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Sample records for scaling-up malaria chemoprevention

  1. Prospects, achievements, challenges and opportunities for scaling-up malaria chemoprevention in pregnancy in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    To describe the prospects, achievements, challenges and opportunities for implementing intermittent preventive treatment for malaria in pregnancy (IPTp) in Tanzania in light of national antenatal care (ANC) guidelines and ability of service providers to comply with them.......To describe the prospects, achievements, challenges and opportunities for implementing intermittent preventive treatment for malaria in pregnancy (IPTp) in Tanzania in light of national antenatal care (ANC) guidelines and ability of service providers to comply with them....

  2. Scaling up Intermittent Rice Irrigation for Malaria Control on the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Scaling up Intermittent Rice Irrigation for Malaria Control on the North Coast of Peru. New research aims to help control malaria in one watershed in northern Peru. Malaria is widespread in Peru's arid North Coast because of the extensive irrigation required to support rice paddies. Rice growing in the region accounts for ...

  3. Acceptability by community health workers in Senegal of combining community case management of malaria and seasonal malaria chemoprevention

    DEFF Research Database (Denmark)

    Tine, Roger Ck; Ndiaye, Pascal; Ndour, Cheikh T

    2013-01-01

    Community case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy. However, little is known about the social acceptability of these interventions. A study was undertaken...... to assess whether combining the interventions would be an acceptable approach to malaria control for community health workers (CHWs)....

  4. Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia

    Directory of Open Access Journals (Sweden)

    Yasuoka Junko

    2012-01-01

    Full Text Available Abstract Background Malaria control has been scaled up in many developing countries in their efforts to achieve the Millennium Development Goals. Cambodia recently scaled up their Village Malaria Worker (VMW project by substantially increasing the number of VMWs and expanding the project's health services to include treatment of fever, diarrhoea, and Acute Respiratory Infections (ARI in children under five. This study examined if the scale-up interfered with VMWs' service quality, actions, and knowledge of malaria control, and analysed VMWs' overall achievements and perceptions of the newly added health services. Methods Structured interviews were conducted pre scale-up in February-March 2008 with 251 VMWs and post scale-up in July-August 2010 with 252 VMWs. Comparing the pre and post scale-up survey results (n = 195, changes were examined in terms of VMWs' 1 service quality, 2 malaria prevention and vector control actions, and 3 knowledge of malaria epidemiology and vector ecology. In addition, VMWs' newly added health services were descriptively analysed based on the post scale-up survey (n = 252. Results VMWs' service quality and actions significantly improved overall during the scale-up of the VMW project (mean index score: +0.805, p p p Conclusions The Cambodian experience clearly demonstrated that a nationwide scale-up of community-based malaria control can be achieved without degrading community health workers' service quality. The government's strategy to expand VMWs' health services, while providing sufficient training to maintain the quality of their original malaria control services, could have contributed to the improvement of VMW's service quality, actions, and knowledge in spite of the rapid scale-up of the project.

  5. Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia

    National Research Council Canada - National Science Library

    Yasuoka, Junko; Poudel, Krishna C; Ly, Po; Nguon, Chea; Socheat, Duong; Jimba, Masamine

    2012-01-01

    .... Cambodia recently scaled up their Village Malaria Worker (VMW) project by substantially increasing the number of VMWs and expanding the project's health services to include treatment of fever, diarrhoea, and Acute Respiratory Infections (ARI...

  6. Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008

    NARCIS (Netherlands)

    M.W. Aregawi (Maru); A.S. Ali (Abdullah); A.-W. Al-Mafazy; F. Molteni (Fabrizio); S. Katikiti (Samson); M. Warsame (Marian); R.J. Njau; R. Komatsu (Ryuichi); E.L. Korenromp (Eline); M. Hosseini (Mehran); D. Low-Beer (Daniel); A. Bjorkman (Anders); U. D'Alessandro (Umberto); M. Coosemans (Marc); M. Otten (Mac)

    2011-01-01

    textabstractBackground: In Zanzibar, the Ministry of Health and partners accelerated malaria control from September 2003 onwards. The impact of the scale-up of insecticide-treated nets (ITN), indoor-residual spraying (IRS) and artemisinin-combination therapy (ACT) combined on malaria burden was

  7. Framework for evaluating the health impact of the scale-up of malaria control interventions on all-cause child mortality in Sub-Saharan Africa

    NARCIS (Netherlands)

    Y. Ye (Yazoume); Eisele, T.P. (Thomas P.); Eckert, E. (Erin); E.L. Korenromp (Eline); Shah, J.A. (Jui A.); Hershey, C.L. (Christine L.); Ivanovich, E. (Elizabeth); Newby, H. (Holly); Carvajal-Velez, L. (Liliana); Lynch, M. (Michael); R. Komatsu (Ryuichi); R.E. Cibulskis (Richard E); Moore, Z. (Zhuzhi); Bhattarai, A. (Achuyt)

    2017-01-01

    textabstractConcerted efforts from national and international partners have scaled up malaria control interventions, including insecticide-treated nets, indoor residual spraying, diagnostics, prompt and effective treatment of malaria cases, and intermittent preventive treatment during pregnancy in

  8. Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008

    Directory of Open Access Journals (Sweden)

    Hosseini Mehran

    2011-02-01

    Full Text Available Abstract Background In Zanzibar, the Ministry of Health and partners accelerated malaria control from September 2003 onwards. The impact of the scale-up of insecticide-treated nets (ITN, indoor-residual spraying (IRS and artemisinin-combination therapy (ACT combined on malaria burden was assessed at six out of seven in-patient health facilities. Methods Numbers of outpatient and inpatient cases and deaths were compared between 2008 and the pre-intervention period 1999-2003. Reductions were estimated by segmented log-linear regression, adjusting the effect size for time trends during the pre-intervention period. Results In 2008, for all age groups combined, malaria deaths had fallen by an estimated 90% (95% confidence interval 55-98%(p Conclusions Scaling-up effective malaria interventions reduced malaria-related burden at health facilities by over 75% within 5 years. In high-malaria settings, intensified malaria control can substantially contribute to reaching the Millennium Development Goal 4 target of reducing under-five mortality by two-thirds between 1990 and 2015.

  9. National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria.

    Science.gov (United States)

    Tesfazghi, Kemi; Hill, Jenny; Jones, Caroline; Ranson, Hilary; Worrall, Eve

    2016-02-01

    New vector control tools are needed to combat insecticide resistance and reduce malaria transmission. The World Health Organization (WHO) endorses larviciding as a supplementary vector control intervention using larvicides recommended by the WHO Pesticides Evaluation Scheme (WHOPES). The decision to scale-up larviciding in Nigeria provided an opportunity to investigate the factors influencing policy adoption and assess the role that actors and evidence play in the policymaking process, in order to draw lessons that help accelerate the uptake of new methods for vector control. A retrospective policy analysis was carried out using in-depth interviews with national level policy stakeholders to establish normative national vector control policy or strategy decision-making processes and compare these with the process that led to the decision to scale-up larviciding. The interviews were transcribed, then coded and analyzed using NVivo10. Data were coded according to pre-defined themes from an analytical policy framework developed a priori. Stakeholders reported that the larviciding decision-making process deviated from the normative vector control decision-making process. National malaria policy is normally strongly influenced by WHO recommendations, but the potential of larviciding to contribute to national economic development objectives through larvicide production in Nigeria was cited as a key factor shaping the decision. The larviciding decision involved a restricted range of policy actors, and notably excluded actors that usually play advisory, consultative and evidence generation roles. Powerful actors limited the access of some actors to the policy processes and content. This may have limited the influence of scientific evidence in this policy decision. This study demonstrates that national vector control policy change can be facilitated by linking malaria control objectives to wider socioeconomic considerations and through engaging powerful policy champions to

  10. Feasibility, safety and effectiveness of combining home based malaria management and seasonal malaria chemoprevention in children less than 10 years in Senegal

    DEFF Research Database (Denmark)

    Tine, Roger C K; Ndour, Cheikh T; Faye, Babacar

    2014-01-01

    Home-based management of malaria (HMM) may improve access to diagnostic testing and treatment with artemisinin combination therapy (ACT). In the Sahel region, seasonal malaria chemoprevention (SMC) is now recommended for the prevention of malaria in children. It is likely that combinations...

  11. Framework for Evaluating the Health Impact of the Scale-Up of Malaria Control Interventions on All-Cause Child Mortality in Sub-Saharan Africa.

    Science.gov (United States)

    Yé, Yazoume; Eisele, Thomas P; Eckert, Erin; Korenromp, Eline; Shah, Jui A; Hershey, Christine L; Ivanovich, Elizabeth; Newby, Holly; Carvajal-Velez, Liliana; Lynch, Michael; Komatsu, Ryuichi; Cibulskis, Richard E; Moore, Zhuzhi; Bhattarai, Achuyt

    2017-09-01

    Concerted efforts from national and international partners have scaled up malaria control interventions, including insecticide-treated nets, indoor residual spraying, diagnostics, prompt and effective treatment of malaria cases, and intermittent preventive treatment during pregnancy in sub-Saharan Africa (SSA). This scale-up warrants an assessment of its health impact to guide future efforts and investments; however, measuring malaria-specific mortality and the overall impact of malaria control interventions remains challenging. In 2007, Roll Back Malaria's Monitoring and Evaluation Reference Group proposed a theoretical framework for evaluating the impact of full-coverage malaria control interventions on morbidity and mortality in high-burden SSA countries. Recently, several evaluations have contributed new ideas and lessons to strengthen this plausibility design. This paper harnesses that new evaluation experience to expand the framework, with additional features, such as stratification, to examine subgroups most likely to experience improvement if control programs are working; the use of a national platform framework; and analysis of complete birth histories from national household surveys. The refined framework has shown that, despite persisting data challenges, combining multiple sources of data, considering potential contributions from both fundamental and proximate contextual factors, and conducting subnational analyses allows identification of the plausible contributions of malaria control interventions on malaria morbidity and mortality.

  12. Exploring the use of routinely-available, retrospective data to study the association between malaria control scale-up and micro-economic outcomes in Zambia.

    Science.gov (United States)

    Comfort, Alison; Leegwater, Anthony; Nakhimovsky, Sharon; Kansembe, Henry; Hamainza, Busiku; Bwalya, Benson; Alilio, Martin; Johns, Ben; Olsho, Lauren

    2017-01-04

    Country-level evidence on the impact of malaria control on micro-economic outcomes is vital for mobilizing domestic and donor resources for malaria control. Using routinely available survey data could facilitate this investigation in a cost-efficient way. The authors used Malaria Indicator Surveys (MIS) and Living Conditions Monitoring Survey (LCMS) data from 2006 to 2010 for all 72 districts in Zambia to relate malaria control scale-up with household food spending (proxy for household well-being), educational attainment and agricultural production. The authors used two quasi-experimental designs: (1) a generalized propensity score for a continuous treatment variable (defined as coverage from owning insecticide-treated bed nets and/or receipt of indoor residual spraying); and, (2) a district fixed effects model to assess changes in the outcome relative to changes in treatment pre-post scale-up. The unit of analysis was at district level. The authors also conducted simulations post-analysis to assess statistical power. Micro-economic outcomes increased (33% increase in food spending) concurrently with malaria control coverage (62% increase) from 2006 to 2010. Despite using data from all 72 districts, both analytic methods yielded wide confidence intervals that do not conclusively link outcomes and malaria control coverage increases. The authors cannot rule out positive, null or negative effects. The upper bound estimates of the results show that if malaria control coverage increases from 60 to 70%, food spending could increase up to 14%, maize production could increase up to 57%, and years of schooling could increase up to 0.5 years. Simulations indicated that the generalized propensity score model did not have good statistical power. While it is technically possible to use routinely available survey data to relate malaria control scale-up and micro-economic outcomes, it is not clear from this analysis that meaningful results can be obtained when survey data are

  13. Scale-up of a programme for malaria vector control using long-lasting insecticide-treated nets: lessons from South Sudan.

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    Chanda, Emmanuel; Remijo, Constantino D; Pasquale, Harriet; Baba, Samson P; Lako, Richard L

    2014-04-01

    Long-lasting insecticidal nets (LLINs) are important tools in malaria control. South Sudan, like many other endemic countries, has struggled to improve LLIN coverage and utilization. In 2006, Southern Sudan - known as South Sudan after independence in 2011 - initiated a strategic plan to increase LLIN coverage so that at least 60% of households had at least one LLIN each. By 2008, the target coverage was 80% of households and the Global Fund had financed a phased scale-up of LLIN distribution in the region. South Sudan's entire population is considered to be at risk of malaria. Poor control of the vectors and the large-scale movements of returnees, internally displaced people and refugees have exacerbated the problem. By 2012, approximately 8.0 million LLINs had been distributed in South Sudan. Between 2006 and 2009, the percentage of households possessing at least one LLIN increased from about 12% to 53% and LLIN utilization rates increased from 5 to 25% among children younger than 5 years and from 5 to 36% among pregnant women. The number of recorded malaria cases increased from 71 948 in 2008 to 1 198 357 in 2012. In post-conflict settings, a phased programme for the national scale-up of LLIN coverage may not have a substantial impact. A nationwide campaign that is centrally coordinated and based on sound guidelines may offer greater benefits. A strong partnership base and effective channels for the timely and supplementary deployment of LLINs may be essential for universal coverage.

  14. Seasonal Malaria Chemoprevention with Sulphadoxine-Pyrimethamine and Amodiaquine Selects Pfdhfr-dhps Quintuple Mutant Genotype in Mali.

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    Hamma Maiga

    Full Text Available Seasonal malaria chemoprevention (SMC with sulphadoxine-pyrimethamine (SP plus amodiaquine (AQ is being scaled up in Sahelian countries of West Africa. However, the potential development of Plasmodium falciparum resistance to the respective component drugs is a major concern.Two cross-sectional surveys were conducted before (August 2012 and after (June 2014 a pilot implementation of SMC in Koutiala, Mali. Children aged 3-59 months received 7 rounds of curative doses of SP plus AQ over two malaria seasons. Genotypes of P. falciparum Pfdhfr codons 51, 59 and 108; Pfdhps codons 437 and 540, Pfcrt codon 76 and Pfmdr1codon 86 were analyzed by PCR on DNA from samples collected before and after SMC, and in non-SMC patient population as controls (November 2014.In the SMC population 191/662 (28.9% and 85/670 (12.7% of children were P. falciparum positive by microscopy and were included in the molecular analysis before (2012 and after SMC implementation (2014, respectively. In the non-SMC patient population 220/310 (71% were successfully PCR analyzed. In the SMC children, the prevalence of all molecular markers of SP resistance increased significantly after SMC including the Pfdhfr-dhps quintuple mutant genotype, which was 1.6% before but 7.1% after SMC (p = 0.02. The prevalence of Pfmdr1-86Y significantly decreased from 26.7% to 15.3% (p = 0.04 while no significant change was seen for Pfcrt 76T. In 2014, prevalence of all molecular markers of SP resistance were significantly higher among SMC children compared to the non-SMC population patient (p < 0.01. No Pfdhfr-164 mutation was found neither at baseline nor post SMC.SMC increased the prevalence of molecular markers of P. falciparum resistance to SP in the treated children. However, there was no significant increase of these markers of resistance in the general parasite population after 2 years and 7 rounds of SMC.

  15. Seasonal Malaria Chemoprevention with Sulphadoxine-Pyrimethamine and Amodiaquine Selects Pfdhfr-dhps Quintuple Mutant Genotype in Mali.

    Science.gov (United States)

    Maiga, Hamma; Lasry, Estrella; Diarra, Modibo; Sagara, Issaka; Bamadio, Amadou; Traore, Aliou; Coumare, Samba; Bahonan, Soma; Sangare, Boubou; Dicko, Yeyia; Diallo, Nouhoum; Tembely, Aly; Traore, Djibril; Niangaly, Hamidou; Dao, François; Haidara, Aboubecrine; Dicko, Alassane; Doumbo, Ogobara K; Djimde, Abdoulaye A

    Seasonal malaria chemoprevention (SMC) with sulphadoxine-pyrimethamine (SP) plus amodiaquine (AQ) is being scaled up in Sahelian countries of West Africa. However, the potential development of Plasmodium falciparum resistance to the respective component drugs is a major concern. Two cross-sectional surveys were conducted before (August 2012) and after (June 2014) a pilot implementation of SMC in Koutiala, Mali. Children aged 3-59 months received 7 rounds of curative doses of SP plus AQ over two malaria seasons. Genotypes of P. falciparum Pfdhfr codons 51, 59 and 108; Pfdhps codons 437 and 540, Pfcrt codon 76 and Pfmdr1codon 86 were analyzed by PCR on DNA from samples collected before and after SMC, and in non-SMC patient population as controls (November 2014). In the SMC population 191/662 (28.9%) and 85/670 (12.7%) of children were P. falciparum positive by microscopy and were included in the molecular analysis before (2012) and after SMC implementation (2014), respectively. In the non-SMC patient population 220/310 (71%) were successfully PCR analyzed. In the SMC children, the prevalence of all molecular markers of SP resistance increased significantly after SMC including the Pfdhfr-dhps quintuple mutant genotype, which was 1.6% before but 7.1% after SMC (p = 0.02). The prevalence of Pfmdr1-86Y significantly decreased from 26.7% to 15.3% (p = 0.04) while no significant change was seen for Pfcrt 76T. In 2014, prevalence of all molecular markers of SP resistance were significantly higher among SMC children compared to the non-SMC population patient (p < 0.01). No Pfdhfr-164 mutation was found neither at baseline nor post SMC. SMC increased the prevalence of molecular markers of P. falciparum resistance to SP in the treated children. However, there was no significant increase of these markers of resistance in the general parasite population after 2 years and 7 rounds of SMC.

  16. Genomic Footprints of Selective Sweeps from Metabolic Resistance to Pyrethroids in African Malaria Vectors Are Driven by Scale up of Insecticide-Based Vector Control.

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    Barnes, Kayla G; Weedall, Gareth D; Ndula, Miranda; Irving, Helen; Mzihalowa, Themba; Hemingway, Janet; Wondji, Charles S

    2017-02-01

    Insecticide resistance in mosquito populations threatens recent successes in malaria prevention. Elucidating patterns of genetic structure in malaria vectors to predict the speed and direction of the spread of resistance is essential to get ahead of the 'resistance curve' and to avert a public health catastrophe. Here, applying a combination of microsatellite analysis, whole genome sequencing and targeted sequencing of a resistance locus, we elucidated the continent-wide population structure of a major African malaria vector, Anopheles funestus. We identified a major selective sweep in a genomic region controlling cytochrome P450-based metabolic resistance conferring high resistance to pyrethroids. This selective sweep occurred since 2002, likely as a direct consequence of scaled up vector control as revealed by whole genome and fine-scale sequencing of pre- and post-intervention populations. Fine-scaled analysis of the pyrethroid resistance locus revealed that a resistance-associated allele of the cytochrome P450 monooxygenase CYP6P9a has swept through southern Africa to near fixation, in contrast to high polymorphism levels before interventions, conferring high levels of pyrethroid resistance linked to control failure. Population structure analysis revealed a barrier to gene flow between southern Africa and other areas, which may prevent or slow the spread of the southern mechanism of pyrethroid resistance to other regions. By identifying a genetic signature of pyrethroid-based interventions, we have demonstrated the intense selective pressure that control interventions exert on mosquito populations. If this level of selection and spread of resistance continues unabated, our ability to control malaria with current interventions will be compromised.

  17. Scale-up of home-based management of malaria based on rapid diagnostic tests and artemisinin-based combination therapy in a resource-poor country: results in Senegal

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    Thiam Sylla

    2012-09-01

    Full Text Available Abstract Background Effective case management of malaria requires prompt diagnosis and treatment within 24 hours. Home-based management of malaria (HMM improves access to treatment for populations with limited access to health facilities. In Senegal, an HMM pilot study in 2008 demonstrated the feasibility of integrated use of RDTs and ACT in remote villages by volunteer Home Care Providers (HCP. Scale-up of the strategy began in 2009, reaching 408 villages in 2009 and 861 villages in 2010. This paper reports the results of the scale-up in the targeted communities and the impact of the strategy on malaria in the formal health sector. Methods Data reported by the HCPs were used to assess their performance in 2009 and 2010, while routine malaria morbidity and mortality data were used to assess the impact of the HMM programme. Two high transmission regions where HMM was not implemented until 2010 were used as a comparison. Results and discussion From July 2009 through May 2010, 12582 suspected cases were managed by HCPs, 93% (11672 of whom were tested with an RDT. Among those tested, 37% (4270 had a positive RDT, 97% (4126 of whom were reported treated and cured. Home care providers referred 6871 patients to health posts for management: 6486 with a negative RDT, 119 infants  Conclusion Home-based management of malaria including diagnosis with RDT and treatment based on test results is a promising strategy to improve the access of remote populations to prompt and effective management of uncomplicated malaria and to decrease mortality due to malaria. When scaled-up to serve remote village communities in the regions of Senegal with the highest malaria prevalence, home care providers demonstrated excellent adherence to guidelines, potentially contributing to a decrease in hospital deaths attributed to malaria.

  18. Estimated impact on birth weight of scaling up intermittent preventive treatment of malaria in pregnancy given sulphadoxine-pyrimethamine resistance in Africa: A mathematical model.

    Science.gov (United States)

    Walker, Patrick G T; Floyd, Jessica; Ter Kuile, Feiko; Cairns, Matt

    2017-02-01

    estimates of resistance. Forty-four percent of these pregnancies (23% of all pregnancies) were not receiving any IPTp-SP despite making ≥3 ANC visits, representing 160,000 (94,000-236,000 95% crI) preventable low birthweight (LBW) deliveries. Only 4% (1.4 million) of pregnancies occurred in settings with >10% prevalence of the sextuple haplotype associated with compromised SP effectiveness. Forty-two percent of all pregnancies occurred in settings where the quintuple dhfr/dhps haplotype had become established but where in vivo efficacy data suggest SP maintains the majority of its effectiveness in clearing infections. Not accounting for protection from the use of ITNs during pregnancy, expanding IPTp-SP to all women with ≥3 ANC visits in Africa could prevent an additional 215,000 (128,000-318,000 95% crI) LBW deliveries. In 26 countries with sufficient recent data to estimate ITN impact (population-based ITN usage data that can be stratified by gravidity), we estimate that, due primarily to low ITN use by primigravidae, only 16.5% of the potential LBW births prevented by scaling up IPTp-SP would in fact have already have been prevented through ITN use. Our analysis also highlights the difficulties associated with estimating the relationship between the effectiveness of interventions against parasitological endpoints such as placental infection at delivery and health outcomes including birthweight, which is also determined by a wide range of unrelated factors. We also did not capture other aspects of malaria burden such as clinical malaria, maternal and neonatal anaemia, and miscarriage, all of which increase the overall importance of effective preventative strategies but have their own relationship with transmission intensity, parity, and SP resistance. Despite recent declines in malaria transmission in Africa, the burden of MiP in the absence of adequate prevention remains substantial. Even accounting for SP resistance, extending IPTp-SP to all women attending ANC, as

  19. Seasonal malaria chemoprevention in an area of extended seasonal transmission in Ashanti, Ghana: an individually randomised clinical trial.

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    Tagbor, Harry; Antwi, Gifty Dufie; Acheampong, Princess Ruhama; Bart Plange, Constance; Chandramohan, Daniel; Cairns, Matthew

    2016-02-01

    To investigate the effectiveness of seasonal malaria chemoprevention (SMC) and community case management with long-acting artemisinin-based combination therapies (ACTs) for the control of malaria in areas of extended seasonal malaria transmission. Individually randomised, placebo-controlled trial in the Ashanti Region of Ghana. A total of 2400 children aged 3-59 months received either: (i) a short-acting ACT for case management of malaria (artemether-lumefantrine, AL) plus placebo SMC, or (ii) a long-acting ACT (dihydroartemisinin-piperaquine, DP) for case management plus placebo SMC or (iii) AL for case management plus active SMC with sulphadoxine-pyrimethamine and amodiaquine. SMC or placebo was delivered on five occasions during the rainy season. Malaria cases were managed by community health workers, who used rapid diagnostic tests to confirm infection prior to treatment. The incidence of malaria was lower in children given SMC during the rainy season. Compared to those given placebo SMC and AL for case management, the adjusted hazard ratio (aHR) was 0.62 (95% CI: 0.41, 0.93), P = 0.020 by intention to treat and 0.53 (95% CI: 0.29, 0.95), P = 0.033 among children given five SMC courses. There were no major differences between groups given different ACTs for case management (aHR DP vs. AL 1.18 (95% CI 0.83, 1.67), P = 0.356). SMC may have an important public health impact in areas with a longer transmission season, but further optimisation of SMC schedules is needed to maximise its impact in such settings. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  20. Integrated community case management of malaria, pneumonia and diarrhoea across three African countries: A qualitative study exploring lessons learnt and implications for further scale up

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    Clare Strachan

    2014-12-01

    Full Text Available Numerous studies highlight the effectiveness of an integrated approach for the management of malaria, pneumonia and diarrhoea at the community level. There has however been little study on lessons learnt from implementation in practice and stakeholder experiences which could inform future programmatic planning and evaluation frameworks. A participatory, qualitative evaluation was conducted in the three varied settings of South Sudan, Uganda and Zambia, which have seen the scale up of integrated community case management (iCCM over the last five years. All key in–country stakeholders were consulted on study design, with a particular focus on scope and methodology. Data collection methods included stakeholder consultations (key informant interviews, focus group discussions, and a review of project and Ministry of Health documentation. Data analysis followed the Framework Approach. Results suggest that iCCM implementation generally followed national pre–agreed guidelines. Overarching key programmatic recommendations included: collaboration with implementing partners in planning stages to positively impact on community acceptance and ownership; adoption of participatory training methods adapted to low literacy populations; development of alternative support supervision methods such as peer support groups; full integration of community level data into the health management information system and emphasizing data analysis, use and feedback at all levels; strengthened supply chains through improved quantification and procurement of commodities in conjunction with the national distribution network; community engagement to establish a support system for community health workers to increase their motivation; enhanced sensitisation and behaviour change communication to raise awareness and usage of appropriate health services; and advocacy at the national level for funding and logistical support for the continuation and integration of iCCM. This

  1. Impact and Lessons Learned from Mass Drug Administrations of Malaria Chemoprevention during the Ebola Outbreak in Monrovia, Liberia, 2014.

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    Anna Kuehne

    Full Text Available In October 2014, during the Ebola outbreak in Liberia healthcare services were limited while malaria transmission continued. Médecins Sans Frontières (MSF implemented a mass drug administration (MDA of malaria chemoprevention (CP in Monrovia to reduce malaria-associated morbidity. In order to inform future interventions, we described the scale of the MDA, evaluated its acceptance and estimated the effectiveness.MSF carried out two rounds of MDA with artesunate/amodiaquine (ASAQ targeting four neighbourhoods of Monrovia (October to December 2014. We systematically selected households in the distribution area and administered standardized questionnaires. We calculated incidence ratios (IR of side effects using poisson regression and compared self-reported fever risk differences (RD pre- and post-MDA using a z-test.In total, 1,259,699 courses of ASAQ-CP were distributed. All households surveyed (n = 222; 1233 household members attended the MDA in round 1 (r1 and 96% in round 2 (r2 (212/222 households; 1,154 household members. 52% (643/1233 initiated ASAQ-CP in r1 and 22% (256/1154 in r2. Of those not initiating ASAQ-CP, 29% (172/590 saved it for later in r1, 47% (423/898 in r2. Experiencing side effects in r1 was not associated with ASAQ-CP initiation in r2 (IR 1.0, 95%CI 0.49-2.1. The incidence of self-reported fever decreased from 4.2% (52/1229 in the month prior to r1 to 1.5% (18/1229 after r1 (p<0.001 and decrease was larger among household members completing ASAQ-CP (RD = 4.9% compared to those not initiating ASAQ-CP (RD = 0.6% in r1 (p<0.001.The reduction in self-reported fever cases following the intervention suggests that MDAs may be effective in reducing cases of fever during Ebola outbreaks. Despite high coverage, initiation of ASAQ-CP was low. Combining MDAs with longer term interventions to prevent malaria and to improve access to healthcare may reduce both the incidence of malaria and the proportion of respondents saving their

  2. Prospects, achievements, challenges and opportunities for scaling-up malaria chemoprevention in pregnancy in Tanzania: the perspective of national level officers

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey; Bygbjerg, Ib; Magnussen, Pascal

    2008-01-01

    of peripheral health facilities has been inadequate and national guidelines on district budgeting for health services have been inflexible. IPTp coverage is generally low partly because IPTp is not systematically enforced like programmes on immunization, tuberculosis, leprosy and other infectious diseases...

  3. Trends in malaria cases, hospital admissions and deaths following scale-up of anti-malarial interventions, 2000-2010, Rwanda.

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    Karema, Corine; Aregawi, Maru W; Rukundo, Alphonse; Kabayiza, Alain; Mulindahabi, Monique; Fall, Ibrahima S; Gausi, Khoti; Williams, Ryan O; Lynch, Michael; Cibulskis, Richard; Fidele, Ngabo; Nyemazi, Jean-Pierre; Ngamije, Daniel; Umulisa, Irenee; Newman, Robert; Binagwaho, Agnes

    2012-07-23

    To control malaria, the Rwandan government and its partners distributed insecticide-treated nets (ITN) and made artemisinin-based combination therapy (ACT) widely available from 2005 onwards. The impact of these interventions on malaria cases, admissions and deaths was assessed using data from district hospitals and household surveys. District records of ITN and ACT distribution were reviewed. Malaria and non-malaria indictors in 30 district hospitals were ascertained from surveillance records. Trends in cases, admissions and deaths for 2000 to 2010 were assessed by segmented log-linear regression, adjusting the effect size for time trends during the pre-intervention period, 2000-2005. Changes were estimated by comparing trends in post-intervention (2006-2010) with that of pre-intervention (2000-2005) period. All-cause deaths in children under-five in household surveys of 2005 and 2010 were also reviewed to corroborate with the trends of deaths observed in hospitals. The proportion of the population potentially protected by ITN increased from nearly zero in 2005 to 38% in 2006, and 76% in 2010; no major health facility stock-outs of ACT were recorded following their introduction in 2006. In district hospitals, after falling during 2006-2008, confirmed malaria cases increased in 2009 coinciding with decreased potential ITN coverage and declined again in 2010 following an ITN distribution campaign. For all age groups, from the pre-intervention period, microscopically confirmed cases declined by 72%, (95% Confidence Interval [CI], 12-91%) in 2010, slide positivity rate declined 58%, (CI, 47%-68%), malaria inpatient cases declined 76% (CI, 49%-88%); and malaria deaths declined 47% (CI, 47%-81%). In children below five years of age, malaria inpatients decreased 82% (CI, 61%-92%) and malaria hospital deaths decreased 77% (CI, 40%-91%). Concurrently, outpatient cases, admissions and deaths due to non-malaria diseases in all age groups either increased or remained

  4. Trends in malaria cases, hospital admissions and deaths following scale-up of anti-malarial interventions, 2000–2010, Rwanda

    Directory of Open Access Journals (Sweden)

    Karema Corine

    2012-07-01

    Full Text Available Abstract Background To control malaria, the Rwandan government and its partners distributed insecticide-treated nets (ITN and made artemisinin-based combination therapy (ACT widely available from 2005 onwards. The impact of these interventions on malaria cases, admissions and deaths was assessed using data from district hospitals and household surveys. Methods District records of ITN and ACT distribution were reviewed. Malaria and non-malaria indictors in 30 district hospitals were ascertained from surveillance records. Trends in cases, admissions and deaths for 2000 to 2010 were assessed by segmented log-linear regression, adjusting the effect size for time trends during the pre-intervention period, 2000–2005. Changes were estimated by comparing trends in post-intervention (2006–2010 with that of pre-intervention (2000–2005 period. All-cause deaths in children under-five in household surveys of 2005 and 2010 were also reviewed to corroborate with the trends of deaths observed in hospitals. Results The proportion of the population potentially protected by ITN increased from nearly zero in 2005 to 38% in 2006, and 76% in 2010; no major health facility stock-outs of ACT were recorded following their introduction in 2006. In district hospitals, after falling during 2006–2008, confirmed malaria cases increased in 2009 coinciding with decreased potential ITN coverage and declined again in 2010 following an ITN distribution campaign. For all age groups, from the pre-intervention period, microscopically confirmed cases declined by 72%, (95% Confidence Interval [CI], 12-91% in 2010, slide positivity rate declined 58%, (CI, 47%–68%, malaria inpatient cases declined 76% (CI, 49%–88%; and malaria deaths declined 47% (CI, 47%–81%. In children below five years of age, malaria inpatients decreased 82% (CI, 61%-92% and malaria hospital deaths decreased 77% (CI, 40%–91%. Concurrently, outpatient cases, admissions and deaths due to non-malaria

  5. Scaling up towards international targets for AIDS, tuberculosis, and malaria: contribution of global fund-supported programs in 2011-2015.

    Directory of Open Access Journals (Sweden)

    Itamar Katz

    Full Text Available OBJECTIVE: The paper projects the contribution to 2011-2015 international targets of three major pandemics by programs in 140 countries funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest external financier of tuberculosis and malaria programs and a major external funder of HIV programs in low and middle income countries. DESIGN: Estimates, using past trends, for the period 2011-2015 of the number of persons receiving antiretroviral (ARV treatment, tuberculosis case detection using the internationally approved DOTS strategy, and insecticide-treated nets (ITNs to be delivered by programs in low and middle income countries supported by the Global Fund compared to international targets established by UNAIDS, Stop TB Partnership, Roll Back Malaria Partnership and the World Health Organisation. RESULTS: Global Fund-supported programs are projected to provide ARV treatment to 5.5-5.8 million people, providing 30%-31% of the 2015 international target. Investments in tuberculosis and malaria control will enable reaching in 2015 60%-63% of the international target for tuberculosis case detection and 30%-35% of the ITN distribution target in sub-Saharan Africa. CONCLUSION: Global Fund investments will substantially contribute to the achievement by 2015 of international targets for HIV, TB and malaria. However, additional large scale international and domestic financing is needed if these targets are to be reached by 2015.

  6. Assessment of molecular markers for anti-malarial drug resistance after the introduction and scale-up of malaria control interventions in western Kenya.

    Science.gov (United States)

    Shah, Monica; Omosun, Yusuf; Lal, Ashima; Odero, Christopher; Gatei, Wangeci; Otieno, Kephas; Gimnig, John E; ter Kuile, Feiko; Hawley, William A; Nahlen, Bernard; Kariuki, Simon; Walker, Edward; Slutsker, Laurence; Hamel, Mary; Shi, Ya Ping

    2015-02-14

    Although it is well known that drug pressure selects for drug-resistant parasites, the role of transmission reduction by insecticide-treated bed nets (ITNs) on drug resistance remains unclear. In this study, the drug resistance profile of current and previous first-line anti-malarials in Kenya was assessed within the context of drug policy change and scale-up of ITNs. National first-line treatment changed from chloroquine (CQ) to sulphadoxine-pyrimethamine (SP) in 1998 and to artemether-lumefantrine (AL) in 2004. ITN use was scaled-up in the Asembo, Gem and Karemo areas of western Kenya in 1997, 1999 and 2006, respectively. Smear-positive samples (N = 253) collected from a 2007 cross-sectional survey among children in Asembo, Gem and Karemo were genotyped for mutations in pfcrt and pfmdr1 (CQ), dhfr and dhps (SP), and at pfmdr-N86 and the gene copy number in pfmdr1 (lumefantrine). Results were compared among the three geographic areas in 2007 and to retrospective molecular data from children in Asembo in 2001. In 2007, 69 and 85% of samples harboured the pfmdr1-86Y mutation and dhfr/dhps quintuple mutant, respectively, with no significant differences by study area. However, the prevalence of the pfcrt-76T mutation differed significantly among areas (p dhps-436A, or dhps-613T. From 2001 to 2007, there were significant increases in the pfcrt-76T mutation from 82 to 94% (p dhps quintuple mutant from 62 to 82% (p drug pressure from the continued use of CQ, SP, and mechanistically similar drugs, such as amodiaquine and cotrimoxazole. There was no clear evidence that differences in transmission intensity, as a result of ITN scale-up, influenced the prevalence of drug resistance molecular markers.

  7. The use of formative research to inform the design of a seasonal malaria chemoprevention intervention in northern Nigeria.

    Science.gov (United States)

    Strachan, Clare E; Kana, Musa; Martin, Sandrine; Dada, John; Wandera, Naome; Marasciulo, Madeleine; Counihan, Helen; Kolawole, Maxwell; Babale, Tanimu; Hamade, Prudence; Meek, Sylvia R; Baba, Ebenezer

    2016-09-15

    Experience of seasonal malaria chemoprevention (SMC) is growing in the Sahel sub-region of Africa, though there remains insufficient evidence to recommend a standard deployment strategy. In 2012, a project was initiated in Katsina state, northern Nigeria, to design an appropriate and effective community-based delivery approach for SMC, in consultation with local stakeholders. Formative research (FR) was conducted locally to explore the potential feasibility and acceptability of SMC and to highlight information gaps and practical considerations to inform the intervention design. The FR adopted qualitative methods; 36 in-depth interviews and 18 focus group discussions were conducted across 13 target groups active across the health system and within the community. Analysis followed the 'framework' approach. The process for incorporating the FR results into the project design was iterative which was initiated by a week-long 'intervention design' workshop with relevant stakeholders. The FR highlighted both supportive and hindering factors to be considered in the intervention design. Malaria control was identified as a community priority, the community health workers were a trusted resource and the local leadership exerted strong influence over household decisions. However, there were perceived challenges with quality of care at both community and health facility levels, referral linkage and supportive supervision were weak, literacy levels lower than anticipated and there was the potential for suspicion of 'outside' interventions. There was broad consensus across target groups that community-based SMC drug delivery would better enable a high coverage of beneficiaries and potentially garner wider community support. A mixed approach was recommended, including both community fixed-point and household-to-household SMC delivery. The FR findings were used to inform the overall distribution strategy, mechanisms for integration into the health system, capacity building and

  8. Effectiveness of Seasonal Malaria Chemoprevention in Children under Ten Years of Age in Senegal: A Stepped-Wedge Cluster-Randomised Trial.

    Science.gov (United States)

    Cissé, Badara; Ba, El Hadj; Sokhna, Cheikh; NDiaye, Jean Louis; Gomis, Jules F; Dial, Yankhoba; Pitt, Catherine; NDiaye, Mouhamed; Cairns, Matthew; Faye, Ernest; NDiaye, Magatte; Lo, Aminata; Tine, Roger; Faye, Sylvain; Faye, Babacar; Sy, Ousmane; Konate, Lansana; Kouevijdin, Ekoue; Flach, Clare; Faye, Ousmane; Trape, Jean-Francois; Sutherland, Colin; Fall, Fatou Ba; Thior, Pape M; Faye, Oumar K; Greenwood, Brian; Gaye, Oumar; Milligan, Paul

    2016-11-01

    Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ), given each month during the transmission season, is recommended for children living in areas of the Sahel where malaria transmission is highly seasonal. The recommendation for SMC is currently limited to children under five years of age, but, in many areas of seasonal transmission, the burden in older children may justify extending this age limit. This study was done to determine the effectiveness of SMC in Senegalese children up to ten years of age. SMC was introduced into three districts over three years in central Senegal using a stepped-wedge cluster-randomised design. A census of the population was undertaken and a surveillance system was established to record all deaths and to record all cases of malaria seen at health facilities. A pharmacovigilance system was put in place to detect adverse drug reactions. Fifty-four health posts were randomised. Nine started implementation of SMC in 2008, 18 in 2009, and a further 18 in 2010, with 9 remaining as controls. In the first year of implementation, SMC was delivered to children aged 3-59 months; the age range was then extended for the latter two years of the study to include children up to 10 years of age. Cluster sample surveys at the end of each transmission season were done to measure coverage of SMC and the prevalence of parasitaemia and anaemia, to monitor molecular markers of drug resistance, and to measure insecticide-treated net (ITN) use. Entomological monitoring and assessment of costs of delivery in each health post and of community attitudes to SMC were also undertaken. About 780,000 treatments were administered over three years. Coverage exceeded 80% each month. Mortality, the primary endpoint, was similar in SMC and control areas (4.6 and 4.5 per 1000 respectively in children under 5 years and 1.3 and 1.2 per 1000 in children 5-9 years of age; the overall mortality rate ratio [SMC: no SMC] was 0.90, 95

  9. Chemopreventive and remediation effect of Adansonia digitata L. Baobab (Bombacaceae) stem bark extracts in mouse model malaria.

    Science.gov (United States)

    Adeoye, A O; Bewaji, C O

    2018-01-10

    Adansonia digitata L. Baobab (Bombacaceae) solvent extracts have been reported to possess medicinal properties and are currently been used traditionally for the treatment of malaria and several other diseases and infection; however few reports exist in literature that provides supportive scientific evidence in favour of its medicinal use. This study investigated the efficacy of Adansonia digitata stem bark extract in offering protection against experimental malaria and also examined its remediation effect when administered after established infection. Weanling albino mice were used in the study. The mice were transfected intraperitonially with an inoculums size of 1× 107 of chloroquine susceptible strain of plasmodium berghei infected erythrocytes. Mechanisms of action of the extract were investigated by measuring the degree of tissue peroxidation and tissue antioxidant status. Severity of malaria was determined by measuring the serum C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and serum and tissue Alkaline phosphatase (ALP) activity. There was a significant increase in serum CRP, TNF-α concentrations and serum and tissue ALP activity in the control mice following Plasmodium berghei infection. All the treatment had effect on the growth of Plasmodium berghei parasites in mice. The extracts showed a significant dose dependent increase packed cell volume (PCV), percentage chemosupression/clearance and a significant decrease in percentage parasitemia at the two doses when administered after established infection. Methanolic extract (MEAD) at 400mg/kg exhibited the highest chemosupressive activity. The extract significantly reduced the degree of tissue peroxidation, increased the level of reduced glutathione (GSH), catalase and superoxide dismutase activity. Administration of the extract after established infection reduced serum CRP and TNF-α concentrations and serum and tissue ALP activity. Our study suggests that Adansonia digitata protects

  10. Effectiveness of Seasonal Malaria Chemoprevention in Children under Ten Years of Age in Senegal: A Stepped-Wedge Cluster-Randomised Trial.

    Directory of Open Access Journals (Sweden)

    Badara Cissé

    2016-11-01

    Full Text Available Seasonal Malaria Chemoprevention (SMC with sulfadoxine-pyrimethamine (SP plus amodiaquine (AQ, given each month during the transmission season, is recommended for children living in areas of the Sahel where malaria transmission is highly seasonal. The recommendation for SMC is currently limited to children under five years of age, but, in many areas of seasonal transmission, the burden in older children may justify extending this age limit. This study was done to determine the effectiveness of SMC in Senegalese children up to ten years of age.SMC was introduced into three districts over three years in central Senegal using a stepped-wedge cluster-randomised design. A census of the population was undertaken and a surveillance system was established to record all deaths and to record all cases of malaria seen at health facilities. A pharmacovigilance system was put in place to detect adverse drug reactions. Fifty-four health posts were randomised. Nine started implementation of SMC in 2008, 18 in 2009, and a further 18 in 2010, with 9 remaining as controls. In the first year of implementation, SMC was delivered to children aged 3-59 months; the age range was then extended for the latter two years of the study to include children up to 10 years of age. Cluster sample surveys at the end of each transmission season were done to measure coverage of SMC and the prevalence of parasitaemia and anaemia, to monitor molecular markers of drug resistance, and to measure insecticide-treated net (ITN use. Entomological monitoring and assessment of costs of delivery in each health post and of community attitudes to SMC were also undertaken. About 780,000 treatments were administered over three years. Coverage exceeded 80% each month. Mortality, the primary endpoint, was similar in SMC and control areas (4.6 and 4.5 per 1000 respectively in children under 5 years and 1.3 and 1.2 per 1000 in children 5-9 years of age; the overall mortality rate ratio [SMC: no SMC

  11. ScaleUp America Communities

    Data.gov (United States)

    Small Business Administration — SBA’s new ScaleUp America Initiative is designed to help small firms with high potential “scale up” and grow their businesses so that they will provide more jobs and...

  12. Scaling up of renewable chemicals.

    Science.gov (United States)

    Sanford, Karl; Chotani, Gopal; Danielson, Nathan; Zahn, James A

    2016-04-01

    The transition of promising technologies for production of renewable chemicals from a laboratory scale to commercial scale is often difficult and expensive. As a result the timeframe estimated for commercialization is typically underestimated resulting in much slower penetration of these promising new methods and products into the chemical industries. The theme of 'sugar is the next oil' connects biological, chemical, and thermochemical conversions of renewable feedstocks to products that are drop-in replacements for petroleum derived chemicals or are new to market chemicals/materials. The latter typically offer a functionality advantage and can command higher prices that result in less severe scale-up challenges. However, for drop-in replacements, price is of paramount importance and competitive capital and operating expenditures are a prerequisite for success. Hence, scale-up of relevant technologies must be interfaced with effective and efficient management of both cell and steel factories. Details involved in all aspects of manufacturing, such as utilities, sterility, product recovery and purification, regulatory requirements, and emissions must be managed successfully. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The SCALE-UP Project

    Science.gov (United States)

    Beichner, Robert

    2015-03-01

    The Student Centered Active Learning Environment with Upside-down Pedagogies (SCALE-UP) project was developed nearly 20 years ago as an economical way to provide collaborative, interactive instruction even for large enrollment classes. Nearly all research-based pedagogies have been designed with fairly high faculty-student ratios. The economics of introductory courses at large universities often precludes that situation, so SCALE-UP was created as a way to facilitate highly collaborative active learning with large numbers of students served by only a few faculty and assistants. It enables those students to learn and succeed not only in acquiring content, but also to practice important 21st century skills like problem solving, communication, and teamsmanship. The approach was initially targeted at undergraduate science and engineering students taking introductory physics courses in large enrollment sections. It has since expanded to multiple content areas, including chemistry, math, engineering, biology, business, nursing, and even the humanities. Class sizes range from 24 to over 600. Data collected from multiple sites around the world indicates highly successful implementation at more than 250 institutions. NSF support was critical for initial development and dissemination efforts. Generously supported by NSF (9752313, 9981107) and FIPSE (P116B971905, P116B000659).

  14. Malaria.

    Science.gov (United States)

    Dupasquier, Isabelle

    1989-01-01

    Malaria, the greatest pandemia in the world, claims an estimated one million lives each year in Africa alone. While it may still be said that for the most part malaria is found in what is known as the world's poverty belt, cases are now frequently diagnosed in western countries. Due to resistant strains of malaria which have developed because of…

  15. Safety of Seasonal Malaria Chemoprevention (SMC with Sulfadoxine-Pyrimethamine plus Amodiaquine when Delivered to Children under 10 Years of Age by District Health Services in Senegal: Results from a Stepped-Wedge Cluster Randomized Trial.

    Directory of Open Access Journals (Sweden)

    J L NDiaye

    Full Text Available It is recommended that children aged 3 months to five years of age living in areas of seasonal transmission in the sub-Sahel should receive Seasonal Malaria Chemoprevention (SMC with sulfadoxine-pyrimethamine plus amodiaquine (SPAQ during the malaria transmission season. The purpose of this study was to evaluate the safety of SMC with SPAQ in children when delivered by community health workers in three districts in Senegal where SMC was introduced over three years, in children from 3 months of age to five years of age in the first year, then in children up to 10 years of age.A surveillance system was established to record all deaths and all malaria cases diagnosed at health facilities and a pharmacovigilance system was established to detect adverse drug reactions. Health posts were randomized to introduce SMC in a stepped wedge design. SMC with SPAQ was administered once per month from September to November, by nine health-posts in 2008, by 27 in 2009 and by 45 in 2010.After three years, 780,000 documented courses of SMC had been administered. High coverage was achieved. No serious adverse events attributable to the intervention were detected, despite a high level of surveillance.SMC is being implemented in countries of the sub-Sahel for children under 5 years of age, but in some areas the age distribution of cases of malaria may justify extending this age limit, as has been done in Senegal. Our results show that SMC is well tolerated in children under five and in older children. However, pharmacovigilance should be maintained where SMC is implemented and provision for strengthening national pharmacovigilance systems should be included in plans for SMC implementation.ClinicalTrials.gov NCT 00712374.

  16. Spectrum-Malaria: a user-friendly projection tool for health impact assessment and strategic planning by malaria control programmes in sub-Saharan Africa.

    Science.gov (United States)

    Hamilton, Matthew; Mahiane, Guy; Werst, Elric; Sanders, Rachel; Briët, Olivier; Smith, Thomas; Cibulskis, Richard; Cameron, Ewan; Bhatt, Samir; Weiss, Daniel J; Gething, Peter W; Pretorius, Carel; Korenromp, Eline L

    2017-02-10

    Scale-up of malaria prevention and treatment needs to continue but national strategies and budget allocations are not always evidence-based. This article presents a new modelling tool projecting malaria infection, cases and deaths to support impact evaluation, target setting and strategic planning. Nested in the Spectrum suite of programme planning tools, the model includes historic estimates of case incidence and deaths in groups aged up to 4, 5-14, and 15+ years, and prevalence of Plasmodium falciparum infection (PfPR) among children 2-9 years, for 43 sub-Saharan African countries and their 602 provinces, from the WHO and malaria atlas project. Impacts over 2016-2030 are projected for insecticide-treated nets (ITNs), indoor residual spraying (IRS), seasonal malaria chemoprevention (SMC), and effective management of uncomplicated cases (CMU) and severe cases (CMS), using statistical functions fitted to proportional burden reductions simulated in the P. falciparum dynamic transmission model OpenMalaria. In projections for Nigeria, ITNs, IRS, CMU, and CMS scale-up reduced health burdens in all age groups, with largest proportional and especially absolute reductions in children up to 4 years old. Impacts increased from 8 to 10 years following scale-up, reflecting dynamic effects. For scale-up of each intervention to 80% effective coverage, CMU had the largest impacts across all health outcomes, followed by ITNs and IRS; CMS and SMC conferred additional small but rapid mortality impacts. Spectrum-Malaria's user-friendly interface and intuitive display of baseline data and scenario projections holds promise to facilitate capacity building and policy dialogue in malaria programme prioritization. The module's linking to the OneHealth Tool for costing will support use of the software for strategic budget allocation. In settings with moderately low coverage levels, such as Nigeria, improving case management and achieving universal coverage with ITNs could achieve

  17. Malaria

    Science.gov (United States)

    ... deadly type occurs in Africa south of the Sahara Desert. Malaria symptoms include chills, flu-like symptoms, fever, vomiting, diarrhea, and jaundice. A blood test can diagnose it. It can be life-threatening. However, you can treat malaria with drugs. ...

  18. Malaria.

    Science.gov (United States)

    Fletcher, Tom E; Beeching, N J

    2013-09-01

    Malaria is a life-threatening disease, with its largest impact being due to Plasmodium falciparum infection in Africa. Military populations continue to be at a high risk of malaria and reported case series have frequently revealed poor compliance with preventative measures. The symptoms of malaria are non-specific and its management depends on awareness of the diagnosis and early recognition and treatment. This is aided by new and simple rapid diagnostic tests, but these should not replace the examination of blood films if these are available. Artemisinin combination therapy provides a more rapid and dependable cure of uncomplicated P falciparum infection, with artesunate now being the drug of choice in severe infection.

  19. Scaling up Intermittent Rice Irrigation for Malaria Control on the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Canada-Latin America and Caribbean Zika Virus Research Program. A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the... View moreCanada-Latin America and Caribbean Zika Virus ...

  20. Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria

    Directory of Open Access Journals (Sweden)

    Onwujekwe Ogochukwu C

    2012-07-01

    Full Text Available Abstract Background Malaria in pregnancy (MIP is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers’ and consumers’ perspectives. Methods The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses providing ante-natal care (ANC services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP. The data was collected from May to June 2010. Results Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p  Conclusions There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers’ knowledge and practices with regards to management of MIP.

  1. Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria.

    Science.gov (United States)

    Onwujekwe, Ogochukwu C; Soremekun, Rebecca O; Uzochukwu, Benjamin; Shu, Elvis; Onwujekwe, Obinna

    2012-07-06

    Malaria in pregnancy (MIP) is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers' and consumers' perspectives. The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses) providing ante-natal care (ANC) services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP). The data was collected from May to June 2010. Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p sector providers and 25 % of public sector providers prescribed chemoprophylaxis using pyrimethamine, chloroquine and proguanil to pregnant women. There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers' knowledge and practices with regards to management of MIP.

  2. Lessons Learned on "Scaling Up" of Projects

    Science.gov (United States)

    Viadero, Debra

    2007-01-01

    Having developed a technology-based teaching unit on weather that appeared to work well for middle school students, Nancy Butler Songer and her colleagues at the University of Michigan decided in the late 1990s to take the next logical step in their research program: They scaled up. This article discusses lessons learned by several faculty…

  3. "Scaling Up" Good Practices in Girls' Education

    Science.gov (United States)

    Subrahmanian, Ramya

    2005-01-01

    This publication focuses on strategies for meeting international targets and national goals for universalizing girls' access to, retention in and completion of quality education. This will be done through "scaling up" successful interventions, or components of interventions that can be replicated. UNESCO published this book within the…

  4. Scaling up: Distributed machine learning with cooperation

    Energy Technology Data Exchange (ETDEWEB)

    Provost, F.J. [NYNEX Science & Technology, White Plains, NY (United States); Hennessy, D.N. [Univ. of Pittsburgh, PA (United States)

    1996-12-31

    Machine-learning methods are becoming increasingly popular for automated data analysis. However, standard methods do not scale up to massive scientific and business data sets without expensive hardware. This paper investigates a practical alternative for scaling up: the use of distributed processing to take advantage of the often dormant PCs and workstations available on local networks. Each workstation runs a common rule-learning program on a subset of the data. We first show that for commonly used rule-evaluation criteria, a simple form of cooperation can guarantee that a rule will look good to the set of cooperating learners if and only if it would look good to a single learner operating with the entire data set. We then show how such a system can further capitalize on different perspectives by sharing learned knowledge for significant reduction in search effort. We demonstrate the power of the method by learning from a massive data set taken from the domain of cellular fraud detection. Finally, we provide an overview of other methods for scaling up machine learning.

  5. Scaling up the curvature of mammalian metabolism

    Directory of Open Access Journals (Sweden)

    Juan eBueno

    2014-10-01

    Full Text Available A curvilinear relationship between mammalian metabolic rate and body size on a log-log scale has been adopted in lieu of thelongstanding concept of a 3/4 allometric relationship (Kolokotrones et al. 2010. The central tenet of Metabolic Ecology (ME states that metabolism at the individual level scales-up to drive the ecology of populations, communities and ecosystems. If this tenet is correct, the curvature of metabolism should be perceived in other ecological traits. By analyzing the size scaling allometry of eight different mammalian traits including basal and field metabolic rate, offspring biomass production, ingestion rate, costs of locomotion, life span, population growth rate and population density we show that the curvature affects most ecological rates and

  6. Chemoprevention of Melanoma

    Science.gov (United States)

    Madhunapantula, SubbaRao V.; Robertson, Gavin P.

    2013-01-01

    Despite advances in drug discovery programs and molecular approaches for identifying the drug targets, incidence and mortality rates due to melanoma continues to rise at an alarming rate. Existing preventive strategies generally involve mole screening followed by surgical removal of the benign nevi and abnormal moles. However, due to lack of effective programs for screening and disease recurrence after surgical resection there is a need for better chemopreventive agents. Although sunscreens have been used extensively for protecting from UV-induced skin cancer, results of correlative population based studies are controversial, requiring further authentication to conclusively confirm the chemoprotective efficacy of sunscreens. Certain studies suggest increased skin-cancer rates in sunscreen users. Therefore, effective chemopreventive agents for preventing melanoma are urgently required. This book-chapter, reviews the current understanding regarding melanoma chemoprevention and the various strategies used to accomplish this objective. PMID:22959032

  7. [Coffee in Cancer Chemoprevention].

    Science.gov (United States)

    Neuwirthová, J; Gál, B; Smilek, P; Urbánková, P

    Coffee consumption is associated with a reduced risk of several diseases including cancer. Its chemopreventive effect has been studied in vitro, in animal models, and more recently in humans. Several modes of action have been proposed, namely, inhibition of oxidative stress and damage, activation of metabolizing liver enzymes involved in carcinogen detoxification processes, and anti-inflammatory effects. The antioxidant activity of coffee relies partly on its chlorogenic acid content and is increased during the roasting process. Maximum antioxidant activity is observed for medium-roasted coffee. The roasting process leads to the formation of several components, e.g., melanoidins, which have antioxidant and anti-inflammatory properties. Coffee also contains two specific diterpenes, cafestol and kahweol, which have anticarcinogenic properties. Roasted coffee is a complex mixture of various chemicals. Previous studies have reported that the chemopreventive components present in coffee induce apoptosis, inhibit growth and metastasis of tumor cells, and elicit antiangiogenic effects. A meta-analysis of epidemiological studies showed that coffee consumption is associated with a lower risk of developing various malignant tumors. This review summarizes the molecular mechanisms and the experimental and epidemiological evidence supporting the chemopreventive effect of coffee.Key words: coffee - chemoprevention - antioxidative enzyme - detoxification enzyme - anti-inflammatory effect The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 11. 9. 2016Accepted: 24. 11. 2016.

  8. Chemoprevention of Lung Cancer

    Science.gov (United States)

    Szabo, Eva; Mao, Jenny T.; Lam, Stephen; Reid, Mary E.

    2013-01-01

    Background: Lung cancer is the most common cause of cancer death in men and women in the United States. Cigarette smoking is the main risk factor. Former smokers are at a substantially increased risk of developing lung cancer compared with lifetime never smokers. Chemoprevention refers to the use of specific agents to reverse, suppress, or prevent the process of carcinogenesis. This article reviews the major agents that have been studied for chemoprevention. Methods: Articles of primary, secondary, and tertiary prevention trials were reviewed and summarized to obtain recommendations. Results: None of the phase 3 trials with the agents β-carotene, retinol, 13-cis-retinoic acid, α-tocopherol, N-acetylcysteine, acetylsalicylic acid, or selenium has demonstrated beneficial and reproducible results. To facilitate the evaluation of promising agents and to lessen the need for a large sample size, extensive time commitment, and expense, surrogate end point biomarker trials are being conducted to assist in identifying the most promising agents for later-stage chemoprevention trials. With the understanding of important cellular signaling pathways and the expansion of potentially important targets, agents (many of which target inflammation and the arachidonic acid pathway) are being developed and tested which may prevent or reverse lung carcinogenesis. Conclusions: By integrating biologic knowledge, additional early-phase trials can be performed in a reasonable time frame. The future of lung cancer chemoprevention should entail the evaluation of single agents or combinations that target various pathways while working toward identification and validation of intermediate end points. PMID:23649449

  9. Readiness for Change. Scaling-Up Brief. Number 3

    Science.gov (United States)

    Fixsen, Dean L.; Blase, Karen A.; Horner, Rob; Sugai, George

    2009-01-01

    The purpose of this "Brief" is to define the variables a state or large district leadership team may wish to consider as they determine if they are "ready" to invest in the scaling-up of an innovation in education. As defined here, "scaling up" means that at least 60% of the students who could benefit from an innovation have access to that…

  10. Chemoprevention by WR-2721

    Energy Technology Data Exchange (ETDEWEB)

    Grdina, D.J. [Argonne National Lab., IL (United States)]|[Chicago Univ., IL (United States). Dept. of Radiation and Cellular Oncology; Carnes, B.A. [Argonne National Lab., IL (United States)

    1993-05-01

    WR-2721 [S-2-(3-aminopropylamino)ethylphosphorothioic acid] is an effective chemopreventive agent. C57BL {times} BALB/c F{sub 1} female mice, were exposed to a single whole-body dose of 206 cGy from a {sup 60}Co photon source. Those groups treated with VATR-2721 (400 mg/kg) were administered the agent i.p. 30 min prior to irradiation. Over 90% of deaths were determined to be due to tumor involvement. WR-2721 afforded significant protection against life shortening due to radiation-induced tumors of connective tissue and epithelial tissue origins. Subsequent survival time in WR-2721-treated and irradiated animals as compared to matched irradiated-only controls was extended up to 59 days. A single exposure of animals to VVR-2721 did not affect the cumulative survival curves for unirradiated mice. WR-2721 possesses chemopreventive properties which can be clinically exploited to reduce the risk to therapy-induced secondary cancers in patients who otherwise would have an excellent prognosis for cure and long-term survival.

  11. Chemoprevention by WR-2721

    Energy Technology Data Exchange (ETDEWEB)

    Grdina, D.J. (Argonne National Lab., IL (United States) Chicago Univ., IL (United States). Dept. of Radiation and Cellular Oncology); Carnes, B.A. (Argonne National Lab., IL (United States))

    1993-01-01

    WR-2721 [S-2-(3-aminopropylamino)ethylphosphorothioic acid] is an effective chemopreventive agent. C57BL [times] BALB/c F[sub 1] female mice, were exposed to a single whole-body dose of 206 cGy from a [sup 60]Co photon source. Those groups treated with VATR-2721 (400 mg/kg) were administered the agent i.p. 30 min prior to irradiation. Over 90% of deaths were determined to be due to tumor involvement. WR-2721 afforded significant protection against life shortening due to radiation-induced tumors of connective tissue and epithelial tissue origins. Subsequent survival time in WR-2721-treated and irradiated animals as compared to matched irradiated-only controls was extended up to 59 days. A single exposure of animals to VVR-2721 did not affect the cumulative survival curves for unirradiated mice. WR-2721 possesses chemopreventive properties which can be clinically exploited to reduce the risk to therapy-induced secondary cancers in patients who otherwise would have an excellent prognosis for cure and long-term survival.

  12. Progress towards malaria control targets in relation to national malaria programme funding

    NARCIS (Netherlands)

    E.L. Korenromp (Eline); M. Hosseini (Mehran); R.D. Newman (Robert D); R.E. Cibulskis (Richard E)

    2013-01-01

    textabstractBackground: Malaria control has been dramatically scaled up the past decade, mainly thanks to increasing international donor financing since 2003. This study assessed progress up to 2010 towards global malaria impact targets, in relation to Global Fund, other donor and domestic malaria

  13. 2. Malaria paper

    African Journals Online (AJOL)

    Continued resistance monitoring and investigation of other potential molecular markers is recommended as wider ACT use is scaled up in the country. INTRODUCTION. Malaria persists as a leading cause of morbidity and mortality in Zambia, claiming more than 4 million clinical cases and 50,000 deaths annually on the.

  14. Cancer chemoprevention by natural compounds

    OpenAIRE

    スズキ, マスミ; Masumi, SUZUI

    2007-01-01

    There is growing interest in the use of natural compounds for the treatment and prevention of a wide variety of diseases, including cancer. Several herb-derived components are currently evaluated in preclinical studies as potential cancer chemopreventive agents. We have recently found that several herbal plants in the Ryukyu Islands, or any other natural compound, have a potential chemopreventive effect on biomarkers of colon carcinogenesis and a growth inhibitory effect on human cancer cells...

  15. Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Daniel M. Parker

    2017-12-01

    Full Text Available Background: Myanmar has one of the largest malaria burdens in the Greater Mekong Subregion (GMS. Throughout the GMS, Plasmodium falciparum parasites are increasingly resistant to artemisinin combination therapies. Given that there are no current alternative treatment therapies, one proposed solution to the threat of untreatable P. falciparum malaria is to eliminate the parasite from the region. Several small-scale elimination projects have been piloted in the GMS, including along the Myanmar-Thailand border. Following the success of the pilot elimination project along the Myanmar-Thailand border, there was a scale up to a broad area of Eastern Kayin State, Myanmar. Here we describe the establishment of the scale up elimination project in Easter Kayin State. Methods: The scale up relied on geographic reconnaissance and a geographic information system, community engagement, generalized access to community-based early diagnosis and treatment, near real-time epidemiological surveillance, cross sectional malaria prevalence surveys and targeted mass drug administration in villages with high prevalence of P. falciparum malaria. Molecular markers of drug resistance were also monitored in individuals with symptomatic and asymptomatic infections. Discussion: This protocol illustrates the establishment of an elimination project and operational research in a remote, rural area encompassing several armed groups, multiple political organizations and a near-absent health care infrastructure. The establishment of the project relied on a strong rapport with the target community, on-the-ground knowledge (through geographic surveys and community engagement, rapid decision making and an approach that was flexible enough to quickly adapt to a complex landscape. The elimination project is ongoing, now over three years in operation, and assessment of the impact of this operational research will follow. This project has relevance not only for other malaria elimination

  16. Chemoprevention of bladder cancer.

    Science.gov (United States)

    Kamat, Ashish M; Lamm, Donald L

    2002-02-01

    The data presented herein, although highly supportive for a protective role of various nutrients against bladder cancer, are far from definitive. Many authorities question the validity of current recommendations for nutritional chemoprevention against bladder cancer. The reason for the wide variations reported in epidemiologic studies lies in the nature of observational studies. Dietary studies are limited in their conclusions because the protection afforded by the consumption of a particular nutrient may be multifactorial, with different components of the food exerting potential chemopreventive effects. Furthermore, measuring levels of nutrients in the food intake of populations is confounded by factors that might affect these levels and also the incidence of cancer. For example, vitamin A can come from animal or vegetarian sources. Because animal fat has been identified as a potential carcinogen in man, depending on the source of the vitamin, varying levels of protection might be deduced. In addition, chemoprevention studies using dietary supplements are expected to have mild effects, and large studies would be required to confirm statistical significance. Even with agents such as intravesical chemotherapy, only half the studies achieve statistical significance [29]. Prospective randomized trials with a large sample size, longer follow-up, and an extended duration of treatment are needed to clarify the association between micronutrients and cancer protection. With these caveats in mind, several recommendations can be made. Simple measures, such as drinking more fluids (especially water), can have a profound impact on the incidence of bladder cancer. Vitamins are being extensively studied in chemopreventive trials for different cancers. There is strong evidence for a chemoprotective effect of vitamin A in bladder cancer. The authors recommend 32,000 IU/day of vitamin A initially, with lower doses (24,000 IU) for persons less than 50 kg. Because liver toxicity is a

  17. Advances and Practices of Bioprocess Scale-up.

    Science.gov (United States)

    Xia, Jianye; Wang, Guan; Lin, Jihan; Wang, Yonghong; Chu, Ju; Zhuang, Yingping; Zhang, Siliang

    2016-01-01

    : This chapter addresses the update progress in bioprocess engineering. In addition to an overview of the theory of multi-scale analysis for fermentation process, examples of scale-up practice combining microbial physiological parameters with bioreactor fluid dynamics are also described. Furthermore, the methodology for process optimization and bioreactor scale-up by integrating fluid dynamics with biokinetics is highlighted. In addition to a short review of the heterogeneous environment in large-scale bioreactor and its effect, a scale-down strategy for investigating this issue is addressed. Mathematical models and simulation methodology for integrating flow field in the reactor and microbial kinetics response are described. Finally, a comprehensive discussion on the advantages and challenges of the model-driven scale-up method is given at the end of this chapter.

  18. Challenges in Designing and Scaling-up Community Services

    DEFF Research Database (Denmark)

    Morelli, Nicola

    2014-01-01

    hidden or latent resources in neighbourhoods. Both the projects are based on the activities in four pilot locations. They are an application of service design to the public sector that provide interesting insights about designing and scaling up highly localised and personalised services and platforms...... several important differences can also be found, that challenge the way those platforms should be designed and scaled up in different contexts. Being at a more advanced stage, the Life 2.0 project obviously provided more insights, whereas MyN gives an opportunity to verify the hypotheses coming from Life...

  19. Malaria prevalence, spatial clustering and risk factors in a low endemic area of Eastern Rwanda: a cross sectional study

    NARCIS (Netherlands)

    Rulisa, Stephen; Kateera, Fredrick; Bizimana, Jean Pierre; Agaba, Steven; Dukuzumuremyi, Javier; Baas, Lisette; de Dieu Harelimana, Jean; Mens, Petra F.; Boer, Kimberly R.; de Vries, Peter J.

    2013-01-01

    Rwanda reported significant reductions in malaria burden following scale up of control intervention from 2005 to 2010. This study sought to; measure malaria prevalence, describe spatial malaria clustering and investigate for malaria risk factors among health-centre-presumed malaria cases and their

  20. Harnessing ICTs to scale-up agricultural innovations | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Agricultural research organizations, governments, and civil society are increasingly looking at how to successfully scale up agriculture and food security innovations to bring more lasting benefits to more people. Information and communication technologies (ICTs) can play an important role in greater uptake of innovations: ...

  1. ORIGINAL ARTICLES Financial and economic costs of scaling up ...

    African Journals Online (AJOL)

    targeted provision of HAART to health care workers may be unavoidable if HAART scale-up plans in ... of knowledge on the cost of providing HAART in resource- constrained settings. Background. Data were ..... absenteeism, reduced productivity, vacancies and inexperience of replacement employees. This study does not ...

  2. Scaling-up Sustainable Aquaculture Development in Sri Lanka ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Scaling-up Sustainable Aquaculture Development in Sri Lanka. The Government of Sri Lanka is increasingly emphasizing aquaculture development as a means to foster rural development, alleviate poverty, and increase food security. A two-year IDRC-funded project identified challenges to the sustainable management of ...

  3. Challenges in Designing and Scaling up Community Services

    DEFF Research Database (Denmark)

    Morelli, Nicola

    2015-01-01

    of the latter is to develop a platform to activate hidden or latent resources in neighbourhoods. Both of the projects are an application of service design to the public sector and together provide useful insights about designing and scaling up highly localized and personalized services and service platforms...

  4. Empirical research methods for technology validation: Scaling up to practice

    NARCIS (Netherlands)

    Wieringa, Roelf J.

    tBefore technology is transferred to the market, it must be validated empirically by simulating future prac-tical use of the technology. Technology prototypes are first investigated in simplified contexts, and thesesimulations are scaled up to conditions of practice step by step as more becomes

  5. Millions Learning: Scaling up Quality Education in Developing Countries

    Science.gov (United States)

    Robinson, Jenny Perlman; Winthrop, Rebecca

    2016-01-01

    "Millions Learning: Scaling up Quality Education in Developing Countries" tells the story of where and how quality education has scaled in low- and middle-income countries. The story emerges from wide-ranging research on scaling and learning, including 14 in-depth case studies from around the globe. Ultimately, "Millions…

  6. Scaling up Prevention of Mother to Child Transmission of HIV ...

    African Journals Online (AJOL)

    Nigeria is scaling up prevention of mother-to-child transmission (PMTCT) of HIV interventions to primary health care centres (PHCs). This retrospective study of PMTCT was at two PHCs in Northwest Nigeria with the main outcome measure being HIV infection rate of exposed infants at 6 weeks of life. Of 10,289 women who ...

  7. New tuberculosis technologies: challenges for retooling and scale-up.

    Science.gov (United States)

    Pai, M; Palamountain, K M

    2012-10-01

    The availability of new tools does not mean that they will be adopted, used correctly, scaled up or have public health impact. Experience to date with new diagnostics suggests that many national tuberculosis programmes (NTPs) in high-burden countries are reluctant to adopt and scale up new tools, even when these are backed by evidence and global policy recommendations. We suggest that there are several common barriers to effective national adoption and scale-up of new technologies: global policy recommendations that do not provide sufficient information for scale-up, complex decision-making processes and weak political commitment at the country level, limited engagement of and support to NTP managers, high cost of tools and poor fit with user needs, unregulated markets and inadequate business models, limited capacity for laboratory strengthening and implementation research, and insufficient advocacy and donor support. Overcoming these barriers will require enhanced country-level advocacy, resources, technical assistance and political commitment. Some of the BRICS (Brazil, Russia, India, China, South Africa) countries are emerging as early adopters of policies and technologies, and are increasing their investments in TB control. They may provide the first opportunities to fully assess the public health impact of new tools.

  8. Scaling up agroforestry farming systems: Lessons from the Malawi ...

    African Journals Online (AJOL)

    The study examined the factors affecting agroforestry technology upscaling and identified gaps in scaling up approaches of agroforestry technologies. One hundred and sixty-four farmers in Malawi Agroforestry Extension (MAFE) project districts of Mzimba, Ntcheu and Mangochi were interviewed. Logistic model was used in ...

  9. Scaling up: Expanding the impact of food security and nutrition ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corey Piccioni

    innovations; and local knowledge combined with cutting- edge science. The experience of IDRC shows that a portfolio approach provides flexibility to test multiple solutions, and to focus on scaling up the solutions with the highest potential for impact. Building leadership. IDRC strengthens the capacities of researchers, ...

  10. Key considerations in scaling up male circumcision in Tanzania ...

    African Journals Online (AJOL)

    Background. Male circumcision (MC) reduces the risk of sexually transmitted infections (STI) including HIV. The WHO and UNAIDS recommend male circumcision as an additional intervention to prevent HIV infection. Tanzania is embarking on activities to scale up safe male circumcision for HIV prevention and other related ...

  11. Scaling up Prevention of Mother to Child Transmission of HIV ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Jigawa State, 3Federal Medical Centre Katsina, Katsina State.4Takai Comprehensive Health Centre, Takai, Kano State. 5Maternal ... Nigeria is scaling up prevention of mother-to-child transmission (PMTCT) of HIV interventions to primary health care centres. (PHCs). ..... stigma, inability to afford transport cost and long.

  12. Moringa oleifera Lam: Targeting Chemoprevention.

    Science.gov (United States)

    Karim, Nurul Ashikin Abd; Ibrahim, Muhammad Din; Kntayya, Saie Brindha; Rukayadi, Yaya; Hamid, Hazrulizawati Abd; Razis, Ahmad Faizal Abdull

    2016-01-01

    Moringa oleifera Lam, family Moringaceae, is a perennial plant which is called various names, but is locally known in Malaysia as "murungai" or "kelor". Glucomoringin, a glucosinolate with from M. oleifera is a major secondary metabolite compound. The seeds and leaves of the plant are reported to have the highest amount of glucosinolates. M. oleifera is well known for its many uses health and benefits. It is claimed to have nutritional, medicinal and chemopreventive potentials. Chemopreventive effects of M. oleifera are expected due to the existence of glucosinolate which it is reported to have the ability to induce apoptosis in anticancer studies. Furthermore, chemopreventive value of M. oleifera has been demonstrated in studies utilizing its leaf extract to inhibit the growth of human cancer cell lines. This review highlights the advantages of M. oleifera targeting chemoprevention where glucosinolates could help to slow the process of carcinogenesis through several molecular targets. It is also includes inhibition of carcinogen activation and induction of carcinogen detoxification, anti-inflammatory, anti-tumor cell proliferation, induction of apoptosis and inhibition of tumor angiogenesis. Finally, for synergistic effects of M. oleifera with other drugs and safety, essential for chemoprevention, it is important that it safe to be consumed by human body and works well. Although there is promising evidence about M. oleifera in chemoprevention, extensive research needs to be done due to the expected rise of cancer in coming years and to gain more information about the mechanisms involved in M. oleifera influence, which could be a good source to inhibit several major mechanisms involved in cancer development.

  13. Collaborative Group Learning using the SCALE-UP Pedagogy

    Science.gov (United States)

    Feldman, Gerald

    2011-10-01

    The time-honored conventional lecture (``teaching by telling'') has been shown to be an ineffective mode of instruction for science classes. In these cases, where the enhancement of critical thinking skills and the development of problem-solving abilities are emphasized, collaborative group learning environments have proven to be far more effective. In addition, students naturally improve their teamwork skills through the close interaction they have with their group members. Early work on the Studio Physics model at Rensselaer Polytechnic Institute in the mid-1990's was extended to large classes via the SCALE-UP model pioneered at North Carolina State University a few years later. In SCALE-UP, students sit at large round tables in three groups of three --- in this configuration, they carry out a variety of pencil/paper exercises (ponderables) using small whiteboards and perform hands-on activities like demos and labs (tangibles) throughout the class period. They also work on computer simulations using a shared laptop for each group of three. Formal lecture is reduced to a minimal level and the instructor serves more as a ``coach'' to facilitate the academic ``drills'' that the students are working on. Since its inception in 1997, the SCALE-UP pedagogical approach has been adopted by over 100 institutions across the country and about 20 more around the world. In this talk, I will present an overview of the SCALE-UP concept and I will outline the details of its deployment at George Washington University over the past 4 years. I will also discuss empirical data from assessments given to the SCALE-UP collaborative classes and the regular lecture classes at GWU in order to make a comparative study of the effectiveness of the two methodologies.

  14. Chemopreventive properties of curcumin analogues ...

    African Journals Online (AJOL)

    Purpose: To examine the chemopreventive activity of curcumin analogues, hexagamavunone-0 (HGV-. 0) and gamavutone-0 (GVT-0), compared to curcumin in a colorectal cancer model in Wistar rats. Methods: Rats (n = 25) were assigned to one of five groups (n = 5 in each group). Colorectal cancer was induced in the ...

  15. Considerations for Scale-Up of Ferronickel Electric Smelting Furnaces

    Science.gov (United States)

    Hundermark, R. J.; Nelson, L. R.

    2017-02-01

    In ferronickel smelting, the selective carbothermic reduction of calcined nickel laterite ores in large electric furnaces yields a crude ferronickel product. The optimal process for nickel laterite smelting requires a fine balance between the metallurgical requirements of the process (feed composition, nickel recovery, energy consumption, product quality) and the capabilities of the feeding, tapping and off-gas systems, and especially of the furnace crucible and electrical system. The scale-up of nickel laterite smelting operations over the last 50 years has seen a tenfold increase in furnace power input. Furnace operations within the industry are examined to identify common trends and some new metrics are proposed which incorporate the combination of electrode power densities and the impact of alloy nickel grade on gas generation rates, and hence local electrode gas fluxes, which may impact on future scale-up of ferronickel furnaces.

  16. Breastfeeding peer counseling: from efficacy through scale-up.

    Science.gov (United States)

    Chapman, Donna J; Morel, Katherine; Anderson, Alex Kojo; Damio, Grace; Pérez-Escamilla, Rafael

    2010-08-01

    An increasing number of publications have evaluated various breastfeeding peer counseling models. This article describes a systematic review of (a) the randomized trials assessing the effectiveness of breastfeeding peer counseling in improving rates of breastfeeding initiation, duration, exclusivity, and maternal and child health outcomes and (b) scientific literature describing the scale-up of breastfeeding peer counseling programs. Twenty-six peer-reviewed publications were included in this review. The overwhelming majority of evidence from randomized controlled trials evaluating breastfeeding peer counseling indicates that peer counselors effectively improve rates of breastfeeding initiation, duration, and exclusivity. Peer counseling interventions were also shown to significantly decrease the incidence of infant diarrhea and significantly increase the duration of lactational amenorrhea. Breastfeeding peer counseling initiatives are effective and can be scaled up in both developed and developing countries as part of well-coordinated national breastfeeding promotion or maternal-child health programs.

  17. Breastfeeding Peer Counseling: From Efficacy through Scale-up

    OpenAIRE

    Chapman, Donna J.; Morel, Katherine; Anderson, Alex Kojo; Damio, Grace; Pérez-Escamilla, Rafael

    2010-01-01

    There are a growing number of publications evaluating various breastfeeding peer counseling (PC) models. We have systematically reviewed a) the randomized trials assessing the effectiveness of breastfeeding PC in improving rates of breastfeeding initiation, duration, exclusivity and maternal and child health outcomes; and b) scientific literature describing the scale-up of breastfeeding PC programs. Twenty-six peer-reviewed publications were included in this review. The overwhelming majority ...

  18. Testing The Scale-up Approach To Introductory Astronomy

    Science.gov (United States)

    Kregenow, Julia M.; Keller, L.; Rogers, M.; Romero, D.

    2008-09-01

    Ithaca College physics department has begun transforming our general education astronomy courses into hands-on, active-learning courses from the previous lecture-based format. We are using the SCALE-UP model (Student Centered Activities for Large Enrollment University Programs) pioneered at North Carolina State University. Expanding on the successes of Studio Physics (developed at RPI), which exchanges traditionally separate lecture/recitation/ laboratory sessions for one dynamic, active-learning environment for approximately 40 students, SCALE-UP extends this model to accommodate 100+ students by using large round tables creating naturally smaller groups of students. Classes meet three times per week with each class blending lecture, hands-on activities, group problem solving, and the use of student polling devices. We are testing whether this mode of teaching astronomy will lead to a better understanding of astronomy and the nature of science. Applying this approach in both the SCALE-UP classroom (90 students) and a traditional lecture classroom (45 students) in spring 2008, we report on our early results and lessons learned after one semester. We also discuss some of our lingering implementation questions and issues, such as: whether to use the same or different instructor in two parallel sections, requiring textbook reading, reading quizzes, on-line homework and activities, how much math to include, development of hands-on activities, and culling the typically overpacked intro astronomy syllabus.

  19. Barriers and Facilitators to Scaling Up Outpatient Palliative Care.

    Science.gov (United States)

    Bekelman, David B; Rabin, Borsika A; Nowels, Carolyn T; Sahay, Anju; Heidenreich, Paul A; Fischer, Stacy M; Main, Deborah S

    2016-04-01

    The Institute of Medicine recommends people with serious advanced illness have access to skilled palliative care. However, the predominant delivery model of nonhospice palliative care is inpatient, consultative care focused on the end of life, with a small specialist palliative care workforce. The study objective was to understand organizational factors that could influence the adoption and scale-up of outpatient palliative care in chronic advanced illness, using the example of heart failure. This was a cross-sectional qualitative study. Participants were 17 health care providers and local, regional, and national health system leaders from the Veterans Health Administration (VHA) who were considering whether and how to adopt and sustain outpatient palliative care. Individual interviews using semistructured questions assessed domains of the Consolidated Framework for Implementation Science. Most providers and leaders perceived outpatient palliative care as high priority in the VHA given its patient-centeredness and potential to decrease health care use and costs associated with conditions like heart failure. They also supported a collaborative care team model of outpatient palliative care delivery where a palliative care specialist collaborates with medical nurses and social workers. They reported lack of performance measures/incentives for patient-centered care processes and outcomes as a potential barrier to implementation. Features of outpatient palliative care viewed as important for successful adoption and scale-up included coordination and communication with other providers, ease of integration into existing programs, and evidence of improving quality of care while not substantially increasing overall health care costs. Incentives such as performance measures and collaboration with local VHA providers and leaders could improve adoption and scale-up of outpatient palliative care.

  20. Scale-up on electrokinetic remediation: Engineering and technological parameters

    Energy Technology Data Exchange (ETDEWEB)

    López-Vizcaíno, Rubén [Department of Chemical Engineering, Institute of Chemical & Environmental Technologies, University of Castilla-La Mancha, Campus Universitario s/n, 13071 Ciudad Real (Spain); Navarro, Vicente; León, María J. [Geoenvironmental Group, Civil Engineering School, University of Castilla-La Mancha, Avda. Camilo José Cela s/n, 13071 Ciudad Real (Spain); Risco, Carolina [Department of Chemical Engineering, Institute of Chemical & Environmental Technologies, University of Castilla-La Mancha, Campus Universitario s/n, 13071 Ciudad Real (Spain); Rodrigo, Manuel A., E-mail: manuel.rodrigo@uclm.es [Department of Chemical Engineering, Faculty of Chemical Sciences & Technologies, University of Castilla-La Mancha, Campus Universitario s/n, 13071 Ciudad Real (Spain); Sáez, Cristina; Cañizares, Pablo [Department of Chemical Engineering, Faculty of Chemical Sciences & Technologies, University of Castilla-La Mancha, Campus Universitario s/n, 13071 Ciudad Real (Spain)

    2016-09-05

    Highlights: • Moisture and compaction of soil must be re-establish in Scale-up of EKR. • Degree of compaction of soil depends on moisture, type of soil and EKR reactor. • Scale of EKR process determines the energy consumption in the treatment. • Electroosmosis and electromigration processes are favoured in prototype scale. • In real scale EKR processes it is important determine evaporation and leaks effects. - Abstract: This study analyses the effect of the scale-up of electrokinetic remediation (EKR) processes in natural soils. A procedure is proposed to prepare soils based on a compacting process to obtaining soils with similar moisture content and density to those found in real soils in the field. The soil used here was from a region with a high agrarian activity (Mora, Spain). The scale-up study was performed in two installations at different scales: a mock-up pilot scale (0.175 m{sup 3}) and a prototype with a scale that was very similar to a real application (16 m{sup 3}). The electrode configuration selected consisted of rows of graphite electrodes facing each other located in electrolyte wells. The discharge of 20 mg of 2,4-dichlorophenoxyacetic acid [2,4-D] per kg of dry soil was treated by applying an electric potential gradient of 1 V cm{sup −1}. An increase in scale was observed to directly influence the amount of energy supplied to the soil being treated. As a result, electroosmotic and electromigration flows and electric heating are more intense than in smaller-scale tests (24%, 1% and 25%, respectively respect to the values in prototype). In addition, possible leaks were evaluated by conducting a watertightness test and quantifying evaporation losses.

  1. Safety issues in scale-up of chemical processes.

    Science.gov (United States)

    Stoessel, F

    2001-11-01

    Fast time-to-market is an important issue in the development of chemical processes for fine chemicals and drug production. However, this needs to be balanced against the equally important issue of process safety. Developing a safe process within a short time frame is a demanding challenge but advances in: (i) risk analysis methods; (ii) procurement and interpretation of safety and scale-up data; and (iii) process control have opened up new perspectives in this field. The thermal stability of chemicals during storage and transportation is another field of interest, and data obtained from research in this area should allow the simplification of certain tedious procedures.

  2. The First Scale-Up Production of Theranostic Nanoemulsions

    Science.gov (United States)

    Liu, Lu; Bagia, Christina; Janjic, Jelena M.

    2015-01-01

    Abstract Theranostic nanomedicines are a promising new technological advancement toward personalized medicine. Although much progress has been made in pre-clinical studies, their clinical utilization is still under development. A key ingredient for successful theranostic clinical translation is pharmaceutical process design for production on a sufficient scale for clinical testing. In this study, we report, for the first time, a successful scale-up of a model theranostic nanoemulsion. Celecoxib-loaded near-infrared-labeled perfluorocarbon nanoemulsion was produced on three levels of scale (small at 54 mL, medium at 270 mL, and large at 1,000 mL) using microfluidization. The average size and polydispersity were not affected by the equipment used or production scale. The overall nanoemulsion stability was maintained for 90 days upon storage and was not impacted by nanoemulsion production scale or composition. Cell-based evaluations show comparable results for all nanoemulsions with no significant impact of nanoemulsion scale on cell toxicity and their pharmacological effects. This report serves as the first example of a successful scale-up of a theranostic nanoemulsion and a model for future studies on theranostic nanomedicine production and development. PMID:26309798

  3. Tissue strands as "bioink" for scale-up organ printing.

    Science.gov (United States)

    Yu, Yin; Ozbolat, Ibrahim T

    2014-01-01

    Organ printing, takes tissue spheroids as building blocks together with additive manufacturing technique to engineer tissue or organ replacement parts. Although a wide array of cell aggregation techniques has been investigated, and gained noticeable success, the application of tissue spheroids for scale-up tissue fabrication is still worth investigation. In this paper, we introduce a new micro-fabrication technique to create tissue strands at the scale of 500-700μm as a "bioink" for future robotic tissue printing. Printable alginate micro-conduits are used as semi-permeable capsules for tissue strand fabrication. Mouse insulinoma beta TC3 cell tissue strands were formed upon 4 days post fabrication with reasonable mechanical strength, high cell viability close to 90%, and tissue specific markers expression. Fusion was readily observed between strands when placing them together as early as 24h. Also, tissue strands were deposited with human umbilical vein smooth muscle cells (HUVSMCs) vascular conduits together to fabricated miniature pancreatic tissue analog. Our study provided a novel technique using tissue strands as "bioink" for scale-up bioprinting of tissues or organs.

  4. TA Beliefs in a SCALE-UP Style Classroom

    Science.gov (United States)

    DeBeck, George; Settelmeyer, Sam; Li, Sissi; Demaree, Dedra

    2010-10-01

    In Spring 2010, the Oregon State University physics department instituted a SCALE-UP (Student-Centered Active Learning Environment for Undergraduate Programs) style studio classroom in the introductory, calculus-based physics series. In our initial implementation, comprised of two hours lecture, two hours of studio, and two hours lab work, the studio session was lead by a faculty member and either 2 GTAs or 1 GTA and 1 LA. We plan to move to a model where senior GTAs can lead studio sections after co-teaching with the faculty member. It is critical that we know how to prepare and support the instructional team in facilitating student learning in this setting. We examine GTA and LA pedagogical beliefs through reflective journaling, interviews, and personal experience of the authors. In particular, we examine how these beliefs changed over their first quarter of instruction, as well as the resources used to adapt to the new classroom environment.

  5. Scale-Up of GRCop: From Laboratory to Rocket Engines

    Science.gov (United States)

    Ellis, David L.

    2016-01-01

    GRCop is a high temperature, high thermal conductivity copper-based series of alloys designed primarily for use in regeneratively cooled rocket engine liners. It began with laboratory-level production of a few grams of ribbon produced by chill block melt spinning and has grown to commercial-scale production of large-scale rocket engine liners. Along the way, a variety of methods of consolidating and working the alloy were examined, a database of properties was developed and a variety of commercial and government applications were considered. This talk will briefly address the basic material properties used for selection of compositions to scale up, the methods used to go from simple ribbon to rocket engines, the need to develop a suitable database, and the issues related to getting the alloy into a rocket engine or other application.

  6. Scaling Up Family Therapy in Fragile, Conflict-Affected States.

    Science.gov (United States)

    Charlés, Laurie L

    2015-09-01

    This article discusses the design and delivery of two international family therapy-focused mental health and psychosocial support training projects, one in a fragile state and one in a post-conflict state. The training projects took place in Southeast Asia and the Middle East/North Africa. Each was funded, supported, and implemented by local, regional, and international stakeholders, and delivered as part of a broader humanitarian agenda to develop human resource capacity to work with families affected by atrocities. The two examples illustrate how task-shifting/task-sharing and transitional justice approaches were used to inform the scaling-up of professionals involved in each project. They also exemplify how state-citizen phenomena in each location affected the project design and delivery. © 2014 Family Process Institute.

  7. Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Daniel M. Parker

    2017-10-01

    Full Text Available Background: Myanmar has one of the largest malaria burdens in Southeast Asia. Along the border with Thailand, Plasmodium falciparum parasites are increasingly showing reduced sensitivity to artemisinin combination therapies. Given that there are no current alternative treatment therapies, one proposed solution to the threat of untreatable P. falciparum malaria is to eliminate the parasite from the region. Several small-scale elimination projects have been piloted along the Myanmar-Thailand border. Following their success, this operational research aimed to scale up the elimination to a broad area of Eastern Kayin State, Myanmar. Methods: The project relied on geographic reconnaissance and a geographic information system, community engagement, generalized access to community-based early diagnosis and treatment, near real-time epidemiological surveillance, cross sectional malaria prevalence surveys and targeted mass drug administration in villages with high prevalence of P. falciparum malaria. Molecular markers of drug resistance were also monitored in individuals with symptomatic and asymptomatic infections. Discussion: This project illustrates the establishment of an elimination project and operational research in a remote, rural area encompassing several armed groups, multiple political organizations and a near-absent health care infrastructure. The establishment of the project relied on a strong rapport with the target community, on-the-ground knowledge (through geographic surveys and community engagement, rapid decision making and an approach that was flexible enough to quickly adapt to a complex landscape. The elimination project is ongoing, now over three years in operation, and assessment of the impact of this operational research will follow. This project has relevance not only for other malaria elimination projects but also for operational research aimed at eliminating other diseases.

  8. Chemopreventive activity of methanol extract of Melastoma ...

    African Journals Online (AJOL)

    Chemopreventive activity of methanol extract of Melastoma malabathricum leaves in DMBA-induced mouse skin carcinogenesis. ... Conclusion: MEMM demonstrated chemoprevention possibly via its antioxidant and anti-inflammatory activities, and the action of flavonoids like quercitrin. Key words: Melastomaceae; skin ...

  9. Nicotinamide for skin cancer chemoprevention.

    Science.gov (United States)

    Damian, Diona L

    2017-08-01

    Nicotinamide (vitamin B 3 ) has a range of photoprotective effects in vitro and in vivo; it enhances DNA repair, reduces UV radiation-induced suppression of skin immune responses, modulates inflammatory cytokine production and skin barrier function and restores cellular energy levels after UV exposure. Pharmacological doses of nicotinamide have been shown to reduce actinic keratoses and nonmelanoma skin cancer incidence in high-risk individuals, making this a nontoxic and accessible option for skin cancer chemoprevention in this population. © 2017 The Australasian College of Dermatologists.

  10. Challenges and Opportunities in Scaling-Up Nutrition in Healthcare

    Directory of Open Access Journals (Sweden)

    Ian Darnton-Hill

    2015-01-01

    Full Text Available Healthcare continues to be in a state of flux; conventionally, this provides opportunities and challenges. The opportunities include technological breakthroughs, improved economies and increasing availability of healthcare. On the other hand, economic disparities are increasing and leading to differing accessibility to healthcare, including within affluent countries. Nutrition has received an increase in attention and resources in recent decades, a lot of it stimulated by the rise in obesity, type 2 diabetes mellitus and hypertension. An increase in ageing populations also has meant increased interest in nutrition-related chronic diseases. In many middle-income countries, there has been an increase in the double burden of malnutrition with undernourished children and overweight/obese parents and adolescents. In low-income countries, an increased evidence base has allowed scaling-up of interventions to address under-nutrition, both nutrition-specific and nutrition-sensitive interventions. Immediate barriers (institutional, structural and biological and longer-term barriers (staffing shortages where most needed and environmental impacts on health are discussed. Significant barriers remain for the near universal access to healthcare, especially for those who are socio-economically disadvantaged, geographically isolated, living in war zones or where environmental damage has taken place. However, these barriers are increasingly being recognized, and efforts are being made to address them. The paper aims to take a broad view that identifies and then comments on the many social, political and scientific factors affecting the achievement of improved nutrition through healthcare.

  11. Scale-up activation of carbon fibres for hydrogen storage

    Energy Technology Data Exchange (ETDEWEB)

    Kunowsky, M.; Marco-Lozar, J.P.; Cazorla-Amoros, D.; Linares-Solano, A. [Grupo de Materiales Carbonosos y Medio Ambiente, Departamento de Quimica Inorganica, Universidad de Alicante, Ap. 99, E-03080 Alicante (Spain)

    2010-03-15

    In a previous study, we investigated, at a laboratory scale, the chemical activation of two different carbon fibres (CF), their porosity characterization, and their optimization for hydrogen storage. In the present work, this study is extended to: (i) a larger range of KOH activated carbon fibres, (ii) a larger range of hydrogen adsorption measurements at different temperatures and pressures (i.e. at room temperature, up to 20 MPa, and at 77 K, up to 4 MPa), and (iii) a scaling-up activation approach in which the obtained activated carbon fibres (ACF) are compared with those from laboratory-scale activation. The prepared samples cover a large range of porosities, which is found to govern their ability for hydrogen adsorption. The hydrogen uptake capacities of all the prepared samples have been analysed both in volumetric and in gravimetric bases. Thus, maximum adsorption capacities of around 5 wt% are obtained at 77 K, and 1.1 wt% at room temperature, respectively. The packing densities of the materials have been measured, turning out to play an important role in order to estimate the total storage capacity of a tank volume. Maximum values of 17.4 g l{sup -1} at 298 K, and 38.6 g l{sup -1} at 77 K were obtained. (author)

  12. Effective scale-up: avoiding the same old traps

    Directory of Open Access Journals (Sweden)

    Nelson David

    2009-01-01

    Full Text Available Abstract Despite progress in developing more effective training methodologies, training initiatives for health workers continue to experience common pitfalls that have beset the overall success and cost-effectiveness of these programs for decades. These include lack of country-level coordination of health training, inequitable access to training, interrupted services, and failure to reinforce skills and knowledge training by addressing other performance factors. These pitfalls are now seen as aggravating the current crisis in human resources for health and impeding the effective scale-up of training and the potential impact of promising strategies such as task shifting to address health worker shortages. Drawing on IntraHealth International's lessons learned in designing reproductive health and HIV/AIDS training and performance improvement programmes, this commentary discusses promising practices for strengthening human resources for health through more efficient and effective training and learning programmes that avoid the same old traps. These promising practices include the following: Assessing performance gaps and opportunities before designing a training initiative; addressing performance factors other than skills and knowledge that health workers need to perform well; applying a "learning for performance" approach; standardizing curricula throughout a country; linking pre-service education, in-service training and professional associations; enhancing traditional education; strengthening human resources information systems to improve workforce planning, policies and management; applying technology to meet training needs.

  13. Scale-up of a new bacterial mannitol production process.

    Science.gov (United States)

    von Weymarn, F Niklas W; Kiviharju, Kristiina J; Jääskeläinen, Seppo T; Leisola, Matti S A

    2003-01-01

    D-Mannitol is a sugar alcohol with applications in chemistry, food and pharmaceutical industries, and medicine. Commercially, mannitol is produced by catalytic hydrogenation. Although this process is widely used, it is not optimal for mannitol production. New processes, including chemical, enzymatic, and microbial processes, are frequently developed and evaluated against the existing hydrogenation processes. In earlier papers, we have described the identification of a food-grade lactic acid bacterium strain, Leuconostoc mesenteroides ATCC-9135, with efficient mannitol production capabilities and the development and optimization of a new bioprocess in which the strain was applied. The new bioprocess is simple. It requires a reduced bioreactor with the following features: sterilization, pH and T control (at mild conditions), and slow mixing. The contamination risk of the new bioprocess is low, and the downstream processing protocol comprises simple, widely used unit operations: evaporation, crystallization, crystal separation, and drying. On a 2-L laboratory scale, high mannitol yields from fructose (93-97%) and volumetric mannitol productivities (>20 g L(-1) h(-1)) were achieved. In this paper, the scalability of the new bioprocess was tested on a small pilot scale (100 L). In the pilot plant, production levels were achieved similar to those in the laboratory. Also, high-purity mannitol crystals were obtained at similar yield levels. The results presented in this paper indicate that the new bioprocess can easily be scaled-up to an industrial scale and that the production levels achieved with it are comparable to the catalytic hydrogenation processes.

  14. Fungal biosynthesis of gold nanoparticles: mechanism and scale up.

    Science.gov (United States)

    Kitching, Michael; Ramani, Meghana; Marsili, Enrico

    2015-11-01

    Gold nanoparticles (AuNPs) are a widespread research tool because of their oxidation resistance, biocompatibility and stability. Chemical methods for AuNP synthesis often produce toxic residues that raise environmental concern. On the other hand, the biological synthesis of AuNPs in viable microorganisms and their cell-free extracts is an environmentally friendly and low-cost process. In general, fungi tolerate higher metal concentrations than bacteria and secrete abundant extracellular redox proteins to reduce soluble metal ions to their insoluble form and eventually to nanocrystals. Fungi harbour untapped biological diversity and may provide novel metal reductases for metal detoxification and bioreduction. A thorough understanding of the biosynthetic mechanism of AuNPs in fungi is needed to reduce the time of biosynthesis and to scale up the AuNP production process. In this review, we describe the known mechanisms for AuNP biosynthesis in viable fungi and fungal protein extracts and discuss the most suitable bioreactors for industrial AuNP biosynthesis. © 2014 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

  15. Fungal biosynthesis of gold nanoparticles: mechanism and scale up

    Science.gov (United States)

    Kitching, Michael; Ramani, Meghana; Marsili, Enrico

    2015-01-01

    Gold nanoparticles (AuNPs) are a widespread research tool because of their oxidation resistance, biocompatibility and stability. Chemical methods for AuNP synthesis often produce toxic residues that raise environmental concern. On the other hand, the biological synthesis of AuNPs in viable microorganisms and their cell-free extracts is an environmentally friendly and low-cost process. In general, fungi tolerate higher metal concentrations than bacteria and secrete abundant extracellular redox proteins to reduce soluble metal ions to their insoluble form and eventually to nanocrystals. Fungi harbour untapped biological diversity and may provide novel metal reductases for metal detoxification and bioreduction. A thorough understanding of the biosynthetic mechanism of AuNPs in fungi is needed to reduce the time of biosynthesis and to scale up the AuNP production process. In this review, we describe the known mechanisms for AuNP biosynthesis in viable fungi and fungal protein extracts and discuss the most suitable bioreactors for industrial AuNP biosynthesis. PMID:25154648

  16. Polyethylene encapsulation of mixed wastes: Scale-up feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Kalb, P.D.; Heiser, J.H.; Colombo, P.

    1991-12-31

    A polyethylene process for the improved encapsulation of radioactive, hazardous, and mixed wastes have been developed at Brookhaven National Laboratory (BNL). Improvements in waste loading and waste form performance have been demonstrated through bench-scale development and testing. Maximum waste loadings of up to 70 dry wt % mixed waste nitrate salt were achieved, compared with 13--20 dry wt % using conventional cement processes. Stability under anticipated storage and disposal conditions and compliance with applicable hazardous waste regulations were demonstrated through a series of lab-scale waste form performance tests. Full-scale demonstration of this process using actual or surrogate waste is currently planned. A scale-up feasibility test was successfully conducted, demonstrating the ability to process nitrate salts at production rates (up to 450 kg/hr) and the close agreement between bench- and full-scale process parameters. Cored samples from the resulting pilot-scale (114 liter) waste form were used to verify homogeneity and to provide additional specimens for confirmatory performance testing.

  17. Scaling Up Data-Centric Middleware on a Cluster Computer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, D T; Franklin, M J; Garlick, J; Abdulla, G M

    2005-04-29

    Data-centric workflow middleware systems are workflow systems that treat data as first class objects alongside programs. These systems improve the usability, responsiveness and efficiency of workflow execution over cluster (and grid) computers. In this work, we explore the scalability of one such system, GridDB, on cluster computers. We measure the performance and scalability of GridDB in executing data-intensive image processing workflows from the SuperMACHO astrophysics survey on a large cluster computer. Our first experimental study concerns the scale-up of GridDB. We make a rather surprising finding, that while the middleware system issues many queries and transactions to a DBMS, file system operations present the first-tier bottleneck. We circumvent this bottleneck and increase the scalability of GridDB by more than 2-fold on our image processing application (up to 128 nodes). In a second study, we demonstrate the sensitivity of GridDB performance (and therefore application performance) to characteristics of the workflows being executed. To manage these sensitivities, we provide guidelines for trading off the costs and benefits of GridDB at a fine-grain.

  18. Chemotherapy and Chemoprevention by Thiazolidinediones

    Directory of Open Access Journals (Sweden)

    Eleonore Fröhlich

    2015-01-01

    Full Text Available Thiazolidinediones (TZDs are synthetic ligands of Peroxisome-Proliferator-Activated Receptor gamma (PPARγ. Troglitazone, rosiglitazone, and pioglitazone have been approved for treatment of diabetes mellitus type II. All three compounds, together with the first TZD ciglitazone, also showed an antitumor effect in preclinical studies and a beneficial effect in some clinical trials. This review summarizes hypotheses on the role of PPARγ in tumors, on cellular targets of TZDs, antitumor effects of monotherapy and of TZDs in combination with other compounds, with a focus on their role in the treatment of differentiated thyroid carcinoma. The results of chemopreventive effects of TZDs are also considered. Existing data suggest that the action of TZDs is highly complex and that actions do not correlate with cellular PPARγ expression status. Effects are cell-, species-, and compound-specific and concentration-dependent. Data from human trials suggest the efficacy of TZDs as monotherapy in prostate cancer and glioma and as chemopreventive agent in colon, lung, and breast cancer. TZDs in combination with other therapies might increase antitumor effects in thyroid cancer, soft tissue sarcoma, and melanoma.

  19. Scaling up health promotion interventions in the era of HIV/AIDS: challenges for a rights based approach.

    Science.gov (United States)

    Chopra, Mickey; Ford, Neil

    2005-12-01

    A sustained scaled up response to global public health challenges such as HIV/AIDS will require a functioning and efficient health system, based on the foundation of strong primary health care. Whilst this is necessary, it is not sufficient. Health promotion strategies need to be put into place to better engage and support families and communities in preventing disease, optimize caring, creating the demand for services and holding service providers to account. There will have to be a move away from the traditional model whereby the problem of HIV/TB/malaria is to be solved by merely increasing resources to a centralized bureaucracy that tries to increase the supply of services including health promotion messages. Development projects and programs that succeed are based on understanding of local practice and preferences, rather than on internationally 'generalized models' of how people or villages should behave and what they should want. This paper will first briefly review different approaches to scaling up health promotion interventions, some of the key obstacles in scaling up and then suggest some possible solutions with a focus on a human rights based approach. This approach changes the emphasis from the content of the message to the characteristics of a community's organisations and institutions. Scaling up occurs as a process of association between state actors and civil society that is planned strategically and involves a sharing of experience and a strong learning process among the association partners. A human rights-based approach can facilitate such an approach through developing a common vision, delineating roles and responsibility and facilitating communication channels for the most vulnerable. But this will require health development agencies to pursue a more overt political agenda.

  20. Scaling-up ultrasound standing wave enhanced sedimentation filters.

    Science.gov (United States)

    Prest, Jeff E; Treves Brown, Bernard J; Fielden, Peter R; Wilkinson, Stephen J; Hawkes, Jeremy J

    2015-02-01

    Particle concentration and filtration is a key stage in a wide range of processing industries and also one that can be present challenges for high throughput, continuous operation. Here we demonstrate some features which increase the efficiency of ultrasound enhanced sedimentation and could enable the technology the potential to be scaled up. In this work, 20 mm piezoelectric plates were used to drive 100 mm high chambers formed from single structural elements. The coherent structural resonances were able to drive particles (yeast cells) in the water to nodes throughout the chamber. Ultrasound enhanced sedimentation was used to demonstrate the efficiency of the system (>99% particle clearance). Sub-wavelength pin protrusions were used for the contacts between the resonant chamber and other elements. The pins provided support and transferred power, replacing glue which is inefficient for power transfer. Filtration energies of ∼4 J/ml of suspension were measured. A calculation of thermal convection indicates that the circulation could disrupt cell alignment in ducts >35 mm high when a 1K temperature gradient is present; we predict higher efficiencies when this maximum height is observed. For the acoustic design, although modelling was minimal before construction, the very simple construction allowed us to form 3D models of the nodal patterns in the fluid and the duct structure. The models were compared with visual observations of particle movement, Chladni figures and scanning laser vibrometer mapping. This demonstrates that nodal planes in the fluid can be controlled by the position of clamping points and that the contacts could be positioned to increase the efficiency and reliability of particle manipulations in standing waves. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Medical Specialties in Oman: Scaling Up through National Action.

    Science.gov (United States)

    Alshishtawy, Moeness

    2009-10-01

    To analyze the situation of medical specialists in the Sultanate of Oman, in terms of its past and current size and future needs. Data of Oman Medical Specialty Board (OMSB) and Ministry of Health (MoH) on medical specialists in Oman and the current Omanization levels in various specialties were reviewed and analyzed. Projections of the need for medical specialists by the End-2020 and in 2032 were calculated based on three different scenarios. Data on the number of medical specialists in Oman revealed a steady increase over the years, starting from only 52 specialists in 1975 to 2,162 in 2008; 25.1% of them were Omanis. The ratios of Omanization showed some inconsistency over the years in certain categories of specialization and were considerably low in some important specialties, e.g. Anesthesiology (5.7%) and Obstetrics & Gynecology (18.5%). By the End-2020, the total workforce of medical specialists in Oman is expected to reach 2,228; 408 of them would be Omanis. Otherwise, to achieve 100% Omanization, the number of Omani specialists required would be 1,772. According to three different scenarios, the number of medical specialists in Oman would range from 2,785-4,569 by 2032; of them 1,859-3,646 would be Omanis. In order to rapidly increase the number of medical specialists in Oman to satisfy the country's needs, OMSB has to adopt a visionary long-term strategy, through which it wouldß be able to gather all stakeholders resources within a national framework and direct a significant investment of funds towards scaling up medical specialists production.

  2. Malaria Research

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Malaria Go to Information for Researchers ► Malaria is a ... for the disease. Why Is the Study of Malaria a Priority for NIAID? Roughly 3.2 billion ...

  3. Comet Assay in Cancer Chemoprevention.

    Science.gov (United States)

    Santoro, Raffaela; Ferraiuolo, Maria; Morgano, Gian Paolo; Muti, Paola; Strano, Sabrina

    2016-01-01

    The comet assay can be useful in monitoring DNA damage in single cells caused by exposure to genotoxic agents, such as those causing air, water, and soil pollution (e.g., pesticides, dioxins, electromagnetic fields) and chemo- and radiotherapy in cancer patients, or in the assessment of genoprotective effects of chemopreventive molecules. Therefore, it has particular importance in the fields of pharmacology and toxicology, and in both environmental and human biomonitoring. It allows the detection of single strand breaks as well as double-strand breaks and can be used in both normal and cancer cells. Here we describe the alkali method for comet assay, which allows to detect both single- and double-strand DNA breaks.

  4. Scaling up debris-flow experiments on a centrifuge

    Science.gov (United States)

    Hung, C.; Capart, H.; Crone, T. J.; Grinspum, E.; Hsu, L.; Kaufman, D.; Li, L.; Ling, H.; Reitz, M. D.; Smith, B.; Stark, C. P.

    2013-12-01

    Boundary forces generated by debris flows can be powerful enough to erode bedrock and cause considerable damage to infrastructure during runout. Formulation of an erosion-rate law for debris flows is therefore a high priority, and it makes sense to build such a law around laboratory experiments. However, running experiments big enough to generate realistic boundary forces is a logistical challenge to say the least [1]. One alternative is to run table-top simulations with unnaturally weak but fast-eroding pseudo-bedrock, another is to extrapolate from micro-erosion of natural substrates driven by unnaturally weak impacts; hybrid-scale experiments have also been conducted [2]. Here we take a different approach in which we scale up granular impact forces by running our experiments under enhanced gravity in a geotechnical centrifuge [3]. Using a 40cm-diameter rotating drum [2] spun at up to 100g, we generate debris flows with an effective depth of over several meters. By varying effective gravity from 1g to 100g we explore the scaling of granular flow forces and the consequent bed and wall erosion rates. The velocity and density structure of these granular flows is monitored using laser sheets, high-speed video, and particle tracking [4], and the progressive erosion of the boundary surfaces is measured by laser scanning. The force structures and their fluctuations within the granular mass and at the boundaries are explored with contact dynamics numerical simulations that mimic the lab experimental conditions [5]. In this presentation we summarize these results and discuss how they can contribute to the formulation of debris-flow erosion law. [1] Major, J. J. (1997), Journal of Geology 105: 345-366, doi:10.1086/515930 [2] Hsu, L. (2010), Ph.D. thesis, University of California, Berkeley [3] Brucks, A., et al (2007), Physical Review E 75, 032301, doi:10.1103/PhysRevE.75.032301 [4] Spinewine, B., et al (2011), Experiments in Fluids 50: 1507-1525, doi: 10.1007/s00348

  5. The distribution and magnitude of malaria in Oromia, Ethiopia

    African Journals Online (AJOL)

    Objective: To assess the importance of health facility data and determine the distribution and; magnitude of malaria on the services of health ... Strengthening the surveillance systems for generating reliable data would also help in reflecting the magnitude of specific diseases ..... scale-up plan for Oromia: 2001-205. Malaria.

  6. Malaria diagnosis in the community: Challenges and potential role ...

    African Journals Online (AJOL)

    kemrilib

    (ACTs) by most African countries as first line treatment for malaria, an effective, but expensive treatment is available, and the case for an expanded role for rapid diagnostics in the fight against malaria is clear. Despite this perceived potential role for RDTs, some challenges hinder their introduction and scale-up in the public.

  7. Improved Prescription of Intermittent Preventive Therapy for Malaria ...

    African Journals Online (AJOL)

    Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria control in Nigeria. Previous data from this hospital reported a very low implementation of this guideline . Scale up of services and training were thereafter implemented. This study assessed the current ...

  8. Chemical carcinogenesis and chemoprevention: Scientific priority ...

    African Journals Online (AJOL)

    Occupational cancers are now a serious concern in industrializing developing countries where exposure levels to hazardous chemicals considerably exceed regulatory limits established in industrialized countries. The association between increasing use of chemicals and associated disorders and chemoprevention or ...

  9. Cancer chemoprevention – selected molecular mechanisms

    Directory of Open Access Journals (Sweden)

    Katarzyna Walczak

    2017-03-01

    Full Text Available The effect of diet on cancer formation and prevention of carcinogenesis has attracted considerable attention for years and is the subject of several studies. Some components of the daily diet, such as resveratrol, curcumin, genistein, gingerol, can significantly reduce the risk of cancer or affect the rate of tumor progression. Cancer chemoprevention assumes the use of natural or synthetic biologically active substances in order to prevent, inhibit or reverse the progression of cancer. There are many biologically active compounds in several natural products, i.e. garlic, ginger, soy, curcuma, tomatoes, cruciferous plants or green tea. Their chemopreventive activity is based on the inhibition of processes underlying carcinogenesis (inflammation, transformation and proliferation, but also affects the final phase of carcinogenesis - angiogenesis and metastasis. Despite the relatively low toxicity of chemopreventive agents, their molecular targets often coincide with the objectives of the currently used cancer therapies. The widespread use of chemopreventive agents may contribute to reduction of the rate of cancer incidence, and increase the effectiveness of conventional cancer therapies. In the present study, selected molecular mechanisms of the chemopreventive activity have been discussed, especially their involvement in the regulation of signal transduction, cell cycle regulation, apoptosis, metastasis and angiogenesis. The role of chemopreventive agents in the inflammatory process, the metabolism of xenobiotics and multidrug resistance has been also characterized.

  10. Malaria successes and challenges in Asia.

    Science.gov (United States)

    Bhatia, Rajesh; Rastogi, Rakesh Mani; Ortega, Leonard

    2013-12-01

    Asia ranks second to Africa in terms of malaria burden. In 19 countries of Asia, malaria is endemic and 2.31 billion people or 62% of the total population in these countries are at risk of malaria. In 2010, WHO estimated around 34.8 million cases and 45,600 deaths due to malaria in Asia. In 2011, 2.7 million cases and > 2000 deaths were reported. India, Indonesia, Myanmar and Pakistan are responsible for >85% of the reported cases (confirmed) and deaths in Asia. In last 10 yr, due to availability of donor's fund specially from Global fund, significant progress has been made by the countries in Asia in scaling-up malaria control interventions which were instrumental in reducing malaria morbidity and mortality significantly. There is a large heterogeneity in malaria epidemiology in Asia. As a result, the success in malaria control/elimination is also diverse. As compared to the data of the year 2000, out of 19 malaria endemic countries, 12 countries were able to reduce malaria incidence (microscopically confirmed cases only) by 75%. Two countries, namely Bangladesh and Malaysia are projected to reach 75% reduction by 2015 while India is projected to reach 50-75% only by 2015. The trend could not be assessed in four countries, namely Indonesia, Myanmar, Pakistan and Timor-Leste due to insufficient consistent data. Numerous key challenges need to be addressed to sustain the gains and eliminate malaria in most parts of Asia. Some of these are to control the spread of resistance in Plasmodium falciparum to artemisinin, control of outdoor transmission, control of vivax malaria and ensuring universal coverage of key interventions. Asia has the potential to influence the malaria epidemiology all over the world as well as to support the global efforts in controlling and eliminating malaria through production of quality-assured ACTs, RDTs and long-lasting insecticidal nets.

  11. DIETARY TERPENOIDS AND PROSTATE CANCER CHEMOPREVENTION

    Science.gov (United States)

    Rabi, Thangaiyan; Gupta, Sanjay

    2014-01-01

    Cancer chemoprevention by phytochemicals may be one of the most feasible approaches for cancer control. Phytochemicals obtained from vegetables, fruits, spices, teas, herbs and medicinal plants, such as terpenoids and other phenolic compounds, have been proven to suppress experimental carcinogenesis in various organs in pre-clinical models. Recent studies have indicated that mechanisms underlying chemopreventive potential may be a combination of antioxidant, anti-inflammatory, immune-enhancing, and hormone modulation effects, with modification of drug metabolizing enzymes, influence on cell cycle and cell differentiation, induction of apoptosis, suppression of proliferation and angiogenesis playing roles in the initiation and secondary modification stages of neoplastic development. Specific features of prostate cancer, such as high prevalence and long latency period provides ample opportunities for chemopreventive agents to work at various stages of disease progression. Finally, suitable populations with appropriate risk factors, including the presence of pre-malignant lesions and genetic predispositions, need to be well characterized for future chemopreventive interventions. Here we review naturally occurring dietary terpenoids as useful agents for prostate cancer chemoprevention with reference to their classes and sources. PMID:18508447

  12. Ellagitannins in Cancer Chemoprevention and Therapy

    Directory of Open Access Journals (Sweden)

    Tariq Ismail

    2016-05-01

    Full Text Available It is universally accepted that diets rich in fruit and vegetables lead to reduction in the risk of common forms of cancer and are useful in cancer prevention. Indeed edible vegetables and fruits contain a wide variety of phytochemicals with proven antioxidant, anti-carcinogenic, and chemopreventive activity; moreover, some of these phytochemicals also display direct antiproliferative activity towards tumor cells, with the additional advantage of high tolerability and low toxicity. The most important dietary phytochemicals are isothiocyanates, ellagitannins (ET, polyphenols, indoles, flavonoids, retinoids, tocopherols. Among this very wide panel of compounds, ET represent an important class of phytochemicals which are being increasingly investigated for their chemopreventive and anticancer activities. This article reviews the chemistry, the dietary sources, the pharmacokinetics, the evidence on chemopreventive efficacy and the anticancer activity of ET with regard to the most sensitive tumors, as well as the mechanisms underlying their clinically-valuable properties.

  13. Seasonal vaccination against malaria: a potential use for an imperfect malaria vaccine.

    Science.gov (United States)

    Greenwood, Brian; Dicko, Alassane; Sagara, Issaka; Zongo, Issaka; Tinto, Halidou; Cairns, Matthew; Kuepfer, Irene; Milligan, Paul; Ouedraogo, Jean-Bosco; Doumbo, Ogobara; Chandramohan, Daniel

    2017-05-02

    In many parts of the African Sahel and sub-Sahel, where malaria remains a major cause of mortality and morbidity, transmission of the infection is highly seasonal. Seasonal malaria chemoprevention (SMC), which involves administration of a full course of malaria treatment to young children at monthly intervals during the high transmission season, is proving to be an effective malaria control measure in these areas. However, SMC does not provide complete protection and it is demanding to deliver for both families and healthcare givers. Furthermore, there is a risk of the emergence in the future of resistance to the drugs, sulfadoxine-pyrimethamine and amodiaquine, that are currently being used for SMC. Substantial progress has been made in the development of malaria vaccines during the past decade and one malaria vaccine, RTS,S/AS01, has received a positive opinion from the European Medicines Authority and will soon be deployed in large-scale, pilot implementation projects in sub-Saharan Africa. A characteristic feature of this vaccine, and potentially of some of the other malaria vaccines under development, is that they provide a high level of efficacy during the period immediately after vaccination, but that this wanes rapidly, perhaps because it is difficult to develop effective immunological memory to malaria antigens in subjects exposed previously to malaria infection. A potentially effective way of using malaria vaccines with high initial efficacy but which provide only a short period of protection could be annual, mass vaccination campaigns shortly before each malaria transmission season in areas where malaria transmission is confined largely to a few months of the year.

  14. A model-based framework for incremental scale-up of wastewater treatment processes

    DEFF Research Database (Denmark)

    Mauricio Iglesias, Miguel; Sin, Gürkan

    Scale-up is traditionally done following specific ratios or rules of thumb which do not lead to optimal results. We present a generic framework to assist in scale-up of wastewater treatment processes based on multiscale modelling, multiobjective optimisation and a validation of the model at the new...

  15. 77 FR 25469 - Applications for New Awards; Investing in Innovation Fund, Scale-Up Grants

    Science.gov (United States)

    2012-04-30

    ... Applications for New Awards; Investing in Innovation Fund, Scale- Up Grants Catalog of Federal Domestic Assistance (CFDA) Number: 84.411A (Scale-up grants). AGENCY: Office of Innovation and Improvement, Department..., the Office of Innovation and Improvement in the U.S. Department of Education published in the Federal...

  16. Narrative review of models and success factors for scaling up public health interventions.

    Science.gov (United States)

    Milat, Andrew J; Bauman, Adrian; Redman, Sally

    2015-08-12

    To maximise the impact of public health research, research interventions found to be effective in improving health need to be scaled up and delivered on a population-wide basis. Theoretical frameworks and approaches are useful for describing and understanding how effective interventions are scaled up from small trials into broader policy and practice and can be used as a tool to facilitate effective scale-up. The purpose of this literature review was to synthesise evidence on scaling up public health interventions into population-wide policy and practice, with a focus on the defining and describing frameworks, processes and methods of scaling up public health initiatives. The review involved keyword searches of electronic databases including MEDLINE, CINAHL, PsycINFO, EBM Reviews and Google Scholar between August and December 2013. Keywords included 'scaling up' and 'scalability', while the search terms 'intervention research', 'translational research', 'research dissemination', 'health promotion' and 'public health' were used to focus the search on public health approaches. Studies included in the review were published in English from January 1990 to December 2013 and described processes, theories or frameworks associated with scaling up public health and health promotion interventions. There is a growing body of literature describing frameworks for scaling health interventions, with the review identifying eight frameworks, the majority of which have an explicit focus on scaling up health action in low and middle income country contexts. Key success factors for scaling up included the importance of establishing monitoring and evaluation systems, costing and economic modelling of intervention approaches, active engagement of a range of implementers and the target community, tailoring the scaled-up approach to the local context, the use of participatory approaches, the systematic use of evidence, infrastructure to support implementation, strong leadership and

  17. 'Scaling-up is a craft not a science': Catalysing scale-up of health innovations in Ethiopia, India and Nigeria.

    Science.gov (United States)

    Spicer, Neil; Bhattacharya, Dipankar; Dimka, Ritgak; Fanta, Feleke; Mangham-Jefferies, Lindsay; Schellenberg, Joanna; Tamire-Woldemariam, Addis; Walt, Gill; Wickremasinghe, Deepthi

    2014-11-01

    Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development partners, civil society organisations and externally funded implementers, professional associations and academic institutions in 2012/13 to explore scale-up of innovative interventions targeting mothers and newborns in Ethiopia, the Indian state of Uttar Pradesh and the six states of northeast Nigeria, which are settings with high burdens of maternal and neonatal mortality. Interviews were analysed using a common analytic framework developed for cross-country comparison and themes were coded using Nvivo. We found that programme implementers across the three settings require multiple steps to catalyse scale-up. Advocating for government to adopt and finance health innovations requires: designing scalable innovations; embedding scale-up in programme design and allocating time and resources; building implementer capacity to catalyse scale-up; adopting effective approaches to advocacy; presenting strong evidence to support government decision making; involving government in programme design; invoking policy champions and networks; strengthening harmonisation among external programmes; aligning innovations with health systems and priorities. Other steps include: supporting government to develop policies and programmes and strengthening health systems and staff; promoting community uptake by involving media, community leaders, mobilisation teams and role models. We conclude that scale-up has no magic bullet solution - implementers must embrace multiple activities, and require substantial support from donors and governments in

  18. Nigerian foodstuffs with prostate cancer chemopreventive polyphenols

    OpenAIRE

    Atawodi, Sunday Eneojo

    2011-01-01

    Dietary polyphenols are antioxidants that can scavenge biological free radicals, and chemoprevent diseases with biological oxidation as their main etiological factor. In this paper, we review our laboratory data vis-?-vis available literature on prostate cancer chemopreventive substances in Nigerian foodstuffs. Dacryodes edulis fruit, Moringa oleifera and Syzygium aromaticum contained prostate active polyphenols like ellagic acid, gallate, methylgallate, catechol, kaempferol quercetin and the...

  19. Meeting Report: Pancreatic Cancer Chemoprevention Translational Workshop

    Science.gov (United States)

    Miller, Mark Steven; Allen, Peter; Brentnall, Teresa; Goggins, Michael; Hruban, Ralph H.; Petersen, Gloria M.; Rao, Chinthalapally V.; Whitcomb, David C.; Brand, Randall E.; Chari, Suresh; Klein, Alison; Lubman, David; Rhim, Andrew; Simeone, Diane M.; Wolpin, Brian; Umar, Asad; Srivastava, Sudhir; Steele, Vernon E.; Ann Rinaudo, Jo

    2016-01-01

    Pancreatic cancer is the 4th leading cause of cancer related deaths in the US with a 5 year survival rate of Cancer Prevention of the NCI sponsored the Pancreatic Cancer Chemoprevention Translational Workshop on September 10–11th 2015. The goal of the workshop was to obtain information regarding the current state of the science and future scientific areas that should be prioritized for pancreatic cancer prevention research, including early detection and intervention for high-risk precancerous lesions. The workshop addressed the molecular/genetic landscape of pancreatic cancer and precursor lesions; high risk populations and criteria to identify a high risk population for potential chemoprevention trials; identification of chemopreventative/immuopreventative agents; and use of potential biomarkers and imaging for assessing short term efficacy of a preventative agent. The field of chemoprevention for pancreatic cancer is emerging and this workshop was organized to begin to address these important issues and promote multi-institutional efforts in this area. The meeting participants recommended the development of an NCI working group to coordinate efforts, provide a framework, and identify opportunities for chemoprevention of pancreatic cancer. PMID:27518363

  20. Cancer chemopreventive property of Bidens pilosa methanolic

    African Journals Online (AJOL)

    admin

    tumor growth. Chemopreventive agents can be broadly classified as blocking and suppressing agents. The blocking agents prevent carcinogenic ... stimulating differentiation in myeloid leukemia cells at a very low concentration, the effects of TPA in mouse with papilloma were investigated in the present study. In the present ...

  1. Cancer chemoprevention by targeting the epigenome.

    Science.gov (United States)

    Huang, Joseph; Plass, Christoph; Gerhauser, Clarissa

    2011-12-01

    The term "epigenetics" refers to modifications in gene expression caused by heritable, but potentially reversible, changes in DNA methylation and chromatin structure. Given the fact that epigenetic modifications occur early in carcinogenesis and represent potentially initiating events in cancer development, they have been identified as promising new targets for prevention strategies. The present review will give a comprehensive overview of the current literature on chemopreventive agents and their influence on major epigenetic mechanisms, that is DNA methylation, histone acetylation and methylation, and microRNAs, both in vitro and in rodent and human studies, taking into consideration specific mechanisms of action, target sites, concentrations, methods used for analysis, and outcome. Chemopreventive agents with reported mechanisms targeting the epigenome include micronutrients (folate, selenium, retinoic acid, Vit. E), butyrate, polyphenols (from green tea, apples, coffee, and other dietary sources), genistein and soy isoflavones, parthenolide, curcumin, ellagitannin, indol-3-carbinol (I3C) and diindolylmethane (DIM), mahanine, nordihydroguaiaretic acid (NDGA), lycopene, sulfur-containing compounds from Allium and cruciferous vegetables (sulforaphane, phenylethyl isothiocyanate (PEITC), phenylhexyl isothiocyanate (PHI), diallyldisulfide (DADS), allyl mercaptan (AM)), antibiotics (mithramycin A, apicidin), pharmacological agents (celecoxib, DFMO, 5-aza-2'-deoxycytidine and zebularine), compounds affecting sirtuin activity (resveratrol, dihydrocoumarin, cambinol), inhibitors of histone acetyl transferases (anacardic acid, garcinol, ursodeoxycholic acid), and relatively unexplored modulators of histone lysine methylation (chaetocin, polyamine analogues, n-3 polyunsaturated fatty acids). Their effects on global DNA methylation, tumor suppressor genes silenced by promoter methylation, histone modifications, and miRNAs deregulated during carcinogenesis have potential

  2. Scaling up community mobilisation through women's groups for maternal and neonatal health: experiences from rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Nahar Tasmin

    2012-01-01

    Full Text Available Abstract Background Program coverage is likely to be an important determinant of the effectiveness of community interventions to reduce neonatal mortality. Rigorous examination and documentation of methods to scale-up interventions and measure coverage are scarce, however. To address this knowledge gap, this paper describes the process and measurement of scaling-up coverage of a community mobilisation intervention for maternal, child and neonatal health in rural Bangladesh and critiques this real-life experience in relation to available literature on scaling-up. Methods Scale-up activities took place in nine unions in rural Bangladesh. Recruitment and training of those who deliver the intervention, communication and engagement with the community and other stakeholders and active dissemination of intervention activities are described. Process evaluation and population survey data are presented and used to measure coverage and the success of scale-up. Results The intervention was scaled-up from 162 women's groups to 810, representing a five-fold increase in population coverage. The proportion of women of reproductive age and pregnant women who were engaged in the intervention increased from 9% and 3%, respectively, to 23% and 29%. Conclusions Examination and documentation of how scaling-up was successfully initiated, led, managed and monitored in rural Bangladesh provide a deeper knowledge base and valuable lessons. Strong operational capabilities and institutional knowledge of the implementing organisation were critical to the success of scale-up. It was possible to increase community engagement with the intervention without financial incentives and without an increase in managerial staff. Monitoring and feedback systems that allow for periodic programme corrections and continued innovation are central to successful scale-up and require programmatic and operational flexibility.

  3. Malaria case detection using rapid diagnostic test at the community level in Ghana: consumer perception and practitioners? experiences

    OpenAIRE

    Danquah, Daniel A.; Buabeng, Kwame O.; Asante, Kwaku P.; Mahama, Emmanuel; Bart-Plange, Constance; Owusu-Dabo, Ellis

    2016-01-01

    Background Ghana has scaled-up malaria control strategies over the past decade. Much as malaria morbidity and mortality seem to have declined with these efforts, there appears to be increased consumption of artemisinin-based combination therapy (ACT). This study explored the perception and experiences of community members and medicines outlet practitioners on malaria case detection using rapid diagnostic test (RDTs) to guide malaria therapy. Methods This was a cross-sectional study using both...

  4. Changing cost of HIV interventions in the context of scaling-up in India

    National Research Council Canada - National Science Library

    Dandona, Lalit; Kumar, Sg Prem; Ramesh, Yk; Rao, M Chalapathi; Kumar, A Anod; Marseille, Elliot; Kahn, James G; Dandona, Rakhi

    2008-01-01

    A rapid scaling up of HIV interventions in India is anticipated, but systematic information on how costs of HIV interventions change over time and programme scale is not available to inform planning...

  5. A Route to Scale Up DNA Origami Using DNA Tiles as Folding Staples

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Zhao; Yan, Hao; Liu, Yan

    2010-01-26

    A new strategy is presented to scale up DNA origami using multi-helical DNA tiles as folding staples. Atomic force microscopy images demonstrate the two-dimensional structures formed by using this strategy.

  6. Metabolic Profiling of Geobacter sulfurreducens during Industrial Bioprocess Scale-Up

    National Research Council Canada - National Science Library

    Muhamadali, Howbeer; Xu, Yun; Ellis, David I; Allwood, J William; Rattray, Nicholas J W; Correa, Elon; Alrabiah, Haitham; Lloyd, Jonathan R; Goodacre, Royston

    2015-01-01

    During the industrial scale-up of bioprocesses it is important to establish that the biological system has not changed significantly when moving from small laboratory-scale shake flasks or culturing...

  7. Methodologies Used for Scaling-up From a Single Energy Production Unit to State Energy Sector

    Science.gov (United States)

    Cimdina, Ginta; Timma, Lelde; Veidenbergs, Ivars; Blumberga, Dagnija

    2015-12-01

    In a well-functioning and sustainable national energy sector, each of its elements should function with maximum efficiency. To ensure maximum efficiency and study possible improvement of the sector, a scaling-up framework is presented in this work. The scaling-up framework means that the starting point is a CHP unit and its operation, the next step of aggregation is in a district heating network, followed by a municipal energy plan and finally leading to a low carbon strategy. In this framework the authors argue, that the successful, innovative practices developed and tested at the lower level of aggregation can be then transferred to the upper levels of aggregation, thus leading to a scaling-up effect of innovative practices. The work summarizes 12 methodologies used in the energy sector, by dividing these methodologies among the levels of aggregation in a scaling-up framework.

  8. Scaling up success to improve health: Towards a rapid assessment guide for decision makers

    Directory of Open Access Journals (Sweden)

    Jason Paltzer

    2015-01-01

    Full Text Available Introduction Evidence-based health interventions exist and are effectively implemented throughout resource-limited settings. The literature regarding scale-up strategies and frameworks is growing. The purpose of this paper is to identify and systematically document the variation in scale-up strategies to develop a rapid assessment tool for decision-makers looking to identify the most appropriate strategy for their organizational and environmental contexts. Methods A list of scale-up strategies and frameworks were identified through an in-depth literature review and conversations with scale-up and quality improvement leaders. The literature search included a broad range of terms that might be used interchangeably with scale-up of best practices. Terms included: implementation research, knowledge translation, translational research, quality improvement research, health systems improvement, scale-up, best practices, improvement collaborative, and community based research. Based on this research, 18 strategies and frameworks were identified, and nine met our inclusion criteria for scale-up of health-related strategies. We interviewed the key contact for four of the nine strategies to obtain additional information regarding the strategy’s scale-up components, targets, underlying theories, evaluation efforts, facilitating factors, and barriers. A comparative analysis of common elements and strategy characteristics was completed by two of the authors on the nine selected strategies. Key strategy characteristics and common factors that facilitate or hinder the strategy’s success in scaling up health-related interventions were identified. Results Common features of scale-up strategies include: 1 the development of context-specific evidence; 2 collaborative partnerships; 3 iterative processes; and 4 shared decision-making. Facilitating factors include strong leadership, community engagement, communication, government collaboration, and a focus on

  9. Methodologies Used for Scaling-up From a Single Energy Production Unit to State Energy Sector

    National Research Council Canada - National Science Library

    Ginta Cimdina; Lelde Timma; Ivars Veidenbergs; Dagnija Blumberga

    2015-01-01

    ... leading to a low carbon strategy. In this framework the authors argue, that the successful, innovative practices developed and tested at the lower level of aggregation can be then transferred to the upper levels of aggregation, thus leading to a scaling-up effect of innovative practices. The work summarizes 12 methodologies used in the energy sector, by dividing these methodologies among the levels of aggregation in a scaling-up framework.

  10. Quality Assessment of Physical and Organoleptic Instant Corn Rice on Scale-Up Process

    Science.gov (United States)

    Kumalasari, R.; Ekafitri, R.; Indrianti, N.

    2017-12-01

    Development of instant corn rice product has been successfully conducted on a laboratory scale. Corn has high carbohydrate content but low in fiber. The addition of fiber in instant corn rice, intended to improve the functioning of the product, and replace fiber loss during the process. Scale up process of Instant corn rice required to increase the production capacity. Scale up was the process to get identic output on a larger scale based on predetermined production scale. This study aimed to assess the changes and differences in the quality of instant corn rice during scale up. Instant corn rice scale up was done on production capacity 3 kg, 4 kg and 5 kg. Results showed that scale up of instant corn rice producing products with rehydration ratio ranges between 514% - 570%, the absorption rate ranged between 414% - 470%, swelling rate ranging between 119% - 134%, bulk density ranged from 0.3661 to 0.4745 (g/ml) and porosity ranging between 30-37%. The physical quality of instant corn rice on scale up were stable from the ones at laboratory scale on swelling rate, rehydration ratio, and absorption rate but not stable on bulk density and porosity. Organoleptic qualities were stable at increased scale compared on a laboratory scale. Bulk density was higher than those at laboratory scale, and the porosity was lower than those at laboratory scale.

  11. Climate change and the global malaria recession.

    Science.gov (United States)

    Gething, Peter W; Smith, David L; Patil, Anand P; Tatem, Andrew J; Snow, Robert W; Hay, Simon I

    2010-05-20

    The current and potential future impact of climate change on malaria is of major public health interest. The proposed effects of rising global temperatures on the future spread and intensification of the disease, and on existing malaria morbidity and mortality rates, substantively influence global health policy. The contemporary spatial limits of Plasmodium falciparum malaria and its endemicity within this range, when compared with comparable historical maps, offer unique insights into the changing global epidemiology of malaria over the last century. It has long been known that the range of malaria has contracted through a century of economic development and disease control. Here, for the first time, we quantify this contraction and the global decreases in malaria endemicity since approximately 1900. We compare the magnitude of these changes to the size of effects on malaria endemicity proposed under future climate scenarios and associated with widely used public health interventions. Our findings have two key and often ignored implications with respect to climate change and malaria. First, widespread claims that rising mean temperatures have already led to increases in worldwide malaria morbidity and mortality are largely at odds with observed decreasing global trends in both its endemicity and geographic extent. Second, the proposed future effects of rising temperatures on endemicity are at least one order of magnitude smaller than changes observed since about 1900 and up to two orders of magnitude smaller than those that can be achieved by the effective scale-up of key control measures. Predictions of an intensification of malaria in a warmer world, based on extrapolated empirical relationships or biological mechanisms, must be set against a context of a century of warming that has seen marked global declines in the disease and a substantial weakening of the global correlation between malaria endemicity and climate.

  12. Establishment of the Ivermectin Research for Malaria Elimination Network: updating the research agenda

    NARCIS (Netherlands)

    Chaccour, C.J.; Rabinovich, N.R.; Slater, H.; Canavati, S.E.; Bousema, T.; Lacerda, M.; Kuile, F. ter; Drakeley, C.; Bassat, Q.; Foy, B.D.; Kobylinski, K.

    2015-01-01

    The potential use of ivermectin as an additional vector control tool is receiving increased attention from the malaria elimination community, driven by the increased importance of outdoor/residual malaria transmission and the threat of insecticide resistance where vector tools have been scaled-up.

  13. Beneficial and adverse effects of chemopreventive agents

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Mu; Park, Kwang-Kyun

    2003-03-01

    The beneficial and adverse effects of some chemopreventive agents, such as Vitamins A, C, E, beta-carotene, indole-3-carbinol, capsaicin, garlic, and aloe are reviewed. Two large randomized trials with a lung cancer endpoint, the Alpha-Tocopherol, Beta-Carotene (ATBC) Prevention Study and the Beta-Carotene and Retinol Efficacy Trial (CARET), suggested that antioxidants might be harmful in smokers. However, the results of the Linxian study and of the ATBC or the CARET studies were significantly different in this respect, and therefore, the relationship between antioxidant and carcinogenesis remains open to debate. Indole-3-carbinol has cancer promoting activities in the colon, thyroid, pancreas, and liver, whereas capsaicin alters the metabolism of chemical carcinogens and may promote carcinogenesis at high doses. Organosulfur compounds and selenium from garlic have no or a little enhancing effect on cancer promotion stage. Information upon chemopreventive mechanisms that inhibit carcinogenesis is imperfect, although the causes and natures of certain human cancers are known. Therefore, definitive preventive guidelines should be carefully offered for various types of tumors, which properly consider ethnic variations, and the efficacies and the safety of chemopreventive agents.

  14. Impact of malaria interventions on child mortality in endemic African settings: comparison and alignment between LiST and Spectrum-Malaria model

    Directory of Open Access Journals (Sweden)

    Eline Korenromp

    2017-11-01

    Full Text Available Abstract Background In malaria-endemic countries, malaria prevention and treatment are critical for child health. In the context of intervention scale-up and rapid changes in endemicity, projections of intervention impact and optimized program scale-up strategies need to take into account the consequent dynamics of transmission and immunity. Methods The new Spectrum-Malaria program planning tool was used to project health impacts of Insecticide-Treated mosquito Nets (ITNs and effective management of uncomplicated malaria cases (CMU, among other interventions, on malaria infection prevalence, case incidence and mortality in children 0–4 years, 5–14 years of age and adults. Spectrum-Malaria uses statistical models fitted to simulations of the dynamic effects of increasing intervention coverage on these burdens as a function of baseline malaria endemicity, seasonality in transmission and malaria intervention coverage levels (estimated for years 2000 to 2015 by the World Health Organization and Malaria Atlas Project. Spectrum-Malaria projections of proportional reductions in under-five malaria mortality were compared with those of the Lives Saved Tool (LiST for the Democratic Republic of the Congo and Zambia, for given (standardized scenarios of ITN and/or CMU scale-up over 2016–2030. Results Proportional mortality reductions over the first two years following scale-up of ITNs from near-zero baselines to moderately higher coverages align well between LiST and Spectrum-Malaria —as expected since both models were fitted to cluster-randomized ITN trials in moderate-to-high-endemic settings with 2-year durations. For further scale-up from moderately high ITN coverage to near-universal coverage (as currently relevant for strategic planning for many countries, Spectrum-Malaria predicts smaller additional ITN impacts than LiST, reflecting progressive saturation. For CMU, especially in the longer term (over 2022–2030 and for lower

  15. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  16. Malaria Matters

    Centers for Disease Control (CDC) Podcasts

    2008-04-18

    This podcast gives an overview of malaria, including prevention and treatment, and what CDC is doing to help control and prevent malaria globally.  Created: 4/18/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/18/2008.

  17. Preparation and scale up of extended-release tablets of bromopride

    Directory of Open Access Journals (Sweden)

    Guilherme Neves Ferreira

    2014-04-01

    Full Text Available Reproducibility of the tablet manufacturing process and control of its pharmaceutics properties depends on the optimization of formulation aspects and process parameters. Computer simulation such as Design of Experiments (DOE can be used to scale up the production of this formulation, in particular for obtaining sustained-release tablets. Bromopride formulations are marketed in the form of extended-release pellets, which makes the product more expensive and difficult to manufacture. The aim of this study was to formulate new bromopride sustained release formulations as tablets, and to develop mathematical models to standardize the scale up of this formulation, controlling weight and hardness of the tablets during manufacture according to the USP 34th edition. DOE studies were conducted using Minitab(tm software. Different excipient combinations were evaluated in order to produce bromopride sustained-release matrix tablets. In the scale-up study, data were collected and variations in tableting machine parameters were measured. Data were processed by Minitab(tm software, generating mathematical equations used for prediction of powder compaction behavior, according to the settings of the tableting machine suitable for scale-up purposes. Bromopride matrix tablets with appropriate characteristics for sustained release were developed. The scale-up of the formulation with the most suitable sustained release profile was established by using mathematical models, indicating that the formulation can be a substitute for the pellets currently marketed.

  18. Scale up of services for mental health in low-income and middle-income countries.

    Science.gov (United States)

    Eaton, Julian; McCay, Layla; Semrau, Maya; Chatterjee, Sudipto; Baingana, Florence; Araya, Ricardo; Ntulo, Christina; Thornicroft, Graham; Saxena, Shekhar

    2011-10-29

    Mental disorders constitute a huge global burden of disease, and there is a large treatment gap, particularly in low-income and middle-income countries. One response to this issue has been the call to scale up mental health services. We assess progress in scaling up such services worldwide using a systematic review of literature and a survey of key national stakeholders in mental health. The large number of programmes identified suggested that successful strategies can be adopted to overcome barriers to scaling up, such as the low priority accorded to mental health, scarcity of human and financial resources, and difficulties in changing poorly organised services. However, there was a lack of well documented examples of services that had been taken to scale that could guide how to replicate successful scaling up in other settings. Recommendations are made on the basis of available evidence for how to take forward the process of scaling up services globally. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. New tools for malaria control - using them wisely.

    Science.gov (United States)

    Greenwood, Brian

    2017-06-01

    The incidence of malaria in sub-Saharan Africa is falling and in many countries on the continent the pattern of malaria infection within the country is becoming more heterogeneous. National malaria control programmes need to take this into account and the 'one size fits all' approach to malaria control may no longer be appropriate, with individual approaches being needed in different parts of a country. This applies particularly to decisions on the introduction of new control tools. Recent experience with Seasonal Malaria Chemoprevention and with the RTS,S/AS01 malaria vaccine provides examples of interventions which need to be deployed on a restricted rather than a national basis, taking account of differences in climate and the intensity of malaria infection between regions within a country. Designing, implementing and monitoring more complex national malaria control programmes will require staff skilled in many disciplines, and substantial funding will be needed to sustain these more complex control programmes, even though the burden of the disease is falling. © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  20. Scaling up Integrated Early Childhood Development programs: lessons from four countries.

    Science.gov (United States)

    Pérez-Escamilla, R; Cavallera, V; Tomlinson, M; Dua, T

    2018-01-01

    There is still limited knowledge regarding the translation of early child development (ECD) knowledge into effective policies and large-scale programmes. A variety of frameworks that outline the key steps in scaling up exist, but we argue that taking a complex adaptive systems (CAS) approach assists in understanding the complex, dynamic processes that result in programmes being taken to scale. The objective of this study is to examine the process of scaling up four major country-level ECD programmes through the application of a CAS framework. Nine key informants with a deep knowledge of how each ECD programme was established and brought to scale were interviewed via Skype or phone by using open-ended interviews. The interviews were tape recorded and then transcribed verbatim for subsequent coding by using CAS domains. The coding and integration of the results to identify unique and common CAS scaling up features across the case studies involved an iterative process of reaching consensus. The scaling up of all four programmes behaved as a CAS including as follows: (i) positive feedback loops (five themes) and negative feedback loops (two themes); (ii) scale-free networks (two themes); (iii) phase transitions (four themes); (iv) path dependence (two themes); and (v) emergent behaviour (six themes). Five additional themes were identified for sustainability, which was repeatedly mentioned as an important consideration when deciding how to scale up programmes. CAS analysis is likely to improve our understanding of how effective ECD programmes become scaled up. Prospective CAS implementation research is needed to continue advancing the knowledge in the field. © 2017 John Wiley & Sons Ltd.

  1. Scaling up interventions for depression in sub-Saharan Africa: lessons from Zimbabwe.

    Science.gov (United States)

    Chibanda, D; Verhey, R; Munetsi, E; Rusakaniko, S; Cowan, F; Lund, C

    2016-01-01

    There is a dearth of information on how to scale-up evidence-based psychological interventions, particularly within the context of existing HIV programs. This paper describes a strategy for the scale-up of an intervention delivered by lay health workers (LHWs) to 60 primary health care facilities in Zimbabwe. A mixed methods approach was utilized as follows: (1) needs assessment using a semi-structured questionnaire to obtain information from nurses ( n  = 48) and focus group discussions with District Health Promoters ( n  = 12) to identify key priority areas; (2) skills assessment to identify core competencies and current gaps of LHWs ( n  = 300) employed in the 60 clinics; (3) consultation workshops ( n  = 2) with key stakeholders to determine referral pathways; and (4) in-depth interviews and consultations to determine funding mechanisms for the scale-up. Five cross-cutting issues were identified as critical and needing to be addressed for a successful scale-up. These included: the lack of training in mental health, unavailability of psychiatric drugs, depleted clinical staff levels, unavailability of time for counseling, and poor and unreliable referral systems for people suffering with depression. Consensus was reached by stakeholders on supervision and support structure to address the cross-cutting issues described above and funding was successfully secured for the scale-up. Key requirements for success included early buy-in from key stakeholders, extensive consultation at each point of the scale-up journey, financial support both locally and externally, and a coherent sustainability plan endorsed by both government and private sectors.

  2. Enabling and challenging factors in institutional reform: The case of SCALE-UP

    Science.gov (United States)

    Foote, Kathleen; Knaub, Alexis; Henderson, Charles; Dancy, Melissa; Beichner, Robert J.

    2016-06-01

    While many innovative teaching strategies exist, integration into undergraduate science teaching has been frustratingly slow. This study aims to understand the low uptake of research-based instructional innovations by studying 21 successful implementations of the Student Centered Active Learning with Upside-down Pedagogies (SCALE-UP) instructional reform. SCALE-UP significantly restructures the classroom environment and pedagogy to promote highly active and interactive instruction. Although originally designed for university introductory physics courses, SCALE-UP has spread to many other disciplines at hundreds of departments around the world. This study reports findings from in-depth, open-ended interviews with 21 key contact people involved with successful secondary implementations of SCALE-UP throughout the United States. We defined successful implementations as those who restructured their pedagogy and classroom and sustained and/or spread the change. Interviews were coded to identify the most common enabling and challenging factors during reform implementation and compared to the theoretical framework of Kotter's 8-step Change Model. The most common enabling influences that emerged are documenting and leveraging evidence of local success, administrative support, interaction with outside SCALE-UP user(s), and funding. Many challenges are linked to the lack of these enabling factors including difficulty finding funding, space, and administrative and/or faculty support for reform. Our focus on successful secondary implementations meant that most interviewees were able to overcome challenges. Presentation of results is illuminated with case studies, quotes, and examples that can help secondary implementers with SCALE-UP reform efforts specifically. We also discuss the implications for policy makers, researchers, and the higher education community concerned with initiating structural change.

  3. Enabling and challenging factors in institutional reform: The case of SCALE-UP

    Directory of Open Access Journals (Sweden)

    Kathleen Foote

    2016-02-01

    Full Text Available While many innovative teaching strategies exist, integration into undergraduate science teaching has been frustratingly slow. This study aims to understand the low uptake of research-based instructional innovations by studying 21 successful implementations of the Student Centered Active Learning with Upside-down Pedagogies (SCALE-UP instructional reform. SCALE-UP significantly restructures the classroom environment and pedagogy to promote highly active and interactive instruction. Although originally designed for university introductory physics courses, SCALE-UP has spread to many other disciplines at hundreds of departments around the world. This study reports findings from in-depth, open-ended interviews with 21 key contact people involved with successful secondary implementations of SCALE-UP throughout the United States. We defined successful implementations as those who restructured their pedagogy and classroom and sustained and/or spread the change. Interviews were coded to identify the most common enabling and challenging factors during reform implementation and compared to the theoretical framework of Kotter’s 8-step Change Model. The most common enabling influences that emerged are documenting and leveraging evidence of local success, administrative support, interaction with outside SCALE-UP user(s, and funding. Many challenges are linked to the lack of these enabling factors including difficulty finding funding, space, and administrative and/or faculty support for reform. Our focus on successful secondary implementations meant that most interviewees were able to overcome challenges. Presentation of results is illuminated with case studies, quotes, and examples that can help secondary implementers with SCALE-UP reform efforts specifically. We also discuss the implications for policy makers, researchers, and the higher education community concerned with initiating structural change.

  4. History of malaria research and its contribution to the malaria control success in Suriname: a review.

    Science.gov (United States)

    Breeveld, Florence J V; Vreden, Stephen G S; Grobusch, Martin P

    2012-03-29

    Suriname has cleared malaria from its capital city and coastal areas mainly through the successful use of chloroquine and DDT (dichloro-diphenyl-trichloroethane) during the Global Malaria Eradication programme that started in 1955. Nonetheless, malaria transmission rates remained high in the interior of the country for a long time. An impressive decline in malaria cases was achieved in the past few years, from 14,403 registered cases in 2003 to 1,371 in 2009. The introduction of artemisinin-based combination therapy (ACT) in 2004 has further fuelled the decrease in the number of infections with Plasmodium falciparum. The only population group still heavily burdened with malaria is gold mining industry workers. Interestingly, an important part of malaria cases diagnosed and treated in Suriname originate from border regions. Therefore, practical initiatives of combined efforts between neighbouring countries must be scaled up in order to effectively attack these specific areas. Furthermore, it is of vital importance to keep investing into the malaria control programme and public awareness campaigns. Especially the correct use of ACT must be promoted in order to prevent the emergence of resistance. However, effective preventive measures and adequate therapeutic options are on their own not enough to control, let alone eliminate malaria. Changing personal and social behaviour of people is particularly difficult, but crucial in making the current success sustainable. With this in mind, research on successfully implemented interventions, focusing on behavioural modifications and methods of measuring their effectiveness, must be expanded.

  5. Scale-up operations of CuSOB4B-NaB2BSOB4B electrolytic ...

    African Journals Online (AJOL)

    Scale-up techniques were established for an Inclined Cathode Electrochemical Cell (ICEC) for the removal of copper ions from a CuSOB4B-NaB2BSOB4B solution at reduced operation power consumption. The scale-up relationshi-ps were derived and applied in conjunction with scale-up factors. With a scale-up factor of 2, ...

  6. Modeling heat efficiency, flow and scale-up in the corotating disc scraped surface heat exchanger

    DEFF Research Database (Denmark)

    Friis, Alan; Szabo, Peter; Karlson, Torben

    2002-01-01

    A comparison of two different scale corotating disc scraped surface heat exchangers (CDHE) was performed experimentally. The findings were compared to predictions from a finite element model. We find that the model predicts well the flow pattern of the two CDHE's investigated. The heat transfer...... performance predicted by the model agrees well with experimental observations for the laboratory scale CDHE whereas the overall heat transfer in the scaled-up version was not in equally good agreement. The lack of the model to predict the heat transfer performance in scale-up leads us to identify the key...

  7. Numerical simulation of scale-up effects of methanol-to-olefins fluidized bed reactors

    DEFF Research Database (Denmark)

    Lu, Bona; Zhang, Jingyuan; Luo, Hao

    2017-01-01

    factors and is expected to speed up the experiment-based scale-up process with lower cost. In this study, we aim to investigate the scale-up effects through simulations of a series of methanol-to-olefins (MTO) reactors of different sizes. The two-fluid model and energy-minimization multi-scale (EMMS......)-based drag models are combined in simulations. The fluidization characteristics in terms of flow structures, velocity distribution, mass fractions of gaseous product and coke distribution are presented against available experimental data for different-sized reactors. It is found that typical hydrodynamic...

  8. Rethinking Sustainability, Scaling Up, and Enabling Environment: A Framework for Their Implementation in Drinking Water Supply

    Directory of Open Access Journals (Sweden)

    Urooj Q. Amjad

    2015-04-01

    Full Text Available The terms sustainability, scaling up, and enabling environment are inconsistently used in implementing water supply projects. To clarify these terms we develop a framework based on Normalization Process Theory, and apply the framework to a hypothetical water supply project in schools. The resulting framework provides guidance on how these terms could be implemented and analyzed in water supply projects. We conclude that effective use of the terms sustainability, scaling up, and enabling environment would focus on purpose, process, and perspective. This is the first known attempt to analyze the implementation of the three terms together in the context of water supply services.

  9. Scale-up of dextransucrase production by Leuconostoc mesenteroides in fed batch fermentation

    Directory of Open Access Journals (Sweden)

    Michelena Georgina L.

    2003-01-01

    Full Text Available Fed batch fermentation was carried out for the dextransucrase enzyme production from Leuconostoc mesenteroides and the production was scale-up using oxygen transfer criteriuom. It was found that in 5 L vessel fermentation capacity, the best agitation speed was 225 min-1 and aeration rate was 0.15 vvm, obtaining dextransucrase activity of 127 DSU/mL.. The maximum enzyme production velocity coincide with the maximum growth velocity between 6 and 7 h of fermentation, which confirmed that dextransucrase production was associated with microbial growth. High enzyme yields were achieved during scale up based on oxygen transfer rate.

  10. Malaria Treatment (United States)

    Science.gov (United States)

    ... a CDC Malaria Branch clinician. malaria@cdc.gov Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  11. Malaria and Travelers

    Science.gov (United States)

    ... a CDC Malaria Branch clinician. malaria@cdc.gov Malaria and Travelers Recommend on Facebook Tweet Share Compartir ... may be at risk for infection. Determine if malaria transmission occurs at the destinations Obtain a detailed ...

  12. Chemopreventive effect of tadalafil in cisplatin-induced ...

    African Journals Online (AJOL)

    Summary: Nephrotoxicity remains a common untoward effect of cisplatin therapy with limited effective chemopreventive options available till date. This study aims to evaluate the possible chemopreventive effect and mechanism(s) of action of 2 mgkg-1 and 5 mgkg-1 of Tadalafil in cisplatin-induced nephrotoxic rats. In this ...

  13. The paradigm of eave tubes: scaling up house improvement and optimizing insecticide delivery against disease-transmitting mosquitoes.

    Science.gov (United States)

    Okumu, Fredros

    2017-05-19

    ) ineligibility of poorest and highest-risk households living in housing structures not amenable to eave tubes, and (3) poor synergies when eave tubes are combined with LLINs or IRS in same households. Overall, this paradigm significantly improves delivery of insecticides against disease-transmitting mosquitoes, and provides opportunities for scaling-up the long-neglected concept of house improvement as a malaria intervention.

  14. Scaling-up of CO2 fluxes to assess carbon sequestration in rangelands of Central Asia

    Science.gov (United States)

    Bruce K. Wylie; Tagir G. Gilmanov; Douglas A. Johnson; Nicanor Z. Saliendra; Larry L. Tieszen; Ruth Anne F. Doyle; Emilio A. Laca

    2006-01-01

    Flux towers provide temporal quantification of local carbon dynamics at specific sites. The number and distribution of flux towers, however, are generally inadequate to quantify carbon fluxes across a landscape or ecoregion. Thus, scaling up of flux tower measurements through use of algorithms developed from remote sensing and GIS data is needed for spatial...

  15. An efficient permeability scaling-up technique applied to the discretized flow equations

    Energy Technology Data Exchange (ETDEWEB)

    Urgelli, D.; Ding, Yu [Institut Francais du Petrole, Rueil Malmaison (France)

    1997-08-01

    Grid-block permeability scaling-up for numerical reservoir simulations has been discussed for a long time in the literature. It is now recognized that a full permeability tensor is needed to get an accurate reservoir description at large scale. However, two major difficulties are encountered: (1) grid-block permeability cannot be properly defined because it depends on boundary conditions; (2) discretization of flow equations with a full permeability tensor is not straightforward and little work has been done on this subject. In this paper, we propose a new method, which allows us to get around both difficulties. As the two major problems are closely related, a global approach will preserve the accuracy. So, in the proposed method, the permeability up-scaling technique is integrated in the discretized numerical scheme for flow simulation. The permeability is scaled-up via the transmissibility term, in accordance with the fluid flow calculation in the numerical scheme. A finite-volume scheme is particularly studied, and the transmissibility scaling-up technique for this scheme is presented. Some numerical examples are tested for flow simulation. This new method is compared with some published numerical schemes for full permeability tensor discretization where the full permeability tensor is scaled-up through various techniques. Comparing the results with fine grid simulations shows that the new method is more accurate and more efficient.

  16. Investing in the foundation of sustainable development: pathways to scale up for early childhood development.

    Science.gov (United States)

    Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan; Heymann, Jody; Boo, Florencia Lopez; Behrman, Jere R; Lu, Chunling; Lucas, Jane E; Perez-Escamilla, Rafael; Dua, Tarun; Bhutta, Zulfiqar A; Stenberg, Karin; Gertler, Paul; Darmstadt, Gary L

    2017-01-07

    Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Including Performance Assessments in Accountability Systems: A Review of Scale-Up Efforts

    Science.gov (United States)

    Tung, Rosann

    2010-01-01

    The purpose of this literature and field review is to understand previous efforts at scaling up performance assessments for use across districts and states. Performance assessments benefit students and teachers by providing more opportunities for students to demonstrate their knowledge and complex skills, by providing teachers with better…

  18. Scaling up Evidence-Based Practices: Strategies from Investing in Innovation (i3)

    Science.gov (United States)

    DeWire, Tom; McKithen, Clarissa; Carey, Rebecca

    2017-01-01

    What can the Investing in Innovation (i3) grantees tell us about scaling innovative educational practices? The newly released white paper "Scaling Up Evidence-Based Practices: Strategies from Investing in Innovation (i3)" captures the experiences of nine grantees whose projects collectively have reached over 1.2 million students across…

  19. Electronic Government in the City of Fez, Morocco : Scaling up to the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In the pilot phase of the project (101980), electronic service delivery was introduced and successfully deployed in the Fez-Agdal local government office. This phase will scale up the project to include the remaining local government offices in the city of Fez. It will also upgrade, enhance and complete the automation of the ...

  20. HIV viral load scale-up: multiple interventions to meet the HIV treatment cascade.

    Science.gov (United States)

    Carmona, Sergio; Peter, Trevor; Berrie, Leigh

    2017-03-01

    In 2015, the WHO urged countries to provide ART to all people living with HIV, irrespective of their CD4 cell count, this new recommendation supports the Joint United Nations Programme on HIV/AIDS elimination targets. However, to meet these aims, urgent scale-up of viral load testing is critical. The multiple interventions in the healthcare system required to support scale-up of viral load testing are reviewed here. It is estimated that 18.2 million individuals are accessing antiretroviral therapy, consequently this will cause significant demand for viral load monitoring; however, at the current rate of implementation, demand will not meet the required target by 2020. To change this trajectory, multiple stakeholders must be involved, communities and key populations need increased treatment literacy to create demand and greater numbers of healthcare workers will require training. In addition, laboratories and point-of-care testing sites will need to be expanded, and adequate monitoring and evaluation tools will need to be put in place to identify gaps in the system, to institute prompt corrective actions and to direct resources where needed. Sufficient scale-up of viral load may well be possible if innovations in mHealth are used to support healthcare workers and patients with regard to the scale-up and effective use of viral load monitoring; new laboratory technologies are implemented, both at a centralized level and point-of-care, to manage higher volumes and improve coverage; and there is careful coordination between implementing partners and funders.

  1. 77 FR 25152 - Applications for New Awards; Investing in Innovation Fund, Scale-Up Grants

    Science.gov (United States)

    2012-04-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Applications for New Awards; Investing in Innovation Fund, Scale- Up Grants Correction In notice document 2012-7362 appearing on pages 18216-18229 in the issue of Tuesday, March 27, 2012 make the following...

  2. An Experiment to Illustrate the Hazards of Exothermic Reaction Scale-Up

    Science.gov (United States)

    Clark, William; Lei, Melinda; Kirichenko, Erika; Dickerson, Kellie; Prytko, Robert

    2017-01-01

    Exothermic reactions can present safety hazards and there is a recognized need for reaction safety education at the undergraduate level. We present an experiment that illustrates the pitfall of direct scale-up of an exothermic reaction that can lead to thermal runaway. The iodide-catalyzed hydrogen peroxide decomposition reaction yields…

  3. Scaling-up vaccine production: implementation aspects of a biomass growth observer and controller

    NARCIS (Netherlands)

    Soons, Z.I.T.A.; IJssel, van den J.; Pol, van der L.A.; Straten, van G.; Boxtel, van A.J.B.

    2009-01-01

    Abstract This study considers two aspects of the implementation of a biomass growth observer and specific growth rate controller in scale-up from small- to pilot-scale bioreactors towards a feasible bulk production process for whole-cell vaccine against whooping cough. The first is the calculation

  4. Integrated Graduate and Continuing Education in Protein Chromatography for Bioprocess Development and Scale-Up

    Science.gov (United States)

    Carta, Jungbauer

    2011-01-01

    We describe an intensive course that integrates graduate and continuing education focused on the development and scale-up of chromatography processes used for the recovery and purification of proteins with special emphasis on biotherapeutics. The course includes lectures, laboratories, teamwork, and a design exercise and offers a complete view of…

  5. Scaling up community mobilisation through women's groups for maternal and neonatal health: Experiences from rural Bangladesh

    NARCIS (Netherlands)

    T. Nahar (Tasmin); K. Azad (Kishwar); B.H. Aumon (Bedowra Haq); L. Younes (Layla); S. Shaha (Sanjit); A. Kuddus (Abdul); A. Prost (Audrey); A.J. Houweling (Tanja); A. Costello (Anthony); E. Fottrell (Edward)

    2012-01-01

    textabstractBackground: Program coverage is likely to be an important determinant of the effectiveness of community interventions to reduce neonatal mortality. Rigorous examination and documentation of methods to scale-up interventions and measure coverage are scarce, however. To address this

  6. Cost-effectiveness of scaling up voluntary counselling and testing in West-Java, Indonesia.

    Science.gov (United States)

    Tromp, Noor; Siregar, Adiatma; Leuwol, Barnabas; Komarudin, Dindin; van der Ven, Andre; van Crevel, Reinout; Baltussen, Rob

    2013-01-01

    to evaluate the costs-effectiveness of scaling up community-based VCT in West-Java. the Asian epidemic model (AEM) and resource needs model (RNM) were used to calculate incremental costs per HIV infection averted and per disability-adjusted life years saved (DALYs). Locally monitored demographic, epidemiological behavior and cost data were used as model input. scaling up community-based VCT in West-Java will reduce the overall population prevalence by 36% in 2030 and costs US$248 per HIV infection averted and US$9.17 per DALY saved. Cost-effectiveness estimation were most sensitive to the impact of VCT on condom use and to the population size of clients of female sex workers (FSWs), but were overall robust. The total costs for scaling up community-based VCT range between US$1.3 and 3.8 million per year and require the number of VCT integrated clinics at public community health centers to increase from 73 in 2010 to 594 in 2030. scaling up community-based VCT seems both an effective and cost-effective intervention. However, in order to prioritize VCT in HIV/AIDS control in West-Java, issues of budget availability and organizational capacity should be addressed.

  7. A framework for scaling up health interventions: lessons from large-scale improvement initiatives in Africa.

    Science.gov (United States)

    Barker, Pierre M; Reid, Amy; Schall, Marie W

    2016-01-29

    Scaling up complex health interventions to large populations is not a straightforward task. Without intentional, guided efforts to scale up, it can take many years for a new evidence-based intervention to be broadly implemented. For the past decade, researchers and implementers have developed models of scale-up that move beyond earlier paradigms that assumed ideas and practices would successfully spread through a combination of publication, policy, training, and example. Drawing from the previously reported frameworks for scaling up health interventions and our experience in the USA and abroad, we describe a framework for taking health interventions to full scale, and we use two large-scale improvement initiatives in Africa to illustrate the framework in action. We first identified other scale-up approaches for comparison and analysis of common constructs by searching for systematic reviews of scale-up in health care, reviewing those bibliographies, speaking with experts, and reviewing common research databases (PubMed, Google Scholar) for papers in English from peer-reviewed and "gray" sources that discussed models, frameworks, or theories for scale-up from 2000 to 2014. We then analyzed the results of this external review in the context of the models and frameworks developed over the past 20 years by Associates in Process Improvement (API) and the Institute for Healthcare improvement (IHI). Finally, we reflected on two national-scale improvement initiatives that IHI had undertaken in Ghana and South Africa that were testing grounds for early iterations of the framework presented in this paper. The framework describes three core components: a sequence of activities that are required to get a program of work to full scale, the mechanisms that are required to facilitate the adoption of interventions, and the underlying factors and support systems required for successful scale-up. The four steps in the sequence include (1) Set-up, which prepares the ground for

  8. Malaria Facts

    Science.gov (United States)

    ... 216 million clinical episodes, and 445,000 deaths. Biology, Pathology, Epidemiology Among the malaria species that infect ... Cinchona spp., South America, 17th century). Get Email Updates To receive email updates about this page, enter ...

  9. Scaling up diarrhea prevention and treatment interventions: a Lives Saved Tool analysis.

    Science.gov (United States)

    Fischer Walker, Christa L; Friberg, Ingrid K; Binkin, Nancy; Young, Mark; Walker, Neff; Fontaine, Olivier; Weissman, Eva; Gupta, Akanksha; Black, Robert E

    2011-03-01

    Diarrhea remains a leading cause of mortality among young children in low- and middle-income countries. Although the evidence for individual diarrhea prevention and treatment interventions is solid, the effect a comprehensive scale-up effort would have on diarrhea mortality has not been estimated. We use the Lives Saved Tool (LiST) to estimate the potential lives saved if two scale-up scenarios for key diarrhea interventions (oral rehydration salts [ORS], zinc, antibiotics for dysentery, rotavirus vaccine, vitamin A supplementation, basic water, sanitation, hygiene, and breastfeeding) were implemented in the 68 high child mortality countries. We also conduct a simple costing exercise to estimate cost per capita and total costs for each scale-up scenario. Under the ambitious (feasible improvement in coverage of all interventions) and universal (assumes near 100% coverage of all interventions) scale-up scenarios, we demonstrate that diarrhea mortality can be reduced by 78% and 92%, respectively. With universal coverage nearly 5 million diarrheal deaths could be averted during the 5-year scale-up period for an additional cost of US$12.5 billion invested across 68 priority countries for individual-level prevention and treatment interventions, and an additional US$84.8 billion would be required for the addition of all water and sanitation interventions. Using currently available interventions, we demonstrate that with improved coverage, diarrheal deaths can be drastically reduced. If delivery strategy bottlenecks can be overcome and the international community can collectively deliver on the key strategies outlined in these scenarios, we will be one step closer to achieving success for the United Nations' Millennium Development Goal 4 (MDG4) by 2015.

  10. Scaling up diarrhea prevention and treatment interventions: a Lives Saved Tool analysis.

    Directory of Open Access Journals (Sweden)

    Christa L Fischer Walker

    2011-03-01

    Full Text Available BACKGROUND: Diarrhea remains a leading cause of mortality among young children in low- and middle-income countries. Although the evidence for individual diarrhea prevention and treatment interventions is solid, the effect a comprehensive scale-up effort would have on diarrhea mortality has not been estimated. METHODS AND FINDINGS: We use the Lives Saved Tool (LiST to estimate the potential lives saved if two scale-up scenarios for key diarrhea interventions (oral rehydration salts [ORS], zinc, antibiotics for dysentery, rotavirus vaccine, vitamin A supplementation, basic water, sanitation, hygiene, and breastfeeding were implemented in the 68 high child mortality countries. We also conduct a simple costing exercise to estimate cost per capita and total costs for each scale-up scenario. Under the ambitious (feasible improvement in coverage of all interventions and universal (assumes near 100% coverage of all interventions scale-up scenarios, we demonstrate that diarrhea mortality can be reduced by 78% and 92%, respectively. With universal coverage nearly 5 million diarrheal deaths could be averted during the 5-year scale-up period for an additional cost of US$12.5 billion invested across 68 priority countries for individual-level prevention and treatment interventions, and an additional US$84.8 billion would be required for the addition of all water and sanitation interventions. CONCLUSION: Using currently available interventions, we demonstrate that with improved coverage, diarrheal deaths can be drastically reduced. If delivery strategy bottlenecks can be overcome and the international community can collectively deliver on the key strategies outlined in these scenarios, we will be one step closer to achieving success for the United Nations' Millennium Development Goal 4 (MDG4 by 2015.

  11. Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis

    Science.gov (United States)

    Walker, Christa L. Fischer; Friberg, Ingrid K.; Binkin, Nancy; Young, Mark; Walker, Neff; Fontaine, Olivier; Weissman, Eva; Gupta, Akanksha; Black, Robert E.

    2011-01-01

    Background Diarrhea remains a leading cause of mortality among young children in low- and middle-income countries. Although the evidence for individual diarrhea prevention and treatment interventions is solid, the effect a comprehensive scale-up effort would have on diarrhea mortality has not been estimated. Methods and Findings We use the Lives Saved Tool (LiST) to estimate the potential lives saved if two scale-up scenarios for key diarrhea interventions (oral rehydration salts [ORS], zinc, antibiotics for dysentery, rotavirus vaccine, vitamin A supplementation, basic water, sanitation, hygiene, and breastfeeding) were implemented in the 68 high child mortality countries. We also conduct a simple costing exercise to estimate cost per capita and total costs for each scale-up scenario. Under the ambitious (feasible improvement in coverage of all interventions) and universal (assumes near 100% coverage of all interventions) scale-up scenarios, we demonstrate that diarrhea mortality can be reduced by 78% and 92%, respectively. With universal coverage nearly 5 million diarrheal deaths could be averted during the 5-year scale-up period for an additional cost of US$12.5 billion invested across 68 priority countries for individual-level prevention and treatment interventions, and an additional US$84.8 billion would be required for the addition of all water and sanitation interventions. Conclusion Using currently available interventions, we demonstrate that with improved coverage, diarrheal deaths can be drastically reduced. If delivery strategy bottlenecks can be overcome and the international community can collectively deliver on the key strategies outlined in these scenarios, we will be one step closer to achieving success for the United Nations' Millennium Development Goal 4 (MDG4) by 2015. Please see later in the article for the Editors' Summary PMID:21445330

  12. Scaling-up NLP Pipelines to Process Large Corpora of Clinical Notes.

    Science.gov (United States)

    Divita, G; Carter, M; Redd, A; Zeng, Q; Gupta, K; Trautner, B; Samore, M; Gundlapalli, A

    2015-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "Big Data and Analytics in Healthcare". This paper describes the scale-up efforts at the VA Salt Lake City Health Care System to address processing large corpora of clinical notes through a natural language processing (NLP) pipeline. The use case described is a current project focused on detecting the presence of an indwelling urinary catheter in hospitalized patients and subsequent catheter-associated urinary tract infections. An NLP algorithm using v3NLP was developed to detect the presence of an indwelling urinary catheter in hospitalized patients. The algorithm was tested on a small corpus of notes on patients for whom the presence or absence of a catheter was already known (reference standard). In planning for a scale-up, we estimated that the original algorithm would have taken 2.4 days to run on a larger corpus of notes for this project (550,000 notes), and 27 days for a corpus of 6 million records representative of a national sample of notes. We approached scaling-up NLP pipelines through three techniques: pipeline replication via multi-threading, intra-annotator threading for tasks that can be further decomposed, and remote annotator services which enable annotator scale-out. The scale-up resulted in reducing the average time to process a record from 206 milliseconds to 17 milliseconds or a 12- fold increase in performance when applied to a corpus of 550,000 notes. Purposely simplistic in nature, these scale-up efforts are the straight forward evolution from small scale NLP processing to larger scale extraction without incurring associated complexities that are inherited by the use of the underlying UIMA framework. These efforts represent generalizable and widely applicable techniques that will aid other computationally complex NLP pipelines that are of need to be scaled out for processing and analyzing big data.

  13. Malaria control in Malawi: are the poor being served?

    Directory of Open Access Journals (Sweden)

    Mathanga Don P

    2007-12-01

    Full Text Available Abstract Background In Africa, national governments and international organizations are focusing on rapidly "scaling up" malaria control interventions to at least 60 percent of vulnerable populations. The potential health and economic benefits of "scaling up" will depend on the equitable access to malaria control measures by the poor. This paper analyses the present inequalities in access to malaria interventions in Malawi. Methods Equity in access to malaria control measures was assessed using the Malawi Demographic Health Survey (DHS 2000 and the 2004 national survey on malaria control. Utilisation of malaria control methods was compared across the wealth quintiles, to determine whether the poor were being reached with malaria control measures. Results Overall ITN coverage increased from 5% in 2000 to 35% in 2004. However, there was a disproportionate concentration of ITNs amongst the least poor compared to the poorest group. Effective treatment of fever remains unacceptably low with only 17% of the under-five children being promptly treated with an effective antimalarial drug. And only 29 percent of pregnant women received the recommended dose of at least two doses during the pregnancy. No income related inequalities were associated with prompt treatment and IPT use. Conclusion The present distribution strategies for ITNs are not addressing the needs of the vulnerable groups, especially the poor. Increasing access to ITNs by the poor will require innovative distribution models which deliberately target the poorest of the poor.

  14. Malaria in school-age children in Africa: an increasingly important challenge.

    Science.gov (United States)

    Nankabirwa, Joaniter; Brooker, Simon J; Clarke, Sian E; Fernando, Deepika; Gitonga, Caroline W; Schellenberg, David; Greenwood, Brian

    2014-11-01

    School-age children have attracted relatively little attention as a group in need of special measures to protect them against malaria. However, increasing success in lowering the level of malaria transmission in many previously highly endemic areas will result in children acquiring immunity to malaria later in life than has been the case in the past. Thus, it can be anticipated that in the coming years there will be an increase in the incidence of both uncomplicated and severe malaria in school-age children in many previously highly endemic areas. In this review, which focuses primarily on Africa, recent data on the prevalence of malaria parasitaemia and on the incidence of clinical malaria in African school-age children are presented and evidence that malaria adversely effects school performance is reviewed. Long-lasting insecticide treated bednets (LLIN) are an effective method of malaria control but several studies have shown that school-age children use LLINs less frequently than other population groups. Antimalarial drugs are being used in different ways to control malaria in school-age children including screening and treatment and intermittent preventive treatment. Some studies of chemoprevention in school-age children have shown reductions in anaemia and improved school performance but this has not been the case in all trials and more research is needed to identify the situations in which chemoprevention is likely to be most effective and, in these situations, which type of intervention should be used. In the longer term, malaria vaccines may have an important role in protecting this important section of the community from malaria. Regardless of the control approach selected, it is important this is incorporated into the overall programme of measures being undertaken to enhance the health of African school-age children. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  15. Nigerian foodstuffs with prostate cancer chemopreventive polyphenols.

    Science.gov (United States)

    Atawodi, Sunday Eneojo

    2011-09-23

    Dietary polyphenols are antioxidants that can scavenge biological free radicals, and chemoprevent diseases with biological oxidation as their main etiological factor. In this paper, we review our laboratory data vis-ὰ-vis available literature on prostate cancer chemopreventive substances in Nigerian foodstuffs. Dacryodes edulis fruit, Moringa oleifera and Syzygium aromaticum contained prostate active polyphenols like ellagic acid, gallate, methylgallate, catechol, kaempferol quercetin and their derivatives. Also Canarium schweinfurthii Engl oil contained ten phenolic compounds and lignans, namely; catechol, p-hydroxybenzaldehyde, dihydroxyphenylacetic acid, tyrosol, p-hydroxybenzoic acid, dihydroxybenzoic acid, vanillic acid, phloretic acid, pinoresinol, secoisolariciresinol. In addition, tomatoes (Lycopersicon esculentum Mill) which contains the powerful antioxidant and anti-prostate cancer agent, lycopene; cabbage (Brassica oleracea) containing indole-3-carbinol; citrus fruits containing pectin; Soursop (Annona muricata) containing annonaceous acetogenins; soya beans (Glycine max) containing isoflavones; chilli pepper (Capsicum annuum) containing capsaicin, and green tea (Camellia sinensis) containing (-) epigallocatechin gallate (EGCG), (-) epicatechin, (-) epicatechin-3-gallate and (-) epigallocatechin -3-gallate which are widely reported to posses prostate cancer chemopreventive compounds are also grown in Nigeria and other African countries. Thus, the high incidence of prostate cancer among males of African extraction can be dramatically reduced, and the age of onset drastically increased, if the population at risk consumes the right kinds of foods in the right proportion, beginning early in life, especially as prostate cancer has a latency period of about 50 years.

  16. A qualitative assessment of participation in a rapid scale-up, diagonally-integrated MDG-related disease prevention campaign in Rural Kenya.

    Directory of Open Access Journals (Sweden)

    Timothy De Ver Dye

    Full Text Available BACKGROUND: Many countries face severe scale-up barriers toward achievement of MDGs. We ascertained motivational and experiential dimensions of participation in a novel, rapid, "diagonal" Integrated Prevention Campaign (IPC in rural Kenya that provided prevention goods and services to 47,000 people within one week, aimed at rapidly moving the region toward MDG achievement. Specifically, the IPC provided interventions and commodities targeting disease burden reduction in HIV/AIDS, malaria, and water-borne illness. METHODS: Qualitative in-depth interviews (IDI were conducted with 34 people (18 living with HIV/AIDS and 16 not HIV-infected randomly selected from IPC attendees consenting to participate. Interviews were examined for themes and patterns to elucidate participant experience and motivation with IPC. FINDINGS: Participants report being primarily motivated to attend IPC to learn of their HIV status (through voluntary counseling and testing, and with receipt of prevention commodities (bednets, water filters, and condoms providing further incentive. Participants reported that they were satisfied with the IPC experience and offered suggestions to improve future campaigns. INTERPRETATION: Learning their HIV status motivated participants along with the incentive of a wider set of commodities that were rapidly deployed through IPC in this challenging region. The critical role of wanting to know their HIV status combined with commodity incentives may offer a new model for rapid scaled-up of prevention strategies that are wider in scope in rural Africa.

  17. Variable piperaquine exposure significantly impacts protective efficacy of monthly dihydroartemisinin-piperaquine for the prevention of malaria in Ugandan children.

    Science.gov (United States)

    Sundell, Kerstin; Jagannathan, Prasanna; Huang, Liusheng; Bigira, Victor; Kapisi, James; Kakuru, Mary M; Savic, Rada; Kamya, Moses R; Dorsey, Grant; Aweeka, Francesca

    2015-09-24

    Anti-malarial chemoprevention with dihydroartemisinin-piperaquine (DHA/PQ) is a promising tool for malaria control, but its efficacy in children may be limited by inadequate drug exposure. Children were enrolled in a non directly-observed trial of DHA/PQ chemoprevention in a high transmission setting in Uganda. Children were randomized at 6 months of age to no chemoprevention (n = 89) or monthly DHA/PQ (n = 87) and followed through 24 months of age, with pharmacokinetic sampling performed at variable times following monthly dosing of DHA/PQ. A previously published pharmacokinetic model was used to estimate piperaquine (PQ) exposure in each child, and associations between PQ exposure and the protective efficacy (PE) of DHA/PQ were explored. The incidence of malaria was 6.83 and 3.09 episodes per person year at risk in the no chemoprevention and DHA/PQ arms, respectively (PE 54 %, 95 % CI 39-66 %, P children randomized to DHA/PQ, 493 pharmacokinetic samples were collected. Despite nearly 100 % reported adherence to study drug administration at home, there was wide variability in PQ exposure, and children were stratified into three groups based on average PQ exposure during the intervention that was determined by model generated percentiles (low, n = 40; medium, n = 37, and high, n = 10). Gender and socioeconomic factors were not significantly associated with PQ exposure. In multivariate models, the PE of DHA/PQ was 31 % in the low PQ exposure group (95 % CI 6-49 %, P = 0.02), 67 % in the medium PQ exposure group (95 % CI 54-76 %, P DHA/PQ chemoprevention in young children was strongly associated with higher drug exposure; in children with the highest PQ exposure, monthly DHA/PQ chemoprevention was nearly 100 % protective against malaria. Strategies to ensure good adherence to monthly dosing and optimize drug exposure are critical to maximize the efficacy of this promising malaria control strategy. Current Controlled Trials Identifier NCT00948896.

  18. Declining burden of malaria over two decades in a rural community of Muheza district, north-eastern Tanzania

    DEFF Research Database (Denmark)

    Ishengoma, Deus S; Mmbando, Bruno P; Segeja, Method D

    2013-01-01

    The recently reported declining burden of malaria in some African countries has been attributed to scaling-up of different interventions although in some areas, these changes started before implementation of major interventions. This study assessed the long-term trends of malaria burden for 20...

  19. Evidence-based adaptation and scale-up of a mobile phone health information service.

    Science.gov (United States)

    L'Engle, Kelly; Plourde, Kate F; Zan, Trinity

    2017-01-01

    The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs. m4RH-Mobile for Reproductive Health-is an SMS, or text message-based, health information service that began in two countries and over a period of 7 years has been adapted and scaled to new population groups and new countries. Success can be attributed to following key principles for scaling up health programs, including continuous stakeholder engagement; ongoing monitoring, evaluation, and research including extensive content and usability testing with the target audience; strategic dissemination of results; and use of marketing and sustainability principles for social initiatives. This article investigates how these factors contributed to vertical, horizontal, and global scale-up of the m4RH program. Vertical scale of m4RH is demonstrated in Tanzania, where the early engagement of stakeholders including the Ministry of Health catalyzed expansion of m4RH content and national-level program reach. Ongoing data collection has provided real-time data for decision-making, information about the user base, and peer-reviewed publications, yielding government endorsement and partner hand-off for sustainability of the m4RH platform. Horizontal scale-up and adaptation of m4RH has occurred through expansion to new populations in Rwanda, Uganda, and Tanzania, where best practices for design and implementation of mHealth programs were followed to ensure the platform meets the needs of target populations. m4RH also has been modified and packaged for global scale-up through licensing and toolkit

  20. Evidence-based adaptation and scale-up of a mobile phone health information service

    Science.gov (United States)

    Plourde, Kate F.; Zan, Trinity

    2017-01-01

    Background The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs. Methods m4RH—Mobile for Reproductive Health—is an SMS, or text message-based, health information service that began in two countries and over a period of 7 years has been adapted and scaled to new population groups and new countries. Success can be attributed to following key principles for scaling up health programs, including continuous stakeholder engagement; ongoing monitoring, evaluation, and research including extensive content and usability testing with the target audience; strategic dissemination of results; and use of marketing and sustainability principles for social initiatives. This article investigates how these factors contributed to vertical, horizontal, and global scale-up of the m4RH program. Results Vertical scale of m4RH is demonstrated in Tanzania, where the early engagement of stakeholders including the Ministry of Health catalyzed expansion of m4RH content and national-level program reach. Ongoing data collection has provided real-time data for decision-making, information about the user base, and peer-reviewed publications, yielding government endorsement and partner hand-off for sustainability of the m4RH platform. Horizontal scale-up and adaptation of m4RH has occurred through expansion to new populations in Rwanda, Uganda, and Tanzania, where best practices for design and implementation of mHealth programs were followed to ensure the platform meets the needs of target populations. m4RH also has been modified and packaged for global scale-up

  1. Scaling-up treatment of depression and anxiety: a global return on investment analysis.

    Science.gov (United States)

    Chisholm, Dan; Sweeny, Kim; Sheehan, Peter; Rasmussen, Bruce; Smit, Filip; Cuijpers, Pim; Saxena, Shekhar

    2016-05-01

    Depression and anxiety disorders are highly prevalent and disabling disorders, which result not only in an enormous amount of human misery and lost health, but also lost economic output. Here we propose a global investment case for a scaled-up response to the public health and economic burden of depression and anxiety disorders. In this global return on investment analysis, we used the mental health module of the OneHealth tool to calculate treatment costs and health outcomes in 36 countries between 2016 and 2030. We assumed a linear increase in treatment coverage. We factored in a modest improvement of 5% in both the ability to work and productivity at work as a result of treatment, subsequently mapped to the prevailing rates of labour participation and gross domestic product (GDP) per worker in each country. The net present value of investment needed over the period 2016-30 to substantially scale up effective treatment coverage for depression and anxiety disorders is estimated to be US$147 billion. The expected returns to this investment are also substantial. In terms of health impact, scaled-up treatment leads to 43 million extra years of healthy life over the scale-up period. Placing an economic value on these healthy life-years produces a net present value of $310 billion. As well as these intrinsic benefits associated with improved health, scaled-up treatment of common mental disorders also leads to large economic productivity gains (a net present value of $230 billion for scaled-up depression treatment and $169 billion for anxiety disorders). Across country income groups, resulting benefit to cost ratios amount to 2·3-3·0 to 1 when economic benefits only are considered, and 3·3-5·7 to 1 when the value of health returns is also included. Return on investment analysis of the kind reported here can contribute strongly to a balanced investment case for enhanced action to address the large and growing burden of common mental disorders worldwide. Grand

  2. Protective efficacy of malaria case management and intermittent preventive treatment for preventing malaria mortality in children: a systematic review for the Lives Saved Tool

    Directory of Open Access Journals (Sweden)

    Steketee Richard W

    2011-04-01

    Full Text Available Abstract Background The Lives Saved Tool (LiST model was developed to estimate the impact of the scale-up of child survival interventions on child mortality. New advances in antimalarials have improved their efficacy of treating uncomplicated and severe malaria. Artemisinin-based combination therapies (ACTs for uncomplicated Plasmodium falciparum malaria and parenteral or rectal artemisinin or quinine for severe malaria syndromes have been shown to be very effective for the treatment of malaria in children. These interventions are now being considered for inclusion in the LiST model. However, for obvious ethical reasons, their protective efficacy (PE compared to placebo is unknown and their impact on reducing malaria-attributable mortality has not been quantified. Methods We performed systematic literature reviews of published studies in P. falciparum endemic settings to determine the protective efficacy (PE of ACT treatment against malaria deaths among children with uncomplicated malaria, as well as the PE of effective case management including parenteral quinine against malaria deaths among all hospitalized children. As no randomized placebo-controlled trials of malaria treatment have been conducted, we used multiple data sources to ascertain estimates of PE, including a previously performed Delphi estimate for treatment of uncomplicated malaria. Results Based on multiple data sources, we estimate the PE of ACT treatment of uncomplicated P. falciparum malaria on reducing malaria mortality in children 1–23 months to be 99% (range: 94-100%, and in children 24-59 months to be 97% (range: 86-99%. We estimate the PE of treatment of severe P. falciparum malaria with effective case management including intravenous quinine on reducing malaria mortality in children 1-59 months to be 82% (range: 63-94% compared to no treatment. Conclusions This systematic review quantifies the PE of ACT used for treating uncomplicated malaria and effective case

  3. Pore-Water Extraction Scale-Up Study for the SX Tank Farm

    Energy Technology Data Exchange (ETDEWEB)

    Truex, Michael J.; Oostrom, Martinus; Wietsma, Thomas W.; Last, George V.; Lanigan, David C.

    2013-01-15

    The phenomena related to pore-water extraction from unsaturated sediments have been previously examined with limited laboratory experiments and numerical modeling. However, key scale-up issues have not yet been addressed. Laboratory experiments and numerical modeling were conducted to specifically examine pore-water extraction for sediment conditions relevant to the vadose zone beneath the SX Tank Farm at Hanford Site in southeastern Washington State. Available SX Tank Farm data were evaluated to generate a conceptual model of the subsurface for a targeted pore-water extraction application in areas with elevated moisture and Tc-99 concentration. The hydraulic properties of the types of porous media representative of the SX Tank Farm target application were determined using sediment mixtures prepared in the laboratory based on available borehole sediment particle size data. Numerical modeling was used as an evaluation tool for scale-up of pore-water extraction for targeted field applications.

  4. Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up.

    Directory of Open Access Journals (Sweden)

    Catherine Hankins

    2011-11-01

    Full Text Available Scaling up voluntary medical male circumcision (VMMC for HIV prevention is cost saving and creates fiscal space in the future that otherwise would have been encumbered by antiretroviral treatment costs. An investment of US$1,500,000,000 between 2011 and 2015 to achieve 80% coverage in 13 priority countries in southern and eastern Africa will result in net savings of US$16,500,000,000. Strong political leadership, country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential. This collection of articles on determining the cost and impact of VMMC for HIV prevention signposts the way forward to scaling up VMMC service delivery safely and efficiently to reap individual- and population-level benefits.

  5. Reduction in extrapulmonary tuberculosis in context of antiretroviral therapy scale-up in rural South Africa.

    Science.gov (United States)

    Hoogendoorn, J C; Ranoto, L; Muditambi, N; Railton, J; Maswanganyi, M; Struthers, H E; McIntyre, J A; Peters, R P H

    2017-09-01

    Scale-up of antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection has reduced the incidence of pulmonary tuberculosis (PTB) in South Africa. Despite the strong association of HIV infection with extrapulmonary tuberculosis (EPTB), the effect of ART on the epidemiology of EPTB remains undocumented. We conducted a retrospective record review of patients initiated on treatment for EPTB in 2009 (ART coverage EPTB (n = 399 in 2009 vs. 336 in 2013; P EPTB cases, the proportion of miliary TB and disseminated TB decreased significantly (both P EPTB cases that is similar to that of PTB in the context of the ART scale-up. The changing profile of EPTB warrants attention of healthcare workers.

  6. Nb3Sn accelerator magnet technology scale up based on cos-theta coils

    Energy Technology Data Exchange (ETDEWEB)

    Nobrega, F.; Ambrosio, G.; Andreev, N.; Barzi, E.; Bossert, R.; Carcagno, R.; Feher, S.; Kashikhin, V.S.; Kashikhin, V.V.; Lamm, M.J.; Novitski, I.; Pischalnikov, Yu.; Sylvester, C.; Tartaglia, M.; Turrioni, D.; Yamada, R.; Zlobin, A.V.; /Fermilab

    2006-08-01

    After successful testing of a 1 m long dipole mirror magnet and three dipole models based on two-layer Nb{sub 3}Sn coils, Fermilab has started a Nb{sub 3}Sn technology scale-up program using the dipole mirror design and the developed Nb{sub 3}Sn coil fabrication technology based on the wind-and-react method. The scale-up will be performed in several steps starting from a 2 m long coil made of Powder-in-Tube (PIT) strand. This will be followed by 4 m long Nb{sub 3}Sn coils made of PIT and RRP strands that will be fabricated into dipole mirror magnets and tested. This paper presents a summary of Fermilab's wind-and-react short model program. It includes details on the 2 m and 4 m long, 2 layer Nb{sub 3}Sn dipole mirror magnet design, mechanical structure, and fabrication infrastructure.

  7. Scale-up of wet kneading in a novel vertical high shear kneader.

    Science.gov (United States)

    Watano, Satoru; Okamoto, Takumi; Sato, Yoshinobu; Ohnishi, Yoshito; Yasutomo, Teruhito; Osako, Yoshifumi

    2005-01-01

    A novel multi-functional vertical high shear kneader has been developed and its performance in wet kneading has previously been reported [Watano et al., Chem. Pharm. Bull., 50(3), 341-345 (2002)]. In this study, scale-up of wet kneading in the novel vertical high shear kneader was conducted. Pharmaceutical excipients composed of lactose, cornstarch and micro-crystalline cellulose were used as powder samples. Kneading operations were conducted under various operating conditions and three different vessel scales. The dried pellets were then prepared by extruding the wet kneaded masses through a dome-type extruder and their drying by a fluidized bed. The physical properties such as strength and disintegration time of the dried pellets were evaluated. It was found that the properties of the dried pellets and their scale-up characteristics were well expressed by an agitation power per unit vessel volume and dimensionless Froude number.

  8. From Project to Program: Tupange's Experience with Scaling Up Family Planning Interventions in Urban Kenya.

    Science.gov (United States)

    Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth

    2015-05-01

    This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya. Copyright © 2015. Published by Elsevier Ltd.

  9. Bioprocess engineering for biohythane production from low-grade waste biomass: technical challenges towards scale up.

    Science.gov (United States)

    Liu, Zhidan; Si, Buchun; Li, Jiaming; He, Jianwei; Zhang, Chong; Lu, Yuan; Zhang, Yuanhui; Xing, Xin-Hui

    2017-09-08

    A concept of biohythane production by combining biohydrogen and biomethane together via two-stage anaerobic fermentation (TSAF) has been recently proposed and considered as a promising approach for sustainable hythane generation from waste biomass. The advantage of biohythane over traditional biogas are more environmentally benign, higher energy recovery and shorter fermentation time. However, many of current efforts to convert waste biomass into biohythane are still at the bench scale. The system bioprocess study and scale up for industrial application are indispensable. This paper outlines the general approach of biohythane by comparing with other biological processes. The technical challenges are highlighted towards scale up of biohythane system, including functionalization of biohydrogen-producing reactor, energy efficiency, and bioprocess engineering of TSAF. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Scaling up of HIV-TB collaborative activities: Achievements and challenges in India.

    Science.gov (United States)

    Deshmukh, Rajesh; Shah, Amar; Sachdeva, K S; Sreenivas, A N; Gupta, R S; Khaparde, S D

    2016-01-01

    India has been implementing HIV/TB collaborative activities since 2001 with rapid scale-up of infrastructure across the country during past decade in National AIDS Control Programme and Revised National TB Control Programme. India has shown over 50% reduction in new infections and around 35% reduction in AIDS-related deaths, thereby being one of the success stories globally. Substantial progress in the implementation of collaborative TB/HIV activities has occurred in India and it is marching towards target set out in the Global Plan to Stop TB and endorsed by the UN General Assembly to halve HIV associated TB deaths by 2015. While the successful approaches have led to impressive gains in HIV/TB control in India, there are emerging challenges including newer pockets with rising HIV trends in North India, increasing drug resistance, high mortality among co-infected patients, low HIV testing rates among TB patients in northern and eastern states in India, treatment delays and drop-outs, stigma and discrimination, etc. In spite of these difficulties, established HIV/TB coordination mechanisms at different levels, rapid scale-up of facilities with decentralisation of treatment services, regular joint supervision and monitoring, newer initiatives like use of rapid diagnostics for early diagnosis of TB among people living with HIV, TB notification, etc. have led to success in combating the threat of HIV/TB in India. This article highlights the steps taken by India, one of the largest HIV/TB programmes in world, in scaling up of the joint HIV-TB collaborative activities, the achievements so far and discusses the emerging challenges which could provide important lessons for other countries in scaling up their programmes. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  11. Chapter 6. Scaling Up Solutions to State, National and Global Levels

    OpenAIRE

    Daniel Kammen; Doug Rotman; Magali Delmas; David Feldman; Mike Mielke; Ramamoorthy Ramesh; Daniel Sperling

    2016-01-01

    Scaling-up solutions require learning and adapting lessons between locations and at different scales. To accomplish this, common metrics are vital to building a shared language. For California, this has meant careful financial, cradle-to-grave life-cycle assessment methods leading to carbon accounting in many avenues of government (via the Low Carbon Fuel Standard or the Cap and Trade program). These methods themselves interact, such as the use of carbon accounting for the resources needed to...

  12. High-Throughput Synthesis, Screening, and Scale-Up of Optimized Conducting Indium Tin Oxides

    OpenAIRE

    Marchand, P; Makwana, N. M.; Tighe, C. J.; Gruar, R. I.; Parkin, I. P.; Carmalt, C. J.; Darr, J. A.

    2016-01-01

    A high-throughput optimization and subsequent scale-up methodology has been used for the synthesis of conductive tin-doped indium oxide (known as ITO) nanoparticles. ITO nanoparticles with up to 12 at % Sn were synthesized using a laboratory scale (15 g/hour by dry mass) continuous hydrothermal synthesis process, and the as-synthesized powders were characterized by powder X-ray diffraction, transmission electron microscopy, energy-dispersive X-ray analysis, and X-ray photoelectron spectroscop...

  13. Development and Scale Up Of a Chemical Process in Pharmaceutical Industry: A Case Study

    OpenAIRE

    Savita Belwal; V. Revanth, K.S.V.V. Dinesh; B. V. Reddy; M. Bhagvanth Rao

    2016-01-01

    Every process has its own significance and one has to study factors which impact to the process and its procedure to be followed. This paper is more concerned of how a process is scaled up from lab scale to pilot plant scale, which is the major step in any industry because moving directly towards manufacturing level consumes time and money. The report introduces about pharmaceutical industry and how it is different from the other industries and provides firsthand experience for al...

  14. Forecasting paediatric malaria admissions on the Kenya Coast using rainfall.

    Science.gov (United States)

    Karuri, Stella Wanjugu; Snow, Robert W

    2016-01-01

    Malaria is a vector-borne disease which, despite recent scaled-up efforts to achieve control in Africa, continues to pose a major threat to child survival. The disease is caused by the protozoan parasite Plasmodium and requires mosquitoes and humans for transmission. Rainfall is a major factor in seasonal and secular patterns of malaria transmission along the East African coast. The goal of the study was to develop a model to reliably forecast incidences of paediatric malaria admissions to Kilifi District Hospital (KDH). In this article, we apply several statistical models to look at the temporal association between monthly paediatric malaria hospital admissions, rainfall, and Indian Ocean sea surface temperatures. Trend and seasonally adjusted, marginal and multivariate, time-series models for hospital admissions were applied to a unique data set to examine the role of climate, seasonality, and long-term anomalies in predicting malaria hospital admission rates and whether these might become more or less predictable with increasing vector control. The proportion of paediatric admissions to KDH that have malaria as a cause of admission can be forecast by a model which depends on the proportion of malaria admissions in the previous 2 months. This model is improved by incorporating either the previous month's Indian Ocean Dipole information or the previous 2 months' rainfall. Surveillance data can help build time-series prediction models which can be used to anticipate seasonal variations in clinical burdens of malaria in stable transmission areas and aid the timing of malaria vector control.

  15. Differences in antiretroviral scale up in three South African provinces: the role of implementation management

    Directory of Open Access Journals (Sweden)

    Van Rensburg Dingie

    2010-07-01

    Full Text Available Abstract Background South Africa’s antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country’s quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. Methods The paper is a comparative case study of the early management of ART scale up in three South African provincial governments – Western Cape, Gauteng and Free State – focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high achieved in the three provinces. Results While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. Conclusions This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.

  16. Theoretical and Practical Issues That Are Relevant When Scaling Up hMSC Microcarrier Production Processes.

    Science.gov (United States)

    Jossen, Valentin; Schirmer, Cedric; Mostafa Sindi, Dolman; Eibl, Regine; Kraume, Matthias; Pörtner, Ralf; Eibl, Dieter

    2016-01-01

    The potential of human mesenchymal stem cells (hMSCs) for allogeneic cell therapies has created a large amount of interest. However, this presupposes the availability of efficient scale-up procedures. Promising results have been reported for stirred bioreactors that operate with microcarriers. Recent publications focusing on microcarrier-based stirred bioreactors have demonstrated the successful use of Computational Fluid Dynamics (CFD) and suspension criteria (N S1u , N S1) for rapidly scaling up hMSC expansions from mL- to pilot scale. Nevertheless, one obstacle may be the formation of large microcarrier-cell-aggregates, which may result in mass transfer limitations and inhomogeneous distributions of stem cells in the culture broth. The dependence of microcarrier-cell-aggregate formation on impeller speed and shear stress levels was investigated for human adipose derived stromal/stem cells (hASCs) at the spinner scale by recording the Sauter mean diameter (d 32) versus time. Cultivation at the suspension criteria provided d 32 values between 0.2 and 0.7 mm, the highest cell densities (1.25 × 10(6) cells mL(-1) hASCs), and the highest expansion factors (117.0 ± 4.7 on day 7), while maintaining the expression of specific surface markers. Furthermore, suitability of the suspension criterion N S1u was investigated for scaling up microcarrier-based processes in wave-mixed bioreactors for the first time.

  17. Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up.

    Science.gov (United States)

    Miller, Ted R; Hendrie, Delia

    2015-12-01

    The literature that addresses cost differences between randomized trials and full-scale replications is quite sparse. This paper examines how costs differed among three randomized trials and six statewide scale-ups of nurse family partnership (NFP) intensive home visitation to low income first-time mothers. A literature review provided data on pertinent trials. At our request, six well-established programs reported their total expenditures. We adjusted the costs to national prices based on mean hourly wages for registered nurses and then inflated them to 2010 dollars. A centralized data system provided utilization. Replications had fewer home visits per family than trials (25 vs. 31, p = .05), lower costs per client ($8860 vs. $12,398, p = .01), and lower costs per visit ($354 vs. $400, p = .30). Sample size limited the significance of these differences. In this type of labor intensive program, costs probably were lower in scale-up than in randomized trials. Key cost drivers were attrition and the stable caseload size possible in an ongoing program. Our estimates reveal a wide variation in cost per visit across six state programs, which suggests that those planning replications should not expect a simple rule to guide cost estimations for scale-ups. Nevertheless, NFP replications probably achieved some economies of scale.

  18. Fermentation scale up for α-arbutin production by Xanthomonas BT-112.

    Science.gov (United States)

    Wei, Meng; Ren, Yi; Liu, Changxia; Liu, Ruican; Zhang, Peng; Wei, Yi; Xu, Tao; Wang, Fang; Tan, Tianwei; Liu, Chunqiao

    2016-09-10

    α-Arbutin is a glycosylated hydroquinone that has an inhibitory function against tyrosinase. The aim of the present study is to develop an efficient and inexpensive method for large-scale production of α-arbutin by using Xanthomonas BT-112 as biocatalyst. To accomplish this goal, various surfactants were tested to enhance the α-arbutin production, and the optimal operational conditions for 30L jar fermenter were scaled up for a production level of 3000L with using a constant volumetric oxygen transfer coefficient (KLa) and the volumetric aeration rate per volume unit (Q/V) as scale-up criteria. Under the optimized conditions, the α-arbutin produced in the presence of 0.4% (w/v) Tween-80 was 124.8% higher than that of the control, and the yield of α-arbutin in 3000L fermenter was 38.2g/L with a molar conversion ratio of 93.7% based on the amount of hydroquinone supplied. This result is comparable to the results from laboratory-scale fermenter. Hence, 100-fold scale-up was successfully achieved. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Differences in antiretroviral scale up in three South African provinces: the role of implementation management.

    Science.gov (United States)

    Schneider, Helen; Coetzee, David; Van Rensburg, Dingie; Gilson, Lucy

    2010-07-02

    South Africa's antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country's quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. The paper is a comparative case study of the early management of ART scale up in three South African provincial governments--Western Cape, Gauteng and Free State--focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high) achieved in the three provinces. While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.

  20. Scale-up of nature's tissue weaving algorithms to engineer advanced functional materials.

    Science.gov (United States)

    Ng, Joanna L; Knothe, Lillian E; Whan, Renee M; Knothe, Ulf; Tate, Melissa L Knothe

    2017-01-11

    We are literally the stuff from which our tissue fabrics and their fibers are woven and spun. The arrangement of collagen, elastin and other structural proteins in space and time embodies our tissues and organs with amazing resilience and multifunctional smart properties. For example, the periosteum, a soft tissue sleeve that envelops all nonarticular bony surfaces of the body, comprises an inherently "smart" material that gives hard bones added strength under high impact loads. Yet a paucity of scalable bottom-up approaches stymies the harnessing of smart tissues' biological, mechanical and organizational detail to create advanced functional materials. Here, a novel approach is established to scale up the multidimensional fiber patterns of natural soft tissue weaves for rapid prototyping of advanced functional materials. First second harmonic generation and two-photon excitation microscopy is used to map the microscopic three-dimensional (3D) alignment, composition and distribution of the collagen and elastin fibers of periosteum, the soft tissue sheath bounding all nonarticular bone surfaces in our bodies. Then, using engineering rendering software to scale up this natural tissue fabric, as well as multidimensional weaving algorithms, macroscopic tissue prototypes are created using a computer-controlled jacquard loom. The capacity to prototype scaled up architectures of natural fabrics provides a new avenue to create advanced functional materials.

  1. Scale-up of nature’s tissue weaving algorithms to engineer advanced functional materials

    Science.gov (United States)

    Ng, Joanna L.; Knothe, Lillian E.; Whan, Renee M.; Knothe, Ulf; Tate, Melissa L. Knothe

    2017-01-01

    We are literally the stuff from which our tissue fabrics and their fibers are woven and spun. The arrangement of collagen, elastin and other structural proteins in space and time embodies our tissues and organs with amazing resilience and multifunctional smart properties. For example, the periosteum, a soft tissue sleeve that envelops all nonarticular bony surfaces of the body, comprises an inherently “smart” material that gives hard bones added strength under high impact loads. Yet a paucity of scalable bottom-up approaches stymies the harnessing of smart tissues’ biological, mechanical and organizational detail to create advanced functional materials. Here, a novel approach is established to scale up the multidimensional fiber patterns of natural soft tissue weaves for rapid prototyping of advanced functional materials. First second harmonic generation and two-photon excitation microscopy is used to map the microscopic three-dimensional (3D) alignment, composition and distribution of the collagen and elastin fibers of periosteum, the soft tissue sheath bounding all nonarticular bone surfaces in our bodies. Then, using engineering rendering software to scale up this natural tissue fabric, as well as multidimensional weaving algorithms, macroscopic tissue prototypes are created using a computer-controlled jacquard loom. The capacity to prototype scaled up architectures of natural fabrics provides a new avenue to create advanced functional materials.

  2. Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services.

    Science.gov (United States)

    Fowler, Patrick J; Farrell, Anne F; Marcal, Katherine E; Chung, Saras; Hovmand, Peter S

    2017-09-01

    Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale-up for the child welfare system. In child welfare, scale-up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale-up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system. © Society for Community Research and Action 2017.

  3. The economics of scaling up: cost estimation for HIV/AIDS interventions.

    Science.gov (United States)

    Kumaranayake, Lilani

    2008-07-01

    The scaling up of HIV/AIDS programming has been one of the most extensive undertakings in international public health. Yet decision-makers are encountering significant uncertainties about financing and the need to understand programming costs at different scales of delivery. To review the economic methodologies for examining costs and variation by scale. To summarize and synthesize the current evidence related to the provision of HIV/AIDS interventions and scaling up. We used a review of economic methodologies to generate a conceptual framework for classifying existing data, looking at both short-run and long-run perspectives. A review of the literature was performed using PubMed and available grey literature. Factors facilitating comparison and generalizability are highlighted. There is growing evidence of scale variation among the costs of HIV/AIDS interventions. Scale variation has been found to explain 26-70% of cost variation across locations for similar interventions. Average costs may become larger or smaller as the volume of services expands, depending on the level of coverage and type of intervention. Key constraints to scaling up include infrastructure investments and cost results need to be interpreted in this light. Evidence to date suggests that cost efficiencies associated with scale may reflect different ways of delivering services at higher volumes, including lower quality outputs. There is still, however, an extremely limited economic evidence base and mechanisms to integrate economic analyses into routine programme monitoring are recommended.

  4. Optimizing Thiadiazole Analogues of Resveratrol vs. Three Chemopreventive Targets

    Science.gov (United States)

    Mayhoub, Abdelrahman S.; Marler, Laura; Kondratyuk, Tamara; Park, Eun-Jung; Pezzuto, John M.; Cushman, Mark

    2011-01-01

    Chemoprevention is an approach to decrease cancer morbidity and mortality through inhibition of carcinogenesis and prevention of disease progression. Although the trans stilbene derivative resveratrol has chemopreventive properties, its action is compromised by weak non-specific effects on many biological targets. Replacement of the stilbene ethylenic bridge of resveratrol with a 1,2,4-thiadiazole heterocycle and modification of the substituents on the two aromatic rings afforded potential chemopreventive agents with enhanced potencies and selectivities when evaluated as inhibitors of aromatase and NF-κB and inducers of quinone reductase 1 (QR1). PMID:22115839

  5. Optimizing thiadiazole analogues of resveratrol versus three chemopreventive targets.

    Science.gov (United States)

    Mayhoub, Abdelrahman S; Marler, Laura; Kondratyuk, Tamara P; Park, Eun-Jung; Pezzuto, John M; Cushman, Mark

    2012-01-01

    Chemoprevention is an approach to decrease cancer morbidity and mortality through inhibition of carcinogenesis and prevention of disease progression. Although the trans stilbene derivative resveratrol has chemopreventive properties, its action is compromised by weak non-specific effects on many biological targets. Replacement of the stilbene ethylenic bridge of resveratrol with a 1,2,4-thiadiazole heterocycle and modification of the substituents on the two aromatic rings afforded potential chemopreventive agents with enhanced potencies and selectivities when evaluated as inhibitors of aromatase and NF-κB and inducers of quinone reductase 1 (QR1). Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Seasonal variation of malaria cases in children aged less than 5 years old following weather change in Zomba district, Malawi.

    Science.gov (United States)

    Hajison, Precious L; Mwakikunga, Bonex W; Mathanga, Don P; Feresu, Shingairai A

    2017-07-03

    Malaria is seasonal and this may influence the number of children being treated as outpatients in hospitals. The objective of this study was to investigate the degree of seasonality in malaria in lakeshore and highland areas of Zomba district Malawi, and influence of climatic factors on incidence of malaria. Secondary data on malaria surveillance numbers and dates of treatment of children malaria epidemic over explanatory variable (rainfall, temperature and humidity). Malaria cases of children malaria in highland compared to lakeshore in Zomba district. This study also found that an increase in average temperature and relative humidity was associated of malaria incidence in children malaria incidence of children malaria seasonality, regardless of strong rainfall seasonality, and marginal drop of malaria incidence in Zomba can be explained by weather variation. Implementation of seasonal chemoprevention of malaria in Zomba could be questionable due to reduced seasonality of malaria. The lower diurnal temperature range contributed to high malaria incidence and this must be further investigated.

  7. Chemopreventive effects of natural dietary compounds on cancer development.

    Science.gov (United States)

    Pan, Min-Hsiung; Ho, Chi-Tang

    2008-11-01

    Chemoprevention, a relatively new and promising strategy to prevent cancer, is defined as the use of natural dietary compounds and/or synthetic substances to block, inhibit, reverse, or retard the process of carcinogenesis. The chemopreventive effects elicited by these natural dietary compounds are believed to include antioxidative, anti-inflammatory activity, induction of phase II enzymes, apoptosis, and cell cycle arrest. Many mechanisms have been shown to account for the anticarcinogenic actions of natural dietary compounds; attention has recently been focused on intracellular-signaling cascades as common molecular targets for various chemopreventive natural dietary compounds. In this critical review, we will summarize current knowledge on natural dietary compounds that act through the signaling pathways and modulate gene expression to induce detoxifying enzymes, programmed cell death, anti-inflammatory, and anti-proliferative effects, thus providing evidence for these substances in cancer chemopreventive action (128 references).

  8. Malaria prevention and treatment

    African Journals Online (AJOL)

    malaria parasites into the blood. Four species of malaria parasites can infect humans and cause illness; only P. falci- parum malaria is potentially life-threat- ening. Most of the malaria found in Af- rica is of the falciparum species - this is the most dangerous species of malaria. Symptoms may develop as soon as seven days ...

  9. falciparum malaria?

    African Journals Online (AJOL)

    destruction by the reticulo-endothelial system.'·. Skudowitz er al. '7 have shown that thrombocytopenia in falciparum malaria is the result of excessive splenic pool- ing as well as decreased platelet survival. Unfortunately, platelet counts could not be measured in our study. In patients with systemic lupus erythemarosus a ...

  10. Kompliceret malaria

    DEFF Research Database (Denmark)

    Rønn, A M; Bygbjerg, Ib Christian; Jacobsen, E

    1989-01-01

    An increasing number of cases of malaria, imported to Denmark, are caused by Plasmodium falciparum and severe and complicated cases are more often seen. In the Department of Infectious Diseases, Rigshospitalet, 23 out of 32 cases, hospitalized from 1.1-30.6.1988, i.e. 72%, were caused by P...

  11. Scale-up considerations relevant to experimental studies of nuclear waste-package behavior

    Energy Technology Data Exchange (ETDEWEB)

    Coles, D.G.; Peters, R.D.

    1986-04-01

    Results from a study that investigated whether testing large-scale nuclear waste-package assemblages was technically warranted are reported. It was recognized that the majority of the investigations for predicting waste-package performance to date have relied primarily on laboratory-scale experimentation. However, methods for the successful extrapolation of the results from such experiments, both geometrically and over time, to actual repository conditions have not been well defined. Because a well-developed scaling technology exists in the chemical-engineering discipline, it was presupposed that much of this technology could be applicable to the prediction of waste-package performance. A review of existing literature documented numerous examples where a consideration of scaling technology was important. It was concluded that much of the existing scale-up technology is applicable to the prediction of waste-package performance for both size and time extrapolations and that conducting scale-up studies may be technically merited. However, the applicability for investigating the complex chemical interactions needs further development. It was recognized that the complexity of the system, and the long time periods involved, renders a completely theoretical approach to performance prediction almost hopeless. However, a theoretical and experimental study was defined for investigating heat and fluid flow. It was concluded that conducting scale-up modeling and experimentation for waste-package performance predictions is possible using existing technology. A sequential series of scaling studies, both theoretical and experimental, will be required to formulate size and time extrapolations of waste-package performance.

  12. Scaling-up the medical workforce in Timor-Leste: challenges of a great leap forward.

    Science.gov (United States)

    Cabral, Jorge; Dussault, Gilles; Buchan, James; Ferrinho, Paulo

    2013-11-01

    The health services system of Timor-Leste (T-L) will, by 2015, add 800 physicians, most of them trained in Cuba, to the 233 employed by the national health system in 2010-2011. The need for more physicians is not in discussion: poor health indicators, low coverage and utilization of services, and poor quality of services are well documented in T-L. However, the choice of this scaling-up, with a relatively narrow focus on the medical workforce, needs to be assessed for its relevance to the health profile of the country, for its comprehensiveness in terms of other complementary measures needed to make it effective. This article discusses the potential effects of the rapid scaling-up of the medical workforce, and the organizational capacity needed to monitor the process and eventually mitigate any deleterious consequences. The analysis is based on a review of documentation collected on site (T-L) and on interviews with key-informants conducted in 2011. We stress that any workforce scaling-up is not simply a matter of increasing numbers of professionals, but should combine improved training, distribution, working conditions, management and motivation, as a means towards better performing health services' systems. This is a major challenge in a context of limited organizational and managerial capacity, underdeveloped information systems, limited training and research capacity, and dependency on foreign aid and technical assistance. Potential risks are associated with funding the additional costs of recruiting more personnel, associated expenditures on infrastructure, equipment and consumables, the impact on current staff mix, and the expected increased demand for services. We conclude that failing to manage effectively the forthcoming "great leap forward" will have long term effects: formal policies and plans for the balanced development of the health workforce, as well as strengthened institutions are urgently needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia.

    Science.gov (United States)

    Mengistu, Brittney S; Vins, Holly; Kelly, Caitrin M; McGee, Daphne R; Spicer, Jennifer O; Derbew, Miliard; Bekele, Abebe; Mariam, Damen Haile; Del Rio, Carlos; Blumberg, Henry M; Comeau, Dawn L

    2017-01-13

    Ethiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons. Recently, the Ethiopian government implemented a "flood and retain" initiative to rapidly increase the quantity of physicians in Ethiopia. Consequently, medical student enrollment at Addis Ababa University (AAU) School of Medicine increased from 100 to approximately 300-400 students per class. This study evaluated the impact of the rapid scale-up in the number of medical students on the quality of medical education at AAU and the impact of the U.S. government-funded Medical Education Partnership Initiative (MEPI) grant awarded to AAU to provide resources to strengthen the quality of medical education at AAU. Qualitative, semi-structured, in-depth interviews were conducted with 22 key informants including faculty members, administrators and medical students at AAU. The audio recordings were transcribed verbatim and interview data were analyzed with thematic analysis. Four key themes emerged from the data. Overall, participants perceived a decrease in the quality of medical education at AAU due to challenges created by the rapid scale-up in the number of medical students. Positive learning environments were described as difficult to achieve due to overcrowding in classrooms and the limited numbers of textbooks. Overall, participants stated that infrastructure improvement is needed to provide adequate medical student training. The medical education initiatives implemented and funded by MEPI have provided significant resources to support the medical student curriculum but additional resources are required to accommodate a large student body. The unprecedented rapid scale-up of medical students has impacted multiple facets of medical education at AAU. It is important to consider the perspectives of students and faculty in order to focus future medical education policies, MEPI programming and the allocation of resources.

  14. Documenting good practices: scaling up the youth friendly health service model in Colombia.

    Science.gov (United States)

    Huaynoca, Silvia; Svanemyr, Joar; Chandra-Mouli, Venkatraman C; Moreno Lopez, Diva Jeaneth

    2015-09-18

    Young people make up for 24.5 % of Latin America's population. Inadequate supply of specific and timely sexual and reproductive health (SRH) services and sexuality education for young people increases their risk of sexual and reproductive ill health. Colombia is one of the few countries in Latin America that has implemented and scaled up specific and differentiated health and SRH services-termed as its Youth Friendly Health Services (YFHS) Model. To provide a systematic description of the crucial factors that facilitated and hindered the scale up process of the YFHS Model in Colombia. A comprehensive literature search on SRH services for young people and national efforts to improve their quality of care in Colombia and neighbouring countries was carried out along with interviews with a selection of key stakeholders. The information gathered was analysed using the World Health Organization-ExpandNet framework (WHO-ExpandNet). In 7 years (2007-2013) of the implementation of the YFHS Model in Colombia more than 800 clinics nationally have been made youth friendly. By 2013, 536 municipalities in 32 departments had YFHS, resulting in coverage of 52 % of municipalities offering YHFS. The analysis using the WHO-ExpandNet framework identified five elements that enabled the scale up process: Clear policies and implementation guidelines on YFHS, clear attributes of the user organization and resource team, establishment and implementation of an inter-sectoral and interagency strategy, identification of and support to stakeholders and advocates of YFHS, and solid monitoring and evaluation. The elements that limited or slowed down the scale up effort were: Insufficient number of health personnel trained in youth health and SRH, a high turnover of health personnel, a decentralized health security system, inadequate supply of financial and human resources, and negative perceptions among community members about providing SRH information and services to young people. Colombia

  15. Scale-up of industrial biodiesel production to 40 m3using a liquid lipase formulation

    DEFF Research Database (Denmark)

    Price, Jason; Nordblad, Mathias; Martel, Hannah H.

    2016-01-01

    In this work, we demonstrate the scale-up from an 80 L fed-batch scale to 40 m3 along with the design of a 4 m3continuous process for enzymatic biodiesel production catalysed by NS-40116 (a liquid formulation of a modified Thermomyces lanuginosus lipase). Based on the analysis of actual pilot plant...... data for the transesterification of used cooking oil and brown grease, we propose a method applying first order integral analysis to fed-batch data based on either the bound glycerol or free fatty acid content in the oil. This method greatly simplifies the modelling process and gives an indication...

  16. Process considerations for the scale-up and implementation of biocatalysis

    DEFF Research Database (Denmark)

    Tufvesson, Pär; Fu, Wenjing; Jensen, Jacob Skibsted

    2010-01-01

    and biocatalysis in particular is a rather young technology. Although significant progress has been made in the implementation of new processes (especially in the pharmaceutical industry) no fixed methods for process design have been established to date. In this paper we present some of the considerations required...... to scale-up a biocatalytic process and some of the recently developed engineering tools available to assist in this procedure. The tools will have a decisive role in helping to identify bottlenecks in the biocatalytic development process and to justify where to put effort and resources....

  17. Bioreactor scale-up and oxygen transfer rate in microbial processes: an overview.

    Science.gov (United States)

    Garcia-Ochoa, Felix; Gomez, Emilio

    2009-01-01

    In aerobic bioprocesses, oxygen is a key substrate; due to its low solubility in broths (aqueous solutions), a continuous supply is needed. The oxygen transfer rate (OTR) must be known, and if possible predicted to achieve an optimum design operation and scale-up of bioreactors. Many studies have been conducted to enhance the efficiency of oxygen transfer. The dissolved oxygen concentration in a suspension of aerobic microorganisms depends on the rate of oxygen transfer from the gas phase to the liquid, on the rate at which oxygen is transported into the cells (where it is consumed), and on the oxygen uptake rate (OUR) by the microorganism for growth, maintenance and production. The gas-liquid mass transfer in a bioprocess is strongly influenced by the hydrodynamic conditions in the bioreactors. These conditions are known to be a function of energy dissipation that depends on the operational conditions, the physicochemical properties of the culture, the geometrical parameters of the bioreactor and also on the presence of oxygen consuming cells. Stirred tank and bubble column (of various types) bioreactors are widely used in a large variety of bioprocesses (such as aerobic fermentation and biological wastewater treatments, among others). Stirred tanks bioreactors provide high values of mass and heat transfer rates and excellent mixing. In these systems, a high number of variables affect the mass transfer and mixing, but the most important among them are stirrer speed, type and number of stirrers and gas flow rate used. In bubble columns and airlifts, the low-shear environment compared to the stirred tanks has enabled successful cultivation of shear sensitive and filamentous cells. Oxygen transfer is often the rate-limiting step in the aerobic bioprocess due to the low solubility of oxygen in the medium. The correct measurement and/or prediction of the volumetric mass transfer coefficient, (k(L)a), is a crucial step in the design, operation and scale-up of

  18. An integrated health sector response to violence against women in Malaysia: lessons for supporting scale up

    Directory of Open Access Journals (Sweden)

    Colombini Manuela

    2012-07-01

    Full Text Available Abstract Background Malaysia has been at the forefront of the development and scale up of One-Stop Crisis Centres (OSCC - an integrated health sector model that provides comprehensive care to women and children experiencing physical, emotional and sexual abuse. This study explored the strengths and challenges faced during the scaling up of the OSCC model to two States in Malaysia in order to identify lessons for supporting successful scale-up. Methods In-depth interviews were conducted with health care providers, policy makers and key informants in 7 hospital facilities. This was complemented by a document analysis of hospital records and protocols. Data were coded and analysed using NVivo 7. Results The implementation of the OSCC model differed between hospital settings, with practise being influenced by organisational systems and constraints. Health providers generally tried to offer care to abused women, but they are not fully supported within their facility due to lack of training, time constraints, limited allocated budget, or lack of referral system to external support services. Non-specialised hospitals in both States struggled with a scarcity of specialised staff and limited referral options for abused women. Despite these challenges, even in more resource-constrained settings staff who took the initiative found it was possible to adapt to provide some level of OSCC services, such as referring women to local NGOs or community support groups, or training nurses to offer basic counselling. Conclusions The national implementation of OSCC provides a potentially important source of support for women experiencing violence. Our findings confirm that pilot interventions for health sector responses to gender based violence can be scaled up only when there is a sound health infrastructure in place – in other words a supportive health system. Furthermore, the successful replication of the OSCC model in other similar settings requires that the

  19. Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland.

    Science.gov (United States)

    Fitzgerald, Laura; Benzerga, Wendy; Mirira, Munamato; Adamu, Tigistu; Shissler, Tracey; Bitchong, Raymond; Malaza, Mandla; Mamba, Makhosini; Mangara, Paul; Curran, Kelly; Khumalo, Thembisile; Mlambo, Phumzile; Njeuhmeli, Emmanuel; Maziya, Vusi

    2016-07-01

    The government of the Kingdom of Swaziland recognizes that it must urgently scale up HIV prevention interventions, such as voluntary medical male circumcision (VMMC). Swaziland has adopted a 2-phase approach to male circumcision scale-up. The catch-up phase prioritizes VMMC services for adolescents and adults, while the sustainability phase involves the establishment of early infant male circumcision (EIMC). Swaziland does not have a modern-day tradition of circumcision, and the VMMC program has met with client demand challenges. However, since the launch of the EIMC program in 2010, Swaziland now leads the Eastern and Southern Africa region in the scale-up of EIMC. Here we review Swaziland's program and its successes and challenges. From February to May 2014, we collected data while preparing Swaziland's "Male Circumcision Strategic and Operational Plan for HIV Prevention 2014-2018." We conducted structured stakeholder focus group discussions and in-depth interviews, and we collected EIMC service delivery data from an implementing partner responsible for VMMC and EIMC service delivery. Data were summarized in consolidated narratives. Between 2010 and 2014, trained providers performed more than 5,000 EIMCs in 11 health care facilities in Swaziland, and they reported no moderate or severe adverse events. According to a broad group of EIMC program stakeholders, an EIMC program needs robust support from facility, regional, and national leadership, both within and outside of HIV prevention coordination bodies, to promote institutionalization and ownership. Providers and health care managers in 3 of Swaziland's 4 regional hospitals suggest that when EIMC is introduced into reproductive, maternal, newborn, and child health platforms, dedicated staff attention can help ensure that EIMC is performed amid competing priorities. Creating informed demand from communities also supports EIMC as a service delivery priority. Formative research shows that EIMC programs should

  20. Studying Scale-Up and Spread as Social Practice: Theoretical Introduction and Empirical Case Study.

    Science.gov (United States)

    Shaw, James; Shaw, Sara; Wherton, Joseph; Hughes, Gemma; Greenhalgh, Trisha

    2017-07-07

    Health and care technologies often succeed on a small scale but fail to achieve widespread use (scale-up) or become routine practice in other settings (spread). One reason for this is under-theorization of the process of scale-up and spread, for which a potentially fruitful theoretical approach is to consider the adoption and use of technologies as social practices. This study aimed to use an in-depth case study of assisted living to explore the feasibility and usefulness of a social practice approach to explaining the scale-up of an assisted-living technology across a local system of health and social care. This was an individual case study of the implementation of a Global Positioning System (GPS) "geo-fence" for a person living with dementia, nested in a much wider program of ethnographic research and organizational case study of technology implementation across health and social care (Studies in Co-creating Assisted Living Solutions [SCALS] in the United Kingdom). A layered sociological analysis included micro-level data on the index case, meso-level data on the organization, and macro-level data on the wider social, technological, economic, and political context. Data (interviews, ethnographic notes, and documents) were analyzed and synthesized using structuration theory. A social practice lens enabled the uptake of the GPS technology to be studied in the context of what human actors found salient, meaningful, ethical, legal, materially possible, and professionally or culturally appropriate in particular social situations. Data extracts were used to illustrate three exemplar findings. First, professional practice is (and probably always will be) oriented not to "implementing technologies" but to providing excellent, ethical care to sick and vulnerable individuals. Second, in order to "work," health and care technologies rely heavily on human relationships and situated knowledge. Third, such technologies do not just need to be adopted by individuals; they need

  1. Advanced modeling to accelerate the scale up of carbon capture technologies

    Energy Technology Data Exchange (ETDEWEB)

    Miller, David C.; Sun, XIN; Storlie, Curtis B.; Bhattacharyya, Debangsu

    2015-06-01

    In order to help meet the goals of the DOE carbon capture program, the Carbon Capture Simulation Initiative (CCSI) was launched in early 2011 to develop, demonstrate, and deploy advanced computational tools and validated multi-scale models to reduce the time required to develop and scale-up new carbon capture technologies. This article focuses on essential elements related to the development and validation of multi-scale models in order to help minimize risk and maximize learning as new technologies progress from pilot to demonstration scale.

  2. An integrated health sector response to violence against women in Malaysia: lessons for supporting scale up.

    Science.gov (United States)

    Colombini, Manuela; Mayhew, Susannah H; Ali, Siti Hawa; Shuib, Rashidah; Watts, Charlotte

    2012-07-24

    Malaysia has been at the forefront of the development and scale up of One-Stop Crisis Centres (OSCC) - an integrated health sector model that provides comprehensive care to women and children experiencing physical, emotional and sexual abuse. This study explored the strengths and challenges faced during the scaling up of the OSCC model to two States in Malaysia in order to identify lessons for supporting successful scale-up. In-depth interviews were conducted with health care providers, policy makers and key informants in 7 hospital facilities. This was complemented by a document analysis of hospital records and protocols. Data were coded and analysed using NVivo 7. The implementation of the OSCC model differed between hospital settings, with practise being influenced by organisational systems and constraints. Health providers generally tried to offer care to abused women, but they are not fully supported within their facility due to lack of training, time constraints, limited allocated budget, or lack of referral system to external support services. Non-specialised hospitals in both States struggled with a scarcity of specialised staff and limited referral options for abused women. Despite these challenges, even in more resource-constrained settings staff who took the initiative found it was possible to adapt to provide some level of OSCC services, such as referring women to local NGOs or community support groups, or training nurses to offer basic counselling. The national implementation of OSCC provides a potentially important source of support for women experiencing violence. Our findings confirm that pilot interventions for health sector responses to gender based violence can be scaled up only when there is a sound health infrastructure in place - in other words a supportive health system. Furthermore, the successful replication of the OSCC model in other similar settings requires that the model - and the system supporting it - needs to be flexible enough to

  3. iCCM policy analysis: strategic contributions to understanding its character, design and scale up in sub-Saharan Africa.

    Science.gov (United States)

    George, Asha; Rodríguez, Daniela C; Rasanathan, Kumanan; Brandes, Neal; Bennett, Sara

    2015-12-01

    Pneumonia, diarrhoea and malaria remain leading causes of death for children under 5 years of age and access to effective and appropriate treatment for sick children is extremely low where it is needed most. Integrated community case management (iCCM) enables community health workers to provide basic lifesaving treatment for sick children living in remote communities for these diseases. While many governments in sub-Saharan Africa recently changed policies to support iCCM, large variations in implementation remain. As a result, the collaboration represented in this supplement examined the policy processes underpinning iCCM through qualitative case study research in six purposively identified countries (Niger, Burkina Faso, Mali, Kenya, Malawi and Mozambique) and the global context. We introduce the supplement, by reviewing how policy analysis can inform: (a) how we frame iCCM and negotiate its boundaries, (b) how we tailor iCCM for national health systems and (c) how we foster accountability and learning for iCCM. In terms of framing, iCCM boundaries reflect how an array of actors use evidence to prioritize particular aspects of child mortality (lack of access to treatment), and how this underpins the ability to reach consensus and legitimate specific policy enterprises. When promoted at national level, contextual health system factors, such as the profile of CHWs and the history of primary health care, cannot be ignored. Adaptation to these contextual realities may lead to unintended consequences not forseen by technical or managerial expertize alone. Further scaling up of iCCM requires understanding of the political accountabilities involved, how ownership can be fostered and learning for improved policies and programs sustained. Collectively these articles demonstrate that iCCM, although often compartmentalized as a technical intervention, also reflects the larger and messier real world of health politics, policy and practice, for which policy analysis is vital

  4. Safer operating conditions and optimal scaling-up process for cyclohexanone peroxide reaction

    Energy Technology Data Exchange (ETDEWEB)

    Zang, Na [Department of Fire Protection Engineering, Chinese People' s Armed Police Force Academy, Langfang 065000, Hebei (China); Jiangsu Key Laboratory of Urban and Industrial Safety, Nanjing University of Technology, Nanjing 211800, Jiangsu (China); Qian, Xin-Ming, E-mail: qsemon@bit.edu.cn [State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081 (China); Liu, Zhen-Yi [State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081 (China); Shu, Chi-Min [Process Safety and Disaster Prevention Laboratory, Department of Safety, Health, and Environmental Engineering, National Yunlin University of Science and Technology, Douliou, Yunlin 64002, Taiwan, ROC (China)

    2015-10-20

    Highlights: • Thermal hazard of cyclohexanone peroxide reaction was measured by experimental techniques. • Levenberg–Marquardt algorithm was adopted to evaluate kinetic parameters. • Safer operating conditions at laboratory scale were acquired by BDs and TDs. • The verified safer operating conditions were used to obtain the optimal scale-up parameters applied in industrial plants. - Abstract: The cyclohexanone peroxide reaction process, one of the eighteen hazardous chemical processes identified in China, is performed in indirectly cooled semibatch reactors. The peroxide reaction is added to a mixture of hydrogen peroxide and nitric acid, which form heterogeneous liquid–liquid systems. A simple and general procedure for building boundary and temperature diagrams of peroxide process is given here to account for the overall kinetic expressions. Such a procedure has been validated by comparison with experimental data. Thermally safer operating parameters were obtained at laboratory scale, and the scaled-up procedure was performed to give the minimum dosing time in an industrial plant, which is in favor of maximizing industrial reactor productivity. The results are of great significance for governing the peroxide reaction process apart from the thermal runaway region. It also greatly aids in determining optimization on operating parameters in industrial plants.

  5. Semantic Representation and Scale-Up of Integrated Air Traffic Management Data

    Science.gov (United States)

    Keller, Richard M.; Ranjan, Shubha; Wei, Mie; Eshow, Michelle

    2016-01-01

    Each day, the global air transportation industry generates a vast amount of heterogeneous data from air carriers, air traffic control providers, and secondary aviation entities handling baggage, ticketing, catering, fuel delivery, and other services. Generally, these data are stored in isolated data systems, separated from each other by significant political, regulatory, economic, and technological divides. These realities aside, integrating aviation data into a single, queryable, big data store could enable insights leading to major efficiency, safety, and cost advantages. In this paper, we describe an implemented system for combining heterogeneous air traffic management data using semantic integration techniques. The system transforms data from its original disparate source formats into a unified semantic representation within an ontology-based triple store. Our initial prototype stores only a small sliver of air traffic data covering one day of operations at a major airport. The paper also describes our analysis of difficulties ahead as we prepare to scale up data storage to accommodate successively larger quantities of data -- eventually covering all US commercial domestic flights over an extended multi-year timeframe. We review several approaches to mitigating scale-up related query performance concerns.

  6. Biological hydrogen production by dark fermentation: challenges and prospects towards scaled-up production.

    Science.gov (United States)

    RenNanqi; GuoWanqian; LiuBingfeng; CaoGuangli; DingJie

    2011-06-01

    Among different technologies of hydrogen production, bio-hydrogen production exhibits perhaps the greatest potential to replace fossil fuels. Based on recent research on dark fermentative hydrogen production, this article reviews the following aspects towards scaled-up application of this technology: bioreactor development and parameter optimization, process modeling and simulation, exploitation of cheaper raw materials and combining dark-fermentation with photo-fermentation. Bioreactors are necessary for dark-fermentation hydrogen production, so the design of reactor type and optimization of parameters are essential. Process modeling and simulation can help engineers design and optimize large-scale systems and operations. Use of cheaper raw materials will surely accelerate the pace of scaled-up production of biological hydrogen. And finally, combining dark-fermentation with photo-fermentation holds considerable promise, and has successfully achieved maximum overall hydrogen yield from a single substrate. Future development of bio-hydrogen production will also be discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Disaster risk reduction education in Indonesia: challenges and recommendations for scaling up

    Science.gov (United States)

    Amri, Avianto; Bird, Deanne K.; Ronan, Kevin; Haynes, Katharine; Towers, Briony

    2017-04-01

    This article investigates the implementation of disaster risk reduction education for children in Indonesia. In the last decade, education programmes related to this subject have been promoted as capable of reducing disaster losses and increasing resilience, based on several studies that have identified positive outcomes. Therefore, it is critical to evaluate and address any potential challenges that might impede their success. The article uses a case study in Jakarta, a rapidly growing megacity that is highly prone to disasters and natural hazards, especially floods and fires, to explore the scaling up and sustainability of disaster risk reduction in Indonesian schools. Based on previous studies, a new approach was developed for evaluating the implementation of education programmes related to these subjects. This study captured the perspectives of children, school personnel, and non-governmental organisations on the challenges of scaling up the implementation of disaster risk reduction education in schools. The study revealed seven key issues and suggests several policy recommendations to move forward. These key issues may also be apparent in many other developing and developed countries, and the suggested recommendations may well be applicable beyond Indonesia.

  8. Increasing power generation for scaling up single-chamber air cathode microbial fuel cells

    KAUST Repository

    Cheng, Shaoan

    2011-03-01

    Scaling up microbial fuel cells (MFCs) requires a better understanding the importance of the different factors such as electrode surface area and reactor geometry relative to solution conditions such as conductivity and substrate concentration. It is shown here that the substrate concentration has significant effect on anode but not cathode performance, while the solution conductivity has a significant effect on the cathode but not the anode. The cathode surface area is always important for increasing power. Doubling the cathode size can increase power by 62% with domestic wastewater, but doubling the anode size increases power by 12%. Volumetric power density was shown to be a linear function of cathode specific surface area (ratio of cathode surface area to reactor volume), but the impact of cathode size on power generation depended on the substrate strength (COD) and conductivity. These results demonstrate the cathode specific surface area is the most critical factor for scaling-up MFCs to obtain high power densities. © 2010 Elsevier Ltd.

  9. Scaling-up the production of thermostable lipolytic enzymes from Thermus aquaticus YT1.

    Science.gov (United States)

    López, Elena; Domínguez, Begoña; Deive, Francisco J; Sanromán, M Ángeles; Longo, María A

    2012-08-01

    The lipolytic enzymes synthesized by Thermusaquaticus YT1 present extremely interesting properties of thermostability (more than 70% of activity after 12 days at 80°C and a half-life time of 1 h at 95°C), which point out the interest of proposing efficient strategies to successfully tackle the scale-up of the production process. In this study,viable scaling-up of the production process was implemented,and relevant aspects affecting the enzyme synthesis, such as the mineral composition of the culture medium, the aeration and the agitation have been evaluated.A strategy combining the modification of the culture medium and the aeration degree was also approached by adding perfluorocarbons, compounds which improve the availability of oxygen in the culture medium. An opposite response of biomass and lipolytic activity to the aeration conditions was found between scales (about 600 U L(-1) at high aeration levels in flask vs. 150 U L(-1) at high aeration rates in reactor), which further demonstrates the important role of the hydrodynamic conditions on the suitable development of the biological process. In all cases, the cultures were kinetically characterized and the Luedeking and Piret model turned out to be a valuable tool to conclude that the produced lipolytic enzyme is a growth-associated metabolite, no matter the medium and the scale.

  10. Scaling up: A guide to high throughput genomic approaches for biodiversity analysis.

    Science.gov (United States)

    Porter, Teresita M; Hajibabaei, Mehrdad

    2018-01-02

    The purpose of this review is to present the most common and emerging DNA-based methods used to generate data for biodiversity and biomonitoring studies. Since environmental assessment and monitoring programs may require biodiversity information at multiple levels, we pay particular attention to the DNA metabarcoding method and discuss a number of bioinformatic tools and considerations for producing DNA-based indicators using operational taxonomic units (OTUs), taxa at a variety of ranks, and community composition. By developing the capacity to harness the advantages provided by the newest technologies, investigators can 'scale-up' by increasing the number of samples and replicates processed, the frequency of sampling over time and space, and even the depth of sampling such as by sequencing more reads per sample or more markers per sample. The ability to scale-up is made possible by the reduced hands-on time and cost per sample provided by the newest kits, platforms, and software tools. Results gleaned from broad-scale monitoring will provide an opportunity to address key scientific questions linked to biodiversity and its dynamics across time and space as well as being more relevant for policy makers, enabling science-based decision making, and provide a greater socio-economic impact. Since genomic approaches are continually evolving, we provide this guide to methods used in biodiversity genomics. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Biohydrogen production from microalgal biomass: energy requirement, CO2 emissions and scale-up scenarios.

    Science.gov (United States)

    Ferreira, Ana F; Ortigueira, Joana; Alves, Luís; Gouveia, Luísa; Moura, Patrícia; Silva, Carla

    2013-09-01

    This paper presents a life cycle inventory of biohydrogen production by Clostridium butyricum through the fermentation of the whole Scenedesmus obliquus biomass. The main purpose of this work was to determine the energy consumption and CO2 emissions during the production of hydrogen. This was accomplished through the fermentation of the microalgal biomass cultivated in an outdoor raceway pond and the preparation of the inoculum and culture media. The scale-up scenarios are discussed aiming for a potential application to a fuel cell hybrid taxi fleet. The H2 yield obtained was 7.3 g H2/kg of S. obliquus dried biomass. The results show that the production of biohydrogen required 71-100 MJ/MJ(H2) and emitted about 5-6 kg CO2/MJ(H2). Other studies and production technologies were taken into account to discuss an eventual process scale-up. Increased production rates of microalgal biomass and biohydrogen are necessary for bioH2 to become competitive with conventional production pathways. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Microbial electrolysis cell scale-up for combined wastewater treatment and hydrogen production.

    Science.gov (United States)

    Gil-Carrera, L; Escapa, A; Mehta, P; Santoyo, G; Guiot, S R; Morán, A; Tartakovsky, B

    2013-02-01

    This study demonstrates microbial electrolysis cell (MEC) scale-up from a 50mL to a 10L cell. Initially, a 50mL membraneless MEC with a gas diffusion cathode was operated on synthetic wastewater at different organic loads. It was concluded that process scale-up might be best accomplished using a "reactor-in-series" concept. Consequently, 855mL and 10L MECs were built and operated. By optimizing the hydraulic retention time (HRT) of the 855mL MEC and individually controlling the applied voltages of three anodic compartments with a real-time optimization algorithm, a COD removal of 5.7g L(R)(-1)d(-1) and a hydrogen production of 1.0-2.6L L(R)(-1)d(-1) was achieved. Furthermore, a two MECs in series 10L setup was constructed and operated on municipal wastewater. This test showed a COD removal rate of 0.5g L(R)(-1)d(-1), a removal efficiency of 60-76%, and an energy consumption of 0.9Whperg of COD removed. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  13. The design and scale-up of spray dried particle delivery systems.

    Science.gov (United States)

    Al-Khattawi, Ali; Bayly, Andrew; Phillips, Andrew; Wilson, David

    2018-01-01

    The rising demand for pharmaceutical particles with tailored physicochemical properties has opened new markets for spray drying especially for solubility enhancement, improving inhalation medicines and stabilization of biopharmaceuticals. Despite this, the spray drying literature is scattered and often does not address the principles underpinning robust development of pharmaceuticals. It is therefore necessary to present clearer picture of the field and highlight the factors influencing particle design and scale-up. Areas covered: The review presents a systematic analysis of the trends in development of particle delivery systems using spray drying. This is followed by exploring the mechanisms governing particle formation in the process stages. Particle design factors including those of equipment configurations and feed/process attributes were highlighted. Finally, the review summarises the current industrial approaches for upscaling pharmaceutical spray drying. Expert opinion: Spray drying provides the ability to design particles of the desired functionality. This greatly benefits the pharmaceutical sector especially as product specifications are becoming more encompassing and exacting. One of the biggest barriers to product translation remains one of scale-up/scale-down. A shift from trial and error approaches to model-based particle design helps to enhance control over product properties. To this end, process innovations and advanced manufacturing technologies are particularly welcomed.

  14. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

    DEFF Research Database (Denmark)

    Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal

    2017-01-01

    In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study...... was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT......) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision...

  15. Scaling up watershed model parameters--Flow and load simulations of the Edisto River Basin

    Science.gov (United States)

    Feaster, Toby D.; Benedict, Stephen T.; Clark, Jimmy M.; Bradley, Paul M.; Conrads, Paul

    2014-01-01

    The Edisto River is the longest and largest river system completely contained in South Carolina and is one of the longest free flowing blackwater rivers in the United States. The Edisto River basin also has fish-tissue mercury concentrations that are some of the highest recorded in the United States. As part of an effort by the U.S. Geological Survey to expand the understanding of relations among hydrologic, geochemical, and ecological processes that affect fish-tissue mercury concentrations within the Edisto River basin, analyses and simulations of the hydrology of the Edisto River basin were made with the topography-based hydrological model (TOPMODEL). The potential for scaling up a previous application of TOPMODEL for the McTier Creek watershed, which is a small headwater catchment to the Edisto River basin, was assessed. Scaling up was done in a step-wise process beginning with applying the calibration parameters, meteorological data, and topographic wetness index data from the McTier Creek TOPMODEL to the Edisto River TOPMODEL. Additional changes were made with subsequent simulations culminating in the best simulation, which included meteorological and topographic wetness index data from the Edisto River basin and updated calibration parameters for some of the TOPMODEL calibration parameters. Comparison of goodness-of-fit statistics between measured and simulated daily mean streamflow for the two models showed that with calibration, the Edisto River TOPMODEL produced slightly better results than the McTier Creek model, despite the significant difference in the drainage-area size at the outlet locations for the two models (30.7 and 2,725 square miles, respectively). Along with the TOPMODEL hydrologic simulations, a visualization tool (the Edisto River Data Viewer) was developed to help assess trends and influencing variables in the stream ecosystem. Incorporated into the visualization tool were the water-quality load models TOPLOAD, TOPLOAD-H, and LOADEST

  16. Health system governance to support scale up of mental health care in Ethiopia: a qualitative study.

    Science.gov (United States)

    Hanlon, Charlotte; Eshetu, Tigist; Alemayehu, Daniel; Fekadu, Abebaw; Semrau, Maya; Thornicroft, Graham; Kigozi, Fred; Marais, Debra Leigh; Petersen, Inge; Alem, Atalay

    2017-01-01

    Ethiopia is embarking upon a ground-breaking plan to address the high levels of unmet need for mental health care by scaling up mental health care integrated within primary care. Health system governance is expected to impact critically upon the success or otherwise of this important initiative. The objective of the study was to explore the barriers, facilitators and potential strategies to promote good health system governance in relation to scale-up of mental health care in Ethiopia. A qualitative study was conducted using in-depth interviews. Key informants were selected purposively from national and regional level policy-makers, planners and service developers (n = 7) and district health office administrators and facility heads (n = 10) from a district in southern Ethiopia where a demonstration project to integrate mental health into primary care is underway. Topic guide development and analysis of transcripts were guided by an established framework for assessing health system governance, adapted for the Ethiopian context. From the perspective of respondents, particular strengths of health system governance in Ethiopia included the presence of high level government support, the existence of a National Mental Health Strategy and the focus on integration of mental health care into primary care to improve the responsiveness of the health system. However, both national and district level respondents expressed concerns about low baseline awareness about mental health care planning, the presence of stigmatising attitudes, the level of transparency about planning decisions, limited leadership for mental health, lack of co-ordination of mental health planning, unreliable supplies of medication, inadequate health management information system indicators for monitoring implementation, unsustainable models for specialist mental health professional involvement in supervision and mentoring of primary care staff, lack of community mobilisation for mental health and low

  17. Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot

    2010-07-01

    Full Text Available Abstract Background Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. Methods In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Results Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country’s political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country’s political crisis, the MoPH’s campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. Conclusion The Thai case study suggests that the political crisis was a

  18. Process engineering and scale-up of autotrophic Clostridium strain P11 syngas fermentation

    Science.gov (United States)

    Kundiyana, Dimple Kumar Aiyanna

    Scope and Method of Study. Biomass gasification followed by fermentation of syngas to ethanol is a potential process to produce bioenergy. The process is currently being researched under laboratory- and pilot-scale in an effort to optimize the process conditions and make the process feasible for commercial production of ethanol and other biofuels such as butanol and propanol. The broad research objectives for the research were to improve ethanol yields during syngas fermentation and to design a economical fermentation process. The research included four statistically designed experimental studies in serum bottles, bench-scale and pilot-scale fermentors to screen alternate fermentation media components, to determine the effect of process parameters such as pH, temperature and buffer on syngas fermentation, to determine the effect of key limiting nutrients of the acetyl-CoA pathway in a continuous series reactor design, and to scale-up the syngas fermentation in a 100-L pilot scale fermentor. Findings and Conclusions. The first experimental study identified cotton seed extract (CSE) as a feasible medium for Clostridium strain P11 fermentation. The study showed that CSE at 0.5 g L-1 can potentially replace all the standard Clostridium strain P11 fermentation media components while using a media buffer did not significantly improve the ethanol production when used in fermentation with CSE. Scale-up of the CSE fermentation in 2-L and 5-L stirred tank fermentors showed 25% increase in ethanol yield. The second experimental study showed that syngas fermentation at 32°C without buffer was associated with higher ethanol concentration and reduced lag time in switching to solventogenesis. Conducting fermentation at 40°C or by lowering incubation pH to 5.0 resulted in reduced cell growth and no production of ethanol or acetic acid. The third experiment studied the effect of three limiting nutrients, calcium pantothenate, vitamin B12 and CoCl2 on syngas fermentation. Results

  19. Factoring quality laboratory diagnosis into the malaria control agenda for sub-Saharan Africa.

    Science.gov (United States)

    Aidoo, Michael

    2013-09-01

    Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.

  20. Non-isothermal flow of viscous liquids: engineering correlations for scale-up guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Dey, A.K.

    1988-10-01

    Measurements of pressure distribution and temperature distribution along the length of model pipeline test rigs were made at varying operating variables for laminar flow of newtonion and power-law liquids. Flow data were also collected for different concentrations of Sobhason Field crude oil mixed with various mixtures of petroleum products. The pressure gradient was found to vary with the length of pipe. The departure of the results from a Poiseuille type equation were examined in the light of related information available in the literature. The selection of proper operating variables could reduce power consumption substantially. The relationships developed from experimental results for a varying range of non-isothermal parameters based on inlet condition and ambient temperature acclaimed importance to scale up in designing pipelines for a given flow rate or pressure drop under variable heat flux conditions. 11 figs., 10 refs., 3 tabs.

  1. Experimental and scale up study of the flame spread over the PMMA sheets

    Directory of Open Access Journals (Sweden)

    Mamourian Mojtaba

    2009-01-01

    Full Text Available To explore the flame spread mechanisms over the solid fuel sheets, downward flame spread over vertical polymethylmethacrylate sheets with thicknesses from 1.75 to 5.75 mm have been examined in the quiescent environment. The dependence of the flame spread rate on the thickness of sheets is obtained by one-dimensional heat transfer model. An equation for the flame spread rate based on the thermal properties and the thickness of the sheet by scale up method is derived from this model. During combustion, temperature within the gas and solid phases is measured by a fine thermocouple. The pyrolysis temperature, the length of the pyrolysis zone, the length of the preheating zone, and the flame temperature are determined from the experimental data. Mathematical analysis has yielded realistic results. This model provides a useful formula to predict the rate of flame spread over any thin solid fuel.

  2. Drug nanocrystals: four basic prerequisites for formulation development and scale-up.

    Science.gov (United States)

    Srivalli, Kale Mohana Raghava; Mishra, Brahmeshwar

    2015-01-01

    Drug nanocrystals have been studied since the 1990s and there are already six therapeutic nanocrystal products on market and many more in clinical trials. Nanocrystals are encapsulating-carrier free nanoparticles wherein 100% drug loading could be achieved. This signifies that nanocrystals, among other nanoparticulate products, could be more easily manufactured even at the initial formulation development stages to evaluate the effect of size reduction on the bioavailability of drugs. Additionally, a drug nanocrystal is considered not as a generic product but as a "new drug" by FDA. Process characterization, equipment choice, robust formulation and stability are discussed as four basic prerequisites for formulation development and scale-up of drug nanocrystals. The fast growing and relatively superior market profile of nanocrystals amongst other nanoparticle systems is due to their rational formulation design and production simplicity. In this emerging scenario, keeping an eye on the four basic prerequisites can further improve the success of drug nanocrystals.

  3. Forest ecosystems and environments scaling up from shoot module to watershed

    CERN Document Server

    Kohyama, Takashi; Ojima, Dennis S

    2005-01-01

    Coastal East and Southeast Asia are characterized by wet growing seasons, and species-rich forest ecosystems develop throughout the latitudinal and altitudinal gradients. In this region, the Global Change Impacts on Terrestrial Ecosystems in Monsoon Asia (TEMA) project was carried out as a unique contribution to the international project Global Change and Terrestrial Ecosystems. TEMA aimed to integrate forest ecosystem processes, from leaf physiology to meteorological budget and prediction of long-term change of vegetation composition and architecture through demographic processes. Special attention was given to watershed processes, where forest ecosystem metabolism affects the properties and biogeochemical budgets of freshwater ecosystems, and where rivers, wetlands, and lakes are subject to direct and indirect effects of environmental change. This volume presents the scaling-up concept for better understanding of ecosystem functioning.

  4. Scaling up the health workforce in the public sector: the role of government fiscal policy.

    Science.gov (United States)

    Vujicic, Marko

    2010-01-01

    Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report.

  5. Evaluation of liquid-fed ceramic melter scale-up correlations

    Energy Technology Data Exchange (ETDEWEB)

    Koegler, S.S.; Mitchell, S.J.

    1988-08-01

    This study was conducted to determine the parameters governing factors of scale for liquid-fed ceramic melters (LFCMs) in order to design full-scale melters using smaller-scale melter data. Results of melter experiments conducted at Pacific Northwest Laboratory (PNL) and Savannah River Laboratory (SRL) are presented for two feed compositions and five different liquid-fed ceramic melters. The melter performance data including nominal feed rate and glass melt rate are correlated as a function of melter surface area. Comparisons are made between the actual melt rate data and melt rates predicted by a cold cap heat transfer model. The heat transfer model could be used in scale-up calculations, but insufficient data are available on the cold cap characteristics. Experiments specifically designed to determine heat transfer parameters are needed to further develop the model. 17 refs.

  6. 3D printed high-throughput hydrothermal reactionware for discovery, optimization, and scale-up.

    Science.gov (United States)

    Kitson, Philip J; Marshall, Ross J; Long, Deliang; Forgan, Ross S; Cronin, Leroy

    2014-11-17

    3D printing techniques allow the laboratory-scale design and production of reactionware tailored to specific experimental requirements. To increase the range and versatility of reactionware devices, sealed, monolithic reactors suitable for use in hydrothermal synthesis have been digitally designed and realized. The fabrication process allows the introduction of reaction mixtures directly into the reactors during the production, and also enables the manufacture of devices of varying scales and geometries unavailable in traditional equipment. The utility of these devices is shown by the use of 3D printed, high-throughput array reactors to discover two new coordination polymers, optimize the synthesis of one of these, and scale-up its synthesis using larger reactors produced on the same 3D printer. Reactors were also used to produce phase-pure samples of coordination polymers MIL-96 and HKUST-1, in yields comparable to synthesis in traditional apparatus. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Scale-up of Multidrug-Resistant Tuberculosis Laboratory Services, Peru

    Science.gov (United States)

    Yagui, Martin; Ascencios, Luis; Yale, Gloria; Suarez, Carmen; Quispe, Neyda; Bonilla, Cesar; Blaya, Joaquin; Taylor, Allison; Contreras, Carmen; Cegielski, Peter

    2008-01-01

    Over the past 10 years, the Peruvian National Tuberculosis (TB) Program, the National Reference Laboratory (NRL), Socios en Salud, and US partners have worked to strengthen the national TB laboratory network to support treatment of multidrug-resistant TB. We review key lessons of this experience. The preparation phase involved establishing criteria for drug susceptibility testing (DST), selecting appropriate DST methods, projecting the quantity of DST and culture to ensure adequate supplies, creating biosafe laboratory facilities for DST, training laboratory personnel on methods, and validating DST methods at the NRL. Implementation involved training providers on DST indications, validating conventional and rapid first-line DST methods at district laboratories, and eliminating additional delays in specimen transport and result reporting. Monitoring included ongoing quality control and quality assurance procedures. Hurdles included logistics, coordinating with policy, competing interests, changing personnel, communications, and evaluation. Operational research guided laboratory scale-up and identified barriers to effective capacity building. PMID:18439349

  8. Scaling-up vaccine production: implementation aspects of a biomass growth observer and controller.

    Science.gov (United States)

    Soons, Zita I T A; van den IJssel, Jan; van der Pol, Leo A; van Straten, Gerrit; van Boxtel, Anton J B

    2009-04-01

    This study considers two aspects of the implementation of a biomass growth observer and specific growth rate controller in scale-up from small- to pilot-scale bioreactors towards a feasible bulk production process for whole-cell vaccine against whooping cough. The first is the calculation of the oxygen uptake rate, the starting point for online monitoring and control of biomass growth, taking into account the dynamics in the gas-phase. Mixing effects and delays are caused by amongst others the headspace and tubing to the analyzer. These gas phase dynamics are modelled using knowledge of the system in order to reconstruct oxygen consumption. The second aspect is to evaluate performance of the monitoring and control system with the required modifications of the oxygen consumption calculation on pilot-scale. In pilot-scale fed-batch cultivation good monitoring and control performance is obtained enabling a doubled concentration of bulk vaccine compared to standard batch production.

  9. Scaling-up of membraneless microbial electrolysis cells (MECs) for domestic wastewater treatment: Bottlenecks and limitations.

    Science.gov (United States)

    Escapa, A; San-Martín, M I; Mateos, R; Morán, A

    2015-03-01

    Microbial electrolysis cells (MECs) have the potential to become a sustainable domestic wastewater (dWW) treatment system. However, new scale-up experiences are required to gain knowledge of critical issues in MEC designs. In this study we assess the ability of two twin membraneless MEC units (that are part of a modular pilot-scale MEC) to treat dWW. Batch tests yielded COD removal efficiencies as high as 92%, with most of the hydrogen (>80% of the total production) being produced during the first 48h. During the continuous tests, MECs performance deteriorated significantly (energy consumption was relatively high and COD removal efficiencies fell below 10% in many cases), which was attributed to an inadequate configuration of the anodic chamber, insufficient mixing inside this chamber, inefficient hydrogen management on the cathode side and finally to dWW in itself. Some alternatives to the current design are suggested. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Using Rainfall and Temperature Data in the Evaluation of National Malaria Control Programs in Africa.

    Science.gov (United States)

    Thomson, Madeleine C; Ukawuba, Israel; Hershey, Christine L; Bennett, Adam; Ceccato, Pietro; Lyon, Bradfield; Dinku, Tufa

    2017-09-01

    Since 2010, the Roll Back Malaria (RBM) Partnership, including National Malaria Control Programs, donor agencies (e.g., President's Malaria Initiative and Global Fund), and other stakeholders have been evaluating the impact of scaling up malaria control interventions on all-cause under-five mortality in several countries in sub-Saharan Africa. The evaluation framework assesses whether the deployed interventions have had an impact on malaria morbidity and mortality and requires consideration of potential nonintervention influencers of transmission, such as drought/floods or higher temperatures. Herein, we assess the likely effect of climate on the assessment of the impact malaria interventions in 10 priority countries/regions in eastern, western, and southern Africa for the President's Malaria Initiative. We used newly available quality controlled Enhanced National Climate Services rainfall and temperature products as well as global climate products to investigate likely impacts of climate on malaria evaluations and test the assumption that changing the baseline period can significantly impact on the influence of climate in the assessment of interventions. Based on current baseline periods used in national malaria impact assessments, we identify three countries/regions where current evaluations may overestimate the impact of interventions (Tanzania, Zanzibar, Uganda) and three countries where current malaria evaluations may underestimate the impact of interventions (Mali, Senegal and Ethiopia). In four countries (Rwanda, Malawi, Mozambique, and Angola) there was no strong difference in climate suitability for malaria in the pre- and post-intervention period. In part, this may be due to data quality and analysis issues.

  11. Geriatric health policy in India: The need for scaling-up implementation

    Directory of Open Access Journals (Sweden)

    N Sherin Susan Paul

    2016-01-01

    Full Text Available In an anticipation of the rising geriatric population in India, the Central government constituted the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. A major strategy of this policy is to encourage families to take care of their older family members. The policy also encourages voluntary organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. The implementation of this policy, particularly in the rural areas, has been negligible and calls for a scaling-up of programs to address the physical, psychological, and social needs of the poor. Due to breakdown of the joint family system and the migration of the younger generation to the towns and cities, the elderly parents in the villages are left to fend for themselves. Too old to work and with little or no source of income, the elders are struggling even to satisfy their basic needs. This article primarily focuses on the various facets of elderly care in India. As a fledgling nation in elderly care, we should take cues from other nations who have pioneered in this field and should constantly evolve to identify and face the various challenges that come up, especially from rural India. The Rural Unit for Health and Social Affairs Department of a well-known Medical College in South India has developed a “senior recreation day care” model which proves to be a useful replicable model to improve the quality of life and nutritional status of the elderly in the lower rungs of society. More than a decade since its inception, it is now the right time to assess the implementation of our geriatric health policy and scale-up programs so that the elderly in our country, irrespective of urban and rural, will have a dignified and good quality life.

  12. Liposome and niosome preparation using a membrane contactor for scale-up.

    Science.gov (United States)

    Pham, Thi Thuy; Jaafar-Maalej, Chiraz; Charcosset, Catherine; Fessi, Hatem

    2012-06-01

    The scaling-up ability of liposome and niosome production, from laboratory scale using a syringe-pump device to a pilot scale using the membrane contactor module, was investigated. For this aim, an ethanol injection-based method was applied for liposome and niosome preparation. The syringe-pump device was used for laboratory scale batches production (30 ml for liposomes, 20 ml for niosomes) then a pilot scale (750 ml for liposomes, 1000 ml for niosomes) were obtained using the SPG membrane contactor. Resulted nanovesicles were characterized in terms of mean vesicles size, polydispersity index (PdI) and zeta potential. The drug encapsulation efficiency (E.E.%) was evaluated using two drug-models: caffeine and spironolactone, a hydrophilic and a lipophilic molecule, respectively. As results, nanovectors mean size using the syringe-pump device was comprised between 82 nm and 95 nm for liposomes and between 83 nm and 127 nm for niosomes. The optimal E.E. of caffeine within niosomes, was found around 9.7% whereas the spironolactone E.E. reached 95.6% which may be attributed to its lipophilic properties. For liposomes these values were about 9.7% and 86.4%, respectively. It can be clearly seen that the spironolactone E.E. was slightly higher within niosomes than liposomes. Optimized formulations, which offered smaller size and higher E.E., were selected for pilot scale production using the SPG membrane. It has been found that vesicles characteristics (size and E.E.%) were reproducible using the membrane contactor module. Thus, the current study demonstrated the usefulness of the membrane contactor as a device for scaling-up both liposome and niosome preparations with small mean sizes. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Manufacturing process scale-up of optical grade transparent spinel ceramic at ArmorLine Corporation

    Science.gov (United States)

    Spilman, Joseph; Voyles, John; Nick, Joseph; Shaffer, Lawrence

    2013-06-01

    While transparent Spinel ceramic's mechanical and optical characteristics are ideal for many Ultraviolet (UV), visible, Short-Wave Infrared (SWIR), Mid-Wave Infrared (MWIR), and multispectral sensor window applications, commercial adoption of the material has been hampered because the material has historically been available in relatively small sizes (one square foot per window or less), low volumes, unreliable supply, and with unreliable quality. Recent efforts, most notably by Technology Assessment and Transfer (TA and T), have scaled-up manufacturing processes and demonstrated the capability to produce larger windows on the order of two square feet, but with limited output not suitable for production type programs. ArmorLine Corporation licensed the hot-pressed Spinel manufacturing know-how of TA and T in 2009 with the goal of building the world's first dedicated full-scale Spinel production facility, enabling the supply of a reliable and sufficient volume of large Transparent Armor and Optical Grade Spinel plates. With over $20 million of private investment by J.F. Lehman and Company, ArmorLine has installed and commissioned the largest vacuum hot press in the world, the largest high-temperature/high-pressure hot isostatic press in the world, and supporting manufacturing processes within 75,000 square feet of manufacturing space. ArmorLine's equipment is capable of producing window blanks as large as 50" x 30" and the facility is capable of producing substantial volumes of material with its Lean configuration and 24/7 operation. Initial production capability was achieved in 2012. ArmorLine will discuss the challenges that were encountered during scale-up of the manufacturing processes, ArmorLine Optical Grade Spinel optical performance, and provide an overview of the facility and its capabilities.

  14. UPC Scaling-up methodology for Deterministic Safety Assessment and Support to Plant Operation

    Energy Technology Data Exchange (ETDEWEB)

    Martínez-Quiroga, V.; Reventós, F.; Batet, Il.

    2015-07-01

    Best Estimate codes along with necessary nodalizations are widely used tools in nuclear engineering for both Deterministic Safety Assessment (DSA) and Support to Plant Operation and Control. In this framework, the application of quality assurance procedures in both codes and nodalizations becomes an essential step prior any significant study. Along these lines the present paper introduces the UPC SCUP, a systematic methodology based on the extrapolation of the Integral Test Facilities (ITF) post-test simulations by means of scaling analyses. In that sense, SCUP fulfills a gap in current nodalization qualification procedures, the related with the validation of NPP nodalizations for Design Basis Accidents conditions. Three are the pillars that support SCUP: judicial selection of the experimental transients, full confidence in the quality of the ITF simulations, and simplicity in justifying discrepancies that appear between ITF and NPP counterpart transients. The techniques that are presented include the socalled Kv scaled calculations as well as the use of two new approaches, ”Hybrid nodalizations” and ”Scaled-up nodalizations”. These last two methods have revealed themselves to be very helpful in producing the required qualification and in promoting further improvements in nodalization. The study of both LSTF and PKL counterpart tests have allowed to qualify the methodology by the comparison with experimental data. Post-test simulations at different sizes allowed to define which phenomena could be well reproduced by system codes and which not, in this way also establishing the basis for the extrapolation to an NPP scaled calculation. Furthermore, the application of the UPC SCUP methodology demonstrated that selected phenomena can be scaled-up and explained between counterpart simulations by carefully considering the differences in scale and design. (Author)

  15. High-Throughput Synthesis, Screening, and Scale-Up of Optimized Conducting Indium Tin Oxides.

    Science.gov (United States)

    Marchand, Peter; Makwana, Neel M; Tighe, Christopher J; Gruar, Robert I; Parkin, Ivan P; Carmalt, Claire J; Darr, Jawwad A

    2016-02-08

    A high-throughput optimization and subsequent scale-up methodology has been used for the synthesis of conductive tin-doped indium oxide (known as ITO) nanoparticles. ITO nanoparticles with up to 12 at % Sn were synthesized using a laboratory scale (15 g/hour by dry mass) continuous hydrothermal synthesis process, and the as-synthesized powders were characterized by powder X-ray diffraction, transmission electron microscopy, energy-dispersive X-ray analysis, and X-ray photoelectron spectroscopy. Under standard synthetic conditions, either the cubic In2O3 phase, or a mixture of InO(OH) and In2O3 phases were observed in the as-synthesized materials. These materials were pressed into compacts and heat-treated in an inert atmosphere, and their electrical resistivities were then measured using the Van der Pauw method. Sn doping yielded resistivities of ∼ 10(-2) Ω cm for most samples with the lowest resistivity of 6.0 × 10(-3) Ω cm (exceptionally conductive for such pressed nanopowders) at a Sn concentration of 10 at %. Thereafter, the optimized lab-scale composition was scaled-up using a pilot-scale continuous hydrothermal synthesis process (at a rate of 100 g/hour by dry mass), and a comparable resistivity of 9.4 × 10(-3) Ω cm was obtained. The use of the synthesized TCO nanomaterials for thin film fabrication was finally demonstrated by deposition of a transparent, conductive film using a simple spin-coating process.

  16. Changing cost of HIV interventions in the context of scaling-up in India.

    Science.gov (United States)

    Dandona, Lalit; Kumar, Sg Prem; Ramesh, Yk; Rao, M Chalapathi; Kumar, A Anod; Marseille, Elliot; Kahn, James G; Dandona, Rakhi

    2008-07-01

    A rapid scaling up of HIV interventions in India is anticipated, but systematic information on how costs of HIV interventions change over time and programme scale is not available to inform planning. We studied the changes in unit costs of two major interventions, voluntary counseling and testing (VCT) and sex worker programmes in the south Indian state of Andhra Pradesh between 2002-2003 and 2005-2006 fiscal years. Economic costs (from the provider perspective) and output data from 17 publicly funded VCT centers and 14 sex worker programmes were collected using standardized methods. We calculated unit costs for each programme in each period and explored possible reasons for the changes seen. In 2005-2006, the VCT centers served 66 445 clients and the sex worker programmes served 32 550. The unit cost of providing VCT dropped over 3 years by half to Indian Rupees (INR) 147.5 (US$3.33) mainly because the number of clients doubled. There was no decrease in the average time spent counseling each client. The unit cost of providing services to sex workers increased 2.4 times over 3 years to INR 1401 (US$31.6) as a result of increases in male condom distribution, staff salaries and training, and treatment for sexually transmitted infections, all suggesting improved services. The unit cost of these two interventions changed dramatically over a 3-year period, but in opposite directions. The current unit cost for VCT in Andhra Pradesh is much lower than the estimated global average for low-income settings. These local longitudinal cost data are useful to inform the currently planned scaling up of HIV interventions in India.

  17. Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

    Directory of Open Access Journals (Sweden)

    Mauricio Toyama

    2017-09-01

    Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

  18. Scale-up guidelines for a circulating fluidized bed biomass pyrolyzer

    Energy Technology Data Exchange (ETDEWEB)

    Haslinger, W.; Hofbauer, H. [Technische Univ., Vienna (Austria); Gavriil, L.; Boukis, I. [Center for Renewable Energy Sources (Greece)

    1999-07-01

    A new circulating fluidized bed design has been proposed and successfully operated at lab scale (10 kg/h biomass feed). This fluidized bed system consists of a bubbling bottom bed, above this bottom bed a riser, a cyclone and a return leg. The heat necessary for the pyrolysis process is produced in the bottom bed by burning some solid residue from the pyrolysis that circulates together with the bed material as the bottom bed is fluidized with air. The flue gas from the bottom bed enters into the riser and serves there as transport gas. The circulation rate is very sensitive to the amount of bed inventory and the fluidization velocities. As the riser uses the flue gas of the dense bottom bed the ratio of the cross sections of the two fluidized beds has to be in a certain range to get a satisfying operation. The fluid mechanic behavior of this new circulating fluidized bed pyrolyzer has been studied using three different cold flow models. One cold flow model was built for the existing 10 kg/h lab scale pyrolyzer according to Glicksman's (1984) similarity rules. The purpose of this cold model was to study the fluid mechanics and optimize the performance with respect to the pyrolysis process. For scale-up purposes further cold flow models (135 kg/h, 1000 kg/h) have been designed, built and investigated intensively. The idea and the new design of the pyrolyzer, the results of the experimental work as well as the scale-up criteria will be presented. (orig.)

  19. Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

    Science.gov (United States)

    Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

    2017-01-01

    Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

  20. Scale up of 2,4-dichlorophenol removal from aqueous solutions using Brassica napus hairy roots

    Energy Technology Data Exchange (ETDEWEB)

    Angelini, Vanina A. [Departamento de Biologia Molecular, FCEFQN, Universidad Nacional de Rio Cuarto, 5800 Rio Cuarto, Cordoba (Argentina); Orejas, Joaquin [Facultad de Ingenieria, Universidad Nacional de Rio Cuarto, 5800 Rio Cuarto, Cordoba (Argentina); Medina, Maria I. [Departamento de Biologia Molecular, FCEFQN, Universidad Nacional de Rio Cuarto, 5800 Rio Cuarto, Cordoba (Argentina); Agostini, Elizabeth, E-mail: eagostini@exa.unrc.edu.ar [Departamento de Biologia Molecular, FCEFQN, Universidad Nacional de Rio Cuarto, 5800 Rio Cuarto, Cordoba (Argentina)

    2011-01-15

    Research highlights: {yields}B. napus hairy roots were effectively used for a large scale removal of 2,4-DCP. {yields} High removal efficiencies were obtained (98%) in a short time (30 min). {yields} Roots were re-used for six consecutive cycles with high efficiency. {yields} Post removal solutions showed no toxicity. {yields} This method could be used for continuous and safe treatment of phenolic effluents. - Abstract: Chlorophenols are harmful pollutants, frequently found in the effluents of several industries. For this reason, many environmental friendly technologies are being explored for their removal from industrial wastewaters. The aim of the present work was to study the scale up of 2,4-dichlorophenol (2,4-DCP) removal from synthetic wastewater, using Brassica napus hairy roots and H{sub 2}O{sub 2} in a discontinuous stirred tank reactor. We have analyzed some operational conditions, because the scale up of such process was poorly studied. High removal efficiencies were obtained (98%) in a short time (30 min). When roots were re-used for six consecutive cycles, 2,4-DCP removal efficiency decreased from 98 to 86%, in the last cycle. After the removal process, the solutions obtained from the reactor were assessed for their toxicity using an acute test with Lactuca sativa L. seeds. Results suggested that the treated solution was less toxic than the parent solution, because neither inhibition of lettuce germination nor effects in root and hypocotyl lengths were observed. Therefore, we provide evidence that Brassica napus hairy roots could be effectively used to detoxify solutions containing 2,4-DCP and they have considerable potential for a large scale removal of this pollutant. Thus, this study could help to design a method for continuous and safe treatment of effluents containing chlorophenols.

  1. Scale-down/scale-up studies leading to improved commercial beer fermentation.

    Science.gov (United States)

    Nienow, Alvin W; Nordkvist, Mikkel; Boulton, Christopher A

    2011-08-01

    Scale-up/scale-down techniques are vital for successful and safe commercial-scale bioprocess design and operation. An example is given in this review of recent studies related to beer production. Work at the bench scale shows that brewing yeast is not compromised by mechanical agitation up to 4.5 W/kg; and that compared with fermentations mixed by CO(2) evolution, agitation ≥ 0.04 W/kg is able to reduce fermentation time by about 20%. Work at the commercial scale in cylindroconical fermenters shows that, without mechanical agitation, most of the yeast sediments into the cone for about 50% of the fermentation time, leading to poor temperature control. Stirrer mixing overcomes these problems and leads to a similar reduction in batch time as the bench-scale tests and greatly reduces its variability, but is difficult to install in extant fermenters. The mixing characteristics of a new jet mixer, a rotary jet mixer, which overcomes these difficulties, are reported, based on pilot-scale studies. This change enables the advantages of stirring to be achieved at the commercial scale without the problems. In addition, more of the fermentable sugars are converted into ethanol. This review shows the effectiveness of scale-up/scale-down studies for improving commercial operations. Suggestions for further studies are made: one concerning the impact of homogenization on the removal of vicinal diketones and the other on the location of bubble formation at the commercial scale. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Minnesota wood energy scale-up project 1994 establishment cost data

    Energy Technology Data Exchange (ETDEWEB)

    Downing, M. [Oak Ridge National Lab., TN (United States); Pierce, R. [Champion International, Alexandria, MN (United States); Kroll, T. [Minnesota Department of Natural Resources-Forestry, St. Cloud, MN (United States)

    1996-03-18

    The Minnesota Wood Energy Scale-up Project began in late 1993 with the first trees planted in the spring of 1994. The purpose of the project is to track and monitor economic costs of planting, maintaining and monitoring larger scale commercial plantings. For 15 years, smaller scale research plantings of hybrid poplar have been used to screen for promising, high-yielding poplar clones. In this project 1000 acres of hybrid poplar trees were planted on Conservation Reserve Program (CRP) land near Alexandria, Minnesota in 1994. The fourteen landowners involved re-contracted with the CRP for five-year extensions of their existing 10-year contracts. These extended contracts will expire in 2001, when the plantings are 7 years old. The end use for the trees planted in the Minnesota Wood Energy Scale-up Project is undetermined. They will belong to the owner of the land on which they are planted. There are no current contracts in place for the wood these trees are projected to supply. The structure of the wood industry in the Minnesota has changed drastically over the past 5 years. Stumpage values for fiber have risen to more than $20 per cord in some areas raising the possibility that these trees could be used for fiber rather than energy. Several legislative mandates have forced the State of Minnesota to pursue renewable energy including biomass energy. These mandates, a potential need for an additional 1700 MW of power by 2008 by Northern States Power, and agricultural policies will all affect development of energy markets for wood produced much like agricultural crops. There has been a tremendous amount of local and international interest in the project. Contractual negotiations between area landowners, the CRP, a local Resource Conservation and Development District, the Minnesota Department of Natural Resources and others are currently underway for additional planting of 1000 acres in spring 1995.

  3. Prototype of a scaled-up microbial fuel cell for copper recovery.

    Science.gov (United States)

    Rodenas Motos, Pau; Molina, Gonzalo; Ter Heijne, Annemiek; Sleutels, Tom; Saakes, Michel; Buisman, Cees

    2017-11-01

    Bioelectrochemical systems (BESs) enable recovery of electrical energy through oxidation of a wide range of substrates at an anode and simultaneous recovery of metals at a cathode. Scale-up of BESs from the laboratory to pilot scale is a challenging step in the development of the process, and there are only a few successful experiences to build on. This paper presents a prototype BES for the recovery of copper. The cell design presented here had removable electrodes, similar to those in electroplating baths. The anode and cathode in this design could be replaced independently. The prototype bioelectrochemical cell consisted of an 835 cm2 bioanode fed with acetate, and a 700 cm2 cathode fed with copper. A current density of 1.2 A/-2 was achieved with 48 mW m-2 of power production. The contribution of each component (anode, electrolytes, cathode and membrane) was evaluated through the analysis of the internal resistance distribution. This revealed that major losses occurred at the anode, and that the design with removable electrodes results in higher internal resistance compared with other systems. To further assess the practical applicability of BES for copper recovery, an economic evaluation was performed. Analysis shows that the internal resistance of several lab-scale BESs is already sufficiently low to make the system economic, while the internal resistance for scaled-up systems still needs to be improved considerably to become economically applicable.© 2017 The Authors. Journal of Chemical Technology & Biotechnology published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

  4. [The role of natural dietary compounds in colorectal cancer chemoprevention].

    Science.gov (United States)

    Olejnik, Anna; Tomczyk, Joanna; Kowalska, Katarzyna; Grajek, Włodzimierz

    2010-04-07

    This review discusses the preventive and therapeutic potential of natural dietary compounds against colorectal cancer. The chemopreventive properties of many natural food matrices and purified bioactive compounds have been evaluated. Prominent among the dietary constituents that are the focus of interest in colorectal cancer chemoprevention are dietary fiber, probiotics and prebiotics, methionine and folate, vitamins D and E, calcium and selenium, anthocyanins, procyanidins, phytoestrogens, isothiocyanates, epigallocatechin gallate, curcumin, and resveratrol. Laboratory studies provide strong evidence for the antitumor potential of these dietary agents. The mechanisms of their chemopreventive action are associated with, for example, the modulation of gene expression involved in the regulation of cell proliferation, differentiation, and apoptosis and the suppression of metastasis and angiogenesis. The anti-carcinogenic properties of these food compounds are also related to inhibition of many inflammatory agents, including the expression of cyclooxygenase-2. In vitro and animal studies showed that most of them can protect against various carcinogens mediating colon cancer and suggest that they can also sensitize tumors to chemotherapy and radiation. Although experimental studies have clearly demonstrated their anticancer activity, not many clinical trials have provided satisfying results, not only because of the lack of efficiency of the chemopreventive agents, but also due to the lack of precise biomarkers monitoring their effects on colon cancer. Despite the lack of strong evidence for the anticancer potential of natural food compounds, clinicians have high hopes for using these factors in colon cancer chemoprevention and decreasing the incidence of this common malignancy in the future.

  5. Fighting malaria in Madhya Pradesh (Central India: Are we loosing the battle?

    Directory of Open Access Journals (Sweden)

    Thimasarn Krongthong

    2009-05-01

    Full Text Available Abstract Malaria control in Madhya Pradesh is complex because of vast tracts of forest with tribal settlement. Fifty four million individuals of various ethnic origins, accounting for 8% of the total population of India, contributed 30% of total malaria cases, 60% of total falciparum cases and 50% of malaria deaths in the country. Ambitious goals to control tribal malaria by launching "Enhanced Malaria Control Project" (EMCP by the National Vector Borne Disease Control Programme (NVBDCP, with the World Bank assistance, became effective in September 1997 in eight north Indian states. Under EMCP, the programme used a broader mix of new interventions, i.e. insecticide-treated bed nets, spraying houses with effective residual insecticides, use of larvivorous fishes, rapid diagnostic tests for prompt diagnosis, treatment of the sick with effective radical treatment and increased public awareness and IEC. However, the challenge is to scale up these services. A retrospective analysis of data on malaria morbidity and associated mortality reported under the existing surveillance system of the Madhya Pradesh (Central India for the years 1996–2007 was carried out to determine the impact of EMCP on malaria morbidity and associated mortality. Analysis revealed that despite the availability of effective intervention tools for the prevention and control of malaria, falciparum malaria remains uncontrolled and deaths due to malaria have increased. Precisely, the aim of this epidemiological analysis is to draw lessons applicable to all international aid efforts, bureaucracy, policy makers and programme managers in assessing its project performance as a new Global Malaria Action Plan is launched with ambitious goal of reducing malaria and its elimination by scaling up the use of existing tools.

  6. EDITORIAL MALARIA DIAGNOSIS Malaria remains the most ...

    African Journals Online (AJOL)

    hi-tech

    2005-03-02

    Mar 2, 2005 ... Malaria remains the most significant parasitic disease affecting man. Prompt and accurate diagnosis of malaria is the key to cost effective management (1). Since the identification of Plasmodium parasites in human blood in 1880, the diagnosis of malaria has remained a hot bed of scientific discussion.

  7. Integrated vector management for malaria control

    Directory of Open Access Journals (Sweden)

    Impoinvil Daniel E

    2008-12-01

    Full Text Available Abstract Integrated vector management (IVM is defined as "a rational decision-making process for the optimal use of resources for vector control" and includes five key elements: 1 evidence-based decision-making, 2 integrated approaches 3, collaboration within the health sector and with other sectors, 4 advocacy, social mobilization, and legislation, and 5 capacity-building. In 2004, the WHO adopted IVM globally for the control of all vector-borne diseases. Important recent progress has been made in developing and promoting IVM for national malaria control programmes in Africa at a time when successful malaria control programmes are scaling-up with insecticide-treated nets (ITN and/or indoor residual spraying (IRS coverage. While interventions using only ITNs and/or IRS successfully reduce transmission intensity and the burden of malaria in many situations, it is not clear if these interventions alone will achieve those critical low levels that result in malaria elimination. Despite the successful employment of comprehensive integrated malaria control programmes, further strengthening of vector control components through IVM is relevant, especially during the "end-game" where control is successful and further efforts are required to go from low transmission situations to sustained local and country-wide malaria elimination. To meet this need and to ensure sustainability of control efforts, malaria control programmes should strengthen their capacity to use data for decision-making with respect to evaluation of current vector control programmes, employment of additional vector control tools in conjunction with ITN/IRS tactics, case-detection and treatment strategies, and determine how much and what types of vector control and interdisciplinary input are required to achieve malaria elimination. Similarly, on a global scale, there is a need for continued research to identify and evaluate new tools for vector control that can be integrated with

  8. Malaria (For Parents)

    Science.gov (United States)

    ... in others. Proper treatment can cure malaria. What Causes Malaria? Malaria is caused by parasites carried by mosquitoes. ... seen a lot, doctors often treat people for malaria who have a fever with no obvious cause without getting lab tests to prove the person ...

  9. Chemoprevention of Radiation Induced Rat Mammary Neoplasms

    Science.gov (United States)

    Huso, David L.

    1999-01-01

    Radiations encountered in space include protons and heavy ions such as iron as well as their secondaries. The relative biological effect (RBE) of these ions is not known, particularly at the doses and dose-rates expected for planetary missions. Neutrons, are not particularly relevant to space travel, but have been found experimentally to have an increase in their RBE with decreasing dose. If a similar trend of increasing RBE with decreasing dose is present for heavy ions and protons during irradiation in space, the small doses received during space travel could potentially have substantial carcinogenic risk. Clearly more investigation of the effects of heavy ions and protons is needed before accurate risk assessment for prolonged travel in space can be done. One means to mitigate the increased risk of cancer due to radiation exposure in space is by developing effective countermeasures that can reduce the incidence of tumor development. Tamoxifen has recently been shown to be an effective chemopreventive agent in both animal models and humans for the prevention of mammary tumors. Tamoxifen is a unique drug, with a highly specific mechanism of action affecting a specific radiation-sensitive population of epithelial cells in the mammary gland. In human studies, the annual incidence of a primary tumor in the contralateral breast of women with previous breast cancer is about 8 per 1000, making them an exceedingly high-risk group for the development of breast cancer. In this high risk group, treated with tamoxifen, daily, for 2 years, the incidence of a new primary tumor in the contralateral breast was approximately one third of that noted in the non-tamoxifen treatment group. Tamoxifen antagonizes the action of estrogen by competing for the nuclear receptor complex thereby altering the association of the receptor complex and nuclear binding sites. Its effects in reducing the development of breast cancer could be accomplished by controlling clinically undetectable

  10. Cancer chemoprevention by dietary phytochemicals: Epidemiological evidence.

    Science.gov (United States)

    Baena Ruiz, Raúl; Salinas Hernández, Pedro

    2016-12-01

    In recent years, natural compounds called "phytochemicals", which are present in fruits, vegetables, and plants, have received special attention due to their potential to interfere with tumour formation and development. Many of these phytochemicals are being used in chemoprevention strategies. However, the scientific evidence regarding the modification of cancer risk continues to be debated. The aim of this paper is to review the current scientific evidence and the most relevant epidemiological studies regarding the consumption or use of phytochemicals and their effects on the incidence of cancer. A search for relevant articles was conducted in EMBASE and PubMed-NCBI through to May 2016 to identify potential interactions between the consumption or use of phytochemicals and cancer risk. The use or consumption of carotenoids, such as lycopene, alpha-carotene, and betacarotene, leads to a reduction in the risk of cancer, such as breast and prostate tumours. For breast cancer, beta-carotene even reduces the risk of recurrence. The use or consumption of soybean isoflavones has led to a reduction in the risk of lung, prostate, colon (in women only), and breast cancers, although this has depended on menopausal and oestrogen receptor status. The use or consumption of isothiocyanates and indole-3-carbinol also seems to reduce the risk of cancer, such as breast, stomach, colorectal, or prostate tumours. The adoption of a diet rich in phytochemicals is associated with a modification of cancer risk. However, the scientific data supporting its use come mainly from in vitro and in vivo studies (especially in animal models). The epidemiological evidence is inconclusive for many of these phytochemicals, so further studies are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Scaling up kangaroo mother care in South Africa: 'on-site' versus 'off-site' educational facilitation

    National Research Council Canada - National Science Library

    Bergh, Anne-Marie; van Rooyen, Elise; Pattinson, Robert C

    2008-01-01

    .... This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care...

  12. Constraints, synergies and avenues for scaling up breastfeeding, antibiotics for pneumonia and IMCI interventions in the Cusco region, Peru

    National Research Council Canada - National Science Library

    Sarganas, Giselle; Scherpbier, Robert; Gericke, Christian A

    2012-01-01

    Objective: The purpose of this qualitative case study was to assess the feasibility of scaling up exclusive breastfeeding for 6 months, antibiotics for pneumonia and integrated management of childhood illness (IMCI...

  13. Constraints, synergies and avenues for scaling up breastfeeding, antibiotics for pneumonia and IMCI interventions in the Cusco region, Peru

    National Research Council Canada - National Science Library

    Sarganas, Giselle; Scherpbier, Robert; Gericke, Christian A

    2012-01-01

    The purpose of this qualitative case study was to assess the feasibility of scaling up exclusive breastfeeding for 6 months, antibiotics for pneumonia and integrated management of childhood illness (IMCI...

  14. Molecular Mechanisms Behind the Chemopreventive Effects of Anthocyanidins

    Directory of Open Access Journals (Sweden)

    De-Xing Hou

    2004-01-01

    Full Text Available Anthocyanins are polyphenolic ring-based flavonoids, and are widespread in fruits and vegetables of red-blue color. Epidemiological investigations and animal experiments have indicated that anthocyanins may contribute to cancer chemoprevention. The studies on the mechanism have been done recently at molecular level. This review summarizes current molecular bases for anthocyanidins on several key steps involved in cancer chemoprevention: (i inhibition of anthocyanidins in cell transformation through targeting mitogen-activated protein kinase (MAPK pathway and activator protein 1 (AP-1 factor; (ii suppression of anthocyanidins in inflammation and carcinogenesis through targeting nuclear factor kappa B (NF-κB pathway and cyclooxygenase 2 (COX-2 gene; (iii apoptotic induction of cancer cells by anthocyanidins through reactive oxygen species (ROS / c-Jun NH2-terminal kinase (JNK-mediated caspase activation. These data provide a first molecular view of anthocyanidins contributing to cancer chemoprevention.

  15. Diet phytochemicals and cutaneous carcinoma chemoprevention: A review.

    Science.gov (United States)

    Wang, Siliang; Shen, Peiliang; Zhou, Jinrong; Lu, Yin

    2017-05-01

    Cutaneous carcinoma, which has occupied a peculiar place among worldwide populations, is commonly responsible for the considerably increasing morbidity and mortality rates. Currently available medical procedures fail to completely avoid cutaneous carcinoma development or to prevent mortality. Cancer chemoprevention, as an alternative strategy, is being considered to reduce the incidence and burden of cancers through chemical agents. Derived from dietary foods, phytochemicals have become safe and reliable compounds for the chemoprevention of cutaneous carcinoma by relieving multiple pathological processes, including oxidative damage, epigenetic alteration, chronic inflammation, angiogenesis, etc. In this review, we presented comprehensive knowledges, main molecular mechanisms for the initiation and development of cutaneous carcinoma as well as effects of various diet phytochemicals on chemoprevention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Malaria Ecology, Disease Burden and Global Climate Change

    Science.gov (United States)

    Mccord, G. C.

    2014-12-01

    Malaria has afflicted human society for over 2 million years, and remains one of the great killer diseases today. The disease is the fourth leading cause of death for children under five in low income countries (after neonatal disorders, diarrhea, and pneumonia) and is responsible for at least one in every five child deaths in sub-Saharan Africa. It kills up to 3 million people a year, though in recent years scale up of anti-malaria efforts in Africa may have brought deaths to below 1 million. Malaria is highly conditioned by ecology, because of which climate change is likely to change the local dynamics of the disease through changes in ambient temperature and precipitation. To assess the potential implications of climate change for the malaria burden, this paper employs a Malaria Ecology Index from the epidemiology literature, relates it to malaria incidence and mortality using global country-level data , and then draws implications for 2100 by extrapolating the index using several general circulation model (GCM) predictions of temperature and precipitation. The results highlight the climate change driven increase in the basic reproduction number of the disease and the resulting complications for further gains in elimination. For illustrative purposes, I report the change in malaria incidence and mortality if climate change were to happen immediately under current technology and public health efforts.

  17. Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

    Directory of Open Access Journals (Sweden)

    Subramanian Savitha

    2011-12-01

    Full Text Available Abstract Background There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs. But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. Methods A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. Results We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. Conclusions The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current

  18. Scaling up kangaroo mother care in South Africa: 'on-site' versus 'off-site' educational facilitation

    OpenAIRE

    van Rooyen Elise; Bergh Anne-Marie; Pattinson Robert C

    2008-01-01

    Abstract Background Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. Methods Thirty-six hospitals in the Provinces of Gauteng and Mpumalanga in South Africa were targeted to implemen...

  19. Scaling Up of Breastfeeding Promotion Programs in Low- and Middle-Income Countries: the “Breastfeeding Gear” Model12

    OpenAIRE

    Pérez-Escamilla, Rafael; Curry, Leslie; Minhas, Dilpreet; Taylor, Lauren; Bradley, Elizabeth

    2012-01-01

    Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother–child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for scale up of BF programs in low- and middle-income countries. The review identified BF programs located in 28 countries in Africa, Latin Ame...

  20. Human resources requirements for highly active antiretroviral therapy scale-up in Malawi

    Directory of Open Access Journals (Sweden)

    Rudatsikira Emmanuel

    2007-12-01

    nurses, 118.1% to 354.2% of all the available pharmacists and pharmacy technicians and 27.9% to 55.7% of all clinical officers and physicians. The actual number of health professionals working in the delivery of HAART in the clinics represented 44% to 88.8% (for clinical officers and medical doctors and 13.6% and 47.6% (for nurses, of what would have been needed based on the literature estimation. Conclusion HAART provision is a labour intensive exercise. Although these data are insufficient to determine whether HAART scale-up has resulted in the weakening or strengthening of the health systems in Malawi, the human resources requirements for HAART scale-up are significant. Malawi is using far less human resources than would be estimated based on the literature from other settings. The impact of HAART scale-up on the overall delivery of health services should be assessed.

  1. Aspirin and colorectal cancer: the promise of precision chemoprevention.

    Science.gov (United States)

    Drew, David A; Cao, Yin; Chan, Andrew T

    2016-03-01

    Aspirin (acetylsalicylic acid) has become one of the most commonly used drugs, given its role as an analgesic, antipyretic and agent for cardiovascular prophylaxis. Several decades of research have provided considerable evidence demonstrating its potential for the prevention of cancer, particularly colorectal cancer. Broader clinical recommendations for aspirin-based chemoprevention strategies have recently been established; however, given the known hazards of long-term aspirin use, larger-scale adoption of an aspirin chemoprevention strategy is likely to require improved identification of individuals for whom the protective benefits outweigh the harms. Such a precision medicine approach may emerge through further clarification of aspirin's mechanism of action.

  2. Considerations for reducing food system energy demand while scaling up urban agriculture

    Science.gov (United States)

    Mohareb, Eugene; Heller, Martin; Novak, Paige; Goldstein, Benjamin; Fonoll, Xavier; Raskin, Lutgarde

    2017-12-01

    There is an increasing global interest in scaling up urban agriculture (UA) in its various forms, from private gardens to sophisticated commercial operations. Much of this interest is in the spirit of environmental protection, with reduced waste and transportation energy highlighted as some of the proposed benefits of UA; however, explicit consideration of energy and resource requirements needs to be made in order to realize these anticipated environmental benefits. A literature review is undertaken here to provide new insight into the energy implications of scaling up UA in cities in high-income countries, considering UA classification, direct/indirect energy pressures, and interactions with other components of the food–energy–water nexus. This is followed by an exploration of ways in which these cities can plan for the exploitation of waste flows for resource-efficient UA. Given that it is estimated that the food system contributes nearly 15% of total US energy demand, optimization of resource use in food production, distribution, consumption, and waste systems may have a significant energy impact. There are limited data available that quantify resource demand implications directly associated with UA systems, highlighting that the literature is not yet sufficiently robust to make universal claims on benefits. This letter explores energy demand from conventional resource inputs, various production systems, water/energy trade-offs, alternative irrigation, packaging materials, and transportation/supply chains to shed light on UA-focused research needs. By analyzing data and cases from the existing literature, we propose that gains in energy efficiency could be realized through the co-location of UA operations with waste streams (e.g. heat, CO2, greywater, wastewater, compost), potentially increasing yields and offsetting life cycle energy demands relative to conventional approaches. This begs a number of energy-focused UA research questions that explore the

  3. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis

    LENUS (Irish Health Repository)

    Walsh, Aisling

    2010-09-17

    Abstract Background Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV\\/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Methods Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Results Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses\\/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. Conclusions This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV\\/AIDS service delivery has been on the back of sustained non

  4. Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability.

    Science.gov (United States)

    Ndlovu, Kagiso; Littman-Quinn, Ryan; Park, Elizabeth; Dikai, Zambo; Kovarik, Carrie L

    2014-01-01

    Effective health care delivery is significantly compromised in an environment where resources, both human and technical, are limited. Botswana's health care system is one of the many in the African continent with few specialized medical doctors, thereby posing a barrier to patients' access to health care services. In addition, the traditional landline and non-robust Information Technology (IT) network infrastructure characterized by slow bandwidth still dominates the health care system in Botswana. Upgrading of the landline IT infrastructure to meet today's health care demands is a tedious, long, and expensive process. Despite these challenges, there still lies hope in health care delivery utilizing wireless telecommunication services. Botswana has recently experienced tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices. This growth inspired the Botswana-UPenn Partnership (BUP) to collaborate with local partners to explore using mobile devices as tools to improve access to specialized health care delivery. Pilot studies were conducted across four medical specialties, including radiology, oral medicine, dermatology, and cervical cancer screening. Findings from the studies became vital evidence in support of the first scale-up project of a mobile telemedicine solution in Botswana, also known as "Kgonafalo." Some technical and social challenges were encountered during the initial studies, such as malfunctioning of mobile devices, accidental damage of devices, and cultural misalignment between IT and healthcare providers. These challenges brought about lessons learnt, including a strong need for unwavering senior management support, establishment of solid local public-private partnerships, and efficient project sustainability plans. Sustainability milestones included the development and signing of a Memorandum of Understanding (MOU) between the Botswana government and a private

  5. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis

    Directory of Open Access Journals (Sweden)

    Simbaya Joseph

    2010-09-01

    Full Text Available Abstract Background Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Methods Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural, to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Results Clinical staff (doctors, nurses and nurse-midwives, and clinical officers numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART and prevention of mother to child transmission (PMTCT per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. Conclusions This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of

  6. Meaningful change or more of the same? The Global Fund's new funding model and the politics of HIV scale-up.

    Science.gov (United States)

    Kapilashrami, Anuj; Hanefeld, Johanna

    2014-01-01

    As we enter the fourth decade of HIV and AIDS, sustainability of treatment and prevention programmes is a growing concern in an environment of shrinking resources. The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) will be critical to maintaining current trajectories of scale-up and ultimately, ensuring access to HIV treatment and prevention for people in low/middle-income countries. The authors' prior research in India, Zambia and South Africa contributed evidence on the politics and impact of new institutional and funding arrangements, revealing a 'rhetoric-reality gap' in their impact on health systems, civil society participation, and achievement of population health. With its new funding strategy and disbursement model, the Fund proposes dramatic changes to its approach, emphasising value for money, greater fund predictability and flexibility and more proactive engagement in recipient countries, while foregrounding a human rights approach. This paper reviews the Fund's new strategy and examines its potential to respond to key criticisms concerning health systems impact, particularly the elite nature of this funding mechanism that generates competition between public and private sectors and marginalises local voices. The authors analyse strategy documents against their own research and published literature and reflect on whether the changes are likely to address challenges faced in bringing HIV programmes to scale and their likely effect on AIDS politics.

  7. A situational analysis of pharmacovigilance plans in the Global Fund Malaria and U.S. President's Malaria Initiative proposals.

    Science.gov (United States)

    Stergachis, Andy; Bartlein, Rebecca J K; Dodoo, Alexander; Nwokike, Jude; Kachur, S Patrick

    2010-05-30

    Pharmacovigilance programmes can monitor and help ensure the safe use of medicines that are critical to the success of global public health programmes. The widespread deployment of artemisinin-based combination therapy (ACT) by national malaria control programmes as part of the overall Global Malaria Action Plan for malaria control to elimination and eradication makes ACT an excellent candidate for pharmacovigilance activities. In 2008, The Roll Back Malaria partnership issued guidelines for inclusion of pharmacovigilance in Global Fund and other related proposals. In light of this recommendation and the rapid scale-up of ACT worldwide, an analysis of Global Fund Round 8 proposals and the President's Malaria Initiative (PMI) 2009 Malaria Operational Plans was conducted to assess if and how pharmacovigilance has been incorporated into countries' national malaria plans and donor budget requests. The Global Fund-Malaria Round 8 proposals for the 26 countries and the PMI Malaria Operational Plans (MOPs) for fiscal year 2009 for the 15 countries that were approved and received funding from either the Global Fund-Malaria Round 8 or PMI were accessed through the programme websites. The analysis consisted of conducting word counts and key word in context analyses of each proposal and plan. Twelve out of 26 (46%) of the Global Fund proposals mentioned that established pharmacovigilance systems were present in their countries. Four of the fifteen PMI MOPs (27%) mentioned that established pharmacovigilance systems were present in their countries. Only seven of the 26 (27%) Global Fund proposals included a request for funding for new or current pharmacovigilance activities. Seven of 15 (47%) MOPs included a request for funding for pharmacovigilance activities. There were relatively few requests for funding for pharmacovigilance activities, demonstrating a lack of emphasis placed on pharmacovigilance systems in recipient countries. The findings stress the need for more active

  8. Methadone Maintenance Therapy in Vietnam: An Overview and Scaling-Up Plan

    Directory of Open Access Journals (Sweden)

    Tam T. M. Nguyen

    2012-01-01

    Full Text Available Vietnam is among the countries with the highest rate of HIV transmission through injecting drug users. HIV prevalence among injecting drug users is 20% and up to 50% in many provinces. An estimated number of drug users in the country by the end of 2011 were 171,000 in which the most common is heroin (85%. Detoxification at home, community, and in rehabilitation centers have been the main modalities for managing heroin addiction until Methadone Maintenance Treatment (MMT was piloted in 2008. Recent reports have demonstrated positive treatment outcomes. Incidence of HIV was found remarkably low among patients on MMT. Treatment has significantly improved the quality of life as well as stability for society. The government has granted the Ministry of Health (MoH to expand Methadone treatment to at least 30 provinces to provide treatment for more than 80,000 drug users by 2015. The Vietnam Administration for HIV/AIDS Control (VAAC and MOH have outlined the role and responsibility of key departments at the central and local levels in implementing and maintaining MMT treatment. This paper will describe the achievements of the MMT pilot program and the scaling-up plan as well as strategies to ensure quality and sustainability and to overcome the challenges in the coming years.

  9. Optimisation of rosemary oil encapsulation in polycaprolactone and scale-up of the process.

    Science.gov (United States)

    Ephrem, Elissa; Greige-Gerges, Hélène; Fessi, Hatem; Charcosset, Catherine

    2014-01-01

    Rosemary essential oil (REO) has many biological activities, such as antioxidant, anticarcinogenic, cognition-enhancing, analgesic and antimicrobial activities. The aim of this study was to prepare, at laboratory scale and larger scale, nanoencapsulating REO in order to reduce its volatilisation, light sensitivity and to enhance its water solubility. The nanoprecipitation method was applied to prepare polycaprolactone (PCL)-based nanocapsules loaded with REO at laboratory scale and then the optimal formulation obtained was scaled-up (×6) using the membrane contactor technique. The effect of several parameters, such as the evaporation method, the type of emulsifiers and the amount of the formulation products (PCL, REO, emulsifiers, etc.) on the REO-loaded nanocapsules properties (mean size, polydispersity index (PdI), zeta potential and REO loss) was evaluated at laboratory scale in order to obtain the optimal formulation. REO-loaded nanocapsules obtained from nanoprecipitation presented a nanometric mean size (220 ± 10 nm) with a PdI below 0.25, indicating an adequate homogeneity of the system, a negative zeta potential (-19.9 ± 4.6 mV) and a high encapsulation efficiency (∼99% for the major components). In addition, the membrane contactor technique gave similar results using an adequate pressure of the organic phase (0.8-1.2 bar). It is then suggested that the nanoprecipitation method can be suitable for the preparation of essential oil-loaded nanocapsules.

  10. Scaling up the Fabrication of Mechanically-Robust Carbon Nanofiber Foams

    Directory of Open Access Journals (Sweden)

    William Curtin

    2016-02-01

    Full Text Available This work aimed to identify and address the main challenges associated with fabricating large samples of carbon foams composed of interwoven networks of carbon nanofibers. Solutions to two difficulties related with the process of fabricating carbon foams, maximum foam size and catalyst cost, were developed. First, a simple physical method was invented to scale-up the constrained formation of fibrous nanostructures process (CoFFiN to fabricate relatively large foams. Specifically, a gas deflector system capable of maintaining conditions supportive of carbon nanofiber foam growth throughout a relatively large mold was developed. ANSYS CFX models were used to simulate the gas flow paths with and without deflectors; the data generated proved to be a very useful tool for the deflector design. Second, a simple method for selectively leaching the Pd catalyst material trapped in the foam during growth was successfully tested. Multiple techniques, including scanning electron microscopy, surface area measurements, and mechanical testing, were employed to characterize the foams generated in this study. All results confirmed that the larger foam samples preserve the basic characteristics: their interwoven nanofiber microstructure forms a low-density tridimensional solid with viscoelastic behavior. Fiber growth mechanisms are also discussed. Larger samples of mechanically-robust carbon nanofiber foams will enable the use of these materials as strain sensors, shock absorbers, selective absorbents for environmental remediation and electrodes for energy storage devices, among other applications.

  11. Methadone maintenance therapy in Vietnam: an overview and scaling-up plan.

    Science.gov (United States)

    Nguyen, Tam T M; Nguyen, Long T; Pham, Manh D; Vu, Hoang H; Mulvey, Kevin P

    2012-01-01

    Vietnam is among the countries with the highest rate of HIV transmission through injecting drug users. HIV prevalence among injecting drug users is 20% and up to 50% in many provinces. An estimated number of drug users in the country by the end of 2011 were 171,000 in which the most common is heroin (85%). Detoxification at home, community, and in rehabilitation centers have been the main modalities for managing heroin addiction until Methadone Maintenance Treatment (MMT) was piloted in 2008. Recent reports have demonstrated positive treatment outcomes. Incidence of HIV was found remarkably low among patients on MMT. Treatment has significantly improved the quality of life as well as stability for society. The government has granted the Ministry of Health (MoH) to expand Methadone treatment to at least 30 provinces to provide treatment for more than 80,000 drug users by 2015. The Vietnam Administration for HIV/AIDS Control (VAAC) and MOH have outlined the role and responsibility of key departments at the central and local levels in implementing and maintaining MMT treatment. This paper will describe the achievements of the MMT pilot program and the scaling-up plan as well as strategies to ensure quality and sustainability and to overcome the challenges in the coming years.

  12. The furthest left behind: the urgent need to scale up harm reduction in prisons.

    Science.gov (United States)

    Sander, Gen; Murphy, Fionnuala

    2017-09-11

    Purpose Raise awareness about the disproportionate impact of HIV and hepatitis C (HCV) on prisoners worldwide and the need for key harm reduction services such as needle and syringe programmes and opioid substitution therapy in prisons offer practical recommendations to assist policy makers in implementing or scaling up these services. The paper aims to discuss these issues. Design/methodology/approach This study is a desk review of existing data and evidence on HIV, HCV and harm reduction in prisons, analysis of political barriers and formulation of key policy recommendations. Findings Harm reduction works, yet service provision in prisons remains extremely limited. There is an urgent need for governments to enhance political leadership and funding for harm reduction in prisons. Authorities must also work to remove obstacles to the implementation of harm reduction services in prisons, enhance the monitoring and evaluation of laws, policies and programmes relating to HIV, HCV and drugs in prison settings, and recognise access to harm reduction in prisons as a fundamental human right. Until these obstacles are addressed, the world will not meet the Sustainable Development Goal of eradicating HIV and HCV by 2030. Originality/value More than just a desk review, this policy brief provides a political analysis of the harm reduction crisis in prisons and offers clear-cut recommendations for policy makers.

  13. Scaling up high throughput field phenotyping of corn and soy research plots using ground rovers

    Science.gov (United States)

    Peshlov, Boyan; Nakarmi, Akash; Baldwin, Steven; Essner, Scott; French, Jasenka

    2017-05-01

    Crop improvement programs require large and meticulous selection processes that effectively and accurately collect and analyze data to generate quality plant products as efficiently as possible, develop superior cropping and/or crop improvement methods. Typically, data collection for such testing is performed by field teams using hand-held instruments or manually-controlled devices. Although steps are taken to reduce error, the data collected in such manner can be unreliable due to human error and fatigue, which reduces the ability to make accurate selection decisions. Monsanto engineering teams have developed a high-clearance mobile platform (Rover) as a step towards high throughput and high accuracy phenotyping at an industrial scale. The rovers are equipped with GPS navigation, multiple cameras and sensors and on-board computers to acquire data and compute plant vigor metrics per plot. The supporting IT systems enable automatic path planning, plot identification, image and point cloud data QA/QC and near real-time analysis where results are streamed to enterprise databases for additional statistical analysis and product advancement decisions. Since the rover program was launched in North America in 2013, the number of research plots we can analyze in a growing season has expanded dramatically. This work describes some of the successes and challenges in scaling up of the rover platform for automated phenotyping to enable science at scale.

  14. Engineering integrated digital circuits with allosteric ribozymes for scaling up molecular computation and diagnostics.

    Science.gov (United States)

    Penchovsky, Robert

    2012-10-19

    Here we describe molecular implementations of integrated digital circuits, including a three-input AND logic gate, a two-input multiplexer, and 1-to-2 decoder using allosteric ribozymes. Furthermore, we demonstrate a multiplexer-decoder circuit. The ribozymes are designed to seek-and-destroy specific RNAs with a certain length by a fully computerized procedure. The algorithm can accurately predict one base substitution that alters the ribozyme's logic function. The ability to sense the length of RNA molecules enables single ribozymes to be used as platforms for multiple interactions. These ribozymes can work as integrated circuits with the functionality of up to five logic gates. The ribozyme design is universal since the allosteric and substrate domains can be altered to sense different RNAs. In addition, the ribozymes can specifically cleave RNA molecules with triplet-repeat expansions observed in genetic disorders such as oculopharyngeal muscular dystrophy. Therefore, the designer ribozymes can be employed for scaling up computing and diagnostic networks in the fields of molecular computing and diagnostics and RNA synthetic biology.

  15. Fortification of condiments with micronutrients in public health: from proof of concept to scaling up.

    Science.gov (United States)

    Garcia-Casal, Maria Nieves; Peña-Rosas, Juan Pablo; Mclean, Mireille; De-Regil, Luz María; Zamora, Gerardo

    2016-09-01

    Fortification of condiments or seasonings may be useful for delivering micronutrients if they are consumed consistently by most of the population, as occurs in many countries. The World Health Organization, in collaboration with the Micronutrient Initiative and the Sackler Institute for Nutrition Science at the New York Academy of Sciences, convened a technical consultation on "Fortification of Condiments and Seasonings with Vitamins and Minerals in Public Health: from Proof of Concept to Scaling Up" to review the role of condiments and seasonings in improving micronutrient status, as constituents of regular diets and patterns of production and consumption worldwide. The consultation covered aspects related to implementation, monitoring, evaluation, and legal frameworks of fortification programs, as well as food safety and policy coherence for condiment fortification in the context of other public health strategies. This paper introduces the background and rationale of the technical consultation, synopsizes the presentations, and provides a summary of the main considerations proposed by the working groups. © 2016 New York Academy of Sciences.

  16. Scale-up potential of cultivating Chlorella zofingiensis in piggery wastewater for biodiesel production.

    Science.gov (United States)

    Yuan, Zhenhong; Wang, Zhongming; Takala, Josu; Hiltunen, Erkki; Qin, Lei; Xu, Zhongbin; Qin, Xiaoxi; Zhu, Liandong

    2013-06-01

    Scale-up potential of cultivating Chlorella zofingiensis in piggery wastewater for simultaneous wastewater treatment and biodiesel production was tested. The cultivation of C. zofingiensis with autoclaved wastewater and NaClO-pretreated wastewater, cultivation of algae indoors and outdoors, and stability of semi-continuous feeding operation were examined. The results showed that C. zofingiensis cultivated in piggery wastewater pretreated by autoclaving and NaClO had no evident difference in the performance of nutrient removal, algal growth and biodiesel production. The outdoor cultivation experiments indicated that C. zofingiensis was able to adapt and grow well outdoors. The semi-continuous feeding operation by replacing 50% of algae culture with fresh wastewater every 1.5 days could provide a stable net biomass productivity of 1.314 g L(-1) day(-1). These findings in this study can prove that it is greatly possible to amplify the cultivation of C. zofingiensis in piggery wastewater for nutrient removal and biodiesel production. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Batch fermentation of black tea by kombucha: A contribution to scale-up

    Directory of Open Access Journals (Sweden)

    Malbaša Radomir V.

    2005-01-01

    Full Text Available Local domestic Kombucha was used in fermentation of 1.5 g L-1 of black tea (Indian tea, " Vitamin ", Horgoš, Serbia and Montenegro, sweetened with approximately 70 g L'1 of sucrose. Inoculation was performed either with 10% or 15% (v/v of fermentation broth from previous process. The fermentation was conducted in geometrically similar vessels with 0.4 L, 0.8 L, 4 L and 8 L of substrate, at 22±1 °C for 28 days. The samples were analyzed after 3, 4 5, 6, 7, 10, 14 and 28 days, so that their pH values, content of total acids sucrose, glucose and fructose contents, as well as contents of ethanol and vitamin C were determined. Based on the experiment design, the response surface for the product pH, as a function of time, beverage volume and inoculum concentration, was defined in the form of a second-order polynomial. From the obtained response surface, a formula for scaling-up of the process was derived.

  18. Development of biomimetic system for scale up of cell spheroids - building blocks for cell transplantation.

    Science.gov (United States)

    Baba, Kazutomo; Sankai, Yoshiyuki

    2017-07-01

    Artificial assembly of mature tissues in vitro is challenging from many viewpoints. Therefore, production of intermediate building blocks - cell spheroids expected to be a viable alternative. The purpose of this research is to develop a biomimetic system for scale up maintenance of spheroids in vitro, and to confirm basic performance of the device. The system consists of a 3D culture unit and a medium perfusion unit. The 3D culture unit is dedicated for spheroid culture without using scaffolds, eliminating concerns about biocompatibility of artificial materials. our culture vessel allows easy disassembly and tissue extraction, as well as the resulting tissue can be formed into an any desirable shape. The spheroids are cultured in a sealed environment and their life are sustained by hollow fiber perfusion fluidics. We confirmed by visual and by microscopic examination that no contamination did occur before and after spheroid inoculation. Moreover, we confirmed growth and fusion between cells when C2C12 spheroids were cultured in this system.

  19. Scaling up antiretroviral therapy in resource-limited settings: adapting guidance to meet the challenges.

    Science.gov (United States)

    Vitoria, Marco; Vella, Stefano; Ford, Nathan

    2013-01-01

    This review describes the evolution of WHO guidelines for antiretroviral therapy (ART) in HIV-infected individuals, considering the key epidemiological, scientific, programmatic, and political changes over the last decade, and highlights the major trends for the management of the HIV disease in future guidelines revisions. In the last few years, new evidence has emerged supporting the potential preventive benefit of ART in reducing HIV transmission. This, together with the potential clinical benefits of earlier initiation of therapy, has led to the consideration of the broader strategic use of ART, taking into account the clinical and public health benefit, and programmatic feasibility. In 2002, WHO established its first guidelines for ART use, primarily focused on a public health approach for resource-limited settings. These recommendations were updated in 2003, 2006, and 2010, incorporating progressive changes reflecting progressive increase in the knowledge of HIV pathogenesis, development of new drugs and diagnostics, and increased experience of HIV treatment and prevention programs. The impact of several international political commitments and scale-up initiatives such as the 3 by 5 Initiative, Universal Access targets, and the Treatment 2.0 Strategy were also important drivers of the global response, increasing the treatment coverage and catalyzing the necessary environment for the establishment of operational and programmatic components for an expanded and sustainable global response to HIV/AIDS.

  20. Nb3Sn accelerator magnet technology scale up using cos-theta dipole coils

    Energy Technology Data Exchange (ETDEWEB)

    Nobrega, F.; Andreev, N.; Ambrosio, G.; Barzi, E.; Bossert, R.; Carcagno, R.; Chlachidze, G.; Feher, S.; Kashikhin, V.S.; Kashikhin, V.V.; Lamm, M.J.; /Fermilab

    2007-06-01

    Fermilab is working on the development of Nb{sub 3}Sn accelerator magnets using shell-type dipole coils and the wind-and-react method. As a part of the first phase of technology development, Fermilab built and tested six 1 m long dipole model magnets and several dipole mirror configurations. The last three dipoles and two mirrors reached their design fields of 10-11 T. The technology scale up phase has started by building 2 m and 4 m dipole coils and testing them in a mirror configuration in which one of the two coils is replaced by a half-cylinder made of low carbon steel. This approach allows for shorter fabrication times and extensive instrumentation preserving almost the same level of magnetic field and Lorentz forces in the coils as in a complete dipole model magnet. This paper presents details on the 2 m (HFDM07) and 4 m long (HFDM08) Nb{sub 3}Sn dipole mirror magnet design and fabrication technology, as well as the magnet test results which are compared with 1 m long models.

  1. Design of an 80 kWe PEM fuel cell system: Scale up effect investigation

    Energy Technology Data Exchange (ETDEWEB)

    Bonnet, C.; Carre, P. [Laboratoire des Sciences du Genie Chimique, Nancy-University-CNRS, 1 rue Grandville, BP20451, 54001 Nancy (France); Didierjean, S.; Colinart, T. [Laboratoire d' Energetique et de Mecanique Theorique et Appliquee, Nancy-University-CNRS, 2 avenue de la Foret de Haye, 54504 Vandoeuvre les Nancy (France); Guillet, N. [CEA-Grenoble LITEN/DTH/LCPEM, 17, rue des martyrs, 38054 Grenoble Cedex 9 (France); Besse, S. [Helion, Domaine du Petit Arbois, Batiment Jules Verne, BP71, 13545 Aix en Provence Cedex 4 (France)

    2008-08-01

    In the frame of SPACT-80 project to design and manufacture a robust and durable air/hydrogen 80 kWe PEM fuel cell for transportation application, experiments have been carried out on various electrode active surfaces since the full scale system could be damaged by some particular operating conditions. Thus, the main objective of this paper was to verify that a 25 cm{sup 2} single cell, a 5-cell pilot stack and a 90-cell stack exhibit the same behaviour and that they are representative of the full device's performance. After a brief description of the studied device the scaling up effect was checked. In non-optimal conditions, experiments were mainly conducted on single cell and pilot stack. In driving cycle and when studying various gas flows, they present similar evolution for the cell voltage as well as for the water management. The water transport coefficient and the diffusion resistance values determined by impedance spectroscopy highlight the presence of liquid water that could have an effect on the gas transport to the electrode. Investigation on the air humidification conditions shows that at lower relative humidity (RH), the two fuel cells have similar behaviour but above 60% RH different evolutions appear. Whatever the air humidification conditions, liquid water is present in both compartments. (author)

  2. Context matters: Successes and challenges of intrapartum care scale-up in four districts of Afghanistan.

    Science.gov (United States)

    Tappis, Hannah; Koblinsky, Marge; Winch, Peter J; Turkmani, Sabera; Bartlett, Linda

    2016-01-01

    Reducing preventable maternal mortality and achieving Sustainable Development Goal targets for 2030 will require increased investment in improving access to quality health services in fragile and conflict-affected states. This study explores the conditions that affect availability and utilisation of intrapartum care services in four districts of Afghanistan where mortality studies were conducted in 2002 and 2011. Information on changes in each district was collected through interviews with community members; service providers; and district, provincial and national officials. This information was then triangulated with programme and policy documentation to identify factors that affect the coverage of safe delivery and emergency obstetric care services. Comparison of barriers to maternal health service coverage across the four districts highlights the complexities of national health policy planning and resource allocation in Afghanistan, and provides examples of the types of challenges that must be addressed to extend the reach of life-saving maternal health interventions to women in fragile and conflict-affected states. Findings suggest that improvements in service coverage must be measured at a sub-national level, and context-specific service delivery models may be needed to effectively scale up intrapartum care services in extremely remote or insecure settings.

  3. Fan-out Estimation in Spin-based Quantum Computer Scale-up.

    Science.gov (United States)

    Nguyen, Thien; Hill, Charles D; Hollenberg, Lloyd C L; James, Matthew R

    2017-10-17

    Solid-state spin-based qubits offer good prospects for scaling based on their long coherence times and nexus to large-scale electronic scale-up technologies. However, high-threshold quantum error correction requires a two-dimensional qubit array operating in parallel, posing significant challenges in fabrication and control. While architectures incorporating distributed quantum control meet this challenge head-on, most designs rely on individual control and readout of all qubits with high gate densities. We analysed the fan-out routing overhead of a dedicated control line architecture, basing the analysis on a generalised solid-state spin qubit platform parameterised to encompass Coulomb confined (e.g. donor based spin qubits) or electrostatically confined (e.g. quantum dot based spin qubits) implementations. The spatial scalability under this model is estimated using standard electronic routing methods and present-day fabrication constraints. Based on reasonable assumptions for qubit control and readout we estimate 102-105 physical qubits, depending on the quantum interconnect implementation, can be integrated and fanned-out independently. Assuming relatively long control-free interconnects the scalability can be extended. Ultimately, the universal quantum computation may necessitate a much higher number of integrated qubits, indicating that higher dimensional electronics fabrication and/or multiplexed distributed control and readout schemes may be the preferredstrategy for large-scale implementation.

  4. Polyethylene encapsulatin of nitrate salt wastes: Waste form stability, process scale-up, and economics

    Energy Technology Data Exchange (ETDEWEB)

    Kalb, P.D.; Heiser, J.H. III; Colombo, P.

    1991-07-01

    A polyethylene encapsulation system for treatment of low-level radioactive, hazardous, and mixed wastes has been developed at Brookhaven National Laboratory. Polyethylene has several advantages compared with conventional solidification/stabilization materials such as hydraulic cements. Waste can be encapsulated with greater efficiency and with better waste form performance than is possible with hydraulic cement. The properties of polyethylene relevant to its long-term durability in storage and disposal environments are reviewed. Response to specific potential failure mechanisms including biodegradation, radiation, chemical attack, flammability, environmental stress cracking, and photodegradation are examined. These data are supported by results from extensive waste form performance testing including compressive yield strength, water immersion, thermal cycling, leachability of radioactive and hazardous species, irradiation, biodegradation, and flammability. The bench-scale process has been successfully tested for application with a number of specific problem'' waste streams. Quality assurance and performance testing of the resulting waste form confirmed scale-up feasibility. Use of this system at Rocky Flats Plant can result in over 70% fewer drums processed and shipped for disposal, compared with optimal cement formulations. Based on the current Rocky Flats production of nitrate salt per year, polyethylene encapsulation can yield an estimated annual savings between $1.5 million and $2.7 million, compared with conventional hydraulic cement systems. 72 refs., 23 figs., 16 tabs.

  5. Scaling-up permafrost thermal measurements in western Alaska using an ecotype approach

    Directory of Open Access Journals (Sweden)

    W. L. Cable

    2016-10-01

    Full Text Available Permafrost temperatures are increasing in Alaska due to climate change and in some cases permafrost is thawing and degrading. In areas where degradation has already occurred the effects can be dramatic, resulting in changing ecosystems, carbon release, and damage to infrastructure. However, in many areas we lack baseline data, such as subsurface temperatures, needed to assess future changes and potential risk areas. Besides climate, the physical properties of the vegetation cover and subsurface material have a major influence on the thermal state of permafrost. These properties are often directly related to the type of ecosystem overlaying permafrost. In this paper we demonstrate that classifying the landscape into general ecotypes is an effective way to scale up permafrost thermal data collected from field monitoring sites. Additionally, we find that within some ecotypes the absence of a moss layer is indicative of the absence of near-surface permafrost. As a proof of concept, we used the ground temperature data collected from the field sites to recode an ecotype land cover map into a map of mean annual ground temperature ranges at 1 m depth based on analysis and clustering of observed thermal regimes. The map should be useful for decision making with respect to land use and understanding how the landscape might change under future climate scenarios.

  6. Vaccinium meridionale Swartz Supercritical CO2 Extraction: Effect of Process Conditions and Scaling Up

    Directory of Open Access Journals (Sweden)

    Alexis López-Padilla

    2016-06-01

    Full Text Available Vaccinium meridionale Swartz (Mortiño or Colombian blueberry is one of the Vaccinium species abundantly found across the Colombian mountains, which are characterized by high contents of polyphenolic compounds (anthocyanins and flavonoids. The supercritical fluid extraction (SFE of Vaccinium species has mainly focused on the study of V. myrtillus L. (blueberry. In this work, the SFE of Mortiño fruit from Colombia was studied in a small-scale extraction cell (273 cm3 and different extraction pressures (20 and 30 MPa and temperatures (313 and 343 K were investigated. Then, process scaling-up to a larger extraction cell (1350 cm3 was analyzed using well-known semi-empirical engineering approaches. The Broken and Intact Cell (BIC model was adjusted to represent the kinetic behavior of the low-scale extraction and to simulate the large-scale conditions. Extraction yields obtained were in the range 0.1%–3.2%. Most of the Mortiño solutes are readily accessible and, thus, 92% of the extractable material was recovered in around 30 min. The constant CO2 residence time criterion produced excellent results regarding the small-scale kinetic curve according to the BIC model, and this conclusion was experimentally validated in large-scale kinetic experiments.

  7. Production of drug metabolites by immobilised Cunninghamella elegans: from screening to scale up.

    Science.gov (United States)

    Quinn, Laura; Dempsey, Rita; Casey, Eoin; Kane, Ayla; Murphy, Cormac D

    2015-05-01

    Cunninghamella elegans is a fungus that has been used extensively as a microbial model of mammalian drug metabolism, whilst its potential as a biocatalyst for the preparative production of human drug metabolites has been often proposed, little effort has been made to enable this. Here, we describe a workflow for the application of C. elegans for the production of drug metabolites, starting from well-plate screening assays leading to the preparative production of drug metabolites using fungus immobilised either in alginate or as a biofilm. Using 12- and 96-well plates, the simultaneous screening of several drug biotransformations was achieved. To scale up the biotransformation, both modes of immobilisation enabled semi-continuous production of hydroxylated drug metabolites through repeated addition of drug and rejuvenation of the fungus. It was possible to improve the productivity in the biofilm culture for the production of 4'-hydroxydiclofenac from 1 mg/l h to over 4 mg/l h by reducing the incubation time for biotransformation and the number of rejuvenation steps.

  8. Water based scale-up of CPO-27 synthesis for nitric oxide delivery.

    Science.gov (United States)

    Cattaneo, Damiano; Warrender, Stewart J; Duncan, Morven J; Castledine, Richard; Parkinson, Nigel; Haley, Ian; Morris, Russell E

    2016-01-14

    The applicability of water-based reflux and room temperature synthesis processes for the production of CPO-27 MOFs, suitable for NO delivery applications, is investigated. NO adsorption, storage and release performance of products obtained under reflux conditions are comparable to those of equivalent samples synthesised from traditional solvothermal methods at small scale. Products obtained from room temperature processes show lower NO release capability, although the quantities that are released are still more than adequate for biomedical applications. Results also reveal differences for the first time in NO uptake, storage and release depending on whether Zn, Ni or Mg is employed. The results indicate that while the crystallinity of CPO-27(Zn) and CPO-27(Mg) is not affected by moving to lower temperature methods, the crystallinity of CPO-27(Ni) is reduced. Particle morphology and size is also affected. The low temperature processes are successfully demonstrated at 20 L and 100 L scale and the main problems encountered during scale-up are outlined. The 100 L scale is in itself an appropriate production scale for some niche biomedical products. Indeed, results indicate that this synthesis approach is suitable for commercial production of MOFs for this application field. We also confirm that BET surface area from nitrogen adsorption at 77 K is not a good indicator for successful adsorption of NO.

  9. Transforming Global Health by Improving the Science of Scale-Up.

    Directory of Open Access Journals (Sweden)

    Margaret E Kruk

    2016-03-01

    Full Text Available In its report Global Health 2035, the Commission on Investing in Health proposed that health investments can reduce mortality in nearly all low- and middle-income countries to very low levels, thereby averting 10 million deaths per year from 2035 onward. Many of these gains could be achieved through scale-up of existing technologies and health services. A key instrument to close this gap is policy and implementation research (PIR that aims to produce generalizable evidence on what works to implement successful interventions at scale. Rigorously designed PIR promotes global learning and local accountability. Much greater national and global investments in PIR capacity will be required to enable the scaling of effective approaches and to prevent the recycling of failed ideas. Sample questions for the PIR research agenda include how to close the gap in the delivery of essential services to the poor, which population interventions for non-communicable diseases are most applicable in different contexts, and how to engage non-state actors in equitable provision of health services in the context of universal health coverage.

  10. Scale-up of phosphate remobilization from sewage sludge in a microbial fuel cell.

    Science.gov (United States)

    Happe, Manuel; Sugnaux, Marc; Cachelin, Christian Pierre; Stauffer, Marc; Zufferey, Géraldine; Kahoun, Thomas; Salamin, Paul-André; Egli, Thomas; Comninellis, Christos; Grogg, Alain-François; Fischer, Fabian

    2016-01-01

    Phosphate remobilization from digested sewage sludge containing iron phosphate was scaled-up in a microbial fuel cell (MFC). A 3litre triple chambered MFC was constructed. This reactor was operated as a microbial fuel cell and later as a microbial electrolysis cell to accelerate cathodic phosphate remobilization. Applying an additional voltage and exceeding native MFC power accelerated chemical base formation and the related phosphate remobilization rate. The electrolysis approach was extended using a platinum-RVC cathode. The pH rose to 12.6 and phosphate was recovered by 67% in 26h. This was significantly faster than using microbial fuel cell conditions. Shrinking core modelling particle fluid kinetics showed that the reaction resistance has to move inside the sewage sludge particle for considerable rate enhancement. Remobilized phosphate was subsequently precipitated as struvite and inductively coupled plasma mass spectrometry indicated low levels of cadmium, lead, and other metals as required by law for recycling fertilizers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Multiphase flow modeling: A tool to aid in scale up of processes

    Science.gov (United States)

    Nandakumar, Krishnaswamy

    2010-10-01

    Multiphase flows are ubiquitous in chemical processing industries. Traditional approach has been to ignore fluid dynamical effects by invoking simplifying assumptions of homogeneity, but pay the price during scale-up of processes. The question that I address is ``Can Multiphase flow modeling come to our rescue in minimizing the need for pilot scale experiments?'' On the fundamental side, we have developed algorithms for direct numerical simulation of multiphase flows. For dispersed rigid particles as in suspension flows, sedimentation etc, we couple the Navier-Stokes equations with the rigid body dynamics in a rigorous fashion to track the particle motion in a fluid. For deformable bubbles/droplets dispersed in another fluid, we also track their motion in an Eulerian grid. The two classes of algorithms show great promise in attempting direct simulation of multiphase flows, from which we can extract statistically meaningful average behavior of suspensions or bubbly flows. On the other hand, there is an immediate need to study flow of complex fluids of industrial importance. Such cases include polymer blending processes, erosion in pipelines and process vessels and mass transfer in packed beds. In such studies we use volume averaged equations as the basis of flow models coupled with experimental validation of such predictions in an effort to develop scale invariant closure models that are needed as part of the volume averaged flow models.

  12. Scale-up of a Luminescent Solar Concentrator-Based Photomicroreactor via Numbering-up

    Science.gov (United States)

    2017-01-01

    The use of solar energy to power chemical reactions is a long-standing dream of the chemical community. Recently, visible-light-mediated photoredox catalysis has been recognized as the ideal catalytic transformation to convert solar energy into chemical bonds. However, scaling photochemical transformations has been extremely challenging due to Bouguer–Lambert–Beer law. Recently, we have pioneered the development of luminescent solar concentrator photomicroreactors (LSC-PMs), which display an excellent energy efficiency. These devices harvest solar energy, convert the broad solar energy spectrum to a narrow-wavelength region, and subsequently waveguide the re-emitted photons to the reaction channels. Herein, we report on the scalability of such LSC-PMs via a numbering-up strategy. Paramount in our work was the use of molds that were fabricated via 3D printing. This allowed us to rapidly produce many different prototypes and to optimize experimentally key design aspects in a time-efficient fashion. Reactors up to 32 parallel channels have been fabricated that display an excellent flow distribution using a bifurcated flow distributor (standard deviations below 10%). This excellent flow distribution was crucial to scale up a model reaction efficiently, displaying yields comparable to those obtained in a single-channel device. We also found that interchannel spacing is an important and unique design parameter for numbered-up LSC-PMs, which influences greatly the photon flux experienced within the reaction channels. PMID:29333350

  13. Scaling-up permafrost thermal measurements in western Alaska using an ecotype approach

    Science.gov (United States)

    Cable, William L.; Romanovsky, Vladimir E.; Torre Jorgenson, M.

    2016-10-01

    Permafrost temperatures are increasing in Alaska due to climate change and in some cases permafrost is thawing and degrading. In areas where degradation has already occurred the effects can be dramatic, resulting in changing ecosystems, carbon release, and damage to infrastructure. However, in many areas we lack baseline data, such as subsurface temperatures, needed to assess future changes and potential risk areas. Besides climate, the physical properties of the vegetation cover and subsurface material have a major influence on the thermal state of permafrost. These properties are often directly related to the type of ecosystem overlaying permafrost. In this paper we demonstrate that classifying the landscape into general ecotypes is an effective way to scale up permafrost thermal data collected from field monitoring sites. Additionally, we find that within some ecotypes the absence of a moss layer is indicative of the absence of near-surface permafrost. As a proof of concept, we used the ground temperature data collected from the field sites to recode an ecotype land cover map into a map of mean annual ground temperature ranges at 1 m depth based on analysis and clustering of observed thermal regimes. The map should be useful for decision making with respect to land use and understanding how the landscape might change under future climate scenarios.

  14. PEPFAR Support for the Scaling Up of Collaborative TB/HIV Activities

    Science.gov (United States)

    Howard, Andrea A.; Gasana, Michel; Getahun, Haileyesus; Harries, Anthony; Lawn, Stephen D.; Miller, Bess; Nelson, Lisa; Sitienei, Joseph; Coggin, William L.

    2014-01-01

    The US President’s Emergency Plan for AIDS Relief (PEPFAR) has supported a comprehensive package of care in which interventions to address HIV-related tuberculosis (TB) have received increased funding and support in recent years. PEPFAR’s TB/HIV programming is based on the World Health Organization 12-point policy for collaborative TB/HIV activities, which are integrated into PEPFAR annual guidance. PEPFAR implementing partners have provided crucial support to TB/HIV collaboration, and as a result PEPFAR-supported countries in sub-Saharan Africa have made significant gains in HIV testing and counseling of TB patients and linkages to HIV care and treatment, intensified TB case finding, and TB infection control. PEPFAR’s support of TB/HIV integration has also included significant investment in health systems, including improved laboratory services and educating and enlarging the workforce. The scale-up of antiretroviral therapy along with support of programs to increase HIV counseling and testing and improve linkage and retention in HIV care may have considerable impact on TB morbidity and mortality, if used synergistically with isoniazid preventive therapy (IPT), intensified case finding and infection control. Issues to be addressed by future programming include accelerating implementation of IPT, increasing access and ensuring appropriate use of new TB diagnostics, supporting early initiation of antiretroviral therapy for HIV-infected TB patients, and strengthening systems to monitor and evaluate program implementation. PMID:22797735

  15. Simulation for Supporting Scale-Up of a Fluidized Bed Reactor for Advanced Water Oxidation

    Science.gov (United States)

    Abdul Raman, Abdul Aziz; Daud, Wan Mohd Ashri Wan

    2014-01-01

    Simulation of fluidized bed reactor (FBR) was accomplished for treating wastewater using Fenton reaction, which is an advanced oxidation process (AOP). The simulation was performed to determine characteristics of FBR performance, concentration profile of the contaminants, and various prominent hydrodynamic properties (e.g., Reynolds number, velocity, and pressure) in the reactor. Simulation was implemented for 2.8 L working volume using hydrodynamic correlations, continuous equation, and simplified kinetic information for phenols degradation as a model. The simulation shows that, by using Fe3+ and Fe2+ mixtures as catalyst, TOC degradation up to 45% was achieved for contaminant range of 40–90 mg/L within 60 min. The concentration profiles and hydrodynamic characteristics were also generated. A subsequent scale-up study was also conducted using similitude method. The analysis shows that up to 10 L working volume, the models developed are applicable. The study proves that, using appropriate modeling and simulation, data can be predicted for designing and operating FBR for wastewater treatment. PMID:25309949

  16. Approaches to scaling up physiological responses of forests to air pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Luxmoore, R.J.

    1991-12-31

    The regional distribution of a forest specie encompasses favorable and unfavorable environments. Modeling of physiological responses of trees to air pollutants in such a range of environments requires a consistent level of modeling detail for both above- and below-ground processes. A source-sink framework is recommended as a suitable physiological basis for modeling the feed forward and feedback relationships between photosynthesis and carbon utilization of forest stands distributed over a heterogeneous region. The variability of soil and plant properties over a region can be represented with frequency distributions of model input variables and these can be efficiently propagated through a simulator with a Monte Carlo procedure called Latin hypercube sampling. The outputs from this method (e.g. forest production, site index) are in the form of frequency distributions that can be compared statistically for alternative air pollutant exposure scenarios. These outputs from physiological modeling can also be used as input distributions in longer time-step models of forest succession and forest management. Selection of suitable variables to propagate from one scale to another is a critical challenge in simulation of long-term forest responses to air pollutants over regional spatial scales. An index of storage carbohydrate is suggested as one important variable for transfer from physiological modeling to forest succession modeling for scaling up purposes.

  17. Optimisation of one-step desolvation and scale-up of gelatine nanoparticle production.

    Science.gov (United States)

    Geh, Katharina J; Hubert, Madlen; Winter, Gerhard

    2016-11-01

    Gelatine nanoparticles (GNPs) are biodegradable and biocompatible drug delivery systems with excellent clinical performances. A two-step desolvation is commonly used for their preparation, although this methodology has several shortcomings: lack of reproducibility, small scales and low yields. A straightforward and more consistent GNP preparation approach is presented here focusing on the development of a one-step desolvation with the use of a commercially available gelatine type. Controlled stirring conditions and ultrafiltration are used to achieve large-scale production of nanoparticles of up to 2.6 g per batch. Particle size distributions are conserved and comparable to those determined for two-step desolvation on small scale. Additionally, a range of cross-linking agents is examined for their effectiveness in stabilising GNPs as an alternative to glutaraldehyde. Glyceraldehyde demonstrated outstanding properties, which led to high colloidal stability. This approach optimises the manufacturing process and the scale-up of the production capacity, providing a clear potential for future applications.

  18. Vaccinium meridionale Swartz Supercritical CO2 Extraction: Effect of Process Conditions and Scaling Up

    Science.gov (United States)

    López-Padilla, Alexis; Ruiz-Rodriguez, Alejandro; Restrepo Flórez, Claudia Estela; Rivero Barrios, Diana Marsela; Reglero, Guillermo; Fornari, Tiziana

    2016-01-01

    Vaccinium meridionale Swartz (Mortiño or Colombian blueberry) is one of the Vaccinium species abundantly found across the Colombian mountains, which are characterized by high contents of polyphenolic compounds (anthocyanins and flavonoids). The supercritical fluid extraction (SFE) of Vaccinium species has mainly focused on the study of V. myrtillus L. (blueberry). In this work, the SFE of Mortiño fruit from Colombia was studied in a small-scale extraction cell (273 cm3) and different extraction pressures (20 and 30 MPa) and temperatures (313 and 343 K) were investigated. Then, process scaling-up to a larger extraction cell (1350 cm3) was analyzed using well-known semi-empirical engineering approaches. The Broken and Intact Cell (BIC) model was adjusted to represent the kinetic behavior of the low-scale extraction and to simulate the large-scale conditions. Extraction yields obtained were in the range 0.1%–3.2%. Most of the Mortiño solutes are readily accessible and, thus, 92% of the extractable material was recovered in around 30 min. The constant CO2 residence time criterion produced excellent results regarding the small-scale kinetic curve according to the BIC model, and this conclusion was experimentally validated in large-scale kinetic experiments. PMID:28773640

  19. Ammonia recovery from urine in a scaled-up Microbial Electrolysis Cell

    Science.gov (United States)

    Zamora, Patricia; Georgieva, Tanya; Ter Heijne, Annemiek; Sleutels, Tom H. J. A.; Jeremiasse, Adriaan W.; Saakes, Michel; Buisman, Cees J. N.; Kuntke, Philipp

    2017-07-01

    A two-step treatment system for nutrient and energy recovery from urine was successfully operated for six months. In the first step, phosphorus (P) was recovered as struvite (magnesium ammonium phosphate or MAP) in a MAP reactor. The effluent of this MAP reactor was used for total ammonia-nitrogen (TAN) recovery and hydrogen production in a Microbial Electrolysis Cell (MEC). This MEC was coupled to a Transmembranechemisorption (TMCS) module, in which the TAN was recovered as an ammonium sulphate solution. The MEC had a projected surface area of 0.5 m2 and was operated at different urine dilutions. The system was stable during the operation on 2 times diluted and undiluted urine at an applied voltage of 0.5 V with an average current density of 1.7 ± 0.2 A m-2. During stable current production, the TAN transport efficiency over the CEM was 92 ± 25% and the TAN recovery was 31 ± 59%. In terms of energy efficiency, the electrical energy required for the TAN recovery was 4.9 ± 1.0 MJ kgN-1, which is lower than competing electrochemical nitrogen removal/recovery technologies. Overall, this study shows, for the first time, the application of a scaled-up MEC for nutrient recovery from urine.

  20. Vaccinium meridionale Swartz Supercritical CO₂ Extraction: Effect of Process Conditions and Scaling Up.

    Science.gov (United States)

    López-Padilla, Alexis; Ruiz-Rodriguez, Alejandro; Restrepo Flórez, Claudia Estela; Rivero Barrios, Diana Marsela; Reglero, Guillermo; Fornari, Tiziana

    2016-06-25

    Vaccinium meridionale Swartz (Mortiño or Colombian blueberry) is one of the Vaccinium species abundantly found across the Colombian mountains, which are characterized by high contents of polyphenolic compounds (anthocyanins and flavonoids). The supercritical fluid extraction (SFE) of Vaccinium species has mainly focused on the study of V. myrtillus L. (blueberry). In this work, the SFE of Mortiño fruit from Colombia was studied in a small-scale extraction cell (273 cm³) and different extraction pressures (20 and 30 MPa) and temperatures (313 and 343 K) were investigated. Then, process scaling-up to a larger extraction cell (1350 cm³) was analyzed using well-known semi-empirical engineering approaches. The Broken and Intact Cell (BIC) model was adjusted to represent the kinetic behavior of the low-scale extraction and to simulate the large-scale conditions. Extraction yields obtained were in the range 0.1%-3.2%. Most of the Mortiño solutes are readily accessible and, thus, 92% of the extractable material was recovered in around 30 min. The constant CO₂ residence time criterion produced excellent results regarding the small-scale kinetic curve according to the BIC model, and this conclusion was experimentally validated in large-scale kinetic experiments.

  1. [Antitumor and chemopreventive activity of lactoferrin].

    Science.gov (United States)

    Artym, Jolanta

    2006-01-01

    Lactoferrin, an evolutionarily old protein of the transferrin family, is among the proteins constituting the system of innate immunity; its action, however, also extends to the regulation of acquired immunity and other immunological phenomena. The actions of LF, confirmed in numerous in vitro and in vivo models, include participation in iron homeostasis, immunoregulatory properties, anti-inflammatory, anti-tumor, and analgesic actions, regulation of bone metabolism, participation in embryonic development, reproductive functions, and others. LF plays an important role in the normal development of a newborn. The anti-tumor properties of LF were discovered about a decade ago and have been confirmed in many laboratory, preclinical, and clinical studies. The immunomodulatory properties of LF play a major role in its anti-tumor actions. Such actions of LF appeared particularly effective in cancer patients with impaired immunity. The growth of tumors is facilitated by low expressions of MHC and co-stimulatory antigens on tumor cells and the induction of suppressor cells and other inhibitory products by tumors. Enhancement of an anti-tumor immunological response may, therefore, restrict tumor growth. Studies showed that LF elevates the number and increases the activity of T and B lymphocytes and NK cells, stimulates the release of a number of cytokines (IL-1, -6, -8, -18, IFN-gamma, TNF alpha), increases phagocytic activity and cytotoxicity of monocytes/macrophages, accelerates the maturation of T and B cells, and elevates the expression of several types of cellular receptors, such as CD4, zeta chain of the CD3 complex, LFA-1, CD11, ICAM-1, and selectin P. Apart from its immunomodulatory properties, LF exhibits direct anti-tumor actions, such as lytic, pro-apoptotic, anti-proliferative, anti-angiogenic, anti-oxidant activity and the chelation of iron ions. LF also possesses chemo-preventive properties, regulates the activity of phase I and II enzymes participating in the

  2. Malaria eradication: the economic, financial and institutional challenge

    Directory of Open Access Journals (Sweden)

    Hanson Kara

    2008-12-01

    Full Text Available Abstract Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices. More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities, the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: ∘ issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between

  3. Scaling up access to oral rehydration solution for diarrhea: Learning from historical experience in low- and high-performing countries.

    Science.gov (United States)

    Wilson, Shelby E; Morris, Saul S; Gilbert, Sarah Skye; Mosites, Emily; Hackleman, Rob; Weum, Kristoffer L M; Pintye, Jillian; Manhart, Lisa E; Hawes, Stephen E

    2013-06-01

    This paper aims to identify factors that systematically predict why some countries that have tried to scale up oral rehydration solution (ORS) have succeeded, and others have not. We examined ORS coverage over time, across countries, and through case studies. We conducted expert interviews and literature and data searches to better understand the history of ORS scale-up efforts and why they failed or succeeded in nine countries. We used qualitative, pairwise (or three-country) comparisons of geographically or otherwise similar countries that had different outcomes in terms of ORS scale-up. An algorithm was developed which scored country performance across key supply, demand and financing activities to quantitatively assess the scale-up efforts in each country. The vast majority of countries have neither particularly low nor encouragingly high ORS use rates. We observed three clearly identifiable contrasts between countries that achieved and sustained high ORS coverage and those that did not. Key partners across sectors have critical roles to play to effectively address supply- and demand-side barriers. Efforts must synchronize demand generation, private provider outreach and public sector work. Many donor funds are either suspended or redirected in the event of political instability, exacerbating the health challenges faced by countries in these contexts. We found little information on the cost of scale-up efforts. We identified a number of characteristics of successful ORS scale-up programs, including involvement of a broad range of key players, addressing supply and demand generation together, and working with both public and private sectors. Dedicated efforts are needed to launch and sustain success, including monitoring and evaluation plans to track program costs and impacts. These case studies were designed to inform programmatic decision-making; thus, rigorous academic methods to qualitatively and quantitatively evaluate country ORS scale-up programs might

  4. Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

    Science.gov (United States)

    Marseille, Elliot; Jiwani, Aliya; Raut, Abhishek; Verguet, Stéphane; Walson, Judd; Kahn, James G

    2014-06-26

    This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars. The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health

  5. Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi

    NARCIS (Netherlands)

    Kabaghe, Alinune N.; Phiri, Mphatso D.; Phiri, Kamija S.; van Vugt, Michèle

    2017-01-01

    Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on

  6. Frugal chemoprevention: targeting Nrf2 with foods rich in sulforaphane.

    Science.gov (United States)

    Yang, Li; Palliyaguru, Dushani L; Kensler, Thomas W

    2016-02-01

    With the properties of efficacy, safety, tolerability, practicability and low cost, foods containing bioactive phytochemicals are gaining significant attention as elements of chemoprevention strategies against cancer. Sulforaphane [1-isothiocyanato-4-(methylsulfinyl)butane], a naturally occurring isothiocyanate produced by cruciferous vegetables such as broccoli, is found to be a highly promising chemoprevention agent against not only a variety of cancers such as breast, prostate, colon, skin, lung, stomach or bladder, but also cardiovascular disease, neurodegenerative diseases, and diabetes. For reasons of experimental exigency, preclinical studies have focused principally on sulforaphane itself, while clinical studies have relied on broccoli sprout preparations rich in either sulforaphane or its biogenic precursor, glucoraphanin. Substantive subsequent evaluation of sulforaphane pharmacokinetics and pharmacodynamics has been undertaken using either pure compound or food matrices. Sulforaphane affects multiple targets in cells. One key molecular mechanism of action for sulforaphane entails activation of the Nrf2-Keap1 signaling pathway although other actions contribute to the broad spectrum of efficacy in different animal models. This review summarizes the current status of pre-clinical chemoprevention studies with sulforaphane and highlights the progress and challenges for the application of foods rich in sulforaphane and/or glucoraphanin in the arena of clinical chemoprevention. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Role of 4-hydroxynonenal in chemopreventive activities of sulforaphane

    Science.gov (United States)

    Sharma, Rajendra; Sharma, Abha; Chaudhary, Pankaj; Sahu, Mukesh; Jaiswal, Shailesh; Awasthi, Sanjay; Awasthi, Yogesh C.

    2012-01-01

    Chemoprevention of cancer via herbal and dietary supplements is a logical approach to combat cancer and presently it is an attractive area of research investigations. Over the years, the use of isothiocyanates, such as sulforaphane (SFN) found in cruciferous vegetables, has been advocated as chemopreventive agents and their efficacy has been demonstrated in cell lines and animal models. In-vivo studies with SFN suggest that besides protecting normal healthy cells from environmental carcinogens it also exhibits cytotoxicity and apoptotic effects against various cancer cell types. Among several mechanisms for the chemopreventive activity of SFN against chemical carcinogenesis, its effect on drug metabolizing enzymes that causes activation/ neutralization of carcinogenic metabolites is well established. Recent studies suggest that SFN exerts its selective cytotoxicity to cancer cells via reactive oxygen species (ROS)-mediated generation of lipid peroxidation (LPO) products particularly 4-hydroxynonenal (HNE). Against the background of the known biochemical effects of SFN on normal and cancer cells, in this article we have reviewed the underlying molecular mechanisms responsible for the overall chemopreventive effects of SFN focusing on the role of HNE in these mechanisms that may also contribute to its selective cytotoxicity to cancer cells. PMID:22579574

  8. Systematic review: molecular chemoprevention of colorectal malignancy by mesalazine.

    Science.gov (United States)

    Lyakhovich, A; Gasche, C

    2010-01-15

    Mesalazine (mesalamine) (5-ASA) is considered an anti-inflammatory drug for the treatment of inflammatory bowel disease. It is well tolerated by most patients and induces mucosal healing specifically in ulcerative colitis. Besides its anti-inflammatory properties, 5-ASA has been studied for cancer inhibitory activities as it seems to reduce colorectal cancer incidence in patients using this drug for long periods of time. However, detailed molecular mechanisms of drug action are vague. To evaluate known molecular mechanisms of 5-ASA on chemoprevention of colorectal malignancy. Systematic review with search terms '5 aminosalicylic acid, mesalazine, 5-ASA, mesalazine, molecular mechanisms, chemoprevention' between 2006 and August 2009. A total of 48 studies were retrieved that link 5-ASA chemopreventive properties to five distinct pathways. These include interference with cell cycle progression (12 references), scavenging of reactive oxygen- or nitrogen-derived metabolites (16 references), TNF-alpha/TGF-ss signalling (11 references), WNT/beta-catenin signalling (5 references) and anti-bacterial properties (4 references). In the recent years, a large amount of molecular data has accumulated supporting the notion that 5-ASA biological effects interfere with colorectal cancer development. These molecular pathways are of special interest in the search for 5-ASA's molecular target(s) and development of novel chemopreventive compounds.

  9. Colon Cancer Chemoprevention by Flavonoid Silibinin | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): Cancer stem cells (CSC) are now recognized as the main cause for initiation, promotion and progression of most of the cancers, including colorectal cancer (CRC). Despite this fact, efficacy of chemopreventive agents towards CSC generation leading to cancer initiation and tumorigenesis has not yet been well- defined. |

  10. Building to collective impact: the Global Fund support for measuring reduction in the burden of malaria.

    Science.gov (United States)

    Nahlen, Bernard L; Low-Beer, Daniel

    2007-12-01

    The Global Fund to Fight AIDS, Tuberculosis, and Malaria was established in 2002 to fund substantial scaling-up coverage of proven and effective interventions to reduce infection, illness, and deaths in those communities most at risk. As of December 2006 the Global Fund has committed $2.6 billion over 5 years to support malaria prevention and control in 85 countries. The Global Fund has worked closely with Roll Back Malaria partners to develop consensus on a set of outcome and impact indicators that have been incorporated into malaria grant agreements. Although the Global Fund has recommended that 5-10% of grant funds be invested in improving the capacity of the national monitoring and evaluation systems, an average of only 3.9% is invested in these systems. Several countries are already demonstrating reductions in the malaria burden. To sustain the scale-up in funding to support malaria interventions, countries must ensure that resources are used now to show robust, systematic, and regular measurement of impact on the burden of malaria.

  11. Evaluating Ecotypes as a means of Scaling-up Permafrost Thermal Measurements in Western Alaska.

    Science.gov (United States)

    Cable, William; Romanovsky, Vladimir

    2015-04-01

    In many regions, permafrost temperatures are increasing due to climate change and in some cases permafrost is thawing and degrading. In areas where degradation has already occurred the effects can be dramatic, resulting in changing ecosystems, carbon release, and damage to infrastructure. Yet in many areas we lack baseline data, such as subsurface temperatures, needed to assess future changes and potential risk areas. Besides climate, the physical properties of the vegetation cover and subsurface material have a major influence on the thermal state of permafrost. These properties are often directly related to the type of ecosystem overlaying permafrost. Thus, classifying the landscape into general ecotypes might be an effective way to scale up permafrost thermal data. To evaluate using ecotypes as a way of scaling-up permafrost thermal data within a region we selected an area in Western Alaska, the Selawik National Wildlife Refuge, which is on the boundary between continuous and discontinuous permafrost. This region was selected because previously an ecological land classification had been conducted and a very high-resolution ecotype map was generated. Using this information we selected 18 spatially distributed sites covering the most abundant ecotypes, where we are collecting low vertical resolution soil temperature data to a depth of 1.5 meters at most sites. At three additional core sites, we are collecting air temperature, snow depth, and high vertical resolution soil temperature to a depth of 3 meters. The sites were installed in the summers of 2011 and 2012; consequently, we have at least two years of data from all sites. Mean monthly and mean annual air temperature and snow depth for all three core sites are similar within the 2012-2014 period. Additionally, the average air temperature and snow depth from our three cores sites compares well with that of a nearby meteorological station for which long-term data is available. During the study period snow depth

  12. Radio-isotope production scale-up at the University of Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Nickles, Robert Jerome [Univ of Wisconsin

    2014-06-19

    Our intent has been to scale up our production capacity for a subset of the NSAC-I list of radioisotopes in jeopardy, so as to make a significant impact on the projected national needs for Cu-64, Zr-89, Y-86, Ga-66, Br-76, I-124 and other radioisotopes that offer promise as PET synthons. The work-flow and milestones in this project have been compressed into a single year (Aug 1, 2012- July 31, 2013). The grant budget was virtually dominated by the purchase of a pair of dual-mini-cells that have made the scale-up possible, now permitting the Curie-level processing of Cu-64 and Zr-89 with greatly reduced radiation exposure. Mile stones: 1. We doubled our production of Cu-64 and Zr-89 during the grant period, both for local use and out-bound distribution to ≈ 30 labs nationwide. This involved the dove-tailing of beam schedules of both our PETtrace and legacy RDS cyclotron. 2. Implemented improved chemical separation of Zr-89, Ga-66, Y-86 and Sc-44, with remote, semi-automated dissolution, trap-and-release separation under LabView control in the two dual-mini-cells provided by this DOE grant. A key advance was to fit the chemical stream with miniature radiation detectors to confirm the transfer operations. 3. Implemented improved shipping of radioisotopes (Cu-64, Zr-89, Tc-95m, and Ho-163) with approved DOT 7A boxes, with a much-improved FedEx shipping success compared to our previous steel drums. 4. Implemented broad range quantitative trace metal analysis, employing a new microwave plasma atomic emission spectrometer (Agilent 4200) capable of ppb sensitivity across the periodic table. This new instrument will prove essential in bringing our radiometals into FDA compliance needing CoA’s for translational research in clinical trials. 5. Expanded our capabilities in target fabrication, with the purchase of a programmable 1600 oC inert gas tube furnace for the smelting of binary alloy target materials. A similar effort makes use of our RF induction furnace, allowing

  13. 'Time is costly': modelling the macroeconomic impact of scaling-up antiretroviral treatment in sub-Saharan Africa.

    Science.gov (United States)

    Ventelou, Bruno; Moatti, Jean-Paul; Videau, Yann; Kazatchkine, Michel

    2008-01-02

    Macroeconomic policy requirements may limit the capacity of national and international policy-makers to allocate sufficient resources for scaling-up access to HIV care and treatment in developing countries. An endogenous growth model, which takes into account the evolution of society's human capital, was used to assess the macroeconomic impact of policies aimed at scaling-up access to HIV/AIDS treatment in six African countries (Angola, Benin, Cameroon, Central African Republic, Ivory Coast and Zimbabwe). The model results showed that scaling-up access to treatment in the affected population would limit gross domestic product losses due to AIDS although differently from country to country. In our simulated scenarios of access to antiretroviral therapy, only 10.3% of the AIDS shock is counterbalanced in Zimbabwe, against 85.2% in Angola and even 100.0% in Benin (a total recovery). For four out of the six countries (Angola, Benin, Cameroon, Ivory Coast), the macro-economic gains of scaling-up would become potentially superior to its associated costs in 2010. Despite the variability of HIV prevalence rates between countries, macro-economic estimates strongly suggest that a massive investment in scaling-up access to HIV treatment may efficiently counteract the detrimental long-term impact of the HIV pandemic on economic growth, to the extent that the AIDS shock has not already driven the economy beyond an irreversible 'no-development epidemiological trap'.

  14. Prelude to rational scale-up of penicillin production: a scale-down study.

    Science.gov (United States)

    Wang, Guan; Chu, Ju; Noorman, Henk; Xia, Jianye; Tang, Wenjun; Zhuang, Yingping; Zhang, Siliang

    2014-03-01

    Penicillin is one of the best known pharmaceuticals and is also an important member of the β-lactam antibiotics. Over the years, ambitious yields, titers, productivities, and low costs in the production of the β-lactam antibiotics have been stepwise realized through successive rounds of strain improvement and process optimization. Penicillium chrysogenum was proven to be an ideal cell factory for the production of penicillin, and successful approaches were exploited to elevate the production titer. However, the industrial production of penicillin faces the serious challenge that environmental gradients, which are caused by insufficient mixing and mass transfer limitations, exert a considerably negative impact on the ultimate productivity and yield. Scale-down studies regarding diverse environmental gradients have been carried out on bacteria, yeasts, and filamentous fungi as well as animal cells. In accordance, a variety of scale-down devices combined with fast sampling and quenching protocols have been established to acquire the true snapshots of the perturbed cellular conditions. The perturbed metabolome information stemming from scale-down studies contributed to the comprehension of the production process and the identification of improvement approaches. However, little is known about the influence of the flow field and the mechanisms of intracellular metabolism. Consequently, it is still rather difficult to realize a fully rational scale-up. In the future, developing a computer framework to simulate the flow field of the large-scale fermenters is highly recommended. Furthermore, a metabolically structured kinetic model directly related to the production of penicillin will be further coupled to the fluid flow dynamics. A mathematical model including the information from both computational fluid dynamics and chemical reaction dynamics will then be established for the prediction of detailed information over the entire period of the fermentation process and

  15. Scaling-up of dental pulp stem cells isolated from multiple niches.

    Directory of Open Access Journals (Sweden)

    Nelson F Lizier

    Full Text Available Dental pulp (DP can be extracted from child's primary teeth (deciduous, whose loss occurs spontaneously by about 5 to 12 years. Thus, DP presents an easy accessible source of stem cells without ethical concerns. Substantial quantities of stem cells of an excellent quality and at early (2-5 passages are necessary for clinical use, which currently is a problem for use of adult stem cells. Herein, DPs were cultured generating stem cells at least during six months through multiple mechanical transfers into a new culture dish every 3-4 days. We compared stem cells isolated from the same DP before (early population, EP and six months after several mechanical transfers (late population, LP. No changes, in both EP and LP, were observed in morphology, expression of stem cells markers (nestin, vimentin, fibronectin, SH2, SH3 and Oct3/4, chondrogenic and myogenic differentiation potential, even after cryopreservation. Six hours after DP extraction and in vitro plating, rare 5-bromo-2'-deoxyuridine (BrdU positive cells were observed in pulp central part. After 72 hours, BrdU positive cells increased in number and were found in DP periphery, thus originating a multicellular population of stem cells of high purity. Multiple stem cell niches were identified in different zones of DP, because abundant expression of nestin, vimentin and Oct3/4 proteins was observed, while STRO-1 protein localization was restricted to perivascular niche. Our finding is of importance for the future of stem cell therapies, providing scaling-up of stem cells at early passages with minimum risk of losing their "stemness".

  16. Protecting HIV information in countries scaling up HIV services: a baseline study

    Directory of Open Access Journals (Sweden)

    Beck Eduard J

    2011-02-01

    Full Text Available Abstract Background Individual-level data are needed to optimize clinical care and monitor and evaluate HIV services. Confidentiality and security of such data must be safeguarded to avoid stigmatization and discrimination of people living with HIV. We set out to assess the extent that countries scaling up HIV services have developed and implemented guidelines to protect the confidentiality and security of HIV information. Methods Questionnaires were sent to UNAIDS field staff in 98 middle- and lower-income countries, some reportedly with guidelines (G-countries and others intending to develop them (NG-countries. Responses were scored, aggregated and weighted to produce standard scores for six categories: information governance, country policies, data collection, data storage, data transfer and data access. Responses were analyzed using regression analyses for associations with national HIV prevalence, gross national income per capita, OECD income, receiving US PEPFAR funding, and being a G- or NG-country. Differences between G- and NG-countries were investigated using non-parametric methods. Results Higher information governance scores were observed for G-countries compared with NG-countries; no differences were observed between country policies or data collection categories. However, for data storage, data transfer and data access, G-countries had lower scores compared with NG-countries. No significant associations were observed between country score and HIV prevalence, per capita gross national income, OECD economic category, and whether countries had received PEPFAR funding. Conclusions Few countries, including G-countries, had developed comprehensive guidelines on protecting the confidentiality and security of HIV information. Countries must develop their own guidelines, using established frameworks to guide their efforts, and may require assistance in adapting, adopting and implementing them.

  17. Protecting HIV information in countries scaling up HIV services: a baseline study.

    Science.gov (United States)

    Beck, Eduard J; Mandalia, Sundhiya; Harling, Guy; Santas, Xenophon M; Mosure, Debra; Delay, Paul R

    2011-02-06

    Individual-level data are needed to optimize clinical care and monitor and evaluate HIV services. Confidentiality and security of such data must be safeguarded to avoid stigmatization and discrimination of people living with HIV. We set out to assess the extent that countries scaling up HIV services have developed and implemented guidelines to protect the confidentiality and security of HIV information. Questionnaires were sent to UNAIDS field staff in 98 middle- and lower-income countries, some reportedly with guidelines (G-countries) and others intending to develop them (NG-countries). Responses were scored, aggregated and weighted to produce standard scores for six categories: information governance, country policies, data collection, data storage, data transfer and data access. Responses were analyzed using regression analyses for associations with national HIV prevalence, gross national income per capita, OECD income, receiving US PEPFAR funding, and being a G- or NG-country. Differences between G- and NG-countries were investigated using non-parametric methods. Higher information governance scores were observed for G-countries compared with NG-countries; no differences were observed between country policies or data collection categories. However, for data storage, data transfer and data access, G-countries had lower scores compared with NG-countries. No significant associations were observed between country score and HIV prevalence, per capita gross national income, OECD economic category, and whether countries had received PEPFAR funding. Few countries, including G-countries, had developed comprehensive guidelines on protecting the confidentiality and security of HIV information. Countries must develop their own guidelines, using established frameworks to guide their efforts, and may require assistance in adapting, adopting and implementing them.

  18. Opportunistic Computing with Lobster: Lessons Learned from Scaling up to 25k Non-Dedicated Cores

    Science.gov (United States)

    Wolf, Matthias; Woodard, Anna; Li, Wenzhao; Hurtado Anampa, Kenyi; Yannakopoulos, Anna; Tovar, Benjamin; Donnelly, Patrick; Brenner, Paul; Lannon, Kevin; Hildreth, Mike; Thain, Douglas

    2017-10-01

    We previously described Lobster, a workflow management tool for exploiting volatile opportunistic computing resources for computation in HEP. We will discuss the various challenges that have been encountered while scaling up the simultaneous CPU core utilization and the software improvements required to overcome these challenges. Categories: Workflows can now be divided into categories based on their required system resources. This allows the batch queueing system to optimize assignment of tasks to nodes with the appropriate capabilities. Within each category, limits can be specified for the number of running jobs to regulate the utilization of communication bandwidth. System resource specifications for a task category can now be modified while a project is running, avoiding the need to restart the project if resource requirements differ from the initial estimates. Lobster now implements time limits on each task category to voluntarily terminate tasks. This allows partially completed work to be recovered. Workflow dependency specification: One workflow often requires data from other workflows as input. Rather than waiting for earlier workflows to be completed before beginning later ones, Lobster now allows dependent tasks to begin as soon as sufficient input data has accumulated. Resource monitoring: Lobster utilizes a new capability in Work Queue to monitor the system resources each task requires in order to identify bottlenecks and optimally assign tasks. The capability of the Lobster opportunistic workflow management system for HEP computation has been significantly increased. We have demonstrated efficient utilization of 25 000 non-dedicated cores and achieved a data input rate of 30 Gb/s and an output rate of 500GB/h. This has required new capabilities in task categorization, workflow dependency specification, and resource monitoring.

  19. REACH: an effective catalyst for scaling up priority nutrition interventions at the country level.

    Science.gov (United States)

    Pearson, Brenda L; Ljungqvist, Björn

    2011-06-01

    Renewed Efforts Against Child Hunger (REACH) is the joint United Nations initiative to address Millennium Development Goal (MDG) 10, Target 3, i.e., to halve the proportion of underweight children under 5 years old by 2015. The United Nations Food and Agriculture Organization (FAO), the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the World Food Programme (WFP), and the International Fund for Agricultural Development (IFAD) developed and tested a facilitation mechanism to act as a catalyst for scaling up multisectoral nutrition activities. The UN-REACH partners developed pilot projects in Mauritania and Lao PDR from 2008 to 2010 and deployed facilitators to improve nutrition governance and coordination. Review missions were conducted in February 2011 to assess the REACH approach and what it achieved. The UN review mission members reviewed documents, assessed policy and management indicators, conducted qualitative interviews, and discussed findings with key stakeholders, including the most senior UN nutrition directors from all agencies. Among other UN-REACH achievements, the Prime Minister of Mauritania agreed to preside over a new National Nutrition Development Council responsible for high-level decision-making and setting national policy objectives. REACH facilitated the completion of Lao's first national Nutrition Strategy and Plan of Action and formation of the multistakeholder Nutrition Task Force. During the REACH engagement, coordination, joint advocacy, situation analysis, policy development, and joint UN programming for nutrition were strengthened in Lao PDR and Mauritania. Improvements in the nutrition governance and management mechanisms in Mauritania and Lao PDR were observed during the period of REACH support through increased awareness of nutrition as a key development objective, establishment of governmental multisectoral coordinating mechanisms, improved government capacity, and new joint UN-government nutrition

  20. Technology transfer and scale-up of the Flublok recombinant hemagglutinin (HA) influenza vaccine manufacturing process.

    Science.gov (United States)

    Buckland, Barry; Boulanger, Robert; Fino, Mireli; Srivastava, Indresh; Holtz, Kathy; Khramtsov, Nikolai; McPherson, Clifton; Meghrous, Jamal; Kubera, Paul; Cox, Manon M J

    2014-09-22

    Multiple different hemagglutinin (HA) protein antigens have been reproducibly manufactured at the 650L scale by Protein Sciences Corporation (PSC) based on an insect cell culture with baculovirus infection. Significantly, these HA protein antigens were produced by the same Universal Manufacturing process as described in the biological license application (BLA) for the first recombinant influenza vaccine approved by the FDA (Flublok). The technology is uniquely designed so that a change in vaccine composition can be readily accommodated from one HA protein antigen to another one. Here we present a vaccine candidate to combat the recently emerged H7N9 virus as an example starting with the genetic sequence for the required HA, creation of the baculovirus and ending with purified protein antigen (or vaccine component) at the 10L scale accomplished within 38 days under GMP conditions. The same process performance is being achieved at the 2L, 10L, 100L, 650L and 2500L scale. An illustration is given of how the technology was transferred from the benchmark 650L scale facility to a retrofitted microbial facility at the 2500L scale within 100 days which includes the time for facility engineering changes. The successful development, technology transfer and scale-up of the Flublok process has major implications for being ready to make vaccine rapidly on a worldwide scale as a defense against pandemic influenza. The technology described does not have the same vulnerability to mutations in the egg adapted strain, and resulting loss in vaccine efficacy, faced by egg based manufacture. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Scale-up of TB and HIV programme collaborative activities in Zambia - a 10-year review.

    Science.gov (United States)

    Kapata, N; Chanda-Kapata, P; Grobusch, M P; O'Grady, J; Schwank, S; Bates, M; Jansenn, S; Mwinga, A; Cobelens, F; Mwaba, P; Zumla, A

    2012-06-01

    To review the activities, progress, achievements and challenges of the Zambia Ministry of Health tuberculosis (TB)/HIV collaborative activities over the past decade. Analysis of Zambia Ministry of Health National TB and HIV programme documents and external independent programme review reports pertaining to 2000-2010. The number of people testing for HIV increased from 37 557 persons in 2003 to 1 327 995 persons in 2010 nationally. Those receiving anti-retroviral therapy (ART) increased from 143 in 2003 to 344 304 in 2010. The national HIV prevalence estimates declined from 14.3% in 2001 to 13.5% in 2009. The proportion of TB patients being tested for HIV increased from 22.6% in 2006 to 84% in 2010 and approximately 70% were HIV positive. The proportion of the HIV-infected TB patients who: (i) started on ART increased from 38% in 2006 to 50% in 2010; (ii) commenced co-trimoxazole preventive therapy (CPT) increased from 31% in 2006 to 70% in 2010; and (iii) were successfully treated increased to an average of 80% resulting in decline of deaths from 13% in 2006 to 9% in 2010. The scale-up of TB/HIV collaborative programme activities in Zambia has steadily increased over the past decade resulting in increased testing for TB and HIV, and anti-retroviral (ARV) rollout with improved treatment outcomes among TB patients co-infected with HIV. Getting service delivery points to adhere to WHO guidelines for collaborative TB/HIV activities remains problematic, especially those meant to reduce the burden of TB in people living with HIV/AIDS (PLWHA). © 2012 Blackwell Publishing Ltd.

  2. When does seed limitation matter for scaling up reforestation from patches to landscapes?

    Science.gov (United States)

    Caughlin, T Trevor; Elliott, Stephen; Lichstein, Jeremy W

    2016-12-01

    Restoring forest to hundreds of millions of hectares of degraded land has become a centerpiece of international plans to sequester carbon and conserve biodiversity. Forest landscape restoration will require scaling up ecological knowledge of secondary succession from small-scale field studies to predict forest recovery rates in heterogeneous landscapes. However, ecological field studies reveal widely divergent times to forest recovery, in part due to landscape features that are difficult to replicate in empirical studies. Seed rain can determine reforestation rate and depends on landscape features that are beyond the scale of most field studies. We develop mathematical models to quantify how landscape configuration affects seed rain and forest regrowth in degraded patches. The models show how landscape features can alter the successional trajectories of otherwise identical patches, thus providing insight into why some empirical studies reveal a strong effect of seed rain on secondary succession, while others do not. We show that seed rain will strongly limit reforestation rate when patches are near a threshold for arrested succession, when positive feedbacks between tree canopy cover and seed rain occur during early succession, and when directed dispersal leads to between-patch interactions. In contrast, seed rain has weak effects on reforestation rate over a wide range of conditions, including when landscape-scale seed availability is either very high or very low. Our modeling framework incorporates growth and survival parameters that are commonly estimated in field studies of reforestation. We demonstrate how mathematical models can inform forest landscape restoration by allowing land managers to predict where natural regeneration will be sufficient to restore tree cover. Translating quantitative forecasts into spatially targeted interventions for forest landscape restoration could support target goals of restoring millions of hectares of degraded land and help

  3. Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice.

    Science.gov (United States)

    Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J

    2014-04-01

    System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children's service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit.

  4. SCALING UP A MOBILE TELEMEDICINE SOLUTION IN BOTSWANA: KEYS TO SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Kagiso eNdlovu

    2014-12-01

    Full Text Available Effective health care delivery is significantly compromised in an environment where resources, both human and technical, are limited. Botswana’s health care system is one of the many in the African continent with few specialised medical doctors, thereby posing a barrier to patients’ access to health care services. In addition, the traditional landline and non-robust Information Technology (IT network infrastructure characterised by slow bandwidth still dominates the health care system in Botswana. Upgrading of the landline IT infrastructure to meet today’s health care demands is a tedious, long and expensive process. Despite these challenges, there still lies hope in health care delivery utilising wireless telecommunication services. Botswana has recently experienced a tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices. This growth inspired the Botswana-UPenn Partnership (BUP to collaborate with local partners to explore using mobile devices as tools to improve access to specialised health care delivery. Pilot studies were conducted across four medical specialties, including radiology, oral medicine, dermatology and cervical cancer screening. Findings from the studies became vital evidence in support of the first scale-up project of a mobile telemedicine solution in Botswana, also known as Kgonafalo. Some technical and social challenges were encountered during the initial studies, such as malfunctioning of mobile devices, accidental damage of devices and cultural misalignment between IT and healthcare providers. These challenges brought about lessons learnt, including a strong need for unwavering senior management support, establishment of solid local public-private partnerships, and efficient project sustainability plans. Sustainability milestones included the development and signing of a Memorandum of Understanding (MOU between the Botswana government and

  5. Scale-Up Design Analysis and Modelling of Cobalt Oxide Silica Membrane Module for Hydrogen Processing

    Directory of Open Access Journals (Sweden)

    Guozhao Ji

    2013-08-01

    Full Text Available This work shows the application of a validated mathematical model for gas permeation at high temperatures focusing on demonstrated scale-up design for H2 processing. The model considered the driving force variation with spatial coordinates and the mass transfer across the molecular sieve cobalt oxide silica membrane to predict the separation performance. The model was used to study the process of H2 separation at 500 °C in single and multi-tube membrane modules. Parameters of interest included the H2 purity in the permeate stream, H2 recovery and H2 yield as a function of the membrane length, number of tubes in a membrane module, space velocity and H2 feed molar fraction. For a single tubular membrane, increasing the length of a membrane tube led to higher H2 yield and H2 recovery, owing to the increase of the membrane area. However, the H2 purity decreased as H2 fraction was depleted, thus reducing the driving force for H2 permeation. By keeping the membrane length constant in a multi-tube arrangement, the H2 yield and H2 recovery increase was attributed to the higher membrane area, but the H2 purity was again compromised. Increasing the space velocity avoided the reduction of H2 purity and still delivered higher H2 yield and H2 recovery than in a single membrane arrangement. Essentially, if the membrane surface is too large, the driving force becomes lower at the expense of H2 purity. In this case, the membrane module is over designed. Hence, maintaining a driving force is of utmost importance to deliver the functionality of process separation.

  6. Scaling-up the biomass production of Cymbopogon citratus L. in temporary immersion system

    Directory of Open Access Journals (Sweden)

    Elisa Quiala

    2014-04-01

    Full Text Available Shoot-tips, collected from greenhouse-grown plants of Cymbopogon citratus L. (lemmon grass, were incubated on a semi-solid Murashige and Skoog (MS medium with 30% (w/v sucrose, and supplemented with 0.89 µM 6-benzyladenine (BA. After three weeks of culture shoots were individualized and then inoculated in 10 litres temporary immersion system (TIS containing 3 litres of the same basal MS liquid medium. The effects of three immersion frequency (immersion every 12, 6 and 4 hours on the production of biomass were studied. Three inoculum densities (forty, fifty and sixty shoots/TIS were also tested. The biomass growth was inûuenced by the immersion frequency. The highest proliferation rate (17.3 shoots/explants and the plant length (45.2 cm were obtained in plants immersed every 4 h. Also, the fresh and dry biomass weight (153.4 gFW and 24.8 gDW, respectively were higher in this treatment. The maximum biomass accumulation (185.2 gFW and 35.2 gDW was achieved after 30 days of culture when an inoculum density of 60 explants per TIS was used. For the first time, biomass of C. citratus has been produced in10 litres TIS. These results represent the first step in the scaling-up the biomass production of this medicinal plant in large temporary immersion bioreactors. Key words: automation, biomass growth, lemmon grass medicinal plant, tissue culture

  7. Gel compression considerations for chromatography scale-up for protein C purification.

    Science.gov (United States)

    He, W; Bruley, D F; Drohan, W N

    1998-01-01

    This work is to establish theoretical and experimental relationships for the scale-up of Immobilized Metal Affinity Chromatography (IMAC) and Immuno Affinity Chromatography for the low cost production of large quantities of Protein C. The external customer requirements for this project have been established for Protein C deficient people with the goal of providing prophylactic patient treatment. Deep vein thrombosis is the major symptom for protein C deficiency creating the potential problem of embolism transport to important organs, such as, lung and brain. Gel matrices for protein C separation are being analyzed to determine the relationship between the material properties of the gel and the column collapse characteristics. The fluid flow rate and pressure drop is being examined to see how they influence column stability. Gel packing analysis includes two considerations; one is bulk compression due to flow rate, and the second is gel particle deformation due to fluid flow and pressure drop. Based on the assumption of creeping flow, Darcy's law is being applied to characterize the flow through the gel particles. Biot's mathematical description of three-dimensional consolidation in porous media is being used to develop a set of system equations. Finite difference methods are being utilized to obtain the equation solutions. In addition, special programs such as finite element approaches, ABAQUS, will be studied to determine their application to this particular problem. Experimental studies are being performed to determine flow rate and pressure drop correlation for the chromatographic columns with appropriate gels. Void fraction is being measured using pulse testing to allow Reynolds number calculations. Experimental yield stress is being measured to compare with the theoretical calculations. Total Quality Management (TQM) tools have been utilized to optimize this work. For instance, the "Scatter Diagram" has been used to evaluate and select the appropriate gels and

  8. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up

    Directory of Open Access Journals (Sweden)

    Agunbiade Ojo M

    2012-04-01

    , scaling up of exclusive breastfeeding among mothers requires concerted efforts at the macro, meso and micro levels of the Nigerian society.

  9. The Design and Scale-Up of Multiple-Impeller Fermenters for Liquid Film Controlled Processes

    Directory of Open Access Journals (Sweden)

    Labík, L.

    2013-05-01

    Full Text Available Mechanically agitated gas-liquid contactors are frequently used in the chemical, food and biochemical industries as fermenters and as hydrogenation or chlorination reactors. However wide is the usage of such vessels, their design is not based on chemical engineering data, but is still rather empirical. Thus, it is highly desirable to have a tool for the rational design of agitated gas-liquid contactors that is based on fundamental chemical engineering parameters that are transferable to other systems and operating conditions. Focusing on liquid film-controlled processes and using the data from fermenters of different scales, we develop kLa correlations that are suitable for scale-up. First, we discuss how to determine the proper experimental kLa values, which are not distorted by other equipment parameters as is the gas residence time. We demonstrate the possible kLa distortion on the pilot-plant experimental data by comparing the results obtained by two different experimental techniques. Further, we present physically correct kLa data for fully non-coalescent (sodium sulphate solution batch. The data are presented both for laboratory and pilot-plant fermenters. We identify the process parameters, the values of which are dependent on the vessel scale when operated under the same power input per volume, and, using these parameters, we develop common kLa correlations suitable to describe the data for various scales of the vessel. The correlations developed reduce the uncertainty in predicting the volume of industrial scale fermenters from almost 1/2 to 1/4 of their total volume, thereby enabling significant reductions in both the initial costs, and operating costs.

  10. Ultrasound assisted acid catalyzed lactose hydrolysis: Understanding into effect of operating parameters and scale up studies.

    Science.gov (United States)

    Gajendragadkar, Chinmay N; Gogate, Parag R

    2017-07-01

    The current work deals with the value addition of lactose by transforming into hydrolyzed lactose syrup containing glucose and galactose in major proportion using the novel approach of ultrasound assisted acid catalyzed lactose hydrolysis. The hydrolysis of lactose was performed in ultrasonic bath (33kHz) at 50% duty cycle at different temperatures as 65°C and 70°C and two different hydrochloric acid (HCl) concentrations as 2.5N and 3N. It was observed that acid concentration, temperature and ultrasonic treatment were the major factors in deciding the time required to achieve ∼90% hydrolysis. The ultrasonic assisted approach resulted in reduction in the reaction time and the extent of intensification was established to be dependent on the temperature, acid concentration and time of ultrasonic exposure. It was observed that the maximum process intensification obtained by introduction of ultrasound in the lactose hydrolysis process performed at 70°C and 3N HCl was reduction in the required time for ∼90% hydrolysis from 4h (without the presence of ultrasound) to 3h. The scale-up study was also performed using an ultrasonic bath with longitudinal horn (36kHz as operating frequency) at 50% duty cycle, optimized temperature of 70°C and acid concentration of 3N. It was observed that the reaction was faster in the presence of ultrasound and stirring by axial impeller at rpm of 225±25. The time required to complete ∼90% of hydrolysis remained almost the same as observed for small scale study on ultrasonic bath (33kHz) at 50% duty cycle. The use of recovered lactose from whey samples instead of pure lactose did not result in any significant changes in the progress of hydrolysis, confirming the efficacy of the selected approach. Overall, the work has presented a novel ultrasound assisted approach for intensified lactose hydrolysis. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice

    Science.gov (United States)

    Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J

    2015-01-01

    Background System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children’s service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. Methods We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Results Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Conclusions Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit. PMID:27512239

  12. Scaling-up of Energy Services Access in East Africa to achieve the Millennium Development Goals

    Energy Technology Data Exchange (ETDEWEB)

    Arvidson, Anders; Nordstroem, Mattias; Forslund, Helena; Syngellakis, Katerina; Marcel, Jean-Christian; Woodsworth, Gregory; Songela, Francis; Sawe, Estomih; Ngigi, Ashington; Macharia, Daniel; Ngoye, Elizabeth

    2006-06-15

    From the 13th to the 15th March 2006, the ENABLE team together with UNDP facilitated a three day consultative workshop hosted by the East African Community. The principal objective of this workshop was to facilitate the design of a regional energy access workplan and accompanying investment programmes to support the achievement of the millennium development goals. The workshop brought together almost 50 stakeholders from the East African region, representing various sectors (health, education, water, agriculture, environment, finance, etc.), organisations (public, private and NGOs) and donors, with the objective to identify and recommend actions that need to be undertaken in East Africa at regional, national and local levels in order to achieve the EAC Regional Energy Access Scale-up targets endorsed by the Ministers of Energy of Kenya, Tanzania and Uganda in August 2005. In order to generate new and substantive information during the three days, a highly interactive and participatory approach was used, where participants worked intensively in small groups with a set of questions which examined the issues and actions needed to achieve the four EAC Regional Energy Access Scale-up targets, as listed below: Target 1: Enable the use of modern fuels for 50% of those who at present use traditional biomass for cooking. Support efforts to develop and adopt the use of improved cook stoves, means to reduce indoor air pollution, and measures to increase sustainable biomass production. Target 2: Access to reliable modern energy services for all urban and peri-urban poor. Target 3: Electricity for services such as lighting, refrigeration, information and communication technology, and water treatment and supply for schools, clinics, hospitals and community centres. Target 4: Access to mechanical power within the community for all communities for productive uses. The main output from the workshop was a set of interventions for each of the energy access scale-up targets

  13. New rodent models for studies of chemopreventive agents.

    Science.gov (United States)

    Lipkin, M

    1997-01-01

    Some recent studies of the effects of chemopreventive agents have begun to use new rodent models to improve the analysis of stages of colonic preneoplasia, and how chemopreventive agents modify progressive abnormal cell development. In one of the models of inherited predisposition to colon cancer, mice carrying a truncated Apc allele with a nonsense mutation in exon 15 have been generated by gene targeting and embryonic stem cell technology (Apc1638 mice). These mice develop multiple gastrointestinal lesions, including adenomas and carcinomas, focal areas of high-grade dysplasia (FAD), and polypoid hyperplasias with FADS. The incidence of inherited colonic neoplasms has now been modulated by a chemopreventive regimen. Colonic lesions significantly increased in Apc1638 mice on a Western-style diet, which has higher fat content and lower calcium and vitamin D compared to the same mice on AIN-76A diet. In another rodent model, Min mice were treated with sulindac, which markedly reduced the incidence of intestinal tumors. A third new rodent model containing a targeted mutation in the gene Mcc (mutated in colorectal cancer) recently became available for chemoprevention studies. These mice develop multiple types of neoplasms including adenocarcinomas, focal areas of gastrointestinal dysplasia, papillomas of the forestomach, and tumors in other organs including lung, liver, and lymphoid tissue. Feeding a Western-style diet to the Mcc mutant mice also resulted in significantly increased gastrointestinal lesions. These nutrient modifications also have been given to normal mice, demonstrating without any chemical carcinogen that a Western-style diet induced colonic tumorigenesis. Western-style diets also have now induced modulation of cell proliferation in other organs including mammary gland, pancreas, and prostate. These findings help develop new preclinical rodent models to aid the analysis of genetic and environmental factors leading to neoplasia, as well as new methods

  14. Chemoprevention of prostate cancer with nutrients and supplements

    Directory of Open Access Journals (Sweden)

    Van Poppel H

    2011-04-01

    Full Text Available Hendrik Van Poppel1, Bertrand Tombal21Department of Urology, University Hospital, KU Leuven, Leuven, Belgium; 2Service d’Urologie, Cliniques Universtaires Saint Luc, Brussels, BelgiumAbstract: As the adult population is increasing, prostate cancer (PCa will become a considerable health problem in the next millennium. This has raised public interest in potential chemoprevention of this disease. As PCa is extremely common and generally slow to progress it is regarded as an ideal candidate for chemoprevention. At present, the 5 alpha-reductase inhibitors finasteride and dutasteride have been identified as preventive agents. This review describes whether selenium, alpha-tocopherol, isoflavones, lycopene green tea polyphenols, calcium, and resveratrol may be useful for decreasing the risk of PCa in men. Although encouraging results are present, some studies show negative results. Differences in study design, sample size, dose administered, and/or concentrations achieved in the body may be the reason for these inconsistencies. Today, chemopreventive agents may be appropriate for high-risk patients like those with high-grade prostatic intraepithelial neoplasia and other high-risk groups such as patients with elevated prostate specific antigen (PSA and negative biopsy, rapid PSA velocity, and with a family history of PCa. Although larger randomized controlled studies are needed and epidemiologic evidence should be placed in a clinical context, physicians must be aware of these preventive opportunities in PCa care. Combinations of chemopreventive agents should be carefully investigated because mechanisms of action may be additive or synergistic.Keywords: alpha-tocopherol, chemoprevention, isoflavones, lycopene, polyphenols, prostate cancer, selenium

  15. Prevention and treatment practices and implications for malaria control in Mukono District Uganda

    DEFF Research Database (Denmark)

    Mbonye, A K; Bygbjerg, I C; Magnussen, P

    2008-01-01

    -sectional survey and key informant interviews was used to assess self-reported malaria at a household level in Mukono District, Uganda. A total of 5583 households were surveyed, and a high proportion (2897, 51.9%) reported a person with malaria two weeks prior to the survey. Only 546 households (9.8%) owned...... and used insecticide-treated nets (ITNs) for malaria prevention. Similarly, only a few households (86, 1.5%) used indoor residual spraying. Self-treatment with home-stocked drugs was high, yet there was low awareness of the effectiveness of expired drugs on malaria treatment. Self-reported malaria...... was associated with socioeconomic, behavioural and environmental factors, but more especially with household ownership of ITNs. These results will contribute to the current debate on identifying new approaches for scaling-up prevention interventions and effective case management, as well as selection of priority...

  16. CFD analysis of the flow-field scale-up influence on the electrodes performance in a PEFC

    Energy Technology Data Exchange (ETDEWEB)

    Squadrito, G.; Barbera, O.; Gatto, I.; Giacoppo, G.; Urbani, F.; Passalacqua, E. [CNR-ITAE, via Salita S. Lucia sopra Contessen. 5, 98126 S. Lucia, Messina (Italy)

    2005-12-01

    A computational fluid dynamic (CFD) analysis was used as a useful tool to obtain numerical relationships among similar flow-field designs having different active areas. Assuming that, at fixed current density, the porous layer velocity distribution calculated for the smallest size geometry was the optimal, a scale-up methodology has been proposed and implemented in software. It allows acquisition of the scaled-up flow-field by multiplying the reference cell parameters by suitable factors (scale factors). A calibration methodology has also been proposed by the introduction of a feedback factor evaluated by CFD analysis. A first application of this procedure has been carried out to scale-up a 5-125cm{sup 2} cell. (author)

  17. The impact and cost of scaling up midwifery and obstetrics in 58 low- and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Linda Bartlett

    Full Text Available BACKGROUND AND METHODS: To guide achievement of the Millennium Development Goals, we used the Lives Saved Tool to provide a novel simulation of potential maternal, fetal, and newborn lives and costs saved by scaling up midwifery and obstetrics services, including family planning, in 58 low- and middle-income countries. Typical midwifery and obstetrics interventions were scaled to either 60% of the national population (modest coverage or 99% (universal coverage. FINDINGS: Under even a modest scale-up, midwifery services including family planning reduce maternal, fetal, and neonatal deaths by 34%. Increasing midwifery alone or integrated with obstetrics is more cost-effective than scaling up obstetrics alone; when family planning was included, the midwifery model was almost twice as cost-effective as the obstetrics model, at $2,200 versus $4,200 per death averted. The most effective strategy was the most comprehensive: increasing midwives, obstetricians, and family planning could prevent 69% of total deaths under universal scale-up, yielding a cost per death prevented of just $2,100. Within this analysis, the interventions which midwifery and obstetrics are poised to deliver most effectively are different, with midwifery benefits delivered across the continuum of pre-pregnancy, prenatal, labor and delivery, and postpartum-postnatal care, and obstetrics benefits focused mostly on delivery. Including family planning within each scope of practice reduced the number of likely births, and thus deaths, and increased the cost-effectiveness of the entire package (e.g., a 52% reduction in deaths with midwifery and obstetrics increased to 69% when family planning was added; cost decreased from $4,000 to $2,100 per death averted. CONCLUSIONS: This analysis suggests that scaling up midwifery and obstetrics could bring many countries closer to achieving mortality reductions. Midwives alone can achieve remarkable mortality reductions, particularly when they

  18. Antiretroviral drug supply challenges in the era of scaling up ART in Malawi.

    Science.gov (United States)

    Schouten, Erik J; Jahn, Andreas; Ben-Smith, Anne; Makombe, Simon D; Harries, Anthony D; Aboagye-Nyame, Francis; Chimbwandira, Frank

    2011-07-06

    The number of people receiving antiretroviral treatment (ART) has increased considerably in recent years and is expected to continue to grow in the coming years. A major challenge is to maintain uninterrupted supplies of antiretroviral (ARV) drugs and prevent stock outs. This article discusses issues around the management of ARVs and prevention of stock outs in Malawi, a low-income country with a high HIV/AIDS burden, and a weak procurement and supply chain management system. This system for ARVs, paid for by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and bypassing the government Central Medical Stores, is in place, using the United Nations Children's Fund's (UNICEF's) procurement services. The system, managed by a handful of people who spend limited time on supply management, is characterized by a centrally coordinated quantification based on verified data from all national ART clinics, parallel procurement through UNICEF, and direct distribution to ART clinics. The model worked well in the first years of the ART programme with a single first-line ARV regimen, but with more regimens becoming available (e.g., alternative first-line, second-line and paediatric regimens), it has become more difficult to administer. Managing supplies through a parallel system has the advantage that weaknesses in the national system have limited influence on the ARV procurement and supply chain management system. However, as the current system operates without a central warehouse and national buffer stock capacity, it diminishes the ability to prevent ARV stock outs. The process of ordering ARVs, from the time that estimates are made to the arrival of supplies in health facilities, takes approximately one year. Addressing the challenges involved in maintaining ARVs through an efficient procurement and supply chain management system that prevents ARV stock outs through the establishment of a dedicated procurement team, a central warehouse and/or national buffer stock is a

  19. Chapter 6. Scaling Up Solutions to State, National and Global Levels

    Directory of Open Access Journals (Sweden)

    Daniel Kammen

    2016-12-01

    Full Text Available Scaling-up solutions require learning and adapting lessons between locations and at different scales. To accomplish this, common metrics are vital to building a shared language. For California, this has meant careful financial, cradle-to-grave life-cycle assessment methods leading to carbon accounting in many avenues of government (via the Low Carbon Fuel Standard or the Cap and Trade program. These methods themselves interact, such as the use of carbon accounting for the resources needed to manage water and other key resources; the use of criteria air pollution monitoring to identify environmental injustices; and the use of carbon market revenues to address these inequalities, through investment in best available abatement technologies (BACT and in job creation in disadvantaged communities anticipated in the emerging clean energy sector.  Creating interdisciplinary partnerships across the UC Campuses and the National Laboratories to innovate science and technology is critical to scalable carbon neutrality solutions. As an example, we can build coordinated research and development programs across UC and California, with strong partnerships with the Federal government to coordinate and “multiply” resources that accelerate development and deployment. These partnerships should be strongly goal-focused, i.e., they are created to solve specific, large problems, to enable quantitatively measurable outcomes within energy generation, efficiency and CO2 abatement categories. Intersectoral partnerships should be fostered across campuses, laboratories, with state, federal and multi-lateral organizations funding to develop technologies and deploy solutions at scale. Integrated partnerships with industry are required to influence markets, deploy solutions, and create new industries and jobs.  Beyond California, we need to establish consortia with industry and foundations to deploy solutions at the regional, state, national, and international scale to

  20. The success factors of scaling-up Estonian sexual and reproductive health youth clinic network--from a grassroots initiative to a national programme 1991-2013

    NARCIS (Netherlands)

    Kempers, J.P.; Ketting, E.; Chandra-Mouli, V.; Raudsepp, T.

    2015-01-01

    BACKGROUND: A growing number of middle-income countries are scaling up youth-friendly sexual and reproductive health pilot projects to national level programmes. Yet, there are few case studies on successful national level scale-up of such programmes. Estonia is an excellent example of scale-up of a

  1. STATUS HEMATOLOGI PENDERITA MALARIA SEREBRAL

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2009-05-01

    Full Text Available AbstrakMalaria masih merupakan masalah kesehatan masyarakat dunia. Berdasarkan klasifikasi klinis, malaria dibedakan atas malaria berat dan malaria tanpa komplikasi. Malaria serebral merupakan komplikasi terberat dari malaria falsiparum.Telah dilakukan penelitian seksi silang terhadap penderita malaria falciparum yang dirawat inap di Bangsal Penyakit Dalam RS. Perjan. Dr. M. Djamil Padang dari bulan Juni 2002 sampai Juni 2006. Pada penelitian ini didapatkan jumlah sampel sebanyak 60 orang, terdiri dari 16 orang penderita malaria serebral dan 44 orang penderita malaria tanpa komplikasi.Data penelitian menunjukan terdapat perbedaan bermakna nilai hematokrit (p<0,05 dan jumlah leukosit (p<0,05 antara penderita malaria serebral dengan penderita malaria tanpa komplikasi. Dan terdapat korelasi positif antara nilai hemoglobin dengan hematokrit (r=0,864; p<0,05 pada penderita malaria falsiparum.Kata kunci: malaria serebral, malaria tanpa komplikasi, malaria falsiparumAbstract Malaria is still a problem of health of world society. Based on the clinical classification, are distinguished on severe malaria and uncomplicated malaria. Cerebral malaria is the worst complication of falciparum malaria. Cross section of the research done at the Hospital Dr. M. Djamil Padang againts medical record of malaria patients who are hospitalized in the Internal Medicine from June 2002 until June 2004. In this study, a total sample of 60 people, consisting of 16 cerebral malaria and 44 uncomplicated malaria. Data showed there were significant differences for hematocrit values (p <0.05 and total leukocytes values (p <0.05 between cerebral malaria and uncomplicated malaria patients. There is a positive correlation between hemoglobin with hematocrit values (r = 0.864; p <0.05 of falciparum malaria patients. Keywords: cerebral malaria, uncomplicated malaria, falciparum malaria

  2. Global challenges with scale-up of the integrated management of childhood illness strategy: results of a multi-country survey

    Directory of Open Access Journals (Sweden)

    Muhe Lulu M

    2011-06-01

    .6%. Countries addressed these by piggy backing IMCI follow-up with routine supervisory visits. Conclusions Financial challenges to ICMT scale-up and follow-up after training are common. As IMCI is accepted globally as one of the key strategies to meet MDG4 several steps need to be taken to facilitate rapid acceleration of ICMT, including reviewing core competencies followed by competency-driven shortened training duration or 'on the job' training, 'distance learning' or training using mobile phones. Linkages with other 'better-funded' programmes e.g. HIV or malaria need to be improved. Routine Primary Health Care (PHC supervision needs to include follow-up after ICMT.

  3. De behandeling van malaria

    NARCIS (Netherlands)

    Kager, P. A.; Zijlmans, C. W.; Boele van Hensbroek, M.; Wetsteyn, J. C.

    1997-01-01

    The diagnosis of malaria should include the species involved and in case of P. falciparum infection the parasitaemia index: the percentage of the infected red cells. P. vivax, ovale and malariae infection are treated with chloroquine, in case of P. vivax and ovale malaria followed by primaquine.

  4. Cancer Chemoprevention and Piperine: Molecular Mechanisms and Therapeutic Opportunities

    Directory of Open Access Journals (Sweden)

    Rafiq A. Rather

    2018-02-01

    Full Text Available Cancer is a genetic disease characterized by unregulated growth and dissemination of malignantly transformed neoplastic cells. The process of cancer development goes through several stages of biochemical and genetic alterations in a target cell. Several dietary alkaloids have been found to inhibit the molecular events and signaling pathways associated with various stages of cancer development and therefore are useful in cancer chemoprevention. Cancer chemoprevention has long been recognized as an important prophylactic strategy to reduce the burden of cancer on health care system. Cancer chemoprevention assumes the use of one or more pharmacologically active agents to block, suppress, prevent, or reverse the development of invasive cancer. Piperine is an active alkaloid with an excellent spectrum of therapeutic activities such as anti-oxidant, anti-inflammatory, immunomodulatory, anti-asthmatic, anti-convulsant, anti-mutagenic, antimycobacterial, anti-amoebic, and anti-cancer activities. In this article, we made an attempt to sum up the current knowledge on piperine that supports the chemopreventive potential of this dietary phytochemical. Many mechanisms have been purported to understand the chemopreventive action of piperine. Piperine has been reported to inhibit the proliferation and survival of many types of cancer cells through its influence on activation of apoptotic signaling and inhibition of cell cycle progression. Piperine is known to affect cancer cells in variety of other ways such as influencing the redox homeostasis, inhibiting cancer stem cell (CSC self-renewal and modulation of ER stress and autophagy. Piperine can modify activity of many enzymes and transcription factors to inhibit invasion, metastasis, and angiogenesis. Piperine is a potent inhibitor of p-glycoprotein (P-gp and has a significant effect on the drug metabolizing enzyme (DME system. Because of its inhibitory influence on P-gp activity, piperine can reverse

  5. Cohorts with familial disposition for colon cancers in chemoprevention trials.

    Science.gov (United States)

    Burt, R W

    1996-01-01

    Colon cancer provides an attractive setting for chemoprevention trials because of the frequency and variation of familial predisposition that is observed in this malignancy. Additionally, the adenomatous polyp, the precursor of colon cancer, is a valuable intermediate marker for judging the effectiveness of candidate chemopreventive agents. Inherited colon cancer susceptibility varies from mild to severe. Conditions with extreme susceptibility include the autosomal dominantly inherited syndromes of familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC). These are highly penetrant syndromes with extreme cancer risk. FAP arises from mutations of the APC gene and HNPCC from mutations of the mismatch repair genes. Specific and individual genetic diagnosis is now possible in both syndromes, thus allowing identification of genetically affected individuals for chemoprevention trials. FAP accounts for less than 1% of colon cancers, while HNPCC may be present in up to 5% of cases. Familial clustering is common in the remainder of cases, which are often referred to as sporadic, but probably arise in part from inherited susceptibility. Epidemiologic studies have shown that first-degree relatives have a two- to four-fold increased risk of acquiring colon cancer compared to the general population. Ten percent of individuals in the U.S. have a first-degree with colon cancer. This clinically identifiable higher risk group thus constitutes a large potential cohort for chemoprevention trials. The common familial cases of colon cancer can be further stratified by severity. A relative diagnosed under the age of 50 or two first-degree relatives affected with colon cancer confers an even greater risk for this malignancy, estimated to be four to six times that of the general population. Adenomatous polyps also precede the development of colon cancer in these categories, thereby providing a readily identifiable clinical endpoint to judge the

  6. School Processes That Can Drive Scaling-Up of an Innovation, or Contribute to Its Abandonment. Conference Paper

    Science.gov (United States)

    Zacamy, Jenna; Newman, Denis; Lazarev, Valeriy; Lin, Li

    2015-01-01

    This paper reports findings from a multi-year study of the scale-up of Reading Apprenticeship (RA), an approach to improve academic literacy by helping teachers provide the support students need to be successful readers in the content areas. WestEd's Strategic Literacy Initiative (SLI), began developing the program in 1995 and has since reached…

  7. Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice.

    Science.gov (United States)

    Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S; Palinkas, Lawrence A; Gunderson, Lara; Willging, Cathleen E; Chaffin, Mark J

    2014-01-01

    Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team approach. Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare. Semistructured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment framework. Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration; competing priorities across levels of leadership; power struggles; and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. System-wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.

  8. A Scale-up Approach for Film Coating Process Based on Surface Roughness as the Critical Quality Attribute.

    Science.gov (United States)

    Yoshino, Hiroyuki; Hara, Yuko; Dohi, Masafumi; Yamashita, Kazunari; Hakomori, Tadashi; Kimura, Shin-Ichiro; Iwao, Yasunori; Itai, Shigeru

    2018-01-05

    Scale-up approaches for film coating process have been established for each type of film coating equipment from thermodynamic and mechanical analyses for several decades. The objective of the present study was to establish a versatile scale-up approach for film coating process applicable to commercial production that is based on critical quality attribute (CQA) using the Quality by Design (QbD) approach and is independent of the equipment used. Experiments on a pilot scale using the Design of Experiment (DoE) approach were performed to find a suitable CQA from surface roughness, contact angle, color difference, and coating film properties by terahertz spectroscopy. Surface roughness was determined to be a suitable CQA from a quantitative appearance evaluation. When surface roughness was fixed as the CQA, the water content of the film-coated tablets was determined to be the critical material attribute (CMA), a parameter that does not depend on scale or equipment. Finally, to verify the scale-up approach determined from the pilot scale, experiments on a commercial scale were performed. The good correlation between the surface roughness (CQA) and the water content (CMA) identified at the pilot scale was also retained at the commercial scale, indicating that our proposed method should be useful as a scale-up approach for film coating process.

  9. Scale-up of a suspension-like polymerization process for the microencapsulation of phase change materials.

    Science.gov (United States)

    Sánchez-Silva, Luz; Carmona, Manuel; de Lucas, Antonio; Sánchez, Paula; Rodríguez, Juan F

    2010-01-01

    Microcapsules of polystyrene with a high level of encapsulated paraffin wax and a narrow size distribution were prepared by a suspension-like polymerization process. The scale-up of this microencapsulation process was carried out by designing a pilot plant that was geometrically proportional to that used on the laboratory scale with the aim of preparing microcapsules with a similar particle size and with the same phase change material (PCM) content as those obtained in the laboratory. In order to verify the effectiveness of the scale-up procedure, a number of experiments on the pilot plant were carried out using the optimal formulation found on the laboratory scale. Only slight differences in mean particle size and encapsulated paraffin content were observed between the two scales at higher stirring rates. The experimental values were fitted to the theoretical expression for the average dissipation rate as a function of the mean particle size. This showed that the classical nonintermittent Kolmogoroff theory is applicable on the laboratory scale, whereas in the pilot plant a large intermittence took place, thus limiting the scale-up to higher stirring rates at which an equal average dissipation rate in both scales led to the same mean particle size. The final results indicated that the assumptions made during the scale-up process were correct.

  10. Scaling up Corporate Social Investments in Education: Five Strategies That Work. Global Views. Policy Paper 2012-01

    Science.gov (United States)

    van Fleet, Justin W.

    2012-01-01

    Scaling up good corporate social investment practices in developing countries is crucial to realizing the "Education for All" and "Millennium Development Goals". Yet very few corporate social investments have the right mix of vision, financing, cross-sector engagement and leadership to come to scale. Globally, 67 million…

  11. Validation of a model for process development and scale-up of packed-bed solid-state bioreactors

    NARCIS (Netherlands)

    Weber, F.J.; Oostra, J.; Tramper, J.; Rinzema, A.

    2002-01-01

    We have validated our previously described model for scale-up of packed-bed solid-state fermenters (Weber et al., 1999) with experiments in an adiabatic 15-dm3 packed-bed reactor, using the fungi Coniothyrium minitans and Aspergillus oryzae. Effects of temperature on respiration, growth, and

  12. A novel Online-to-Offline (O2O model for pre-exposure prophylaxis and HIV testing scale up

    Directory of Open Access Journals (Sweden)

    Tarandeep Anand

    2017-01-01

    Conclusions: Adam’s Love O2O model is highly effective in linking online at-risk MSM and TG to PrEP and HIV testing services, and has high potential to be replicated and scaled up in other settings with high Internet penetration among key populations.

  13. Fenton chemistry-based detemplation of an industrially relevant microcrystalline beta zeolite. Optimization and scaling-up studies

    NARCIS (Netherlands)

    Ortiz-Iniesta, Maria Jesus; Melian-Cabrera, Ignacio

    A mild template removal of microcrystalline beta zeolite, based on Fenton chemistry, was optimized. Fenton detemplation was studied in terms of applicability conditions window, reaction rate and scale up. TGA and CHN elemental analysis were used to evaluate the detemplation effectiveness, while 'CP,

  14. High Temperature Syngas Cleanup Technology Scale-up and Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

    Gardner, Ben [Research Triangle Inst. (RTI), Research Triangle Park, NC (United States); Turk, Brian [Research Triangle Inst. (RTI), Research Triangle Park, NC (United States); Denton, David [Research Triangle Inst. (RTI), Research Triangle Park, NC (United States); Gupta, Raghubir [Research Triangle Inst. (RTI), Research Triangle Park, NC (United States)

    2015-09-30

    Gasification is a technology for clean energy conversion of diverse feedstocks into a wide variety of useful products such as chemicals, fertilizers, fuels, electric power, and hydrogen. Existing technologies can be employed to clean the syngas from gasification processes to meet the demands of such applications, but they are expensive to build and operate and consume a significant fraction of overall parasitic energy requirements, thus lowering overall process efficiency. RTI International has developed a warm syngas desulfurization process (WDP) utilizing a transport-bed reactor design and a proprietary attrition-resistant, high-capacity solid sorbent with excellent performance replicated at lab, bench, and pilot scales. Results indicated that WDP technology can improve both efficiency and cost of gasification plants. The WDP technology achieved ~99.9% removal of total sulfur (as either H2S or COS) from coal-derived syngas at temperatures as high as 600°C and over a wide range of pressures (20-80 bar, pressure independent performance) and sulfur concentrations. Based on the success of these tests, RTI negotiated a cooperative agreement with the U.S. Department of Energy for precommercial testing of this technology at Tampa Electric Company’s Polk Power Station IGCC facility in Tampa, Florida. The project scope also included a sweet water-gas-shift process for hydrogen enrichment and an activated amine process for 90+% total carbon capture. Because the activated amine process provides some additional non-selective sulfur removal, the integration of these processes was expected to reduce overall sulfur in the syngas to sub-ppmv concentrations, suitable for most syngas applications. The overall objective of this project was to mitigate the technical risks associated with the scale up and integration of the WDP and carbon dioxide capture technologies, enabling subsequent commercial-scale demonstration. The warm syngas cleanup pre-commercial test unit

  15. Scale-up of two-phase flow in heterogeneous chalk. Matrix properties

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-01

    This investigation presents scale-up of a detailed heterogeneous geostatistical model to a full field reservoir simulation model, considering both single and two-phase flow properties. The model represents a typical low permeability Danish North Sea chalk reservoir and includes capillary pressure and saturation end-point variations. Two new up-scaling methods has been investigated, all based on fine scale simulation on a cross section of the geomodel. The first methods assumes piston style behaviour and a coupled viscosity is introduced into the basic Darcy`s equations. The second method is a modification of the JBN method traditionally applied in analysing results from core flooding experiments, which emerged as the most successful and therefore also the recommended method. 1. In addition to the up scaling work we review the Equivalent Radius Method for capillary pressure normalisation with explicit derivation of type functions for Maastrichtian and Danian chalk types. Implementation of the Equivalent Radiuo Method in the COSI reservoir simulator by an optikal set of key-words. There are six specific results from this work: 1. The equivalent radius method is robust to changes of scale and yields model initialisations by initial and irreducible water saturations on a full field simulation scale that agree well with values derived from averaging on a fine-scale. 2. The residual oil saturations are strongly scale dependent and the description of the residual oil as a function of the irreducible water is not applicable on a full field scale and will lead to an overestimation of the residual oil present in the reservoir. The effective residual oil saturations on a full field-scale must be considered functions of the effective initial water saturations, in order to take into account fine-scale variations in the oil/water contacts. 3. The effective permeability as calculated by statistical averages does not differ seriously from results obtained by fine-grid numerical

  16. Solar thermal production of zinc - Final steps toward scale-up - Final report

    Energy Technology Data Exchange (ETDEWEB)

    Meier, A.

    2008-05-15

    A 10 kW receiver-reactor prototype (called ZIRRUS) was further improved and tested for the solar thermal de-composition of ZnO, which is the 1{sup st} step of the two-step water-splitting thermochemical ZnO/Zn cycle. The rotating cylindrical cavity was made of either sintered ZnO or sintered Al{sub 2}O{sub 3} tiles placed on top of a multi-layer Al{sub 2}O{sub 3}-SiO{sub 2}-Y{sub 2}O{sub 3}-based ceramics for thermal shock resistance, mechanical stability, gas diffusion barrier, and thermal insulation. Pre-heated Ar gas was injected for aerodynamic window protection and for minimizing recombination of product gases in the cavity. Experimentation was carried out at PSI's High-Flux Solar Simulator with the direct heating 10 kW reactor prototype subjected to peak radiative fluxes exceeding 5,800 suns. The reactor operated without incident for a total of more than 40 h at maximum temperatures - measured behind the ZnO and Al{sub 2}O{sub 3} tiles - ranging from 1807-1907 K. Thermal dissociation of ZnO(s) near 2000 K was demonstrated for experimental runs over 4 h in transient ablation mode with up to nine semi-continuous feed cycles of ZnO particles. A working Zn/O{sub 2} separation device based on the rapid quenching of the Zn/O{sub 2} mixture is ready to be incorporated at the exit of the solar reactor. Zinc yields of up to 94% were obtained when using total Ar/Zn(g) dilution of 530 and a cooling rate of about 10{sup 5} K/s. The fully integrated solar reactor will be scaled up to the pilot scale of 100 kW. A newly developed reactor model that couples radiation, conduction, and convection heat transfer to the reaction kinetics will allow determining optimal operational conditions for matching the feeding rate to the reaction rate and for maximizing solar-to-chemical energy conversion efficiency. The 2{sup nd} step of the ZnO/Zn cycle has been experimentally demonstrated at ETH using an aerosol-flow reactor for in-situ formation and hydrolysis of Zn nanoparticles

  17. Catalyzing the scale-up of community-based primary healthcare in a rural impoverished region of northern Ghana.

    Science.gov (United States)

    Awoonor-Williams, John Koku; Phillips, James F; Bawah, Ayaga A

    2016-10-01

    Ghana's Community-based Health Planning and Services (CHPS) initiative develops accessible healthcare with participatory community support, using strategies developed and tested by a project of the Navrongo Health Research Centre. In 1996, the project was expanded to a district-wide four-celled trial. In response to evidence that strategies could reduce fertility and childhood mortality, a replication project was launched to develop methods for scale-up. Based on experience gained, CHPS scale-up was launched in 2000. Although CHPS now reaches all of Ghana's districts, the pace of scale-up within districts has been slow. In response, the Ministry of Health conducted a review of factors that constrain CHPS scale-up and problems that detract from its original evidence-based design. To resolve problems that were identified, a project was launched in 2010 to test means of accelerating CHPS scale-up and expand its range of care. Known as the Ghana Essential Health Interventions Program (GEHIP), the project provided catalytic revenue to four treatment district managers for 3 years, in conjunction with implementation of strategies for comprehensive leadership development and community partnership. Monitoring systems were developed to gauge CHPS coverage time trends in all nine study districts. GEHIP successfully accelerated CHPS implementation, producing 100% of its targeted community coverage within 5 years of implementation. Coverage in comparison districts also improved. However, the rate of coverage and per cent of the population reached by CHPS in comparison districts was only half that of GEHIP districts. GEHIP success in completing CHPS coverage represents the initial stage of a national program for strengthening community health systems in Ghana. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Impact monitoring of the national scale up of zinc treatment for childhood diarrhea in Bangladesh: repeat ecologic surveys.

    Directory of Open Access Journals (Sweden)

    Charles P Larson

    2009-11-01

    Full Text Available BACKGROUND: Zinc treatment of childhood diarrhea has the potential to save 400,000 under-five lives per year in lesser developed countries. In 2004 the World Health Organization (WHO/UNICEF revised their clinical management of childhood diarrhea guidelines to include zinc. The aim of this study was to monitor the impact of the first national campaign to scale up zinc treatment of childhood diarrhea in Bangladesh. METHODS/FINDINGS: Between September 2006 to October 2008 seven repeated ecologic surveys were carried out in four representative population strata: mega-city urban slum and urban nonslum, municipal, and rural. Households of approximately 3,200 children with an active or recent case of diarrhea were enrolled in each survey round. Caretaker awareness of zinc as a treatment for childhood diarrhea by 10 mo following the mass media launch was attained in 90%, 74%, 66%, and 50% of urban nonslum, municipal, urban slum, and rural populations, respectively. By 23 mo into the campaign, approximately 25% of urban nonslum, 20% of municipal and urban slum, and 10% of rural under-five children were receiving zinc for the treatment of diarrhea. The scale-up campaign had no adverse effect on the use of oral rehydration salt (ORS. CONCLUSIONS: Long-term monitoring of scale-up programs identifies important gaps in coverage and provides the information necessary to document that intended outcomes are being attained and unintended consequences avoided. The scale-up of zinc treatment of childhood diarrhea rapidly attained widespread awareness, but actual use has lagged behind. Disparities in zinc coverage favoring higher income, urban households were identified, but these were gradually diminished over the two years of follow-up monitoring. The scale up campaign has not had any adverse effect on the use of ORS. Please see later in the article for the Editors' Summary.

  19. Scaling up paediatric HIV care with an integrated, family-centred approach: an observational case study from Uganda.

    Science.gov (United States)

    Luyirika, Emmanuel; Towle, Megan S; Achan, Joyce; Muhangi, Justus; Senyimba, Catherine; Lule, Frank; Muhe, Lulu

    2013-01-01

    Family-centred HIV care models have emerged as an approach to better target children and their caregivers for HIV testing and care, and further provide integrated health services for the family unit's range of care needs. While there is significant international interest in family-centred approaches, there is a dearth of research on operational experiences in implementation and scale-up. Our retrospective case study examined best practices and enabling factors during scale-up of family-centred care in ten health facilities and ten community clinics supported by a non-governmental organization, Mildmay, in Central Uganda. Methods included key informant interviews with programme management and families, and a desk review of hospital management information systems (HMIS) uptake data. In the 84 months following the scale-up of the family-centred approach in HIV care, Mildmay experienced a 50-fold increase of family units registered in HIV care, a 40-fold increase of children enrolled in HIV care, and nearly universal coverage of paediatric cotrimoxazole prophylaxis. The Mildmay experience emphasizes the importance of streamlining care to maximize paediatric capture. This includes integrated service provision, incentivizing care-seeking as a family, creating child-friendly service environments, and minimizing missed paediatric testing opportunities by institutionalizing early infant diagnosis and provider-initiated testing and counselling. Task-shifting towards nurse-led clinics with community outreach support enabled rapid scale-up, as did an active management structure that allowed for real-time review and corrective action. The Mildmay experience suggests that family-centred approaches are operationally feasible, produce strong coverage outcomes, and can be well-managed during rapid scale-up.

  20. Malaria in Children.

    Science.gov (United States)

    Cohee, Lauren M; Laufer, Miriam K

    2017-08-01

    Malaria is a leading cause of morbidity and mortality in endemic areas, leading to an estimated 438,000 deaths in 2015. Malaria is also an important health threat to travelers to endemic countries and should be considered in evaluation of any traveler returning from a malaria-endemic area who develops fever. Considering the diagnosis of malaria in patients with potential exposure is critical. Prompt provision of effective treatment limits the complications of malaria and can be life-saving. Understanding Plasmodium species variation, epidemiology, and drug-resistance patterns in the geographic area where infection was acquired is important for determining treatment choices. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M.; Bloch, Paul; Magnussen, Pascal

    2010-01-01

    seeking behaviour of pregnant women because it seriously affected their domestic responsibilities. CONCLUSION: A variety of resource-related factors were shown to affect the health seeking behaviour of pregnant women in rural Tanzania. Thus, accessibility to ANC services was hampered by direct......) service providers' application of fines, penalties and blame when failing to adhere to service schedules. Interestingly, the time associated with travelling long distances to ANC clinics and ITN retailers and with waiting for services at clinic-level was a major factor of discouragement in the health...... and indirect costs, travel distances and waiting time. Strengthening of user-fee exemption practices and bringing services closer to the users, for example by promoting community-directed control of selected public health services, including IPTp, are urgently needed measures for increasing equity in health...

  2. Shrimp Lipids: A Source of Cancer Chemopreventive Compounds

    Directory of Open Access Journals (Sweden)

    Armando Burgos-Hernández

    2013-10-01

    Full Text Available Shrimp is one of the most popular seafoods worldwide, and its lipids have been studied for biological activity in both, muscle and exoskeleton. Free fatty acids, triglycerides, carotenoids, and other lipids integrate this fraction, and some of these compounds have been reported with cancer chemopreventive activities. Carotenoids and polyunsaturated fatty acids have been extensively studied for chemopreventive properties, in both in vivo and in vitro studies. Their mechanisms of action depend on the lipid chemical structure and include antioxidant, anti-proliferative, anti-mutagenic, and anti-inflammatory activities, among others. The purpose of this review is to lay groundwork for future research about the properties of the lipid fraction of shrimp.

  3. Chemopreventive functional food through selenium biofortification of cauliflower plants

    Directory of Open Access Journals (Sweden)

    Anca Oancea

    2016-03-01

    Full Text Available The aim of this work was to develop a biotechnological approach for production of cauliflower as safe functional food, with an optimal content of chemopreventive compounds, by a protective biofortification, through selenium application together with betaine and spraying adjuvants. In the control and treated cauliflower plants we determined the amount of total selenium, glucosinolates (sulforaphane and SAH (S-Adenosyl-homocysteine. We also assayed the chemopreventive effects of compounds formed in the treated cruciferous plants through in vitro tests, using human colorectal tumor cell line (CaCo2. Extracts of plants treated with selenium applied together with betaine and spraying adjuvant were significantly more active on reduction of tumoral cell viability than the extract of control plants. Cauliflower plants, obtained after our treatments for protective biofortification, were used to feed rabbits, for 10 days. The ingestion of biofortified cauliflower did not modify the hematological and biochemical parameters on the laboratory animals.

  4. Role of saffron and its constituents on cancer chemoprevention

    Science.gov (United States)

    Zhang, Zhiyu; Wang, Chong-Zhi; Wen, Xiao-Dong; Shoyama, Yukihiro; Yuan, Chun-Su

    2014-01-01

    Context Cancer dramatically impacts human life expectancy and quality of life. Natural substances from vegetables, herbs and spices could be beneficial in the prevention or treatment of a variety of cancers. Crocus sativus, which has been used as a folk medicine for treating diseases for ages, showed obvious cancer chemoprevention potential. Objective This article focuses on the effects of Crocus sativus and its main ingredients, such as crocin, on cancer therapeutics. Methods We reviewed research data from saffron, a spice derived from the flower of Crocus sativus, and its constituents using the major databases, viz., Web of Science, SciFinder, and PubMed. Results and conclusion Saffron possesses free radical-scavenging properties and antitumor activities. Significant cancer chemopreventive effects have been shown in both in vitro and in vivo models. Based on current data, saffron and its ingredients could be considered as a promising candidate for clinical anticancer trials. PMID:23570520

  5. Role of saffron and its constituents on cancer chemoprevention.

    Science.gov (United States)

    Zhang, Zhiyu; Wang, Chong-Zhi; Wen, Xiao-Dong; Shoyama, Yukihiro; Yuan, Chun-Su

    2013-07-01

    Cancer dramatically impacts human life expectancy and quality of life. Natural substances from vegetables, herbs and spices could be beneficial in the prevention or treatment of a variety of cancers. Crocus sativus (Iridaceae), which has been used as a folk medicine for treating diseases for ages, showed obvious cancer chemoprevention potential. This article focuses on the effects of Crocus sativus and its main ingredients, such as crocin, on cancer therapeutics. We reviewed research data from saffron, a spice derived from the flower of Crocus sativus, and its constituents using the major databases, namely, Web of Science, SciFinder and PubMed. Saffron possesses free radical-scavenging properties and antitumor activities. Significant cancer chemopreventive effects have been shown in both in vitro and in vivo models. Based on current data, saffron and its ingredients could be considered as a promising candidate for clinical anticancer trials.

  6. Polyphenols: Key Issues Involved in Chemoprevention of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Sebastiano Cimino

    2012-01-01

    Full Text Available Prostate cancer is is the most common solid neoplasm and it is now recognized as one of the most important medical problems facing the male population. Due to its long latency and its identifiable preneoplastic lesions, prostate cancer is an ideal target tumor for chemoprevention. Different compounds are available and certainly polyphenols represent those with efficacy against prostate cancer. This review take a look at activity and properties of major polyphenolic substances, such as epigallocatechin-3-gallate, curcumin, resveratrol and the flavonoids quercetin and genistein. Although the current studies are limited, mechanisms of action of polyphenols added with the lack of side effects show a a start for future strategies in prostate chemoprevention.

  7. Chemoprevention of cancer: current evidence and future prospects [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Vassiliki Benetou

    2015-09-01

    Full Text Available Cancer chemoprevention refers to the use of agents for the inhibition, delay, or reversal of carcinogenesis before invasion. In the present review, agents examined in the context of cancer chemoprevention are classified in four major categories—hormonal, medications, diet-related agents, and vaccines—and the main representatives of each category are presented. Although there are serious constraints in the documentation of effectiveness of chemopreventive agents, mainly stemming from the long latency of the condition they are addressing and the frequent lack of intermediate biomarkers, there is little disagreement about the role of aspirin, whereas a diet rich in vegetables and fruits appears to convey more protection than individual micronutrients. Among categories of cancer chemopreventive agents, hormonal ones and vaccines might hold more promise for the future. Also, the identification of individuals who would benefit most from chemopreventive interventions on the basis of their genetic profiles could open new prospects for cancer chemoprevention.

  8. Chemoprevention of Breast Cancer: The Paradox of Evidence versus Advocacy Inaction

    Directory of Open Access Journals (Sweden)

    Rakhshanda Layeequr Rahman

    2012-10-01

    Full Text Available Women who are at high risk of breast cancer can be offered chemoprevention. Chemoprevention strategies have expanded over the past decade and include selective receptor modulator inhibitors and aromatase inhibitors. Physicians are expected to provide individualized risk assessments to identify high risk women who may be eligible for chemoprevention. It is prudent that physicians utilize a shared decision approach when counseling high risk women about their preventive options. Barriers and misperceptions however exist with patient and physician acceptance of chemoprevention and continue to impede uptake of chemoprevention as a strategy to reduce breast cancer risk. Programs to increase awareness and elucidate the barriers are critical for women to engage in cancer prevention and promote chemoprevention adherence.

  9. Synergistic chemopreventive effects of nobiletin and atorvastatin on colon carcinogenesis.

    Science.gov (United States)

    Wu, Xian; Song, Mingyue; Qiu, Peiju; Rakariyatham, Kanyasiri; Li, Fang; Gao, Zili; Cai, Xiaokun; Wang, Minqi; Xu, Fei; Zheng, Jinkai; Xiao, Hang

    2017-04-01

    Different cancer chemopreventive agents may act synergistically and their combination may produce enhanced protective effects against carcinogenesis than each individual agent alone. Herein, we investigated the chemopreventive effects of nobiletin (NBT, a citrus polymethoxyflavone) and atorvastatin (ATST, a lipid-lowering drug) in colon cancer cells/macrophages and an azoxymethane (AOM)-induced colon carcinogenesis rat model. The results demonstrated that co-treatments of NBT/ATST produced enhanced growth inhibitory and anti-inflammatory effects on the colon cancer cells and macrophages, respectively. Isobologram analysis confirmed that these interactions between NBT and ATST were synergistic. NBT/ATST co-treatment also synergistically induced extensive cell cycle arrest and apoptosis in colon cancer cells. Oral administration of NBT (0.1%, w/w in diet) or ATST (0.04%, w/w in diet) significantly decreased colonic tumor incidence and multiplicity in AOM-treated rats. Most importantly, co-treatment of NBT/ATST at their half doses (0.05% NBT + 0.02% ATST, w/w in diet) resulted in even stronger inhibitory effects on colonic tumor incidence and multiplicity than did NBT or ATST alone at higher doses. Statistical analysis confirmed that the enhanced chemopreventive activities against colon carcinogenesis in rats by the NBT/ATST combination were highly synergistic. Our results further demonstrated that NBT/ATST co-treatment profoundly modulated key cellular signaling regulators associated with inflammation, cell proliferation, cell cycle progression, apoptosis, angiogenesis and metastasis in the colon of AOM-treated rats. In conclusion, for the first time, our results demonstrated a strong synergy in inhibiting colon carcinogenesis produced by the co-treatment of NBT and ATST, which provided a scientific basis for using NBT in combination with ATST for colon cancer chemoprevention in humans. © The Author 2017. Published by Oxford University Press. All rights reserved

  10. Aspirin Metabolomics in Colorectal Cancer Chemoprevention | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): Substantial evidence supports the effectiveness of aspirin for cancer chemoprevention in addition to its well-established role in cardiovascular protection. In recent meta-analyses of randomized controlled trials in humans, daily aspirin use reduced incidence, metastasis and mortality from several common types of cancer, especially colorectal cancer. The mechanism(s) by which aspirin exerts an anticancer benefit is uncertain; numerous effects have been described involving both cyclooxygenase-dependent and -independent pathways. |

  11. Chemopreventive potential of natural compounds in head and neck cancer

    OpenAIRE

    Rahman, Mohammad Aminur; Amin, A.R.M. Ruhul; Shin, Dong M.

    2010-01-01

    Head and neck squamous cell carcinoma (HNSCC) is one of the most fatal cancers world-wide. Despite advances in the management of HNSCC, the overall survival for patients has not improved significantly due to advanced stages at diagnosis, high recurrence rate after surgical removal, and second primary tumor development, which together underscore the importance of novel strategies for cancer prevention. Cancer chemoprevention, the use of natural or synthetic compounds to prevent, arrest, or rev...

  12. Arsenic and skin cancer – Case report with chemoprevention

    OpenAIRE

    Uwe Wollina

    2016-01-01

    ABSTRACT Introduction: Arsenic is a potentially hazardous metalloid that can cause skin cancer. We want to demonstrate a case of chronic arsenicosis and the potential of chemoprevention with retinoids. Case Report: This is a case report of a 72-year-old male patient who was exposed to arsenics by dust and direct skin contact over 3 years in a chemical plant in the late fourties. He developed multiple arsenic keratosis clincialll resembling actinic keratoses, Bowen’s disease and palmar...

  13. Cancer chemopreventive activity of compounds isolated from Waltheria indica.

    Science.gov (United States)

    Monteillier, Aymeric; Cretton, Sylvian; Ciclet, Olivier; Marcourt, Laurence; Ebrahimi, Samad Nejad; Christen, Philippe; Cuendet, Muriel

    2017-05-05

    Waltheria indica L. is traditionally used in several countries against inflammatory related diseases and cancer, mainly as a decoction of the aerial parts. The transcription factor NF-κB is known to induce tumor promotion and progression and is considered a major player in inflammation-driven cancers. Therefore, inhibitors of this pathway possess cancer chemopreventive and chemotherapeutic activities. This study aimed first to confirm the use of Waltheria indica as a traditional anti-inflammatory remedy by assessing the NF-κB inhibitory activity and then to identify the major bioactive compounds. The isolated compounds were also tested for their QR inducing property, a complementary strategy in cancer chemoprevention able to target tumor initiation. Finally, the relevance of in vitro results was examined by investigating the occurrence of the active compounds in traditional preparations. Compounds were isolated from the dichloromethane extract of the aerial parts using flash chromatography and semi-preparative HPLC. NF-κB inhibitory activity of pure compounds from Waltheria indica was assessed using a luciferase reporter assay in HEK293 cells. Their QR inducing activity was also assessed in Hepa1c1c7 cells. Twenty-nine compounds, of which 5 are new, were obtained from the dichloromethane extract and tested for their cancer chemoprevention activity. Eleven compounds inhibited NF-κB and/or induced QR in the low to mid µM range. Chrysosplenol E (20) was active in both tests. Two of the most potent NF-κB inhibitors, waltherione A (4) and waltherione C (5), as well as 20 were found in the traditional decoction, in which 4 and 5 were major compounds. The presence of potent NF-κB inhibitors and QR inducing compounds in the decoction of the aerial parts of Waltheria indica supports its traditional use in inflammatory-related diseases and cancer chemoprevention. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  14. Malaria og graviditet

    DEFF Research Database (Denmark)

    Hoffmann, A L; Rønn, A M; Langhoff-Roos, J

    1992-01-01

    In regions where malaria is endemism, the disease is a recognised cause of complications of pregnancy such as spontaneous abortion, premature delivery, intrauterine growth retardation and foetal death. Malaria is seldom seen in pregnant women in Denmark but, during the past two years, the authors...... the patients but also their practitioners were unaware that malaria can occur several years after exposure. Three out of the four patients had employed malaria prophylaxis. As resistance to malarial prophylactics in current use is increasing steadily, chemoprophylaxis should be supplemented by mechanical...... protection against malaria and insect repellents. As a rule, malaria is treated with chloroquine. In cases of Falciparum malaria in whom chloroquine resistance is suspected, treatment with mefloquine may be employed although this should only be employed in cases of dire necessity in pregnant patients during...

  15. Malaria: Epidemiology and Diagnostic

    Directory of Open Access Journals (Sweden)

    Lukman Hakim

    2011-12-01

    Full Text Available Malaria is an infectious disease caused by Plasmodium spp, are naturally trans­mitted by the mosquito Anopheles spp. Malaria transmission occurs because of interaction between the agent, the definitive host and intermediate hosts (humans. Therefore, the trans­mission of malaria is injluenced by the presence and fluctuations in vector populations (i.e transmitting mosquito Anopheles spp.Malaria diagnosis consists of clinical diagnosis and diagnosis based on laboratory examina­tion. Clinical diagnosis or clinical malaria diagnosis was presumptive diagnosis of malaria based on clinical examination of patients with symptoms include fever (periodical, heat, level of consciousness, dizziness, etc. as well as specific local typical symptoms. Experiences of medical personnel who perform precise diagnosis will determine whether or not the diag­nosis, so that clinical diagnosis cannot be the main reference in the treatment of malaria be­cause of high error rates.

  16. Sulforaphane (SFN: An Isothiocyanate in a Cancer Chemoprevention Paradigm

    Directory of Open Access Journals (Sweden)

    Mohammad Fahad Ullah

    2015-07-01

    Full Text Available The International Agency for Research on Cancer (IARC in its latest World Cancer Report (2014 has projected the increase in the global cancer burden from 14 million (2012 to 22 million incidence annually within the next two decades. Such statistics warrant a collaborative engagement of conventional and complementary and alternative therapies to contain and manage cancer. In recent years, there has been a shift in the cancer chemoprevention paradigm with a significant focus turning towards bioactive components of human diets for their anticancer properties. Since diet is an integral part of lifestyle and given that an estimated one third of human cancers are believed to be preventable though appropriate lifestyle modification including dietary habits, the current shift in the conventional paradigm assumes significance. Several epidemiological studies have indicated that consumption of broccoli is associated with a lower risk of cancer incidence including breast, prostate, lung, stomach and colon cancer. The edible plant belonging to the family of cruciferae such as broccoli is a rich source of glucoraphanin, a precursor of isothiocyanate sulforaphane which is considered to be a potent anti-cancer agent. Plant-based dietary agents such as sulforaphane mimic chemotherapeutic drugs such as vorinostat, possessing histone deacetylase inhibition activity. Evidence from epidemiological and experimental studies have emerged, enhancing the clinical plausibility and translational value of sulforaphane in cancer chemoprevention. The present review provides the current understanding of the cancer chemopreventive pharmacology of sulforaphane towards its potential as an anticancer agent.

  17. Use of nonsteroidal antiinflamatory drugs for chemoprevention of colon cancer

    Directory of Open Access Journals (Sweden)

    Milić Aleksandra

    2013-01-01

    Full Text Available Colorectal cancer is in the third most frequent cancer among malignant tumors of both sexes in developed countries. It is predominantly a disease of older persons and occurs mostly after the age of 60. Although the etiology of colon cancer is unknown, it is assumed to arise as a result of unclear and complex interactions between genetic and environmental factors. The main element in the etiology of colorectal cancer is the process of genetic changes in epithelial cells of colon mucosa. It is believed that specific epidemiological factors such as stress, hypoxia, reduced intake of glucose and other nutrients, a hereditary predisposition to mutagenic effects, the meat in the diet, bile acids, reduced intake of minerals and vitamins as well as changes in pH of feces lead to initiation of the process of carcinogenesis in mucosa of the colon. Cancer chemoprevention is defined as the use of chemical agents in order to block, prevent or delay the reversal development or progress of cancer. It is believed that chemoprevention is a key component of cancer control, and numerous studies indicate potential role of NSAIDs in chemoprevention of colon cancer.

  18. Chemopreventive opportunities to control basal cell carcinoma: Current perspectives.

    Science.gov (United States)

    Tilley, Cynthia; Deep, Gagan; Agarwal, Rajesh

    2015-09-01

    Basal cell carcinoma (BCC) is a major health problem with approximately 2.8 million new cases diagnosed each year in the United States. BCC incidences have continued to rise due to lack of effective chemopreventive options. One of the key molecular characteristics of BCC is the sustained activation of hedgehog signaling through inactivating mutations in the tumor suppressor gene patch (Ptch) or activating mutations in Smoothened. In the past, several studies have addressed targeting the activated hedgehog pathway for the treatment and prevention of BCC, although with toxic effects. Other studies have attempted BCC chemoprevention through targeting the promotional phase of the disease especially the inflammatory component. The compounds that have been utilized in pre-clinical and/or clinical studies include green and black tea, difluoromethylornithine, thymidine dinucleotide, retinoids, non-steroidal anti-inflammatory drugs, vitamin D3, and silibinin. In this review, we have discussed genetic and epigenetic modifications that occur during BCC development as well as the current state of BCC pre-clinical and clinical chemoprevention studies. © 2015 Wiley Periodicals, Inc.

  19. Biomarkers and their use in cervical cancer chemoprevention.

    Science.gov (United States)

    Vlastos, Anne Thérèse; Schottenfeld, David; Follen, Michele

    2003-06-01

    Cervical cancer chemoprevention agents under study include diet and micronutrients (particularly beta-carotene, folate, and vitamins A, C, and E); medications such as retinoids (retinyl acetate gel, all-trans-retinoic acid, and 4-hydroxyphenylretinamide) that are chemically related to micronutrients; and other chemopreventives meant to affect the carcinogenic process at the cellular level, including such polyamine synthesis inhibitors as alpha-difluoromethylornithine. Agents become reasonable candidates for study when they have a biologic rationale, they are of low toxicity, and they can be taken for a long period of time. Since the human papillomavirus (HPV) is the major etiologic agent, the medication should show activity against HPV-positive preinvasive and invasive cell lines. The medication needs to be of low toxicity because it may be taken for long periods of time and less toxicity is tolerated in the precancerous setting. Until 1995, none of the studies used surrogate end point biomarkers (SEBs), relying instead on histologic and colposcopic regression as end points. All studies typically included subjects with cervical intraepithelial neoplasia. Conclusions to be drawn from these studies include the following: Though micronutrients are logical candidates for chemoprevention, they haven't worked consistently, and the reasons remain unclear. Furthermore, SEBs need to be validated in phase I trials. Finally, a better understanding of the role of HPV needs elucidation, including an understanding of the relationship of the medication to HPV status and of the immunobiology of HPV throughout the trial.

  20. Risk factors and chemoprevention in Barrett's esophagus--an update.

    Science.gov (United States)

    Winberg, Hanna; Lindblad, Mats; Lagergren, Jesper; Dahlstrand, Hanna

    2012-04-01

    Barrett's esophagus (BO) is a precursor of esophageal adenocarcinoma (OAC), a cancer with a poor prognosis and an increasing incidence. Hence there is an interest in mapping causal factors underlying BO and finding strategies to reduce the risk of dysplasia progression in patients with BO. Here we review current knowledge on established as well as less risk factors for the development of BO. Additionally, we summarize today's status on the use of chemoprevention aiming to reduce the risk of cancer progression in BO patients. We searched Medline and the Cochrane Library using the MeSH terms "Barrett's esophagus" and "Barrett esophagus," both alone and combined with the terms "risk factor," "aetiology," "diet," or "prevention." Focus was on original contributions, systematic reviews, and meta-analyses. Established risk factors for the development of BO include gastro-esophageal reflux, obesity, male gender, Caucasian ethnicity, and increasing age. Smoking might increase the risk of BO, while aspirin/NSAIDs, Helicobacter pylori infection, and specific "healthy" dietary factors may lower the risk. The potential value of using chemoprevention with proton pump inhibitors, aspirin/NSAIDs, or statins is still uncertain. There is today a substantial knowledge of risk factors of BO. Certain diet may be protective of BO, albeit yet to be proven. The efficiency of chemoprevention in BO is currently addressed further in randomized clinical trials.

  1. Green tea polyphenols for prostate cancer chemoprevention: A translational perspective

    Science.gov (United States)

    Johnson, J.J.; Bailey, H.H.; Mukhtar, H.

    2009-01-01

    Every year nearly 200,000 men in the United States are diagnosed with prostate cancer (PCa), and another 29,000 men succumb to the disease. Within certain regions of the world population based studies have identified a possible role for green tea in the prevention of certain cancers, especially PCa. One constituent in particular, epigallocatechin-3-gallate also known as EGCG has been shown in cell culture models to decrease cell viability and promote apoptosis in multiple cancer cell lines including PCa with no effect on non-cancerous cell lines. In addition, animal models have consistently shown that standardized green tea polyphenols when administered in drinking water delay the development and progression of PCa. Altogether, three clinical trials have been performed in PCa patients and suggest that green tea may have a distinct role as a chemopreventive agent. This review will present the available data for standardized green tea polyphenols in regard to PCa chemoprevention that will include epidemiological, mechanism based studies, safety, pharmacokinetics, and applicable clinical trials. The data that has been collected so far suggests that green tea may be a promising agent for PCa chemoprevention and further clinical trials of participants at risk of PCa or early stage PCa are warranted. PMID:19959000

  2. Arsenic and skin cancer – Case report with chemoprevention

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2016-04-01

    Full Text Available ABSTRACT Introduction: Arsenic is a potentially hazardous metalloid that can cause skin cancer. We want to demonstrate a case of chronic arsenicosis and the potential of chemoprevention with retinoids. Case Report: This is a case report of a 72-year-old male patient who was exposed to arsenics by dust and direct skin contact over 3 years in a chemical plant in the late fourties. He developed multiple arsenic keratosis clincialll resembling actinic keratoses, Bowen’s disease and palmar minute keratoses. To prevent a transformation into invasive cancer and to lower the burden of precancerous and in situ cancer lesions, he was treated orally with acitretin 20 mg/day. During 9 months of chemopreventive retinoid therapy a partial response of pre-existent skin lesions was noted. Treatment was well tolerated. During follow-up of 5 years no invasive malignancy developed. Conclusions: Intense exposure to arsenics during a relatively short period of 3 years bears a life-long health hazard with the delayed development of multiple in situ carcinomas and precancerous lesions. Chemoprevention with retinoids can induce a partial response.

  3. Jacalin Has Chemopreventive Effects on Colon Cancer Development

    Directory of Open Access Journals (Sweden)

    Thais Herrero Geraldino

    2017-01-01

    Full Text Available Colorectal cancer, which is one of the most common causes of cancer-related deaths worldwide, has a slow natural history that provides a great opportunity for prevention strategies. Plant-derived natural products have received considerable attention because of their inherent colorectal cancer chemopreventive effects. The plant lectin jacalin specifically recognizes the tumor-associated Thomsen-Friedenreich antigen and has antiproliferative effects on human colon cancer cells, highlighting its potential antitumor activity. To evaluate jacalin’s potential application in colorectal cancer chemoprevention, we studied its effects on the early stages of carcinogenesis. Balb/c mice were given 4 intrarectal deposits of 0.1 ml solution of Methyl-N′-Nitro-N-Nitroso-Guanidine (5 mg/ml twice a week (with a 3-day interval for 2 weeks. Starting 2 weeks before carcinogen administration, animals were treated orally with jacalin (0.5 and 25 μg three times a week (on alternate weekdays for 10 weeks. We show that jacalin treatment reduced the number of preneoplastic lesions in carcinogen-exposed mice. This anticarcinogenic activity was associated with decreased colonic epithelial cell proliferation and stromal COX-2 expression and with increased intestinal production of TNF-α. Our results demonstrate that jacalin is able to modulate the early stages of colon carcinogenesis and emphasize its promising chemopreventive activity in colorectal cancer.

  4. Jacalin Has Chemopreventive Effects on Colon Cancer Development.

    Science.gov (United States)

    Geraldino, Thais Herrero; Modiano, Patricia; Veronez, Luciana Chain; Flória-Santos, Milena; Garcia, Sergio Britto; Pereira-da-Silva, Gabriela

    2017-01-01

    Colorectal cancer, which is one of the most common causes of cancer-related deaths worldwide, has a slow natural history that provides a great opportunity for prevention strategies. Plant-derived natural products have received considerable attention because of their inherent colorectal cancer chemopreventive effects. The plant lectin jacalin specifically recognizes the tumor-associated Thomsen-Friedenreich antigen and has antiproliferative effects on human colon cancer cells, highlighting its potential antitumor activity. To evaluate jacalin's potential application in colorectal cancer chemoprevention, we studied its effects on the early stages of carcinogenesis. Balb/c mice were given 4 intrarectal deposits of 0.1 ml solution of Methyl-N'-Nitro-N-Nitroso-Guanidine (5 mg/ml) twice a week (with a 3-day interval) for 2 weeks. Starting 2 weeks before carcinogen administration, animals were treated orally with jacalin (0.5 and 25 μg) three times a week (on alternate weekdays) for 10 weeks. We show that jacalin treatment reduced the number of preneoplastic lesions in carcinogen-exposed mice. This anticarcinogenic activity was associated with decreased colonic epithelial cell proliferation and stromal COX-2 expression and with increased intestinal production of TNF-α. Our results demonstrate that jacalin is able to modulate the early stages of colon carcinogenesis and emphasize its promising chemopreventive activity in colorectal cancer.

  5. Scaled-Up Production and Transport Applications of Graphitic Carbon Nanomaterials

    Science.gov (United States)

    Saviers, Kimberly R.

    Graphitic carbon nanomaterials enhance the performance of engineered systems for energy harvesting and storage. However, commercial availability remains largely cost-prohibitive due to technical barriers to mass production. This thesis examines both the scaled-up production and energy transport applications of graphitic materials. Cost driven-production of graphitic petals is developed, carbon nanotube array thermal interface materials enhance waste heat energy harvesting, and microsupercapacitors are visually examined using a new electroreflectance measurement method. Graphitic materials have previously been synthesized using batch-style processing methods with small sample sizes, limiting their commercial viability. In order to increase production throughput, a roll-to-roll radio-frequency plasma chemical vapor deposition method is employed to continuously deposit graphitic petals on carbon fiber tow. In consideration of a full production framework, efficient and informative characterization methods in the form of electrical resistance and electrochemical capacitance are highlighted. To co-optimize the functional characteristics of the material, the processing conditions are comprehensively varied using a data-driven predictive design of experiments method. Repeatable and reliable production of graphitic materials will enable a host of creative graphene-based devices to emerge into the marketplace. Two such applications are discussed in the remaining chapters. Waste heat is most efficiently harvested at high temperatures, such as vehicle exhaust systems near 600°C. However, the resistance to heat flux at the interfaces between the harvesting device and its surroundings is detrimental to the system-level performance. To study the performance of thermal interface materials up to 700°C, a reference bar measurement method was designed. Design considerations are discussed and compared to past implementations, particularly regarding radiation heat flux and thermal

  6. Adherence to malaria diagnosis and treatment guidelines among healthcare workers in Ogun State, Nigeria.

    Science.gov (United States)

    Bamiselu, Oluyomi F; Ajayi, IkeOluwapo; Fawole, Olufunmilayo; Dairo, David; Ajumobi, Olufemi; Oladimeji, Abisola; Steven, Yoon

    2016-08-19

    Malaria case management remains a vital component of malaria control strategies. Despite the introduction of national malaria treatment guidelines and scale-up of malaria control interventions in Nigeria, anecdotal evidence shows some deviations from the guidelines in malaria case management. This study assessed factors influencing adherence to malaria diagnosis and treatment guidelines among healthcare workers in public and private sectors in Ogun State, Nigeria. A comparative cross-sectional study was carried out among 432 (216 public and 216 private) healthcare workers selected from nine Local Government Areas using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on availability and use of malaria Rapid Diagnostic Test (mRDT) and artemisinin combination therapy (ACT), for management of uncomplicated malaria. Adherence was defined as when choice of antimalarials for parasitological confirmed malaria cases was restricted to recommended antimalarial medicines. Association between adherence and independent variables were tested using Chi-square at 5 % level of significance. Malaria RDT was available in 81.9 % of the public health facilities and 19.4 % of the private health facilities (p = 0.001). Its use was higher among public healthcare workers (85.2 %) compared to 32.9 % in private facilities (p = 0.000). Presumptive diagnosis of malaria was higher among private healthcare workers (94.9 %) compared to 22.7 % public facilities (p = malaria diagnosis and treatment guidelines. Interventions to improve private sector engagement in implementation of the guidelines, training and supply of recommended antimalarial medicines should be intensified.

  7. Chemoprevention with Acetylsalicylic Acid, Vitamin D and Calcium Reduces Risk of Carcinogen-induced Lung Tumors

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, J

    2013-01-01

    Background/Aim: Research has shown that chemoprevention may be effective against the development of lung cancer. The purpose of the present study was to evaluate the effect of oral chemoprevention in a mouse model of tobacco carcinogen-induced lung tumor.......Background/Aim: Research has shown that chemoprevention may be effective against the development of lung cancer. The purpose of the present study was to evaluate the effect of oral chemoprevention in a mouse model of tobacco carcinogen-induced lung tumor....

  8. Australian clinicians and chemoprevention for women at high familial risk for breast cancer

    Directory of Open Access Journals (Sweden)

    Keogh Louise A

    2009-05-01

    Full Text Available Abstract Objectives Effective chemoprevention strategies exist for women at high risk for breast cancer, yet uptake is low. Physician recommendation is an important determinant of uptake, but little is known about clinicians' attitudes to chemoprevention. Methods Focus groups were conducted with clinicians at five Family Cancer Centers in three Australian states. Discussions were recorded, transcribed and analyzed thematically. Results Twenty three clinicians, including genetic counselors, clinical geneticists, medical oncologists, breast surgeons and gynaecologic oncologists, participated in six focus groups in 2007. The identified barriers to the discussion of the use of tamoxifen and raloxifene for chemoprevention pertained to issues of evidence (evidence for efficacy not strong enough, side-effects outweigh benefits, oophorectomy superior for mutation carriers, practice (drugs not approved for chemoprevention by regulatory authorities and not government subsidized, chemoprevention not endorsed in national guidelines and not many women ask about it, and perception (clinicians not knowledgeable about chemoprevention and women thought to be opposed to hormonal treatments. Conclusion The study demonstrated limited enthusiasm for discussing breast cancer chemoprevention as a management option for women at high familial risk. Several options for increasing the likelihood of clinicians discussing chemoprevention were identified; maintaining up to date national guidelines on management of these women and education of clinicians about the drugs themselves, the legality of "off-label" prescribing, and the actual costs of chemopreventive medications.

  9. Cactus pear: a natural product in cancer chemoprevention

    Directory of Open Access Journals (Sweden)

    Wang Jian

    2005-09-01

    Full Text Available Abstract Background Cancer chemoprevention is a new approach in cancer prevention, in which chemical agents are used to prevent cancer in normal and/or high-risk populations. Although chemoprevention has shown promise in some epithelial cancers, currently available preventive agents are limited and the agents are costly, generally with side effects. Natural products, such as grape seed, green tea, and certain herbs have demonstrated anti-cancer effects. To find a natural product that can be used in chemoprevention of cancer, we tested Arizona cactus fruit solution, the aqueous extracts of cactus pear, for its anti-cancer effects in cultured cells and in an animal model. Method Aqueous extracts of cactus pear were used to treat immortalized ovarian and cervical epithelial cells, as well as ovarian, cervical, and bladder cancer cells. Aqueous extracts of cactus pear were used at six concentrations (0, 0.5, 1, 5, 10 or 25% to treat cells for 1, 3, or 5 days. Growth inhibition, apoptosis induction, and cell cycle changes were analyzed in the cultured cells; the suppression of tumor growth in nude mice was evaluated and compared with the effect of a synthetic retinoid N-(4-hydroxyphernyl retinamide (4-HPR, which is currently used as a chemoprevention agent. Immunohistochemistry staining of tissue samples from animal tumors was performed to examine the gene expression. Results Cells exposed to cactus pear extracts had a significant increase in apoptosis and growth inhibition in both immortalized epithelial cells and cancer cells in a dose- and time-dependent manner. It also affected cell cycle of cancer cells by increasing G1 and decreasing G2 and S phases. Both 4-HPR and cactus pear extracts significantly suppressed tumor growth in nude mice, increased annexin IV expression, and decreased VEGF expression. Conclusion Arizona cactus pear extracts effectively inhibited cell growth in several different immortalized and cancer cell cultures, suppressed

  10. Sri Lanka Malaria Maps

    Directory of Open Access Journals (Sweden)

    van der Hoek Wim

    2003-07-01

    Full Text Available Abstract Background Despite a relatively good national case reporting system in Sri Lanka, detailed maps of malaria distribution have not been publicly available. Methods In this study, monthly records over the period 1995 – 2000 of microscopically confirmed malaria parasite positive blood film readings, at sub-district spatial resolution, were used to produce maps of malaria distribution across the island. Also, annual malaria trends at district resolution were displayed for the period 1995 – 2002. Results The maps show that Plasmodium vivax malaria incidence has a marked variation in distribution over the island. The incidence of Plasmodium falciparum malaria follows a similar spatial pattern but is generally much lower than that of P. vivax. In the north, malaria shows one seasonal peak in the beginning of the year, whereas towards the south a second peak around June is more pronounced. Conclusion This paper provides the first publicly available maps of both P. vivax and P. falciparum malaria incidence distribution on the island of Sri Lanka at sub-district resolution, which may be useful to health professionals, travellers and travel medicine professionals in their assessment of malaria risk in Sri Lanka. As incidence of malaria changes over time, regular updates of these maps are necessary.

  11. Two stage hydrolysis of corn stover at high solids content for mixing power saving and scale-up applications.

    Science.gov (United States)

    Liu, Ke; Zhang, Jian; Bao, Jie

    2015-11-01

    A two stage hydrolysis of corn stover was designed to solve the difficulties between sufficient mixing at high solids content and high power input encountered in large scale bioreactors. The process starts with the quick liquefaction to convert solid cellulose to liquid slurry with strong mixing in small reactors, then followed the comprehensive hydrolysis to complete saccharification into fermentable sugars in large reactors without agitation apparatus. 60% of the mixing energy consumption was saved by removing the mixing apparatus in large scale vessels. Scale-up ratio was small for the first step hydrolysis reactors because of the reduced reactor volume. For large saccharification reactors in the second step, the scale-up was easy because of no mixing mechanism was involved. This two stage hydrolysis is applicable for either simple hydrolysis or combined fermentation processes. The method provided a practical process option for industrial scale biorefinery processing of lignocellulose biomass. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Evaluation of ethanol production from corncob using Scheffersomyces (Pichia) stipitis CBS 6054 by volumetric scale-up

    Science.gov (United States)

    Jae-Won Lee; J.Y. Zhu; Danilo Scordia; Thomas W. Jeffries

    2011-01-01

    In scale-up, the potential of ethanol production by dilute sulfuric acid pretreatment using corncob was investigated. Pretreatments were performed at 170 °C with various acid concentrations ranging from 0% to 1.656% based on oven dry weight. Following pretreatment, pretreated biomass yield ranged from 59% to 67%. More than 90% of xylan was removed at 0.828% of sulfuric...

  13. Understanding the scaling-up of community energy niches through Strategic Niche Management Theory: insights from Finland

    OpenAIRE

    Ruggiero, Salvatore; Martiskainen, Mari; Onkila, Tiina

    2018-01-01

    The growing phenomenon of civil society involvement in renewable energy generation has attracted researchers’ interest. However, rather little is known of how a diverse and relatively small sector such as community energy could scale up and promote a change in energy production. We examine this issue through the lens of Strategic Niche Management (SNM) and conceptualize community energy as a socio-technical niche that holds the potential to promote a transition to renewable energy. Drawing on...

  14. Challenges and support for scaling up upcycling businesses in the UK: Insights from small-business entrepreneurs

    OpenAIRE

    Sung, Kyungeun; Cooper, Tim; Ramanathan, Usha; Singh, Jagdeep

    2017-01-01

    open access article Upcycling is the creation or modification of a product from used materials, components and products which is of equal or higher quality or value than the compositional elements. Within the context of increased product longevity, it enables a reduction in the use of raw materials by extending the lifetime of used materials, components and products, thereby increasing material efficiency and reducing industrial energy consumption. If scaled up to a considerable level thro...

  15. Scaling-up public sector childhood diarrhea management program: Lessons from Indian states of Gujarat, Uttar Pradesh and Bihar.

    Science.gov (United States)

    Kumar, Sanjeev; Roy, Rajashree; Dutta, Sucharita

    2015-12-01

    Diarrhea remains a leading cause of death among children under five in India. Public health sector is an important source for diarrhea treatment with oral rehydration salts (ORS) and zinc. In 2010, Micronutrient Initiative started a project to improve service delivery for childhood diarrhea management through public health sector in Gujarat, Uttar Pradesh (UP) and Bihar. This paper aims to highlight feasible strategies, experiences and lessons learned from scaling-up zinc and ORS for childhood diarrhea management in the public sector in three Indian states. The project was implemented in six districts of Gujarat, 12 districts of UP and 15 districts of Bihar, which includes 10.5 million children. Program strategies included capacity building of health care providers, expanding service delivery through community health workers (CHWs), providing supportive supervision to CHWs, ensuring supplies and conducting monitoring and evaluation. The lessons described in this paper are based on program data, government documents and studies that were used to generate evidence and inform program scale-up. 140 000 health personnel, including CHWs, were trained in childhood diarrhea management. During three years, CHWs had sustained knowledge and have treated and reported more than three million children aged 2-59 months having diarrhea, of which 84% were treated with both zinc and ORS. The successful strategies were scaled-up. It is feasible and viable to introduce and scale-up zinc and ORS for childhood diarrhea treatment through public sector. Community-based service delivery, timely and adequate supplies, trained staff and pro-active engagement with government were essential for program success.

  16. Constraints, synergies and avenues for scaling up breastfeeding, antibiotics for pneumonia and IMCI interventions in the Cusco region, Peru

    OpenAIRE

    Giselle Sarganas; Robert Scherpbier; Gericke, Christian A

    2012-01-01

    Objective: The purpose of this qualitative case study was to assess the feasibility of scaling up exclusive breastfeeding for 6 months, antibiotics for pneumonia and integrated management of childhood illness (IMCI) child interventions in three districts of the Cusco region, Peru. Methods: During field visits, constraints, synergies and solutions to the implementation of the selected interventions were collected through observational recording and interviews of mothers, health workers, and he...

  17. Scaling up of breastfeeding promotion programs in low- and middle-income countries: the "breastfeeding gear" model.

    Science.gov (United States)

    Pérez-Escamilla, Rafael; Curry, Leslie; Minhas, Dilpreet; Taylor, Lauren; Bradley, Elizabeth

    2012-11-01

    Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother-child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for scale up of BF programs in low- and middle-income countries. The review identified BF programs located in 28 countries in Africa, Latin America and the Caribbean, and Asia. Study designs included case studies, qualitative studies, and observational quantitative studies. Only 1 randomized, controlled trial was identified. A total of 22 enabling factors and 15 barriers were mapped into a scale-up framework termed "AIDED" that was used to build the parsimonious breastfeeding gear model (BFGM). Analogous to a well-oiled engine, the BFGM indicates the need for several key "gears" to be working in synchrony and coordination. Evidence-based advocacy is needed to generate the necessary political will to enact legislation and policies to protect, promote, and support BF at the hospital and community levels. This political-policy axis in turn drives the resources needed to support workforce development, program delivery, and promotion. Research and evaluation are needed to sustain the decentralized program coordination "gear" required for goal setting and system feedback. The BFGM helps explain the different levels of performance in national BF outcomes in Mexico and Brazil. Empirical research is recommended to further test the usefulness of the AIDED framework and BFGM for global scaling up of BF programs.

  18. A country on the verge of malaria elimination--the Kingdom of Saudi Arabia.

    Directory of Open Access Journals (Sweden)

    Michael Coleman

    Full Text Available Significant headway has been made in the global fight against malaria in the past decade and as more countries enter the elimination phase, attention is now focused on identifying effective strategies to shrink the malaria map. Saudi Arabia experienced an outbreak of malaria in 1998, but is now on the brink of malaria elimination, with just 82 autochthonous cases reported in 2012. A review of published and grey literature was performed to identify the control strategies that have contributed to this achievement. The number of autochthonous malaria cases in Saudi Arabia decreased by 99.8% between 1998 and 2012. The initial steep decline in malaria cases coincided with a rapid scaling up of vector control measures. Incidence continued to be reported at low levels (between 0.01 and 0.1 per 1,000 of the population until the adoption of artesunate plus sulfadoxine-pyrimethamine as first line treatment and the establishment of a regional partnership for a malaria-free Arabian Peninsula, both of which occurred in 2007. Since 2007, incidence has decreased by nearly an order of magnitude. Malaria incidence is now very low, but a high proportion of imported cases, continued potential for autochthonous transmission, and an increased proportion of cases attributable to Plasmodium vivax all present challenges to Saudi Arabia as they work toward elimination by 2015.

  19. Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa.

    Directory of Open Access Journals (Sweden)

    Kelly Curran

    2011-11-01

    Full Text Available Voluntary medical male circumcision (VMMC reduces female-to-male HIV transmission by approximately 60%; modeling suggests that scaling up VMMC to 80% of men 15- to 49-years-old within five years would avert over 3.3 million new HIV infections in 14 high priority countries/regions in southern and eastern Africa by 2025 and would require 20.33 million circumcisions. However, the shortage of health professionals in these countries must be addressed to reach these proposed coverage levels. To identify human resource approaches that are being used to improve VMMC volume and efficiency, we looked at previous literature and conducted a program review. We identified surgical efficiencies, non-surgical efficiencies, task shifting, task sharing, temporary redeployment of public sector staff during VMMC campaign periods, expansion of the health workforce through recruitment of unemployed, recently retired, newly graduating, or on-leave health care workers, and the use of volunteer medical staff from other countries as approaches that address human resource constraints. Case studies from Kenya, Tanzania, and Swaziland illustrate several innovative responses to human resource challenges. Although the shortage of skilled personnel remains a major challenge to the rapid scale-up of VMMC in the 14 African priority countries/regions, health programs throughout the region may be able to replicate or adapt these approaches to scale up VMMC for public health impact.

  20. An effective and simplified scale-up strategy for acarbose fermentation based on the carbon source control.

    Science.gov (United States)

    Li, Kun-tai; Wie, Sai-jin; Huang, Lin; Cheng, Xin

    2012-02-01

    The scale-up strategy for acarbose fermentation by Actinoplanes sp. A56 was explored in this paper. The results obtained in shake-flask cultivation demonstrated that the ratio of maltose and glucose had significant effects on the biosynthesis of acarbose, and the feeding medium containing 3:1 (mass ratio) of maltose and glucose was favorable for acarbose production. Then the correlation of the carbon source concentration with acarbose production was further investigated in 100-l fermenter, and the results showed that 7.5-8.0 g of total sugar/100 ml and 4.0-4.5 g of reducing sugar/100 ml were optimal for acarbose production. Based on the results in 100-l fermenter, an effective and simplified scale-up strategy was successfully established for acarbose fermentation in a 30-m(3) fermenter, by using total sugar and reducing sugar as the scale-up parameter. As a result, 4,327 mg of acarbose/l was obtained at 168 h of fermentation.

  1. At-line process analytical technology (PAT) for more efficient scale up of biopharmaceutical microfiltration unit operations.

    Science.gov (United States)

    Watson, Douglas S; Kerchner, Kristi R; Gant, Sean S; Pedersen, Joseph W; Hamburger, James B; Ortigosa, Allison D; Potgieter, Thomas I

    2016-01-01

    Tangential flow microfiltration (MF) is a cost-effective and robust bioprocess separation technique, but successful full scale implementation is hindered by the empirical, trial-and-error nature of scale-up. We present an integrated approach leveraging at-line process analytical technology (PAT) and mass balance based modeling to de-risk MF scale-up. Chromatography-based PAT was employed to improve the consistency of an MF step that had been a bottleneck in the process used to manufacture a therapeutic protein. A 10-min reverse phase ultra high performance liquid chromatography (RP-UPLC) assay was developed to provide at-line monitoring of protein concentration. The method was successfully validated and method performance was comparable to previously validated methods. The PAT tool revealed areas of divergence from a mass balance-based model, highlighting specific opportunities for process improvement. Adjustment of appropriate process controls led to improved operability and significantly increased yield, providing a successful example of PAT deployment in the downstream purification of a therapeutic protein. The general approach presented here should be broadly applicable to reduce risk during scale-up of filtration processes and should be suitable for feed-forward and feed-back process control. © 2015 American Institute of Chemical Engineers.

  2. Up-scaling expectations among Pakistan's HIV bureaucrats: entrepreneurs of the self and job precariousness post-scale-up.

    Science.gov (United States)

    Qureshi, Ayaz

    2014-01-01

    Existing research has documented how the expansion of HIV programming has produced new subjectivities among the recipients of interventions. However, this paper contends that changes in politics, power and subjectivities may also be seen among the HIV bureaucracy in the decade of scale-up. One year's ethnographic fieldwork was conducted among AIDS control officials in Pakistan at a moment of rolling back a World Bank-financed Enhanced Programme. In 2003, the World Bank convinced the Musharraf regime to scale up the HIV response, offering a multimillion dollar soft loan package. I explore how the Enhanced Programme initiated government employees into a new transient work culture and turned the AIDS control programmes into a hybrid bureaucracy. However, the donor money did not last long and individuals' entrepreneurial abilities were tested in a time of crisis engendered by dependence on aid, leaving them precariously exposed to job insecurity, and undermining the continuity of AIDS prevention and treatment in the country. I do not offer a story of global 'best practices' thwarted by local 'lack of capacity', but an ethnographic critique of the transnational HIV apparatus and its neoliberal underpinning. I suggest that this Pakistan-derived analysis is more widely relevant in the post-scale-up decade.

  3. Process scale-up considerations for non-thermal atmospheric-pressure plasma synthesis of nanoparticles by homogenous nucleation

    Science.gov (United States)

    Cole, Jonathan; Zhang, Yao; Liu, Tianqi; Liu, Chang-jun; Mohan Sankaran, R.

    2017-08-01

    Scale-up of non-thermal atmospheric-pressure plasma reactors for the synthesis of nanoparticles by homogeneous nucleation is challenging because the active volume is typically reduced to facilitate gas breakdown, enhance discharge stability, and limit particle size and agglomeration, but thus limits throughput. Here, we introduce a dielectric barrier discharge reactor consisting of a coaxial electrode geometry for nanoparticle production that enables a simple scale-up strategy whereby increasing the outer and inner electrode diameters, the plasma volume is increased approximately linearly, while maintaining a sufficiently small electrode gap to maintain the electric field strength. We show with two test reactors that for a given residence time, the nanoparticle production rate increases linearly with volume over a range of precursor concentrations, while having minimal effect on the shape of the particle size distribution. However, our study also reveals that increasing the total gas flow rate in a smaller volume reactor leads to an enhancement of precursor conversion and a comparable production rate to a larger volume reactor. These results suggest that scale-up requires better understanding of the influence of reactor geometry on particle growth dynamics and may not always be a simple function of reactor volume.

  4. Congenital Malaria in China

    Science.gov (United States)

    Liu, Xue; Culleton, Richard; Tao, Li; Xia, Hui; Gao, Qi

    2014-01-01

    Abstract Background Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria-endemic regions. It is recognized as a serious problem in Plasmodium falciparum–endemic sub-Saharan Africa, where recent data suggests that it is more common than previously believed. In such regions where malaria transmission is high, neonates may be protected from disease caused by congenital malaria through the transfer of maternal antibodies against the parasite. However, in low P. vivax–endemic regions, immunity to vivax malaria is low; thus, there is the likelihood that congenital vivax malaria poses a more significant threat to newborn health. Malaria had previously been a major parasitic disease in China, and congenital malaria case reports in Chinese offer valuable information for understanding the risks posed by congenital malaria to neonatal health. As most of the literature documenting congenital malaria cases in China are written in Chinese and therefore are not easily accessible to the global malaria research community, we have undertaken an extensive review of the Chinese literature on this subject. Methods/Principal Findings Here, we reviewed congenital malaria cases from three major searchable Chinese journal databases, concentrating on data from 1915 through 2011. Following extensive screening, a total of 104 cases of congenital malaria were identified. These cases were distributed mainly in the eastern, central, and southern regions of China, as well as in the low-lying region of southwest China. The dominant species was P. vivax (92.50%), reflecting the malaria parasite species distribution in China. The leading clinical presentation was fever, and other clinical presentations were anaemia, jaundice, paleness, diarrhoea, vomiting, and general weakness. With the exception of two cases, all patients were cured

  5. Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

    Science.gov (United States)

    Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

    2013-08-23

    providing only malaria control services. This underlines the importance of scaling-up VMWs' capacity by adding child health services of good quality, which will result in improving child health status in remote Cambodia.

  6. HIV AND MALARIA

    Directory of Open Access Journals (Sweden)

    Ririek Parwitasari

    2014-01-01

    Full Text Available IV/AIDS is a global problem involving industrialized and developing country including Indonesia. Malaria has killed millions ofhuman beings almost 3 million people each year, whereas since 1999, nearly 36 million people in the world infected with HIV and 3 million more have died (Kakilaya, 2006. HIV infection increases the risk and aggravate malaria. In Africa in the area of malaria transmission intensities high and low, HIVaggravate malaria and improve case fatality at any age (Eline 2006. HIVis an RNA viruses whose hallmark is the reverse transcriptation ofits genomic. Malaria is a protozoan disease transmitted by the bite ofinfected anopheles mosquito. Infection malaria can stimulate HIV replication and may cause faster progression ofHIV disease.

  7. A process evaluation of the scale up of a youth-friendly health services initiative in northern Tanzania

    Directory of Open Access Journals (Sweden)

    Renju Jenny

    2010-08-01

    Full Text Available Abstract Background While there are a number of examples of successful small-scale, youth-friendly services interventions aimed at improving reproductive health service provision for young people, these projects are often short term and have low coverage. In order to have a significant, long-term impact, these initiatives must be implemented over a sustained period and on a large scale. We conducted a process evaluation of the 10-fold scale up of an evaluated youth-friendly services intervention in Mwanza Region, Tanzania, in order to identify key facilitating and inhibitory factors from both user and provider perspectives. Methods The intervention was scaled up in two training rounds lasting six and 10 months. This process was evaluated through the triangulation of multiple methods: (i a simulated patient study; (ii focus group discussions and semi-structured interviews with health workers and trainers; (iii training observations; and (iv pre- and post-training questionnaires. These methods were used to compare pre- and post-intervention groups and assess differences between the two training rounds. Results Between 2004 and 2007, local government officials trained 429 health workers. The training was well implemented and over time, trainers' confidence and ability to lead sessions improved. The district-led training significantly improved knowledge relating to HIV/AIDS and puberty (RR ranged from 1.06 to 2.0, attitudes towards condoms, confidentiality and young people's right to treatment (RR range: 1.23-1.36. Intervention health units scored higher in the family planning and condom request simulated patient scenarios, but lower in the sexually transmitted infection scenario than the control health units. The scale up faced challenges in the selection and retention of trained health workers and was limited by various contextual factors and structural constraints. Conclusions Youth-friendly services interventions can remain well delivered, even

  8. Malaria and Tropical Travel

    Centers for Disease Control (CDC) Podcasts

    2008-05-15

    Malaria is a serious mosquito-borne disease that can lead to death. This podcast discusses malaria risk when traveling to tropical areas, as well as how to protect yourself and your family from malaria infection.  Created: 5/15/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 5/29/2008.

  9. Analysis of Preventive Interventions for Malaria: Exploring Partial and Complete Protection and Total and Primary Intervention Effects.

    Science.gov (United States)

    Cairns, Matthew; Cheung, Yin Bun; Xu, Ying; Asante, Kwaku Poku; Owusu-Agyei, Seth; Diallo, Diadier; Konate, Amadou T; Dicko, Alassane; Chandramohan, Daniel; Greenwood, Brian; Milligan, Paul

    2015-06-15

    Event dependence, the phenomenon in which future risk depends on past disease history, is not commonly accounted for in the statistical models used by malaria researchers. However, recently developed methods for the analysis of repeated events allow this to be done, while also accounting for heterogeneity in risk and nonsusceptible subgroups. Accounting for event dependence allows separation of the primary effect of an intervention from its total effect, which is composed of its primary effect on risk of disease and its secondary effect mediated by event dependence. To illustrate these methods and show the insights they can provide, we have reanalyzed 2 trials of seasonal malaria chemoprevention (SMC) in Boussé, Burkina Faso, and Kati, Mali, in 2008-2009, as well as a trial of intermittent preventive treatment of malaria in infants in Navrongo, Ghana, in 2000-2004. SMC completely protects a large fraction of recipients, while intermittent preventive treatment in infants provides modest partial protection, consistent with the rationale of these 2 different chemopreventive approaches. SMC has a primary effect that is substantially greater than the total effect previously estimated by trials, with the lower total effect mediated by negative event dependence. These methods contribute to an understanding of the mechanisms of protection from these interventions and could improve understanding of other tools to control malaria, including vaccines. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  10. Vaccines against malaria.

    Science.gov (United States)

    Ouattara, Amed; Laurens, Matthew B

    2015-03-15

    Despite global efforts to control malaria, the illness remains a significant public health threat. Currently, there is no licensed vaccine against malaria, but an efficacious vaccine would represent an important public health tool for successful malaria elimination. Malaria vaccine development continues to be hindered by a poor understanding of antimalarial immunity, a lack of an immune correlate of protection, and the genetic diversity of malaria parasites. Current vaccine development efforts largely target Plasmodium falciparum parasites in the pre-erythrocytic and erythrocytic stages, with some research on transmission-blocking vaccines against asexual stages and vaccines against pregnancy-associated malaria. The leading pre-erythrocytic vaccine candidate is RTS,S, and early results of ongoing Phase 3 testing show overall efficacy of 46% against clinical malaria. The next steps for malaria vaccine development will focus on the design of a product that is efficacious against the highly diverse strains of malaria and the identification of a correlate of protection against disease. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Childhood malaria admission rates to four hospitals in Malawi between 2000 and 2010.

    Directory of Open Access Journals (Sweden)

    Emelda A Okiro

    Full Text Available The last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance. However, there is only limited country-specific information on the health impact of expanded coverage of these interventions.Paediatric admission data were assembled from 4 hospitals in Malawi reflecting different malaria ecologies. Trends in monthly clinical malaria admissions between January 2000 and December 2010 were analysed using time-series models controlling for covariates related to climate and service use to establish whether changes in admissions can be related to expanded coverage of interventions aimed at reducing malaria infection.In 3 of 4 sites there was an increase in clinical malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean clinical malaria admission rates at two hospitals (trend P<0.05. At these hospitals clinical malaria admissions had increased from 2000 by 41% to 100%. Comparison of changes in malaria risk and ITN coverage appear to correspond to a lack of disease declines over the period. Changes in intervention coverage within hospital catchments showed minimal increases in ITN coverage from <6% across all sites in 2000 to maximum of 33% at one hospital site by 2010. Additionally, malaria transmission intensity remained unchanged between 2000-2010 across all sites.Despite modest increases in coverage of measures to reduce infection there has been minimal changes in paediatric clinical malaria cases in four hospitals in Malawi. Studies across Africa are increasingly showing a mixed set of impact results and it is important to assemble more data from more sites to understand the wider implications of malaria funding investment. We also caution that impact surveillance should continue in areas where intervention coverage is increasing with time, for example Malawi, as decline may become evident within a

  12. Time series analysis of trends in malaria cases and deaths at hospitals and the effect of antimalarial interventions, 2001-2011, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Maru Aregawi

    Full Text Available The Government of Ethiopia and its partners have deployed artemisinin-based combination therapies (ACT since 2004 and long-lasting insecticidal nets (LLINs since 2005. Malaria interventions and trends in malaria cases and deaths were assessed at hospitals in malaria transmission areas during 2001-2011.Regional LLINs distribution records were used to estimate the proportion of the population-at-risk protected by LLINs. Hospital records were reviewed to estimate ACT availability. Time-series analysis was applied to data from 41 hospitals in malaria risk areas to assess trends of malaria cases and deaths during pre-intervention (2001-2005 and post-interventions (2006-2011 periods.The proportion of the population-at-risk potentially protected by LLINs increased to 51% in 2011. The proportion of facilities with ACTs in stock exceeded 87% during 2006-2011. Among all ages, confirmed malaria cases in 2011 declined by 66% (95% confidence interval [CI], 44-79% and SPR by 37% (CI, 20%-51% compared to the level predicted by pre-intervention trends. In children under 5 years of age, malaria admissions and deaths fell by 81% (CI, 47%-94% and 73% (CI, 48%-86% respectively. Optimal breakpoint of the trendlines occurred between January and June 2006, consistent with the timing of malaria interventions. Over the same period, non-malaria cases and deaths either increased or remained unchanged, the number of malaria diagnostic tests performed reflected the decline in malaria cases, and rainfall remained at levels supportive of malaria transmission.Malaria cases and deaths in Ethiopian hospitals decreased substantially during 2006-2011 in conjunction with scale-up of malaria interventions. The decrease could not be accounted for by changes in hospital visits, malaria diagnostic testing or rainfall. However, given the history of variable malaria transmission in Ethiopia, more data would be required to exclude the possibility that the decrease is due to other factors.

  13. Time Series Analysis of Trends in Malaria Cases and Deaths at Hospitals and the Effect of Antimalarial Interventions, 2001–2011, Ethiopia

    Science.gov (United States)

    Aregawi, Maru; Lynch, Michael; Bekele, Worku; Kebede, Henok; Jima, Daddi; Taffese, Hiwot Solomon; Yenehun, Meseret Aseffa; Lilay, Abraham; Williams, Ryan; Thomson, Madeleine; Nafo-Traore, Fatoumata; Admasu, Kesetebirhan; Gebreyesus, Tedros Adhanom; Coosemans, Marc

    2014-01-01

    Background The Government of Ethiopia and its partners have deployed artemisinin-based combination therapies (ACT) since 2004 and long-lasting insecticidal nets (LLINs) since 2005. Malaria interventions and trends in malaria cases and deaths were assessed at hospitals in malaria transmission areas during 2001–2011. Methods Regional LLINs distribution records were used to estimate the proportion of the population-at-risk protected by LLINs. Hospital records were reviewed to estimate ACT availability. Time-series analysis was applied to data from 41 hospitals in malaria risk areas to assess trends of malaria cases and deaths during pre-intervention (2001–2005) and post-interventions (2006–2011) periods. Findings The proportion of the population-at-risk potentially protected by LLINs increased to 51% in 2011. The proportion of facilities with ACTs in stock exceeded 87% during 2006–2011. Among all ages, confirmed malaria cases in 2011 declined by 66% (95% confidence interval [CI], 44–79%) and SPR by 37% (CI, 20%–51%) compared to the level predicted by pre-intervention trends. In children under 5 years of age, malaria admissions and deaths fell by 81% (CI, 47%–94%) and 73% (CI, 48%–86%) respectively. Optimal breakpoint of the trendlines occurred between January and June 2006, consistent with the timing of malaria interventions. Over the same period, non-malaria cases and deaths either increased or remained unchanged, the number of malaria diagnostic tests performed reflected the decline in malaria cases, and rainfall remained at levels supportive of malaria transmission. Conclusions Malaria cases and deaths in Ethiopian hospitals decreased substantially during 2006–2011 in conjunction with scale-up of malaria interventions. The decrease could not be accounted for by changes in hospital visits, malaria diagnostic testing or rainfall. However, given the history of variable malaria transmission in Ethiopia, more data would be required to exclude the

  14. Telomerase as an Androgen Receptor-Regulated Target in Selenium Chemoprevention of Prostate Cancer

    Science.gov (United States)

    2011-04-01

    and Vita- min E Chemoprevention Trial (SELECT) indicated that supplementation of healthy individuals with nutritional dose of selenium did not reduce...were conducted by using pharmacologic doses of selenium , not the nutritional dose that was used in the SELECT. Therefore, the negative SELECT finding...Regulated Target in Selenium Chemoprevention of Prostate Cancer PRINCIPAL INVESTIGATOR: Shuang Liu, Ph.D

  15. Identification of dithiolethiones with better chemopreventive properties than oltipraz.

    Science.gov (United States)

    Maxuitenko, Y Y; Libby, A H; Joyner, H H; Curphey, T J; MacMillan, D L; Kensler, T W; Roebuck, B D

    1998-09-01

    Oltipraz and related dithiolethiones are an important class of chemopreventive agents. Studies were undertaken to identify cancer chemopreventive dithiolethiones more active than oltipraz. Largely based upon enzyme induction activities in vitro, 17 dithiolethiones, including oltipraz, were analyzed for their ability to induce hepatic phase II enzyme activities in vivo. Of these compounds, 15 produced greater induction of NAD(P)H:quinone reductase and 11 yielded greater induction of glutathione S-transferase than oltipraz. All 17 dithiolethiones were then tested for their ability to inhibit acute hepatotoxicity by aflatoxin B1 (AFB1), which previously has been shown to be an intermediate predictor of chemopreventive activity. Rats were pretreated with dithiolethiones (0.3 mmol/kg body wt, three times a week per os) and challenged with two acutely toxic doses of AFB1 (0.5 mg/kg body wt, once daily for two successive days per os). Inhibition of hepatotoxicity was measured by changes in body weight gain during AFB1 challenge, reduction in levels of hepatic enzymes in serum and diminution of bile duct cell proliferation. Nine dithiolethiones spanning a range of responses in this toxicity screen were further tested for their ability to prevent AFB1-induced tumorigenicity, as assessed by a reduction in hepatic burden of putative preneoplastic foci. Six dithiolethiones were found to be considerably more effective than oltipraz in preventing AFB1-induced tumorigenesis. In general, dithiolethiones that were very effective in inhibition of acute hepatotoxicity were also found to be effective in prevention of hepatic tumorigenesis.

  16. Nicotinamide and skin cancer chemoprevention: The jury is still out.

    Science.gov (United States)

    Gilmore, Stephen J

    2018-02-01

    Following the publication of the results of a Phase III trial, the administration of oral nicotinamide has been widely advocated as effective in non-melanoma skin cancer chemoprevention in high-risk individuals. However, I performed a Bayesian analysis of the reported findings and show there is insufficient evidence to demonstrate its efficacy, highlighting the significant probability that the positive conclusions drawn will not be reproducible. Given the potential widespread use of oral nicotinamide, future position statements regarding its efficacy are likely to require higher standards of evidence. © 2017 The Australasian College of Dermatologists.

  17. Chemoprevention targets for tobacco-related head and neck cancer: past lessons and future directions.

    Science.gov (United States)

    Sheth, Siddharth H; Johnson, Daniel E; Kensler, Thomas W; Bauman, Julie E

    2015-06-01

    Progress toward identifying an effective chemopreventive agent to reduce the incidence of head and neck squamous cell carcinoma (HNSCC) has been limited by poor efficacy and intolerable toxicity profiles. In this review, we summarize the biological basis of HNSCC chemoprevention, and outline challenges associated with identifying appropriate high-risk HNSCC populations for chemoprevention studies. We discuss findings and lessons learned from clinical trials that have investigated micronutrient and molecular targeting interventions. Finally, we introduce the concept of green chemoprevention, interventions based upon whole plant foods or simple extracts that may represent a safe and cost-conscious option for the next generation of studies. As our scientific understanding of HNSCC reaches new levels, the field is poised to develop chemoprevention studies based on rigorous biological validation with accessibility to all affected individuals regardless of socioeconomic barriers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. ADVANCING THE FUNDAMENTAL UNDERSTANDING AND SCALE-UP OF TRISO FUEL COATERS VIA ADVANCED MEASUREMENT AND COMPUTATIONAL TECHNIQUES

    Energy Technology Data Exchange (ETDEWEB)

    Biswas, Pratim; Al-Dahhan, Muthanna

    2012-11-01

    Tri-isotropic (TRISO) fuel particle coating is critical for the future use of nuclear energy produced byadvanced gas reactors (AGRs). The fuel kernels are coated using chemical vapor deposition in a spouted fluidized bed. The challenges encountered in operating TRISO fuel coaters are due to the fact that in modern AGRs, such as High Temperature Gas Reactors (HTGRs), the acceptable level of defective/failed coated particles is essentially zero. This specification requires processes that produce coated spherical particles with even coatings having extremely low defect fractions. Unfortunately, the scale-up and design of the current processes and coaters have been based on empirical approaches and are operated as black boxes. Hence, a voluminous amount of experimental development and trial and error work has been conducted. It has been clearly demonstrated that the quality of the coating applied to the fuel kernels is impacted by the hydrodynamics, solids flow field, and flow regime characteristics of the spouted bed coaters, which themselves are influenced by design parameters and operating variables. Further complicating the outlook for future fuel-coating technology and nuclear energy production is the fact that a variety of new concepts will involve fuel kernels of different sizes and with compositions of different densities. Therefore, without a fundamental understanding the underlying phenomena of the spouted bed TRISO coater, a significant amount of effort is required for production of each type of particle with a significant risk of not meeting the specifications. This difficulty will significantly and negatively impact the applications of AGRs for power generation and cause further challenges to them as an alternative source of commercial energy production. Accordingly, the proposed work seeks to overcome such hurdles and advance the scale-up, design, and performance of TRISO fuel particle spouted bed coaters. The overall objectives of the proposed work are

  19. Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up?

    Science.gov (United States)

    Tobi, Patrick; George, Gavin; Schmidt, Elena; Renton, Adrian

    2008-12-01

    To investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. Exploratory interviews with health managers and senior clinical staff were used to identify locally relevant work environment indicators. A self-reported Likert scale questionnaire was administered to a randomly selected cohort of 269 health professionals at health facilities in KwaZulu Natal and Western Cape provinces of South Africa that included ART delivery sites. The cohort was disaggregated into ART and non-ART groups and differences between the two compared with Fisher's exact test and the non-parametric Mann-Whitney U-test. The ART sub-cohort reported: (i) a lighter workload (P = 0.013), (ii) higher level of staffing (P = 0.010), (iii) lower sickness absence (P = 0.032), (iv) higher overall job satisfaction (P = 0.010), (v) poorer physical state of their work premises (P = 0.003), and (vi) higher staff turnover (P = 0.036). Conclusion Scale-up affects the work environment in ways that influence workers' motivation both positively and negatively. A net negative balance is likely to drive staff out-migration, undermine the quality of care and compromise the capacity of the programme to achieve significant scale. As health workers are the most important element of the health system, a comprehensive and systematic understanding of scale-up impacts on their working conditions and motivation needs to be an integral part of any delivery strategy.

  20. Population size estimation of men who have sex with men through the network scale-up method in Japan.

    Directory of Open Access Journals (Sweden)

    Satoshi Ezoe

    Full Text Available BACKGROUND: Men who have sex with men (MSM are one of the groups most at risk for HIV infection in Japan. However, size estimates of MSM populations have not been conducted with sufficient frequency and rigor because of the difficulty, high cost and stigma associated with reaching such populations. This study examined an innovative and simple method for estimating the size of the MSM population in Japan. We combined an internet survey with the network scale-up method, a social network method for estimating the size of hard-to-reach populations, for the first time in Japan. METHODS AND FINDINGS: An internet survey was conducted among 1,500 internet users who registered with a nationwide internet-research agency. The survey participants were asked how many members of particular groups with known population sizes (firepersons, police officers, and military personnel they knew as acquaintances. The participants were also asked to identify the number of their acquaintances whom they understood to be MSM. Using these survey results with the network scale-up method, the personal network size and MSM population size were estimated. The personal network size was estimated to be 363.5 regardless of the sex of the acquaintances and 174.0 for only male acquaintances. The estimated MSM prevalence among the total male population in Japan was 0.0402% without adjustment, and 2.87% after adjusting for the transmission error of MSM. CONCLUSIONS: The estimated personal network size and MSM prevalence seen in this study were comparable to those from previous survey results based on the direct-estimation method. Estimating population sizes through combining an internet survey with the network scale-up method appeared to be an effective method from the perspectives of rapidity, simplicity, and low cost as compared with more-conventional methods.

  1. Scaling-up a public health innovation: a comparative study of post-abortion care in Bolivia and Mexico.

    Science.gov (United States)

    Billings, Deborah L; Crane, Barbara B; Benson, Janie; Solo, Julie; Fetters, Tamara

    2007-06-01

    Post-abortion care (PAC), an innovation for treating women with complications of unsafe abortion, has been introduced in public health systems around the world since the 1994 International Conference on Population and Development (ICPD). This article analyzes the process of scaling-up two of the three key elements of the original PAC model: providing prompt clinical treatment to women with abortion complications and offering post-abortion contraceptive counseling and methods in Bolivia and Mexico. The conceptual framework developed from this comparative analysis includes the environmental context for PAC scale-up; the major influences on start-up, expansion, and institutionalization of PAC; and the health, financial, and social impacts of institutionalization. Start-up in both Bolivia and Mexico was facilitated by innovative leaders or catalyzers who were committed to introducing PAC services into public health care settings, collaboration between international organizations and public health institutions, and financial resources. Important processes for successful PAC expansion included strengthening political commitment to PAC services through research, advocacy, and partnerships; improving health system capacity through training, supervision, and development of service guidelines; and facilitating health system access to essential technologies. Institutionalization of PAC has been more successful in Bolivia than Mexico, as measured by a series of proposed indicators. The positive health and financial impacts of PAC institutionalization have been partially measured in Bolivia and Mexico. Other hypotheses--that scaling-up PAC will significantly reduce maternal mortality and morbidity, decrease abortion-related stigma, and prepare the way for efforts to reform restrictive abortion laws and policies--have yet to be tested.

  2. The BeUpstanding ProgramTM: Scaling up the Stand Up Australia Workplace Intervention for Translation into Practice

    Directory of Open Access Journals (Sweden)

    Genevieve N Healy

    2016-05-01

    Full Text Available Context and purpose: Too much sitting is now recognised as a common risk factor for several health outcomes, with the workplace identified as a key setting in which to address prolonged sitting time. The Stand Up Australia intervention was designed to reduce prolonged sitting in the workplace by addressing influences at multiple-levels, including the organisation, the environment, and the individual. Intervention success has been achieved within the context of randomised controlled trials, where research staff deliver several of the key intervention components. This study describes the initial step in the multi-phase process of scaling up the Stand Up Australia intervention for workplace translation. Methods: A research-government partnership was critical in funding and informing the prototype for the scaled up BeUpstanding programTM. Evidence, protocols and materials from Stand Up Australia were adapted in collaboration with funding partner Workplace Health and Safety Queensland to ensure consistency and compatibility with existing government frameworks and resources. In recognition of the key role of workplace champions in facilitating workplace health promotion programs, the BeUpstanding programTM is designed to be delivered through a stand-alone, free, website-based toolkit using a 'train the champion' approach. Key findings and significance: The BeUpstanding programTM was influenced by the increasing recognition of prolonged sitting as an emerging health issue as well as industry demand. The research-government partnership was critical in informing and resourcing the development of the scaled-up program.

  3. Bioprocess integration for human mesenchymal stem cells: From up to downstream processing scale-up to cell proteome characterization.

    Science.gov (United States)

    Cunha, Bárbara; Aguiar, Tiago; Carvalho, Sofia B; Silva, Marta M; Gomes, Ricardo A; Carrondo, Manuel J T; Gomes-Alves, Patrícia; Peixoto, Cristina; Serra, Margarida; Alves, Paula M

    2017-04-20

    To deliver the required cell numbers and doses to therapy, scaling-up production and purification processes (at least to the liter-scale) while maintaining cells' characteristics is compulsory. Therefore, the aim of this work was to prove scalability of an integrated streamlined bioprocess compatible with current good manufacturing practices (cGMP) comprised by cell expansion, harvesting and volume reduction unit operations using human mesenchymal stem cells (hMSC) isolated from bone marrow (BM-MSC) and adipose tissue (AT-MSC). BM-MSC and AT-MSC expansion and harvesting steps were scaled-up from spinner flasks to 2L scale stirred tank single-use bioreactor using synthetic microcarriers and xeno-free medium, ensuring high cellular volumetric productivities (50×106cellL-1day-1), expansion factors (14-16 fold) and cell recovery yields (80%). For the concentration step, flat sheet cassettes (FSC) and hollow fiber cartridges (HF) were compared showing a fairly linear scale-up, with a need to slightly decrease the permeate flux (30-50 LMH, respectively) to maximize cell recovery yield. Nonetheless, FSC allowed to recover 18% more cells after a volume reduction factor of 50. Overall, at the end of the entire bioprocess more than 65% of viable (>95%) hMSC could be recovered without compromising cell's critical quality attributes (CQA) of viability, identity and differentiation potential. Alongside the standard quality assays, a proteomics workflow based on mass spectrometry tools was established to characterize the impact of processing on hMSC's CQA; These analytical tools constitute a powerful tool to be used in process design and development. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Trends in malaria research in 11 Asian Pacific countries: an analysis of peer-reviewed publications over two decades

    Directory of Open Access Journals (Sweden)

    Taleo George

    2011-05-01

    Full Text Available Abstract Background Quantitative data are lacking on published malaria research. The purpose of the study is to characterize trends in malaria-related literature from 1990 to 2009 in 11 Asian-Pacific countries that are committed to malaria elimination as a national goal. Methods A systematic search was conducted for articles published from January 1990 to December 2009 in PubMed/MEDLINE using terms for malaria and 11 target countries (Bhutan, China, North Korea, Indonesia, Malaysia, Philippines, Solomon Islands, South Korea, Sri Lanka, Thailand and Vanuatu. The references were collated and categorized according to subject, Plasmodium species, and whether they contained original or derivative data. Results 2,700 articles published between 1990 and 2009 related to malaria in the target countries. The annual output of malaria-related papers increased linearly whereas the overall biomedical output from these countries grew exponentially. The percentage of malaria-related publications was nearly 3% (111/3741 of all biomedical publications in 1992 and decreased to less than 1% (118/12171; p Conclusions The proportion of malaria-related publications out of the overall biomedical output from the 11 target Asian-Pacific countries is decreasing. The discovery and evaluation of new, safe and effective drugs and vaccines is paramount. In addition the elimination of malaria will require operational research to implement and scale up interventions.

  5. Scaling up watershed model parameters: flow and load simulations of the Edisto River Basin, South Carolina, 2007-09

    Science.gov (United States)

    Feaster, Toby D.; Benedict, Stephen T.; Clark, Jimmy M.; Bradley, Paul M.; Conrads, Paul

    2014-01-01

    As part of an ongoing effort by the U.S. Geological Survey to expand the understanding of relations among hydrologic, geochemical, and ecological processes that affect fish-tissue mercury concentrations within the Edisto River Basin, analyses and simulations of the hydrology of the Edisto River Basin were made using the topography-based hydrological model (TOPMODEL). A primary focus of the investigation was to assess the potential for scaling up a previous application of TOPMODEL for the McTier Creek watershed, which is a small headwater catchment to the Edisto River Basin. Scaling up was done in a step-wise manner, beginning with applying the calibration parameters, meteorological data, and topographic-wetness-index data from the McTier Creek TOPMODEL to the Edisto River TOPMODEL. Additional changes were made for subsequent simulations, culminating in the best simulation, which included meteorological and topographic wetness index data from the Edisto River Basin and updated calibration parameters for some of the TOPMODEL calibration parameters. The scaling-up process resulted in nine simulations being made. Simulation 7 best matched the streamflows at station 02175000, Edisto River near Givhans, SC, which was the downstream limit for the TOPMODEL setup, and was obtained by adjusting the scaling factor, including streamflow routing, and using NEXRAD precipitation data for the Edisto River Basin. The Nash-Sutcliffe coefficient of model-fit efficiency and Pearson’s correlation coefficient for simulation 7 were 0.78 and 0.89, respectively. Comparison of goodness-of-fit statistics between measured and simulated daily mean streamflow for the McTier Creek and Edisto River models showed that with calibration, the Edisto River TOPMODEL produced slightly better results than the McTier Creek model, despite the substantial difference in the drainage-area size at the outlet locations for the two models (30.7 and 2,725 square miles, respectively). Along with the TOPMODEL

  6. Biogas potential of high strength municipal wastewater treatment in laboratory scale up-flow anaerobic slugde blanket (UASB) reactors

    OpenAIRE

    Safitri, Anissa Sukma

    2016-01-01

    The main focus of this study is investigating the effectiveness of anaerobic treatment of municipal wastewater for converting organic matter to methane production in anaerobic granular sludge reactors. In-house designed laboratory scale, up-flow anaerobic sludge blanket (UASB) reactor systems were set up for treating of high strength municipal wastewater treatment i.e. below 1200 mg COD/l under mesophilic condition (20 – 25 °C). Three UASB reactors were set up in the study; one reactor (React...

  7. Membrane-aerated biofilms for high rate biotreatment: performance appraisal, engineering principles, scale-up, and development requirements.

    Science.gov (United States)

    Syron, Eoin; Casey, Eoin

    2008-03-15

    Diffusion of the electron acceptor is the rate controlling step in virtually all biofilm reactors employed for aerobic wastewater treatment. The membrane-aerated biofilm reactor (MABR) is a technology that can deliver oxygen at high rates and transfer efficiencies, thereby enhancing the biofilm activity. This paper provides a comparative performance rate analysis of the MABR in terms of its application for carbonaceous pollutant removal, nitrification/denitrification and xenobiotic biotreatment. We also describe the mechanisms influencing process performance in the MABR and the inter-relationships between these factors. The challenges involved in scaling-up the process are discussed with recommendations for prioritization of research needs.

  8. Application of twin screw extrusion to the manufacture of cocrystals: scale-up of AMG 517-sorbic acid cocrystal production.

    Science.gov (United States)

    Daurio, Dominick; Nagapudi, Karthik; Li, Lan; Quan, Peter; Nunez, Fernando-Alvarez

    2014-01-01

    The application of twin screw extrusion (TSE) in the scale-up of cocrystal production was investigated by using AMG 517-sorbic acid as a model system. Extrusion parameters that influenced conversion to the cocrystal such as temperature, feed rate and screw speed were investigated. Extent of conversion to the cocrystal was found to have a strong dependence on temperature and a moderate dependence on feed rate and screw speed. Cocrystals made by the TSE process were found to have superior mechanical properties than solution grown cocrystals. Additionally, moving to a TSE process eliminated the need for solvent.

  9. Bacteraemia in cerebral malaria

    NARCIS (Netherlands)

    Enwere, G.; van Hensbroek, M. B.; Adegbola, R.; Palmer, A.; Onyiora, E.; Weber, M.; Greenwood, B.

    1998-01-01

    As part of a treatment trial of cerebral malaria, blood cultures were done in 276 Gambian children, aged between 1 and 9 years, with cerebral malaria. Fourteen (5%) of these were positive. The organisms isolated were Staphylococcus aureus (6), coliforms (4), Pseudomonas spp. (2), Salmonella spp. (1)

  10. Changing the Malaria Environment

    African Journals Online (AJOL)

    tega

    Changing the Malaria Environment. On Friday, 21st ... that malaria exerts a great burden in Africa, but even the World Health Organization (WHO) acknowledges the difficulty of counting ... Although selectivity and resistance also limits the deployment of biological control mechanisms, they represent local technologies.

  11. MALARIA AMONG CHILDREN (1)

    African Journals Online (AJOL)

    BACKGROUND: Malaria is the most important parasitic disease of humans affecting more than half of the world population, majority of ... of this study was to describe patterns and trend of severe and complicated malaria cases, which could partly measure impact of .... Core body temperature >40°C. Hyperbilirubinemia.

  12. Malaria at Johannesburg Hospital

    African Journals Online (AJOL)

    AGE GROUPS. There were 43 positive blood smears from 32 male and 11 female patients (median age 30 years; range 3 - 66 years). The incidence of malaria in the different age groups is shown in. Table I. Over the last 10 - 15 years the deterioration in the incidence of malaria in Mrica has been partly due to the increasing ...

  13. Fighting malaria without DDT

    International Development Research Centre (IDRC) Digital Library (Canada)

    Nancy Minogue

    The women are part of a successful Mexican initiative that is fighting malaria on many fronts. Through community involve- ment in control strategies, improved surveillance and treatment, and the use of new household spraying techniques, Mexico has dramatically reduced malaria transmission. In 2001 there were just 4,996 ...

  14. Scaling up a School-Based Sexual and Reproductive Health Intervention in Rural Tanzania: A Process Evaluation Describing the Implementation Realities for the Teachers

    Science.gov (United States)

    Renju, Jenny; Nyalali, Kija; Andrew, Bahati; Kishamawe, Coleman; Kimaryo, Micheal; Remes, Pieter; Changalucha, John; Obasi, Angela

    2010-01-01

    Little is known about the nature and mechanisms of factors that facilitate or inhibit the scale-up and subsequent implementation of school-based adolescent sexual and reproductive health (ASRH) interventions. We present process evaluation findings examining the factors that affected the 10-fold scale-up of such an intervention, focussing on…

  15. A SCALE-UP Mock-Up: Comparison of Student Learning Gains in High- and Low-Tech Active-Learning Environments

    Science.gov (United States)

    Soneral, Paula A. G.; Wyse, Sara A.

    2017-01-01

    Student-centered learning environments with upside-down pedagogies (SCALE-UP) are widely implemented at institutions across the country, and learning gains from these classrooms have been well documented. This study investigates the specific design feature(s) of the SCALE-UP classroom most conducive to teaching and learning. Using pilot survey…

  16. Identifying the Characteristics of Effective High Schools: Report from Year One of the National Center on Scaling up Effective Schools. Research Report

    Science.gov (United States)

    Rutledge, Stacey; Cohen-Vogel, Lora; Osborne-Lampkin, La'Tara

    2012-01-01

    The National Center on Scaling up Effective Schools (NCSU) is a five-year project working to develop, implement, and test new processes to scale up effective practices in high schools that districts will be able to apply within the context of their own unique goals and circumstances. This report describes the activities and findings of the first…

  17. MALARIA DI PURWOREJO

    Directory of Open Access Journals (Sweden)

    Harijani A. Marwoto

    2012-10-01

    Full Text Available Dalam 5 tahun terakhir banyak laporan tentang adanya peningkatan  angka penyakit yang dapat menimbulkan wabah di Jawa Tengah, terutama malaria. Angka malaria/API (Annual Parasite Incidence meningkat > 16 kali lipat, di mana 65% diantaranya berasal dari Purworejo. Masalah malaria tinggi meliputi 11 kecamatan, dengan jumlah desa HCI (High Case Incidence mencapai 171 buah. Masalah malaria tersebut meluas ke daerah pegunungan Menoreh (Magelang,    Wonosobo, Kebumen dan Banyumas. Bahkan sejak tahun 1999 mulai masuk wilayah Kota Purworejo.Sejak tahun 1999 telah dilakukan penelitian kerjasama antara Badan Penelitian dan Pengem­bangan Kesehatan (BPPK - Naval Medical Reseach Unit 2 (Namru 2 - Dinas Kesehatan Ka­bupaten (DKK Purworejo dalam berbagai aspek untuk penanggulangan malaria setempat.

  18. Severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2017-01-01

    BACKGROUND: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. METHODS: The European Network for Tropical Medicine and Travel Health (Trop......Net) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre...... for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria. RESULTS: From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections...

  19. Resveratrol in human cancer chemoprevention--choosing the 'right' dose.

    Science.gov (United States)

    Scott, Edwina; Steward, William P; Gescher, Andreas J; Brown, Karen

    2012-01-01

    There is now robust preclinical evidence to suggest that resveratrol possesses cancer chemopreventive properties. A series of clinical pilot studies has provided insights into its pharmacokinetics, and data on its human antineoplastic pharmacodynamics start to emerge. It is likely that resveratrol will be developed further in the clinic as a putative cancer chemopreventive agent. The question that remains unresolved is: What is the most suitable dose of resveratrol for effective cancer preventive intervention? Mechanistic studies in cells in vitro have almost invariably used concentrations of resveratrol in the 10(-5) to 10(-4)  M range, which is much higher than those which can be achieved in the human biophase after consumption of doses up to 1 g. Many of the preclinical efficacy studies in rodent models of carcinogenesis have employed doses which are dramatically above those which can be ingested with the diet. New experimental paradigms need to be used to obtain information on pharmacological changes elicited by resveratrol when present at very low concentrations or when administered at dietary-relevant doses. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Ginseng Metabolites on Cancer Chemoprevention: An Angiogenesis Link?

    Directory of Open Access Journals (Sweden)

    Chong-Zhi Wang

    2015-09-01

    Full Text Available Cancer is a leading cause of death in the United States. Angiogenesis inhibitors have been introduced for the treatment of cancer. Based on the fact that many anticancer agents have been developed from botanical sources, there is a significant untapped resource to be found in natural products. American ginseng is a commonly used herbal medicine in the U.S., which possesses antioxidant properties. After oral ingestion, natural ginseng saponins are biotransformed to their metabolites by the enteric microbiome before being absorbed. The major metabolites, ginsenoside Rg3 and compound K, showed significant potent anticancer activity compared to that of their parent ginsenosides Rb1, Rc, and Rd. In this review, the molecular mechanisms of ginseng metabolites on cancer chemoprevention, especially apoptosis and angiogenic inhibition, are discussed. Ginseng gut microbiome metabolites showed significant anti-angiogenic effects on pulmonary, gastric and ovarian cancers. This review suggests that in addition to the chemopreventive effects of ginseng compounds, as angiogenic inhibitors, ginsenoside metabolites could be used in combination with other cancer chemotherapeutic agents in cancer management.

  1. Grapefruit and its biomedical, antigenotoxic and chemopreventive properties.

    Science.gov (United States)

    Cristóbal-Luna, José Melesio; Álvarez-González, Isela; Madrigal-Bujaidar, Eduardo; Chamorro-Cevallos, Germán

    2018-02-01

    Grapefruit (Citrus paradisi Mcfad) is a perenifolium tree 5-6 m high with a fruit of about 15 cm in diameter, protected by the peel we can find about 11-14 segments (carpels), each of which is surrounded by a membrane and each containing the juice sacs, as well as the seeds. The fruit is made up of numerous compounds, and is known to have nutritive value because of the presence of various vitamins and minerals, among other chemicals. The fruit is also used in the field of gastronomy. Information has been accumulated regarding the participation of the fruit structures in a variety of biomedical, antigenotoxic and chemopreventive effects, surely related with the presence of the numerous chemicals that have been determined to constitute the fruit. Such studies have been carried out in different in vitro and in vivo experimental models, and in a few human assays. The information published so far has shown interesting results, therefore, the aims of the present review are to initially examine the main characteristics of the fruit, followed by systematization of the acquired knowledge concerning the biomedical, antigenotoxic and chemopreventive effects produced by the three main structures of the fruit: peel, seed, and pulp. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Antioxidative and Chemopreventive Properties of Vernonia amygdalina and Garcinia biflavonoid

    Directory of Open Access Journals (Sweden)

    Olatunde Owoeye

    2011-06-01

    Full Text Available Recently, considerable attention has been focused on dietary and medicinal phytochemicals that inhibit, reverse or retard diseases caused by oxidative and inflammatory processes. Vernonia amygdalina is a perennial herb belonging to the Asteraceae family. Extracts of the plant have been used in various folk medicines as remedies against helminthic, protozoal and bacterial infections with scientific support for these claims. Phytochemicals such as saponins and alkaloids, terpenes, steroids, coumarins, flavonoids, phenolic acids, lignans, xanthones, anthraquinones, edotides and sesquiterpenes have been extracted and isolated from Vernonia amygdalina. These compounds elicit various biological effects including cancer chemoprevention. Garcinia kola (Guttiferae seed, known as “bitter kola”, plays an important role in African ethnomedicine and traditional hospitality. It is used locally to treat illnesses like colds, bronchitis, bacterial and viral infections and liver diseases. A number of useful phytochemicals have been isolated from the seed and the most prominent of them is the Garcinia bioflavonoids mixture called kolaviron. It has well-defined structure and an array of biological activities including antioxidant, antidiabetic, antigenotoxic and hepatoprotective properties. The chemopreventive properties of Vernonia amygdalina and Garcinia biflavonoids have been attributed to their abilities to scavenge free radicals, induce detoxification, inhibit stress response proteins and interfere with DNA binding activities of some transcription factors.

  3. The Chemopreventive and Chemotherapeutic Potentials of Tea Polyphenols

    Science.gov (United States)

    Thakur, Vijay S; Gupta, Karishma; Gupta, Sanjay

    2011-01-01

    Tea is the second most consumed beverage in the world reported to have multiple health benefits. Preventive and therapeutic benefits of tea polyphenols include enhanced general well being and anti-neoplastic effects. The pharmacologic action of tea is often attributed to various catechins present therein. Experiments conducted in cancer cell lines and animal models demonstrate that tea polyphenols protect against cellular damage caused by oxidative stress and altered immunity. Tea polyphenols modify various metabolic and signaling pathways in the regulation of proliferation, apoptosis, angiogenesis, and metastasis and therefore restrict clonal expansion of cancer cells. Tea polyphenols have been shown to reactivate tumor suppressors, block the unlimited replicative potential of cancer cells, and physically bind to nucleic acids involved in epigenetic alterations of gene regulation. Remarkable interest in green tea as a potential chemopreventive agent has been generated since recent epigenetic data showed that tea polyphenols have the potential to reverse epigenetic modifications which might otherwise be carcinogenic. Like green tea, black tea may also possess chemopreventive and chemotherapeutic potential; however, there is still not enough evidence available to make any conclusive statements. Here we present a brief description of tea polyphenols and discuss the findings of various in vitro and in vivo studies of the anticancer effects of tea polyphenols. Detailed discussion of various studies related to epigenetic changes caused by tea polyphenols leading to prevention of oncogenesis or cancer progression is included. Finally, we discuss on the scope and development of tea polyphenols in cancer prevention and therapy. PMID:21466438

  4. Neoflavonoids and tetrahydroquinolones as possible cancer chemopreventive agents

    Science.gov (United States)

    Luqman, Suaib; Meena, Abha; Singh, Pragya; Kondratyuk, Tamara P.; Marler, Laura E.; Pezzuto, John M.; Negi, Arvind Singh

    2012-01-01

    Several lactone and lactam based neoflavonoids and tetrahydroquinolones were synthesized and evaluated for cancer chemopreventive studies using cell and molecular target based in vitro bioassays, namely NFκB, aromatase, and quinone reductase 1 (QR1). These analogues blocked TNF-α-induced NFκB activation in a dose-dependent manner with IC50 values in the range of 0.11–3.2 μM. In addition, compound 8 inhibited aromatase activity with an IC50 value of 12.12 μM and compound 10 affected QR1 induction (IR: 3.6, CD: 19.57 μM). Neoflavonoids 8 and 10 exhibiting good results, can further be optimized for improved therapeutic profiles. However, investigations into the actions of neoflavonoids and tetrahydroquinolones, especially those related to the NFκB signaling pathway, aromatase inhibition, induction of QR1 expression and in vivo studies could provide new insights into the cancer chemopreventive ability of these molecules. PMID:22726671

  5. Mode of action of aspirin as a chemopreventive agent.

    Science.gov (United States)

    Dovizio, Melania; Bruno, Annalisa; Tacconelli, Stefania; Patrignani, Paola

    2013-01-01

    Aspirin taken for several years at doses of at least 75 mg daily reduced long-term incidence and mortality due to colorectal cancer. The finding of aspirin benefit at low-doses given once daily, used for cardioprevention, locates the antiplatelet effect of aspirin at the center of its antitumor efficacy. In fact, at low-doses, aspirin acts mainly by an irreversible inactivation of platelet cyclooxygenase (COX)-1 in the presystemic circulation, which translates into a long-lasting inhibition of platelet function. Given the short half-life of aspirin in the human circulation(approximately 20 min) and the capacity of nucleated cells to resynthesize the acetylated COX-isozyme(s), it seems unlikely that a nucleated cell could be the target of aspirin chemoprevention. These findings convincingly suggest that colorectal cancer and atherothrombosis may share a common mechanism of disease, i.e. platelet activation in response to epithelial(in tumorigenesis) and endothelial(in tumorigenesis and atherothrombosis) injury. Activated platelets may also enhance the metastatic potential of cancer cells (through a direct interaction and/or the release of soluble mediators or exosomes) at least in part by inducing the overexpression of COX-2. COX-independent mechanisms of aspirin, such as the inhibition of NF-kB signaling and Wnt/β-catenin signaling and the acetylation of extra-COX proteins, have been suggested to play a role in its chemopreventive effects. However, their relevance remains to be demonstrated in vivo at clinical doses.

  6. Chemopreventive potential of natural compounds in head and neck cancer.

    Science.gov (United States)

    Rahman, Mohammad Aminur; Amin, A R M Ruhul; Shin, Dong M

    2010-01-01

    Head and neck squamous cell carcinoma (HNSCC) is one of the most fatal cancers worldwide. Despite advances in the management of HNSCC, the overall survival for patients has not improved significantly due to advanced stages at diagnosis, high recurrence rate after surgical removal, and second primary tumor development, which underscore the importance of novel strategies for cancer prevention. Cancer chemoprevention, the use of natural or synthetic compounds to prevent, arrest, or reverse the process of carcinogenesis at its earliest stages, aims to reverse premalignancies and prevent second primary tumors. Genomics and proteomics information including initial mutation, cancer promotion, progression, and susceptibility has brought molecularly targeted therapies for drug development. The development of preventive approaches using specific natural or synthetic compounds, or both, requires a depth of understanding of the cross-talk between cancer signaling pathways and networks to retain or enhance chemopreventive activity while reducing known toxic effects. Many natural dietary compounds have been identified with multiple molecular targets, effective in the prevention and treatment of cancer. This review describes recent advances in the understanding of the complex signaling networks driving cancer progression and of molecularly targeted natural compounds under preclinical and clinical investigation.

  7. The success factors of scaling-up Estonian sexual and reproductive health youth clinic network--from a grassroots initiative to a national programme 1991-2013.

    Science.gov (United States)

    Kempers, Jari; Ketting, Evert; Chandra-Mouli, Venkatraman; Raudsepp, Triin

    2015-01-08

    A growing number of middle-income countries are scaling up youth-friendly sexual and reproductive health pilot projects to national level programmes. Yet, there are few case studies on successful national level scale-up of such programmes. Estonia is an excellent example of scale-up of a small grassroots adolescent sexual and reproductive health initiative to a national programme, which most likely contributed to improved adolescent sexual and reproductive health outcomes. This study; (1) documents the scale-up process of the Estonian youth clinic network 1991-2013, and (2) analyses factors that contributed to the successful scale-up. This research provides policy makers and programme managers with new insights to success factors of the scale-up, that can be used to support planning, implementation and scale-up of adolescent sexual and reproductive health programmes in other countries. Information on the scale-up process and success factors were collected by conducting a literature review and interviewing key stakeholders. The findings were analysed using the WHO-ExpandNet framework, which provides a step-by-step process approach for design, implementation and assessment of the results of scaling-up health innovations. The scale-up was divided into two main phases: (1) planning the scale-up strategy 1991-1995 and (2) managing the scaling-up 1996-2013. The planning phase analysed innovation, user organizations (youth clinics), environment and resource team (a national NGO and international assistance). The managing phase examines strategic choices, advocacy, organization, resource mobilization, monitoring and evaluation, strategic planning and management of the scale-up. The main factors that contributed to the successful scale-up in Estonia were: (1) favourable social and political climate, (2) clear demonstrated need for the adolescent services, (3) a national professional organization that advocated, coordinated and represented the youth clinics, (4) enthusiasm

  8. Some lessons for the future from the Global Malaria Eradication Programme (1955-1969).

    Science.gov (United States)

    Nájera, José A; González-Silva, Matiana; Alonso, Pedro L

    2011-01-25

    Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT) against malaria, the World Health Organization (WHO) embarked on the Global Malaria Eradication Program (GMEP) in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA) was established. Lessons learned from the GMEP (1955-1969) highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed.

  9. Some Lessons for the Future from the Global Malaria Eradication Programme (1955–1969)

    Science.gov (United States)

    Nájera, José A.; González-Silva, Matiana; Alonso, Pedro L.

    2011-01-01

    Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT) against malaria, the World Health Organization (WHO) embarked on the Global Malaria Eradication Program (GMEP) in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA) was established. Lessons learned from the GMEP (1955–1969) highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed. PMID:21311585

  10. Some lessons for the future from the Global Malaria Eradication Programme (1955-1969.

    Directory of Open Access Journals (Sweden)

    José A Nájera

    2011-01-01

    Full Text Available Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT against malaria, the World Health Organization (WHO embarked on the Global Malaria Eradication Program (GMEP in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA was established. Lessons learned from the GMEP (1955-1969 highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed.

  11. Extraction of bioactives from Orthosiphon stamineus using microwave and ultrasound-assisted techniques: Process optimization and scale up.

    Science.gov (United States)

    Chan, Chung-Hung; See, Tiam-You; Yusoff, Rozita; Ngoh, Gek-Cheng; Kow, Kien-Woh

    2017-04-15

    This work demonstrated the optimization and scale up of microwave-assisted extraction (MAE) and ultrasonic-assisted extraction (UAE) of bioactive compounds from Orthosiphon stamineus using energy-based parameters such as absorbed power density and absorbed energy density (APD-AED) and response surface methodology (RSM). The intensive optimum conditions of MAE obtained at 80% EtOH, 50mL/g, APD of 0.35W/mL, AED of 250J/mL can be used to determine the optimum conditions of the scale-dependent parameters i.e. microwave power and treatment time at various extraction scales (100-300mL solvent loading). The yields of the up scaled conditions were consistent with less than 8% discrepancy and they were about 91-98% of the Soxhlet extraction yield. By adapting APD-AED method in the case of UAE, the intensive optimum conditions of the extraction, i.e. 70% EtOH, 30mL/g, APD of 0.22W/mL, AED of 450J/mL are able to achieve similar scale up results. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. FatMan vs. LittleBoy: Scaling up Linear Algebraic Operations in Scale-out Data Platforms

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seung-Hwan [ORNL; Xu, Luna [Virginia Tech, Blacksburg, VA; Butt, Ali R [Virginia Tech, Blacksburg, VA; Sukumar, Sreenivas Rangan [ORNL; Kannan, Ramakrishnan [ORNL

    2016-01-01

    Linear algebraic operations such as matrix manipulations form the kernel of many machine learning and other crucial algorithms. Scaling up as well as scaling out such algorithms are highly desirable to enable efficient processing over millions of data points. To this end, we present a matrix manipulation approach to effectively scale-up each node in a scale-out data parallel platform such as Apache Spark. Specifically, we enable hardware acceleration for matrix multiplications in a distributed Spark setup without user intervention. Our approach supports both dense and sparse distributed matrices, and provides flexible control of acceleration by matrix density. We demonstrate the benefit of our approach for generalized matrix multiplication operations over large matrices with up to four billion elements. To connect the effectiveness of our approach with machine learning applications, we performed Gramian matrix computation via generalized matrix multiplications. Our experiments show that our approach achieves more than 2x performance speed-up, and up to 96.1% computation improvement, compared to a state of the art Spark MLlib for dense matrices.

  13. Scaling up physical activity interventions worldwide: stepping up to larger and smarter approaches to get people moving.

    Science.gov (United States)

    Reis, Rodrigo S; Salvo, Deborah; Ogilvie, David; Lambert, Estelle V; Goenka, Shifalika; Brownson, Ross C

    2016-09-24

    The global pandemic of physical inactivity requires a multisectoral, multidisciplinary public-health response. Scaling up interventions that are capable of increasing levels of physical activity in populations across the varying cultural, geographic, social, and economic contexts worldwide is challenging, but feasible. In this paper, we review the factors that could help to achieve this. We use a mixed-methods approach to comprehensively examine these factors, drawing on the best available evidence from both evidence-to-practice and practice-to-evidence methods. Policies to support active living across society are needed, particularly outside the health-care sector, as demonstrated by some of the successful examples of scale up identified in this paper. Researchers, research funders, and practitioners and policymakers in culture, education, health, leisure, planning, and transport, and civil society as a whole, all have a role. We should embrace the challenge of taking action to a higher level, aligning physical activity and health objectives with broader social, environmental, and sustainable development goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Antiretroviral Treatment Scale-Up and Tuberculosis Mortality in High TB/HIV Burden Countries: An Econometric Analysis.

    Science.gov (United States)

    Yan, Isabel; Bendavid, Eran; Korenromp, Eline L

    2016-01-01

    Antiretroviral therapy (ART) reduces mortality in patients with active tuberculosis (TB), but the population-level relationship between ART coverage and TB mortality is untested. We estimated the reduction in population-level TB mortality that can be attributed to increasing ART coverage across 41 high HIV-TB burden countries. We compiled TB mortality trends between 1996 and 2011 from two sources: (1) national program-reported TB death notifications, adjusted for annual TB case detection rates, and (2) WHO TB mortality estimates. National coverage with ART, as proportion of HIV-infected people in need, was obtained from UNAIDS. We applied panel linear regressions controlling for HIV prevalence (5-year lagged), coverage of TB interventions (estimated by WHO and UNAIDS), gross domestic product per capita, health spending from domestic sources, urbanization, and country fixed effects. Models suggest that that increasing ART coverage was followed by reduced TB mortality, across multiple specifications. For death notifications at 2 to 5 years following a given ART scale-up, a 1% increase in ART coverage predicted 0.95% faster mortality rate decline (p = 0.002); resulting in 27% fewer TB deaths in 2011 alone than would have occurred without ART. Based on WHO death estimates, a 1% increase in ART predicted a 1.0% reduced TB death rate (peconometric analysis supports a substantial impact of ART on population-level TB mortality realized already within the first decade of ART scale-up, that is apparent despite variable-quality mortality data.

  15. Isolation of a novel high erythritol-producing Pseudozyma tsukubaensis and scale-up of erythritol fermentation to industrial level.

    Science.gov (United States)

    Jeya, Marimuthu; Lee, Kyoung-Mi; Tiwari, Manish Kumar; Kim, Jung-Soo; Gunasekaran, Paramasamy; Kim, Sang-Yong; Kim, In-Won; Lee, Jung-Kul

    2009-05-01

    This study isolated a novel erythritol-producing yeast strain, which is capable of growth at high osmolarity. Characteristics of the strain include asexual reproduction by multilateral budding, absence of extracellular starch-like compounds, and a negative Diazonium blue B color reaction. Phylogenetic analysis based on the 26S rDNA sequence and physiological analysis indicated that the strain belongs to the species Pseudozyma tsukubaensis and has been named P. tsukubaensis KN75. When P. tsukubaensis KN75 was cultured aerobically in a fed-batch culture with glucose as a carbon source, it produced 245 g/L of erythritol, corresponding to 2.86 g/L/h productivity and 61% yield, the highest erythritol yield ever reported by an erythritol-producing microorganism. Erythritol production was scaled up from a laboratory scale (7 L fermenter) to pilot (300 L) and plant (50,000 L) scales using the dissolved oxygen as a scale-up parameter. Erythritol production at the pilot and plant scales was similar to that at the laboratory scale, indicating that the production of erythritol by P. tsukubaensis KN75 holds commercial potential.

  16. Climate-related environmental stress in intertidal grazers: scaling-up biochemical responses to assemblage-level processes

    Directory of Open Access Journals (Sweden)

    Elena Maggi

    2016-10-01

    Full Text Available Background Organisms are facing increasing levels of environmental stress under climate change that may severely affect the functioning of biological systems at different levels of organization. Growing evidence suggests that reduction in body size is a universal response of organisms to global warming. However, a clear understanding of whether extreme climate events will impose selection directly on phenotypic plastic responses and how these responses affect ecological interactions has remained elusive. Methods We experimentally investigated the effects of extreme desiccation events on antioxidant defense mechanisms of a rocky intertidal gastropod (Patella ulyssiponensis, and evaluated how these effects scaled-up at the population and assemblage levels. Results With increasing levels of desiccation stress, limpets showed significant lower levels of total glutathione, tended to grow less and had reduced per capita interaction strength on their resources. Discussion Results suggested that phenotypic plasticity (i.e., reduction in adults’ body size allowed buffering biochemical responses to stress to scale-up at the assemblage level. Unveiling the linkages among different levels of biological organization is key to develop indicators that can anticipate large-scale ecological impacts of climate change.

  17. Scaling up health interventions in resource-poor countries: what role does research in stated-preference framework play?

    Directory of Open Access Journals (Sweden)

    Pokhrel Subhash

    2006-03-01

    Full Text Available Abstract Despite improved supply of health care services in low-income countries in the recent past, their uptake continues to be lower than anticipated. This has made it difficult to scale-up those interventions which are not only cost-effective from supply perspectives but that might have substantial impacts on improving the health status of these countries. Understanding demand-side barriers is therefore critically important. With the help of a case study from Nepal, this commentary argues that more research on demand-side barriers needs to be carried out and that the stated-preference (SP approach to such research might be helpful. Since SP techniques place service users' preferences at the centre of the analysis, and because preferences reflect individual or social welfare, SP techniques are likely to be helpful in devising policies to increase social welfare (e.g. improved service coverage. Moreover, the SP data are collected in a controlled environment which allows straightforward identification of effects (e.g. that of process attributes of care and large quantities of relevant data can be collected at moderate cost. In addition to providing insights into current preferences, SP data also provide insights into how preferences are likely to respond to a proposed change in resource allocation (e.g. changing service delivery strategy. Finally, the SP-based techniques have been used widely in resource-rich countries and their experience can be valuable in conducting scaling-up research in low-income countries.

  18. Assessing the Impact of a Vinasse Pilot Plant Scale-Up on the Key Processes of the Ethanol Supply Chain

    Directory of Open Access Journals (Sweden)

    Rocio Ramos-Hernández

    2016-01-01

    Full Text Available One of the byproducts generated in the cane sugar production is molasses, which is used for ethanol distillation. However, one of the problems of distilleries is vinasse. Vinasse is highly water pollutant and is dumped untreated in lakes or rivers and damages the environment. The company FALA developed a pilot plant that uses vinasse to produce a type of livestock feed called MD60. In this paper, the impact of the pilot plant’s scale-up in the key processes of the company’s supply chain is analyzed. With the help of a sensitivity analysis, this study finds the values that would allow the company to improve its order fulfillment indicator and to increase profits, assuming an expected demand by the introduction of this new product into the market. The results show that (1 the pilot plant fulfills 32% of the orders, (2 according to the current vinasse storage capacity, it is possible to fulfill up to 77% of the orders by scaling up the pilot plant, (3 to satisfy 100% of the orders, it is necessary to use all the vinasse generated, and (4 the highest profit is reached by processing all the vinasse and by considering the upper sale price.

  19. Establishment, Culture, and Scale-up of Brugmansia candida Hairy Roots for the Production of Tropane Alkaloids.

    Science.gov (United States)

    Cardillo, Alejandra Beatriz; Rodriguez Talou, Julián; Giulietti, Ana María

    2016-01-01

    Brugmansia candida (syn. Datura candida) is a South American native plant that produces tropane alkaloids. Hyoscyamine, 6β-hydroxyhyoscyamine (anisodamine), and scopolamine are the most important ones due to their anticholinergic activity. These bioactive compounds have been historically and widely applied in medicine and their demand is continuous. Their chemical synthesis is costly and complex, and thereby, these alkaloids are industrially produced from natural producer plants. The production of these secondary metabolites by plant in vitro cultures such as hairy roots presents certain advantages over the natural source and chemical synthesis. It is well known that hairy roots produced by Agrobacterium rhizogenes infection are fast-growing cultures, genetically stable and able to grow in hormone-free media. Additionally, recent progress achieved in the scaling up of hairy root cultures makes this technology an attractive tool for industrial processes. This chapter is focused on the methods for the induction and establishment of B. candida hairy roots. In addition, the scaling up of hairy root cultures in bioreactors and tropane alkaloid analysis is discussed.

  20. Constraints, synergies and avenues for scaling up breastfeeding, antibiotics for pneumonia and IMCI interventions in the Cusco region, Peru.

    Science.gov (United States)

    Sarganas, Giselle; Scherpbier, Robert; Gericke, Christian A

    2012-01-01

    The purpose of this qualitative case study was to assess the feasibility of scaling up exclusive breastfeeding for 6 months, antibiotics for pneumonia and integrated management of childhood illness (IMCI) child interventions in three districts of the Cusco region, Peru. During field visits, constraints, synergies and solutions to the implementation of the selected interventions were collected through observational recording and interviews of mothers, health workers, and health managers/decision makers. Results are presented for each intervention according to the health system level where they occurred: mother/community, health worker, health centre, and political/managerial levels. This case study demonstrates that it is feasible to scale up exclusive breastfeeding, antibiotics for pneumonia and IMCI interventions in poverty-stricken rural areas of a low-income country. Factors that helped and hindered the implementation were identified for each intervention. The need for a coherent multi-sector approach that includes regulation, implementation and monitoring of health policies and education of all involved stakeholders was apparent. This study also demonstrates that global health interventions need to undergo local adaptation. Identifying local constraints and facilitating factors in a systematic way as proposed in this study is a useful step to increase their effectiveness and reach at the local level and to identify areas for improvement in the original intervention policies.

  1. Top-spray fluid bed coating: Scale-up in terms of relative droplet size and drying force

    DEFF Research Database (Denmark)

    Hede, Peter Dybdahl; Bach, P.; Jensen, Anker Degn

    2008-01-01

    Top-spray fluid bed coating scale-up experiments have been performed in three scales in order to test the validity of two parameters as possible scaling parameters: The drying force and the relative droplet size. The aim was to be able to reproduce the degree of agglomeration as well as the mecha......Top-spray fluid bed coating scale-up experiments have been performed in three scales in order to test the validity of two parameters as possible scaling parameters: The drying force and the relative droplet size. The aim was to be able to reproduce the degree of agglomeration as well...... as binder. Coating experiments were repeated for various drying force and relative droplet size values in three top-spray fluid bed scales being a small-scale (Type: GEA Aeromatic-Fielder Strea-1), medium-scale (Type: Niro MP-1) and large-scale (Type: GEA MP-2/3). The tendency of agglomeration was assessed...... in terms of particle size fractions larger than 425 mu m determined by sieve analysis. Results indicated that the particle size distribution may be reproduced across scale with statistical valid precision by keeping the drying force and the relative droplet size constant across scale. It is also shown...

  2. Climate-related environmental stress in intertidal grazers: scaling-up biochemical responses to assemblage-level processes.

    Science.gov (United States)

    Maggi, Elena; Cappiello, Mario; Del Corso, Antonella; Lenzarini, Francesca; Peroni, Eleonora; Benedetti-Cecchi, Lisandro

    2016-01-01

    Organisms are facing increasing levels of environmental stress under climate change that may severely affect the functioning of biological systems at different levels of organization. Growing evidence suggests that reduction in body size is a universal response of organisms to global warming. However, a clear understanding of whether extreme climate events will impose selection directly on phenotypic plastic responses and how these responses affect ecological interactions has remained elusive. We experimentally investigated the effects of extreme desiccation events on antioxidant defense mechanisms of a rocky intertidal gastropod (Patella ulyssiponensis), and evaluated how these effects scaled-up at the population and assemblage levels. With increasing levels of desiccation stress, limpets showed significant lower levels of total glutathione, tended to grow less and had reduced per capita interaction strength on their resources. Results suggested that phenotypic plasticity (i.e., reduction in adults' body size) allowed buffering biochemical responses to stress to scale-up at the assemblage level. Unveiling the linkages among different levels of biological organization is key to develop indicators that can anticipate large-scale ecological impacts of climate change.

  3. Scale-up of an electrical capacitance tomography sensor for imaging pharmaceutical fluidized beds and validation by computational fluid dynamics

    Science.gov (United States)

    Wang, Haigang; Yang, Wuqiang

    2011-10-01

    The aim of this research is to apply electrical capacitance tomography (ECT) in pharmaceutical fluidized beds and scale up the application of ECT from a lab-scale fluidized bed to a production-scale fluidized bed. The objective is to optimize the design of the production-scale fluidized bed and to improve the operation efficiency of the fluidization processes. This is the first time that ECT has been scaled up to a production-scale fluidized bed of 1.0 m diameter and batch process capacity of 100 kg in a real industrial environment. With a large-scale fluidized bed in a real industrial environment, some key issues on the ECT sensor design must be addressed. To validate ECT measurement results, a two-phase flow model has been used to simulate the process in a lab-scale and pilot-scale fluidized bed. The key process parameters include solid concentration, average concentration profiles, the frequency spectrum of signal fluctuation obtained by the fast Fourier transfer (FFT) and multi-level wavelet decomposition in the time domain. The results show different hydrodynamic behaviour of fluidized beds of different scales. The time-averaged parameters from ECT and computational fluid dynamics are compared. Future work on the ECT sensor design for large-scale fluidized beds are given in the end of the paper.

  4. Bioprocess scale-up/down as integrative enabling technology: from fluid mechanics to systems biology and beyond.

    Science.gov (United States)

    Delvigne, Frank; Takors, Ralf; Mudde, Rob; van Gulik, Walter; Noorman, Henk

    2017-09-01

    Efficient optimization of microbial processes is a critical issue for achieving a number of sustainable development goals, considering the impact of microbial biotechnology in agrofood, environment, biopharmaceutical and chemical industries. Many of these applications require scale-up after proof of concept. However, the behaviour of microbial systems remains unpredictable (at least partially) when shifting from laboratory-scale to industrial conditions. The need for robust microbial systems is thus highly needed in this context, as well as a better understanding of the interactions between fluid mechanics and cell physiology. For that purpose, a full scale-up/down computational framework is already available. This framework links computational fluid dynamics (CFD), metabolic flux analysis and agent-based modelling (ABM) for a better understanding of the cell lifelines in a heterogeneous environment. Ultimately, this framework can be used for the design of scale-down simulators and/or metabolically engineered cells able to cope with environmental fluctuations typically found in large-scale bioreactors. However, this framework still needs some refinements, such as a better integration of gas-liquid flows in CFD, and taking into account intrinsic biological noise in ABM. © 2017 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

  5. Modelling the potential impact and cost of scaling-up male circumcision in resource poor settings: A case of Uganda.

    Science.gov (United States)

    Tumwesigye, Nazarius M; Wabwire-Mangen, Fred; Bagenda, Danstan; Ssengooba, Freddie; Opio, Alex; Nalwadda, Christine K; Bollinger, Lori; Stover, John

    2013-03-01

    This study modelled estimates of the cost and impact of male circumcision (MC) under different scenarios using the Decision Maker's Program Planning Tool on data from Uganda. Results showed that the number of new adult HIV infections could be reduced by 23 000 if MC could be increased from the current 25% to 80% by 2015. The incidence of HIV could be reduced by 0.2 percentage points over the same period. If a scale up programme is to meet a target of 80% by 2015 then the annual number of MCs performed should be over twice as many as those performed in 2011. The discounted net cost per infection averted would be US$559 for the period 2011-2015 and the country would save US$6 841 per infection. A scale up of MC will reduce HIV prevalence and incidence substantially and it would be highly cost effective. The government should mobilise funding to meet high MC targets that would deliver the desired reduction in prevalence and incidence in a short period of time.

  6. Childhood Malaria Admission Rates to Four Hospitals in Malawi between 2000 and 2010

    Science.gov (United States)

    Okiro, Emelda A.; Kazembe, Lawrence N.; Kabaria, Caroline W.; Ligomeka, Jeffrey; Noor, Abdisalan M.; Ali, Doreen; Snow, Robert W.

    2013-01-01

    Introduction The last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance. However, there is only limited country-specific information on the health impact of expanded coverage of these interventions. Methods Paediatric admission data were assembled from 4 hospitals in Malawi reflecting different malaria ecologies. Trends in monthly clinical malaria admissions between January 2000 and December 2010 were analysed using time-series models controlling for covariates related to climate and service use to establish whether changes in admissions can be related to expanded coverage of interventions aimed at reducing malaria infection. Results In 3 of 4 sites there was an increase in clinical malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean clinical malaria admission rates at two hospitals (trend Pmalaria admissions had increased from 2000 by 41% to 100%. Comparison of changes in malaria risk and ITN coverage appear to correspond to a lack of disease declines over the period. Changes in intervention coverage within hospital catchments showed minimal increases in ITN coverage from malaria transmission intensity remained unchanged between 2000–2010 across all sites. Discussion Despite modest increases in coverage of measures to reduce infection there has been minimal changes in paediatric clinical malaria cases in four hospitals in Malawi. Studies across Africa are increasingly showing a mixed set of impact results and it is important to assemble more data from more sites to understand the wider implications of malaria funding investment. We also caution that impact surveillance should continue in areas where intervention coverage is increasing with time, for example Malawi, as decline may become evident within a period when coverage reaches optimal levels. PMID:23638008

  7. Scaling up Telemedicine

    DEFF Research Database (Denmark)

    Christensen, Jannie Kristine Bang; Nielsen, Jeppe Agger; Gustafsson, Jeppe

    through negotiating, mobilizing coalitions, and legitimacy building. To illustrate and further develop this conceptualization, we build on insights from a longitudinal case study (2008-2014) and provide a rich empirical account of how a Danish telemedicine pilot was transformed into a large......-scale telemedicine project through simultaneous translation and theorization efforts in a cross-sectorial, politicized social context. Although we focus on upscaling as a bottom up process (from pilot to large scale), we argue that translation and theorization, and associated political behavior occurs in a broader...

  8. Design and scale-up of a combustion process for inherent CO{sub 2} separation by chemical looping combustion; Design und Scale-up eines Verbrennungsverfahrens zur inhaerenten CO{sub 2} - Abtrennung mittels Chemical-Looping Combustion

    Energy Technology Data Exchange (ETDEWEB)

    Kronberger, B.; Luisser, M.; Loeffler, G.; Hofbauer, H. [Technische Universitaet Wien, Institut fuer Verfahrenstechnik, Umwelttechnik und Technische Biowissenschaften, Wien (Austria)

    2004-07-01

    Chemical looping combustion (CLC) is a novel power plant concept with inherent separation of carbon dioxide. Using metal oxides as oxygen carriers, oxygen is separated from the combustion air and is supplied to the fuel for oxidation. There is no direct contact between fuel and combustion air, and the combustion products CO2 and water are obtained separately from nitrogen. The contribution presents the state of development of the process. Design criteria are derived from the research findings so far in the fields of oxygen carrier reactivity and stability, fluid dynamics of the reactor system, simulation of power plant processes, and prototype operation. The design criteria, together with the scale-up criteria developed for CLC, provide the basis for developing a power plant concept with integrated CLC combustion. (orig.)

  9. [Malaria in Algerian Sahara].

    Science.gov (United States)

    Hammadi, D; Boubidi, S C; Chaib, S E; Saber, A; Khechache, Y; Gasmi, M; Harrat, Z

    2009-08-01

    Thanks to the malaria eradication campaign launched in Algeria in 1968, the number of malaria cases fell down significantly from 95,424 cases in 1960 to 30 cases in 1978. At that time the northern part of the country was declared free of Plasmodium falciparum. Only few cases belonging to P. vivax persisted in residual foci in the middle part of the country. In the beginning of the eighties, the south of the country was marked by an increase of imported malaria cases. The resurgence of the disease in the oases coincided with the opening of the Trans-Saharan road and the booming trade with the neighbouring southern countries. Several authors insisted on the risk of introduction of malaria or its exotic potential vectors in Algeria via this new road. Now, the totality of malaria autochthonous cases in Algeria are located in the south of the country where 300 cases were declared during the period (1980-2007). The recent outbreak recorded in 2007 at the borders with Mall and the introduction of Anopheles gambiae into the Algerian territory show the vulnerability of this area to malaria which is probably emphasized by the local environmental changes. The authors assess the evolution of malaria in the Sahara region and draw up the distribution of the anopheles in this area.

  10. Modern malaria chemoprophylaxis.

    Science.gov (United States)

    Shanks, G Dennis; Edstein, Michael D

    2005-01-01

    Currently available medications for malaria chemoprophylaxis are efficacious but the problems of patient compliance, the advance of parasite drug resistance, and real or perceived serious adverse effects mean that new chemical compounds are needed.Primaquine, which has been widely used to treat relapsing malaria since the 1950s, has been shown to prevent malaria when taken daily. Tafenoquine is a new 8-aminoquinoline with a much longer half-life than primaquine. Field trials to date indicate that tafenoquine is efficacious and can be taken weekly or perhaps even less frequently. Both primaquine and tafenoquine require exact knowledge of a person's glucose 6-phosphate dehydrogenase status in order to prevent drug-induced haemolysis. Other potential malaria chemoprophylactic drugs such as third-generation antifol compounds and Mannich bases have reached advanced preclinical testing. Mefloquine has been seen to cause serious neuropsychiatric adverse effects on rare occasions. Recent public controversy regarding reputedly common serious adverse effects has made many Western travellers unwilling to take mefloquine. Special risk groups exposed to malaria, such as long-term travellers, children, pregnant women, aircrew and those requiring unimpeded psychomotor reactions, migrants returning to visit malarious countries of origin and febrile persons who have returned from malaria endemic areas, all require a nuanced approach to the use of drugs to prevent malaria. The carrying of therapeutic courses of antimalarial drugs to be taken only if febrile illness develops is indicated in very few travellers despite its appeal to some who fear adverse effects more than they fear potentially lethal malaria infection. Travellers with a significant exposure to malaria require a comprehensive plan for prevention that includes anti-mosquito measures but which is still primarily be based on the regular use of efficacious antimalarial medications.

  11. Scaling up kangaroo mother care in South Africa: 'on-site' versus 'off-site' educational facilitation.

    Science.gov (United States)

    Bergh, Anne-Marie; van Rooyen, Elise; Pattinson, Robert C

    2008-07-23

    Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. Thirty-six hospitals in the Provinces of Gauteng and Mpumalanga in South Africa were targeted to implement kangaroo mother care and participated in the trial. The hospitals were paired with respect to their geographical location and annual number of births. One hospital in each pair was randomly allocated to receive either 'on-site' facilitation (Group A) or 'off-site' facilitation (Group B). Hospitals in Group A received two on-site visits, whereas delegates from hospitals in Group B attended one off-site, 'hands-on' workshop at a training hospital. All hospitals were evaluated during a site visit six to eight months after attending an introductory workshop and were scored by means of an existing progress-monitoring tool with a scoring scale of 0-30. Successful implementation was regarded as demonstrating evidence of practice (score>10) during the site visi