54 research outputs found
A perturbative approach to non-Markovian stochastic Schr\"odinger equations
In this paper we present a perturbative procedure that allows one to
numerically solve diffusive non-Markovian Stochastic Schr\"odinger equations,
for a wide range of memory functions. To illustrate this procedure numerical
results are presented for a classically driven two level atom immersed in a
environment with a simple memory function. It is observed that as the order of
the perturbation is increased the numerical results for the ensembled average
state approach the exact reduced state found via
Imamo\=glu's enlarged system method [Phys. Rev. A. 50, 3650 (1994)].Comment: 17 pages, 4 figure
Models of peer support to remediate post-intensive care syndrome: A report developed by the SCCM Thrive International Peer Support Collaborative
Objective: Patients and caregivers can experience a range of physical, psychological, and
cognitive problems following critical care discharge. The use of peer support has been
proposed as an innovative support mechanism.
Design: We sought to identify technical, safety and procedural aspects of existing
operational models of peer support, among the Society of Critical Care Medicine Thrive Peer
Support Collaborative. We also sought to categorize key distinctions between these models
and elucidate barriers and facilitators to implementation.
Subjects: 17 Thrive sites from the USA, UK, and Australia were represented by a range of
healthcare professionals.
Interventions: Via an iterative process of in-person and email/conference calls, members
of the Collaborative, defined the key areas on which peer support models could be defined
and compared; collected detailed self-reports from all sites; reviewed the information and
identified clusters of models. Barriers and challenges to implementation of peer support
models were also documented.
Results: Within the Thrive Collaborative, six general models of peer support were identified:
Community based, Psychologist-led outpatient, Models based within ICU follow-up clinics,
Online, Groups based within ICU and Peer mentor models. The most common barriers to
implementation were: recruitment to groups, personnel input and training: sustainability
and funding, risk management and measuring success.
Conclusion: A number of different models of peer support are currently being developed
to help patients and families recover and grow in the post-critical care setting
The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance
INTRODUCTION
Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic.
RATIONALE
We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs).
RESULTS
Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants.
CONCLUSION
Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century
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