Objective:To assess the extent of existing published evidence on cholera and to characterize the epidemiologic data of cholera in Nepal.Methods:We conducted a literature scoping review by summarizing published literat...Objective:To assess the extent of existing published evidence on cholera and to characterize the epidemiologic data of cholera in Nepal.Methods:We conducted a literature scoping review by summarizing published literature reporting on cholera in Nepal from January 1946 to March 2019 in online databases:MEDLINE,Embase,Cochrane,and Global Health.Additionally,we reviewed national surveillance data on clinically diagnosed and laboratory confirmed cholera reported by the Ministry of Health and Population.Results:Most of the published studies were conducted predominantly in Kathmandu Valley during the rainy season;however,outbreaks have been reported in other parts of Nepal including Terai,Hilly and Mountain regions.Our literature review exhibited that all age groups were affected by cholera,but particularly children and young adults were at-risk age groups in Nepal.Vibrio cholerae serogroup O1,biotype El Tor,serotype Ogawa has been predominantly isolated with an emergence of resistant strains since 1996.Two mass vaccination campaigns using oral cholera vaccines were conducted:Rautahat district in 2014 and Banke district in 2017.Conclusions:Capacity building for a nation wide systematic cholera surveillance with rapid and reliable diagnosis is needed to better estimate the burden of cholera and identify geographically at-risk areas associated with the disease in Nepal.It is essential for developing an adequate policy on oral cholera vaccine introduction and effective water,sanitation and hygiene interventions.展开更多
Objective: To identify predictors of ascites collected prior to the hCG administration in patients undergoing IVF/ICSI treatment at moderate risk of developing moderate/severe ovarian hyperstimulation syndrome (OHSS),...Objective: To identify predictors of ascites collected prior to the hCG administration in patients undergoing IVF/ICSI treatment at moderate risk of developing moderate/severe ovarian hyperstimulation syndrome (OHSS), and, based on these predictors, develop a nomogram for estimation of the probability of presence of ascites. Methods and Materials: Data were derived from 53 patients with 20 - 30 follicles ≥10 mmat end of stimulation. All patients received a single dose of hCG (250 mg) to trigger final follicular maturation when ≥2 follicles of ≥18 mmwere observed. Transvaginal ultrasound to measure ascites (total amount of peritoneal fluid ≥9 cm2inlithotomy position) was performed 2, 5 and 8 days after the hCG administration. Associations between clinical, sonographic and endocrinological variables recorded prior to the hCG administration and presence of ascites were analyzed by univariable and multivariable logistic regression. Results: Thirty-four patients (64%) had ultrasonic evidence of ascites. The multivariable analysis identified the total number of follicles [OR 1.29 (95% CI: 1.02 - 1.69, P = 0.043)], the ovarian volume [OR 1.05 (95% CI: 1.00 - 1.11, P = 0.047)] and BMI [OR 0.76 (95% CI: 0.56 - 0.99, P = 0.053)] as predictors of ascites (AUC = 0.825). A nomogram (PROFET) was designed with these three variables for individual prediction of the probability of development of ascites. Conclusions: This pilot investigation indicates that the risk of peritoneal fluid accumulation in IVF/ICSI patients at moderate risk of developing moderate/severe OHSS is influenced by the number of follicles and the ovarian volume on the day of hCG administration as well as the BMI.展开更多
Background:Monitoring the transmission of coronavirus disease 2019(COVID-19)requires accurate estimation of the effective reproduction number(Rt).However,existing methods for calculating Rt may yield biased estimates ...Background:Monitoring the transmission of coronavirus disease 2019(COVID-19)requires accurate estimation of the effective reproduction number(Rt).However,existing methods for calculating Rt may yield biased estimates if important real-world factors,such as delays in confirmation,pre-symptomatic transmissions,or imperfect data observation,are not considered.Method:To include real-world factors,we expanded the susceptible-exposed-infectiousrecovered(SEIR)model by incorporating pre-symptomatic(P)and asymptomatic(A)states,creating the SEPIAR model.By utilizing both stochastic and deterministic versions of the model,and incorporating predetermined time series of Rt,we generated simulated datasets that simulate real-world challenges in estimating Rt.We then compared the performance of our proposed particle filtering method for estimating Rt with the existing EpiEstim approach based on renewal equations.Results:The particle filtering method accurately estimated Rt even in the presence of data with delays,pre-symptomatic transmission,and imperfect observation.When evaluating via the root mean square error(RMSE)metric,the performance of the particle filtering method was better in general and was comparable to the EpiEstim approach if perfectly deconvolved infection time series were provided,and substantially better when Rt exhibited short-term fluctuations and the data was right truncated.Conclusions:The SEPIAR model,in conjunction with the particle filtering method,offers a reliable tool for predicting the transmission trend of COVID-19 and assessing the impact of intervention strategies.This approach enables enhanced monitoring of COVID-19 transmission and can inform public health policies aimed at controlling the spread of the disease.展开更多
基金supported by the Governments of Koreathe Governments of Sweden+1 种基金the Governments of IndiaBill and Melinda Gates Foundation(#OPP52797).
文摘Objective:To assess the extent of existing published evidence on cholera and to characterize the epidemiologic data of cholera in Nepal.Methods:We conducted a literature scoping review by summarizing published literature reporting on cholera in Nepal from January 1946 to March 2019 in online databases:MEDLINE,Embase,Cochrane,and Global Health.Additionally,we reviewed national surveillance data on clinically diagnosed and laboratory confirmed cholera reported by the Ministry of Health and Population.Results:Most of the published studies were conducted predominantly in Kathmandu Valley during the rainy season;however,outbreaks have been reported in other parts of Nepal including Terai,Hilly and Mountain regions.Our literature review exhibited that all age groups were affected by cholera,but particularly children and young adults were at-risk age groups in Nepal.Vibrio cholerae serogroup O1,biotype El Tor,serotype Ogawa has been predominantly isolated with an emergence of resistant strains since 1996.Two mass vaccination campaigns using oral cholera vaccines were conducted:Rautahat district in 2014 and Banke district in 2017.Conclusions:Capacity building for a nation wide systematic cholera surveillance with rapid and reliable diagnosis is needed to better estimate the burden of cholera and identify geographically at-risk areas associated with the disease in Nepal.It is essential for developing an adequate policy on oral cholera vaccine introduction and effective water,sanitation and hygiene interventions.
文摘Objective: To identify predictors of ascites collected prior to the hCG administration in patients undergoing IVF/ICSI treatment at moderate risk of developing moderate/severe ovarian hyperstimulation syndrome (OHSS), and, based on these predictors, develop a nomogram for estimation of the probability of presence of ascites. Methods and Materials: Data were derived from 53 patients with 20 - 30 follicles ≥10 mmat end of stimulation. All patients received a single dose of hCG (250 mg) to trigger final follicular maturation when ≥2 follicles of ≥18 mmwere observed. Transvaginal ultrasound to measure ascites (total amount of peritoneal fluid ≥9 cm2inlithotomy position) was performed 2, 5 and 8 days after the hCG administration. Associations between clinical, sonographic and endocrinological variables recorded prior to the hCG administration and presence of ascites were analyzed by univariable and multivariable logistic regression. Results: Thirty-four patients (64%) had ultrasonic evidence of ascites. The multivariable analysis identified the total number of follicles [OR 1.29 (95% CI: 1.02 - 1.69, P = 0.043)], the ovarian volume [OR 1.05 (95% CI: 1.00 - 1.11, P = 0.047)] and BMI [OR 0.76 (95% CI: 0.56 - 0.99, P = 0.053)] as predictors of ascites (AUC = 0.825). A nomogram (PROFET) was designed with these three variables for individual prediction of the probability of development of ascites. Conclusions: This pilot investigation indicates that the risk of peritoneal fluid accumulation in IVF/ICSI patients at moderate risk of developing moderate/severe OHSS is influenced by the number of follicles and the ovarian volume on the day of hCG administration as well as the BMI.
基金supported by Government-wide R&D Fund project for infectious disease research (GFID),Republic of Korea (grant number:HG18C0088)National Institute for Mathematical Sciences (NIMS)grant funded by the Korean Government (NIMS-B23730000).
文摘Background:Monitoring the transmission of coronavirus disease 2019(COVID-19)requires accurate estimation of the effective reproduction number(Rt).However,existing methods for calculating Rt may yield biased estimates if important real-world factors,such as delays in confirmation,pre-symptomatic transmissions,or imperfect data observation,are not considered.Method:To include real-world factors,we expanded the susceptible-exposed-infectiousrecovered(SEIR)model by incorporating pre-symptomatic(P)and asymptomatic(A)states,creating the SEPIAR model.By utilizing both stochastic and deterministic versions of the model,and incorporating predetermined time series of Rt,we generated simulated datasets that simulate real-world challenges in estimating Rt.We then compared the performance of our proposed particle filtering method for estimating Rt with the existing EpiEstim approach based on renewal equations.Results:The particle filtering method accurately estimated Rt even in the presence of data with delays,pre-symptomatic transmission,and imperfect observation.When evaluating via the root mean square error(RMSE)metric,the performance of the particle filtering method was better in general and was comparable to the EpiEstim approach if perfectly deconvolved infection time series were provided,and substantially better when Rt exhibited short-term fluctuations and the data was right truncated.Conclusions:The SEPIAR model,in conjunction with the particle filtering method,offers a reliable tool for predicting the transmission trend of COVID-19 and assessing the impact of intervention strategies.This approach enables enhanced monitoring of COVID-19 transmission and can inform public health policies aimed at controlling the spread of the disease.
