2,010 research outputs found

    Physicians, Primary Caregivers and Topical Repellent: All Under-Utilised Resources in Stopping Dengue Virus Transmission in Affected Households

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    BACKGROUND: Primary health care facilities frequently manage dengue cases on an ambulatory basis for the duration of the patient’s illness. There is a great opportunity for specific messaging, aimed to reduce dengue virus (DENV) transmission in and around the home, to be directly targeted toward this high-risk ambulatory patient group, as part of an integrated approach to dengue management. The extent however, to which physicians understand, and can themselves effectively communicate strategies to stop focal DENV transmission around an ambulatory dengue case is unknown; the matter of patient comprehension and recollection then ensues. In addition, the effectiveness of N,N-diethyl-3-methylbenzamide (DEET)-based insect repellent in protecting dengue patients from Aedes aegypti mosquitoes’ bites has not been investigated. METHODOLOGY: A knowledge, attitude and practice (KAP) survey, focusing on the mechanisms of DENV transmission and prevention, was performed using semi-structured questionnaires. This survey was targeted towards the patients and family members providing supportive care, and physicians routinely involved in dengue patient management in Southern Vietnam. An additional clinical observational study was conducted to measure the efficacy of a widely-used 13% DEET-based insect repellent to repel Ae. aegypti mosquitoes from the forearms of dengue cases and matched healthy controls. PRINCIPAL FINDINGS: Among both the physician (n = 50) and patient (n = 49) groups there were several respondents lacking a coherent understanding of DENV transmission, leading to some inappropriate attitudes and inadequate acute preventive practices in the household. The application of insect repellent to protect patients and their relatives from mosquito bites was frequently recommended by majority of physicians (78%) participating in the survey. Nevertheless, our tested topical application of 13% DEET conferred only ~1hr median protection time from Ae. aegypti landing. This is notably shorter than that advertised on the manufacturer’s label. No differences in landing time between febrile dengue cases or matched healthy controls (n = 19 experiments) were observed. CONCLUSIONS/SIGNIFICANCE: Our study identifies missed opportunities for primary care physicians to improve public health through communication of strategies that could prevent focal dengue transmission in and around a case household. We advocate better access to more efficient communication methods for physicians and auxilliary health workers, supporting to educate those at high risk of DENV transmission. Our empirical testing of a widely-available 13% DEET-based repellent was limited in its protective efficacy against Ae. aegypti mosquito bites, and therefore DENV transmission, suggesting more frequent application is necessary to be beneficial

    Mortality Prediction Analysis among COVID-19 Inpatients Using Clinical Variables and Deep Learning Chest Radiography Imaging Features.

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    The emergence of the COVID-19 pandemic over a relatively brief interval illustrates the need for rapid data-driven approaches to facilitate clinical decision making. We examined a machine learning process to predict inpatient mortality among COVID-19 patients using clinical and chest radiographic data. Modeling was performed with a de-identified dataset of encounters prior to widespread vaccine availability. Non-imaging predictors included demographics, pre-admission clinical history, and past medical history variables. Imaging features were extracted from chest radiographs by applying a deep convolutional neural network with transfer learning. A multi-layer perceptron combining 64 deep learning features from chest radiographs with 98 patient clinical features was trained to predict mortality. The Local Interpretable Model-Agnostic Explanations (LIME) method was used to explain model predictions. Non-imaging data alone predicted mortality with an ROC-AUC of 0.87 ± 0.03 (mean ± SD), while the addition of imaging data improved prediction slightly (ROC-AUC: 0.91 ± 0.02). The application of LIME to the combined imaging and clinical model found HbA1c values to contribute the most to model prediction (17.1 ± 1.7%), while imaging contributed 8.8 ± 2.8%. Age, gender, and BMI contributed 8.7%, 8.2%, and 7.1%, respectively. Our findings demonstrate a viable explainable AI approach to quantify the contributions of imaging and clinical data to COVID mortality predictions

    Cyclooxygenase-2 mediates microglial activation and secondary dopaminergic cell death in the mouse MPTP model of Parkinson's disease

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    BACKGROUND: Accumulating evidence suggests that inflammation plays an important role in the progression of Parkinson's disease (PD). Among many inflammatory factors found in the PD brain, cyclooxygenase (COX), specifically the inducible isoform, COX-2, is believed to be a critical enzyme in the inflammatory response. Induction of COX-2 is also found in an experimental model of PD produced by administration of 1-methy-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). METHOD: COX-2-deficient mice or C57BL/6 mice were treated with MPTP to investigate the effects of COX-2 deficiency or by using various doses of valdecoxib, a specific COX-2 inhibitor, which induces inhibition of COX-2 on dopaminergic neuronal toxicity and locomotor activity impairment. Immunohistochemistry, stereological cell counts, immunoblotting, an automated spontaneous locomotor activity recorder and rotarod behavioral testing apparatus were used to assess microglial activation, cell loss, and behavioral impariments. RESULTS: MPTP reduced tyrosine hydroxylase (TH)-positive cell counts in the substantia nigra pars compacta (SNpc); total distance traveled, vertical activity, and coordination on a rotarod; and increased microglia activation. Valdecoxib alleviated the microglial activation, the loss of TH-positive cells and the decrease in open field and vertical activity. COX-2 deficiency attenuated MPTP-induced microglial activation, degeneration of TH-positive cells, and loss of coordination. CONCLUSION: These results indicate that reducing COX-2 activity can mitigate the secondary and progressive loss of dopaminergic neurons as well as the motor deficits induced by MPTP, possibly by suppression of microglial activation in the SNpc

    ÎĽNDN: an Orchestrated Microservice Architecture for Named Data Networking

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    International audienceAs an extension of Network Function Virtualization, mi-croservice architectures are a promising way to design future network services. At the same time, Information-Centric Networking architectures like NDN would benefit from this paradigm to offer more design choices for the network architect while facilitating the deployment and the operation of the network. We propose µµNDN, an orchestrated suite of microservices as an alternative way to implement NDN forwarding and support functions. We describe seven essential micro-services we developed, explain the design choices behind our solution and how it is orchestrated. We evaluate each service alone and the whole microservice architecture through two realistic scenarios to show its ability to react and mitigate some performance and security issues thanks to the orchestration. Our results show that µNDN can replace a monolithic NDN forwarder while being more powerful and scalable

    Rapid integrated assessment of food safety and nutrition related to pork consumption of regular consumers and mothers with young children in Vietnam

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    Pork is the most common and widely consumed meat product in Vietnam. The study aimed to assess nutrition and food safety risks and opportunities associated with pork value chains in Vietnam. Twenty-nine focus group discussions (FGD) were conducted in Hung Yen and Nghe An provinces with 164 participants who were both regular pork consumers and mothers with young children. In each province, three districts were selected, and in each district we selected one commune. To assess the quality of pork, we took 30 swab samples of pig carcasses at slaughterhouses, 90 pork samples at slaughterhouses and markets and analysed all samples for total bacterial count (TBC), coliforms, water holding capacity and pH. The results showed that pork was the main livestock product consumed and women are responsible for buying and preparing food for daily meals. Pork was the main animal sourced food (ASF) for Vietnamese consumers, for 50–60% of ASF. There was little knowledge of zoonotic diseases. The findings suggest further studies to address consumers’ concern on chemical contamination. Most market pork samples were not within the allowable range of limits standards of Vietnam for bacterial contamination: 90% of samples were above the official permissible limit for TBC and 98% did not meet standards for coliforms. Fifty percent of samples had acceptable pH but only 5% had acceptable water holding capacity. There were no significant differences in pork quality between intensifying Hung Yen and traditional Nghe An provinces, although there was a tendency for samples from Hung Yen to have better compliance. This rapid assessment revealed considerable interest and knowledge on pork nutrition and safety and found some behavioural but few quality and safety differences between traditional and intensifying systems. This indicated marketed pork is of low quality and safety, and a lack of support to consumers in making good choices
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