Sero Survei dan Analisa Pengetahuan Sikap Penjamah Unggas terhadap Penyakit Flu Burung di Indonesia Tahun 2008

The bird flu in Indonesia actually is Avian Influenza Virus H5N1 type. Is known bird flu virus in Humans occur if direct contact with infected poultry or through contact with environmental enclosure, and the carcasses of infected poultry products. The absence of the data if the handlers of poultry in the cases of bird flu virus has been exposed to the research conducted sero survey of bird flu antibody titers in handlers poultry attitudes and knowledge of poultry against bird flu incident. The research objective measure antibodies against respondents tirer AI H5N1 virus, assess knowledge and attitudes against bird flu handlers through the interview. The study design was cross sectional. Handlers of poultry population in the region is ever going Extraordinary Cases of bird flu. Samples were responders/poultry handlers venous blood taken for H5N1 antibody titer by Ellisa, H5N1 conducted interviews using a questionnaire. The study used the respondents informed consent agreement. Research time in February to November 2007 in the island of Java. The number of samples of 80 samples of respondents. The results obtained are not found of H5N1 avian influenza antibody titer in responders. The results of the interview most of the handlers to wash Their hands after doing Their job (82.1%). A total of 52.9% residential handlers is more than a mile from where the management of poultry, (69%) lived outside market handlers/Abattoir of poultry.Handler to act entered correctly (53.3%%) and almost all handlers (97%) would bring the patient/patient ill with signs of bird flu infection to health facilities. Keywords: poultry handlers, bird flu virus, knowledge and attitudes of poultry handlers Abstrak Yang dimaksud Flu burung di Indonesia sebetulnya adalah Virus Avian Influenza dengan tipe H5N1. Selama ini diketahui penularan virus flu burung pada manusia terjadi jika kontak langsung dengan unggas yang terinfeksi atau melalui kontak dengan lingkungan kandang, karkas dan hasil produk unggas yang terinfeksi. Belum adanya data apakah penjamah unggas di daerah kasus sudah terpapar virus flu burung maka dilakukan penelitian sero survei titer antibodi flu burung dan pengetahuan sikap pada pejamah unggas terhadap kejadian flu burung. Tujuan penelitian mengukur tirer anti bodi responden terhadap virus AI H5N1, menilai pengetahuan dan sikap penjamah terhadap penyakit flu burung melalui wawancara. Desain penelitian adalah cross sectional. Populasi adalah penjamah unggas di daerah yang pernah terjadi Kasus Luar Biasa flu burung. Sampel adalah responden/penjamah unggas yang diambil darah vena untuk mendapatkan titer antibodi H5N1 dengan cara Ellisa, 5N1H5 juga dilakukan wawancara dengan menggunakan kuesioner. Penelitian menggunakan persetujuan inform consent pada responden. Waktu penelitian pada bulan Febuari sampai Nopember 2007 di daerah Pulau Jawa. Jumlah sampel sebanyak 80 sampel responden. Hasil yang diperoleh tidak ditemukan titer antibodi Avian Influenza H5N1 pada responden. Hasil wawancara sebagian besar penjamah melakukan cuci tangan setelah melakukan pekerjaannya (82,1%). Sebanyak 52,9 % tempat tinggal penjamah berjarak lebih dari satu km dari tempat pengelolaan unggas, (69%) penjamah tinggal diluar pasar/tempat pemotongan unggas.Hampir semua penjamah melakukan tindakan dengan benar (53,3%) dan hampir semua penjamah (97%) akan membawa pasien/penderita sakit dengan tanda terinfeksi flu burung ke sarana kesehatan. Kata kunci : penjamah unggas, virus flu burung, Pengetahuan dan sikap penjamah unggas

Potential effects of vaccinations on the prevention of COVID-19: rationale, clinical evidence, risks, and public health considerations

Introduction Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), has quickly spread around the world. Areas covered This review will discuss the available immunologic and clinical evidence to support the benefit of the influenza, pneumococcal, and tuberculosis vaccines in the context of COVID-19 as well as to provide an overview on the COVID-19-specific vaccines that are in the development pipeline. In addition, implications for vaccination strategies from a public health perspective will be discussed. Expert opinion Some vaccines are being considered for their potentially beneficial role in preventing or improving the prognosis of COVID-19: influenza, pneumococcal and tuberculosis vaccines. These vaccines may have either direct effect on COVID-19 via different types of immune responses or indirect effects by reducing the burden of viral and bacterial respiratory diseases on individual patients and national healthcare system and by facilitating differential diagnoses with other viral/bacterial respiratory disease. On the other hand, a large number of candidate vaccines against SARS-CoV-2 are currently in the pipeline and undergoing phase I, II, and III clinical studies. As SARS-CoV-2 vaccines are expected to be marketed through accelerated regulatory pathways, vaccinovigilance as well as planning of a successful vaccination campaign will play a major role in protecting public health

Anti-hypertensive drugs deprescribing: an updated systematic review of clinical trials

Background Polypharmacy is defined as the prescription of at least 5 different medicines for therapeutic or prophylactic effect and is a serious issue among elderly patients, who are frequently affected by multi-morbidity. Deprescribing is one of the proposed approaches to reduce the number of administered drugs, by eliminating those that are inappropriately prescribed. The aim of this systematic review is to provide an updated and systematic assessment of the benefit-risk profile of deprescribing of anti-hypertensive drugs, which are among the most commonly used drugs. Methods MEDLINE, EMBASE and The Cochrane Library were searched for studies assessing the efficacy and safety of anti-hypertensive drugs deprescribing in the period between January, 12,016 and December, 312,019. The quality of randomized clinical trials (RCTs) was assessed using the GRADE approach for the evaluation of the main outcomes. The risk of bias assessment was carried out using the Cochrane risk-of-bias tool. Results Overall, two RCTs were identified. Despite summarized evidence was in favor of anti-hypertensive deprescribing, the overall risk of bias was rated as high for each RCT included. According to the GRADE approach, the overall quality of the RCTs included was moderate regarding the following outcomes: systolic blood pressure < 150 mmHg after 12 weeks of follow-up, quality of life, frailty and cardiovascular risk. Conclusions This updated systematic review of the efficacy and safety of anti-hypertensive treatment deprescribing found two recently published RCTs, in addition to the previous guideline of the National Institute for Health and Care Excellence (NICE). Evidence points towards non-inferiority of anti-hypertensive deprescribing as compared to treatment continuation, despite the quality of published studies is not high. High quality experimental studies are urgently needed to further assess the effect of deprescribing for this drug class in specific categories of patients

Anisotropic cerebral vascular architecture causes orientation dependency in cerebral blood flow and volume measured with dynamic susceptibility contrast magnetic resonance imaging

\u3cp\u3eMeasurements of cerebral perfusion using dynamic susceptibility contrast magnetic resonance imaging rely on the assumption of isotropic vascular architecture. However, a considerable fraction of vessels runs in parallel with white matter tracts. Here, we investigate the effects of tissue orientation on dynamic susceptibility contrast magnetic resonance imaging. Tissue orientation was measured using diffusion tensor imaging and dynamic susceptibility contrast was performed with gradient echo planar imaging. Perfusion parameters and the raw dynamic susceptibility contrast signals were correlated with tissue orientation. Additionally, numerical simulations were performed for a range of vascular volumes of both the isotropic vascular bed and anisotropic vessel components, as well as for a range of contrast agent concentrations. The effect of the contrast agent was much larger in white matter tissue perpendicular to the main magnetic field compared to white matter parallel to the main magnetic field. In addition, cerebral blood flow and cerebral blood volume were affected in the same way with angle-dependent variations of up to 130%. Mean transit time and time to maximum of the residual curve exhibited weak orientation dependency of 10%. Numerical simulations agreed with the measured data, showing that one-Third of the white matter vascular volume is comprised of vessels running in parallel with the fibre tracts.\u3c/p\u3

Independent Component Analysis Filter for Small Vessel Contrast Imaging During Fast Tissue Motion

Suppressing tissue clutter is an essential step in blood flow estimation and visualization, even when using ultrasound contrast agents. Blind source separation (BSS)-based clutter filter for high-framerate ultrasound imaging has been reported to perform better in tissue clutter suppression than the conventional frequency-based wall filter and nonlinear contrast pulsing schemes. The most notable BSS technique, singular value decomposition (SVD) has shown compelling results in cases of slow tissue motion. However, its performance degrades when the tissue motion is faster than the blood flow speed, conditions that are likely to occur when imaging the small vessels, such as in the myocardium. Independent component analysis (ICA) is another BSS technique that has been implemented as a clutter filter in the spatiotemporal domain. Instead, we propose to implement ICA in the spatial domain where motion should have less impact. In this work, we propose a clutter filter with the combination of SVD and ICA to improve the contrast-to-background ratio (CBR) in cases where tissue velocity is significantly faster than the flow speed. In an in vitro study, the range of fast tissue motion velocity was 5-25 mm/s and the range of flow speed was 1-12 mm/s. Our results show that the combination of ICA and SVD yields 7-10 dB higher CBR than SVD alone, especially in the tissue high-velocity range. The improvement is crucial for cardiac imaging where relatively fast myocardial motions are expected.ImPhys/Medical Imagin

3-D contrast enhanced ultrasound imaging of an in vivo chicken embryo with a sparse array and deep learning based adaptive beamforming

3-D contrast enhanced ultrasound enables better visualization of inherently 3-D vascular geometries compared to an intersecting plane. Additionally, it would allow the application of motion correction techniques for all directions. Both contrast detection and motion correction work better on high-frame rate data. However high-frame rate 3-D ultrasound imaging with dense matrix arrays is challenging to realize. Sparse arrays alleviate some of the limitations in cable count and data rate that fully populated arrays encounter, but their increased level of secondary lobes negatively impacts image contrast. Meanwhile the use of unfocused transmit beams needed to achieve high-frame rates negatively impacts resolution. Here we propose to use adaptive beamforming by deep learning (ABLE) to improve the image quality of contrast enhanced ultrasound images acquired with a sparse spiral array. We train the neural network on simulated data and evaluate simulated images and in vivo images of an ex ovo chicken embryo. ABLE improved resolution compared to delay-and-sum (DAS) and spatial coherence (SC) beamforming on the simulated and in vivo data. The qualitative improvements persist after histogram matching, indicating that the image quality improvement of the ABLE images was not purely due to dynamic range stretching. Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.ImPhys/Imaging PhysicsImPhys/Medical Imagin

Global epidemiology of acromegaly: a systematic review and meta-analysis

Objective: To date, no systematic reviews and meta-analysis on the global epidemiology of acromegaly are available in the literature. The aims of this study are to provide a systema tic review and a meta-analysis of the global epidemiology of acromegaly and to evaluate the quality of study reporting fo r the identified studies. Methods: MEDLINE, EMBASE and The Cochrane Library databases were search ed for studies assessing the epidemiology of acromegaly from inception until 31 January 2020 . We included original observational studies written in English, reporting acromegaly prevalence and/or incidence fo r a well-defined geographic area. Two reviewers independently extracted data and performed quality assessments. Prevalence and incidence pooled estimates were derived by performing a random-effects meta-analysis. Results: A total of 32 studies were included in the systematic review, and 22 of them were included in the meta-analysis. The pooled prevalence of acromegaly was 5.9 (95% CI: 4.4-7.9) per 100 000 persons, while the incidence rate (IR) was 0.38 (95% CI: 0.32-0.44) cases per 100 000 person-year s. For both prevalence and IR, considerable between-study heterogeneity was found (I2 = 99.3 and 86.0%, respectively). The quality of study reporting was rated as the medium for 20 studies and low for 12 studies. Conclusions: Although the largest amount of heterogeneity was due to the hi gh precision of the studies' estimates, data source and geographic area could represent relevant study-level factors which could explain about 50% of the total between-study variability. Large-scale high-quality studies on the epidemiology of acromegaly are warranted to help the public health system in making decisions

High-frame-rate Volumetric Porcine Cardiac Imaging

Volumetric echocardiography can potentially give a more complete picture of cardiac dynamics than its two-dimensional (2D) counterpart. Current clinical volumetric imaging probes have relatively low frame rates, and often require ECG gating to stitch together an entire volume. This makes measuring fast dynamics of the heart as well as imaging patients with irregular heartbeats difficult. We have previously designed and manufactured 2D sparse arrays with elements seeded in a density-tapered spiral pattern for cardiac imaging. Using these prototypes, we demonstrate in this paper the first high-frame-rate volumetric closed-chest porcine cardiac as well as open-chest myocardial blood flow results. These preliminary results suggest the potential of performing high-frame-rate volumetric cardiac imaging using the sparse spiral arrays.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.ImPhys/Verweij groupImPhys/Medical ImagingImPhys/De Jong grou

High Frame Rate Volumetric Imaging of Microbubbles Using a Sparse Array and Spatial Coherence Beamforming

Volumetric ultrasound imaging of blood flow with microbubbles enables a more complete visualization of the microvasculature. Sparse arrays are ideal candidates to perform volumetric imaging at reduced manufacturing complexity and cable count. However, due to the small number of transducer elements, sparse arrays often come with high clutter levels, especially when wide beams are transmitted to increase the frame rate. In this study, we demonstrate with a prototype sparse array probe and a diverging wave transmission strategy, that a uniform transmission field can be achieved. With the implementation of a spatial coherence beamformer, the background clutter signal can be effectively suppressed, leading to a signal to background ratio improvement of 25 dB. With this approach, we demonstrate the volumetric visualization of single microbubbles in a tissue-mimicking phantom as well as vasculature mapping in a live chicken embryo chorioallantoic membrane.ImPhys/Medical Imagin