Mobile Personal Healthcare System for Non-Invasive, Pervasive and Continuous Blood Pressure Monitoring: A Feasibility Study

Background: Smartphone-based blood pressure (BP) monitor using photoplethysmogram (PPG) technology has emerged as a promising approach to empower users with self-monitoring for effective diagnosis and control ofhypertension (HT). Objective: This study aimed to develop a mobile personal healthcare system for non-invasive, pervasive, and continuous estimation of BP level and variability to be user-friendly to elderly. Methods: The proposed approach was integrated by a self-designed cuffless, calibration-free, wireless and wearable PPG-only sensor, and a native purposely-designed smartphone application using multilayer perceptron machine learning techniques from raw signals. We performed a pilot study with three elder adults (mean age 61.3 ± 1.5 years; 66% women) to test usability and accuracy of the smartphone-based BP monitor. Results: The employed artificial neural network (ANN) model performed with high accuracy in terms of predicting the reference BP values of our validation sample (n=150). On average, our approach predicted BP measures with accuracy \u3e90% and correlations \u3e0.90 (P \u3c .0001). Bland-Altman plots showed that most of the errors for BP prediction were less than 10 mmHg. Conclusions: With further development and validation, the proposed system could provide a cost-effective strategy to improve the quality and coverage of healthcare, particularly in rural zones, areas lacking physicians, and solitary elderly populations

GPS Tracking of Free-Ranging Pigs to Evaluate Ring Strategies for the Control of Cysticercosis/Taeniasis in Peru

Background Taenia solium, a parasitic cestode that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. T. solium eggs are released into the environment through the stool of humans infected with an adult intestinal tapeworm (a condition called taeniasis), and cause cysticercosis when ingested by pigs or other humans. A control strategy to intervene within high-risk foci in endemic communities has been proposed as an alternative to mass antihelminthic treatment. In this ring strategy, antihelminthic treatment is targeted to humans and pigs residing within a 100 meter radius of a pig heavily-infected with cysticercosis. Our aim was to describe the roaming ranges of pigs in this region, and to evaluate whether the 100 meter radius rings encompass areas where risk factors for T. solium transmission, such as open human defecation and dense pig activity, are concentrated. Methodology/Principal Findings In this study, we used Global Positioning System (GPS) devices to track pig roaming ranges in two rural villages of northern Peru. We selected 41 pigs from two villages to participate in a 48-hour tracking period. Additionally, we surveyed all households to record the locations of open human defecation areas. We found that pigs spent a median of 82.8% (IQR: 73.5, 94.4) of their time roaming within 100 meters of their homes. The size of home ranges varied significantly by pig age, and 93% of the total time spent interacting with open human defecation areas occurred within 100 meters of pig residences. Conclusions/Significance These results indicate that 100 meter radius rings around heavily-infected pigs adequately capture the average pig’s roaming area (i.e., home range) and represent an area where the great majority of exposure to human feces occurs

Factores domiciliarios asociados con la presencia de hidatidosis humana en tres comunidades rurales de Junín, Perú

Introduction. Hydatid disease, a zoonosis caused by the larval stage of the parasite Echinococcus granulosus, is a public health problem at national level, especially in those regions dedicated to raising livestock. By now, there are many factors, at individual level, that have been associated to the infection by E. granulosus; nevertheless there is not any previous report that explore the association between household characteristics and the presence of the disease among household members. Objective. To explore the association between household characteristics and the presence of hydatid disease among household members. Material and methods. We performed a cross-sectional study in the households of 3 rural communities located in Junín, we evaluated the association between household characteristics and the presence of hydatid disease by multiple logistic regression (MLR). Results. from 417 evaluated households, 56 (13%) of them had at least one positive case among its members. Multivariate analysis showed that households with three or more members, located in the community with the lowest quintile of poverty, that reported raising livestock, and with evaluation coverage greater than 25% were more likely to have at least one positive case among its members. Conclusion. The observed characteristics be taken into account in the preliminary definition of high-risk subgroups, optimizing the use of resources and improving the effectiveness of screening programs. Introducción. La hidatidosis, zoonosis producida por el estadio larvario de la taenia Echinococcus granulosus, es un problema de salud pública a nivel nacional, en especial en aquellas regiones dedicadas a la crianza de ganado. A la fecha, se han descrito factores, a nivel individual, asociados con la infección por E. granulosus; sin embargo, no se encontró reporte previo que explore la asociación entre características de la vivienda y la presencia de esta enfermedad en alguno de sus miembros. Objetivos. Explorar la asociación entre las características de la vivienda y la presencia de hidatidosis entre las personas que la habitan. Materiales y métodos. Se realizó un estudio transversal en viviendas de tres comunidades rurales de Junín. Se evaluó el grado de asociación entre las características de la vivienda y la presencia de hidatidosis en el hogar mediante un análisis de regresión logística múltiple (RLM). Resultados. De un total de 417 viviendas evaluadas, 56 (13%) de ellas tenían al menos un caso positivo entre sus miembros; luego del análisis de RLM se observó que aquellas viviendas con más de tres miembros, localizadas en la comunidad con quintil de pobreza más bajo, que refirieron crianza de animales, y con una cobertura de evaluación mayor al 25% presentaron una mayor probabilidad de tener al menos un caso de positivo entre sus miembros. Conclusión. Las características observadas deben ser tomadas en cuenta para la determinación preliminar de subgrupos de alto riesgo, optimizando así el uso de los recursos y mejorando la eficacia de los programas de despistaje

Insights Gained into Marginalized Students Access Challenges During the COVID-19 Academic Response

The American Chemical Society (ACS) Committee on Minority Affairs (CMA) endeavors to support all chemistry faculty and staff as they educate all of our students during this pandemic. While the chemistry education community and the ACS have both provided resources as most institutions transitioned to virtual platforms, this pandemic disproportionally affects our students of color, lower socio-economic and rural backgrounds, and students with disabilities. Specifically, these students must overcome hurdles of technology access, environmental disruptions, and cultural pressures in order to be successful. Therefore, CMA has formulated partnerships with both academic and industrial institutions to highlight some best practices to improve future virtual learning experiences of these oftentimes marginalized students. Specifically, the work presented here examines programs and policies at three academic institutions with very different student body demographics and surrounding learning environments (Indiana University Purdue University Indianapolis (IUPUI), The College of New Jersey (TCNJ), and Los Angeles Community College District (LACCD)) with an attempt to identify variables that enhance marginalized student success in chemistry courses. The combination of their results suggests elements such as access to technology, home responsibility, and impostor syndrome, that other learning programs should consider to increase virtual learning success. Furthermore, other stopgap measures implemented at industrial partners give insight as to how these considerations can be implemented during virtual internship programs to meet their learning objectives associated with entering their institutional pipeline

Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study.

OBJECTIVES: To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town. METHODS: Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot. RESULTS: Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P < 0.05). A similarly increasing pattern of higher seroprevalence was observed among migrants by age at migration. In rural villagers, there was strong evidence of an association between positive serology and having seizures (P = 0.011) but such an association was not observed in long-term migrants or in urban residents. In the entire study population, compared with seronegative participants, those with strong antibody reactions (≥ 4 antibody bands) were more likely to have epilepsy (P < 0.001). CONCLUSIONS: It is not only international migration that affects cysticercosis endemicity; internal migration can also affect patterns of endemicity within an endemic country. The neurological consequences of cysticercosis infection likely outlast the antibody response for years after rural-to-urban migration

The infectiousness of tuberculosis patients coinfected with HIV

The current understanding of airborne tuberculosis (TB) transmission is based on classic 1950s studies in which guinea pigs were exposed to air from a tuberculosis ward. Recently we recreated this model in Lima, Peru, and in this paper we report the use of molecular fingerprinting to investigate patient infectiousness in the current era of HIV infection and multidrug-resistant (MDR) TB

Research training needs in Peruvian national TB/HIV programs

<p>Abstract</p> <p>Background</p> <p>There are few published reports of <it>research training </it>needs assessments and research training programs. In an effort to expand this nascent field of study and to bridge the gap between research and practice, we sought to systematically assess the research training needs of health care professionals working at Peruvian governmental institutions leading HIV and tuberculosis (TB) control and among senior stakeholders in the field.</p> <p>Methods</p> <p>Six institutional workshops were conducted with the participation of 161 mid-level health professionals from agencies involved in national HIV and TB control. At each workshop informants completed a structured questionnaire and participated in small and large group discussions. Additional data and institutional commitment was obtained through in-depth interviews from 32 senior managers and researchers from the Ministry of Health, academia and NGOs.</p> <p>Results</p> <p>Participants exhibited an overwhelming receptivity for additional research training, observing a gap between current levels of research training and their perceived importance. Specialized skills in obtaining funding, developing research protocols, particularly in operational, behavioral and prevention research were considered in greatest need. Beyond research training, participants identified broader social, economic and political factors as influential in infectious disease control.</p> <p>Conclusions</p> <p>The needs assessment suggests that future training should focus on operational research techniques, rather than on clinical skill building or program implementation only. Strengthening health systems not only requires additional research training, but also adequate financial resources to implement research findings.</p

Spatial analysis of the Halpha emission in the local star-forming UCM galaxies

We present a photometric study of the Halpha emission in the Universidad Complutense de Madrid (UCM) Survey galaxies. This work complements our previously-published spectroscopic data. We study the location of the star-forming knots, their intensity, concentration, and the relationship of these properties with those of the host galaxy. We also estimate that the amount of Halpha emission that arises from the diffuse ionized gas is about 15-30% of the total Halpha flux for a typical UCM galaxy. This percentage seems to be independent of the Hubble type. Conversely, we found that an `average' UCM galaxy harbours a star formation event with 30% of its Halpha luminosity arising from a nuclear component. The implications of these results for higher-redshift studies are discussed, including the effects of galaxy size and the depth of the observations. A correlation between the SFR and the Balmer decrement is observed, but such correlation breaks down for large values of the extinction. Finally, we recalculate the Halpha luminosity function and star formation rate density of the local Universe using the new imaging data. Our results point out that, on average, spectroscopic observations detected about one third of the total emission-line flux of a typical UCM galaxy. The new values obtained for the Halpha luminosity density and the star formation rate density of the local Universe are 10^(39.3+/-0.2) erg s-1 Mpc-3, and rho_SFR=0.016^(+0.007)_(-0.004) Mass_sun yr-1 Mpc-3 (H_0=50 km s-1 Mpc-1, Omega_M=1.0, Lambda=0). The corresponding values for the `concordance cosmology' (H_0=70 km s-1 Mpc-1, Omega_M=0.3, Lambda=0.7) are 10^(39.5+/-0.2) erg s-1 Mpc-3 rho_SFR=0.029^(+0.008)_(-0.005) Mass_sun yr-1 Mpc-3.Comment: 48 pages, 11 PostScript figures, 2 tables, accepted for publication in ApJ. Halpha images available at http://www.ucm.es/info/Astrof/UCM_Survey/UCM/ha_images.htm

Decline in Kidney Function among Apparently Healthy Young Adults at Risk of Mesoamerican Nephropathy.

Background Epidemic levels of CKD of undetermined cause, termed Mesoamerican nephropathy in Central America, have been found in low- and middle-income countries. We investigated the natural history of, and factors associated with, loss of kidney function in a population at high risk for this disease.Methods We conducted a 2-year prospective, longitudinal study with follow-up every 6 months in nine rural communities in northwestern Nicaragua and included all men (n=263) and a random sample of women (n=87) ages 18-30 years old without self-reported CKD, diabetes, or hypertension. We used growth mixture modeling to identify subgroups of eGFR trajectory and weighted multinomial logistic regression to examine associations with proposed risk factors.Results Among men, we identified three subpopulations of eGFR trajectory (mean baseline eGFR; mean eGFR change over follow-up): 81% remained stable (116 ml/min per 1.73 m2; -0.6 ml/min per 1.73 m2 per year), 9.5% experienced rapid decline despite normal baseline function (112 ml/min per 1.73 m2; -18.2 ml/min per 1.73 m2 per year), and 9.5% had baseline dysfunction (58 ml/min per 1.73 m2; -3.8 ml/min per 1.73 m2 per year). Among women: 96.6% remained stable (121 ml/min per 1.73 m2; -0.6 ml/min per 1.73 m2 per year), and 3.4% experienced rapid decline (132 ml/min per 1.73 m2; -14.6 ml/min per 1.73 m2 per year; n=3 women). Among men, outdoor and agricultural work and lack of shade availability during work breaks, reported at baseline, were associated with rapid decline.Conclusions Although Mesoamerican nephropathy is associated with agricultural work, other factors may also contribute to this disease

Upper-Room Ultraviolet Light and Negative Air Ionization to Prevent Tuberculosis Transmission

Background Institutional tuberculosis (TB) transmission is an important public health problem highlighted by the HIV/AIDS pandemic and the emergence of multidrug- and extensively drug-resistant TB. Effective TB infection control measures are urgently needed. We evaluated the efficacy of upper-room ultraviolet (UV) lights and negative air ionization for preventing airborne TB transmission using a guinea pig air-sampling model to measure the TB infectiousness of ward air. Methods and Findings For 535 consecutive days, exhaust air from an HIV-TB ward in Lima, Perú, was passed through three guinea pig air-sampling enclosures each housing approximately 150 guinea pigs, using a 2-d cycle. On UV-off days, ward air passed in parallel through a control animal enclosure and a similar enclosure containing negative ionizers. On UV-on days, UV lights and mixing fans were turned on in the ward, and a third animal enclosure alone received ward air. TB infection in guinea pigs was defined by monthly tuberculin skin tests. All guinea pigs underwent autopsy to test for TB disease, defined by characteristic autopsy changes or by the culture of Mycobacterium tuberculosis from organs. 35% (106/304) of guinea pigs in the control group developed TB infection, and this was reduced to 14% (43/303) by ionizers, and to 9.5% (29/307) by UV lights (both p < 0.0001 compared with the control group). TB disease was confirmed in 8.6% (26/304) of control group animals, and this was reduced to 4.3% (13/303) by ionizers, and to 3.6% (11/307) by UV lights (both p < 0.03 compared with the control group). Time-to-event analysis demonstrated that TB infection was prevented by ionizers (log-rank 27; p < 0.0001) and by UV lights (log-rank 46; p < 0.0001). Time-to-event analysis also demonstrated that TB disease was prevented by ionizers (log-rank 3.7; p = 0.055) and by UV lights (log-rank 5.4; p = 0.02). An alternative analysis using an airborne infection model demonstrated that ionizers prevented 60% of TB infection and 51% of TB disease, and that UV lights prevented 70% of TB infection and 54% of TB disease. In all analysis strategies, UV lights tended to be more protective than ionizers. Conclusions Upper-room UV lights and negative air ionization each prevented most airborne TB transmission detectable by guinea pig air sampling. Provided there is adequate mixing of room air, upper-room UV light is an effective, low-cost intervention for use in TB infection control in high-risk clinical settings