Hand, Foot and Mouth Disease in Vietnam: Epidemiology, Heart Rate Variability and Economic Burden

Over the last two decades, hand, foot and mouth disease (HFMD) has become a major clinical problem in Vietnam and the Asia-Pacific region. HFMD affects children, especially those under 5 years old, and has pandemic potential. Since 1997, there have been several outbreaks with severe clinical phenotypes, including brain stem encephalitis, attacking millions of children and causing thousands of deaths. Synthesizing data on epidemiology, etiology, disease pathophysiology and economic burden of this emerging infection remains essential to inform clinical management and health policy makers in prioritizing the development of intervention strategies. Using data from >56,000 hospitalized cases over an 11 year period, I described the spatial and temporal distribution of HFMD in Ho Chi Minh City, the main hotspot of HFMD in Vietnam. I found that the disease started in the west and then moved to the south-east and finally came back the west of the city. Results from a prospective multi-hospital based study conducted during 2015–2018 showed that of ~1200 enrolled patients, enterovirus A71 (EV-A71) was the most common HFMD pathogen detected, while coxsackievirus A6 (CV-A6) has emerged and replaced CV-A16 to become the second most common virus causing HFMD in Vietnam during the study period. Despite the emergence of other pathogens and the diversity of enterovirus serotypes (~20 serotypes) detected in HFMD patients, EV-A71 was the main cause of severe HFMD. Using long-term data synthesized as part of the research program, I also demonstrated for the first time that compared to EV-A71 subgenogroup B5, subgenogroup C4 was associated with more severe clinical phenotypes. Moreover, the predominance of subgenogroup C4 coincided with large, severe HFMD outbreaks in Vietnam (e.g. in 2011-12 and 2018). Collectively, the data suggest that an EV-A71 vaccine would be likely to substantially reduce the burden of HFMD, but a multivalent vaccine should be developed to control the ongoing HFMD epidemic because CV-A6, CV-A10 and CV-A16 were responsible for approximately 12% of severe HFMD cases and cross-reaction between these CV-As and EV-A71 is poor. In order to improve our knowledge of HFMD pathophysiology, I used ECG signal recorded by a wearable device (e-Patch) to depict the distribution of heart rate variability (HRV) indices by severity and by detected pathogens and found that compared to mild disease HRV parameters reflecting parasympathetic nervous system activation in the severe group decreased whereas those mirroring sympathetic activity and autonomic nervous system imbalance increased. In a similar trend, compared to HFMD associated with non-EV-A71, HRV indices reflecting the imbalance between sympathetic and parasympathetic activation in HFMD associated with EV-A71 were significantly higher. This suggests that children with EV-A71 infection were more likely to have ANS imbalance. Alongside with these findings, the feasibility of this wearable device in children has brought promising applications in HFMD case management by early detection of severe disease in future. To inform health policy makers in Vietnam about the burden of HFMD, I also estimated its economic burden. I showed that the total cost per case for mild and severe disease was $245.8 and$1326.7, respectively. Additionally, I also found that compared to CV-A infections, EV-A71 infection resulted in higher illness costs. At nationwide level, the total economic burden in Vietnam was estimated at >US$90 million for two-year period of 2016 – 2017

Introduction toSocialRadio Case Studies and Perspectives

National audienceIn this paper, we introduce a Social Radio platform designed to support contextual communication between communities. Radio communication was no longer used for information broadcast using different communication channels. The same concept is used in this work but for different purposes. We set up a microblogging community channel to report, comment or simply vote some events. In order to understand the concept we detail a scenario in the epidemic field

Vers un modèle de vérification de la couche logique d'entreprise dans une architecture à 3 couches: modèle CPN-ECA

International audienceThis paper proposes a model for building a flexible system, which accepts and verifies the change on business logic, including both business processes and business rules, while the system has to cover the properties as reliability and reuse. In this model, the business process will be designed with Colour Petri Net and translated into a set of Event-Condition-Action rules, this set will be combined with business rules for checking the respect of a business process to the business rules in design and modifying the process. Hierarchical Colour Petri Net is also used to guarantee the reliability and to reuse properties of the system.Ce document propose un modèle pour la création d'un système flexible, qui accepte et vérifie les modifications apportées à la logique métier, y compris les processus et les règles métier, tandis que le système doit couvrir les propriétés en termes de fiabilité et de réutilisation. Dans ce modèle, le processus de gestion sera conçu avec un réseau Pétri coloré et traduit en un ensemble de règles Event-Condition-Action (ECA). Cet ensemble sera combiné à des règles de gestion permettant de vérifier le respect du processus de gestion par modifier le processus. Un réseau Pétri coloré hiérarchisé est également utilisé pour garantir la fiabilité et pour réutiliser les propriétés du systèm

Synthèse d'activités du groupe PSP

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Une introduction à l'univers de Briefs

Premier rapport de recherche sur les BriefsWe propose in this paper a study of basic information structure, called "Brief" for annotating observations of phenomena in a spatiotemporal context through interconnection networks. One of various features of these" briefs" is that they can be used in an observation made both by human or machine through communicating objects (CO). These annotations will allow implementation of services for automatic or manual processing annotations on various phenomena. It can be used as a standard interchange format for these annotations between applications on networks. We show that we can deal metrics and techniques of computational geography and those coming from the Semantic Web to enhance the mechanisms of analysis and processing of these masses of information on the networks.Nous proposons dans cet article d'étudier une structure d'information élémentaire, appelée Brief, permettant d'annoter des observations de phénomènes dans un contexte spatiotemporel via les réseaux d'interconnexion. Une des particularités de ces Briefs est qu'ils peuvent être utilisés dans une observation effectuée par l'homme ou par la machine à travers les objets communicants Cette forme d'annotation permettra une mise en place des services de traitement automatiques ou manuels des annotations sur divers phénomènes. Elle peut être utilisée comme un format d'échange standard de ces annotations entre les applications sur réseaux. Nous montrons que l'on peut composer les métriques et techniques de la géographie algorithmique et celles venant du web sémantique pour enrichir les mécanismes d'analyse et de traitement de ces masses de fractions d'information sur les réseaux