A hidden HIV epidemic among women in Vietnam

<p>Abstract</p> <p>Background</p> <p>The HIV epidemic in Vietnam is still concentrated among high risk populations, including IDU and FSW. The response of the government has focused on the recognized high risk populations, mainly young male drug users. This concentration on one high risk population may leave other populations under-protected or unprepared for the risk and the consequences of HIV infection. In particular, attention to women's risks of exposure and needs for care may not receive sufficient attention as long as the perception persists that the epidemic is predominantly among young males. Without more knowledge of the epidemic among women, policy makers and planners cannot ensure that programs will also serve women's needs.</p> <p>Methods</p> <p>More than 300 documents appearing in the period 1990 to 2005 were gathered and reviewed to build an understanding of HIV infection and related risk behaviors among women and of the changes over time that may suggest needed policy changes.</p> <p>Results</p> <p>It appears that the risk of HIV transmission among women in Vietnam has been underestimated; the reported data may represent as little as 16% of the real number. Although modeling predicted that there would be 98,500 cases of HIV-infected women in 2005, only 15,633 were accounted for in reports from the health system. That could mean that in 2005, up to 83,000 women infected with HIV have not been detected by the health care system, for a number of possible reasons. For both detection and prevention, these women can be divided into sub-groups with different risk characteristics. They can be infected by sharing needles and syringes with IDU partners, or by having unsafe sex with clients, husbands or lovers. However, most new infections among women can be traced to sexual relations with young male injecting drug users engaged in extramarital sex. Each of these groups may need different interventions to increase the detection rate and thus ensure that the women receive the care they need.</p> <p>Conclusion</p> <p>Women in Vietnam are increasingly at risk of HIV transmission but that risk is under-reported and under-recognized. The reasons are that women are not getting tested, are not aware of risks, do not protect themselves and are not being protected by men. Based on this information, policy-makers and planners can develop better prevention and care programs that not only address women's needs but also reduce further spread of the infection among the general population.</p

FPGA-based sensorless PMSM speed control using reduced-order extended kalman filters

© 2014 IEEE. This paper presents the design and implementation of a field-programmable gate array (FPGA)-based architecture for the speed control of sensorless permanent-magnet synchronous motor (PMSM) drives. For the reduction of computation resources, as well as accuracy improvement in the rotor position estimation, a parallel reduced-order extended Kalman filter (EKF) is proposed in this work. Compared with an EKF, the system order is reduced and the iteration process is greatly simplified, resulting in significant savings of resource utility, while maintaining high estimation performance. The whole control system includes a current-control-and-coordinate-transformation unit, a proportional-integral (PI) speed controller, and other accessory modules, all implemented in a single FPGA chip. A hardware description language is adopted to describe advantageous features of the proposed control system. Moreover, the finite-state-machine method is applied with the purpose to reduce logic elements used in the FPGA chip. The validity of the approach is verified through simulation based on the Modelsim/Simulink cosimulation method. Finally, experimental results are obtained on an FPGA platform with an inverter-fed PMSM to show the feasibility and effectiveness of the proposed system-on-programmable-chip for PMSM drives

FPGA sensorless PMSM drive with adaptive fading extended Kalman filtering

© 2014 IEEE. This paper addresses the design and implementation of an Adaptive Fading Extended Kaiman Filter (AF-EKF) for the sensorless Permanent Magnet Synchronous Motor (PMSM) on a Field Programmable Gate Array (FPGA) chip. The rotor position and speed of the motor are estimated by the implemented AF-EKF and their estimates are then used in vector control of the PMSM. In conventional Kaiman filtering, abrupt state changes may not be tracked adequately since sudden variations may seriously affect the auto-correlation Gaussian property of white noise in the filter residuals. For this, the AF-EKF has been developed to recover the estimation results in events of frequent and sharp state jumps. The AF-EKF is, therefore, a promising estimator for PMSM drives that are subject to frequently-varying loads speed commands. Here, for realization of the PMSM sensorless control using the system-on-programmable-chip technology, high-speed arithmetic functions and pipelining are employed in the FPGA implementation. The finite state machine method is also used to facilitate the execution timing and chip design. The co-simulation of Modelsim/Simulink shows effectiveness of the proposed chip-based AF-EKF PMSM speed estimation

Dengue in Vietnamese infants--results of infection-enhancement assays correlate with age-related disease epidemiology, and cellular immune responses correlate with disease severity.

The pathogenesis of severe dengue is not well understood. Maternally derived subneutralizing levels of dengue virus-reactive IgG are postulated to be a critical risk factor for severe dengue during infancy. In this study, we found that, in healthy Vietnamese infants, there was a strong temporal association between the Fc-dependent, dengue virus infection-enhancing activity of neat plasma and the age-related epidemiology of severe dengue. We then postulated that disease severity in infants with primary infections would be associated with a robust immune response, possibly as a consequence of higher viral burdens in vivo. Accordingly, in infants hospitalized with acute dengue, the activation phenotype of peripheral-blood NK cells and CD8+ and CD4+ T cells correlated with overall disease severity, but HLA-A*1101-restricted NS3(133-142)-specific CD8+ T cells were not measurable until early convalescence. Plasma levels of cytokines/chemokines were generally higher in infants with dengue shock syndrome. Collectively, these data support a model of dengue pathogenesis in infants whereby antibody-dependent enhancement of infection explains the age-related case epidemiology and could account for antigen-driven immune activation and its association with disease severity. These results also highlight potential risks in the use of live attenuated dengue vaccines in infants in countries where dengue is endemic

FPGA-based sensorless PMSM drive using parallel reduced-order Extended Kalman Filter

This paper presents the design and evaluation of a Field Programmable Gate Array (FPGA)-based speed sensorless controller for Permanent Magnet Synchronous Motor (PMSM). The estimation of the rotor position and speed is achieved by using a parallel reduced-order Extended Kalman Filter (EKF) to alleviate the need of physical sensors. Compared with the traditional method of EKF, the system order is reduced, the process of iteration of speed estimation algorithm is greatly simplified and it is easy to realize the digital system. To achieve this objective, a comparison is made between the parallel reduced-order EKF, full-order EKF and sliding mode observer (SMO). The developed controller has been implemented in a FPGA-based environment and the very high speed integrated circuit-hardware description language (VHDL) is adopted to describe advantageous features of the proposed control system. The validity of the approach is verified through simulation results based on the Modelsim/Simulink co-simulation method. © 2012 IEEE

Dengue virus infections and maternal antibody decay in a prospective birth cohort study of Vietnamese infants.

Dengue hemorrhagic fever can occur in primary dengue virus (DENV) infection of infants. The decay of maternally derived DENV immunoglobulin (Ig) G and the incidence of DENV infection were determined in a prospectively studied cohort of 1244 Vietnamese infants. Higher concentrations of total IgG and DENV-reactive IgG were found in cord plasma relative to maternal plasma. Maternally derived DENV-neutralizing and E protein-reactive IgG titers declined to below measurable levels in &gt;90% of infants by 6 months of age. In contrast, IgG reactive with whole DENV virions persisted until 12 months of age in 20% of infants. Serological surveillance identified 10 infants with asymptomatic DENV infection for an incidence of 1.7 cases per 100 person-years. DENV-neutralizing antibodies remained measurable for &gt; or = 1 year after infection. These results suggest that whereas DENV infection in infants is frequently subclinical, there is a window between 4 and 12 months of age where virion-binding but nonneutralizing IgG could facilitate antibody-dependent enhancement

The epidemiology and aetiology of diarrhoeal disease in infancy in southern Vietnam: a birth cohort study

Previous studies indicate a high burden of diarrhoeal disease in Vietnamese children, however longitudinal community-based data on burden and aetiology are limited. The findings from a large, prospective cohort study of diarrhoeal disease in infants in southern Vietnam are presented herein.Infants were enrolled at birth in urban Ho Chi Minh City and a semi-rural district in southern Vietnam, and followed for 12 months (n=6706). Diarrhoeal illness episodes were identified through clinic-based passive surveillance, hospital admissions, and self-reports.The minimum incidence of diarrhoeal illness in the first year of life was 271/1000 infant-years of observation for the whole cohort. Rotavirus was the most commonly detected pathogen (50% of positive samples), followed by norovirus (24%), Campylobacter (20%), Salmonella (18%), and Shigella (16%). Repeat infections were identified in 9% of infants infected with rotavirus, norovirus, Shigella, or Campylobacter, and 13% of those with Salmonella infections.The minimum incidence of diarrhoeal disease in infants in both urban and semi-rural settings in southern Vietnam was quantified prospectively. A large proportion of laboratory-diagnosed disease was caused by rotavirus and norovirus. These data highlight the unmet need for a rotavirus vaccine in Vietnam and provide evidence of the previously unrecognized burden of norovirus in infants

Maternal Antibody and Viral Factors in the Pathogenesis of Dengue Virus in Infants

The pathogenesis of dengue in infants is poorly understood. We postulated that dengue severity in infants would be positively associated with markers of viral burden and that maternally derived, neutralizing anti-dengue antibody would have decayed before the age at which infants with dengue presented to the hospital. In 75 Vietnamese infants with primary dengue, we found significant heterogeneity in viremia and NS1 antigenemia at hospital presentation, and these factors were independent of disease grade or continuous measures of disease severity. Neutralizing antibody titers, predicted in each infant at the time of their illness, suggested that the majority of infants (65%) experienced dengue hemorrhagic fever when the maternally derived neutralizing antibody titer had declined to &lt;1:20. Collectively, these data have important implications for dengue vaccine research because they suggest that viral burden may not solely explain severe dengue in infants and that neutralizing antibody is a reasonable but not absolute marker of protective immunity in infants