Epidemiological characteristics of cryptococcal meningoencephalitis associated with Cryptococcus neoformans var. grubii from HIV-infected patients in Madagascar : a cross-sectional study

Cryptococcal meningoencephalitis (CM) remains the most prevalent invasive fungal infection worldwide. The main objective of this study was to describe the prevalence of CM and cryptococcal infection in HIV-infected patients in Madagascar. The secondary objectives were to assess the adjusted prevalence of CM according to clinical presentation and patient characteristics, to determine crude 90-day survival according to cryptococcal antigen (CrAg) status and CM, and to identify the genotypes of Cryptococcus clinical isolates. This cross-sectional study was carried out at two urban hospitals in Antananarivo (central highlands) and Toamasina (east coast) between November 2014 and December 2016. Consecutive HIV-infected adults presenting with CD4 cell counts 64200/\u3bcl were enrolled. Lateral flow immunoassays of CrAg were performed on serum for all patients, and on cerebrospinal fluid for patients with CM symptoms. MALDI-ToF MS, ITS sequencing, and determinations of the molecular and mating types of the isolates were performed. Fluconazole is the only drug for CM treatment available in Madagascar. Patients were treated orally, with high doses (1200 mg/day) for 10-12 weeks and then with 200 mg/day. Minimum inhibitory concentrations were determined for amphotericin B, flucytosine, voriconazole and fluconazole in E-tests. Overall prevalence was 13.2% (95% CI 7.9-20.3) for cryptococcal infection and 10.9% (95% CI 6.1-17.5) for CM, among the 129 HIV-infected patients studied. The 90-day mortality rate was 58.8% (10/17) in CrAg-positive patients and 17.9% (20/112) in CrAg-negative patients (p<0.001). The 13 Cryptococcus strains obtained at baseline were all Cryptococcus neoformans var. grubii, genotypes VNI-\u3b1A (3 isolates), VNII-\u3b1A (4 isolates) or hybrid VNI/VNII-\u3b1AA\u3b1 (6 isolates), suggesting high diversity. Two strains acquired fluconazole resistance after four and five months of exposure, respectively. The prevalence of cryptococcosis is high in Madagascar and this serious condition is life-threatening in HIV-infected patients. These findings will be used to raise the awareness of national authorities to strengthen the national HIV/AIDS control program

CoSyR: a novel beam dynamics code for the modeling of synchrotron radiation effects

The self-consistent nonlinear dynamics of a relativistic charged particle beam interacting with its complete self-fields is a fundamental problem underpinning many of the accelerator design issues in high brightness beam applications, as well as the development of advanced accelerators. Particularly, synchrotron radiation induced effects in a magnetic dispersive beamline element can lead to collective beam instabilities and emittance growth. A novel beam dynamic code is developed based on a Lagrangian method for the calculation of the particles' radiation near-fields using wavefront/wavelet meshes via the Green's function of the Maxwell equations. These fields are then interpolated onto a moving mesh for dynamic update of the beam. This method allows radiation co-propagation and self-consistent interaction with the beam in the simulation at greatly reduced numerical errors. Multiple levels of parallelisms are inherent in this method and implemented in our code CoSyR to enable at-scale simulations of nonlinear beam dynamics on modern computing platforms using MPI, multi-threading, and GPUs. CoSyR has been used to evaluate the transverse and longitudinal coherent radiation effects on the beam and to investigate beam optics designs proposed for mitigation of beam brightness degradation in a magnetic bunch compressor. In this paper, the design of CoSyR, as well as the benchmark with other coherent synchrotron radiation models, are described and discussed.Comment: 17 pages, 14 figure

Creating a Worldwide Network For the Global Environment for Network Innovations (GENI) and Related Experimental Environments

Many important societal activities are global in scope, and as these activities continually expand world-wide, they are increasingly based on a foundation of advanced communication services and underlying innovative network architecture, technology, and core infrastructure. To continue progress in these areas, research activities cannot be limited to campus labs and small local testbeds or even to national testbeds. Researchers must be able to explore concepts at scale—to conduct experiments on world-wide testbeds that approximate the attributes of the real world. Today, it is possible to take advantage of several macro information technology trends, especially virtualization and capabilities for programming technology resources at a highly granulated level, to design, implement and operate network research environments at a global scale. GENI is developing such an environment, as are research communities in a number of other countries. Recently, these communities have not only been investigating techniques for federating these research environments across multiple domains, but they have also been demonstration prototypes of such federations. This chapter provides an overview of key topics and experimental activities related to GENI international networking and to related projects throughout the world

A cluster randomized controlled trial for assessing POC-CCA test based praziquantel treatment for schistosomiasis control in pregnant women and their young children: study protocol of the freeBILy clinical trial in Madagascar.

BACKGROUND: Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years. METHODS: A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar's highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers. DISCUSSION: This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research. TRIAL REGISTRATION: Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019

A spectral-based clustering for structural health monitoring of the Sydney Harbour Bridge

© 2016 Elsevier Ltd This paper presents the results of a large scale Structural Health Monitoring application on the Sydney Harbour Bridge in Australia. This bridge has many structural components, and our work focuses on a subset of 800 jack arches under the traffic lane 7. Our goal is to identify which of these jack arches (if any) respond differently to the traffic input, due to potential structural damages or instrumentation issues. We propose a novel non-model-based method to achieve this objective, using a spectrum-driven feature based on the Spectral Moments (SMs) from measured responses from the jack arches. SMs contain information from the entire frequency range, thus subtle differences between the normal signals and distorted ones could be identified. Our method then applies a modified k-means−− clustering algorithm to these features, followed by a selection mechanism on the clustering results to identify jack arches with abnormal responses. We performed an extensive evaluation of the proposed method using real data from the bridge. This evaluation included a control component, where the approach successfully detected jack arches with already known damage or issues. It also included a test component, which applied the method to a large set of nodes over a month of data to detect any potential anomaly. The detected anomalies turned out to have indeed system issues after further investigations

A tensor-based structural damage identification and severity assessment

Early damage detection is critical for a large set of global ageing infrastructure. Structural Health Monitoring systems provide a sensor-based quantitative and objective approach to continuously monitor these structures, as opposed to traditional engineering visual inspection. Analysing these sensed data is one of the major Structural Health Monitoring (SHM) challenges. This paper presents a novel algorithm to detect and assess damage in structures such as bridges. This method applies tensor analysis for data fusion and feature extraction, and further uses one-class support vector machine on this feature to detect anomalies, i.e., structural damage. To evaluate this approach, we collected acceleration data from a sensor-based SHM system, which we deployed on a real bridge and on a laboratory specimen. The results show that our tensor method outperforms a state-of-the-art approach using the wavelet energy spectrum of the measured data. In the specimen case, our approach succeeded in detecting 92.5% of induced damage cases, as opposed to 61.1% for the wavelet-based approach. While our method was applied to bridges, its algorithm and computation can be used on other structures or sensor-data analysis problems, which involve large series of correlated data from multiple sensors

Thermal comfort analysis: comparison between model and experimental data in tropical climate

International audienceHumans in the 21st century spend nearly 90% of their time in an indoor environment. This environment is far from the one in which humans have developed their physiological adaptation and regulation mechanisms. The indoor environment must be optimized for wellbeing and cognitive performance with an anthropocentric and multidisciplinary approach. The objective of this paper is to identify and evaluate the reliability of approaches to characterize thermal comfort in a humid tropical climate. To do so, we will present (i) an experiment conducted to evaluate this perception in a quantitative (physical measurements) and qualitative (field survey) way, and finally (iii) an intermodal and experimental comparison analysis. The results reveal some notable discrepancies between numerical approaches and experimental data. This finding reinforces our study perspectives on the need to engage a multimodal and multidisciplinary analysis to improve the accuracy of comfort models