The international politics of disease reporting : towards post-Westphalianism?

Since the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, there has been much discussion about whether the international community has moved into a new post-Westphalian era, where states increasingly recognize certain shared norms that guide what they ought to do in responding to infectious disease outbreaks. In this article I identify this new obligation as the ‘duty to report’, and examine competing accounts on the degree to which states appreciate this new obligation are considered by examining state behaviour during the H5N1 human infectious outbreaks in East Asia (since 2004). The article examines reporting behaviour for H5N1 human infectious cases in Cambodia, China, Indonesia, Thailand and Vietnam from 2004 to 2010. The findings lend strong support to the claim that East Asian states have come to accept and comply with the duty to report infectious disease outbreaks and that the assertions of sovereignty in response to global health governance frameworks have not systematically inhibited reporting compliance.

Graft versus host disease in oncology nursing practice

INTRODUCTION: Gastrointestinal graft-versus-host disease (GI-GvHD) is extremely debilitating and is multifactorial in its causative factors, management and treatment. It is an exaggeration of normal physiological mechanisms wherein the donor immune system attempts to rid itself of the host. The inflammatory process that follows has the benefit of providing an anti-tumour effect for many diseases, but unfortunately in patients undergoing human stem-cell transplantation, the nature of the inflammation can result in disability, wasting and death. AIM: The aim of this article is to discuss the pathophysiology of this often misunderstood or misdiagnosed condition, as well as its signs and symptoms, management and considerations for nursing care. Considerations for nursing practice: While the medical management is aimed at minimising GvHD through the reduction of T-cell production and proliferation and gastrointestinal decolonisation, the nursing care is often focused on the signs and symptoms that can have the most prominent impact on patients. CONCLUSION: GI-GvHD has serious life-threatening complications, namely wasting syndrome, diarrhoea and dehydration. The basis of signs and symptomology is easily recognisable owing to the stages of progression through the human stem-cell transplantation process. Oncology nurses are in a prime position to identify these serious risks, initiate treatment immediately and collaborate effectively within the multidisciplinary team to minimise GvHD onset and provide expert support to patients, family and caregivers.

Executive function and postural instability in people with Parkinson’s disease

The specific aspects of cognition contributing to balance and gait have not been clarified in people with Parkinson’s disease (PD). Twenty PD participants and twenty age- and gender-matched healthy controls were assessed on cognition and clinical mobility tests. General cognition was assessed with the Mini Mental State Exam and the Addenbrooke’s Cognitive Exam. Executive function was evaluated using the Trail Making Tests (TMT-A and TMT-B) and a computerized cognitive battery which included a series of choice reaction time (CRT) tests. Clinical gait and balance measures included the Tinetti, Timed Up & Go, Berg Balance and Functional Reach tests. PD participants performed significantly worse than the controls on the tests of cognitive and executive function, balance and gait. PD participants took longer on Trail Making Tests, CRT-Location and CRT-Colour (inhibition response). Furthermore, executive function, particularly longer times on CRT-Distracter and greater errors on the TMT-B were associated with worse balance and gait performance in the PD group. Measures of general cognition were not associated with balance and gait measures in either group. For PD participants, attention and executive function were impaired. Components of executive function, particularly those involving inhibition response and distracters, were associated with poorer balance and gait performance in PD.

Cholesterol regulates Syntaxin 6 trafficking at trans-Golgi network endosomal boundaries.

Inhibition of cholesterol export from late endosomes causes cellular cholesterol imbalance, including cholesterol depletion in the trans-Golgi network (TGN). Here, using Chinese hamster ovary (CHO) Niemann-Pick type C1 (NPC1) mutant cell lines and human NPC1 mutant fibroblasts, we show that altered cholesterol levels at the TGN/endosome boundaries trigger Syntaxin 6 (Stx6) accumulation into VAMP3, transferrin, and Rab11-positive recycling endosomes (REs). This increases Stx6/VAMP3 interaction and interferes with the recycling of αVβ3 and α5β1 integrins and cell migration, possibly in a Stx6-dependent manner. In NPC1 mutant cells, restoration of cholesterol levels in the TGN, but not inhibition of VAMP3, restores the steady-state localization of Stx6 in the TGN. Furthermore, elevation of RE cholesterol is associated with increased amounts of Stx6 in RE. Hence, the fine-tuning of cholesterol levels at the TGN-RE boundaries together with a subset of cholesterol-sensitive SNARE proteins may play a regulatory role in cell migration and invasion.

Determination of battery storage capacity in energy buffer for wind farm

Design of a battery energy storage system (BESS) in a buffer scheme is examined for the purpose of attenuating the effects of unsteady input power from wind farms. The design problem is formulated as maximization of an objective function that measures the economic benefit obtainable from the dispatched power from the wind farm against the cost of the BESS. Solution to the problem results in the determination of the capacity of the BESS to ensure constant dispatched power to the connected grid, while the voltage level across the dc-link of the buffer is kept within preset limits. A computational procedure to determine the BESS capacity and the evaluation of the dc voltage is shown. Illustrative examples using the proposed design method are included.

Buffer scheme with battery energy storage capability for enhancement of network transient stability and load ride-through

This paper examines a buffer scheme to mitigate the negative impacts of power-conditioned loads on network voltage and transient stabilities. The scheme is based on the use of battery energy-storage systems in the buffers. The storage systems ensure that protected loads downstream of the buffers can ride through upstream voltage sags and swells. Also, by controlling the buffers to operate in either constant impedance or constant power modes, power is absorbed or injected by the storage systems. The scheme thereby regulates the rotor-angle deviations of generators and enhances network transient stability. A computational method is described in which the capacity of the storage systems is determined to achieve simultaneously the above dual objectives of load ride-through and stability enhancement. The efficacy of the resulting scheme is demonstrated through numerical examples.

Contactless and replaceable modularized battery energy storage system for electric vehicles

A novel replaceable, modularized energy storage system with wireless interface is proposed for a battery operated electric vehicle (EV). The operation of the proposed system is explained and analyzed with an equivalent circuit and an averaged state-space model. A non-linear feedback linearization based controller is developed and implemented to regulate the DC link voltage by modulating the phase shift ratio. The working and control of the proposed system is verified through simulation and some preliminary results are presented.

A direct integration scheme for battery-supercapacitor hybrid energy storage systems with the use of grid side inverter

Battery-supercapacitor hybrid energy storage systems are becoming popular in the renewable energy sector due to their improved power and energy performances. These hybrid systems require separate dc-dc converters, or at least one dc-dc converter for the supercapacitor bank, to connect them to the dc-link of the grid interfacing inverter. These additional dc-dc converters increase power losses, complexity and cost. Therefore, possibility of their direct connection is investigated in this paper. The inverter system used in this study is formed by cascading two 3-level inverters, named as the “main inverter” and the “auxiliary inverter”, through a coupling transformer. In the test system the main inverter is connected with the rectified output of a wind generator while the auxiliary inverter is directly attached to a battery and a supercapacitor bank. The major issues with this approach are the dynamic changes in dc-link voltages and inevitable imbalances in the auxiliary inverter voltages, which results in unevenly distributed space vectors. A modified SVM technique is proposed to solve this issue. A PWM based time sharing method is proposed for power sharing between the battery and the supercapacitor. Simulation results are presented to verify the efficacy of the proposed modulation and control techniques.

Melanopsin expressing intrinsically photosensitive Retinal Ganglion cells in retinal disease

Melanopsin containing intrinsically photosensitive Retinal Ganglion Cells (ipRGCs) are a class of photoreceptors with established roles in non-image forming processes. Their contributions to image forming vision may include the estimation of brightness. Animal models have been central for understanding the physiological mechanisms of ipRGC function and there is evidence of conservation of function across species. ipRGCs can be divided into 5 ganglion cell subtypes that show morphological and functional diversity. Research in humans has established that ipRGCs signal environmental irradiance to entrain the central body clock to the solar day for regulating circadian processes and sleep. In addition, ipRGCs mediate the pupil light reflex (PLR), making the PLR a readily accessible behavioural marker of ipRGC activity. Less is known about ipRGC function in retinal and optic nerve disease, with emerging research providing insight into their function in diabetes, retinitis pigmentosa, glaucoma and hereditary optic neuropathy. We briefly review the anatomical distributions, projections and basic physiological mechanisms of ipRGCs, their proposed and known functions in animals and humans with and without eye disease. We introduce a paradigm for differentiating inner and outer retinal inputs to the pupillary control pathway in retinal disease and apply this paradigm to patients with age-related macular degeneration (AMD). In these cases of patients with AMD, we provide the initial evidence that ipRGC function is altered, and that the dysfunction is more pronounced in advanced disease. Our perspective is that with refined pupillometry paradigms, the pupil light reflex can be extended to AMD assessment as a tool for the measurement of inner and outer retinal dysfunction.

Design of a renewable - hybrid energy storage power scheme for short-term power dispatch

A hybrid energy storage system (HESS) consisting of battery and supercapacitor (SC) is proposed for use in a wind farm in order to achieve power dispatchability. In the designed scheme, the rate of charging/discharging powers of the battery is controlled while the faster wind power transients are diverted to the SC. This enhances the lifetime of the battery. Furthermore, by taking into consideration the random nature of the wind power, a statistical design method is developed to determine the capacities of the HESS needed to achieve specified confidence level in the power dispatch. The proposed approach is useful in the planning of the wind farm-HESS scheme and the coordination of the power flows between the battery and SC.

Outbreak detection algorithms for seasonal disease data : a case study using Ross River virus disease

Background Detection of outbreaks is an important part of disease surveillance. Although many algorithms have been designed for detecting outbreaks, few have been specifically assessed against diseases that have distinct seasonal incidence patterns, such as those caused by vector-borne pathogens. Methods We applied five previously reported outbreak detection algorithms to Ross River virus (RRV) disease data (1991-2007) for the four local government areas (LGAs) of Brisbane, Emerald, Redland and Townsville in Queensland, Australia. The methods used were the Early Aberration Reporting System (EARS) C1, C2 and C3 methods, negative binomial cusum (NBC), historical limits method (HLM), Poisson outbreak detection (POD) method and the purely temporal SaTScan analysis. Seasonally-adjusted variants of the NBC and SaTScan methods were developed. Some of the algorithms were applied using a range of parameter values, resulting in 17 variants of the five algorithms. Results The 9,188 RRV disease notifications that occurred in the four selected regions over the study period showed marked seasonality, which adversely affected the performance of some of the outbreak detection algorithms. Most of the methods examined were able to detect the same major events. The exception was the seasonally-adjusted NBC methods that detected an excess of short signals. The NBC, POD and temporal SaTScan algorithms were the only methods that consistently had high true positive rates and low false positive and false negative rates across the four study areas. The timeliness of outbreak signals generated by each method was also compared but there was no consistency across outbreaks and LGAs. Conclusions This study has highlighted several issues associated with applying outbreak detection algorithms to seasonal disease data. In lieu of a true gold standard, a quantitative comparison is difficult and caution should be taken when interpreting the true positives, false positives, sensitivity and specificity.

Grid-side cascade inverter system as an interface for wind energy storage

Additional converters that are used to interface energy storage devices incur power losses as well as increased system cost and complexity. The need for additional converters can be eliminated if the grid side inverter can itself be effectively used as the interface for energy storage. This paper therefore proposes a technique whereby the grid side inverter can also be used as an interface to connect a supercapacitor energy storage for wind energy conversion systems. The proposed grid side inverter is formed by cascading a 3-level inverter and a 2-level inverter through a coupling transformer. The three-level inverter is the main inverter and it is powered by the rectified output of the wind turbine coupled AC generator while the 2-level auxiliary inverter is connected to the super capacitor bank that is used to compensate short term power fluctuations. Novel modulation and control techniques are proposed to address the problems associated with non-integer and dynamically-changing dc-link voltage ratio, which is caused by the random nature of wind. Simulation results are presented to verify the efficacy of the proposed system in suppressing short term wind power fluctuations.

Geographical distribution of human Schistosoma japonicum infection in the Philippines : tools to support disease control and further elimination

S. japonicum infection is believed to be endemic in 28 of the 80 provinces of the Philippines and the most recent data on schistosomiasis prevalence have shown considerable variability between provinces. In order to increase the efficient allocation of parasitic disease control resources in the country, we aimed to describe the small scale spatial variation in S. japonicum prevalence across the Philippines, quantify the role of the physical environment in driving the spatial variation of S. japonicum, and develop a predictive risk map of S. japonicum infection. Data on S. japonicum infection from 35,754 individuals across the country were geo-located at the barangay level and included in the analysis. The analysis was then stratified geographically for Luzon, the Visayas and Mindanao. Zero-inflated binomial Bayesian geostatistical models of S. japonicum prevalence were developed and diagnostic uncertainty was incorporated. Results of the analysis show that in the three regions, males and individuals aged ≥ 20 years had significantly higher prevalence of S. japonicum compared with females and children <5 years. The role of the environmental variables differed between regions of the Philippines. S. japonicum infection was widespread in the Visayas whereas it was much more focal in Luzon and Mindanao. This analysis revealed significant spatial variation in prevalence of S. japonicum infection in the Philippines. This suggests that a spatially targeted approach to schistosomiasis interventions, including mass drug administration, is warranted. When financially possible, additional schistosomiasis surveys should be prioritized to areas identified to be at high risk, but which were underrepresented in our dataset.

A Battery Energy Storage interface for wind power systems with the use of grid side inverter

This paper presents a novel concept of Energy Storage System (ESS) interfacing with the grid side inverter in wind energy conversion systems. The inverter system used here is formed by cascading a 2-level inverter and a three level inverter through a coupling transformer. The constituent inverters are named as the “main inverter” and the “auxiliary inverter” respectively. The main inverter is connected with the rectified output of the wind generator while the auxiliary inverter is attached to a Battery Energy Storage System (BESS). The BESS ensures constant power dispatch to the grid irrespective of change in wind condition. Furthermore, this unique combination of BESS and inverter eliminates the need of additional dc-dc converters. Novel modulation and control techniques are proposed to address the problem of non-integer, dynamically-changing dc-link voltage ratio, which is due to random wind changes. Strategies used to handle auxiliary inverter dc-link voltage imbalances and controllers used to charge batteries at different rates are explained in detail. Simulation results are presented to verify the efficacy of the proposed modulation and control techniques in suppressing random wind power fluctuations.

Nonvolatile multilevel data storage memory device from controlled ambipolar charge trapping mechanism

The capability of storing multi-bit information is one of the most important challenges in memory technologies. An ambipolar polymer which intrinsically has the ability to transport electrons and holes as a semiconducting layer provides an opportunity for the charge trapping layer to trap both electrons and holes efficiently. Here, we achieved large memory window and distinct multilevel data storage by utilizing the phenomena of ambipolar charge trapping mechanism. As fabricated flexible memory devices display five well-defined data levels with good endurance and retention properties showing potential application in printed electronics.