Mass prophylaxis dispensing concerns: traffic and public access to PODs

The ability to quickly dispense postexposure prophylaxis (PEP) using multiple points of dispensing (PODs) following a bioterrorism event could potentially save a large proportion of those who were exposed, while failure in PEP dispensing could have dire public health consequences. A Monte Carlo simulation was developed to explore the traffic flow and parking around PODs under different arrival rates and how these factors might affect the utilization rate of POD workers. The results demonstrate that the public can reasonably access the PODs under ideal conditions assuming a stationary (uniform) arrival rate. For the 5 nonstationary arrival rates tested, however, the available parking spaces quickly become filled, causing long traffic queues and resulting in total processing times that range from 1 hour to over 6 hours. Basic planning considerations should include the use of physical barriers, signage, and traffic control officers to help direct vehicular and pedestrian access to the PODs. Furthermore, the parking and traffic surrounding PODs creates long queues of people waiting to access the PODs. Thus, POD staff are fully used approximately 90% of the time, which can lead to worker fatigue and burn out.

Generation and amplification of magnetic islands by drift interchange turbulence

We investigate the multiscale nonlinear dynamics of a linearly stable or unstable tearing mode with small-scale interchange turbulence using 2D MHD numerical simulations. For a stable tearing mode, the nonlinear beating of the fastest growing small-scale interchange modes drives a magnetic island with an enhanced growth rate to a saturated size that is proportional to the turbulence generated anomalous diffusion. For a linearly unstable tearing mode the island saturation size scales inversely as one-fourth power of the linear tearing growth rate in accordance with weak turbulence theory predictions. Turbulence is also seen to introduce significant modifications in the flow patterns surrounding the magnetic island.

Pore-network modeling of biofilm evolution in porous media

The influence of bacterial biomass on hydraulic properties of porous media (bioclogging) has been explored as a viable means for optimizing subsurface bioremediation and microbial enhanced oil recovery. In this study, we present a pore network simulator for modeling biofilm evolution in porous media including hydrodynamics and nutrient transport based on coupling of advection transport with Fickian diffusion and a reaction term to account for nutrient consumption. Biofilm has non-zero permeability permitting liquid flow and transport through the biofilm itself. To handle simultaneous mass transfer in both liquid and biofilm in a pore element, a dual-diffusion mass transfer model is introduced. The influence of nutrient limitation on predicted results is explored. Nutrient concentration in the network is affected by diffusion coefficient for nutrient transfer across biofilm (compared to water/water diffusion coefficient) under advection dominated transport, represented by mass transport Péclet number >1. The model correctly predicts a dependence of rate of biomass accumulation on inlet concentration. Poor network connectivity shows a significantly large reduction of permeability, for a small biomass pore volume.

Sporadic hemiplegic migraine in children: a report of two new cases

Two cases of sporadic hemiplegic migraine, which fulfilled the diagnostic criteria as laid down in International Classification of Headache Disorders (ICHD)-2, are reported in children. In the first case, two unusual features were noted, namely, the occurrence of dysphsia in association with a left hemiparesis and the spread of sensory symptoms to the contralateral side during attacks. The second case is perhaps the youngest patient reported with this disorder.

Application of semi-quantitative M gene-based hydrolysis probe (TaqMan) real-time RT-PCR assay for the detection of peste des petits ruminants virus in the clinical samples for investigation into clinical prevalence of disease

Peste des petits ruminants (PPR) is a contagious, notifiable and economically important transboundary viral disease of small ruminants. In this study, a hydrolysis probe-based real-time reverse transcription-polymerase chain reaction (rt RT-PCR) assay for the detection and semi-quantification of PPR virus (PPRV) nucleic acid was developed using the virus RNA and matrix (M) gene-specific primers with Hex-labelled fluorescent probe and applied for the detection of PPRV in clinical samples to identify outbreaks and to monitor the prevalence of disease. The assay was found specific with a sensitivity detection limit of 0.5 pg of total PPRV RNA. Based on a serial dilution of the live-attenuated PPR vaccine virus, the detection limits were approximately 0.1 and 1 TCID₅₀ for the hydrolysis probe and conventional RT-PCR assays, respectively. The assay was linear within a range of 50 ng to 0.5 pg total virus RNA with an intra-assay coefficient of variation (CV) in the range of 0.91-2.86% and an inter-assay CV ranging between 0.59% and 2.37%. The standardized rt RT-PCR was easily employed for the detection of PPRV nucleic acid directly in the experimental/field clinical samples. This assay detected the PPRV in pre-clinical swab materials as early as the 4th day post-infection (dpi) and up to 17th dpi in nasal, ocular and oral swabs collected from experimentally infected animals. The rt RT-PCR was rapid, specific and 10 times more sensitive than conventional RT-PCR. It is an alternative test to the existing diagnostic assays and could be useful with enhanced applicability in field clinical diagnosis by avoiding the use of expensive commercial real-time PCR reagents. This assay was adopted directly in the detection of PPRV nucleic acid in clinical samples collected from sheep and goats suspected of PPR to monitor outbreak situations and the clinical prevalence of PPR in India.

Sequence and phylogenetic analyses of the structural genes of virulent isolates and vaccine strains of peste des petits ruminants virus from India

Peste des petits ruminants (PPR) is an acute, highly contagious, notifiable and economically important transboundary viral disease of sheep and goats. In this study, sequence and phylogenetic analyses of structural protein genes, namely the nucleocapsid (N), the matrix (M), the fusion (F) and the haemagglutinin (H) coding sequences of virulent and vaccine strains of PPR virus (PPRV), were undertaken to determine the genetic variations between field isolates and vaccine strains. The open reading frame (ORF) of these genes of the isolates/strains was amplified by RT-PCR, cloned and sequenced. The ORF of N, M, F and H genes was 1578, 1008, 1641 and 1830 nucleotides (nt) in length and encodes polypeptides of 525, 335, 546 and 609 amino acids (aa), respectively, as reported earlier. Comparative sequence analyses of these four genes of isolates/strains were carried out with published sequences. It revealed an identity of 97.7-100% and 97.7-99.8% among the Asian lineage IV and 89.6-98.7% and 89.8-98.9% with other lineages of PPRV at nt and aa levels, respectively. The phylogenetic analyses of these isolates based on the aa sequences showed that all the viruses belonged to lineage IV along with other Asian isolates. This is in agreement with earlier observations that only PPRV lineage IV is in circulation in India since the disease was first reported. Further, sequence analysis of the thermostable/thermo-adapted vaccine strains showed no significant changes in the functional or structural surface protein-coding gene sequences. It is important to monitor the circulation of the PPRV in susceptible animals by H gene-based sequence comparisons in addition to the F gene- and N gene-based approaches to identify the distribution and spread of virus in the regular outbreaks that occur in endemic countries like India.

Comparative Study of Predeposit and Bedside Leucodepletion Filters

BACKGROUND

Removal of leucocytes from cellular blood components is associated with reduction of several transfusion associated adverse reactions.

METHODS

A total of 400 units of packed red blood cells (RBCs) were subjected to leucodepletion at room temperature and 4°C using different commercially available prestorage and bedside filters (Terumo Penpol Immugard III and Pall Medical BPF-4). Pre-filtration and post-filtration parameters were compared to assess the efficacy of prestorage leucodepletion vis-à-vis bedside leucodepletion and the requirement of universal leucodepletion.

RESULT

Mean post-filtration red cell recovery ranged from 88.49-93.49% with all bags showing more than 85% red cell recovery. Mean post-filtration residual leucocyte count ranged from 0.205 × 10(6)-0.338 × 10(6)/bag with all bags showing more than log 3 leucoreduction. Prestorage leucoreduction achieved by the polyurethane filter was better than that achieved by the polyester filter. Red cell recovery with the bedside filters at room temperature was significantly less than that with prestorage filters at either temperature.

CONCLUSION

This study suggests that prestorage leucoreduction is preferable over bedside leucoreduction and that polyurethane filters are better than polyester filters since leucodepletion achieved with the former is higher. We recommend selective log 3 leucodepletion using polyurethane prestorage filters for patients with specific indications.

Isolation and identification of virulent peste des petits ruminants viruses from PPR outbreaks in India

In this study, three outbreaks of peste des petits ruminants (PPR) in goats and sheep flocks with high morbidity and considerable mortality were recorded at Jhansi and Revati in Uttar Pradesh and Bhopal in Madhya Pradesh, India during 2003-2006. Clinical samples were collected from the affected flocks for laboratory investigation. The PPR virus (PPRV) antigen/nucleic acid in the infected tissues/swab materials was demonstrated by using sandwich enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction techniques, and the antibody to PPRV in serum samples was detected by competitive ELISA. The causative agent of the outbreaks, PPRV, was successfully isolated in Vero cells at first passage itself, and its identity was confirmed. The isolated PPR viruses belong to lineage IV based on phylogenetic analysis of partial fusion gene sequences and are closely related to other Asian or Indian PPRV isolates/strains.

Nonlinear wave propagation in strongly coupled dusty plasmas

The nonlinear propagation of low-frequency waves in a strongly coupled dusty plasma medium is studied theoretically in the framework of the phenomenological generalized hydrodynamic (GH) model. A set of simplified model nonlinear equations are derived from the original nonlinear integrodifferential form of the GH model by employing an appropriate physical ansatz. Using standard perturbation techniques characteristic evolution equations for finite small amplitude waves are then obtained in various propagation regimes. The influence of viscoelastic properties arising from dust correlation contributions on the nature of nonlinear solutions is discussed. The modulational stability of dust acoustic waves to parallel perturbation is also examined and it is shown that dust compressibility contributions influenced by the Coulomb coupling effects introduce significant modification in the threshold and range of the instability domain.

Understanding how women's groups improve maternal and newborn health in Makwanpur, Nepal: a qualitative study

Women's groups, working through participatory learning and action, can improve maternal and newborn survival. We describe how they stimulated change in rural Nepal and the factors influencing their effectiveness. We collected data from 19 women's group members, 2 group facilitators, 16 health volunteers, 2 community leaders, 21 local men, and 23 women not attending the women's groups, through semi-structured interviews, group interviews, focus group discussions and unstructured observation of groups. Participants took photographs of their locality for discussion in focus groups using photoelicitation methods. Framework analysis procedures were used, and data fed back to respondents. When group members were compared with 11 184 women who had recently delivered, we found that they were of similar socioeconomic status, despite the context of poverty, and caste inequalities. Four mechanisms explain the women's group impact on health outcomes: the groups learned about health, developed confidence, disseminated information in their communities, and built community capacity to take action. Women's groups enable the development of a broader understanding of health problems, and build community capacity to bring health and development benefit.

Putative role of cocaine- and amphetamine-regulated transcript (CARTPT) in dominant follicle selection in cattle

The mechanisms regulating development of a single (dominant) follicle capable of ovulation during each follicular wave in cattle and atresia of remaining follicles (dominant follicle selection) are not well understood. FSH and IGF1 are known regulators of follicle growth and granulosa cell estradiol production during follicular waves. Recent evidence indicates cocaine and amphetamine regulated transcript (CARTPT), with intraovarian expression only in single-ovulating species, is a novel regulator of follicular development. The mature CARTPT peptide (CART) is a potent negative regulator of FSH and IGF1 action on granulosa cells in vitro and can inhibit follicular estradiol production in vivo. Follicular fluid CART concentrations in healthy follicles decrease after dominant follicle selection and CARTPT mRNA is lower in healthy versus atretic follicles collected prior to and early after initiation of follicle dominance, suggestive of a regulatory role in the selection process. The inhibitory actions of CART on FSH signaling and estradiol production are dependent on the G(o/i)-subclass of inhibitory G proteins and linked to multiple components of the FSH signal transduction pathway resulting in reduced CYP19A1 mRNA and estradiol production. Evidence to date supports a potential important functional role for CART in regulation of dominant follicle selection and the species-specific ovulatory quota in monotocous species.

Nonlinear dynamics of magnetic islands imbedded in small-scale turbulence

The nonlinear dynamics of magnetic tearing islands imbedded in a pressure gradient driven turbulence is investigated numerically in a reduced magnetohydrodynamic model. The study reveals regimes where the linear and nonlinear phases of the tearing instability are controlled by the properties of the pressure gradient. In these regimes, the interplay between the pressure and the magnetic flux determines the dynamics of the saturated state. A secondary instability can occur and strongly modify the magnetic island dynamics by triggering a poloidal rotation. It is shown that the complex nonlinear interaction between the islands and turbulence is nonlocal and involves small scales.

Physical work capacity of young underprivileged school girls impact of daily vs intermittent iron folic acid supplementation: a randomized controlled trial

OBJECTIVES

To assess impact of daily and intermittent iron-folate (IFA) supplementation on physical work capacity of underprivileged schoolgirls in Vadodara.

DESIGN

Randomized controlled trial.

SETTING

Municipal Primary schools.

PARTICIPANTS

Schoolgirls (n=163) in the age group of 9-13 years.

INTERVENTION

Three randomly selected schools were given IFA tablets (100 mg elemental iron + 0.5 mg folic acid) either once weekly or twice weekly or daily for one year. The fourth was the control school.

OUTCOME MEASURES

Hemoglobin, modified Harvards Step test for physical work capacity.

RESULTS

All three IFA supplemented groups showed significant improvement in number of steps climbed and recovery time compared to controls; with impact being relatively better in girls with higher Hb gain (> 1 g/dL) vs. lower Hb gain. Similarly, higher the frequency of dosing better was the impact- it being the best in daily IFA group. Twice weekly IFA was as good as daily IFA under conditions of good compliance.

CONCLUSION

Twice weekly IFA supplementation is comparable to daily IFA in terms of beneficial effects on physical work capacity in young girls.