Managing Potential Laboratory Exposure to Ebola Virus by Using a Patient Biocontainment Care Unit1

One-sentence summary for table of contents: Recommendations are needed for management of potential laboratory exposure to a Biosafety Level 4 pathogen

Introduction of the European Union case definitions to primary care physicians has improved the quality of communicable diseases notification in Tuzla, Bosnia and Herzegovina

Aim: The Public Health Reform II project was implemented in Bosnia and Herzegovina from December 2011 to December 2013 and was funded by the European Union Aid schema. The principal aim of the project was to strengthen public health services in the country through improved control of public health threats. Workshops for primary care physicians were provided to improve the situation and increase communicable diseases notification rates in eight selected primary care centres. They were followed with visits from the project’s implementing team to verify the effects of trainings. Methods: The quality of notifications from physicians in Tuzla region was compared before and after the workshop. The timeliness was used as an indicator of quality. Medians of timeliness before and after the training were compared by use of Wilcoxon test, whereas the averages of timeliness were compared by use of the t-test. Results: There were 980 reported cases, 80% before the training and 20% after the training. A lower median of timeliness for all the reported cases after the training was statistically significant compared to the median value before the training. A similar picture was revealed for specific diseases i.e. tuberculosis and enteritis, not so for scarlet fever and scabies. Conclusion: The significant reduction in time response between the first symptoms and disease diagnosis indicates the positive impact of the training program in Tuzla. Hence, primary care physicians provided better quality of reported data after the training course

Efficient Online Surface Correction for Real-time Large-Scale 3D Reconstruction

State-of-the-art methods for large-scale 3D reconstruction from RGB-D sensors usually reduce drift in camera tracking by globally optimizing the estimated camera poses in real-time without simultaneously updating the reconstructed surface on pose changes. We propose an efficient on-the-fly surface correction method for globally consistent dense 3D reconstruction of large-scale scenes. Our approach uses a dense Visual RGB-D SLAM system that estimates the camera motion in real-time on a CPU and refines it in a global pose graph optimization. Consecutive RGB-D frames are locally fused into keyframes, which are incorporated into a sparse voxel hashed Signed Distance Field (SDF) on the GPU. On pose graph updates, the SDF volume is corrected on-the-fly using a novel keyframe re-integration strategy with reduced GPU-host streaming. We demonstrate in an extensive quantitative evaluation that our method is up to 93% more runtime efficient compared to the state-of-the-art and requires significantly less memory, with only negligible loss of surface quality. Overall, our system requires only a single GPU and allows for real-time surface correction of large environments.Comment: British Machine Vision Conference (BMVC), London, September 201

Role of inclusive self-help groups in prevention and management of diabetes and hypertension in Myanmar:a qualitative study

Background: Noncommunicable diseases (NCDs) are a growing public health concern in Myanmar. Community-based self-help groups are essential for participating in health-related activities. However, little is known about the role of inclusive self-help groups (ISHG) in hypertension and diabetes management. This study aimed to assess knowledge and perception of health-related activities of ISHG and explore challenges ISHG group members encountered in performing hypertension and diabetes prevention and management activities.Methods: The study included six townships from three different regions of Myanmar, where ISHG existed. Two focus group discussions (FGDs) were held in each township. A total of twelve FGDs were conducted. All discussions were conducted, audio-recorded and transcribed verbatim in Myanmar language. A thematic analysis was performed using inductive and deductive approaches.Results: The findings revealed that ISHG members provided advice and counselling on behavioural risk factors for hypertension and diabetes prevention and screenings for those diseases. They also offered home care for the elderly and stroke patients who required their assistance. Community members regarded ISHG as a valuable community structure. Members of the ISHG identified a number of challenges, including lack of resources (funding, manpower, and time), lack of confidence, and lack of recognition and acceptance. Support and strengthening activities by local authorities and the government were critical to sustain ISHG's activities and efforts.Conclusions: Hypertension and diabetes management activities of ISHG are appreciative. The public and government should recognize and support ISHG to strengthen their community activities

Comparative analysis of high-sensitivity cardiac troponin I and T for their association with coronary computed tomography-assessed calcium scoring represented by the Agatston score

Background: This study evaluates the association between high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) and coronary calcium concentration (CAC) detected by coronary computed tomography (CCT) and evaluated with the Agatston score in patients with suspected coronary artery disease (CAD). Methods: Patients undergoing CCT during routine clinical care were enrolled prospectively. CCT was indicated for patients with a low to intermediate pretest probability for CAD. Within 24 h of CCT examination, peripheral blood samples were taken to measure cardiac biomarkers hs-cTnI and hs-cTnT. Results: A total of 76 patients were enrolled including 38% without detectable CAC, 36% with an Agatston score from 1 to 100, 17% from 101 to 400, and 9% with values ≥ 400. hs-cTnI was increasing alongside Agatston score and was able to differentiate between different groups of Agatston scores. Both hs-cTn discriminated values greater than 100 (hs-cTnI, AUC = 0.663; p = 0.032; hs-cTnT, AUC = 0.650; p = 0.048). In univariate and multivariate logistic regression models, hs-cTnT and hs-cTnI were significantly associated with increased Agatston scores. Patients with hs-cTnT ≥ 0.02 µg/l and hs-cTnI ≥ 5.5 ng/l were more likely to reveal values ≥ 400 (hs-cTnT; OR = 13.4; 95% CI 1.545–116.233; p = 0.019; hs-cTnI; OR = 8.8; 95% CI 1.183–65.475; p = 0.034). Conclusion: The present study shows that the Agatston score was significantly correlated with hs cardiac troponins, both in univariable and multivariable linear regression models. Hs-cTnI is able to discriminate between different Agatston values. The present results might reveal potential cut-off values for hs cardiac troponins regarding different Agatston values. Trial registration Cardiovascular Imaging and Biomarker Analyses (CIBER), NCT03074253 https://clinicaltrials.gov/ct2/show/record/NCT0307425

Risk factor paradox: No prognostic impact of arterial hypertension and smoking in patients with ventricular tachyarrhythmias

Background: Data regarding the outcome of patients with ventricular tachyarrhythmias related to arterial hypertension (AHT) and smoking is limited. The study sought to assess the prognostic impact of AHT and smoking on survival in patients presenting with ventricular tachyarrhythmias. Methods: All consecutive patients surviving ventricular tachycardia (VT) and ventricular fibrillation (VF) upon admission to the University Medical Center Mannheim (UMM), Germany from 2002 to 2016 were included and stratified according to AHT and smoking by propensity score matching. The primary prognostic endpoint was all-cause mortality at 30 months.Results: A total of 988 AHT-matched patients (494 each, with and without AHT) and a total of 872 smoking-matched patients (436 each, with and without smoking) were included. The rates of VT and VF were similar in both groups (VT: AHT 60% vs. no AHT 60%; smokers 61% vs. non-smokers 62%; VF: AHT 35% vs. no AHT 38%; smokers 39% vs. non-smokers 38%). Neither AHT nor smoking were associated with the primary endpoint of long-term all-cause mortality at 30 months (long-term mortality rates: AHT/no AHT, 26% vs. 28%; log-rank p = 0.525; smoking/non-smoking, 22% vs. 25%; log-rank p = 0.683).Conclusions: Paradoxically, neither AHT nor smoking were associated with differences of long-term all-cause mortality in patients presenting with ventricular tachyarrhythmias

Investigating feasibility of 2021 WHO protocol for cervical cancer screening in underscreened populations:PREvention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC)

Abstract Background High-risk human papillomavirus (hrHPV) testing has been recommended by the World Health Organization as the primary screening test in cervical screening programs. The option of self-sampling for this screening method can potentially increase women’s participation. Designing screening programs to implement this method among underscreened populations will require contextualized evidence. Methods PREvention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC) will use a multi-method approach to investigate the feasibility of implementing a cervical cancer screening strategy with hrHPV self-testing as the primary screening test in Bangladesh, India, Slovak Republic and Uganda. The primary outcomes of study include uptake and coverage of the screening program and adherence to follow-up. These outcomes will be evaluated through a pre-post quasi-experimental study design. Secondary objectives of the study include the analysis of client-related factors and health system factors related to cervical cancer screening, a validation study of an artificial intelligence decision support system and an economic evaluation of the screening strategy. Discussion PRESCRIP-TEC aims to provide evidence regarding hrHPV self-testing and the World Health Organization’s recommendations for cervical cancer screening in a variety of settings, targeting vulnerable groups. The main quantitative findings of the project related to the impact on uptake and coverage of screening will be complemented by qualitative analyses of various determinants of successful implementation of screening. The study will also provide decision-makers with insights into economic aspects of implementing hrHPV self-testing, as well as evaluate the feasibility of using artificial intelligence for task-shifting in visual inspection with acetic acid. Trial registration ClinicalTrials.gov, NCT05234112 . Registered 10 February 202

Hepatitis B Outbreak Among Men Who Have Sex with Men in the Autonomous Province of Vojvodina, Serbia

** From Crossref via Jisc Publications Router.The European Centre for Disease Prevention and Control reported that there were 2896 acute hepatitis B cases in 24 EU/EEA countries in 2013.1 The incidence ranged from 0.1 cases per 100,000 in France and Portugal to 4.3 per 100,000 in Latvia, with a male-to-female ratio of 2.2:1 in EU/EEA countries, and transmission among men who have sex with men (MSM) reported in 9.4% of all cases of acute hepatitis B.1 Some authors consider hepatitis B virus (HBV) infection to be endemic in the MSM population with the incidence 20 times higher in MSM than in the general population worldwide.2 However, data on HBV prevalence among MSM are available for only four EU/EEA countries.3 Six to ten percent of MSM infected with HBV worldwide are co-infected with HIV.4sch_iih5pub4999pub