RESUMO
This paper demonstrates a high-speed spiral imaging technique for an atomic force microscope (AFM). As an alternative to traditional raster scanning, an approach of gradient pulsing using a spiral line is implemented and spirals are generated by applying single-frequency cosine and sine waves of slowly varying amplitudes to the X and Y-axes of the AFM's piezoelectric tube scanner (PTS). Due to these single-frequency sinusoidal input signals, the scanning process can be faster than that of conventional raster scanning. A linear quadratic Gaussian controller is designed to track the reference sinusoid and a vibration compensator is combined to damp the resonant mode of the PTS. An internal model of the reference sinusoidal signal is included in the plant model and an integrator for the system error is introduced in the proposed control scheme. As a result, the phase error between the input and output sinusoids from the X and Y-PTSs is reduced. The spirals produced have particularly narrow-band frequency measures which change slowly over time, thereby making it possible for the scanner to achieve improved tracking and continuous high-speed scanning rather than being restricted to the back and forth motion of raster scanning. As part of the post-processing of the experimental data, a fifth-order Butterworth filter is used to filter noises in the signals emanating from the position sensors and a Gaussian image filter is used to filter the images. A comparison of images scanned using the proposed controller (spiral) and the AFM PI controller (raster) shows improvement in the scanning rate using the proposed method.
RESUMO
We undertook a trial of artesunate + amodiaquine (AS + AQ) and artesunate + sulphadoxine-pyrimethamine (AS + SP) in 180 children of age 6-59 months with uncomplicated malaria in Democratic Republic of Congo. Children were randomly allocated to receive 3 days observed treatment of AS + AQ (n = 90) or 3 days of AS + SP (n = 90). Primary efficacy outcomes were 28-day parasite recurrence rates, and recrudescence rates were adjusted by genotyping to distinguish new infection and recrudescence. In addition, we determined the prevalence of molecular markers of resistance to sulphadoxine and pyrimethamine. Day 28 parasite recurrence rates were 16.9% (14/83; 95% CI: 9.5-26.7) in the AS + AQ group and 34.6% (28/81; 95% CI: 24.3-46.0) in the AS + SP group (P = 0.009). After PCR correction, recrudescence rates were 6.7% (5/74; 95% CI: 2.2-15.1) for AS + AQ and 19.7% (13/66; 95% CI: 10.9-31.3) for AS + SP (P = 0.02). There was no significant difference between the two arms in time to parasite clearance, fever clearance and gametocyte clearance. Parasite genotyping showed high frequencies of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) molecular SP-resistance markers, with 57% of the samples showing more than three mutations linked to SP resistance, and 27% with triple-dhfr/double-dhps haplotype, confirming that SP treatment failure rates are likely to be high. AS + AQ had significantly higher efficacy than AS + SP. These results contributed to the subsequent change to AS + AQ as first-line regimen in the country. Efforts to properly implement the new protocol and maintain adherence at acceptable levels should include health staff and patient sensitization. The 6.8% recrudescence rate indicates that AS + AQ should be monitored closely until a more effective artemisinin combination therapy regimen is needed and can be introduced.
