Prevalence and evolution of clinical cases of Yellow Fever in Brazil between the years 2007 to 2016

Yellow Fever (YF) is a non-contagious infectious disease of variable symptoms that occurs mainly in tropical forests regions of the Americas and Africa and is caused by a Flavivirus belonging to the Flaviviridae family. Its vectors are mosquitoes of the genus Haemagogus, Sabethes and Aedes, and these have non-human primates as the main source of infection. In Brazil, there has been no record of urban AF since 1942, although the increase in cases of the wild form combined with low vaccination coverage contribute to the risk of re-urbanization of the disease Material and methods: For the study, epidemiological data were obtained from confirmed cases of Yellow Fever reported in the Notification System for Health Disorders (SINAN) available at the Informatics Department of the Unified Health System (DATASUS). Results and discussion: A total of 177 cases of were reported in Brazil, the year with the highest notification was in 2016 (52). The region with the highest occurrence of cases were the Southeast (95). Regarding the clinical evolution, of the 177 cases, 68 affected patients were cured, while 89 died from the reported injury, evidencing a high rate of lethality (50.2%). Conclusion: YF remains a public health problem, over the years there was a decrease in cases, this was due to immunization campaigns in the country, however, there was a significant increase in notifications in 2016, this whole panorama reinforces the need intensifying surveillance and expanding vaccine coverage.

Factors associated with bronchopulmonary aspiration: a national-based study

ABSTRACT Objectives: to determine the prevalence of bronchopulmonary aspiration in the Brazilian scenario, the factors associated with the incident and the variables associated with death. Methods: a cross-sectional and analytical study, carried out from analysis of notifications of incidents related to bronchopulmonary aspiration of the Health Surveillance Notification System, from January 2014 to December 2018. Results: of the 264,590 notifications, 553 referred to aspiration, whose prevalence rate was 0.21%. There was an association between the event and age, ethnicity, main medical diagnosis, country region, service type, health unit and consequences for patients. Furthermore, four independent predictor variables for death were found: living in the North or South regions, being elderly and receiving healthcare at night. Conclusions: the prevalence rate of bronchopulmonary aspiration was small, but with a negative impact on patients.

COVID-19 Cluster in School: A Study on Epidemiology and Clinical Manifestations among Cases from Rengas Cluster in Perak, Malaysia

Background: A COVID-19 cluster named as Rengas Cluster was declared on 6th November 2020 after nine students from a boarding school in Padang Rengas, Perak diagnosed as positive COVID-19. Risk assessment was conducted and Targeted Enhanced Movement Control Order (TEMCO) was enforced at the school to contain the viral transmission. An investigation was carried out to analyze epidemiological data, clinical manifestations among cases and effect of TEMCO on this cluster. Methods: A retrospective cross-sectional study was conducted from 2nd August 2021 until 3rd September 2021 using data that obtained from Kuala Kangsar District Health Office Crisis Preparedness and Response Centre (CPRC) Surveillance System through e-COVID notification system. The variables used in this current study include socio-demographic and clinical characteristics that include age group, gender, occupation, co-morbidities, symptoms and signs. Results: There were 132 cases out of 324 exposed populations whereby most cases were students (87.9%) and aged between 11 and 20 years old (84.8%). More than half of cases were female (57.6%) with only one case had existing co-morbidity. Majority of cases were asymptomatic (64.4%). Those symptomatic mainly presented with cough (66%) and the strongest significant positive correlation were observed between anosmia and ageusia (r = 0.807, n = 47, p < 0.001). There was no significant association between age group and development of symptoms [χ2 (6, N = 132) = 6.014, p > 0.05]. An abrupt decline in number of cases was observed following TEMCO enforcement. Conclusion: COVID-19 cases in Rengas Cluster were mostly among young students, asymptomatic and mildly symptomatic. This cluster was timely and effectively controlled by TEMCO enforcement which contributed towards early diagnosis, isolation and treatment for more effective control and preventive measures.

Usability of Video Observed Therapy with a Notification System to Improve Monitoring of Tuberculosis Treatment in Thailand (Preprint)

BACKGROUND In Thailand, the healthcare system has struggled to cope with the coronavirus disease 2019 (COVID-19), resulting in directly observed therapy (DOT) for tuberculosis (TB) being de-emphasized. Video observed therapy (VOT) or, more specifically, the Thai VOT “TH VOT” system, was then developed to replace DOT. According to the pilot study, the system needed a notification to improve usability and user compliance. The updated version of the TH VOT system thus enabled LINE notifications. OBJECTIVE This study aimed to reassess the user compliance and usability of the updated TH VOT system. METHODS This study was conducted in Hat Yai and Meuang Songkhla districts in Songkhla Province, Southern Thailand. The system was used by not only TB patients but also TB staff as observers in primary health care settings. Some of the observers used the simulated VOT system instead of the actual system due to the lack of participating patients in their jurisdiction. After 30-day usage, VOT session records were analyzed to determine the compliance of the patients and observers. The User Experience Questionnaire (UEQ) was administered to reassess the usability of the system and compare the ratings of the participants with the general benchmark scores of the UEQ. The results were summarized to reveal the user compliance and usability based on three groups: the patient, actual VOT observer, and simulated VOT observer. RESULTS Of the 19 observers, 10 were used the actual VOT, and the remaining 9 used the simulated VOT; there were also 10 TB patients. The patients, actual VOT observers, and simulated observers had about 80%, 65%, and 50% compliance, respectively, in terms of following the standard operating procedures every day. The scores of all groups on all dimensions were well above the average scores. There was no significant difference in any of the dimensional scores among the three groups. CONCLUSIONS The updated version of the TH VOT was deemed usable by both the patients and the healthcare staff. Compliance to use the system was high among the patients but moderate among the observers.

Compliance of Clinical Trial Protocols for Foods with Function Claims (FFC) in Japan: Consistency between Clinical Trial Registrations and Published Reports

Background: A new type of foods with a health claims notification system, the Foods with Function Claims (FFC), was introduced in Japan in April 2015. This cross-sectional study sought to clarify compliance of clinical trial protocols reported as the scientific basis of efficacy in the FFC system. Methods: All articles based on clinical trials published on the Consumer Affairs Agency website from 1 July 2018 to 30 June 2021 were reviewed. Items assessed included first author characteristics (for-profit or academia), journal name, year published, journal impact factor in 2020, article language, name of clinical trial registration (CTR), and seven compliance items (Title: T, Participant: P, Intervention: I, Comparison: C, Outcome: O, Study design: S, and Institutional Review Board, IRB). Among studies that conducted CTR, consistency with these seven compliance items was evaluated. Results: Out of 136 studies that met all inclusion criteria, 103 (76%) performed CTR, and CTR was either not performed or not specified for 33 (24%). Compliance between the protocol and the text was high (≥96%) for items P and S, but considerably lower for items T, I, C, O, and IRB (52%, 15%, 13%, 69%, and 27%, respectively). Furthermore, 43% of protocols did not include functional ingredients or food names in items T or I. The total score was 3.7 ± 1.1 pts (out of 7). Conclusions: Some CTs had no protocol registration, and even registered protocols were suboptimal in transparency. In addition to selective reporting, a new problem identified was that the content of the intervention (test food) was intentionally concealed.

Gisola: A High-Performance Computing Application for Real-Time Moment Tensor Inversion

Automatic moment tensor (MT) determination is essential for real-time seismological applications. In this article, Gisola, a highly evolved software for MT determination, oriented toward high-performance computing, is presented. The program employs enhanced algorithms for waveform data selection via quality metrics, such as signal-to-noise ratio, waveform clipping, data and metadata inconsistency, long-period disturbances, and station evaluation based on power spectral density measurements in parallel execution. The inversion code, derived from ISOLated Asperities—an extensively used manual MT retrieval utility—has been improved by exploiting the performance efficiency of multiprocessing on the CPU and GPU. Gisola offers the ability for a 4D spatiotemporal adjustable MT grid search and multiple data resources interconnection to the International Federation of Digital Seismograph Networks Web Services (FDSNWS), the SeedLink protocol, and the SeisComP Data Structure standard. The new software publishes its results in various formats such as QuakeML and SC3ML, includes a website suite for MT solutions review, an e-mail notification system, and an integrated FDSNWS-event for MT solutions distribution. Moreover, it supports the ability to apply user-defined scripts, such as dispatching the MT solution to SeisComP. The operator has full control of all calculation aspects with an extensive and adjustable configuration. MT’s quality performance, for 531 manual MT solutions in Greece between 2012 and 2021, was measured and proved to be highly efficient.

Roadmap for Digitalized Asset Integrity Management System

Asset integrity management system (AIMS) consisting of risk based inspection (RBI) and inspection management system (IMS) coupled with digitized equipment records and use of inspection tablets/mobiles will make paperless system for fast and timely decisions & actions. This paper provides a roadmap for implementation of an efficient and cost effective asset integrity management system that will increase the plant reliability & availability, decrease the time and efforts required for inspection, thus ultimately reducing the associated costs of operations. In this paper, the focus is towards digitalized AIMS that should make a company move to digital transformation and enabling it to adapt to industry 4.0 technologies such as artificial intelligence, augmented reality, data analytics, machine learning etc. First step is to perform a gap assessment of existing system to compare what is currently available within organization and what is required for going fully digital for AIM. Next step is to identify software features that are required for AIM digitalization and establish them as point based rating system which are used for rating best suitable software available in the market. Unique features for RBI module, inspection management module and field interface (tablet) module are identified with appropriate weightage to influence the software selection decision. Finally, an estimation of required resources, manpower timeline is provided that will guide in all phases of the implementation. Return on investment on such projects is manifolds. The digitalized AIM will greatly reduce the cost of day to to asset integrity management operations as it will no longer be needed to use multiple paper based reports and separate systems for RBI and IMS functions. Use of field tablet/mobile with possibility of artificial intelligence tools, will significantly reduce the time required for inspectors to do the on site inspection/testing & reporting. Interfacing of digitalized system with ERP/CMMS will automate the work order/notification system. Thus it will reduce an overall effort both in terms of time & money. The roadmap for digitalization of AIMS system will help any organization to make its AIMS digital and achieve the benefits of such system. The methodology provided is unique and can be adopted as best practices by the industry for digitally transforming the AIMS.

User Perceptions of a Technology-Based Social Memory Aid for Persons With Memory Concerns

People with memory concerns (PWMC) are likely to experience social withdrawal and isolation. Although assistive technologies and memory aids are available to support PWMC and their family caregivers, few have been shown to improve social engagement. This study aimed to gain perspectives of PWMC and their family caregivers on the feasibility and utility of a technology-based social memory aid. We recruited 20 dyads of people with mild to moderate memory concerns and family caregivers to evaluate Smartwatch Reminder (SR), a notification system that provides a name, relationship, and photograph of nearby social contacts to aid in recognition. Dyads viewed a demonstration of the SR prototype, and then participated in semi-structured interviews over Zoom video conferencing from June to August, 2020. Interview transcripts were analyzed using thematic analysis, with analyses completed in August 2021. Our findings indicate that participants anticipated important benefits from using the technology, and thought the technology would be easy to use. Participants perceived that the memory aid could benefit them now and in the future by alleviating socialization-related stress for both members of the care dyad; however, certain features of SR restricted the potential benefits, such as the requirement that social contacts have the SR application, and that prompts are only provided during social encounters. Our findings will inform future technology-enabled memory aid development to improve social engagement for PWMC and support family caregivers.

Effect of COVID-19 on vaccination coverage in Brazil

During the COVID-19 pandemic, recommendations for maintaining physical distance, restricted mobility measures, as well as fear of mass transmission by going to health centers have significantly contributed to the general vaccination coverage, which by and large is decreasing worldwide; thus, favoring the potential re-emergence of vaccine-preventable diseases. In this study, we have used the existing data on vaccination coverage during the pre-pandemic (2019) as well as the pandemic (2020) period to evaluate the impact of coronavirus outbreaks during the vaccination drive in Brazil. Furthermore, we have accumulated data since 2015 among the different regions of the country to acquire more consistent information. The various vaccines analyzed in our study were meningococcal C conjugate, Triple antigen vaccine, 10-valent pneumococcal conjugate, and BCG; subsequently, the data were obtained from the National Disease Notification System. This study revealed that the ongoing immunization drive saw a steep decline of around 10 to 20% during the (2019–2020) pandemic period in Brazil. These results provide strong evidence towards the decreasing trends following the vaccination programs during the COVID-19 pandemic period in Brazil. Furthermore, our results also highlight the importance of adopting widespread multi-component interventions to improve vaccination uptake rates.