332 research outputs found
Challenges to clinical research in a rural african hospital; a personal perspective from Tanzania.
No full textUNLABELLED: This article is based on a talk given at the Japanese Society for Tropical medicine Annual Meeting in 2014. The severe febrile illness study was established in 2005. The aim of the project was to define the aetiology of febrile disease in children admitted to a hospital in Tanzania. Challenges arose in many areas: STUDY DESIGN: An initial plan to recruit only the severely ill was revised to enroll all febrile admissions leading to a more comprehensive dataset but much increased costs. Operationally a decision was made to set up a paediatric acute admissions unit (PAAU) in the hospital to facilitate recruitment and to provide appropriate initial care in line with perceived ethical obligations. This had knock on effects relating to the responsibilities that were taken on but also some unexpected positive outcomes. Study personnel: Local research staff were sometimes called upon to make up temporary shortfalls in the hospital staffing. Lack of staff made it impossible to recruit patients around the clock, seven days a week creating the challenge of ensuring representative sampling. Quality control: Studies based on clinical examination create unique quality control challenges-how to ensure that clinical staff are examining in a systematic and reproducible way. We designed a sub-study to both explore this and improve quality. SUMMARY: Setting up clinical research projects is severely resource poor settings creates many challenges including those of an operational, technical and ethical nature. Whilst there are no 'right answers' an awareness of these problems can help overcome them
Erratum: Immunogenicity, antigenicity and epitope mapping of Salmonella InvH protein: An in silico study
No full textThere was an error in the author list of the published article.
Two authors (T Hashempour, Z Hasanshahi) requested to remove from the authors lists. After obtaining the agreement of the authors and the corresponding author, Editor-in-Chief accept the corrections as listed below.
The correct author list is:
Behzad Dehghani, Iraj Rasooli
We apologize for any inconvenience this may have caused.
Erratum for:
Immunogenicity, antigenicity and epitope mapping of Salmonella InvH protein: An in silico study
B Dehghani, T Hashempour, Z Hasanshahi, I Rasooli
J Curr Biomed Rep. 2020; 1(1): 9-16
Use of an HRP2-based rapid diagnostic test to guide treatment of children admitted to hospital in a malaria-endemic area of north-east Tanzania.
No full textOBJECTIVE: To compare the performance of the Paracheck™ rapid diagnostic test (RDT) with microscopy for diagnosing malaria in hospitalised children. METHODS: Children aged between 2 months and 13 years with fever were enrolled in the study over 1 year. A standard clinical history and examination were recorded and blood drawn for culture, complete blood count, Paracheck™ RDT and double-read blood slide. RESULTS: Of 3639 children enrolled, 2195 (60.3%) were slide positive. The sensitivity and specificity of Paracheck were 97.5% (95% CI 96.9-98.0) and 65.3% (95% CI 63.8-66.9), respectively. There was an inverse relationship between age-specific prevalence of parasitaemia and Paracheck specificity. In logistic regression model, false-positive Paracheck results were significantly associated with pre-admission use of antimalarial drug (OR 1.44, 95% CI 1.16-1.78), absence of current fever (OR 0.64, 95% CI 0.52-0.79) and non-typhi Salmonella bacteraemia (OR 3.89. 95% CI 2.27-6.63). In spite of high sensitivity, 56/2195 (2.6%) of true infections were Paracheck negative and 8/56 (14.3%) were in patients with >50,000 parasites/μl. CONCLUSIONS: Paracheck had poor specificity in diagnosing malaria in severely ill children; this was likely to be due to HRP2 persistence following recent parasite clearance. The combination of positive Paracheck and negative blood slide results identified a group of children at high risk of non-typhi Salmonella infection. While Paracheck was highly sensitive, some high-density infections were missed. For children with severe febrile illness, at least two reliable negative parasitological test results should be available to justify withholding antimalarial treatment; the optimal choice of these has yet to be identified
Towards an evidence base in the treatment of severe febrile illness in East African children
No full textFebrile illness is the primary cause of childhood outpatient attendance, admission to
hospital and death in Africa. This series of studies were aimed at ascertaining the
treatable causes of infection in children admitted to a district hospital typical of those
found throughout East Africa, in an area of high transmission of malaria. The studies
were also designed to determine the clinical correlates of infection and predictors of
mortality, looking in particular at malaria, invasive bacterial disease and HIV
infection. These studies also explored to what extent clinical examination by one
group of staff was replicable by another.After informed consent a detailed history and structured examination was performed
on all children admitted to the hospital. Blood was drawn for culture, microscopy for
malaria, HIV testing, full blood count, bedside haemoglobin, blood glucose and
lactate measurement and HRP-2 based rapid diagnostic test for falciparum malaria.
Outcomes were recorded at death or discharge.Sufficient data was available on 3,639 children including 184 deaths (5.1%).
Invasive bacterial disease was detected in 341 children (9.4%) and HIV in 142
(3.9%). Children with HIV and those with evidence of recent malaria were
significantly more likely to have invasive bacterial disease. The most common
organisms isolated were non-typhi Salmonella (46.9%), Strep, pneumoniae (16.4%)
and Haemophilus influenzae b (11.4%). The most frequently encountered pathogen
was P. falciparum, with 2,195 children found to have asexual parasitaemia (60.3%).
Falciparum parasitaemia was detected in 100 children with invasive bacterial disease (29.3%). Falciparum malaria was detected in over half (51.6%) of childhood deaths,
invasive bacterial disease was documented in 31.5%.In children with a positive blood slide for malaria, WHO severe malaria criteria
identified 91.6% of the children that died. A multivariate analysis showed that signs
of malnutrition, respiratory distress, altered consciousness, hypoxia according to
pulse oximetry, hypoglycaemia, raised blood lactate, invasive bacterial disease and
female sex were all associated with an increased risk of death. In children with
negative blood slides signs of malnutrition, respiratory distress, altered
consciousness, hypoglycaemia, raised blood lactate and invasive bacterial disease
were all independently associated with mortality by multivariate analysis.WHO defined criteria of syndromes which would warrant antibiotics predicted 56%
of cases of coinfection with invasive bacterial disease and malaria and 69.7% of
cases of invasive bacterial disease in slide negative children. Treating all children
with severe malaria for bacterial disease would result in 71% of children with
coinfection being treated. In children with negative slides including severe anaemia
or prostration as syndromes requiring antibiotic therapy would have resulted in
74.7% of children with invasive bacterial disease receiving antibiotic therapy. There
was moderate agreement between staff over the presence of clinical signs in children,
with hospital nurses performing as well as hospital clinical officers. Agreement was
better in children over 18 months of age and in children who were not crying during
examination.Current WHO guidelines on antibiotic use performed poorly in this setting. Gram
negative infections were the most common cause of invasive infection and many of
these are likely to be resistant to penicillin and other commonly used antibiotics.
Consideration should be given to expanding the indications for antibiotic use and
using more broad-spectrum antibiotics in severely ill children
Correction to:Value of 2-[18F]FDG-PET/CT in identifying immune-related adverse events in patients with melanoma or non-small cell lung cancer: a systematic scoping review (Clinical and Translational Imaging, (2024), 12, 2, (187-195), 10.1007/s40336-024-00618-3)
No full textIn this article the author name Mohammad Naghavi-Behzad was incorrectly written as Mohammad Naghavi-Bezhad. The original article has been corrected.</p
Optimizing parallel I/O performance of HPC applications
No full textParallel I/O is an essential component of modern High Performance Computing (HPC). Obtaining good I/O performance for a broad range of applications on diverse HPC platforms is a major challenge, in part because of complex inter-dependencies between I/O middleware and hardware. The parallel file system and I/O middleware layers all offer optimization parameters that can, in theory, result in better I/O performance. Unfortunately, the right combination of parameters is highly dependent on the application, HPC platform, and problem size/concurrency. Scientific application developers do not have the time or expertise to take on the substantial burden of identifying good parameters for each problem configuration. They resort to using system defaults, a choice that frequently results in poor I/O performance. We expect this problem to be compounded on exascale class machines, which will likely have a deeper software stack with hierarchically arranged hardware resources.
We present a line of solution to this problem containing an autotuning system for optimizing I/O performance, I/O performance modeling, I/O tuning, I/O kernel generation, and I/O patterns. We demonstrate the value of these solution across platforms, applications, and at scale.Submission published under a 24 month embargo labeled 'U of I Access', the embargo will last until 2017-12-01The student, Babak Behzad, accepted the attached license on 2015-11-20 at 13:31.The student, Babak Behzad, submitted this Dissertation for approval on 2015-11-20 at 13:45.This Dissertation was approved for publication on 2015-11-23 at 13:41.DSpace SAF Submission Ingestion Package generated from Vireo submission #8816 on 2016-03-02 at 14:06:01Made available in DSpace on 2016-03-02T20:23:36Z (GMT). No. of bitstreams: 4
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Previous issue date: 2015-11-23Embargo set by: Seth Robbins for item 91322
Lift date: 2018-03-02T20:24:31Z
Reason: Author requested U of Illinois access only (OA after 2yrs) in Vireo ETD systemU of I Only Restriction Lifted for Item 91322 on 2018-03-03T10:15:34Z
Competition in dual-channel supply chains: The manufacturers' channel selection
No full text© 2020 The Author(s) Innovative selling channels have brought about opportunities as well as challenges for upstream manufacturers. The past few years have witnessed both the success and failure of manufacturers with different channel strategies. To explore the rationale of different channel strategies in various contexts, we develop a model to analyze a manufacturer's channel selection decision among three channel strategies, i.e., a direct-channel strategy, a retail-channel strategy, and a dual-channel strategy consisting of both direct and retail channels. The model rests on the channel differentiation in terms of consumers’ channel preferences and operating costs of retail and direct channels. Specifically, we incorporate the action of a competitor and track down its influence on the focal manufacturer's channel preference. Our research clarifies the role of competition in the market and offers insights into the competitive nature of business in real life. Results show that the manufacturer's channel preference depends not only on the channels’ operating costs and consumers’ channel preferences but also on the competitor's channel strategy. We find that symmetric manufacturers can adopt asymmetric strategies as Nash equilibria and also that there are situations where no Nash equilibrium exists. We characterize the Nash equilibria in the channel selection game based on the exogenous parameters of the model
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