A demonstration of mobile phone deployment to support the treatment of acutely ill children under five in Bushenyi district, Uganda.

Background: Benefits of mobile phone deployment for children <5 in low-resource settings remain unproven. The target population of the current demonstration study in Bushenyi District, Uganda, presented with acute fever, pneumonia, or diarrhoea and were treated by community health workers (CHWs) providing integrated community case management (iCCM). Methods: An observational study was conducted in five parishes (47 villages) served by CHWs well versed in iCCM with supplemental training in mobile phone use. Impact was assessed by quantitative measures and qualitative evaluation through household surveys, focus group discussions, and key informant interviews. Results: CHWs in targeted sites improved child healthcare through mobile phone use coupled with iCCM. Of acutely ill children, 92.6% were correctly managed. Significant improvements in clinical outcomes compared to those obtained by CHWs with enhanced iCCM training alone were unproven in this limited demonstration. Nonetheless, qualitative evaluation showed gains in treatment planning, supply management, and logistical efficiency. Provider confidence and communications were enhanced as was ease and accuracy of record keeping. Conclusion: Mobile phones appear synergistic with iCCM to bolster basic supportive care for acutely ill children provided by CHWs. The full impact of expanded mobile phone deployment warrants further evaluation prior to scaling up in low-resource settings.

Incidence and Pattern of Pneumonia in Goats Slaughtered at the Kumasi Abattoir, Ghana

This study aimed at determining the incidence and pattern of pneumonia, in slaughtered goats in Kumasi abattoir, Ghana. One thousand three hundred and fifty lungs of goats; (1,012 Sahelian and 338 West Africa Dwarf goats (WAD) lungs) of different ages (less than a year to above 4 years) were used in this study. The frequency of occurrence of pneumonia, the degree of consolidation as a percentage of the total lung volume and histological assessment were determined by standard techniques. Fifty five (55) lungs (39 Sahelian, 16 WAD goats) were pneumonic (4.07% prevalence). The right lungs had a significant higher average lung consolidation percentage (19.11) while the right cranial lobes were more affected (9.37). WAD goats of 1-2 years are mostly affected with an average percentage consolidation of 11.73% while Sahelian goats above 4 years of age were the most affected with 32.59% consolidation. Does of both breeds were more while Sahelian goats had higher consolidation than other breeds. Histological examination revealed the presence of giant cell, fibrinous and suppurative bronchointerstitial pneumonia suggesting complicated viral pneumonia which was observed to be the most important caprine pneumonia in slaughtered goats in Ghana. Transportation and pregnancy stress were the major contributory factor to the pneumonia observed hence effective ante-mortem examinations will help to minimize the slaughter of pregnant does and transportation stress in Ghana.

Lineup identification accuracy: the effects of alcohol, target presence, confidence ratings, and response time

Despite the intoxication of many eyewitnesses at crime scenes, only four published studies to date have investigated the effects of alcohol intoxication on eyewitness identification performance. While one found intoxication significantly increased false identification rates from target absent showups, three found no such effect using the more traditional lineup procedure. The present study sought to further explore the effects of alcohol intoxication on identification performance and examine whether accurate decisions from intoxicated witnesses could be postdicted by confidence and response times. One hundred and twenty participants engaged in a study examining the effects of intoxication (control, placebo, and mild intoxication) and target presence on identification performance. Participants viewed a simultaneous lineup one week after watching a mock crime video of a man attempting to steal cars. Ethanol intoxication (0.6 ml/kg) was found to make no significant difference to identification accuracy and such identifications from intoxicated individuals were made no less confidently or slowly than those from sober witnesses. These results are discussed with respect to the previous research examining intoxicated witness identification accuracy and the misconceptions the criminal justice system holds about the accuracy of such witnesses.

The interpretation of scholars' interpretations of confidence intervals: criticism, replication, and extension of Hoekstra et al. (2014)

Hoekstra et al. (Psychonomic Bulletin & Review, 2014, 21:1157–1164) surveyed the interpretation of confidence intervals (CIs) by first-year students, master students, and researchers with six items expressing misinterpretations of CIs. They asked respondents to answer all items, computed the number of items endorsed, and concluded that misinterpretation of CIs is robust across groups. Their design may have produced this outcome artifactually for reasons that we describe. This paper discusses first the two interpretations of CIs and, hence, why misinterpretation cannot be inferred from endorsement of some of the items. Next, a re-analysis of Hoekstra et al.’s data reveals some puzzling differences between first-year and master students that demand further investigation. For that purpose, we designed a replication study with an extended questionnaire including two additional items that express correct interpretations of CIs (to compare endorsement of correct vs. nominally incorrect interpretations) and we asked master students to indicate which items they would have omitted had they had the option (to distinguish deliberate from uninformed endorsement caused by the forced-response format). Results showed that incognizant first-year students endorsed correct and nominally incorrect items identically, revealing that the two item types are not differentially attractive superficially; in contrast, master students were distinctively more prone to endorsing correct items when their uninformed responses were removed, although they admitted to nescience more often that might have been expected. Implications for teaching practices are discussed.

On the Economic Aspects of Unemployment: The Case of Consumer Confidence

Unemployment is related to economic, political and social aspects. One of the least analysed economic aspects is the relationship of unemployment to the level of confidence that characterizes some macroeconomic relevant agents, such as consumers or investors. Expanding previous work on this matter, this chapter considers a fuzzy logic methodology in order to uncover the relationship that exists between the unemployment rate and the consumer confidence level for a large group of European Union countries, in the period 1995-2015. It is concluded that this relationship is stronger than apparently it looks, especially in certain countries. This result should therefore be used as an extra argument in making economic decisions leading to the diminishment of unemployment, which will boost economic confidence.

Pneumonia and influenza: specific considerations in care homes

This review provides an update on current evidence surrounding epidemiology, treatment and prevention of lower respiratory tract infection, with special reference to pneumonia and influenza, in care home residents. The care home sector is growing and provides a unique ecological niche for infections, housing frail older people with multiple comorbidities and frequent contact with healthcare services. There are therefore considerations in the epidemiology and management of these conditions which are specific to care homes. Opportunities for prevention, in the form of vaccination strategies and improving oral hygiene, may reduce the burden of these diseases in the future. Work is needed to research these infections specifically in the care home setting and this article highlights current gaps in our knowledge.

CURB-65 and other markers of illness severity in community-acquired pneumonia among HIV-positive patients

Introduction: As the relative burden of community-acquired bacterial pneumonia among HIV-positive patients increases, adequate prediction of case severity on presentation is crucial. We sought to determine what characteristics measurable on presentation are predictive of worse outcomes. Methods: We studied all admissions for community-acquired bacterial pneumonia over 1 year at a tertiary centre. Patient demographics, comorbidities, HIV-specific markers and CURB-65 scores on Emergency Department presentation were reviewed. Outcomes of interest included mortality, bacteraemia, intensive care unit admission and orotracheal intubation. Results: A total of 396 patients were included, 49 HIV positive and 347 HIV negative. Mean CURB-65 score was 1.3 for HIV-positive and 2.2 for HIV-negative patients (p<0.0001), its predictive value for mortality being maintained in both groups (p¼0.03 and p<0.001, respectively). Adjusting for CURB-65 scores, HIV infection by itself was only associated with bacteraemia (adjusted odds ratio 7.1 CI 95% [2.6–19.5]). Patients with<200 CD4 cells/mL presented similar CURB- 65 adjusted mortality (adjusted odds ratio 1.7 CI 95% [0.2–15.2]), but higher risk of intensive care unit admission (adjusted odds ratio 5.7 CI 95% [1.5–22.0]) and orotracheal intubation (adjusted odds ratio 9.1 CI 95% [2.2–37.1]), compared to HIV-negative patients. These two associations were not observed in the>200 CD4 cells/mL subgroup (adjusted odds ratio 2.2 CI 95% [0.7–7.6] and adjusted odds ratio 0.8 CI 95% [0.1–6.5] respectively). Antiretroviral therapy and viral load suppression were not associated with different outcomes (p>0.05). Conclusions: High CURB-65 scores and CD4 counts<200 cells/mL were both associated with worse outcomes. Severity assessment scales and CD4 counts may both be helpful in predicting severity in HIV-positive patients presenting with community-acquired bacterial pneumonia.

Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations

Respiratory syncytial virus (RSV) infection is the leading cause of hospitalisation for respiratory diseases among children under 5 years old. The aim of this study was to analyse RSV seasonality in the five distinct regions of Brazil using time series analysis (wavelet and Fourier series) of the following indicators: monthly positivity of the immunofluorescence reaction for RSV identified by virologic surveillance system, and rate of hospitalisations per bronchiolitis and pneumonia due to RSV in children under 5 years old (codes CID-10 J12.1, J20.5, J21.0 and J21.9). A total of 12,501 samples with 11.6% positivity for RSV (95% confidence interval 11 - 12.2), varying between 7.1 and 21.4% in the five Brazilian regions, was analysed. A strong trend for annual cycles with a stable stationary pattern in the five regions was identified through wavelet analysis of the indicators. The timing of RSV activity by Fourier analysis was similar between the two indicators analysed and showed regional differences. This study reinforces the importance of adjusting the immunisation period for high risk population with the monoclonal antibody palivizumab taking into account regional differences in seasonality of RSV.

Extracorporeal circuit for Panton-Valentine leukocidin-producing Staphylococcus aureus necrotizing pneumonia [Traitement par ECMO d'une pneumopathie nécrosante à Staphylococcus aureus producteur de la leucocidine de Panton-Valentine]

National audience

Th1/Th2 Cytokine Profile and Its Diagnostic Value in Mycoplasma pneumoniae Pneumonia

Background: The levels of Th1/Th2 cytokine can alter in pathogenic infection in children with pneumonia. Objectives: To evaluate Th1/Th2 cytokine profile and its diagnostic value in M. pneumoniae pneumonia in children. Patients and Methods: Children with M. pneumoniae mono-infection and 30 healthy children were tested with cytokines assay. We used real time PCR to detect M. pneumoniae in children with pneumonia. Results: M. pneumoniae test was positive in 2188 (16.62%) out of 13161 pneumonia children. Children aged 5 - 9 years had the highest rate and summer was a season with high rate of M. pneumoniae incidence in Zhejiang province. During the course of study, in 526 pneumonia children with M. pneumoniae mono-infection and 30 healthy children cytokines assay was performed. IL-2 level of M. pneumoniae pneumonia children was lower than that of healthy children (median levels, pg/mL: IL-2: 3.2 vs. 5.7, P = 0.00), while IL-4, IL-10 and IFN-γ were higher than in healthy children (median levels, pg/mL: IL-4: 3.2 vs. 1.5, P = 0.00; IL-10: 5.6 vs. 2.5, P = 0.001; IFN-γ: 20.4 vs. 4.8, P = 0.001). Conclusions: IL-2 decreases and IL-4, IL-10 and IFN-γ increase in children with M. pneumoniae pneumonia, which has a promising prospect in diagnosis of this disease in clinical practice.

Evaluation of confidence-driven cost aggregation strategies

In this thesis I describe eight new stereo matching algorithms that perform the cost-aggregation step using a guided filter with a confidence map as guidance image, and share the structure of a linear stereo matching algorithm. The results of the execution of the proposed algorithms on four pictures from the Middlebury dataset are shown as well. Finally, based on these results, a ranking of the proposed algorithms is presented.

Pneumonia por Pneumocystis Jirovecii complicada por pneumotórax, pneumomediastino e enfisema subcutâneo

info:eu-repo/semantics/publishedVersion

Confidence intervals for large non- centrality parameter

We use asymptotic linearity to derive confidence intervals for large noncentrality parameters. These results enable us to measure relevance of effects and interactions in multifactors models when we get highly statistically significant the values of F tests statistics. We show how to use our approach by considering two sets of data as application examples.