Optimising the management of vaginal discharge syndrome in Bulgaria: cost effectiveness of four clinical algorithms with risk assessment

OBJECTIVES: To evaluate the performance and cost effectiveness of the WHO recommendations of incorporating risk-assessment scores and population prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) into vaginal discharge syndrome (VDS) algorithms. METHODS: Non-pregnant women presenting with VDS were recruited at a non-governmental sexual health clinic in Sofia, Bulgaria. NG and CT were diagnosed by PCR and vaginal infections by microscopy. Risk factors for NG/CT were identified in multivariable analysis. Four algorithms based on different combinations of behavioural factors, clinical findings and vaginal microscopy were developed. Performance of each algorithm was evaluated for detecting vaginal and cervical infections separately. Cost effectiveness was based on cost per patient treated and cost per case correctly treated. Sensitivity analysis explored the influence of NG/CT prevalence on cost effectiveness. RESULTS: 60% (252/420) of women had genital infections, with 9.5% (40/423) having NG/CT. Factors associated with NG/CT included new and multiple sexual partners in the past 3 months, symptomatic partner, childlessness and >or=10 polymorphonuclear cells per field on vaginal microscopy. For NG/CT detection, the algorithm that relied solely on behavioural risk factors was less sensitive but more specific than those that included speculum examination or microscopy but had higher correct-treatment rate and lower over-treatment rates. The cost per true case treated using a combination of risk factors, speculum examination and microscopy was euro 24.08. A halving and tripling of NG/CT prevalence would have approximately the inverse impact on the cost-effectiveness estimates. CONCLUSIONS: Management of NG/CT in Bulgaria was improved by the use of a syndromic approach that included risk scores. Approaches that did not rely on microscopy lost sensitivity but were more cost effective

Macromolecular recognition in the Protein Data Bank

X-ray structures in the PDB illustrate both the specific recognition of two polypeptide chains in protein–protein complexes and dimeric proteins and their nonspecific interaction at crystal contacts

Reducing errors by increasing the error rate: MLP Acoustic Modeling for Broadcast News Transcription

We describe some aspects of a Broadcast News recognition system based on hybrid HMM/MLP acoustic modeling. These include the use of novel 'modulation spectrogram' features which are combined with conventional models at the posterior probability level, some experiments with nonlinear segment normalization, and an investigation of the interaction of model size and training set size for an multilayer perceptron (MLP) acoustic classifier. We also report preliminary results of incorporating gender-dependence into this system

Walking automata in free inverse monoids

International audienceWalking automata, be they running over words, trees or even graphs, possibly extended with pebbles that can be dropped and lifted on vertices, have long been defined and studied in Computer Science. However, questions concerning walking automata are surprisingly complex to solve. In this paper, we study a generic notion of walking automata over graphs whose semantics naturally lays within inverse semigroup theory. Then, from the simplest notion of walking automata on birooted trees, that is, elements of free inverse monoids, to the more general cases of walking automata on birooted finite subgraphs of Cayley's graphs of groups, that is, elements of free E-unitary inverse monoids, we provide a robust algebraic framework in which various classes of recognizable or regular languages of birooted graphs can uniformly be defined and related one with the other

Qualité du bois de six essences du maquis méditerranéen

L étude des caractéristiques physico-mécaniques du bois de six essences du maquis, ainsi qu un essai de tournage conduit par une petite entreprise spécialisée, a montré que certaines utilisations (tournage, menuiserie fine) permettent une bonne valorisation des bois du maquis, et que ceux-ci peuvent rivaliser par leur finition, leur dureté et leur bel aspect avec de nombreux bois tropicaux importés

Cold-atom shaping with MEMS scanning mirrors

We demonstrate the integration of micro-electro-mechanical-systems (MEMS) scanning mirrors as active elements for the local optical pumping of ultra-cold atoms in a magneto-optical trap. A pair of MEMS mirrors steer a focused resonant beam through a cloud of trapped atoms shelved in the \textit{F}=1 ground-state of \textsuperscript{87}Rb for spatially-selective fluorescence of the atom cloud. Two-dimensional control is demonstrated by forming geometrical patterns along the imaging axis of the cold atom ensemble. Such control of the atomic ensemble with a microfabricated mirror pair could find applications in single atom selection, local optical pumping and arbitrary cloud shaping. This approach has significant potential for miniaturisation and in creating portable control systems for quantum optic experiments.Comment: 4 pages, 3 figure

Eight Weeks Later - The Unprecedented Rise of 3D Printing during the COVID-19 Pandemic : a Case Study, Lessons Learned, and Implications on the Future of Global Decentralized Manufacturing

The eruption of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (corona virus disease, COVID-19) in Wuhan, China, and its global spread has led to an exponentially growing number of infected patients, currently exceeding over 6.6 million and over 390,000 deaths as of the 5th of June 2020. In this pandemic situation, health systems have been put under stress, and the demand for personal protective equipment (PPE) exceeded the delivery capabilities of suppliers. To address this issue, 3D printing was identified as a possible solution to quickly produce PPE items such as face shields, mask straps, masks, valves, and ear savers. Around the world, companies, universities, research institutions, and private individuals/hobbyists stepped into the void, using their 3D printers to support hospitals, doctors, nursing homes, and even refugee camps by providing them with PPE. In Germany, the makervsvirus movement took up the challenge and connected thousands of end users, makers, companies, and logistic providers for the production and supply of face shields, protective masks, and ear savers. The Karlsruhe Institute of Technology (KIT) also joined the makervsvirus movement and used its facilities to print headbands for face shield assemblies and ear savers. Within this paper, the challenges and lessons learned from the quick ramp up of a research laboratory to a production site for medium-sized batches of PPE, the limitations in material supply, selection criteria for suitable models, quality measures, and future prospects are reported and conclusions drawn

Structured reactive programming with polymorphic temporal tiles

International audienceIn functional reactive programming (FRP), system inputs and outputs are generally modeled as functions over continuous time (behaviors) whose future values are governed by sudden changes (events). In this approach, discrete events are embedded into piece-wise continuous behaviors. In the field of reactive music system programming, we develop an orthogonal approach that seems to better fit our need. Much like piano keys can be played and combined both in sequence and in parallel, we model system inputs and outputs as spatio-temporal combinations of what we call temporal values: continuous functions over time whose domain lays between two events: a start and a stop event. Various high level data types and program constructs can then be derived from such a model. They are shown to satisfy robust algebraic and category theoretic properties. Altogether, this eventually provides a simple, robust and elegant programming front-end, temporal tile programming, for reading, memorizing, stretching, combining and transforming flows of inputs into flows of outputs. Although at its infancy, the resulting approach has been experimentally validated for reactive and real-time music system programming

Theory and simulation of short-range models of globular protein solutions

We report theoretical and simulation studies of phase coexistence in model globular protein solutions, based on short-range, central, pair potential representations of the interaction among macro-particles. After reviewing our previous investigations of hard-core Yukawa and generalised Lennard-Jones potentials, we report more recent results obtained within a DLVO-like description of lysozyme solutions in water and added salt. We show that a one-parameter fit of this model based on Static Light Scattering and Self-Interaction Chromatography data in the dilute protein regime, yields demixing and crystallization curves in good agreement with experimental protein-rich/protein-poor and solubility envelopes. The dependence of cloud and solubility points temperature of the model on the ionic strength is also investigated. Our findings highlight the minimal assumptions on the properties of the microscopic interaction sufficient for a satisfactory reproduction of the phase diagram topology of globular protein solutions.Comment: 17 pages, 8 figures, Proc. of Conference "Structural Arrest Transitions in Colloidal Systems with Short-Range Attractions", Messina (ITALY) 17-20 December 200

Study of errors in the integration of the two-body problem using generalized Sundman's anomalies

[EN] As is well known, the numerical integration of the two body problem with constant step presents problems depending on the type of coordinates chosen. It is usual that errors in Runge-Lenz's vector cause an artificial and secular precession of the periaster although the form remains symplectic, theoretically, even when using symplectic methods. Provided that it is impossible to preserve the exact form and all the constants of the problem using a numerical method, a possible option is to make a change in the variable of integration, enabling the errors in the position of the periaster and in the speed in the apoaster to be minimized for any eccentricity value between 0 and 1. The present work considers this casuistry. We provide the errors in norm infinite, of different quantities such as the Energy, the module of the Angular Moment vector and the components of Runge-Lenz's vector, for a large enough number of orbital revolutions.Lopez Orti, JA.; Marco Castillo, FJ.; Martínez Uso, MJ. (2014). Study of errors in the integration of the two-body problem using generalized Sundman's anomalies. SEMA SIMAI Springer Series. 4:105-112. doi:10.1007/978-3-319-06953-1_11S1051124Brower, D., Clemence, G.M.: Celestial Mechanics. Academic, New York (1965)Brumberg, E.V.: Length of arc as independent argument for highly eccentric orbits. Celest. Mech. 53, 323–328 (1992)Fehlberg, E., Marsall, G.C.: Classical fifth, sixth, seventh and eighth Runge–Kutta formulas with stepsize control. Technical report, NASA, R-287 (1968)Ferrándiz, J.M., Ferrer, S., Sein-Echaluce, M.L.: Generalized elliptic anomalies. Celest. Mech. 40, 315–328 (1987)Gragg, W.B.: Repeated extrapolation to the limit in the numerical solution of ordinary differential equations. SIAM J. Numer. Anal. 2, 384–403 (1965)Janin, G.: Accurate computation of highly eccentric satellite orbits. Celest. Mech. 10, 451–467 (1974)Janin, G., Bond, V.R.: The elliptic anomaly. Technical memorandum, NASA, n. 58228 (1980)Levallois, J.J., Kovalevsky, J.: Géodésie Générale, vol. 4. Eyrolles, Paris (1971)López, J.A., Agost, V., Barreda, M.: A note on the use of the generalized Sundman transformations as temporal variables in celestial mechanics. Int. J. Comput. Math. 89, 433–442 (2012)López, J.A., Marco, F.J., Martínez, M.J.: A study about the integration of the elliptical orbital motion based on a special one-parametric family of anomalies. Abstr. Appl. Anal. 2014, ID 162060, 1–11 (2014)Nacozy, P.: The intermediate anomaly. Celest. Mech. 16, 309–313 (1977)Sundman, K.: Memoire sur le probleme des trois corps. Acta Math. 36, 105–179 (1912)Tisserand, F.F.: Traité de Mecanique Celeste. Gauthier-Villars, Paris (1896)Velez, C.E., Hilinski, S.: Time transformation and Cowell’s method. Celest. Mech. 17, 83–99 (1978