BackgroundThe human population in the highlands of Nyanza Province, western Kenya, is subject to sporadic epidemics of Plasmodium falciparum. Indoor residual spraying (IRS) and long-lasting insecticide treated nets (LLINs) are used widely in this area. These interventions are most effective when Anopheles rest and feed indoors and when biting occurs at times when individuals use LLINs. It is therefore important to test the current assumption of vector feeding preferences, and late night feeding times, in order to estimate the extent to which LLINs protect the inhabitants from vector bites.MethodsMosquito collections were made for six consecutive nights each month between June 2011 and May 2012. CDC light-traps were set next to occupied LLINs inside and outside randomly selected houses and emptied hourly. The net usage of residents, their hours of house entry and exit and times of sleeping were recorded and the individual hourly exposure to vectors indoors and outdoors was calculated. Using these data, the true protective efficacy of nets (P*), for this population was estimated, and compared between genders, age groups and from month to month.ResultsPrimary vector species (Anopheles funestus s.l. and Anopheles arabiensis) were more likely to feed indoors but the secondary vector Anopheles coustani demonstrated exophagic behaviour (p < 0.05). A rise in vector biting activity was recorded at 19:30 outdoors and 18:30 indoors. Individuals using LLINs experienced a moderate reduction in their overall exposure to malaria vectors from 1.3 to 0.47 bites per night. The P* for the population over the study period was calculated as 51% and varied significantly with age and season (p < 0.01).ConclusionsIn the present study, LLINs offered the local population partial protection against malaria vector bites. It is likely that P* would be estimated to be greater if the overall suppression of the local vector population due to widespread community net use could be taken into account. However, the overlap of early biting habit of vectors and human activity in this region indicates that additional methods of vector control are required to limit transmission. Regular surveillance of both vector behaviour and domestic human-behaviour patterns would assist the planning of future control interventions in this region.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0766-4) contains supplementary material, which is available to authorized users.

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This article illustrates the positive impact of fluoroscopic imaging equipment on radiation dose reduction in CTO PCI.• The reader should recognize the importance of purchasing and maintaining the best equipment, understanding procedure/patient complexity, and assuring operator training in radiation dose reduction.• Future efforts/studies should focus upon all three areas of dose reduction for best results.Radiation safety in the cardiac catheterization laboratory has been an important aspect of patient care from its inception. The founders of SCAI, Mason Sones and Melvin Judkins, worked closely with experts in X-ray imaging creating an imaging service to assist laboratories in providing the highest quality images at the lowest dose. With time, (performed) most documentations on fluoroscopy, only short cine runs, no extreme angles, and optimal table (collimation) settings".Operator and staff must maximize their distance from the X-ray tube (The Inverse Square Law), utilize all available shielding, and keep all appendages, operator and patient, out of the imaging field. Societies have published guidelines summarizing these best practices. 5As invasive cardiology expanded from diagnostic to intervention to peripheral to structural, the interventional cardiologist have been inundated by technology requiring the mastering of many skills. This is returning the invasive cardiologists primarily to the cath lab and potentially even specializing in certain areas of interventional practice.Due to the complexity of the equipment, patient/procedure, and operator training, CTOs personify this specialization. The interventional operator must appreciate best practices in radiation safety that includes high quality imaging equipment, a thorough understanding of the patient/procedure, and appropriate operator (and staff ) training in radiation safety. As the professional "gambler" at a race track seldom gambles without full knowledge of the entire race, the interventional cardiologist similarly must understand the total environment. Whether it be the track, horse, and expertise in the betting of the gambler, or the equipment, procedure, and training of the interventionalist, perfecting the trifecta is essential to achieve the best results.