A Model of Tuberculosis Transmission and Intervention Strategies in an Urban Residential Area

The model herein aims to explore the dynamics of the spread of tuberculosis (TB) in an informal settlement or township. The population is divided into households of various sizes and also based on commuting status. The model dynamics distinguishes between three distinct social patterns: the exposure of commuters during travel, random diurnal interaction and familial exposure at night. Following the general SLIR models, the population is further segmented into susceptible (S), exposed/latently infected (L), active/infectious (I), and recovered (R) individuals. During the daytime, commuters travel on public transport, while non-commuters randomly interact in the community to mimic chance encounters with infectious persons. At night, each family interacts and sleeps together in the home. The risk of exposure to TB is based on the proximity, duration, and frequency of encounters with infectious persons. The model is applied to a hypothetical population to explore the effects of different intervention strategies including vaccination, wearing of masks or scarves during the commute, prophylactic treatment of latent infections and more effective case-finding and treatment. The most important findings of the model are: (1) members of larger families are responsible for more disease transmissions than those from smaller families, (2) daily commutes on public transport provide ideal conditions for transmission of the disease, (3) improved diagnosis and treatment has the greatest impact on the spread of the disease, and (4) detecting TB at the first clinic visit, when patients are still smear negative, is key

A Model of Tuberculosis Transmission and Intervention Strategies in an Urban Residential Area

The model herein aims to explore the dynamics of the spread of tuberculosis (TB) in an informal settlement or township. The population is divided into households of various sizes and also based on commuting status. The model dynamics distinguishes between three distinct social patterns: the exposure of commuters during travel, random diurnal interaction and familial exposure at night. Following the general SLIR models, the population is further segmented into susceptible (S), exposed/latently infected (L), active/infectious (I), and recovered (R) individuals. During the daytime, commuters travel on public transport, while non-commuters randomly interact in the community to mimic chance encounters with infectious persons. At night, each family interacts and sleeps together in the home. The risk of exposure to TB is based on the proximity, duration, and frequency of encounters with infectious persons. The model is applied to a hypothetical population to explore the effects of different intervention strategies including vaccination, wearing of masks or scarves during the commute, prophylactic treatment of latent infections and more effective case-finding and treatment. The most important findings of the model are: (1) members of larger families are responsible for more disease transmissions than those from smaller families, (2) daily commutes on public transport provide ideal conditions for transmission of the disease, (3) improved diagnosis and treatment has the greatest impact on the spread of the disease, and (4) detecting TB at the first clinic visit, when patients are still smear negative, is key

Digital Drug Safety Surveillance: Monitoring Pharmaceutical Products in Twitter

Background: Traditional adverse event (AE) reporting systems have been slow in adapting to online AE reporting from patients, relying instead on gatekeepers, such as clinicians and drug safety groups, to verify each potential event. In the meantime, increasing numbers of patients have turned to social media to share their experiences with drugs, medical devices, and vaccines. Objective: The aim of the study was to evaluate the level of concordance between Twitter posts mentioning AE-like reactions and spontaneous reports received by a regulatory agency. Methods: We collected public English-language Twitter posts mentioning 23 medical products from 1 November 2012 through 31 May 2013. Data were filtered using a semi-automated process to identify posts with resemblance to AEs (Proto-AEs). A dictionary was developed to translate Internet vernacular to a standardized regulatory ontology for analysis (MedDRA®). Aggregated frequency of identified product-event pairs was then compared with data from the public FDA Adverse Event Reporting System (FAERS) by System Organ Class (SOC). Results: Of the 6.9 million Twitter posts collected, 4,401 Proto-AEs were identified out of 60,000 examined. Automated, dictionary-based symptom classification had 72 % recall and 86 % precision. Similar overall distribution profiles were observed, with Spearman rank correlation rho of 0.75 (p < 0.0001) between Proto-AEs reported in Twitter and FAERS by SOC. Conclusion: Patients reporting AEs on Twitter showed a range of sophistication when describing their experience. Despite the public availability of these data, their appropriate role in pharmacovigilance has not been established. Additional work is needed to improve data acquisition and automation

The initial appraisal of buried DAS system in CO2CRC Otway Project: the comparison of buried standard fibre-optic and helically wound cables using 2D imaging

This study aims to assess the ability of shallow distributed acoustic sensing (DAS) to serve as a cost-effective seismic sensor array for permanent monitoring applications. To this end, as part of the CO2CRC seismic monitoring program, a fibre-optic DAS array was deployed alongside a permanently buried geophone array at the Otway Project site (Victoria, Australia). The DAS array consisted of a standard commercially available tactical fibre-optic cable, which was deployed in 0.8 m deep trenches. A custom-designed helically wound (HW) cable was also deployed in one of the DAS trenches for comparison of the cable designs. Simultaneous acquisition of the seismic data was carried out using ~ 3000 vibroseis source points and geophones, DAS standard and HW cables. For initial assessment of the seismic images acquired with DAS and to compare different cable designs, preliminary 2D seismic reflection processing is conducted on both DAS cables and geophone data along a single 2D line. The geophone data processing guided processing of the DAS data. Several shallow structures (100–450 ms) and some important reflectors at 450–600 ms are observed on the final DAS images. Comparison of the two different DAS cable types demonstrated that seismic imaging would benefit DAS technology. However, the benefit of utilising HW cable is modest compared with the standard cable. The workflows and results of this study pave the way for processing of the 3D seismic data set acquired with the DAS array, as well as further detailed analysis of the DAS cables and the system itself

Geophysical Prospecting

A B S T R A C T A modular borehole monitoring concept has been implemented to provide a suite of well-based monitoring tools that can be deployed cost effectively in a flexible and robust package. The initial modular borehole monitoring system was deployed as part of a CO 2 injection test operated by the Southeast Regional Carbon Sequestration Partnership near Citronelle, Alabama. The Citronelle modular monitoring system transmits electrical power and signals, fibre-optic light pulses, and fluids between the surface and a reservoir. Additionally, a separate multi-conductor tubing-encapsulated line was used for borehole geophones, including a specialized clamp for casing clamping with tubing deployment. The deployment of geophones and fibre-optic cables allowed comparison testing of distributed acoustic sensing. We designed a large source effort (&gt;64 sweeps per source point) to test fibre-optic vertical seismic profile and acquired data in 2013. The native measurement in the specific distributed acoustic sensing unit used (an iDAS from Silixa Ltd) is described as a localized strain rate. Following a processing flow of adaptive noise reduction and rebalancing the signal to dimensionless strain, improvement from repeated stacking of the source was observed. Conversion of the rebalanced strain signal to equivalent velocity units, via a scaling by local apparent velocity, allows quantitative comparison of distributed acoustic sensing and geophone data in units of velocity. We see a very good match of uncorrelated time series in both amplitude and phase, demonstrating that velocityconverted distributed acoustic sensing data can be analyzed equivalent to vertical geophones. We show that distributed acoustic sensing data, when averaged over an interval comparable to typical geophone spacing, can obtain signal-to-noise ratios of 18 dB to 24 dB below clamped geophones, a result that is variable with noise spectral amplitude because the noise characteristics are not identical. With vertical seismic profile processing, we demonstrate the effectiveness of downgoing deconvolution from the large spatial sampling of distributed acoustic sensing data, along with improved upgoing reflection quality. We conclude that the extra source effort currently needed for tubing-deployed distributed acoustic sensing vertical seismic profile, as part of a modular monitoring system, is well compensated by the extra spatial sampling and lower deployment cost as compared with conventional borehole geophones

Surveillance Sans Frontières: Internet-Based Emerging Infectious Disease Intelligence and the HealthMap Project

John Brownstein and colleagues discuss HealthMap, an automated real-time system that monitors and disseminates online information about emerging infectious diseases

Costs associated with febrile neutropenia in solid tumor and lymphoma patients - an observational study in Singapore.

BackgroundThe primary objective was to describe the total direct inpatient costs among solid tumor and lymphoma patients with chemotherapy-induced febrile neutropenia (FN) and the factors that were associated with higher direct cost. The secondary objective was to describe the out-of-pocket patient payments and the factors that were associated with higher out-of-pocket patient payments.MethodsThis was a single-center observational study conducted at the largest cancer center in Singapore. All of the adult cancer patients hospitalized due to FN from 2009 to 2012 were studied. The primary outcomes were the total hospital cost and the out-of-pocket patient payments (adjusted by government subsidy) per FN episode. Univariate analysis and multiple linear regression were conducted to identify the factors associated with higher FN costs.ResultsThree hundred and sixty seven adult cancer patients were documented with FN-related hospitalizations. The mean total hospital cost was US$4,193 (95$3,779-4,607) and the mean out-of-pocket patient payment was US$2,230 (95$1,976-2,484), per FN episode. The factors associated with a higher total hospital cost were longer length of stay, severe sepsis, and lymphoma as underlying cancer. The out-of-pocket patient payment was positively associated with longer length of stay, severe sepsis, lymphoma diagnosed as underlying cancer, the therapeutic use of granulocyte colony-stimulating factor (GCSF), the private ward class, and younger patients.ConclusionsThe total hospital cost and out-of-pocket patient payments of FN management in lymphoma cases were substantial compared with other solid tumors. Factors associated with a higher FN management cost may be useful for developing appropriate strategies to reduce the cost of FN for cancer patients

Reactive transport modeling to study changes in water chemistry induced by CO2 injection at the Frio-I brine pilot

To demonstrate the potential for geologic storage of CO{sub 2} in saline aquifers, the Frio-I Brine Pilot was conducted, during which 1600 tons of CO{sub 2} were injected into a high-permeability sandstone and the resulting subsurface plume of CO{sub 2} was monitored using a variety of hydrogeological, geophysical, and geochemical techniques. Fluid samples were obtained before CO{sub 2} injection for baseline geochemical characterization, during the CO{sub 2} injection to track its breakthrough at a nearby observation well, and after injection to investigate changes in fluid composition and potential leakage into an overlying zone. Following CO{sub 2} breakthrough at the observation well, brine samples showed sharp drops in pH, pronounced increases in HCO{sub 3}{sup -} and aqueous Fe, and significant shifts in the isotopic compositions of H{sub 2}O and dissolved inorganic carbon. Based on a calibrated 1-D radial flow model, reactive transport modeling was performed for the Frio-I Brine Pilot. A simple kinetic model of Fe release from the solid to aqueous phase was developed, which can reproduce the observed increases in aqueous Fe concentration. Brine samples collected after half a year had lower Fe concentrations due to carbonate precipitation, and this trend can be also captured by our modeling. The paper provides a method for estimating potential mobile Fe inventory, and its bounding concentration in the storage formation from limited observation data. Long-term simulations show that the CO{sub 2} plume gradually spreads outward due to capillary forces, and the gas saturation gradually decreases due to its dissolution and precipitation of carbonates. The gas phase is predicted to disappear after 500 years. Elevated aqueous CO{sub 2} concentrations remain for a longer time, but eventually decrease due to carbonate precipitation. For the Frio-I Brine Pilot, all injected CO{sub 2} could ultimately be sequestered as carbonate minerals