication duties. In addition to the next-generation spacecraft currently under construction, including the Orion capsule, NASA is also investigating and developing cutting edge navigation sensors which will allow for autonomous state estimation in low Earth orbit (LEO) and cislunar space. Such instruments could provide an extra layer of redundancy in avionics systems and reduce the reliance on support and on the Deep Space Network (DSN). One such sensor is the weak-signal Global Positioning System (GPS) receiver "Navigator" being developed at NASA's Goddard Space Flight Center (GSFC). At the heart of the Navigator is a Field Programmable Gate Array (FPGA) based acquisition engine. This engine allows for the rapid acquisition/reacquisition of strong GPS signals, enabling the receiver to quickly recover from outages due to blocked satellites or atmospheric entry. Additionally, the acquisition algorithm provides significantly lower sensitivities than a conventional space-based GPS receiver, permitting it to acquire satellites well above the GPS constellation. This paper assesses the performance of the Navigator receiver based upon three of the major flight regimes of a manned lunar mission: Earth ascent, cislunar navigation, and entry. Representative trajectories for each of these segments were provided by NASA. The Navigator receiver was connected to a Spirent GPS signal generator, to allow for the collection of real-time, hardware-in-the-loop results for each phase of the flight. For each of the flight segments, the Navigator was tested on its ability to acquire and track GPS satellites under the dynamical

  6. Vulcan: A deep-towed CSEM receiver

    Science.gov (United States)

    Constable, Steven; Kannberg, Peter K.; Weitemeyer, Karen

    2016-03-01

    We have developed a three-axis electric field receiver designed to be towed behind a marine electromagnetic transmitter for the purpose of mapping the electrical resistivity in the upper 1000 m of seafloor geology. By careful adjustment of buoyancy and the use of real-time monitoring of depth and altitude, we are able to deep-tow multiple receivers on arrays up to 1200 m long within 50 m of the seafloor, thereby obtaining good coupling to geology. The rigid body of the receiver is designed to reduce noise associated with lateral motion of flexible antennas during towing, and allows the measurement of the vertical electric field component, which modeling shows to be particularly sensitive to near-seafloor resistivity variations. The positions and orientations of the receivers are continuously measured, and realistic estimates of positioning errors can be used to build an error model for the data. During a test in the San Diego Trough, offshore California, inversions of the data were able to fit amplitude and phase of horizontal electric fields at three frequencies on three receivers to about 1% in amplitude and 1° in phase and vertical fields to about 5% in amplitude and 5° in phase. The geological target of the tests was a known cold seep and methane vent in 1000 m water depth, which inversions show to be associated with a 1 km wide resistor at a depth between 50 and 150 m below seafloor. Given the high resistivity (30 Ωm) and position within the gas hydrate stability field, we interpret this to be massive methane hydrate.

  7. Urinary tract infection - children

    Science.gov (United States)

    UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children ... They may occur often around age 3, as children begin toilet training. Boys who are not circumcised ...

  8. Credits and Exemptions for Children. Tax Facts from the Tax Policy Center. Tax Notes[R

    Science.gov (United States)

    Maag, Elaine

    2009-01-01

    The Earned Income Tax Credit, Child Tax Credit (CTC), Additional Child Tax Credit (ACTC), and the dependent exemption all provide benefits to families with children. In 2009, a single mom (or dad) with two children can receive benefits ranging from $0 to about $7,500--depending on her income, age of the children, and where the children live. While…

  9. Psychiatric Disorder or Impairing Psychology in Children Who Have Been Excluded from School: A Systematic Review

    Science.gov (United States)

    Whear, Rebecca; Marlow, Ruth; Boddy, Kate; Ukoumunne, Obioha C.; Parker, Claire; Ford, Tamsin; Thompson-Coon, Jo; Stein, Ken

    2014-01-01

    When children with special educational needs are excluded from school, it should raise the concern that these children are not receiving adequate help and support. This systematic review aims to identify the prevalence of psychiatric disorder or impairing psychopathology among children who are excluded from school compared to children who are not…

  10. Likeable children, uneasy children

    DEFF Research Database (Denmark)

    Anderson, Sally Dean

    2014-01-01

    Drawing on fieldwork in small-town schools with children of Muslim background whose families came to Denmark as United Nation refugees, the chapter explores how pedagogical ideologies of school-based peer sociability inflect children’s experiences of ‘being Muslim.’ Danish provincial schools, with...... their permanent classes, emphasis on class-based sociability, and particular understandings of what constitutes religion, represent a particular context for children’s school experiences. An analysis of two contrasting cases reveals that participation in peer sociability in and beyond school tends to...

  11. Ground receiving station (GRS) of UMS - receiving and processing the electromagnetic wave data from satellite

    International Nuclear Information System (INIS)

    The low resolution Automatic Picture Transmission (APT) data from the National Oceanic and Atmospheric Administration (NOAA) polar-orbiting satellites Advanced Very High Resolution Radiometer (AVHRR) is being received and recorded in real-time mode at ground receiving station in School of Science and Technology, Universiti Malaysia Sabah. The system is suitable for the developing and undeveloped countries in south and Southeast Asia and is said to be acceptable for engineering, agricultural, climatological and environmental applications. The system comprises a personal computer attached with a small APT receiver. The data transmission between the ground receiving station and NOAA satellites is using the electromagnetic wave. The relation for receiving and processing the electromagnetic wave in the transmission will be discussed. (Author)

  12. Behind the Curtains of e-State: Determinants of Online Sexual Harassment Among Estonian Children

    OpenAIRE

    Veronika Kalmus; Mare Ainsaar; Kadri Soo

    2012-01-01

    "This article analyses the risk of receiving online sexual messages and experiencing harm among Estonian children. In particular, the paper examines the association between receiving sexual messages and behavioural, psychological and demographic characteristics, and the social mediation of children’s Internet use. Estonian data from ‘EU Kids Online’ survey are used, involving 780 children aged 11-16. Results demonstrate that 19% of children who use the Internet have received online sexual mes...

  13. Massage for Children Undergoing Hematopoietic Cell Transplantation: A Qualitative Report

    OpenAIRE

    Ackerman, Sara L.; E. Anne Lown; Dvorak, Christopher C.; Dunn, Elizabeth A.; Abrams, Donald I; Horn, Biljana N.; Marcia Degelman; Cowan, Morton J.; Mehling, Wolf E.

    2012-01-01

    Background. No in-depth qualitative research exists about the effects of therapeutic massage with children hospitalized to undergo hematopoietic cell transplantation (HCT). The objective of this study is to describe parent caregivers' experience of the effects of massage/acupressure for their children undergoing HCT. Methods. We conducted a qualitative analysis of open-ended interviews with 15 parents of children in the intervention arm of a massage/acupressure trial. Children received both p...

  14. Pathogenetic approaches to the treatment of children with chronic pneumonia

    OpenAIRE

    Rano Musajanova

    2011-01-01

    We observed 60 children with chronic pneumonia aged from 3 to 14 years compared with 20 healthy children of the same age. Analysis of the biochemical data in children who received thiotriazoline showed reliable reduce of malondialdehyde and dien conjugates in comparison with control group. The levels of superoxidismutase and catalase increased. The results of immunological investigations showed that in children who took thiotriazoline noted reliable increase of T-lymphocytes, T-helpers, T-sup...

  15. Salt Content Impacts Food Preferences and Intake among Children

    OpenAIRE

    Bouhlal, Sofia; Chabanet, Claire; Issanchou, Sylvie; Nicklaus, Sophie

    2013-01-01

    Decreasing dietary sodium intake, which can be achieved by reducing salt content in food, is recommended. Salt contributes to the taste of foods and makes them more enjoyable. Whether a food is liked or disliked is an important determinant of food intake, especially among children. However, the role of salt in children's food acceptance has received little attention. The impact of salt content on children's hedonic rating and intake of two foods was investigated in children. Using a within-su...

  16. Reading Ability in Children with Mild and Moderate Hearing Imairment

    OpenAIRE

    Gustafsson, Fredrik

    2008-01-01

    While reading in deaf children has been the object of a number of studies, the reading abilitiesof children with mild and moderate hearing impairment and their relation to cognitiveprocessing have not received very much attention. Predictive factors of reading ability inhearing children are well known, with phonological and working memory abilities beingnecessary prerequisites for reading development. Existing studies suggest, however, thatcertain hearing-impaired children achieve a reading l...

  17. CERN Press Office receives award from Euroscience

    CERN Multimedia

    2009-01-01

    The CERN Communication group has received an award for its efforts in communicating the LHC first beam to the media and the public. James Gillies, head of the Communication group was presented the AlphaGalileo Research Public Relations Award on Wednesday, 14 October during the Euroscience Media Award Ceremony in Hannover. "It’s great to receive this recognition," said Gillies. "Of course, we had great material to work with: the LHC is a fantastic story and one that is going to get even better. Angels, Demons and black holes also had their roles to play, but behind the media interest there’s been a lot of hard work by my team. This is for them." The CERN Communication group also works with communication professionals in all the CERN Member States and major physics labs around the world through the European Particle Physics Communication Network, and the InterAction collaboration. "Without them," says Gillies, &am...

  18. Screen-printed flexible MRI receive coils

    Science.gov (United States)

    Corea, Joseph R.; Flynn, Anita M.; Lechêne, Balthazar; Scott, Greig; Reed, Galen D.; Shin, Peter J.; Lustig, Michael; Arias, Ana C.

    2016-03-01

    Magnetic resonance imaging is an inherently signal-to-noise-starved technique that limits the spatial resolution, diagnostic image quality and results in typically long acquisition times that are prone to motion artefacts. This limitation is exacerbated when receive coils have poor fit due to lack of flexibility or need for padding for patient comfort. Here, we report a new approach that uses printing for fabricating receive coils. Our approach enables highly flexible, extremely lightweight conforming devices. We show that these devices exhibit similar to higher signal-to-noise ratio than conventional ones, in clinical scenarios when coils could be displaced more than 18 mm away from the body. In addition, we provide detailed material properties and components performance analysis. Prototype arrays are incorporated within infant blankets for in vivo studies. This work presents the first fully functional, printed coils for 1.5- and 3-T clinical scanners.

  19. Fused silica windows for solar receiver applications

    Science.gov (United States)

    Hertel, Johannes; Uhlig, Ralf; Söhn, Matthias; Schenk, Christian; Helsch, Gundula; Bornhöft, Hansjörg

    2016-05-01

    A comprehensive study of optical and mechanical properties of quartz glass (fused silica) with regard to application in high temperature solar receivers is presented. The dependence of rupture strength on different surface conditions as well as high temperature is analyzed, focussing particularly on damage by devitrification and sandblasting. The influence of typical types of contamination in combination with thermal cycling on the optical properties of fused silica is determined. Cleaning methods are compared regarding effectiveness on contamination-induced degradation for samples with and without antireflective coating. The FEM-aided design of different types of receiver windows and their support structure is presented. A large-scale production process has been developed for producing fused silica dome shaped windows (pressurized window) up to a diameter of 816 mm. Prototypes were successfully pressure-tested in a test bench and certified according to the European Pressure Vessel Directive.

  20. Reducing the convective losses of cavity receivers

    Science.gov (United States)

    Flesch, Robert; Grobbel, Johannes; Stadler, Hannes; Uhlig, Ralf; Hoffschmidt, Bernhard

    2016-05-01

    Convective losses reduce the efficiency of cavity receivers used in solar power towers especially under windy conditions. Therefore, measures should be taken to reduce these losses. In this paper two different measures are analyzed: an air curtain and a partial window which covers one third of the aperture opening. The cavity without modifications and the usage of a partial window were analyzed in a cryogenic wind tunnel at -173°C. The cryogenic environment allows transforming the results from the small model cavity to a large scale receiver with Gr≈3.9.1010. The cavity with the two modifications in the wind tunnel environment was analyzed with a CFD model as well. By comparing the numerical and experimental results the model was validated. Both modifications are capable of reducing the convection losses. In the best case a reduction of about 50 % was achieved.

  1. Screen-printed flexible MRI receive coils.

    Science.gov (United States)

    Corea, Joseph R; Flynn, Anita M; Lechêne, Balthazar; Scott, Greig; Reed, Galen D; Shin, Peter J; Lustig, Michael; Arias, Ana C

    2016-01-01

    Magnetic resonance imaging is an inherently signal-to-noise-starved technique that limits the spatial resolution, diagnostic image quality and results in typically long acquisition times that are prone to motion artefacts. This limitation is exacerbated when receive coils have poor fit due to lack of flexibility or need for padding for patient comfort. Here, we report a new approach that uses printing for fabricating receive coils. Our approach enables highly flexible, extremely lightweight conforming devices. We show that these devices exhibit similar to higher signal-to-noise ratio than conventional ones, in clinical scenarios when coils could be displaced more than 18 mm away from the body. In addition, we provide detailed material properties and components performance analysis. Prototype arrays are incorporated within infant blankets for in vivo studies. This work presents the first fully functional, printed coils for 1.5- and 3-T clinical scanners. PMID:26961073

  2. Perception of older adults receiving palliative care

    Directory of Open Access Journals (Sweden)

    Fernanda Laporti Seredynskyj

    2014-06-01

    Full Text Available The present study aimed at understanding the perception of older adults who are receiving palliative oncological care on self care in relation to different stages of the disease and how such perception affected their lives. This is a qualitative study using oral history conducted with 15 older adults receiving palliative chemotherapy treatment in a health institution. The following categories emerged: social network, perspectives for confronting life, changes and spirituality. It is necessary for nursing staff to understand this process so that the measures implemented take into account all of the implications of the disease and aim at improving quality of life.   doi: 10.5216/ree.v16i2.22795.

  3. Cryogenic Amplifier Based Receivers at Submillimeter Wavelengths

    Science.gov (United States)

    Chattopadhyay, Goutam; Reck, Theodore and; Schlecht, Erich; Lin, Robert; Deal, William

    2012-01-01

    The operating frequency of InP high electron mobility transistor (HEMT) based amplifiers has moved well in the submillimeter-wave frequencies over the last couple of years. Working amplifiers with usable gain in waveguide packages has been reported beyond 700 GHz. When cooled cryogenically, they have shown substantial improvement in their noise temperature. This has opened up the real possibility of cryogenic amplifier based heterodyne receivers at submillimeter wavelengths for ground-based, air-borne, and space-based instruments for astrophysics, planetary, and Earth science applications. This paper provides an overview of the science applications at submillimeter wavelengths that will benefit from this technology. It also describes the current state of the InP HEMT based cryogenic amplifier receivers at submillimeter wavelengths.

  4. Teleseismic receiver functions imaging of Siberia

    DEFF Research Database (Denmark)

    Soliman, Mohammad Youssof Ahmad; Thybo, Hans; Artemieva, Irina

    2014-01-01

    We map the lithosphere in Siberia by using the available broadband seismic data for calculation of Ps- and Sp-wave receiver functions (RF). RFs show converted waves from discontinuities in the vicinity of the seismic stations. The main objective is to image the Moho and upper mantle discontinuities...... results to the recent detailed model of crustal structure in the whole of Siberia (SibCrust, Cherepanova et al., 2013) and with seismic models for similar geodynamic settings worldwide....

  5. Flexible Receivers in CMOS for Wireless Communication

    OpenAIRE

    Nejdel, Anders

    2015-01-01

    Consumers are pushing for higher data rates to support more services that are introduced in mobile applications. As an example, a few years ago video-on-demand was only accessed through landlines, but today wireless devices are frequently used to stream video. To support this, more flexible network solutions have merged in 4G, introducing new technical problems to the mobile terminal. New techniques are thus needed, and this dissertation explores five different ideas for receiver front-ends, ...

  6. Defense TRU waste transportation and receiving simulation

    International Nuclear Information System (INIS)

    Pacific Northwest Laboratory has recently conducted a simulation analysis to predict the transportation and waste handling equipment requirements for transporting government-owned transuranic waste to the Waste Isolation Pilot Plant (WIPP). Two interrelated models were developed. One estimates the time required to receive and unload shipping containers at the WIPP. The other model uses this estimate to predict the number of shipping containers and transporters that will be required

  7. Methodological problems of accounting received discounts

    OpenAIRE

    Shishkina Anna Vladimirovna

    2015-01-01

    The article contains the already existing approaches to business and financial accounting of the discounts, acquired by the discount-receiver, analyzes their advantages and disadvantages from the perspective of their correspondence with the active legislation and economic content of the discounts operations. The article also covers the problem of the absence of patterns for accounting discounting operations which would altogether pass the standard ФЗ [FZ] “On accounting”, Accounting Regulatio...

  8. Search Based Software Design for Communication Receivers

    OpenAIRE

    Ibing, Andreas

    2011-01-01

    This work aims at finding the optimal software design and implementation of an SDR physical layer on a homogeneous multicore architecture, and illustrates the approach developing a realtime demonstrator for novel mobile radio systems. Using stochastic inference methods, the generic receiver architecture is derived as breakdown into components. Different approximative algorithms are investigated to implement the components with a limited number of instructions. A method is derived to quickl...

  9. Development of Receiver Stimulator for Auditory Prosthesis

    Directory of Open Access Journals (Sweden)

    K. Raja Kumar

    2010-05-01

    Full Text Available The Auditory Prosthesis (AP is an electronic device that can provide hearing sensations to people who are profoundly deaf by stimulating the auditory nerve via an array of electrodes with an electric current allowing them to understand the speech. The AP system consists of two hardware functional units such as Body Worn Speech Processor (BWSP and Receiver Stimulator. The prototype model of Receiver Stimulator for Auditory Prosthesis (RSAP consists of Speech Data Decoder, DAC, ADC, constant current generator, electrode selection logic, switch matrix and simulated electrode resistance array. The laboratory model of speech processor is designed to implement the Continuous Interleaved Sampling (CIS speech processing algorithm which generates the information required for electrode stimulation based on the speech / audio data. Speech Data Decoder receives the encoded speech data via an inductive RF transcutaneous link from speech processor. Twelve channels of auditory Prosthesis with selectable eight electrodes for stimulation of simulated electrode resistance array are used for testing. The RSAP is validated by using the test data generated by the laboratory prototype of speech processor. The experimental results are obtained from specific speech/sound tests using a high-speed data acquisition system and found satisfactory.

  10. Transient simulation of molten salt central receiver

    Science.gov (United States)

    Doupis, Dimitri; Wang, Chuan; Carcorze-Soto, Jorge; Chen, Yen-Ming; Maggi, Andrea; Losito, Matteo; Clark, Michael

    2016-05-01

    Alstom is developing concentrated solar power (CSP) utilizing 60/40wt% NaNO3-KNO3 molten salt as the working fluid in a tower receiver for the global renewable energy market. In the CSP power generation cycle, receivers undergo a daily cyclic operation due to the transient nature of solar energy. Development of robust and efficient start-up and shut-down procedures is critical to avoiding component failures due to mechanical fatigue resulting from thermal transients, thus maintaining the performance and availability of the CSP plant. The Molten Salt Central Receiver (MSCR) is subject to thermal transients during normal daily operation, a cycle that includes warmup, filling, operation, draining, and shutdown. This paper describes a study to leverage dynamic simulation and finite element analysis (FEA) in development of start-up, shutdown, and transient operation concepts for the MSCR. The results of the FEA also verify the robustness of the MSCR design to the thermal transients anticipated during the operation of the plant.

  11. Radio Astronomy Software Defined Receiver Project

    Energy Technology Data Exchange (ETDEWEB)

    Vacaliuc, Bogdan [ORNL; Leech, Marcus [Shirleys Bay Radio Astronomy Consortium; Oxley, Paul [Retired; Flagg, Richard [Retired; Fields, David [ORNL

    2011-01-01

    The paper describes a Radio Astronomy Software Defined Receiver (RASDR) that is currently under development. RASDR is targeted for use by amateurs and small institutions where cost is a primary consideration. The receiver will operate from HF thru 2.8 GHz. Front-end components such as preamps, block down-converters and pre-select bandpass filters are outside the scope of this development and will be provided by the user. The receiver includes RF amplifiers and attenuators, synthesized LOs, quadrature down converters, dual 8 bit ADCs and a Signal Processor that provides firmware processing of the digital bit stream. RASDR will interface to a user s PC via a USB or higher speed Ethernet LAN connection. The PC will run software that provides processing of the bit stream, a graphical user interface, as well as data analysis and storage. Software should support MAC OS, Windows and Linux platforms and will focus on such radio astronomy applications as total power measurements, pulsar detection, and spectral line studies.

  12. Russian institute receives CMS Gold Award

    CERN Multimedia

    Patrice Loïez

    2003-01-01

    The Snezhinsk All-Russian Institute of Scientific Research for Technical Physics (VNIITF) of the Russian Federal Nuclear Centre (RFNC) is one of twelve CMS suppliers to receive awards for outstanding performance this year. The CMS Collaboration took the opportunity of the visit to CERN of the Director of VNIITF and his deputy to present the CMS Gold Award, which the institute has received for its exceptional performance in the assembly of steel plates for the CMS forward hadronic calorimeter. This calorimeter consists of two sets of 18 wedge-shaped modules arranged concentrically around the beam-pipe at each end of the CMS detector. Each module consists of steel absorber plates with quartz fibres inserted into them. The institute developed a special welding technique to assemble the absorber plates, enabling a high-quality detector to be produced at relatively low cost.RFNC-VNIITF Director Professor Georgy Rykovanov (right), is seen here receiving the Gold Award from Felicitas Pauss, Vice-Chairman of the CMS ...

  13. Facilitating children's eyewitness recall with the revised cognitive interview.

    Science.gov (United States)

    McCauley, M R; Fisher, R P

    1995-08-01

    Eighty-six 2nd-grade children participated in a Simon says game with an unfamiliar adult. The children were subsequently interviewed twice with either a standard interview or the revised cognitive interview (CI), once within 3 hr of the event and then 2 weeks later. On both the initial interview and the 2-week delayed interview, children receiving the revised CI recalled significantly more correct information than did children receiving a standard interview. In addition, children who were interviewed twice with the revised CI recalled more unique accurate facts (M = 25.44) than children who received 2 standard interviews (M = 16.75). The CI also elicited more inaccurate facts; however, the accuracy rate (proportion of reported facts that were accurate) for the 2 groups was equivalent. The research has implications for police and others who interview real child victims and witnesses. PMID:7642461

  14. Okul Öncesi Eğitimi Almış Çocukların Akran İlişkileri Değişkenlerinin 5 Ve 6 Yaşta İncelenmesi: İki Yıllık Boylamsal Çalışma Investigation Of Variables Of Peer Relationships Of Children Receiving Preschool Education In Ages 5 And 6: A Two-Year Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Hatice ERTEN SARIKAYA

    2013-09-01

    Full Text Available The purpose of this study is to examine whether variables of peerrelationships of children who attend preschool education significantlychange in ages 5 and 6 or not. The sample group of the study consistedof 78 children aged 5 and 6, who attended a private kindergarten in thecity center of Denizli and 2 independent kindergartens in Tavas andSerinhisar districts in the school year of 2010-2011, as well as 7preschool teachers. Ladd and Profilet Child Behavior Scale and PeerVictimization Scale were used in the study. The data collection processwas performed by applying the scales on the same sample group once in2011 and once in 2012. Preschool teachers filled out the “ChildBehavior Scale and Peer Victimization Scale” once for each child duringeach application period. While the first data of the study were collectedin May of 2011, one year later the second data were collected in May of2012. One way analysis of variance (ANOVA was used for the correlatedsamples in the data analysis in order to examine whether variables ofpeer relationships of children attending preschool educationsignificantly change in ages 5 and 6 or not.According to the general results of the study; while aggressionlevels, asocial behavior levels, anxious-fearful levels, exclusion levelsand peer victimization levels of preschool children decrease at the age of6, their prosocial behavior levels increase at the age of 6. Variables ofpeer relationships of children who received preschool education vary inages 5 and 6. Aggression levels, prosocial behavior levels, asocialbehavior levels, anxious-fearful levels, exclusion levels and peervictimization levels, which were among peer relationship variables ofchildren who received preschool education, did not remain stable inages 5 and 6 and showed decreases and increases. Araştırmanın amacı, okul öncesi eğitime devam eden çocuklarının akran ilişkileri değişkenlerinin 5 ve 6 yaşta anlamlı düzeyde değişiklik gösterip g

  15. A perspectiva dos pais sobre a obtenção do diagnóstico de leucemia linfóide aguda em crianças e adolescentes: uma experiência no Brasil The parents' perspective on receiving a diagnosis of acute lymphoid leukemia in children and adolescents: a Brazilian experiment

    Directory of Open Access Journals (Sweden)

    Rosa Maria Quadros Nehmy

    2011-09-01

    Full Text Available OBJETIVOS: conhecer a percepção dos pais para o diagnóstico de leucemia em seus filhos. MÉTODOS: pesquisa qualitativa tendo como referencial a teoria das representações sociais ancorada na tradição da sociologia compreensiva. Utilizou-se entrevista semi estruturada para a coleta de dados. Foram entrevistados 20 pais de crianças e adolescentes com diagnóstico de leucemia linfóide aguda (LLA. Para análise dos dados empregou-se a técnica de "análise do conteúdo". As diretrizes de humanização da assistência e princípios bioéticos foram os eixos norteadores da análise dos dados. RESULTADOS: os pais recordaram-se claramente da progressão dos sintomas da doença até o diagnóstico. A palavra leucemia foi associada ao câncer e à morte. Dificuldades relacionadas à escuta dos sintomas, a particularidades clínicas da leucemia e ao encaminhamento no sistema de saúde foram os principais motivos para a demora do diagnóstico definitivo. Destacam-se as peregrinações por diferentes locais, perda da resolubilidade, gastos desnecessários, desgaste emocional e atraso nas ações de saúde. CONCLUSÕES: o câncer envolve valores culturais sobre a morte, cuja carga simbólica é maior no caso da criança. A busca do diagnóstico da leucemia pelos pais é exemplo emblemático do tortuoso caminho percorrido quando o mal que acomete a criança não se enquadra no rótulo das doenças "comuns".OBJECTIVES: to investigate how parents perceive a diagnosis of lymphoid leukemia in their children. METHODS: qualitative research based on the sociological theory of social representations was used. Data was gathered by way of semi-structured interviews. Twenty parents of children diagnosed as having acute lymphoid leukemia (ALL. The content analysis technique was used to analyze data. Data analysis was guided by the principles of bioethics and humane care. RESULTS: the parents clearly recalled the progression of symptoms up to diagnosis. The word

  16. Lawnmower injuries in children.

    LENUS (Irish Health Repository)

    Nugent, Nora

    2012-02-03

    OBJECTIVE: Power lawnmowers can pose significant danger of injury to both the operator and the bystander, from direct contact with the rotary blades or missile injury. Our objective was to review our experience with paediatric lawnmower-associated trauma, and the safety recommendations available to operators of power lawnmowers. METHODS: The patient cohort comprised paediatric (<16 years of age) patients treated for lawnmower-associated trauma, by the plastic surgery service, between 1996 and 2003. These patients were identified retrospectively. Age at the time of injury, location and extent of bony and soft tissue injuries sustained, treatment instituted and clinical outcome were recorded. Brochures and instruction manuals of six lawnmower manufacturers were reviewed, and safety recommendations noted. RESULTS: Fifteen patients were identified. The majority of injuries occurred from direct contact with the rotary blades (93%); the remaining child sustained a burn injury. Fourteen children (93%) required operative intervention. Seven patients (46%) sustained injuries resulting in amputation, two of whom had major limb amputations. All children, except the burns patient, underwent wound debridement and received antibiotic therapy. Reconstructive methods ranged from primary closure to free tissue transfer. Many patients required multiple procedures. In all instruction manuals, instructions to keep children and pets indoors or out of the yard when mowing were found. CONCLUSIONS: Lawnmower injuries can be devastating, particularly in children. Many victims have lasting deformities as a result of their injuries. Awareness of and stringent adherence to safety precautions during use of power lawnmowers can prevent many of these accidents.

  17. English Education of Children

    Institute of Scientific and Technical Information of China (English)

    盛雨潇

    2014-01-01

    With the further development of China's reform and opening up, our communication with the world more and more frequently, more and more closely. As the primary tool of international communication, English is particularly important. Now, to strengthen foreign language teaching, especially to learn foreign languages at children, has become a global trend. In China, many schools and teachers for many years to carry out a useful attempt of children's English teaching, and accumulated a lot of successful experience, of course, there are many difficulties and setbacks, and even failure. How to exclude the difficulty and the setback, avoid failure? I combined with my own teaching practice, discusses and studies for many years, has received the good ef-fect.

  18. Receivers Gather Data for Climate, Weather Prediction

    Science.gov (United States)

    2012-01-01

    Signals from global positioning system (GPS) satellites are now being used for more than just location and navigation information. By looking at the radio waves from GPS satellites, a technology developed at NASA s Jet Propulsion Laboratory (JPL) not only precisely calculates its position, but can also use a technique known as radio occultation to help scientists study the Earth s atmosphere and gravity field to improve weather forecasts, monitor climate change, and enhance space weather research. The University Corporation for Atmospheric Research (UCAR), a nonprofit group of universities in Boulder, Colorado, compares radio occultation to the appearance of a pencil when viewed though a glass of water. The water molecules change the path of visible light waves so that the pencil appears bent, just like molecules in the air bend GPS radio signals as they pass through (or are occulted by) the atmosphere. Through measurements of the amount of bending in the signals, scientists can construct detailed images of the ionosphere (the energetic upper part of the atmosphere) and also gather information about atmospheric density, pressure, temperature, and moisture. Once collected, this data can be input into weather forecasting and climate models for weather prediction and climate studies. Traditionally, such information is obtained through the use of weather balloons. In 1998, JPL started developing a new class of GPS space science receivers, called Black Jack, that could take precise measurements of how GPS signals are distorted or delayed along their way to the receiver. By 2006, the first demonstration of a GPS radio occultation constellation was launched through a collaboration among Taiwan s National Science Council and National Space Organization, the U.S. National Science Foundation, NASA, the National Oceanic and Atmospheric Administration (NOAA), and other Federal entities. Called the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC

  19. Full-wave receiver architecture for the homodyne motion sensor

    Energy Technology Data Exchange (ETDEWEB)

    Haugen, Peter C.; Dallum, Gregory E.; Welsh, Patrick A.; Romero, Carlos E.

    2015-09-29

    A homodyne motion sensor or detector based on ultra-wideband radar utilizes the entire received waveform through implementation of a voltage boosting receiver. The receiver includes a receiver input and a receiver output. A first diode is connected to the receiver output. A first charge storage capacitor is connected from between the first diode and the receiver output to ground. A second charge storage capacitor is connected between the receiver input and the first diode. A second diode is connected from between the second charge storage capacitor and the first diode to ground. The dual diode receiver performs voltage boosting of a RF signal received at the receiver input, thereby enhancing receiver sensitivity.

  20. Optoelectronic Receiver For Communication And Control

    Science.gov (United States)

    Kunath, Richard; Bendett, Mark; Mactaggart, I. Ross

    1994-01-01

    Many operational and diagnostic features integrated into circuit chip. GaAs-based integrated circuit designed to serve as optoelectronic interface in phased-array antenna. Intended function to receive digital control signals transmitted on optical fiber and to convert signals to electronic control signals, which then applied to monolithic microwave integrated circuit (MMIC). Also used in reception of high-rate optical digital communications within computers, between computers, and in signal-distribution systems in aircraft, automobiles, and ships. Interface circuit represents significant improvement over preexisting interface circuits in that its clock-signal-recovery subcircuit requires little or no preamble for immediate synchronization.

  1. Methodological problems of accounting received discounts

    Directory of Open Access Journals (Sweden)

    Shishkina Anna Vladimirovna

    2015-12-01

    Full Text Available The article contains the already existing approaches to business and financial accounting of the discounts, acquired by the discount-receiver, analyzes their advantages and disadvantages from the perspective of their correspondence with the active legislation and economic content of the discounts operations. The article also covers the problem of the absence of patterns for accounting discounting operations which would altogether pass the standard ФЗ [FZ] “On accounting”, Accounting Regulations requirements, and interest of the concerned external users.

  2. Radiation Doses Received by the Irish Population

    International Nuclear Information System (INIS)

    Some chemical elements present in the environment since the Earth was formed are naturally radioactive and exposure to these sources of radiation cannot be avoided. There have also been additions to this natural inventory from artificial sources of radiation that did not exist before the 1940s. Other sources of radiation exposure include cosmic radiation from outer space and the use of radiation in medical diagnosis and treatment. There can be large variability in the dose received by invividual members of the population from any given source. Some sources of radiation expose every member of the population while, in other cases, only selected individuals may be exposed. For example, natural radioactivity is found in all soils and therefore everybody receives some radiation dose from this activity. On the other hand, in the case of medical exposures, only those who undergo a medical procedure using radiation will receive a radiation dose. The Radiological Protection Institute of Ireland (RPII) has undertaken a comprehensive review of the relevant data on radiation exposure in Ireland. Where no national data have been identified, the RPII has either undertaken its own research or has referred to the international literature to provide a best estimate of what the exposure in Ireland might be. This has allowed the relative contribution of each source to be quantified. This new evaluation is the most up-to-date assessment of radiation exposure and updates the assessment previously reported in 2004. The dose quoted for each source is the annual 'per caput' dose calculated on the basis of the most recently available data. This is an average value calculated by adding the doses received by each individual exposed to a given radiation source and dividing the total by the current population of 4.24 million. All figures have been rounded, consistent with the accuracy of the data. In line with accepted international practice, where exposure takes place both indoors and

  3. Compressed Sensing-Based Direct Conversion Receiver

    DEFF Research Database (Denmark)

    Pierzchlewski, Jacek; Arildsen, Thomas; Larsen, Torben

    2012-01-01

    conversion receiver. In the presented solution, the filtered down-converted radio signals are randomly sampled with an average sampling frequency lower than its Nyquist rate, and then reconstructed in a DSP system. To enable compressed sensing, this approach exploits the frequency domain sparsity of the down......-converted radio signals. As shown in an experiment presented in the article, when the proposed method is used, it is possible to relax the requirements for the quadrature down-converter filters. A random sampling device and an additional digital signal processing module is the price to pay for these relaxed...

  4. MSW devices for EW receiver applications

    Science.gov (United States)

    Adam, J. D.

    A compressive electronic warfare receiver has been constructed using a magnetostatic wave (MSW) dispersive delay line and filter bank. Attention is presently given to the performance characteristics and potentialities of these devices with respect to dynamic range, probability of signal detection, and digital processing. Phase error and amplitude response improvements are noted to be required in order to achieve the full potential of this approach; in particular, the video outputs from a 1-GHz bandwidth delay line cannot be adequately processed by means of current electronic techniques.

  5. SIMULTANEOUS DETERMINATION OF INVENTORIES AND ACCOUNTS RECEIVABLE

    OpenAIRE

    Ayub, Mehar

    2001-01-01

    The study presents a model based on 3,375 observations from industrial firms in Pakistan, and the Three-Stage Least Square (3SLS) technique has been applied for the estimation. The results indicate that the Economic Order Quantity (EOQ) of inventories is not a constant magnitude; it is a variable closely associated with 'time trend'. While the ‘buffer stock’ element can be estimated through the constant term of an equation. Receivables from customers show a negative correlation with liquid as...

  6. Interpretation of Receiver Operating Characteristics (ROC)

    International Nuclear Information System (INIS)

    The purpose of this paper is to explain the making procedure and the usage of receiver operating characteristic curve (ROC) for interpretation of radiographic images. The conventional radiograms obtained after the creation of the lesions in the acrylic plates and were enhanced in color. The observer were informed of which tooth to examine, the 'a priori' probability of a lesion present and the approximate diameter of the lesions. The two groups of films were interpreted separately by the same observer using the same rating scale. The following rating scale was used: A; definitely no lesion, B; probably no lesion, C; not sure, D; probably a lesion, and E; definitely a lesion. In analysis, for each observer the diagnostic results in terms of true positive (TP) and false positive (FP) decisions were plotted on a graph. The lowest point on the graph represents the TP and FP when only decisions designated as E according to the rating scale are included. The next point shows the TP and FP values when diagnoses designated as D are added and so forth. By connecting such plot points, a receiver operating characteristic curves (ROC) is obtained. The area under the curve represents the diagnostic accuracy resulting from a diagnostic performance at pure chance level and a value of 1.0 at perfect performance. This method has been known as an useful method to detect the minute difference for each radiographic technic, each observer and for the different lesion depths.

  7. Superconductor Digital-RF Receiver Systems

    Science.gov (United States)

    Mukhanov, Oleg A.; Kirichenko, Dmitri; Vernik, Igor V.; Filippov, Timur V.; Kirichenko, Alexander; Webber, Robert; Dotsenko, Vladimir; Talalaevskii, Andrei; Tang, Jia Cao; Sahu, Anubhav; Shevchenko, Pavel; Miller, Robert; Kaplan, Steven B.; Sarwana, Saad; Gupta, Deepnarayan

    Digital superconductor electronics has been experiencing rapid maturation with the emergence of smaller-scale, lower-cost communications applications which became the major technology drivers. These applications are primarily in the area of wireless communications, radar, and surveillance as well as in imaging and sensor systems. In these areas, the fundamental advantages of superconductivity translate into system benefits through novel Digital-RF architectures with direct digitization of wide band, high frequency radio frequency (RF) signals. At the same time the availability of relatively small 4K cryocoolers has lowered the foremost market barrier for cryogenically-cooled digital electronic systems. Recently, we have achieved a major breakthrough in the development, demonstration, and successful delivery of the cryocooled superconductor digital-RF receivers directly digitizing signals in a broad range from kilohertz to gigahertz. These essentially hybrid-technology systems combine a variety of superconductor and semiconductor technologies packaged with two-stage commercial cryocoolers: cryogenic Nb mixed-signal and digital circuits based on Rapid Single Flux Quantum (RSFQ) technology, room-temperature amplifiers, FPGA processing and control circuitry. The demonstrated cryocooled digital-RF systems are the world's first and fastest directly digitizing receivers operating with live satellite signals in X-band and performing signal acquisition in HF to L-band at ˜30GHz clock frequencies.

  8. Woese on the received view of evolution.

    Science.gov (United States)

    Sarkar, Sahotra

    2014-01-01

    As part of his attempt to reconstruct the earliest phase of the evolution of life on Earth, Woese produced a compelling critique of the received view of evolution from the 20th century. This paper explicitly articulates two related features of that critique that are fundamental but the first of which has not been sufficiently clearly recognized in the context of evolutionary theorizing: (1) according to Woese's scenario of communal evolution during life's earliest phase (roughly, the first billion years of life on Earth), well-defined biological individuals (and, thus, individual lineages) did not exist; and (2) during that phase, evolutionary change took place through ubiquitous horizontal gene transfer (HGT) rather than through vertical transmission of features (including genes) and the combinatorics of HGT was the dominant mechanism of evolutionary change. Both factors present serious challenges to the received view of evolution and that framework would have to be radically altered to incorporate these factors. The extent to which this will be necessary will depend on whether Woese's scenario of collective early evolution is correct. PMID:24572738

  9. Degraded Compound Multi-receiver Wiretap Channels

    CERN Document Server

    Ekrem, Ersen

    2009-01-01

    In this paper, we study the degraded compound multi-receiver wiretap channel. The degraded compound multi-receiver wiretap channel consists of two groups of users and a group of eavesdroppers, where, if we pick an arbitrary user from each group of users and an arbitrary eavesdropper, they satisfy a certain Markov chain. We study two different communication scenarios for this channel. In the first scenario, the transmitter wants to send a confidential message to users in the first (stronger) group and a different confidential message to users in the second (weaker) group, where both messages need to be kept confidential from the eavesdroppers. For this scenario, we assume that there is only one eavesdropper. We obtain the secrecy capacity region for the general discrete memoryless channel model, the parallel channel model, and the Gaussian parallel channel model. For the Gaussian multiple-input multiple-output (MIMO) channel model, we obtain the secrecy capacity region when there is only one user in the second...

  10. The Submillimeter Array Antennas and Receivers

    CERN Document Server

    Blundell, R

    2005-01-01

    The Submillimeter Array (SMA) was conceived at the Smithsonian Astrophysical Observatory in 1984 as a six element interferometer to operate in the major atmospheric windows from about 200 to 900 GHz. In 1996, the Academica Sinica Institute of Astronomy and Astrophysics of Taiwan joined the project and agreed to provide additional hardware to expand the interferometer to eight elements. All eight antennas are now operating at the observatory site on Mauna Kea, and astronomical observations have been made in the 230, 345, and 650 GHz bands. The SMA antennas have a diameter of 6 m, a surface accuracy of better than 25 micron rms, and can be reconfigured to provide spatial resolutions down to about 0.5" at 200 GHz and, eventually, 0.1" at 850 GHz. Coupling to the receiver package within each antenna is achieved via a beam waveguide, in a bent Nasmyth configuration, comprised of a flat tertiary mirror and two ellipsoidal mirrors that form a secondary pupil used for receiver calibration. An additional fixed mirror ...

  11. Transactions Security Tools in Account Receivables Management

    Directory of Open Access Journals (Sweden)

    Anna Wodyńska

    2008-01-01

    Full Text Available Large competition among goods and services suppliers caused that granting clients deferred term of payment became a standard, so in other word granting clients commercial credit is a standard. Companies try to limit credit risk by securing their trade transactions in accordance with their credit policy that determines in some way the choice of trade transaction security tools.This article presents a full range of trade transaction security tools according to the general division into personal and property securities. The author pays attention to the fact that while conducting a proper credit policy in relation to clients, a company has chances to monitor efficiently the receivables and insist on their payment as well as use, as needed, the earlier prepared trade transaction security tools.The author convinces that regardless of the choice of trade transaction security tools, or reasons leading the receivables managing person, the basic criterion of security evaluation shall be its real, checked and verified value. The pledge on an object that does not exist is not worth much. The same applies to security granted by an insolvent person.

  12. Steam Rankine Solar Receiver, phase 2

    Science.gov (United States)

    Deanda, L. E.; Faust, M.

    1981-01-01

    A steam rankine solar receiver (SRSR) based on a tubular concept was designed and developed. The SRSR is an insulated, cylindrical coiled tube boiler which is mounted at the focal plane of a fully tracking parabolic solar reflector. The concentrated solar energy received at the focal plane is then transformed to thermal energy through steam generation. The steam is used in a small Rankine cycle heat engine to drive a generator for the production of electrical energy. The SRSR was designed to have a dual mode capability, performing as a once through boiler with and without reheat. This was achieved by means of two coils which constitute the boiler. The boiler core size of the SRSR is 17.0 inches in diameter and 21.5 inches long. The tube size is 7/16 inch I.D. by 0.070 inch wall for the primary, and 3/4 inch I.D. by 0.125 inch wall for the reheat section. The materials used were corrosion resistant steel (CRES) type 321 and type 347 stainless steel. The core is insulated with 6 inches of cerablanket insulation wrapped around the outer wall. The aperture end and the reflector back plate at the closed end section are made of silicon carbide. The SRSR accepts 85 kwth and has a design life of 10,000 hrs when producing steam at 1400 F and 2550 psig.

  13. Osteopenia in children surviving brain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Whitton, A.C.; Eves, M. [Children' s Hospital at Chedoke-McMaster, Room 3N27B, Health Sciences Centre, McMaster University, 1200 Main Street West, Hamilton, Ontario (Canada); Hay, J. [Brock University, St. Catharines, Ontario (Canada); Gill, G.J.; Webber, C.E. [Faculty of Health Sciences, McMaster University (Canada); Simpson, T. [Hamilton Regional Cancer Centre, Hamilton, Ontario (Canada); Barr, R.D. [Children' s Hospital at Chedoke-McMaster, Room 3N27B, Health Sciences Centre, McMaster University, 1200 Main Street West, Hamilton, Ontario (Canada)

    1998-05-01

    Osteopenia has been reported in children surviving acute lymphoblastic leukaemia, apparently as a consequence of therapy. It has been suggested that cranial irradiation may play a crucial role in this disorder. To explore that possibility, survivors of brain tumours in childhood, all of whom had received radiotherapy, were examined for evidence of bone mineral loss. 19 children were assessed, on average at 7 years after treatment. Measurements of growth velocities, plain radiography of the skeleton, bone densitometry, health-related quality of life and physical activity were undertaken. Growth hormone (GH) deficiency had been detected in 6 children and 5 had received GH replacement, for a minimum of more than 3 years. 9 children were radiographically osteopenic (including the 5 who had received GH). Z scores for bone mineral density (BMD) were negative in the majority of children. Health-related quality of life was less and pain more frequent in those with low BMD scores. Pain was correlated negatively with both free-time activity and seasonal activity (P<0.01). Osteopenia is a common sequel of therapy in children with brain tumours. Those with osteopenia have more pain and more compromised, health-related quality of life than those who are not osteopenic, and pain significantly limits physical activity. The pathogenesis of osteopenia in these children is still uncertain, but is likely to be multifactorial. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  14. Osteopenia in children surviving brain tumours

    International Nuclear Information System (INIS)

    Osteopenia has been reported in children surviving acute lymphoblastic leukaemia, apparently as a consequence of therapy. It has been suggested that cranial irradiation may play a crucial role in this disorder. To explore that possibility, survivors of brain tumours in childhood, all of whom had received radiotherapy, were examined for evidence of bone mineral loss. 19 children were assessed, on average at 7 years after treatment. Measurements of growth velocities, plain radiography of the skeleton, bone densitometry, health-related quality of life and physical activity were undertaken. Growth hormone (GH) deficiency had been detected in 6 children and 5 had received GH replacement, for a minimum of more than 3 years. 9 children were radiographically osteopenic (including the 5 who had received GH). Z scores for bone mineral density (BMD) were negative in the majority of children. Health-related quality of life was less and pain more frequent in those with low BMD scores. Pain was correlated negatively with both free-time activity and seasonal activity (P<0.01). Osteopenia is a common sequel of therapy in children with brain tumours. Those with osteopenia have more pain and more compromised, health-related quality of life than those who are not osteopenic, and pain significantly limits physical activity. The pathogenesis of osteopenia in these children is still uncertain, but is likely to be multifactorial. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  15. "Borderline" Children.

    Science.gov (United States)

    Gualtieri, C. Thomas C.; And Others

    1983-01-01

    The use of the diagnosis "borderline" was evaluated with 16 children (6 to 13 years old) who were referred for comprehensive evaluation. None met DSM III criteria for borderline personality disorder. The borderline label had a negative impact on some children and was not helpful for treatment planning or disposition. (Author/SEW)

  16. 75 FR 31702 - Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Assistance from...

    Science.gov (United States)

    2010-06-04

    ... example, the normal operations and objectives of our public schools are to educate our nation's children. Public schools, for instance, have received Federal environmental grants, to establish ecology clubs or... (NPRM) under the authority of the ADEA (see 75 FR 7212 (Feb. 18, 2010)). EEOC's NPRM defines the...

  17. 75 FR 31738 - Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Assistance From...

    Science.gov (United States)

    2010-06-04

    ... apply. (40 CFR 7.150) For example, the normal operations and objectives of our public schools are to educate our nation's children. Public schools, for instance, have received federal environmental grants... (see 75 FR 7212 (Feb. 18, 2010)). EEOC's NPRM defines the term ``reasonable factors other than...

  18. Radioactive contamination in monitors received for calibration

    International Nuclear Information System (INIS)

    The Calibration Laboratory - LABCAL, from the Research Center for Metrology and Testing - METROBRAS, MRA Comercio de Instrumentos Eletronicos Ltda., began activities in October 2008 and, in August 2009, decided to establish a procedure for monitoring tests, external and internal, of all packages received from customers, containing instruments for calibration. The aim was to investigate possible contamination radioactive on these instruments. On July 2011, this procedure was extended to packagings of personal thermoluminescent dosemeters - TLD, received by the newly created Laboratory Laboratorio de Dosimetria Pessoal - LDP . In the monitoring procedure were used monitors with external probe, type pancake, MRA brand, models GP - 500 and MIR 7028. During the 37 months in which this investigation was conducted, were detected 42 cases of radioactive contamination, with the following characteristics: 1) just one case was personal dosimeter, TLD type; 2) just one case was not from a packing from nuclear medicine service - was from a mining company; 3) contamination occurred on packs and instruments, located and/or widespread; 4) contamination values ranged from slightly above the level of background radiation to about a thousand fold. Although METROBRAS has facilities for decontamination, in most cases, especially those of higher contamination, the procedure followed was to store the contaminated material in a room used for storage of radioactive sources. Periodically, each package and/or instrument was monitored, being released when the radiation level matched the background radiation. Every contamination detected, the client and/or owner of the instrument was informed. The Brazilian National Energy Commission - CNEN, was informed, during your public consultation for reviewing the standard for nuclear medicine services, held in mid-2012, having received from METROBRAS the statistical data available at the time. The high frequency of contamination detected and the high

  19. Three Specialized Innovations for FAST Wideband Receiver

    Science.gov (United States)

    Zhang, Xia; Yu, Xinying; Duan, Ran; Hao, Jie; Li, Di

    2015-08-01

    The National Astronomical Observatories of the Chinese Academy of Sciences (NAOC) will soon finish the largest antenna in the world. Known as FAST, the Five-hundred-meter Aperture Spherical Radio Telescope will be the most sensitive single-dish radio telescope in the low frequency radio bands between 70 MHz and 3 GHz.To take advantage of its giant aperture, all relevant cutting-edge technology should be applied to FAST to ensure that it achieves the best possible overall performance. The wideband receiver that is currently under development can not only be directly applied to FAST, but also used for other Chinese radio telescopes, such as the Shanghai 65-meter telescope and the Xinjiang 110-meter telescope, to ensure that these telescopes are among the best in the world. Recently, rapid development related to this wideband receiver has been underway. In this paper, we will introduce three key aspects of the FAST wideband receiver project. First is the use of a high-performance analog-to-digital converter (ADC). With the cooperation of Hao Jie’s team from the Institute of Automation of the Chinese Academy of Sciences(CASIA), we have developed 3-Gsps,12-bit ADCs, which have not been used previously in astronomy, and we expect to realize the 3-GHz bandwidth in a single step by covering the entire bandwidth via interleaving or a complex fast Fourier transform (FFT).Second is the front-end analog signal integrated circuit board. We wish to achieve a series of amplification, attenuation, and mixing filtering operations on a single small board, thereby achieving digital control of the bandpass behavior both flexibly and highly-efficiently. This design will not only greatly reduce the required cost and power but will also make the best use of the digital-system’s flexibility. Third is optimization of the FFT: the existing FFT is not very efficient; therefore, we will optimize the FFT for large-scale operation. For this purpose, we intend to cascade two FFTs. Another

  20. Eosinophils increase in animals that received biotherapic

    Directory of Open Access Journals (Sweden)

    Pedro Gilberto Silva Morais

    2012-12-01

    Full Text Available Dairy industry is an important Brazilian economic activity participating of income generation. European breeds cattle aren’t adapted to parasites found in the tropics, like the Rhipicephalus microplus tick. Parasites can acquire resistance to allopathic products, but not to homeopathic products. We evaluate the efficacy of an antiparasiticide biotherapic against the R. microplus tick. The biotherapic was prepared according to the homeopathic pharmacopoeia recommendations from vegetable (Abrotanum and animal products (Rhipicephalus microplus, Amblyomma cajenennense, Haematobia irritans, Musca domestica, Dermatobia hominis, all diluted and vigorous shaken (dynamized in water or alcohol at a ratio of 1:99, in the 12th Centesimal Hahnemann (CH12, with limestone as the carrier. This homeophatic product found in veterinary pharmacies of Ituiutaba’s region, Minas Gerais State, is registered at Ministério da Agricultura, Pecuária e Abastecimento (MAPA. Natural tick infestation was accessed in thirty Girolando (Gir x Holstein cows with 7 to 13 year-old, by monthly counting of tick female bigger than 6 mm, from October/2009 to July/2011. Cows were divided in three groups of 10 similar animals. The treated group (T1 received roughage, concentrate and biotherapic. The placebo group (T2 received roughage, concentrate and limestone and the control group (T3 received only roughage and concentrate. T1 and T2 groups were managed together and remained in the same paddock. T3 group was separed from T1 and T2 by a wire fence. From October 2009 to September 2010 blood cell counts and serum biochemical tests were performed monthly only in T1 and T2, but visual clinical observations were made in all animals. Any group was treated with acaricide when the count’s average reached 50 or more ticks. It was necessary 7 baths with acaricide in T1 and T2, while in T3 group (control group it was necessary 19 acaricide baths to control the cattle tick. We verified

  1. Brain tumor - children

    Science.gov (United States)

    ... children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children) ... The cause of primary brain tumors is unknown. Primary brain tumors may ... (spread to nearby areas) Cancerous (malignant) Brain tumors ...

  2. Remote bistatic receiver synchronization using DLL techniques

    Science.gov (United States)

    Aguasca, A.; Broquetas, A.; Fdez de Muniain, J.; Ambros, A.

    An experimental staggered pulse repetition frequency synchronizer, based on a delay-lock loop (DLL) was tested using a transmitter signal simulator that simulates the staggering sequence windowed by the antenna beam. The measured system performance ensures synchronization with a 30-ms direct illumination, with an accumulated delay error in the order of the resolution cell positioning error in range. An artificial time expansion of the received pulses is performed in order to reduce the acquisition time synchronization. A bistatic radar synchronization method based on DLL was is analyzed by linearization of the different parts and signals involved. The parameters that degrade system performance are obtained. And some solutions are represented in order to minimize their effects.

  3. Jiang Zemin Receives New ACWF Leadership

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    FOUR days after the adjournment of the 8th Chinese Women’s National Congress, President Jiang Zemin received all the newly-elected members of the executive committee and several deputies at Zhongnanhai. Gu Xiulian, Vice President and the First Member of the Secretariat of the All-China Women’s Federation (ACWF), briefed Jiang on the congress. She said deputies had reached consensus on certain issues: that women should capitalize on their abilities in the overall social participation; that the uplifting of women’s quality should be seen as a long-term strategy; and that women’s development requires a supportive social environment. Jiang Zemin listened attentively to the speeches delivered by seven deputies. Jiang Daguo, president of Hubei Provincial Women’s Federation, from one of the

  4. Receiver based PAPR reduction in OFDMA

    KAUST Repository

    Ali, Anum Z.

    2014-05-01

    High peak-to-average power ratio is one of the major drawbacks of orthogonal frequency division multiplexing (OFDM). Clipping is the simplest peak reduction scheme, however, it requires clipping mitigation at the receiver. Recently compressed sensing has been used for clipping mitigation (by exploiting the sparse nature of clipping signal). However, clipping estimation in multi-user scenario (i.e., OFDMA) is not straightforward as clipping distortions overlap in frequency domain and one cannot distinguish between distortions from different users. In this work, a collaborative clipping removal strategy is proposed based on joint estimation of the clipping distortions from all users. Further, an effective data aided channel estimation strategy for clipped OFDM is also outlined. Simulation results are presented to justify the effectiveness of the proposed schemes. © 2014 IEEE.

  5. Partitioned-Interval Quantum Optical Communications Receiver

    Science.gov (United States)

    Vilnrotter, Victor A.

    2013-01-01

    The proposed quantum receiver in this innovation partitions each binary signal interval into two unequal segments: a short "pre-measurement" segment in the beginning of the symbol interval used to make an initial guess with better probability than 50/50 guessing, and a much longer segment used to make the high-sensitivity signal detection via field-cancellation and photon-counting detection. It was found that by assigning as little as 10% of the total signal energy to the pre-measurement segment, the initial 50/50 guess can be improved to about 70/30, using the best available measurements such as classical coherent or "optimized Kennedy" detection.

  6. The BINP receives its Golden Hadron award

    CERN Multimedia

    2002-01-01

    On Thursday, 14 September, the LHC Project Leader, Lyn Evans, handed over a Golden Hadron award to Alexander Skrinsky of Russia's Budker Institute of Nuclear Physics (BINP). The prize is awarded in recognition of exceptional performances by suppliers and this year prizes were awarded to two firms, Cockerill-Sambre (Belgium) and Wah-Chang (United States), and to the Budker Institute, which was unable to receive the award at the same time as the two other recipients (see Bulletin No 34/2002, of 19 August 2002). The Russian institute has been rewarded for the particularly high-quality production of 360 dipole magnets and 185 quadrupole magnets for the LHC proton beam transfer lines.

  7. Fast digitization and digital receiver technology

    International Nuclear Information System (INIS)

    The potentially lucrative wireless market has led to technological advances in mixed signal devices such as high speed, high resolution A/D and D/A converters. This same market has also driven the development of high performance multi-channel digital receiver and digital transmitter ICs. Similarly, advances in semiconductor processes, coupled with the need for reduced time-to-market, has led to the development of large, enhanced performance, in-circuit programmable logic devices. A review of the key characteristics of these mixed-signal, signal processing and programmable logic devices is presented. The application of these devices and technologies to the instrumentation of Accelerators and Storage Rings is discussed and presented by way of examples. Issues relating to the requirements associated with real-time processing, I/O throughput, reconfigurability, reliability, maintainability and packaging requirements are also addressed

  8. UK malaria treatment guidelines 2016.

    Science.gov (United States)

    Lalloo, David G; Shingadia, Delane; Bell, David J; Beeching, Nicholas J; Whitty, Christopher J M; Chiodini, Peter L

    2016-06-01

    . Most patients treated for P. falciparum malaria should be admitted to hospital for at least 24 h as patients can deteriorate suddenly, especially early in the course of treatment. In specialised units seeing large numbers of patients, outpatient treatment may be considered if specific protocols for patient selection and follow up are in place. 10. Uncomplicated P. falciparum malaria should be treated with an artemisinin combination therapy (Grade 1A). Artemether-lumefantrine (Riamet(®)) is the drug of choice (Grade 2C) and dihydroartemisinin-piperaquine (Eurartesim(®)) is an alternative. Quinine or atovaquone-proguanil (Malarone(®)) can be used if an ACT is not available. Quinine is highly effective but poorly-tolerated in prolonged treatment and should be used in combination with an additional drug, usually oral doxycycline. 11. Severe falciparum malaria, or infections complicated by a relatively high parasite count (more than 2% of red blood cells parasitized) should be treated with intravenous therapy until the patient is well enough to continue with oral treatment. Severe malaria is a rare complication of P. vivax or P. knowlesi infection and also requires parenteral therapy. 12. The treatment of choice for severe or complicated malaria in adults and children is intravenous artesunate (Grade 1A). Intravenous artesunate is unlicensed in the EU but is available in many centres. The alternative is intravenous quinine, which should be started immediately if artesunate is not available (Grade 1A). Patients treated with intravenous quinine require careful monitoring for hypoglycemia. 13. Patients with severe or complicated malaria should be managed in a high-dependency or intensive care environment. They may require haemodynamic support and management of: acute respiratory distress syndrome, disseminated intravascular coagulation, acute kidney injury, seizures, and severe intercurrent infections including Gram-negative bacteraemia/septicaemia. 14. Children with

  9. Transmit-receive eddy current probes

    International Nuclear Information System (INIS)

    In the last two decades, due to increased inspection demands, eddy current instrumentation has advanced from single-frequency, single-output instruments to multifrequency, computer-aided systems. This has significantly increased the scope of eddy current testing, but, unfortunately, it has also increased the cost and complexity of inspections. In addition, this approach has not always improved defect detectability or signal-to-noise. Most eddy current testing applications are still performed with impedance probes, which have well known limitations. However, recent research at AECL has led to improved eddy current inspections through the design and development of transmit-receive (T/R) probes. T/R eddy current probes, with laterally displaced transmit and receive coils, present a number of advantages over impedance probes. They have improved signal-to-noise ratio in the presence of variable lift-off compared to impedance probes. They have strong directional properties, permitting probe optimization for circumferential or axial crack detection, and possess good phase discrimination to surface defects. They can significantly increase the scope of eddy current testing permitting reliable detection and sizing of cracks in heat exchanger tubing as well as in welded areas of both ferritic and non-ferromagnetic components. This presentation will describe the operating principles of T/R probes with the help of computer-derived normalized voltage diagrams. We will discuss their directional properties and analyze the advantages of using single and multiple T/R probes over impedance probes for specific inspection cases. Current applications to surface and tube testing and some typical inspection results will be described. (author)

  10. IAEA receives Iraq's nuclear-related declaration

    International Nuclear Information System (INIS)

    Full text: The Director General of the International Atomic Energy Agency, Mohamed ElBaradei, announced that the IAEA received this evening, Sunday, 8 December 2002, at its Headquarters in Vienna, an approximately 2400 page declaration on Iraq's nuclear programme. The declaration consists of about 2100 pages in English and 300 pages in Arabic. The declaration was submitted by the Government of Iraq in response to paragraph 3 of Security Council resolution 1441 (8 November 2002), which requires Iraq to provide to UNMOVIC, the IAEA and to the Security Council, not later than 30 days of the date of that resolution, with 'currently accurate, full, and complete declaration of all aspects of its programmes to develop chemical, biological, and nuclear weapons, ballistic missiles, and other delivery systems... as well as all other chemical, biological, and nuclear programmes, including any which it claims are for purposes not related to weapon production or material'. 'The IAEA will immediately begin to assess this important new document,' said Mr. ElBaradei, 'including the painstaking and systematic cross-checking of the information provided by Iraq against information which the IAEA already has, information that it expects to receive from other Member States, as contemplated in resolution 1441, and results of past and present Agency verification activities.' Complete assessment of the declaration will be time consuming, particularly in light of the need to translate the 300 pages of Arabic text into English. However, the IAEA expects to be able to provide a preliminary analysis of the document to the Security Council within the next ten days, with a fuller assessment to be provided when it reports to the Council at the end of January. (IAEA)

  11. Children’s spontaneous emotional expressions while receiving (unwanted prizes in the presence of peers

    Directory of Open Access Journals (Sweden)

    Mandy eVisser

    2015-09-01

    Full Text Available Although current emotion theories emphasize the importance of contextual factors for emotional expressive behavior, developmental studies that examine such factors are currently thin on the ground. In this research, we studied the course of emotional expressions of 8- and 11-year-old children after winning a (large first prize or a (substantially smaller consolation prize, while playing a game competing against the computer or a physically co-present peer. We analyzed their emotional reactions by conducting two perception tests in which participants rated children’s level of happiness. Results showed that co-presence positively affected children’s happiness only when receiving the first prize. Moreover, for children who were in the presence of a peer, we found that eye contact affected children’s expressions of happiness, but that the effect was different for different age groups: 8-year-old children were negatively affected, and 11-year-old children positively. Overall, we can conclude that as children grow older and their social awareness increases, the presence of a peer affects their nonverbal expressions, regardless of their appreciation of their prize.

  12. Voice disorders in children.

    Science.gov (United States)

    Gray, S D; Smith, M E; Schneider, H

    1996-12-01

    Pediatric patients with voice or speech problems usually should receive a team assessment in which communication between the pediatrician or primary care physician, the otolaryngologist, and speech pathologist occurs. Although speech or voice problems may prompt an otolaryngologic evaluation, the voice or speech problem simply may be the manifestation or symptom of a larger or more complex disease process. Whether that is the case of hypernasal speech, eventually leading to the diagnosis of velocardiofacial syndrome, or bilateral vocal fold paralysis, eventually leading to the diagnosis of hydrocephalus, it is apparent that patients with speech or voice disorders may eventually require multidisciplinary evaluation. The outlook for children with speech and voice difficulties is better than ever. Recent equipment advances, such as flexible laryngoscopy, video stroboscopy, and nasometry, for detection, evaluation, and management of speech problems have created a better environment than ever existed for care of these problems. Much research is being performed in the area of pediatric voice and speech problems. The National Institute of Deafness and Communicative Disorders and the National Institute of Dental Research have funded and currently fund many projects in these areas. Many pediatric hospitals now have voice or speech disorder clinics in which multiple disciplines are brought together to evaluate children with these problems. Children benefit best when speech and voice problems are managed in an interdisciplinary setting when necessary and by professionals who have experience and training in these specialized pediatric problems. Given the local, professional, and national resources that are expended toward recognition and treatment of speech disorders in children, it is truly a tragedy when those resources cannot be brought to assist children with voice and speech problems. Although voice and speech problems usually are recognized by parents or concerned family

  13. 18 CFR 367.1720 - Account 172, Rents receivable.

    Science.gov (United States)

    2010-04-01

    ... receivable. (a) This account must include rents receivable or accrued on property rented or leased by the service company to others. (b) Rents receivable from associate companies must be included in account 146, Accounts receivable from associate companies (§ 367.1460)....

  14. Does anti-malarial drug knowledge predict anti-malarial dispensing practice in drug outlets? A survey of medicine retailers in western Kenya

    Directory of Open Access Journals (Sweden)

    Rusk Andria

    2012-08-01

    Full Text Available Abstract Background Malaria is a major cause of morbidity and mortality in Kenya, where it is the fifth leading cause of death in both children and adults. Effectively managing malaria is dependent upon appropriate treatment. In Kenya, between 17 to 83 percent of febrile individuals first seek treatment for febrile illness over the counter from medicine retailers. Understanding medicine retailer knowledge and behaviour in treating suspected malaria and dispensing anti-malarials is crucial. Methods To investigate medicine retailer knowledge about anti-malarials and their dispensing practices, a survey was conducted of all retail drug outlets that sell anti-malarial medications and serve residents of the Webuye Health and Demographic Surveillance Site in the Bungoma East District of western Kenya. Results Most of the medicine retailers surveyed (65% were able to identify artemether-lumefantrine (AL as the Kenyan Ministry of Health recommended first-line anti-malarial therapy for uncomplicated malaria. Retailers who correctly identified this treatment were also more likely to recommend AL to adult and paediatric customers. However, the proportion of medicine retailers who recommend the correct treatment is disappointingly low. Only 48% would recommend AL to adults, and 37% would recommend it to children. It was discovered that customer demand has an influence on retailer behaviour. Retailer training and education were found to be correlated with anti-malarial drug knowledge, which in turn is correlated with dispensing practices. Medicine retailer behaviour, including patient referral practice and dispensing practices, are also correlated with knowledge of the first-line anti-malarial medication. The Kenya Ministry of Health guidelines were found to influence retailer drug stocking and dispensing behaviours. Conclusion Most medicine retailers could identify the recommended first-line treatment for uncomplicated malaria, but the percentage that could

  15. Physical activity of preschool children and their parents in the Medvode municipality

    OpenAIRE

    Mohorič, Martina

    2012-01-01

    The purpose of our diploma thesis was to analyze the physical/sporting exercise in preschool children and their parents in the municipality of Medvode. We wanted to determine the intensity and variety of physical/sporting exercises in children and their parents as well as to determine whether children in urban areas receive a greater variety of physical/sporting exercises than children living in villages. We also wanted to know if parents and their children are sufficiently physically active ...

  16. Flux Density Measurement on Large-Scale Receivers

    OpenAIRE

    Röger, Marc; Herrmann, Patrik; Ebert, Miriam; Prahl, Christoph; Ulmer, Steffen; Göhring, Felix

    2011-01-01

    Commercial solar tower plants have much larger aperture surfaces than the receiver prototypes tested in earlier R&D projects. Existing methods to measure the solar flux density in the receiver aperture face new challenges regarding the receiver size. Also, the requirements regarding costs, accuracy, spatial resolution, and measuring speed are different. Flux density measurement delivers the spatial distribution of the concentrated solar radiation on a receiver aperture, measures receiver inpu...

  17. Street children

    Directory of Open Access Journals (Sweden)

    Rončević Nevenka

    2013-01-01

    Full Text Available According to UNICEF, street child is any child under the age of 18 for whom the street has become home and/or source of income and which is not adequately protected or supervised by adult, responsible person. It has been estimated that there are between 100 and 150 million street children worldwide. Life and work on the street have long term and far-reaching consequences for development and health of these children. By living and working in the street, these children face the highest level of risk. Street children more often suffer from the acute illness, injuries, infection, especially gastrointestinal, acute respiratory infections and sexually transmitted diseases, inadequate nutrition, mental disorders, and drug abuse. They are more often victims of abuse, sexual exploitation, trafficking; they have higher rate of adolescent pregnancy than their peers from poor families. Street children and youth have higher rates of hospitalization and longer hospital stay due to seriousness of illness and delayed health care. Street children/youth are reluctant to seek health care, and when they try, they face many barriers. Street children are invisible to the state and their number in Serbia is unknown. Recently, some non­governmental organizations from Belgrade, Novi Sad and Nis have recognized this problem and tried to offer some help to street children, by opening drop­in centers, but this is not enough. To solve this problem, an engagement of the state and the whole community is necessary, and primary responsibility lies in health, social and educational sector. The best interests of the child must serve as a basic guideline in all activities aimed at improving health, quality of life and rights of children involved in the life and work in the street.

  18. Integrated Submm Wave Receiver: Development and Applications

    Science.gov (United States)

    Koshelets, Valery P.; Birk, Manfred; Boersma, Dick; Dercksen, Johannes; Dmitriev, Pavel; Ermakov, Andrey B.; Filippenko, Lyudmila V.; Golstein, Hans; Hoogeveen, Ruud W. M.; de Jong, Leo; Khudchenko, Andrey V.; Kinev, Nickolay V.; Kiselev, Oleg S.; Kudryashov, Pavel V.; Van Kuik, Bart; de Lange, Arno; de Lange, Gert; L. Lapitsky, Irina; I. Pripolzin, Sergey; van Rantwijk, Joris; Selig, Avri M.; Sobolev, Alexander S.; Torgashin, Mikhail Yu; Vaks, Vladimir L.; de Vries, Ed; Wagner, Georg; Yagoubov, Pavel A.

    A superconducting integrated receiver (SIR) comprises in a single chip a planar antenna combined with a superconductor-insulator-superconductor (SIS) mixer, a superconducting Flux Flow Oscillator (FFO) acting as a Local Oscillator (LO) and a second SIS harmonic mixer (HM) for the FFO phase locking. In this report, an overview of the SIR and FFO developments and optimizations is presented. Improving on the fully Nb-based SIR we have developed and studied Nb-AlN-NbN circuits, which exhibit an extended operation frequency range. Continuous tuning of the phase locked frequency has been experimentally demonstrated at any frequency in the range 350-750 GHz. The FFO free-running linewidth has been measured between 1 and 5 MHz, which allows to phase lock up to 97% of the emitted FFO power. The output power of the FFO is sufficient to pump the matched SIS mixer. Therefore, it is concluded that the Nb-AlN-NbN FFOs are mature enough for practical applications.These achievements enabled the development of a 480-650 GHz integrated receiver for the atmospheric-research instrument TErahertz and submillimeter LImb Sounder (TELIS). This balloon-borne instrument is a three-channel superconducting heterodyne spectrometer for the detection of spectral emission lines of stratospheric trace gases that have their rotational transitions at THz frequencies. One of the channels is based on the SIR technology. We demonstrate for the first time the capabilities of the SIR technology for heterodyne spectroscopy in general, and atmospheric limb sounding in particular. We also show that the application of SIR technology is not limited to laboratory environments, but that it is well suited for remote operation under harsh environmental conditions. Light weight and low power consumption combined with broadband operation and nearly quantum limited sensitivity make the SIR a perfect candidate for future airborne and space-borne missions. The noise temperature of the SIR was measured to be as low as

  19. Densitometric disorders in children infected with HIV

    Directory of Open Access Journals (Sweden)

    M Marczyñska

    2012-11-01

    Full Text Available The aim of study was to assess the prevalence of densitometric disorders and deficiencies of vitamin D3 in children vertically HIV-infected, treated with cART. In 34 children vertically HIV-infected aged 10–16 years (mean 13 years, receiving cART≥5, bone densitometry and the titer of 25-OHD3 was done. We analyzed at the time of diagnosis of HIV infection and at the time of the study: age, clinical and immunological classification, the length, effectiveness of cART, the lowest immunological classification. 15/34 (44% children had abnormal dual-energy X-ray absorptiometry examination (DEXA of the lumbar aged-matched mean Z-score −2.1 (range −1.2 to −3.5, of which 8 also had abnormal DEXA whole spine aged-matched mean Z-score −1.6 (range −1.1 to−2.2. Level of 25-OHD3 was abnormal (<20 ng/ml in 29/34 (85%, in 7 of them the level was very low (<4.0 ng /ml. 4/5 children with normal values of 25-OHD3 parallel had correct densitometry; 1/5 with a normal value of 25-OHD3 had significant abnormalities of bone density, visible in radiographs of the hand. Clinical classification at diagnosis was: N/A in 17, B in 12, C in 5 and immunological classification: 1 in 11, 2 in 9, 3 in 13 cases. The lowest classification was AIDS in 9 children, 15 had moderate signs of infection, and 10 mild signs; deep immune deficiency occurred in 17 children, 15 had moderate and 2 have never had immunodeficiency. The regimens based on PI received 9 children, NNTRI −6, all 3 classes received 19. At the time of the study 31 children were successfully treated, 32 had no immunodeficiency, two had moderate deficiency. 32 children were qualified to N/A group, one was in the classification of B and one in C. All children unsuccessfully treated (3 had low levels of 25-OHD3. In a significant percentage of older children receiving antiretroviral treatment≥5 years, had abnormal results of densytometry examination. There was no correlation between age, duration of the c

  20. Romanian parents' social representations of children's vaccination

    OpenAIRE

    Arhiri, L.

    2014-01-01

    The current research aimed to explore Romanian parents’ social representations of vaccination in children and to identify how they fluctuate across gender and degree of reliance on information regarding this practice learned from media and, respectively, medical experts. The first study was conducted on a sample of 80 mothers and fathers of children who were supposed to receive the inactivated polio vaccine (IPV) later that year. The analysis of the data gathered upon the completion of the As...

  1. Waste Receiving and Processing (WRAP) Facility technology

    International Nuclear Information System (INIS)

    Waste treatment capabilities for Waste Receiving and Processing (WRAP) Facility Module 1 (WRAP-1) will be limited to opening and repackaging of suspect transuranic (TRU) drums and the necessary nondestructive examination (NDE) and nondestructive assay (NDA) services for shipment of the certified waste packages to the designated disposal facilities. The technologies used in WRAP Module 2 (WRAP-2) are principally those waste treatment methodologies necessary to ensure the final waste forms are in compliance with disposal and/or transportation criteria. The WRAP-2 will treat all TRU noncompliant waste items that do not meet the WIPP Waste Acceptance Criteria (WAC) segregated in WRAP-1, all the Hanford Site radioactive/hazardous low-level mixed waste (LLMW), all large items requiring size reduction/sorting/treatment needed for disposal (mostly large suspect TRU waste items), and remote-handled (high surface dose) waste items. The current scope of the WRAP-2 Facility will employ the following waste treatment technologies: passivation of the waste by chemical additives, waste immobilization (within grout matrixes), size reduction via shears/mechanical saws/plasma arc torches/lasers, compaction, shred/grouting, plasma melting, and wet chemical decontamination techniques. All waste materials will be certified to meet the appropriate US Department of Energy (DOE) orders for waste characterization and will adhere to the Resource Conservation and Recovery Act (RCRA) regulations in compliance with the promulgated treatment standards. 3 figs

  2. The Parkes Ultra-Wideband Receiver

    Science.gov (United States)

    Manchester, Richard N.

    2015-08-01

    An ultra-wideband receiver system for the Parkes 64-m radio telescope covering the frequency range 0.7 - 4.0 GHz is currently under construction. Its main applications will be to pulsar studies, but it will also be used for spectral-line and continuum background polarisation studies and VLBI. A new feed design with remarkably constant beam properties across the band and excellent polarisation performance will be used. We plan to directly digitise the RF signals in the focus cabin and transmit the digital data via optical fibre to a versatile signal processing system using FPGA processors and a GPU cluster located in the telescope tower. With the relatively low radio frequency and very wide band, dealing with radio frequency interference is a critical issue. We have undertaken surveys of the RFI environment at Parkes and are developing several complementary techniques for mitigating the effects on data quality of both broad-band transients and quasi-stationary narrow-band signals.

  3. Patrick Janot receives the CNRS silver medal

    CERN Multimedia

    2005-01-01

    Patrick Janot during the award ceremony. (Photo Schwemling, Paris) On 25 November, Patrick Janot of the CERN Physics Department received the CNRS silver medal for IN2P3 (Institut national de physique nucléaire et de physique des particules). This prize, one of the most prestigious awarded by the French research centre, is given to scientists for the 'originality, quality and importance of their work, as recognised both nationally and internationally'. Patrick Janot joined the ALEPH collaboration, one of the four experiments at LEP, then under construction, in 1987. First a CERN Fellow, he went on to work for the CNRS at LAL in 1989. Together with his team, he developed innovative algorithms for the reconstruction of events. This work and others earned him the bronze CNRS medal in 1993, which is awarded to scientists for their first achievements. In 1997, he became a permanent physicist at CERN, where he continued to work for ALEPH. He was appointed LEP scientific co-ordinator for the last two years of the ac...

  4. Social Interactions Receive Priority to Conscious Perception.

    Science.gov (United States)

    Su, Junzhu; van Boxtel, Jeroen J A; Lu, Hongjing

    2016-01-01

    Humans are social animals, constantly engaged with other people. The importance of social thought and action is hard to overstate. However, is social information so important that it actually determines which stimuli are promoted to conscious experience and which stimuli are suppressed as invisible? To address this question, we used a binocular rivalry paradigm, in which the two eyes receive different action stimuli. In two experiments we measured the conscious percept of rival actions and found that actions engaged in social interactions are granted preferential access to visual awareness over non-interactive actions. Lastly, an attentional task that presumably engaged the mentalizing system enhanced the priority assigned to social interactions in reaching conscious perception. We also found a positive correlation between human identification of interactive activity and the promotion of socially-relevant information to visual awareness. The present findings suggest that the visual system amplifies socially-relevant sensory information and actively promotes it to consciousness, thereby facilitating inferences about social interactions. PMID:27509028

  5. CERN safety expert receives international award

    CERN Multimedia

    2005-01-01

    On 18 December 2004, the President of the Swiss Electro-technical Committee, Martin Reichle (left), presented the award to Helmut Schönbacher. Helmut Schönbacher, of the Safety Commission at CERN, has received, the "1906 Award" of the International Electrotechnical Commission (IEC) for his standardisation work on the influence of ionizing radiation on insulating materials. From 1986 until 2004, Schönbacher was leader of a working group on radiation composed of internationally recognised experts. It edited standards of the IEC 60544 series on the determination of the effects of ionizing radiation on electrical insulating materials. The working group also edited three IEC Technical Reports on the determination of long-term radiation ageing in polymers. This standardisation work and long-term experience from CERN on the radiation ageing of materials also contributed to research coordination programmes of the International Atomic Energy Agency (IAEA). From 1968 until 1988, Schönbacher was a member of the Rad...

  6. Every second cancer patient receives radiotherapy

    International Nuclear Information System (INIS)

    Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

  7. CERN Web Pages Receive a Makeover

    CERN Multimedia

    2001-01-01

    Asudden allergic reaction to the colour turquoise? Never fear, from Monday 2 April you'll be able to click in the pink box at the top of the CERN users' welcome page to go to the all-new welcome page, which is simpler and better organized. CERN's new-look intranet is the first step in a complete Web-makeover being applied by the Web Public Education (WPE) group of ETT Division. The transition will be progressive, to allow users to familiarize themselves with the new pages. Until 17 April, CERN users will still get the familiar turquoise welcome page by default, with the new pages operating in parallel. From then on, the default will switch to the new pages, with the old ones being finally switched off on 25 May. Some 400 pages have received the makeover treatment. For more information about the changes to your Web, take a look at: http://www.cern.ch/CERN/NewUserPages/ Happy surfing!

  8. Receiving of iodoinsulin with preserved biological activity

    International Nuclear Information System (INIS)

    The paper presents a method of receiving iodoinsulin with preserved biological activity. As a raw material recrystallized bovine insulin produced by ''Polfa'' was used. Chloramine T was used as an oxidizing agent in the iodize reaction. Insulin was marked with 125I or 127I in the rate of molar concentration of NaI and insulin 0.6. The obtained product contained about 0.3 of iodine atom per one insulin molecule. Specific radioactivity of the iodoinsulin was between 77 and 147 μCi/μg. Such an insulin was in over 95% precipitable with trichloroacetic acid. Its immunological reactivity varied from 89% to 100% while biological activity, determined with the consumption of glucose by the fatty tissue of epididymis of rat, was 92% +- 24% of the native insulin activity. Half-life time of 125I insulin in the rat blood circulation was determined. Curve of the isotope disappearance was biphasic. Half-life time of the first phase (shorter one) was 0.64 +- 0.2 minute while the longer phase 8.89 +- 2.16 minutes. (author)

  9. Acute myelogenous leukemia (AML) - children

    Science.gov (United States)

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  10. Chromosomal aberrations in children exposed to diagnostic x-rays

    International Nuclear Information System (INIS)

    Among children who have received high x-ray doses congenital dislocation of the hip joint is the predominating diagnosis. In a series of 9 children who had received high x-ray doses (8 with luxation of the hip joint and one with achondroplasia) a significant increase of chromosomal aberrations was found. The increase concerned mainly chromosome type aberrations. The shorter the time since the last x-ray investigation the higher was the frequency of chromosome type aberrations. (author)

  11. Protect children from EMF.

    Science.gov (United States)

    Markov, M; Grigoriev, Y

    2015-09-01

    The twenty-first century is marked with aggressive development of the wireless communications (satellite, mobile phones, Internet, Wi-Fi). In addition to thousand of satellites that deliver radio and TV signals, large satellite and base station networks secure intensive instant delivery of audio and video information. It is fair to say that that the entire civilization, both biosphere and mankind are exposed to continuous exposure of multitude of radiofrequency (RF) signals. It should be taken into account that the entire world population is exposed to exponentially increasing RF radiation from base stations and satellite antennas. While several years ago the potential hazard was connected with placement of mobile phones close to human head, today "smart phones" represent small, but powerful computers continuously receiving audio and video data. The largest group of users is the children and teenagers who "need" to communicate nearly 24 h a day. This is even more important because cell phones and tablets may be seen in the hands of children as little as two years in age. There is no way to assess and predict the potential damages of children brain, vision and hearing under exposure to RF radiation. The WHO precautionary principle and IARC classification must be applied in discussing the potential hazard of the use of today's and tomorrow's communication devices. PMID:26444201

  12. Parents' Satisfaction and Compliance with Recommendations Following Psychoeducational Assessment of Children.

    Science.gov (United States)

    Human, Margaret T.; Teglasi, Hedwig

    1993-01-01

    Examined effectiveness of psychoeducational evaluations. Subjects were parents of children, aged 5-18, who received evaluations in private agencies. Major analyses were on 77 subjects, subset of 154 parents who had completed all phases of study and received recommendation to pursue tutoring for their children. Found significant role played by…

  13. SNS: Analytic Receiver Analysis Software Using Electrical Scattering Matrices

    CERN Document Server

    King, Oliver G

    2010-01-01

    SNS is a MATLAB-based software library written to aid in the design and analysis of receiver architectures. It uses electrical scattering matrices and noise wave vectors to describe receiver architectures of arbitrary topology and complexity. It differs from existing freely-available software mainly in that the scattering matrices used to describe the receiver and its components are analytic rather than numeric. This allows different types of modeling and analysis of receivers to be performed. Non-ideal behavior of receiver components can be parameterized in their scattering matrices. SNS enables the instrument designer to then derive analytic expressions for the signal and noise at the receiver outputs in terms of parameterized component imperfections, and predict their contribution to receiver systematic errors precisely. This can drive the receiver design process by, for instance, allowing the instrument designer to identify which component imperfections contribute most to receiver systematic errors, and h...

  14. Childrens testimony

    OpenAIRE

    Sjöberg, Rickard L

    2002-01-01

    Background: Most cases of child sexual use are identified through statements made by children and in many cases such statements constitute the only evidence available that abuse occurred. Despite its importance the use of children's testimonies is however complicated by the fact that a substantial proportion of victims delay disclosure of abuse or even deny such experiences when asked for them directly. A further complicating factor, highlighted by an abundance of experiment...

  15. Street children

    OpenAIRE

    Rončević Nevenka; Stojadinović Aleksandra; Batrnek­antonić Daliborka

    2013-01-01

    According to UNICEF, street child is any child under the age of 18 for whom the street has become home and/or source of income and which is not adequately protected or supervised by adult, responsible person. It has been estimated that there are between 100 and 150 million street children worldwide. Life and work on the street have long term and far-reaching consequences for development and health of these children. By living and working in the street, thes...

  16. The psychosocial experience of parents receiving care closer to home for their ill child.

    Science.gov (United States)

    Spiers, Gemma; Parker, Gillian; Gridley, Kate; Atkin, Karl

    2011-11-01

    Current health policy in England regarding the management of childhood illness advocates for care to be delivered as close to home as possible. The aim of this article is to report findings from a qualitative component of a larger study evaluating models of care closer to home (CCTH) for children and young people who are ill. The focus is on parents' psychosocial experience of receiving CCTH for their ill child. A qualitative case study design was used, with four Primary Care Trusts in England as the case study sites. In-depth, semi-structured interviews were conducted with 27 parents and one extended family caregiver of children using CCTH services within the case study sites. Interviews were conducted face-to-face and audio-recorded with permission. Data were collected in 2009. There was an overall preference for CCTH over hospital-based care where possible. The parents in this study experienced differing levels of responsibility as part of this care, and responded to this in different ways. Being supported emotionally and socially by practitioners was an important part of receiving CCTH for parents, especially when they had increased responsibility as part of this care. Developing relationships with practitioners appeared to be a medium through which parents received support. If the provision of CCTH continues to expand in line with current policy, provision of support for parents should be considered a fundamental aspect of service development. PMID:21623985

  17. Children Literature: Shaping Gender Identities

    Directory of Open Access Journals (Sweden)

    IQRA JABEEN

    2014-02-01

    Full Text Available The aim of this paper is to analyze stereotype construction of gender roles in the text of children's stories which inculcate in the children’s crude minds socially developed gender differences. For this purpose, the study followed Dell Hymes’ speaking model. This model has sixteen components that can be applied to different types of Discourse (speech interaction: message form; message content; setting; scene; Speaker/sender; address or; the hearer/receiver/audience; addressee; purposes (outcomes; purposes (goals; key; channels; forms of speech; norms of interaction; norms of interpretation; and genres. Selected children's stories were analyzed to identify their role as primary thought developing sources in the mind of young learners thus shaping their gender identities. This study would be beneficial in drawing the attention of authors, editors and writers of children's literature to redefine gender roles in order to minimize gender differences.

  18. Geographic, Racial/Ethnic, and Sociodemographic Disparities in Parent-Reported Receipt of Family-Centered Care among US Children

    Directory of Open Access Journals (Sweden)

    Romuladus E. Azuine

    2015-01-01

    Full Text Available This study examined geographic, racial/ethnic, and sociodemographic disparities in parental reporting of receipt of family-centered care (FCC and its components among US children aged 0–17 years. We used the 2011-2012 National Survey of Children’s Health to estimate the prevalence and odds of not receiving FCC by covariates. Based on parent report, 33.4% of US children did not receive FCC. Children in Arizona, Mississippi, Nevada, California, New Jersey, Virginia, Florida, and New York had at least 1.51 times higher adjusted odds of not receiving FCC than children in Vermont. Non-Hispanic Black and Hispanic children had 2.11 and 1.58 times higher odds, respectively, of not receiving FCC than non-Hispanic White children. Children from non-English-speaking households had 2.23 and 2.35 times higher adjusted odds of not receiving FCC overall and their doctors not spending enough time in their care than children from English-speaking households, respectively. Children from low-education and low-income households had a higher likelihood of not receiving FCC. The clustering of children who did not receive FCC and its components in several Southern and Western US states, as well as children from poor, uninsured, and publicly insured and of minority background, is a cause for concern in the face of federal policies to reduce health care disparities.

  19. Qualification test for the flexible receiver

    International Nuclear Information System (INIS)

    This document provides the test plan and procedures to certify and design verify the 42 inch and 4--6 inch Flexible Receiver (FR) is a safety class 3 system. Verification of the design will be handled in two parts. The first part will be to show that it meets design requirements set forth by documents and the second part will perform test(s) to verify its operational aspects. To qualify the design of the FR systems for field use this test will demonstrate environmentally safe removal of a Tank Farm pump mock-up from a Tank Farm riser mock-up. Testing will also demonstrate the performance of supporting equipment. The FR and the Secondary Bagging (SB) equipment shall be tested to verify successful operation of the equipment to the following criteria: The FR can be placed on a riser and connections made to the supporting equipment; The FR bag can accept equipment and be successfully sealed; The SB system encases the seal of the primary FR bag; The flexible bag(s) do not tear and maintain integrity during the entire test; The FR control system operates in the fail safe forced sequence mode; The FR control system will operate in the manual override mode (out of sequence operations); The CCTV Video system monitors and records the removal of the test item; The spray wash system operates without leaks and effectively provides coverage; The item being removed can be reinserted to a depth of 8 feet and the bag reinstalled onto the vertical bag supports; and The system prohibits momentary mechanical fluctuations due to the application of system power, including power interruptions

  20. Turcotte Receives 2003 William Bowie Medal

    Science.gov (United States)

    Cathles, Lawrence M.; Turcotte, Donald L.

    2004-01-01

    ``Few have contributed more to fundamental geophysics, or been better at encouraging others to contribute, than Donald L. Turcotte. Don trained as an engineer, receiving a Ph.D. in Aeronautics and Physics from the California Institute of Technology in 1958. After a year at the Naval Postgraduate School in Monterey, he joined the Cornell Graduate School of Aeronautical Engineering, rising to full professor. He established expertise on seeded combustion, magnetohydrodynamic and electrical phenomena in turbulent boundary layers, and shock waves and authored a book, Space Propulsion, and co-authored a textbook, Statistical Thermodynamics. ``In 1965 he went on sabbatical to Oxford and returned an Earth scientist. The catalyst was Ron Oxburgh. Plate tectonics was just on the horizon, and Don joined his quantitative abilities and physical intuition with Ron's skills and knowledge of geology to produce over the next decade a remarkable series of 24 papers that explored topics such as the many implications of the Earth's thermal boundary layer, ridge melting, subduction zone volcanism, and intraplate tectonics and magmatism, and established the physical bases for many of the processes operating on our planet. Shifting to the Cornell Department of Geological Sciences in 1973, Don explored virtually every aspect of physical Earth geology and became an expert on planetary remote sensing and geophysical interpretation. He published over 150 papers on thermal subsidence in sedimentary basins, two-phase hydrothermal porous media convection, lithosphere flexure, cyclic sedimentation, and stick-slip earthquakes and the lithospheres and mantles of the other planets. He worked and published with outstanding students and colleagues including Ken Torrance, Gerald Schubert, David Spence, Marc Parmentier, Bill Haxby, John Ockendon, Kevin Burke, Jud Ahern, Steve Emerman, and Charlie Angevine. In 1982 he published Geodynamics with Jerry Schubert, a book that became the primary reference in