2,350 research outputs found
Novel approaches to evaluate the impact of the SAFE strategy on trachoma and other neglected tropical diseases in Amhara National Regional State, Ethiopia
No full textBackground: Trachoma, a blinding bacterial disease of the ocular surface, is the leading
cause of infectious blindness, responsible for the visual impairment of 2.2 million people
worldwide and an estimated economic loss of US$ 5.3 billion annually. Blinding trachoma,
considered a neglected tropical disease, is targeted for global elimination as a public health
problem by the year 2020. To achieve elimination, the World Health Organization (WHO)
recommends implementing an integrated intervention package of surgery, antibiotics, facial
cleanliness, and environmental improvement, known as the SAFE strategy. Surgery aims to
correct trichiasis, the blinding anatomical condition of inward turning lashes touching the eye.
Antibiotics are distributed annually to endemic communities to treat relatively asymptomatic
ocular Chlamydia trachomatis infections to reduce the infectious reservoir. The promotion of
facial cleanliness and environmental improvements, use of water and latrines for hygiene
and sanitation, both target interrupting transmission of the infection. Of the 325 million
persons estimated living in trachoma endemic communities, over 70% reside in sub-Saharan
Africa. Within the region, Ethiopia, Nigeria, and South Sudan are estimated to have the
highest burden of disease. The SAFE strategy in Ethiopia has been implemented since 2007
targeting all 17 million residents of the Amhara National Regional State.
Goals and specific objectives: The goal of this PhD thesis was to investigate novel
approaches of measuring the impact of SAFE interventions on trachoma and other
neglected tropical diseases within the context of a national elimination programme as
implemented in the Amhara National Regional State of Ethiopia. The specific operational
research objectives were to determine whether areas receiving 3-5 years of interventions
had achieved elimination by applying new evaluation guidelines; whether new electronic
data collection technology could facilitate impact evaluation; whether SAFE interventions
had any impact on trachomatous scarring (TS) among children; whether school-based
surveys might serve as an alternative method to assess trachoma; and whether SAFE
interventions have had any impact on intestinal parasitic infections.
Methods: Data collection for the thesis project occurred in three phases. The first phase
involved the implementation of a population-based, cross-sectional study utilising a cluster
random sampling design to survey 360 communities in South Wollo zone to estimate
prevalence of trachoma after three years of SAFE interventions. Data was collected using
standard paper-based questionnaires. The second phase involved the development and
field-testing of a new electronic data collection system in a pilot study utilising a mixed,
quantitative and qualitative, study design. The last phase involved the implementation of
another population-based cross-sectional study in South Gondar zone after receiving five
years of SAFE interventions. The same sampling methodology was used to survey another
360 communities, yet integrating both assessment of trachoma and intestinal parasitic
infections. Additionally, data was collected strictly by the newly developed electronic system.
Clinical signs of trachoma were individually assessed using the WHO simplified trachoma
grading system. Intestinal parasitic infections among children aged 2-15 years were
determined by concentrating preserved stool specimens with ether for microscopic
examination.
Results: From 714 communities in the two zones, 72,452 persons were examined for
trachoma. The prevalence of trachomatous inflammation follicular (TF) among children aged
1-9 years was 26.4% in South Wollo and 25.9% in South Gondar zone. Trachomatous
inflammation intense (TI) was less prevalent than TF; 4.3% and 7.0% in South Wollo and
South Gondar respectively. TT prevalence in the two zones suggest that over 59,000
persons are estimated to have trichiasis and in need of surgery. In South Gondar the
prevalence of TS among children under the age of 11 years has declined from 24.9% in
2000 to 2.2% in 2011. While declines in intense inflammation and scarring were observed
among children since intervention, the WHO targets for elimination have not been achieved.
The android-based tablet computer and the standard paper questionnaire were
comparable in regards to time required to collect data during the pilot study, proportion of
mistakes made while recording data and costs when considering data entry of paper
questionnaires. Data recorders preferred to collect data electronically even though initially
they felt the tablet interrupted their connection with the interview respondents. Electronic
data collection resulted in completion of the large-scale surveys from preparation to
presentation of results in 35% less time (one month earlier) than the standard paper-based
surveys.
An analysis of 75,864 children examined in community-based surveys in Ethiopia
(from field work described in this thesis), Mali, Niger, and Nigeria found that differences
between children who attend and do not attend school varies across survey settings in
regards to age, gender, having a clean face, and participation in antibiotic distribution for
trachoma control. Meta-analysis of the data found that TF was less likely (odds ratio=0.71)
among school-attendees than non-attendees when controlling for age, sex, and clustering at
the household and community levels. Children attending school did not represent the target
age group recommended for assessment of trachoma prevalence.
Stool specimens from 2,338 children aged 2-15 years from 99 communities in South
Gondar were assessed for intestinal parasites. The prevalence of any helminth infection was
24.2%, which represented a 50% reduction from a previously published study prior to the
SAFE interventions. Over 70% of children had at least one type of intestinal protozoan
infection. Significant increases were observed in household latrine ownership, access to
water, use of an improved water source for drinking, and face washing behaviour since the
start of the interventions.
Conclusions: Trachoma remains a public health problem in South Wollo and South Gondar
zones of the Amhara National Regional State of Ethiopia and ongoing interventions are
warranted to control transmission to prevent incident blinding disease and provide surgery
for prevalent and incident cases of trichiasis. The application of new WHO guidelines to
evaluate trachoma at the sub-district level was feasible, but required significant resources.
Electronic data capture facilitates the implementation of such large-scale impact evaluation
surveys for neglected tropical diseases allowing the results to be generated immediately with
as few mistakes as were made with paper-based data collection. Measuring prevalence of
TS among children over time offers an additional way to monitor impact of the SAFE
strategy. Children under the age of 11 years have substantially benefited from having lived in
an environment where the SAFE strategy has been implemented for five years. The use of
school-based sampling approaches for assessing trachoma prevalence risks
underestimating true prevalence in the community. The prevalence of intestinal helminths
among school-aged children has declined alongside significant increases in household-level
indicators of water, sanitation, and hygiene since the implementation of the SAFE strategy in
South Gondar. Yet, there is ongoing transmission of intestinal parasitic infections warranting
improved control interventions. Integrating both the assessment of trachoma and intestinal
parasitic infections in community-based surveys was a feasible approach to evaluate a
broader impact of the SAFE strategy in a programmatic setting. Overall, the operational
research presented in this thesis successfully generated evidence for health system
decisions, contributed new information to the respective scientific fields, and identified areas
warranting additional research
Armand Robin: a pulsão politradutória
No full textThis study approaches the polytranslation impulse by analyzing its manifestation in the writings of the Breton poet translator Armand Robin (1912 - 1961). This impulse, bound to an intended metaphysics in Berman\u27s writings (1984) - defined as the romantic quest for the "pure language" —, is reevaluated in this essay focusing on the aspects concerning Robin mentioned previously. Although he forsakes being an Author and claims the denial of himself (rejection), underlying this exalted chronicle of non-translation there is an attempt to subvert an ethnocentric French tradition and an inner desire of authorship (reassurance and acceptance).Em sua obra L\u27épreuve de l\u27étranger (1984), Berman propõe uma teoria sobre o sujeito politradutor que vincula a pulsion du traduire do poète breton Armand Robin a uma visada metafísica — definida por este autor como a busca romântica da "pura língua". No presente ensaio, essas conclusões são reavaliadas a partir de referências inéditas sobre o poeta abordadas antecipadamente. Embora ele tenha renunciado a ser Autor e tenha proclamado a negação de si mesmo (rejeição), subjazem a essa crônica exaltada denominada non-traduction tanto a tentativa de subverter uma tradição francesa etnocêntrica quanto o desejo íntimo de se ver autor (afirmação e aceitação)
Phylogenetic relationships, song and distribution of the endangered Rufous-headed Robin Larvivora ruficeps
No full textThe Rufous-headed Robin Larvivora ruficeps is one of the world's rarest and least known birds. We summarize the known records since it was first described in 1905 from Shaanxi Province, central China. All subsequent Chinese records are from seven adjacent localities in nearby Sichuan Province. We studied its phylogenetic position for the first time using mitochondrial and nuclear markers for all species of Larvivora and a broad selection of other species in the family Muscicapidae. Our results confirmed that L. ruficeps is appropriately placed in the genus Larvivora, and suggested that it is sister to the Rufous-tailed Robin Larvivora sibilans, with these two forming a sister clade to a clade comprising both the Japanese Robin Larvivora akahige and Ryukyu Robin Larvivora komadori. Siberian Blue Robin Larvivora cyane and Indian Blue Robin Larvivora brunnea form the sister clade to the other Larvivora species. In contrast, song analyses indicated that the song of L. ruficeps is most similar to that of L. komadori, whereas the song of L. sibilans is relatively more similar to that of L. akahige, and songs of L. cyane and L. brunnea closely resemble each other. We used ecological niche modelling to estimate the suitable habitats of L. ruficeps based on the records from breeding grounds, suggesting that north and central Sichuan, south Gansu, south Shaanxi and south-east Tibet are likely to contain the most suitable habitats for this species.Jornvall Foundation; Sound Approach; National Science Foundation of China [31471990]; Ministry of Science and Technology of the People's Republic of China (MOST) [2011FY120200-3]; NSFC programme [J1210002]SCI(E)ARTICLE1204-21615
The Robin problem for the Helmholtz equation in a starlike planar domain
No full textThe interior and exterior Robin problems for the Helmholtz equation in starlike planar domains are addressed by using a suitable Fourier-like technique. Attention is in particular focused on normal-polar domains whose boundaries are defined by the so-called “superformula” introduced by J. Gielis. A dedicated numerical procedure based on the computer algebra system Mathematica© is developed in order to validate the proposed approach. In this way, highly accurate approximations of the solution, featuring properties similar to the classical ones, are obtained. The computed results are found to be in good agreement with the theoretical findings on Fourier series expansion presented by L. Carleson.TelecommunicationsElectrical Engineering, Mathematics and Computer Scienc
Cervico-thoracic kyphosis in a girl with Pierre Robin sequence
No full textCongenital cervico-thoracic kyphosis has been encountered in a girl with Pierre Robin sequence. The constellation of the spine malformation complex such as incomplete development of the vertebral bodies associated with defective ossification of the cervico-thoracic pedicles causing effectively the development of complete spinal cord injury at the kyphotic level of C7/T1 were present. Congenital kyphosis secondary to vertebral body hypoplasia has not been reported in connection with Pierre Robin sequence
A comparison of fair sharing algorithms for regulating search as a service API
No full textProviders of a Search as a Service (SaaS) environment must ensure that their users will not monopolize the service or use more than their fair share of resources. Fair sharing algorithms have long been used in computer networking to balance access to a router or switch, and some of these algorithms have also been applied to the control of queries submitted to search engine APIs. If a search query’s execution cost can be reliably estimated, fair sharing algorithms can be applied to the input of a SaaS API to ensure everyone has equitable access to the search engine.
The novelty of this paper lies in presenting a Single-Server Max-Min Fair Deficit Round Robin algorithm, a modified version of the Multi-Server Max-Min Fair Deficit Round Robin algorithm. The Single-Server Max-Min Fair Deficit Round Robin algorithm is compared to three other fair sharing algorithms, token-bucket, Deficit Round Robin (DRR), and Peng and Plale’s [1] Modified Deficit Round Robin (MDRR) in terms of three different usage scenarios, balanced usage, unbalanced usage as well as an idle client usage, to determine which is the most suitable fair sharing algorithm for use in regulating traffic to a SaaS API. This research demonstrated that the Single-Server Max-Min Fair DRR algorithm provided the highest throughput of traffic to the search engine while also maintaining a fair balance of resources among clients by re-allocating unused throughput to clients with saturated queues so a max-min allocation was achieved.Journal ArticleFinal article publishe
convex segmentation and mixed-integer footstep planning for a walking robot
No full textThesis: S.M., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2014.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student-submitted PDF version of thesis.Includes bibliographical references (pages 77-82).This work presents a novel formulation of the footstep planning problem as a mixed-integer convex optimization. The footstep planning problem involves choosing a set of footstep locations which a walking robot can follow to safely reach a goal through an environment with obstacles. Rather than attempting to avoid the obstacles, which would require nonconvex constraints, we use integer variables to assign each footstep to a convex region of obstacle-free terrain, while simultaneously optimizing its pose within that safe region. Since existing methods for generating convex obstacle-free regions were ill-suited to this task, we also present IRIS (Iterative Regional In Inflation by Semidefinite programming), a new method to generate such regions through a series of convex optimizations. Combining IRIS with the mixed-integer optimization gives a complete footstep planning architecture, which can produce complex footstep plans on height map data constructed from onboard sensors. We demonstrate the footstep planner in simulated environments and with real data sensed by the Atlas humanoid, and we discuss future applications to running robots, aerial vehicles, and robots with more than two legs.by Robin L. H. Deits.S.M
Huntsville Times sleeve HT0006182
No full textMallard Fox Creek port / Decatur, Alabama / Global Materials Services LLC / Don Viator / Michael L. Meece / David D. Bailey / Pamela A. Hill / [Business cards and negatives from 21 September also included
Theology in suspense : how the detective fiction of P.D. James provokes theological thought
No full textElectronic redacted version excludes material for which permission has not been granted by the rights holderThe following dissertation argues that the detective fiction of P.D. James
provokes her readers to think theologically. I present evidence from the body of
James’s work, including her detective fiction that features the Detective Adam
Dalgliesh, as well as her other novels, autobiography, and non-fiction work. I also
present a brief history of detective fiction. This history provides the reader with a
better understanding of how P.D James is influenced by the detective genre as well as
how she stands apart from the genre’s traditions.
This dissertation relies on an interview that I conducted with P.D. James in
November, 2008. During the interview, I asked James how Christianity has
influenced her detective fiction and her responses greatly contribute to this
dissertation. However, James’s novels should be interpreted and explored in the
manner that they are received by the reader. How the reader receives and responds to
the novels, not only how James writes the novels, is what causes her stories to
provoke theological thinking.
By examining Christian symbolism that is present in setting, character, the
Detective Adam Dalgliesh, and plot, this dissertation seeks to assert that James
contributes to a theological conversation through her popular detective fiction
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