Description, Classification, and Prediction of Dengue Illnesses in a Thai Pediatric Cohort: A Dissertation

Dengue fever (DF) and dengue hemorrhagic fever (DHF) are emerging infectious diseases which are endemic in many regions of the globe, many of which are resource-poor areas. DHF and DF impose a severe economic health burden in tropical and subtropical areas. Dengue virus causes an acute febrile illness that can be a self-limited febrile illness, as seen in most cases of DF, or a life-threatening illness with plasma leakage and shock, as seen in cases of DHF. A systematic review of the literature revealed gaps in the knowledge base of clinical laboratory findings of dengue illness with regards to longitudinal dynamics and classification and predictive modeling of disease severity. The objective of this thesis was to investigate the utility of clinical laboratory variables for classification and prediction of disease outcomes. The data used in this investigation was derived from a prospective study of Thai children presenting to either of two study hospitals within 72 hours of onset of an acute febrile illness. Systematic data collection, including clinical laboratory parameters, and routine clinical management continued each day until 24 hours after the fever had subsided. A final diagnosis of DHF, DF, or other febrile illness (OFI) was assigned by an expert physician after chart review. The first research objective of this study was to describe the temporal dynamics of clinical laboratory parameters among subjects with DHF, DF, or OFI. Data were analyzed using lowess curves and population-average models. Quadratic functions of clinical variables over time were established and demonstrated significantly divergent patterns between the various diagnostic groups. The second research objective was to establish and validate tools for classification of illness severity using easily obtained clinical laboratory measures. Bivariate logistic regression models were established using data from one hospital in an urban area of Thailand as a training data set and validated with a second data set from a hospital in a rural area of Thailand. The validated models maintained a high sensitivity and specificity in distinguishing severe dengue illnesses without using the hallmark indicators of plasma leakage. The third research objective used classification and regression tree (CART) analysis to established diagnostic decisions trees using data obtained on the day of study enrollment, within the first 3 days of acute illness. Decision trees with high sensitivity were established for severe dengue defined either as: 1) DHF with evidence of shock (dengue shock syndrome, DSS); or 2) DSS or dengue with significant pleural effusion. This study expands existing knowledge of the potential utility of clinical laboratory variables during different phases of dengue illness. The application of the results of these studies should lead to promising opportunities in the fields of epidemiological research and disease surveillance to reduce the health burden, and improve the clinical management, of dengue illness. Future directions involve application of these algorithms to different study populations and age groups. Additionally, other analytical techniques, such as those involving CART analysis, can be explored with these data

Indenture, Marshall County, 17 December 1840

https://egrove.olemiss.edu/aldrichcorr_b/1019/thumbnail.jp

Effects of Superdispersant-25 on the sorption dynamics of naphthalene and phenanthrene in marine sediments

Acknowledgements: The authors acknowledge the assistance of Mike Mcgibbon in analysing carbon content, the crews of the MRV Scotia and MRV Temora for sample collection. Dr. Hedda Weitz and Prof. Graeme Patton are thanked for facilitating access to laboratory space and equipment. Funding information: LJP was funded through MarCRF funds for a PhD project designed by UW, JA and AG and awarded to LJP.Peer reviewedPostprin

Characterisation of microbial communities of drill cuttings piles from offshore oil and gas installations

Acknowledgements The authors would like to acknowledge the support of the Maxwell computer cluster funded by the University of Aberdeen. Dr. Axel Aigle is acknowledged for guidance and assistance in molecular analysis. Hedda Weitz and Heather Richmond are thanked for technical support. This work was supported by the Natural Environment Research Council [NE/L00982X/1 to UW, JA and EG]. CGR was supported by a University Research Fellowship from the Royal Society [UF150571]. DC samples, environmental analysis and all geochemical datasets were kindly provided by Marathon Oil UK LLC (referred to as Marathon Oil).Peer reviewedPublisher PD

Chronic environmental perturbation influences microbial community assembly patterns

Acknowledgements Next-generation sequencing and library construction was performed by NCIMB Ltd., Aberdeen and CGEBM, Aberdeen. The authors would like to acknowledge the support of the Maxwell computer cluster funded by the University of Aberdeen. Dr Axel Aigle is acknowledged for assistance in molecular analysis. This work was supported by the Natural Environment Research Council [NE/L00982X/1] with financial support from BP UK Ltd and Intertek Group PLC. CGR was supported by a University Research Fellowship from the Royal Society [UF150571]Peer reviewedPostprin

Hospitalist involvement in family medicine residency training: A CERA study

BACKGROUND AND OBJECTIVES: Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching. METHODS: Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics. RESULTS: Forty-one percent (n=175) of residency directors completed the hospitalist section of the CERA survey. Sixty-six percent of residency programs were community based/university affiliated. The majority of directors who have, or are planning to develop, a hospitalist service currently use an internal medicine service (92.5%), followed by family medicine (39.1%), pediatrics (35.4%), OB/laborists (18.0%), and combined services (8.7%). The majority of programs with a hospitalist training track (or plans to develop one) indicated that this was for a family medicine service. Sixty percent of programs that have a hospitalist service involve hospitalists in teaching. Twenty percent of directors reported that hospitalists serve as family medicine faculty, and 63% viewed them as good educators. However, 85% reported no reduction in inpatient teaching by family medicine faculty despite using hospitalist teaching services. CONCLUSIONS: Hospitalists have a significant educational role in family medicine resident training. Further research is needed to explore how hospitalists and family medicine faculty can collaborate to promote enhanced efficiency and effectiveness as residency teachers

The effect of chemical dispersant concentration on hydrocarbon mobility through permeable North-East Scotland sands

The authors acknowledge Paul Hallett and Annette Raffan for granting access to and training on the tensiometer, respectively. Cruickshank Analytical Lab staff are acknowledged for assistance in carbon content analysis. The Marine Collaboration Research Forum is acknowledged for funding LJP's PhD project. BP are acknowledged for providing Schiehallion crude oil.Peer reviewedPostprintPostprin

Effect of spatial origin and hydrocarbon composition on bacterial consortia community structure and hydrocarbon biodegradation rates

This work was supported by the Natural Environment Research Council [NE/L00982X/1 to UW, JA and EG]. CGR was supported by a University Research Fellowship from the Royal Society [UF150571].Peer reviewedPublisher PD

Projecting the effect of crop yield increases, dietary change and different price scenarios on land use under two different state security regimes

Peer reviewedPublisher PD