Knowledge, attitudes, and practices of Florida physicians regarding dengue before and after an educational intervention.

BACKGROUND: Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. The objective of this study was to evaluate physician knowledge of dengue and its management before and after an educational intervention in Florida. METHODS: From 2012-13 we conducted 14 grand-rounds style lectures on dengue clinical management attended by 413 physicians, and analyzed data from the pre- and post-tests. RESULTS: Of those attending, 231 and 220 completed the pre-and post-tests, respectively. Overall, the mean pre-test score for knowledge-based questions was 74.3 and average post-test score was 94.2 %, indicating a mean increase of 19.9 % (P \u3c 0.0001, 95 % CI 17.7-22.4). Reported confidence in dengue recognition and management also increased. Non-US trained physicians and those who had treated more than ten dengue cases performed significantly better in the pre-test. Post-test scores did not differ by subgroup. CONCLUSIONS: The train-the-trainer approach with grand-rounds style presentations appear to be an effective intervention to improve knowledge of dengue among physicians

Knowledge, attitudes, and practices of Florida physicians regarding dengue before and after an educational intervention.

BACKGROUND: Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. The objective of this study was to evaluate physician knowledge of dengue and its management before and after an educational intervention in Florida. METHODS: From 2012-13 we conducted 14 grand-rounds style lectures on dengue clinical management attended by 413 physicians, and analyzed data from the pre- and post-tests. RESULTS: Of those attending, 231 and 220 completed the pre-and post-tests, respectively. Overall, the mean pre-test score for knowledge-based questions was 74.3 and average post-test score was 94.2 %, indicating a mean increase of 19.9 % (P \u3c 0.0001, 95 % CI 17.7-22.4). Reported confidence in dengue recognition and management also increased. Non-US trained physicians and those who had treated more than ten dengue cases performed significantly better in the pre-test. Post-test scores did not differ by subgroup. CONCLUSIONS: The train-the-trainer approach with grand-rounds style presentations appear to be an effective intervention to improve knowledge of dengue among physicians

Estimation of Individual Micro Data from Aggregated Open Data

In this paper, we propose a method of estimating individual micro data from aggregated open data based on semi-supervised learning and conditional probability. Firstly, the proposed method collects aggregated open data and support data, which are related to the individual micro data to be estimated. Then, we perform the locality sensitive hashing (LSH) algorithm to find a subset of the support data that is similar to the aggregated open data and then classify them by using the Ensemble classification model, which is learned by semi-supervised learning. Finally, we use conditional probability to estimate the individual micro data by finding the most suitable record for the probability distribution of the individual micro data among the classification results. To evaluate the performance of the proposed method, we estimated the individual building data where the fire occurred using the aggregated fire open data. According to the experimental results, the micro data estimation performance of the proposed method is 59.41% on average in terms of accuracy.Comment: 7 page

Association between maternal haemoglobin and stillbirth: a cohort study among a multi-ethnic population in England

© 2017 The Authors. Published by Wiley. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1111/bjh.14961The study objectives were to examine the association of maternal haemoglobin with stillbirth and perinatal death in a multi-ethnic population in England. We conducted a retrospective cohort analysis using anonymised maternity data from 14 001 women with singleton pregnancies ≥24 weeks’ gestation giving birth between 2013 and 2015 in two hospitals - the Royal Wolverhampton NHS Trust and Guy's and St Thomas’ NHS Foundation Trust. Multivariable logistic regression analyses were undertaken to analyse the associations between maternal haemoglobin at first visit and at 28 weeks with stillbirth and perinatal death, adjusting for 11 other risk factors. Results showed that 46% of the study population had anaemia (haemoglobin <110 g/l) at some point during their pregnancy. The risk of stillbirth and perinatal death decreased linearly per unit increase in haemoglobin concentration at first visit (adjusted odds ratio [aOR] stillbirth = 0·70, 95% confidence interval [CI] 0·58–0·85, aOR perinatal death = 0·71, 95% CI 0·60–0·84) and at 28 weeks (aOR stillbirth = 0·83, 95% CI 0·66–1·04; aOR perinatal death = 0·86, 95%CI 0·67–1·12). Compared with women with haemoglobin ≥110 g/l, the risk of stillbirth and perinatal death was five- and three-fold higher in women with moderate-severe anaemia (haemoglobin <100 g/l) at first visit and 28 weeks, respectively. These findings have clinical and public health importance.This paper presents independent research funded by the National Institute for Health Research (NIHR) as part of a Professorship award to Marian Knight. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Published versio

Descriptive epidemiology of birth trauma in the United States in 2003

Sauber-Schatz EK, Markovic N, Weiss HB, Bodnar LM, Wilson JW, Pearlman MD. Descriptive epidemiology of birth trauma in the United States in 2003. Paediatric and Perinatal Epidemiology 2010; 24: 116–124.The rate of birth trauma in the US has been reported to range between 0.2 and 37 birth traumas per 1000 births. Because of the minimal number of population-based studies and the inconsistencies among the published birth trauma rates, the rate of birth trauma in the US remains unclear. This is a cross-sectional study that was conducted using 890 582 in-hospital birth discharges from the 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database. A neonate was defined as having birth trauma if their hospital discharge record contained an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code from 767.0 to 767.9. Weighted data were used to calculate rates for all birth traumas and specific types of birth traumas, and rates and odds ratios by demographic, hospital and clinical variables. Weighted data represented a national estimate of 3 920 787 in-hospital births.Birth trauma was estimated to occur in 29 per 1000 births. The three most frequently diagnosed birth traumas were injuries to the scalp, other injuries to the skeleton and fracture of the clavicle. Significant univariable predictors for birth trauma included male gender, Asian or Pacific Islander race, living in urban or wealthy areas, being born in Western, urban and/or teaching hospital, a co-diagnosis of high birthweight, instrument delivery, malpresentation and other complications during labour and delivery. Birth trauma risk factors including those identified in this study may be useful to consider during labour and delivery. In conclusion, additional research is necessary to identify ways to reduce birth trauma and subsequent infant morbidity and mortality.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79198/1/j.1365-3016.2009.01077.x.pd

The Dark Energy Survey Data Processing and Calibration System

The Dark Energy Survey (DES) is a 5000 deg2 grizY survey reaching characteristic photometric depths of 24th magnitude (10 sigma) and enabling accurate photometry and morphology of objects ten times fainter than in SDSS. Preparations for DES have included building a dedicated 3 deg2 CCD camera (DECam), upgrading the existing CTIO Blanco 4m telescope and developing a new high performance computing (HPC) enabled data management system (DESDM). The DESDM system will be used for processing, calibrating and serving the DES data. The total data volumes are high (~2PB), and so considerable effort has gone into designing an automated processing and quality control system. Special purpose image detrending and photometric calibration codes have been developed to meet the data quality requirements, while survey astrometric calibration, coaddition and cataloging rely on new extensions of the AstrOmatic codes which now include tools for PSF modeling, PSF homogenization, PSF corrected model fitting cataloging and joint model fitting across multiple input images. The DESDM system has been deployed on dedicated development clusters and HPC systems in the US and Germany. An extensive program of testing with small rapid turn-around and larger campaign simulated datasets has been carried out. The system has also been tested on large real datasets, including Blanco Cosmology Survey data from the Mosaic2 camera. In Fall 2012 the DESDM system will be used for DECam commissioning, and, thereafter, the system will go into full science operations.Comment: 12 pages, submitted for publication in SPIE Proceeding 8451-1