Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015:a systematic review and modelling study

Background: We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015. Methods: We estimated the incidence and hospital admission rate of RSV-associated ALRI (RSV-ALRI) in children younger than 5 years stratified by age and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies. We estimated the RSV-ALRI incidence for 132 developing countries using a risk factor-based model and 2015 population estimates. We estimated the in-hospital RSV-ALRI mortality by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-ALRI mortality by identifying studies reporting monthly data for ALRI mortality in the community and RSV activity. Findings: We estimated that globally in 2015, 33·1 million (uncertainty range [UR] 21·6–50·3) episodes of RSV-ALRI, resulted in about 3·2 million (2·7–3·8) hospital admissions, and 59 600 (48 000–74 500) in-hospital deaths in children younger than 5 years. In children younger than 6 months, 1·4 million (UR 1·2–1·7) hospital admissions, and 27 300 (UR 20 700–36 200) in-hospital deaths were due to RSV-ALRI. We also estimated that the overall RSV-ALRI mortality could be as high as 118 200 (UR 94 600–149 400). Incidence and mortality varied substantially from year to year in any given population. Interpretation: Globally, RSV is a common cause of childhood ALRI and a major cause of hospital admissions in young children, resulting in a substantial burden on health-care services. About 45% of hospital admissions and in-hospital deaths due to RSV-ALRI occur in children younger than 6 months. An effective maternal RSV vaccine or monoclonal antibody could have a substantial effect on disease burden in this age group

Effectiveness of Structured Teaching Programme on knowledge regarding ICDS among Anganwadi Workers

<p>Background: In India, Integrated Child Development Services were first implemented in October 1975. Integrated Child Development Services are provided in Anganwadi Centers through the Anganwadi Workers. Anganwadi Worker's knowledge about ICDS is directly linked to the ultimate outcome of the ICDS scheme. Therefore, the aim of the study was to assess the effectiveness of Structured Teaching Programme in terms of knowledge regarding ICDS among Anganwadi Workers.</p><p>Materials and methods: A Pre-experimental one group pre-test post-test design was adopted in quantitative approach. A total of 100 AWWs working in ICDS-Prem Nagar Project were selected using total enumerative sampling technique. Data was collected through structured knowledge questionnaire (KR20 - 0.8) in June-2022. On Day-1, Pre-test followed by Structured Teaching Programme on ICDS was administered. On Day-7, Post-test was conducted.  </p><p>Results: Pre-test study results showed that only 3% AWWs had excellent knowledge, 45% had good knowledge, 40% had average knowledge and 12% had below average knowledge regarding ICDS. After intervention, Post-test scores improved significantly. Pre-test mean+SD was 16.82+4.085 and Post-test mean+SD was 24.29+3.586.The mean post-test knowledge score was higher than the mean pre-test score with mean difference of 7.47, which was found to be statistically significant (Z= 13.739) at p<0.05.No significant association was found between the pre-test knowledge level of the AWWs and selected socio-demographic variables at p<0.05.</p><p>Conclusion: Based on the findings of the study it can be concluded that structured teaching programme on ICDS was significantly effective in enhancing the knowledge among Anganwadi workers.</p&gt

Excitation energy transfer in covalently linked pheophorbied—porphyrin systems

Steady-state fluorescence, lifetime measurements and time-resolved absorption spectra of the covalently linked hetero dimers consisting of pheophorbide and porphyrin revealed rapid (1011–1012s−1) and efficient singlet—singlet excitation energy transfer from porphyrin unit to pheophorbide

Optimization of Pr\u3csup\u3e3+\u3c/sup\u3e doped fluoride fiber amplifiers and substantial performance improvement with a pump reflecting mirror

We report on optimized performance of Pr3+ doped fluoride fiber amplifiers (PDFA) using a comprehensive spatial and spectral computer model. We show the correspondence between results that were experimentally determined and those obtained using our model. Waveguide parameters for these amplifiers have been optimized for low and moderate values of relative refractive index difference. A cut-off wavelength of 750 nm gives maximum gain for NA = 0.1 and 0.2. Particular emphasis is given to a comparison of the PDFA\u27s performance with and without a Bragg reflecting pump mirror etched at the output end of the fiber. A pump reflecting mirror gives higher gain at smaller amplifier lengths (≈ 1/3) in both, the small and large signal regimes. We also report on the quantum conversion effiencies (QCE) of PDFA. For the same length of fiber and a 0 dBm input signal, PDFA with a pump reflecting mirror has a QCE about twice that of a PDFA without a pump reflecting mirror at its ouput end

Pr\u3csup\u3e+\u3c/sup\u3e-doped fluoride fiber amplifiers: optimum design considerations

Waveguide parameters for Pr+-doped fluoride fiber amplifiers have been optimized for low and moderate values of relative refractive index difference. A cut-off wavelength of 750 nm gives maximum gain for NA = 0.1 and 0.2. A pump reflecting mirror etched at the output end of the amplifier gives higher gain at smaller lengths (≈ 1/3) in both the small and large signal regimes

Prospective Evaluation of High Titer Autoantibodies and Fetal Home Monitoring in the Detection of Atrioventricular Block Among Anti-SSA/Ro Pregnancies

OBJECTIVE: This prospective study of pregnant patients, Surveillance To Prevent AV Block Likely to Occur Quickly (STOP BLOQ), addresses the impact of anti-SSA/Ro titers and utility of ambulatory monitoring in the detection of fetal second-degree atrioventricular block (AVB). METHODS: Women with anti-SSA/Ro autoantibodies by commercial testing were stratified into high and low anti-52-kD and/or 60-kD SSA/Ro titers applying at-risk thresholds defined by previous evaluation of AVB pregnancies. The high-titer group performed fetal heart rate and rhythm monitoring (FHRM) thrice daily and weekly/biweekly echocardiography from 17-26 weeks. Abnormal FHRM prompted urgent echocardiography to identify AVB. RESULTS: Anti-52-kD and/or 60-kD SSA/Ro met thresholds for monitoring in 261 of 413 participants (63%); for those, AVB frequency was 3.8%. No cases occurred with low titers. The incidence of AVB increased with higher levels, reaching 7.7% for those in the top quartile for anti-60-kD SSA/Ro, which increased to 27.3% in those with a previous child who had AVB. Based on levels from 15 participants with paired samples from both an AVB and a non-AVB pregnancy, healthy pregnancies were not explained by decreased titers. FHRM was considered abnormal in 45 of 30,920 recordings, 10 confirmed AVB by urgent echocardiogram, 7 being second-degree AVB, all \u3c12 hours from normal FHRM and within another 0.75 to 4 hours to echocardiogram. The one participant with second/third-degree and two participants with third-degree AVB were diagnosed by urgent echocardiogram \u3e17 to 72 hours from an FHRM. Surveillance echocardiograms detected no AVB when the preceding interval FHRM recordings were normal. CONCLUSION: High-titer antibodies are associated with an increased incidence of AVB. Anti-SSA/Ro titers remain stable over time and do not explain the discordant recurrence rates, suggesting that other factors are required. Fetal heart rate and rhythm (FHRM) with results confirmed by a pediatric cardiologist reliably detects conduction abnormalities, which may reduce the need for serial echocardiograms