Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India

The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country’s capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Implementing Information Integrity Technology - A Feedback Control System Approach

Intrinsic information integrity attributes of accuracy, consistency and reliability are central to any information system in that in their absence the information systems (IS) will have massive amounts of polluted (error – filled) data and useless, even dangerous information. These errors are essentially caused by on-line factors of change, complexity, communication, conversion and corruption which have their presence mainly through system environment which is external to computing (and hence the application) system and overlaps with the user environment. Need, therefore, is for on-line error detection and integrity improvement mechanisms in the IS models in the form of automatic feedback control systems. The paper addresses this research issue of implementing integrity technology. Specifically, the paper begins with the choice of information model for integrity improvement, followed by presentation of some alternatives for quantification of intrinsic integrity attributes and development of integrity profile and cumulative information integrity index as a means for demonstrating integrity improvement. This is followed by presentation of information integrity technology implementation steps. Finally, the paper gives a description of information integrity technology, thus emerging, as a software product and details it.

Two new families of low-correlation interleaved QAM sequence

Two families of low correlation QAM sequences are presented here. In a CDMA setting, these sequences have the ability to transport a large amount of data as well as enable variable-rate signaling on the reverse link. The first family Á2SQ - B2− is constructed by interleaving 2 selected QAM sequences. This family is defined over M 2-QAM, where M = 2 m , m ≥ 2. Over 16-QAM, the normalized maximum correlation [`(q)]maxmax is bounded above by <~1.17 ÖNUnknown control sequence '\lesssim' , where N is the period of the sequences in the family. This upper bound on [`(q)]maxmax is the lowest among all known sequence families over 16-QAM.The second family Á4SQ4 is constructed by interleaving 4 selected QAM sequences. This family is defined over M 2-QAM, where M = 2 m , m ≥ 3, i.e., 64-QAM and beyond. The [`(q)]maxmax for sequences in this family over 64-QAM is upper bounded by <~1.60 ÖNUnknown control sequence '\lesssim' . For large M, [`(q)]max <~1.64 ÖNUnknown control sequence '\lesssim' . These upper bounds on [`(q)]maxmax are the lowest among all known sequence families over M 2-QAM, M = 2 m , m ≥ 3

Studies on the isolation and characterization of flavones and triterpenoids from a few plants

In the present scenario, there is an increasing demand for natural products in food industry, pharmaceuticals, cosmetics and agricultural sectors. In this context phytochemical study to identify newer chemicals has got great relevance. Phytochemical studies have become more reliable and encouraging with the development of modern analytical techniques.In the present work the leaves of Piper colubrinum (Piperaceae), aerial parts of Mussaenda fiondosa (Rubiaceae) and Humboldtia vahliana (Leguminosae) and the pericarp of fruits of Artocarpus heterophyllus (Moraceae) were investigated for their secondary metabolites. The major compounds isolated belong to the groups of flavonoids and triterpenoids.Naturally occurring flavonoids have been used widely in chemotaxonomic studies of plants. Flavones and flavonols constitute a group of biosynthetically related natural products. No universal function has been established for flavones and flavonols in plants. However, many functions in individual plants have been demonstrated. These include protection of plants from ultraviolet light, insects and pests; pollinator attractants; antioxidants; plant hormone controllers; enzyme inhibitors and allelopathic agents. Flavonoids are attracting the attention of medical scientists in recent years because of their anticarcinogenic, antiallergic and antiinflammatory properties. The recent discovery that flavonoids are involved in the process of nitrogen fixation in plants also opens the way for agricultural application of these constituents.Triterpenoids are another class of compounds that are ubiquitous in plants. Some triterpenoids present in the latex and resins of plants are believed to be involved in chemical defence against pathogens and herbivores. Triterpenoids possess various biological properties including anti-inflammatory, antifeedant, pesticidal, fungitoxic and antimicrobial activities. Triterpenoids with cytotoxic activity and inhibitory effect on seed germination are also known

Elastic Behaviour Of Twisted Yarns

Twisted yarns are normally used for increasing the lateral cohesion of filaments and also for ease of handling. By twisting yarns, the micro-damages can be localised leading to possible increase in the failure strength of the yarns. In this paper, an analytical method is presented for predicting the elastic properties of twisted yarns. In the analysis, varying degree of twist in filaments at different radii of the yarn and possible migration and microbuckling are considered. The effect of twist angle and the extent of migration and microbuckling on elastic properties and the prestraining of the yarn is presented. KEYWORDS: Twisted yarn, elastic properties, varying twist, migration, microbuckling. NOTATIONS D : Diameter of the yarn D mig : Diameter corresponding to equivalent twist ` mig E; G; : Elastic properties h : pitch length of the idealised yarn h mb : P itch of the yarn after taking into account microbuckling I 1 ; : : : ; I 6 : Coefficients as explained in the text l : Leng..