DRAFT Report:Community Systems Strengthening Toward a Research Agenda

Communities have a long history of acting to preserve and promote the health of their members. Public health researchers, programmers, and funders are increasingly recognizing that community involvement is essential to improving health, especially among populations that are disproportionately affected by HIV. The Global Fund to fight AIDS, Tuberculosis and Malaria, together with civil society organizations and other development partners, created the Community Systems Strengthening (CSS) Framework to help Global Fund applicants frame, define, and quantify efforts to strengthen community contributions engagement (Global Fund 2011). Although the use of a CSS approach in health programming implementation shows promise, it lacks a theoretical framework to guide collaborations with communities. Additionally, it suffers from a paucity of program designs and evaluation practices, an incomplete evidence-based rationale for investing in CSS, and imprecise definitions (e.g., what is meant by “community” and “CSS”).The purpose of this paper is to highlight promising areas for future research related to CSS. Toward this objective, we propose to lay a foundation for a CSS research agenda by using theories and approaches relevant to CSS, reinforced with evidence from projects that employ similar approaches

Resource Sharing via Planed Relay for HWN

We present an improved version of adaptive distributed cross-layer routing algorithm (ADCR) for hybrid wireless network with dedicated relay stations () in this paper. A mobile terminal (MT) may borrow radio resources that are available thousands mile away via secure multihop RNs, where RNs are placed at pre-engineered locations in the network. In rural places such as mountain areas, an MT may also communicate with the core network, when intermediate MTs act as relay node with mobility. To address cross-layer network layers routing issues, the cascaded ADCR establishes routing paths across MTs, RNs, and cellular base stations (BSs) and provides appropriate quality of service (QoS). We verify the routing performance benefits of over other networks by intensive simulation

HWN* Mobility Management Considering QoS, Optimisation and Cross Layer Issues

In this paper, we address mobility management for 4th generation heterogeneous networks from a quality of service (QoS), optimisation and cross layer design perspective. Users are classified as high profile, normal profile and low profile according to their differentiated service requirements. Congestion avoidance control and adaptive handover mechanisms are implemented for efficient cooperation within the mobile heterogeneous network environment consisting of a TDMA network, ad hoc network and relay nodes. A previous proposed routing algorithm is also revised to include mobility management

Predicting consumer product demands via Big Data: the roles of online promotional marketing and online reviews

This study aims to investigate the contributions of online promotional marketing and online reviews as predictors of consumer product demands. Using electronic data from Amazon.com, we attempt to predict if online review variables such as valence and volume of reviews, the number of positive and negative reviews, and online promotional marketing variables such as discounts and free deliveries, can influence the demand of electronic products in Amazon.com. A Big Data architecture was developed and Node.JS agents were deployed for scraping the Amazon.com pages using asynchronous Input/Output calls. The completed Web crawling and scraping data-sets were then preprocessed for Neural Network analysis. Our results showed that variables from both online reviews and promotional marketing strategies are important predictors of product demands. Variables in online reviews in general were better predictors as compared to online marketing promotional variables. This study provides important implications for practitioners as they can better understand how online reviews and online promotional marketing can influence product demands. Our empirical contributions include the design of a Big Data architecture that incorporate Neural Network analysis which can used as a platform for future researchers to investigate how Big Data can be used to understand and predict online consumer product demands

Rapid gastrointestinal loss of Clostridial Clusters IV and XIVa in the ICU associates with an expansion of gut pathogens

Commensal gastrointestinal bacteria resist the expansion of pathogens and are lost during critical illness, facilitating pathogen colonization and infection. We performed a prospective, ICU-based study to determine risk factors for loss of gut colonization resistance during the initial period of critical illness. Rectal swabs were taken from adult ICU patients within 4 hours of admission and 72 hours later, and analyzed using 16S rRNA gene sequencing and selective culture for vancomycin-resistant Enterococcus (VRE). Microbiome data was visualized using principal coordinate analyses (PCoA) and assessed using a linear discriminant analysis algorithm and logistic regression modeling. 93 ICU patients were analyzed. At 72 hours following ICU admission, there was a significant decrease in the proportion of Clostridial Clusters IV/XIVa, taxa that produce short chain fatty acids (SCFAs). At the same time, there was a significant expansion in Enterococcus. Decreases in Cluster IV/XIVa Clostridia were associated with loss of gut microbiome colonization resistance (reduced diversity and community stability over time). In multivariable analysis, both decreased Cluster IV/XIVa Clostridia and increased Enterococcus after 72 hours were associated with receipt of antibiotics. Cluster IV/XIVa Clostridia, although a small fraction of the overall gastrointestinal microbiome, drove distinct clustering on PCoA. During initial treatment for critical illness, there was a loss of Cluster IV/XIVa Clostridia within the distal gut microbiome which associated with an expansion of VRE and with a loss of gut microbiome colonization resistance. Receipt of broad-spectrum antibiotics was associated with these changes

Trajectory of long-term outcome in severe pediatric diffuse axonal injury: An exploratory study

Introduction: Pediatric severe traumatic brain injury (TBI) is one of the leading causes of disability and death. One of the classic pathoanatomic brain injury lesions following severe pediatric TBI is diffuse (multifocal) axonal injury (DAI). In this single institution study, our overarching goal was to describe the clinical characteristics and long-term outcome trajectory of severe pediatric TBI patients with DAI.Methods: Pediatric patients (<18 years of age) with severe TBI who had DAI were retrospectively reviewed. We evaluated the effect of age, sex, Glasgow Coma Scale (GCS) score, early fever ≥ 38.5°C during the first day post-injury, the extent of ICP-directed therapy needed with the Pediatric Intensity Level of Therapy (PILOT) score, and MRI within the first week following trauma and analyzed their association with outcome using the Glasgow Outcome Score—Extended (GOS-E) scale at discharge, 6 months, 1, 5, and 10 years following injury.Results: Fifty-six pediatric patients with severe traumatic DAI were analyzed. The majority of the patients were >5 years of age and male. There were 2 mortalities. At discharge, 56% (30/54) of the surviving patients had unfavorable outcome. Sixty five percent (35/54) of surviving children were followed up to 10 years post-injury, and 71% (25/35) of them made a favorable recovery. Early fever and extensive DAI on MRI were associated with worse long-term outcomes.Conclusion: We describe the long-term trajectory outcome of severe pediatric TBI patients with pure DAI. While this was a single institution study with a small sample size, the majority of the children survived. Over one-third of our surviving children were lost to follow-up. Of the surviving children who had follow-up for 10 years after injury, the majority of these children made a favorable recovery