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

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

On a Nonlinear Wave Equation of Kirchhoff-Carrier Type: Linear Approximation and Asymptotic Expansion of Solution in a Small Parameter

We consider the Robin-Dirichlet problem for a nonlinear wave equation of Kirchhoff-Carrier type. Using the Faedo-Galerkin method and the linearization method for nonlinear terms, the existence and uniqueness of a weak solution are proved. An asymptotic expansion of high order in a small parameter of a weak solution is also discussed

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

Ensuring the Semantic Correctness of Workflow Processes: An Ontological Approach

International audienceWorkflow verification has been known as an important as-pect of workflow management systems. Many existing approaches con-centrate on ensuring the correctness of workflow processes at the syntac-tic level. However, these approaches are not sufficient to detect errors at the semantic level. This paper contributes to ensure the semantic cor-rectness of workflow processes. First, we propose a formal definition of semantic constraints and an O(n 3)-time algorithm for detecting redun-dant and conflicting constraints. Second, by relying on the CPN Ontology (a representation of Coloured Petri Nets with OWL DL ontology) and sets of semantic constraints, workflow processes are semantically created. And third, we show how to check the semantic correctness of workflow processes with the SPARQL query language

Representation of RDF-oriented Composition with OWL DL Ontology

International audienceThis paper introduces a solution for representing RDF-oriented compositions with OWL DL ontologies. Firstly, we present an overview of RDF-oriented Composition Definition Language (RDFCDL), which is defined for creating/composing RDF manipulation operations. Secondly, we propose an approach for representing RDFNet with OWL DL ontology. We focus on translating some key components of the RDFCDL language into classes, properties and axioms of OWL DL ontology

Ensuring the Correctness of Business Workflows at the Syntactic Level: An Ontological Approach

International audienceHigh quality business workflow definitions play an important role in the organization. An incorrectly defined workflow may lead to unexpected results. Therefore, each business workflow definition should be carefully analyzed before it is put into use. In this paper, we propose an ontological approach which is suitable for ensuring the syntactic correct-ness of business workflows. In details, to represent CPNs with OWL DL, we first introduce the CPN Ontology. Then, we define axioms, which are added to the CPN Ontology to provide automated support for establishing the correctness of business workflows. Finally, by relying on the CORESE semantic engine, SPARQL queries are implemented to detect shortcomings in concrete workflows. To the best of our knowledge, this is a novel approach for the representation and verification of business workflows based on ontologies