Vaccines safety; effect of supervision or SMS on reporting rates of adverse events following immunization (AEFI) with meningitis vaccine (MenAfriVac?): a randomized controlled trial.

BACKGROUND: To ensure vaccines safety, given the weaknesses of the national pharmacovigilance system in Cameroon, there is a need to identify effective interventions that can contribute to improving AEFI reporting. OBJECTIVE: To assess the effect of: (i) sending weekly SMS, or (ii) weekly supervisory visits on AEFI reporting rate during a meningitis immunization campaign conducted in Cameroon in 2012 using the meningitis A conjugate vaccine (MenAfriVac?). METHODS: Health facilities that met the inclusion criteria were randomly assigned to receive: (i) a weekly standardized SMS, (ii) a weekly standardized supervisory visits or (iii) no intervention. The primary outcome was the reported AEFI incidence rate from week 5 to 8 after the immunization campaign. Poisson regression model was used to estimate the effect of interventions after adjusting for health region, type of health facility, type and position of health workers as well as the cumulative number of AEFI reported from weeks 1 to 4. RESULTS: A total of 348 (77.2%) of 451 health facility were included, and 116 assigned to each of three groups. The incidence rate of reported AEFI per 100 health facility per week was 20.0 (15.9-24.1) in the SMS group, 40.2 (34.4-46.0) in supervision group and 13.6 (10.1-16.9) in the control group. Supervision led to a significant increase of AEFI reporting rate compared to SMS [adjusted RR=2.1 (1.6-2.7); p<0.001] and control [RR=2.8(2.1-3.7); p<0.001)] groups. The effect of SMS led to some increase in AEFI reporting rate compared to the control group, but the difference was not statistically significant [RR=1.4(0.8-1.6); p=0.07)]. CONCLUSION: Supervision was more effective than SMS or routine surveillance in improving AEFI reporting rate. It should be part of any AEFI surveillance system. SMS could be useful in improving AEFI reporting rates but strategies need to be found to improve its effectiveness, and thus maximize its benefits.

Tuoteturvallisuusriskien hallinta suorituskyvyn johtamisen tukena sähkö- ja elektroniikkateollisuudessa

Eurooppalaisia ja suomalaisia markkinavalvontatilastoja tutkimalla havaitaan, ettei tuoteturvallisuuden hallinta ole itsestään selvää sähkö- ja elektroniikka-alalla. Vuodesta 2000 maaliskuuhun 2006Euroopan markkinoilla havaittiin 3040 vaarallista kuluttajien käyttöön tarkoitettua sähkötuotetta. Työn päätavoitteena on selvittää, miten tuoteturvallisuusriskien hallinta kytkeytyy yrityksen suorituskyvyn johtamiseen. Työssä on käytetty konstruktiivista tutkimusotetta. Aineistopohjaisen analyysin avulla kartoitetaan suorituskyvyn johtamisen teoriaa, suorituskyvyn käytännön mittaamista pienissä ja keskisuurissa yrityksissä sekä tuoteturvallisuusriskejä jariskienhallinnan periaatteita. Lisäksi kartoitetaan lainsäädännön vaatimuksia, tuotesuunnittelua, valmistusta ja osaamista sekä tarkastellaan tuoteturvallisuuden viranomaisvalvonnan tuloksia. Tutkimuksessa analysoidaan kirjallisuutta ja tilastoja etsien tuoteriskien hallinnan ja suorituskyvyn johtamisen välistä yhteyttä. Analyysiä täydennetään tutkimuksen tekijän kokemuksella tuoteturvallisuuden testauksesta ja sertifioinnista, standardisoimistyöstä sekä tuoteturvallisuuden viranomaisvalvonnasta. Riskienhallinta muodostaa parhaimmillaan osan yrityksen johtamis- ja hallintakäytäntöä. Tuoteturvallisuusriskien hallinta on yrityksen strateginen päätös, joka tukee suorituskyvyn johtamista. Työssämallinnetaan kolme toimintatapaa, joilla eri kehitysvaiheessa olevat sähkö- ja elektroniikkateollisuuden valmistajat voivat hallita tuoteturvallisuusriskejään.Työssä kootaan yhteen tuoteturvallisuuden tekijöitä, jotka suorituskyvyn mittareissa monitoroivat tuoteriskien tilaa. Lisäksi kootaan yhteen riskienhallinnan kustannuksia, joilla yritys voi arvioida etukäteen kokonaiskustannuksia.

Kidney-sparing surgery for upper tract urothelial cancer.

PURPOSE OF REVIEW: This article reviews and summarizes current knowledge on kidney-sparing surgery (KSS) for upper tract urothelial carcinoma (UTUC). RECENT FINDINGS: Radical nephroureterectomy (RNU) has been central to the treatment of UTUC for decades, but KSS has been applied to a rising number of patients to preserve renal function. Ablation or resection through flexible ureteroscopy or the percutaneous route seems to provide comparable cancer-specific survival and overall survival to RNU, but the risk of local and bladder recurrence remains relatively high. Segmental ureterectomy is used for low-risk unifocal UTUC with recent studies confirming its oncologic safety and equivalence to RNU. Antegrade or retrograde instillation therapy may be considered as adjuvant treatment after conservative surgery, but their efficacy needs to be proven. Intravesical single-dose chemotherapy is likely to become part of the therapy algorithm of UTUC treated by KSS or RNU to lower bladder seeding and recurrence. Postoperative vigilant radiographic and endoscopic surveillance are obligatory because of the high probability of recurrence. SUMMARY: KSS should be regarded as a valid alternative to RNU in case of technically resectable low-risk upper tract urothelial cell carcinoma, even in case of a normal contralateral kidney. Advances in technology and biological and clinical risk estimation will make the management of UTUC more evidence based thereby lowering overtreatment.

La veille bibliographique. Partie 2, Un élément de surveillance

Cet article est la seconde partie d'une série de quatre consacrée aux résultats d'une veille bibliographique sur la surveillance biologique de l'exposition aux produits chimiques en milieu de travail (SBEPC MT). Alors que la précédente partie présentait les objectifs et l'organisation de la veille, cette partie ainsi que la partie 3 vont donc présenter une vue d'ensemble de la base de données en fonction de l'indexation des articles analysés par différents mots clés.

FPGA-Based Control Design for Power Electronic Applications

Tehoelektoniikkalaitteella tarkoitetaan ohjaus- ja säätöjärjestelmää, jolla sähköä muokataan saatavilla olevasta muodosta haluttuun uuteen muotoon ja samalla hallitaan sähköisen tehon virtausta lähteestä käyttökohteeseen. Tämä siis eroaa signaalielektroniikasta, jossa sähköllä tyypillisesti siirretään tietoa hyödyntäen eri tiloja. Tehoelektroniikkalaitteita vertailtaessa katsotaan yleensä niiden luotettavuutta, kokoa, tehokkuutta, säätötarkkuutta ja tietysti hintaa. Tyypillisiä tehoelektroniikkalaitteita ovat taajuudenmuuttajat, UPS (Uninterruptible Power Supply) -laitteet, hitsauskoneet, induktiokuumentimet sekä erilaiset teholähteet. Perinteisesti näiden laitteiden ohjaus toteutetaan käyttäen mikroprosessoreja, ASIC- (Application Specific Integrated Circuit) tai IC (Intergrated Circuit) -piirejä sekä analogisia säätimiä. Tässä tutkimuksessa on analysoitu FPGA (Field Programmable Gate Array) -piirien soveltuvuutta tehoelektroniikan ohjaukseen. FPGA-piirien rakenne muodostuu erilaisista loogisista elementeistä ja niiden välisistä yhdysjohdoista.Loogiset elementit ovat porttipiirejä ja kiikkuja. Yhdysjohdot ja loogiset elementit ovat piirissä kiinteitä eikä koostumusta tai lukumäärää voi jälkikäteen muuttaa. Ohjelmoitavuus syntyy elementtien välisistä liitännöistä. Piirissä on lukuisia, jopa miljoonia kytkimiä, joiden asento voidaan asettaa. Siten piirin peruselementeistä voidaan muodostaa lukematon määrä erilaisia toiminnallisia kokonaisuuksia. FPGA-piirejä on pitkään käytetty kommunikointialan tuotteissa ja siksi niiden kehitys on viime vuosina ollut nopeaa. Samalla hinnat ovat pudonneet. Tästä johtuen FPGA-piiristä on tullut kiinnostava vaihtoehto myös tehoelektroniikkalaitteiden ohjaukseen. Väitöstyössä FPGA-piirien käytön soveltuvuutta on tutkittu käyttäen kahta vaativaa ja erilaista käytännön tehoelektroniikkalaitetta: taajuudenmuuttajaa ja hitsauskonetta. Molempiin testikohteisiin rakennettiin alan suomalaisten teollisuusyritysten kanssa soveltuvat prototyypit,joiden ohjauselektroniikka muutettiin FPGA-pohjaiseksi. Lisäksi kehitettiin tätä uutta tekniikkaa hyödyntävät uudentyyppiset ohjausmenetelmät. Prototyyppien toimivuutta verrattiin vastaaviin perinteisillä menetelmillä ohjattuihin kaupallisiin tuotteisiin ja havaittiin FPGA-piirien mahdollistaman rinnakkaisen laskennantuomat edut molempien tehoelektroniikkalaitteiden toimivuudessa. Työssä on myösesitetty uusia menetelmiä ja työkaluja FPGA-pohjaisen säätöjärjestelmän kehitykseen ja testaukseen. Esitetyillä menetelmillä tuotteiden kehitys saadaan mahdollisimman nopeaksi ja tehokkaaksi. Lisäksi työssä on kehitetty FPGA:n sisäinen ohjaus- ja kommunikointiväylärakenne, joka palvelee tehoelektroniikkalaitteiden ohjaussovelluksia. Uusi kommunikointirakenne edistää lisäksi jo tehtyjen osajärjestelmien uudelleen käytettävyyttä tulevissa sovelluksissa ja tuotesukupolvissa.

ME - Mobile Electronic Personality

Digital services require personal information for a variety of reasons. Due to advances in communication technology, new types of services are evolving alongwith traditional Internet services. Due to the diversity of services, the traditional approaches to personal information handling designed for Internet services are inadequate. Therefore, new approaches are necessary. In this thesis, a solution where personal information is stored in and accessed from the user's mobile device is presented. This approach is called Mobile Electronic Personality (ME). The ME approach is compared to the existing approaches which rely on a database either at a service, a trusted third party or a client program. Various personal information properties are taken into account in the comparison of storage locations. The thesis presents both the internal and the communication architecture of the ME. The internal architecture defines how the information is stored in the mobile device. The communication architecture defines how the information can be accessed by different types of services from the ME. The use of the architecture is described for services in different environments. A simple ME based solution for the authentication of a user is defined. The authentication of service, which is required to protect the privacy of the users is also presented.

Evaluation of an electronic nose to assess fruit ripeness

The main goal of our study was to see whether an artificial olfactory system can be used as a nondestructive instrument to measure fruit maturity. In order to make an objective comparison, samples measured with our electronic nose prototype were later characterized using fruit quality techniques. The cultivars chosen for the study were peaches, nectarines, apples, and pears. With peaches and nectarines, a PCA analysis on the electronic nose measurements helped to guess optimal harvest dates that were in good agreement with the ones obtained with fruit quality techniques. A good correlation between sensor signals and some fruit quality indicators was also found. With pears, the study addressed the possibility of classifying samples regarding their ripeness state after different cold storage and shelf-life periods. A PCA analysis showed good separation between samples measured after a shelf-life period of seven days and samples with four or less days. Finally, the electronic nose monitored the shelf-life ripening of apples. A good correlation between electronic nose signals and firmness, starch index, and acidity parameters was found. These results prove that electronic noses have the potential of becoming a reliable instrument to assess fruit ripeness.

Bioinspired electronic white cane implementation based on a LIDAR, a tri-axial accelerometer and a tactile belt

This work proposes the creation of a bioinspired electronic white cane for blind people using the whiskers principle for short-range navigation and exploration. Whiskers are coarse hairs of an animal's face that tells the animal that it has touched something using the nerves of the skin. In this work the raw data acquired from a low-size terrestrial LIDAR and a tri-axial accelerometer is converted into tactile information using several electromagnetic devices configured as a tactile belt. The LIDAR and the accelerometer are attached to the user’s forearm and connected with a wire to the control unit placed on the belt. Early validation experiments carried out in the laboratory are promising in terms of usability and description of the environment.

Ultrasonic and LIDAR sensors for electronic canopy characterization in vineyards: advances to improve pesticide application methods

Canopy characterization is a key factor to improve pesticide application methods in tree crops and vineyards. Development of quick, easy and efficient methods to determine the fundamental parameters used to characterize canopy structure is thus an important need. In this research the use of ultrasonic and LIDAR sensors have been compared with the traditional manual and destructive canopy measurement procedure. For both methods the values of key parameters such as crop height, crop width, crop volume or leaf area have been compared. Obtained results indicate that an ultrasonic sensor is an appropriate tool to determine the average canopy characteristics, while a LIDAR sensor provides more accuracy and detailed information about the canopy. Good correlations have been obtained between crop volume (CVU) values measured with ultrasonic sensors and leaf area index, LAI (R2 = 0.51). A good correlation has also been obtained between the canopy volume measured with ultrasonic and LIDAR sensors (R2 = 0.52). Laser measurements of crop height (CHL) allow one to accurately predict the canopy volume. The proposed new technologies seems very appropriate as complementary tools to improve the efficiency of pesticide applications, although further improvements are still needed.

Meckel-Gruber Syndrome: a population-based study on prevalence, prenatal diagnosis, clinical features, and survival in Europe.

Meckel-Gruber Syndrome is a rare autosomal recessive lethal ciliopathy characterized by the triad of cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. We present the largest population-based epidemiological study to date using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network. The study population consisted of 191 cases of MKS identified between January 1990 and December 2011 in 34 European registries. The mean prevalence was 2.6 per 100 000 births in a subset of registries with good ascertainment. The prevalence was stable over time, but regional differences were observed. There were 145 (75.9%) terminations of pregnancy after prenatal diagnosis, 13 (6.8%) fetal deaths, 33 (17.3%) live births. In addition to cystic kidneys (97.7%), encephalocele (83.8%) and polydactyly (87.3%), frequent features include other central nervous system anomalies (51.4%), fibrotic/cystic changes of the liver (65.5% of cases with post mortem examination) and orofacial clefts (31.8%). Various other anomalies were present in 64 (37%) patients. As nowadays most patients are detected very early in pregnancy when liver or kidney changes may not yet be developed or may be difficult to assess, none of the anomalies should be considered obligatory for the diagnosis. Most cases (90.2%) are diagnosed prenatally at 14.3±2.6 (range 11-36) gestational weeks and pregnancies are mainly terminated, reducing the number of LB to one-fifth of the total prevalence rate. Early diagnosis is important for timely counseling of affected couples regarding the option of pregnancy termination and prenatal genetic testing in future pregnancies.

Targeting the tumor vasculature to enhance T cell activity.

T cells play a critical role in tumor immune surveillance as evidenced by extensive mouse-tumor model studies as well as encouraging patient responses to adoptive T cell therapies and dendritic cell vaccines. It is well established that the interplay of tumor cells with their local cellular environment can trigger events that are immunoinhibitory to T cells. More recently it is emerging that the tumor vasculature itself constitutes an important barrier to T cells. Endothelial cells lining the vessels can suppress T cell activity, target them for destruction, and block them from gaining entry into the tumor in the first place through the deregulation of adhesion molecules. Here we review approaches to break this tumor endothelial barrier and enhance T cell activity.

Toxicity assessment of refill liquids for electronic cigarettes.

We analyzed 42 models from 14 brands of refill liquids for e-cigarettes for the presence of micro-organisms, diethylene glycol, ethylene glycol, hydrocarbons, ethanol, aldehydes, tobacco-specific nitrosamines, and solvents. All the liquids under scrutiny complied with norms for the absence of yeast, mold, aerobic microbes, Staphylococcus aureus, and Pseudomonas aeruginosa. Diethylene glycol, ethylene glycol and ethanol were detected, but remained within limits authorized for food and pharmaceutical products. Terpenic compounds and aldehydes were found in the products, in particular formaldehyde and acrolein. No sample contained nitrosamines at levels above the limit of detection (1 μg/g). Residual solvents such as 1,3-butadiene, cyclohexane and acetone, to name a few, were found in some products. None of the products under scrutiny were totally exempt of potentially toxic compounds. However, for products other than nicotine, the oral acute toxicity of the e-liquids tested seems to be of minor concern. However, a minority of liquids, especially those with flavorings, showed particularly high ranges of chemicals, causing concerns about their potential toxicity in case of chronic oral exposure.