Giau Minh Truong Interview

Bio: Giau Minh Truong is a company member of A-Squared Theatre Workshop and an at- large artist for various performing arts companies in the Chicago area. For A-Squared, he directed Ching Chong Chinaman, The Other Shore, and short plays for My Asian Mom, acted in Trial By Water, and designed lights for The Wind Cries Mary. Giau’s other directorial credits include Downward Facing, Lights Out, Everybody, and Theatre of Women for Dream Theatre Company. He directed Sister Outlaw, Mr. and Mrs. LaQuesta Go Dancing, My Name is Flor Contemplacion, and I Dream Electric for CIRCA-Pintig, Chicago’s long-running Filipino American theatre company for which he served as artistic director from 2007 through 2012. Giau has also directed plays for James Downing Theatre Company and Theatre for a Change. He serves as a teaching artist and program manager for Storycatchers, stage manages with Chamber Opera Chicago and various other companies and is a resident technical director for Links Hall. (Bio taken from https://halcyontheatre.org/people/giautruong

A genotype-guided strategy for oral P2Y₁₂ Inhibitors in primary PCI

BACKGROUND: It is unknown whether patients undergoing primary percutaneous coronary intervention (PCI) benefit from genotype-guided selection of oral P2Y12 inhibitors. METHODS: We conducted a randomized, open-label, assessor-blinded trial in which patients undergoing primary PCI with stent implantation were assigned in a 1:1 ratio to receive either a P2Y12 inhibitor on the basis of early CYP2C19 genetic testing (genotype-guided group) or standard treatment with either ticagrelor or prasugrel (standard-treatment group) for 12 months. In the genotype-guided group, carriers of CYP2C19*2 or CYP2C19*3 loss-of-function alleles received ticagrelor or prasugrel, and noncarriers received clopidogrel. The two primary outcomes were net adverse clinical events - defined as death from any cause, myocardial infarction, definite stent thrombosis, stroke, or major bleeding defined according to Platelet Inhibition and Patient Outcomes (PLATO) criteria - at 12 months (primary combined outcome; tested for noninferiority, with a noninferiority margin of 2 percentage points for the absolute difference) and PLATO major or minor bleeding at 12 months (primary bleeding outcome). RESULTS: For the primary analysis, 2488 patients were included: 1242 in the genotype-guided group and 1246 in the standard-treatment group. The primary combined outcome occurred in 63 patients (5.1%) in the genotype-guided group and in 73 patients (5.9%) in the standard-treatment group (absolute difference, -0.7 percentage points; 95% confidence interval [CI], -2.0 to 0.7; P<0.001 for noninferiority). The primary bleeding outcome occurred in 122 patients (9.8%) in the genotype-guided group and in 156 patients (12.5%) in the standard-treatment group (hazard ratio, 0.78; 95% CI, 0.61 to 0.98; P = 0.04). CONCLUSIONS: In patients undergoing primary PCI, a CYP2C19 genotype-guided strategy for selection of oral P2Y12 inhibitor therapy was noninferior to standard treatment with ticagrelor or prasugrel at 12 months with respect to thrombotic events and resulted in a lower incidence of bleeding. (Funded by the Netherlands Organization for Health Research and Development; POPular Genetics ClinicalTrials.gov number, NCT01761786; Netherlands Trial Register number, NL2872.)

Risk assessment of infectious respiratory disease transmission in indoor environments

Pathogens of infectious respiratory diseases can be transmitted via aerosols. These pathogen-laden aerosols are responsible for several modes of transmission of infectious diseases. Multidisciplinary knowledge is required to understand the mechanics and mechanism of transmission of infectious disease via aerosols. Step-by-step procedures are necessary to realistically assess the infection risk associated with these infectious particles. This research integrates knowledge and techniques of mechanical engineering and health sciences to further study the transmission of infectious respiratory diseases in a multidisciplinary perspective and to assess their risk in realistic indoor environments. Multiphase fluid dynamics modeling was employed to estimate the transport of the infectious particles in air and their deposition onto indoor environmental surfaces. Knowing the distribution and the fate of these aerosols, together with respiratory physiological and microbiological data, exposure level and intake dose of the pathogens were estimated. Epidemiological and/or experimental biological models were then used to correlate the intake dose of pathogen to the infection risk of the receptor. Ensemble averaging and Poisson probability were used to express the uncertainties in the infection risk assessment process. Exposure and risk assessment models for different exposure pathways and a retrospective model used to analyze past outbreak cases were developed in this research. Using these models, infection risk assessments were performed in a number of indoor environments, including a general hospital ward, an isolation ward and an aircraft cabin. A Varicella outbreak was analyzed using the retrospective model. The infectious source strength of the index case was predicted by the model. It is found that the infection risks were highly related to the aerosol and airflow dynamics in all these cases. The models developed in this research can be used to predict the spread of infectious respiratory diseases and to evaluate the effectiveness of infection control strategy

Review and comparison between the Wells-Riley and dose-response approaches to risk assessment of infectious respiratory diseases

P>Infection risk assessment is very useful in understanding the transmission dynamics of infectious diseases and in predicting the risk of these diseases to the public. Quantitative infection risk assessment can provide quantitative analysis of disease transmission and the effectiveness of infection control measures. The Wells-Riley model has been extensively used for quantitative infection risk assessment of respiratory infectious diseases in indoor premises. Some newer studies have also proposed the use of dose-response models for such purpose. This study reviews and compares these two approaches to infection risk assessment of respiratory infectious diseases. The Wells-Riley model allows quick assessment and does not require interspecies extrapolation of infectivity. Dose-response models can consider other disease transmission routes in addition to airborne route and can calculate the infectious source strength of an outbreak in terms of the quantity of the pathogen rather than a hypothetical unit. Spatial distribution of airborne pathogens is one of the most important factors in infection risk assessment of respiratory disease. Respiratory deposition of aerosol induces heterogeneous infectivity of intake pathogens and randomness on the intake dose, which are not being well accounted for in current risk models. Some suggestions for further development of the risk assessment models are proposed. Practical Implications This review article summarizes the strengths and limitations of the Wells-Riley and the dose-response models for risk assessment of respiratory diseases. Even with many efforts by various investigators to develop and modify the risk assessment models, some limitations still persist. This review serves as a reference for further development of infection risk assessment models of respiratory diseases. The Wells-Riley model and dose-response model offer specific advantages. Risk assessors can select the approach that is suitable to their particular conditions to perform risk assessment. © 2009 John Wiley & Sons A/S

Estimation of the Aerodynamic Sizes of Single Bacterium-laden Expiratory Aerosols using Stochastic Modeling with Experimental Validation

The aerodynamic size of pathogen-laden expiratory aerosols plays an important role in their dispersion in air and deposition onto surfaces, both of which are related to the spread of infectious respiratory diseases. The size of bacterial cells is on a similar scale to the size of expiratory aerosols, but because some bacterial cells are nonspherical, bacterium-laden expiratory aerosols often have irregular shapes and highly variable aerodynamic sizes. An algorithm that can estimate their aerodynamic sizes is highly desirable in studying their physical transport and to assess the subsequent exposure level and infection risk. In this study, an algorithm based on stochastic modeling was developed to predict the distribution of the aerodynamic size of bacterium-laden expiratory aerosols. The applicability of the algorithm was tested experimentally by conducting biological air sampling using a multi-stage impactor in a test facility. The proposed algorithm was used to predict the size profile of simulated expiratory aerosols encasing a strain of benign rod-shaped bacterium. Simulated bacterium-laden expiratory aerosols were generated using a cough machine with a solution containing the bacteria. Air at three different positions was then sampled to obtain the size profile of bacterium-laden aerosols at each position. The results were compared to the prediction by the algorithm and by another method, which simply considers the evaporative shrinkage of the expiratory aerosols and neglects the inclusion of the pathogen. It was found that the prediction by the proposed algorithm generally matched the measured results much better than the method that neglects the inclusion of the bacterium. Limitations of the current algorithm and further research and development are also discussed in this article. 2011 07 31

Analyzing the Spatial Distribution Pattern of Infection Cases using Mathematical Likelihood: Implication on Airborne Disease Transmission and Risk Assessment

This study proposes a method to analyze the spatial distribution of infection cases in outbreaks of airborne transmissible diseases. Infection risk assessment is first performed to estimate the infection risks of the susceptible people in the outbreak. A modified likelihood function could then be used to establish the likelihood of the estimated infection risk which is the true infection risk. The method can be used to estimate unknown parameters in the outbreak, such as the infectious source strength. A real outbreak of chickenpox was analyzed to demonstrate the use of the proposed method. It was found that the estimation of the quanta generation rate using the classical well-mixed assumption would cause significant error in the selected outbreak case

A Model for Assessing the Infection Risk of Respiratory Diseases by Fomite Transmission

A model for estimating pathogen exposure via fomite transmission and for predicting the infection risk was proposed. The estimation of exposure was based on the amount of pathogen-laden expiratory aerosols deposited on surfaces, which was obtained by particle-tracking simulations. In a hypothetical case of influenza transmission in an aircraft cabin mock-up, spatial distribution of infection risks according to the aerosol deposition characteristics was revealed using the proposed model. The passengers next to and immediately in front of the source had infection risks via the fomite transmission route 1-2 orders of magnitude higher than other passengers. The proposed model can be a tool for investigating the effects of different parameters on infection risks by fomite transmission