Prevention of HIV and other STIs in rural Senegal: a study of prevention-related events collected by sentinel observers

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PLoS One

Estimating and selecting risk factors with extremely low prevalences of exposure for a binary outcome is a challenge because classical standard techniques, markedly logistic regression, often fail to provide meaningful results in such settings. While penalized regression methods are widely used in high-dimensional settings, we were able to show their usefulness in low-dimensional settings as well. Specifically, we demonstrate that Firth correction, ridge, the lasso and boosting all improve the estimation for low-prevalence risk factors. While the methods themselves are well-established, comparison studies are needed to assess their potential benefits in this context. This is done here using the dataset of a large unmatched case-control study from France (2005-2008) about the relationship between prescription medicines and road traffic accidents and an accompanying simulation study. Results show that the estimation of risk factors with prevalences below 0.1% can be drastically improved by using Firth correction and boosting in particular, especially for ultra-low prevalences. When a moderate number of low prevalence exposures is available, we recommend the use of penalized techniques

The Use of NTFPs in the Baka and Kounabembe Traditional Pharmacopoeia in the Northern Periphery of the Boumba-Bek National Park (Southeastern Cameroon)

Forest conservation around protected areas includes among others sustainable management of natural resources. This study was conducted in the area of the northern outskirts of the Boumba-Bek National Park in order to evaluate the potential use of plants in traditional medicine. Ethnobotanical surveys were conducted with local people using AFLORA survey forms. A total of 132 plant species used in traditional medicine for primary health care were identified. These plants belong to 109 genera and 45 families. 224 treatments for 101 disease symptoms were collected. These diseases include the nervous system, excretory system and nutritional function. The most recurrent diseases are cough, sexual weakness, back pain, abscess, general tiredness, malaria. Some plants such as Baillonella toxisperma, Alstonia boonei, Annonidium mannii, Ricinidendron heudelotii, Klainedoxa gabonensis, Scorodophloeus zenkeri, Swartzia sp. treat several diseases at once. The plant parts mostly used are stem bark, leaves, seeds, sap, the marrow of the bark, the pith of the stem. The main method of preparation of these recipes is decoction while the most common method of administration is oral administration. The plant resources of this village have a high potential in traditional medicine for primary health care. The importance index varied from plant to plant. Keywords: NTFPs, AFLORA, medicinal plants, traditional medicine, primary health care. DOI: 10.7176/JBAH/11-4-07 Publication date: February 28th 202

High rate of adverse events following circumcision of young male adults with the Tara KLamp technique: A randomized trial in South Africa.

Background: The Tara KLamp invention has been claimed to enable circumcisions to be performed safely and easily in many environments. Published evaluation studies were conducted among young children only. Methods: Following a randomized controlled trial (MCRCT) in 3274 participants on the impact of male circumcision on HIV transmission, 69 control group members participated in this male circumcision methods trial (MCMT) and were randomized to a Forceps Guided (FG) group and a Tara KLamp (TK) group) and circumcised. Results: Of the 166 men asked to participate 97 declined, most (94) refusing circumcision with the Tara KLamp technique; 34 men were randomized to the FG group and 35 to the TK group, and 32 and 24 patients were circumcised with the FG and TK methods respectively, of whom respectively 91% and 79% attended the post-circumcision visit. All 12 adverse event sheets corresponded to the TK group (

Les données du SAMU comme moyen de surveillance de la santé de la population

National audienceLes données enregistrées lors d'appels aux SAMU en Gironde constituent une source d'information riche (données temporelles, spatiales, cliniques, textuelles). L'application de méthodes d'apprentissage aux rapports disponibles en textes libres permet de classer ces appels en fonction des pathologies ou des symptômes en cause. Nous avons également développé un outil de visualisation des tableaux de bord afin de réaliser une analyse exploratoire dynamique et spatiale de ces données

Work

Road accidents are the leading type of work-related fatalities, but the impact of work-related travel on overall traffic safety has been scarcely studied. The main objective of the present study was to assess drivers' relative road accident risk between work-related and personal journeys. A responsible/non-responsible case-control study was performed on a sample of 7,051 road accidents in France from the VOIESUR project. Logistic regression determined odds-ratios according to work-related versus personal travel, and identified risk factors for responsibility, specific to each of the two sub-groups. Drivers traveling on duty or commuting home were significantly less often responsible for accidents than drivers on personal journeys: OR = 0.75 [0.63; 0.89] and 0.65 [0.53; 0.80] respectively. Responsibility was significantly more frequent in commuting to versus from work: OR = 1.38 [1.06; 1.78]. Among on-duty drivers, professional passenger-transport drivers had the lowest risk of responsibility (OR = 0.25 [0.11; 0.58]), while those on temporary or work/study contracts and professional light goods vehicle drivers had the highest risk (OR = 11.64 [2.15; 62.94] and OR = 29.83 [5.19; 171.38] respectively). When driving under the influence of alcohol, risk of responsibility was higher in commuting home than in personal journeys. On-duty drivers showed lower risk of responsibility for an accident than other drivers. However, on-duty drivers on temporary or work/study contracts, who are usually not subject to specific regulations, showed higher risk, and should be the subject of particular attention regarding occupational risk prevention.Vehicule Occupant Infrastructure Etudes de la Sécurité des Usagers de la Rout

Performance en classification de données textuelles des passages aux urgences des modèles BERT pour le français

National audienceContextualized language models based on the Transformer architecture such as BERT (Bidirectional Encoder Representations from Transformers) have achieved remarkable performances in various language processing tasks. CamemBERT and FlauBERT are pre-trained versions for French.We used these two models to automatically classify free clinical notes from emergency department visits following a trauma. Their performances were compared to the TF-IDF (Term-Frequency - Inverse Document Frequency) method associated with the SVM (Support Vector Machine) classifier on 22481 clinical notes from the emergency department of the Bordeaux University Hospital. CamemBERT and FlauBERT obtained slightly better results than the TF-IDF/SVM couple for the micro F1-score. These encouraging results allow us to consider further developments in the use of transformers in the automation of emergency department data processing in order to consider the implementation of a national observatory of trauma in France.Les modèles de langue contextualisés basés sur l'architecture Transformer tels que BERT (Bidirectional Encoder Representations from Transformers) ont atteint des performances remarquables dans des diverses tâches de traitement de la langue. CamemBERT et FlauBERT en sont des versions pré-entraînées pour le français. Nous avons utilisé ces deux modèles afin de classer automatiquement des notes cliniques libres issues de visites aux urgences à la suite d'un traumatisme. Leurs performances ont été comparées à la méthode TF-IDF (Term-Frequency-Inverse Document Frequency) associé au classifieur SVM (Support Vector Machine) sur 22481 notes cliniques provenant du service des urgences du CHU de Bordeaux. CamemBERT et FlauBERT ont obtenu des résultats légèrement supérieurs à ceux du couple TF-IDF/SVM pour le micro F1-score. Ces résultats encourageants permettent d'envisager l'utilisation des transformers pour automatiser le traitement des données des urgences dans le cadre de la mise en place d'un observatoire national du traumatisme en France

Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial

BACKGROUND: Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis. METHODS AND FINDINGS: A total of 3,274 uncircumcised men, aged 18–24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR) of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 − RR. The trial was stopped at the interim analysis, and the mean (interquartile range) follow-up was 18.1 mo (13.0–21.0) when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years) in the intervention group and 49 (2.1 per 100 person-years) in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%–0.68%; p < 0.001). This RR corresponds to a protection of 60% (95% CI: 32%–76%). When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%–77%). CONCLUSION: Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil.