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Byline: Mani. Anand, Sanjay. Deshmukh, Harveen. Gulati, Prashant. Yadav Sir, Angiomyxolipoma is a rare benign mesenchymal tumor. We describe this lesion in an 81-year-old male who presented with a gradually [...]

Despite increased investments in procurement of essential medicines, their availability at health facilities remains extremely low in many low- and middle-income countries. The lack of a well-functioning supply chain for essential medicines is often the cause of this poor availability. Using a randomized trial conducted in 439 health facilities and 24 districts in Zambia, this study helps understand the optimal supply chain structure for essential medicines distribution in the public sector in low-income countries. It shows that a more direct distribution system where clinics order and receive medicines supply directly from the central agency through a cross-docking arrangement significantly reduces the duration and frequency of stockouts compared to a traditional three-level drug distribution system. As an example, the frequency of stockouts for first line pediatric malaria medicines reduced from 47.9% to 13.3% and the number of days of stockout in a quarter reduced from 27 days to 5 days. The direct flow of demand and order information from health facilities to the central supply agency reduces the problem of diffuse accountability that exists in multi-tiered distribution systems. It also shifts the locus of decision making for complex supply chain functions such as scarce stock allocation and adjustment of health facility order quantities to levels in the system where staff competency is aligned with what the function needs. Even when supply chain system redesign such as the one evaluated in this paper are demonstrated to be technically robust using rigorous evidence, they often require navigating a complex political economy within the overall health system and its actors. [ABSTRACT FROM AUTHOR]

Keywords: Infection prevention; Supply chain; Epidemic management/response; Pandemic preparedness; Hospital preparedness/response EN Infection prevention Supply chain Epidemic management/response Pandemic preparedness Hospital preparedness/response 357 358 2 08/17/22 20220701 NES 220701 The infection prevention and control (IPC) workforce is central to ensuring adequate preparation in the interepidemic period - the period between epidemics - and a robust control response in outbreak settings.[1] Supply chain management issues including supply security, inventory management, and stockouts became evident when a shortage of personal protective equipment (PPE) threatened to hamper the outbreak response to Ebola virus disease in West Africa in 2014-2016 and, more recently, with the COVID-19 pandemic.[2],[3] While interest in the supply chains of more complex health technologies such as vaccines and oxygen has grown, supplies such as alcohol-based hand rub/sanitizer and PPE have garnered less attention. Supply chain, Hospital preparedness/response, Infection prevention, Epidemic management/response, Pandemic preparedness. [Extracted from the article]

Despite substantial financial aid from international donors for procurement of health products, stockouts of life-saving drugs related to prevalent infectious diseases are still widespread in Africa. Rigorous research to understand the underlying causes of these stockouts is lacking. To this end, we study the relationship between The Global Fund to Fight AIDS, Tuberculosis and Malaria and its grant recipients. Specifically, we leverage historical fund disbursement and drug procurement data from 2002 to 2013 to build a discrete-event simulation model predicting the joint impact of procurement and grant disbursement processes on national drug availability for the Global Fund's recipient countries in Africa. This model is validated against cumulative stockout levels inferred from historical grant implementation lengths, and used to evaluate potential high-level modifications in the disbursement or procurement process. Results show the existence of significant intrinsic stockout risks in most African countries, with particularly high levels in East Africa, due to the unpredictability of fund disbursements and the frequency of grant performance monitoring performed by the Global Fund. Interventions shifting some fund disbursements upfront to protect against disbursement timing uncertainty are predicted to be more effective than others that include regional buffer stocks and bridge financing. [ABSTRACT FROM AUTHOR]

Creation of variation in existing gene pool of crop plants is the foremost requirement in crop improvement programmes. Genome editing is a tool to produce knock out of target genes either by introduction of insertion or by deletion that disrupts the function of a specific gene. The CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9) system is the most recent addition to the toolbox of sequence-specific nucleases that includes ZFNs and TALENs. The CRISPR/Cas9 system allows targeted cleavage of genomic DNA guided by a small noncoding RNA, resulting in gene modifications by both non-homologous end joining and homology-directed repair mechanisms. Here, we present an overview of mechanisms of CRISPR, its potential roles in creating variation in germplasm and applications of this novel interference pathway in crop improvement. The availability of the CRISPR/Cas9 system holds promise in facilitating both forward and reverse genetics and will enhance research in crops that lack genetic resources. [ABSTRACT FROM AUTHOR]