NEUROLOGICAL ADVERSE EVENTS FOLLOWING IMMUNIZATION (AEFI) ON HEALTH WORKFORCE OF A SECONDARY REFERRAL HOSPITAL IN SOUTH SULAWESI WHO RECEIVED THE

Background: The COVID-19 vaccination can relate to the occurrence of neurological adverse events following immunization (AEFI) that could impact work and daily activities. This problem is particularly important in the health workforce. However, little is known about neurological AEFI among the health workforce working in peripheral facilities. Objective: To study the neurological AEFIs and their impact among the health workforce who received the COVID-19 vaccination in a secondary referral hospital in South Sulawesi, the Andi Makassau Hospital (Rumah Sakit Umum Daerah Andi Makassau/RSAM). Methods: The COVID-19 pandemic, we created a questionnaire about neurological AEFIs and their effects which were distributed online using the Google Form application to the health workforce at the RSAM who had received at least one dose of COVID-19 vaccination. Results: We obtained 97 subjects. There were 78.5% neurological AEFIs with the most reported type being muscle pain (16%). Most neurological AEFIs were experienced by women (84.9%), age group 21-35 years (53.8%), and non-doctors/nurses (60.8%). The significant influencing factors in multivariate analysis were age group 36-45 years (p = 0.04), nursing proffesion (p = 0.005), and non- viral-based baccine type (p = < 0.0001). Conclusion: Neurological AEFI is commonly found among the health workforce who received the COVID-19 vaccination. However, it only has a little impact on their work and attitudes towards vaccination. This may be because all subjects experienced mild neurological AEFI

An empirical approach for evaluating the usability of model-driven tools

MDD tools are very useful to draw conceptual models and to automate code generation. Even though this would bring many benefits, wide adoption of MDD tools is not yet a reality. Various research activities are being undertaken to find why and to provide the required solutions. However, insufficient research has been done on a key factor for the acceptance of MDD tools: usability. With the help of end-users, this paper presents a framework to evaluate the usability of MDD tools. The framework will be used as a basis for a family of experiments to get clear insights into the barriers to usability that prevent MDD tools from being widely adopted in industry. To illustrate the applicability of our framework, we instantiated it for performing a usability evaluation of a tool named INTEGRANOVA. Furthermore, we compared the outcome of the study with another usability evaluation technique based on ergonomic criteria.This work has been developed with the support of the Intra European Marie Curie Fellowship Grant 50911302 PIEF-2010, MICINN (TIN2008-00555, PROS-Req TIN2010-19130-C02-02), GVA (ORCA PROMETEO/2009/015), and co-financed with ERDF. We also acknowledge the support of the ITEA2 Call 3 UsiXML (20080026) and financed by the MITYC under the project TSI-020400-2011-20. Our thanks also to Ignacio Romeu for the video data gathering setup.Condori-Fernandez, N.; Panach Navarrete, JI.; Baars, AI.; Vos, TE.; Pastor López, O. (2013). An empirical approach for evaluating the usability of model-driven tools. Science of Computer Programming. 78(11):2245-2258. https://doi.org/10.1016/j.scico.2012.07.017S22452258781

Towards an Experimental Framework for Measuring Usability of Model-Driven Tools 1

Abstract. According to the Model-Driven Development (MDD) paradigm, analysts can substantially improve the software development process concentrating their efforts on a conceptual model, which can be transformed into code by means of transformation rules applied by a model compiler. However, MDD tools are not widely used in industry. One of the reasons for this poor adoption is the lack of usability of MDD tools. This paper presents a framework to evaluate the usability of such tools. The framework will be used as a basis for a family of experiments to get clear insights into the barriers to usability that prevent MDD tools from being widely adopted in industry

Bendiocarb and Malathion Resistance in Two Major Malaria Vector Populations in Cameroon Is Associated with High Frequency of the G119S Mutation (Ace-1) and Overexpression of Detoxification Genes

The spread of pyrethroid resistance in malaria vectors is a major threat affecting the performance of current control measures. However, there is still not enough information on the resistance profile of mosquitoes to carbamates and organophosphates which could be used as alternatives. The present study assessed the resistance profile of Anopheles gambiae s.l. to bendiocarb and malathion, at the phenotypic and molecular levels, in different eco-epidemiological settings in Cameroon. Anopheles gambiae s.l. mosquitoes were collected from four eco-epidemiological settings across the country and their susceptibility level to bendiocarb and malathion was determined using WHO tubes bioassays. The ace-1 target site G119S mutation was screened by PCR. Reverse Transcription quantitative PCR 3-plex TaqMan assays were used to quantify the level of expression of eight genes associated with metabolic resistance. Resistance to malathion and/or bendiocarb was recorded in all study sites except in mosquitoes collected in Kaélé and Njombé. The Ace-1 (G119S) mutation was detected in high frequencies (>40%) in Kékem and Santchou. Both An. gambiae and An. coluzzii were detected carrying this mutation. The cytochrome P450s gene Cyp6p3 associated with carbamate resistance and the glutathione S-transferase gene Gste2 associated with organophosphate resistance were found to be overexpressed. Genes associated with pyrethroid (Cyp6m2, Cyp9k1, Cyp6p3) and organochlorine (Gste2, Cyp6z1, Cyp6m2) and cuticle resistance (Cyp4g16) were also overexpressed. The rapid spread of resistance to organophosphates and carbamates could seriously compromise future control strategies based on IRS. It is therefore becoming important to assess the magnitude of bendiocarb and malathion resistance countrywide

Macrophage susceptibility to infection by Ghanaian Mycobacterium tuberculosis complex lineages 4 and 5 varies with self-reported ethnicity

BackgroundThe epidemiology of Mycobacterium tuberculosis complex (MTBC) lineage 5 (L5) infections in Ghana revealed a significantly increased prevalence in Ewes compared to other self-reported ethnic groups. In that context, we sought to investigate the early phase of tuberculosis (TB) infection using ex vivo infection of macrophages derived from the blood of Ewe and Akan ethnic group volunteers with MTBC L4 and L5 strains.MethodsThe study participants consisted of 16 controls, among which self-reported Akan and Ewe ethnicity was equally represented, as well as 20 cured TB cases consisting of 11 Akans and 9 Ewes. Peripheral blood mononuclear cells were isolated from both healthy controls and cured TB cases. CD14+ monocytes were isolated and differentiated into monocyte-derived macrophages (MDMs) before infection with L4 or L5 endemic strains. The bacterial load was assessed after 2 hours (uptake) as well as 3 and 7 days post-infection.ResultsWe observed a higher capacity of MDMs from Ewes to phagocytose L4 strains (p &lt; 0.001), translating into a higher bacillary load on day 7 (p &lt; 0.001) compared to L5, despite the higher replication rate of L5 in Ewe MDMs (fold change: 1.4 vs. 1.2, p = 0.03) among the controls. On the contrary, within macrophages from Akans, we observed a significantly higher phagocytic uptake of L5 (p &lt; 0.001) compared to L4, also translating into a higher load on day 7 (p = 0.04). However, the replication rate of L4 in Akan MDMs was higher than that of L5 (fold change: L4 = 1.2, L4 = 1.1, p = 0.04). Although there was no significant difference in the uptake of L4 and L5 among cured TB cases, there was a higher bacterial load of both L4 (p = 0.02) and L5 (p = 0.02) on day 7 in Ewe MDMs.ConclusionOur results suggest that host ethnicity (driven by host genetic diversity), MTBC genetic diversity, and individual TB infection history are all acting together to modulate the outcome of macrophage infections by MTBC

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Diderot en 1765-1766. Vie privée et bien public

Wilson Arthur, Murstein Nelly. Diderot en 1765-1766. Vie privée et bien public. In: Dix-huitième Siècle, n°3, 1971. pp. 297-316