RÉSUMÉ
Objective:To evaluate the effects of smart stethoscope on the monitoring childhood asthma exacerbation, so as to assist family management in childhood asthma.Methods:A prospective randomized controlled study was carried out.A total of 80 children with asthma who were treated at Department of Pediatric Respiratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine and Shanghai Tonxin Pediatric Clinic from November 2020 to May 2021 were enrolled and randomly divided into a test group of 40 cases (used the smart stethoscope) and a control group of 40 cases(not used the smart stethoscope). Medical history data were collected.The control group received monthly routine follow-up, while the test group was followed up both routinely and by smart stethoscope.In the test group, hearing wheezing sound was regarded as asthma exacerbation, and in the control group, the asthma exacerbation was reported by the parents themselves.The frequency of asthma exacerbation, asthma control level and quality of life were compared between the two groups.The recognition, diagnosis, treatment and outcomes of acute asthma exacerbation in two groups of children were described and analyzed.Measurement data were analyzed by t test or Mann- Whitney U test.Numeration data were analyzed by χ2 test. Results:Respiratory sounds collected by smart stethoscope in the test group were assessed by 3 specialist physicians.There were 12 wheezing rales (42.86%), 1 moist rale (3.57%) and 1 rhonchi rale (3.57%). Besides, 12 files (42.86%) were difficult to distinguish, and 2 files (7.14%) induced inconsistent identification.The number of asthma exacerbation was 12 in the test group and 5 in the control group.In the test group, 12 were recognized by the smart stethoscope, and only 6 were recognized by the parents.Comparing the diagnosis and treatment measures between two groups, it was found that there were more children in the test group (38.1%) receiving home treatment through telemedicine than those in the control group (20.0%). Besides, there were less children (61.9%) in the test group receiving unplanned hospital treatment (including unplanned outpatient, emergency and hospitalization) than those in the control group (80.0%). There was no statistically significant difference between the two groups of children during acute asthma exacerbation ( χ2=4.67, P=0.097). Parents were satisfied with the common functions, convenience and stability of smart stethoscope. Conclusions:Smart stethoscope can acquire the respiratory sounds of children with asthma in real time, achieving timely detection, diagnosis and treatment of asthma exacerbation in children.What′s more, smart stethoscope reduces the incidence of unplanned hospital diagnosis and treatment, and assists parents with better family management of children asthma.
RÉSUMÉ
The implementation of lockdowns has been a key policy to curb the spread of COVID-19 and to keep under control the number of infections. However, quantitatively predicting in advance the effects of lockdowns based on their stringency and duration is a complex task, in turn making it difficult for governments to design effective strategies to stop the disease. Leveraging a novel mathematical "hybrid" approach, we propose a new epidemic model that is able to predict the future number of active cases and deaths when lockdowns with different stringency levels or durations are enforced. The key observation is that lockdown-induced modifications of social habits may not be captured by traditional mean-field compartmental models because these models assume uniformity of social interactions among the population, which fails during lockdown. Our model is able to capture the abrupt social habit changes caused by lockdowns. The results are validated on the data of Israel and Germany by predicting past lockdowns and providing predictions in alternative lockdown scenarios (different stringency and duration). The findings show that our model can effectively support the design of lockdown strategies by stringency and duration, and quantitatively forecast the course of the epidemic during lockdown.