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1.
BMC Infect Dis ; 22(1): 460, 2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-35562690

RESUMO

BACKGROUND: With the decline in local malaria transmission in Vietnam as a result of the National Malaria Control Program (NMCP) elimination activities, a greater focus on the importation and potential reintroduction of transmission are essential to support malaria elimination objectives. METHODS: We conducted a multi-method assessment of the demographics, epidemiology, and clinical characteristics of imported malaria among international laborers returning from African or Southeast Asian countries to Vietnam. Firstly, we conducted a retrospective review of hospital records of patients from January 2014 to December 2016. Secondly, we conducted a mixed-methods prospective study for malaria patients admitted to the study sites from January 2017 to May 2018 using a structured survey with blood sample collection for PCR analysis and in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. RESULTS: International laborers were young (median age 33.0 years IQR 28.0-39.5 years), predominantly male (92%) adults returning mostly from the African continent (84%) who stayed abroad for prolonged periods (median time 13.5 months; IQR 6.0-331.5 months) and were involved in occupations that exposed them to a higher risk of malaria infection. Epidemiological trends were also similar amongst study strands and included the importation of Plasmodium falciparum primarily from African countries and P. vivax from Southeast Asian countries. Of 11 P. malariae and P. ovale infections across two study strands, 10 were imported from the African continent. Participants in the qualitative arm demonstrated limited knowledge about malaria prior to travelling abroad, but reported knowledge transformation through personal or co-worker's experience while abroad. Interestingly, those who had a greater understanding of the severity of malaria presented to the hospital for treatment sooner than those who did not; median of 3 days (IQR 2.0-7.0 days) versus 5 days (IQR 4.0-9.5 days) respectively. CONCLUSION: To address the challenges to malaria elimination raised by a growing Vietnamese international labor force, consideration should be given to appropriately targeted interventions and malaria prevention strategies that cover key stages of migration including pre-departure education and awareness, in-country prevention and prophylaxis, and malaria screening upon return.


Assuntos
Malária Vivax , Malária , Adulto , Feminino , Humanos , Malária/tratamento farmacológico , Malária/epidemiologia , Malária/prevenção & controle , Malária Vivax/epidemiologia , Masculino , Plasmodium falciparum , Estudos Prospectivos , Vietnã/epidemiologia
2.
Malar J ; 20(1): 373, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34535140

RESUMO

BACKGROUND: A key step to advancing the goal of malaria elimination in Viet Nam by 2030 is focusing limited resources for treatment and prevention to groups most at risk for malaria transmission. METHODS: To better understand risk factors for malaria transmission in central Viet Nam, a survey of 1000 malaria positive cases and 1000 malaria negative controls was conducted. Cases and controls were matched for age and gender and self-presented at commune health stations (CHS) in Binh Phuoc, Dak Nong and Dak Lak Provinces. Diagnoses were confirmed with microscopy, rapid diagnostic test and PCR. Participants were interviewed about 50 potential risk factors for malaria, which included information about occupation, forest visitation, travel, healthcare-seeking behaviour and prior use of anti-malaria interventions. Participants were enrolled by trained government health workers and the samples were analysed in Vietnamese government laboratories. Data were analysed by univariable, block-wise and multivariable logistic regression. RESULTS: Among cases, 61.8% had Plasmodium falciparum, 35.2% Plasmodium vivax and 3% mixed species infections. Median (IQR) age was 27 (21-36) years and 91.2% were male. Twenty-five risk factors were associated with being a case and eleven with being a control. Multivariable analysis found that malaria cases correlated with forest workers, recent forest visitation, longer duration of illness, having a recorded fever, number of malaria infections in the past year, having had prior malaria treatment and having previously visited a clinic. CONCLUSIONS: This study demonstrates the benefits of increased statistical power from matched controls in malaria surveillance studies, which allows identification of additional independent risk factors. It also illustrates an example of research partnership between academia and government to collect high quality data relevant to planning malaria elimination activities. Modifiable risk factors and implications of the findings for malaria elimination strategy are presented.


Assuntos
Coinfecção/epidemiologia , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Malária Falciparum/parasitologia , Malária Vivax/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium falciparum/fisiologia , Plasmodium vivax/fisiologia , Fatores de Risco , Vietnã/epidemiologia , Adulto Jovem
3.
BMC Infect Dis ; 20(1): 757, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059623

RESUMO

BACKGROUND: Individuals that work and sleep in remote forest and farm locations in the Greater Mekong Subregion continue to remain at high risk of both acquiring and transmitting malaria. These difficult-to-access population groups largely fall outside the reach of traditional village-centered interventions, presenting operational challenges for malaria programs. In Vietnam, over 60% of malaria cases are thought to be individuals who sleep in forests or on farms. New malaria elimination strategies are needed in countries where mobile and migrant workers frequently sleep outside of their homes. The aim of this study was to apply targeted surveillance-response based investigative approaches to gather location-specific data on confirmed malaria cases, with an objective to identify associated malaria prevention, treatment and risk behaviors of individuals sleeping in remote forest and farms sites in Vietnam. METHODS: A cross-sectional study using novel targeted reactive investigative approaches at remote area sleeping sites was conducted in three mountainous communes in Phu Yen province in 2016. Index cases were defined as individuals routinely sleeping in forests or farms who had tested positive for malaria. Index cases and non-infected neighbors from forest and farm huts within 500 m of the established sleeping locations of index cases were interviewed at their remote-area sleeping sites. RESULTS: A total of 307 participants, 110 index cases and 197 neighbors, were enrolled. Among 93 participants who slept in the forest, index cases were more likely to make > 5 trips to the forest per year (prevalence odds ratio (POR) 7.41, 95% confidence interval (CI) 2.66-20.63), sleep in huts without walls (POR 44.00, 95% CI 13.05-148.33), sleep without mosquito nets (POR 2.95, 95% CI 1.26-6.92), and work after dark (POR 5.48, 95% CI 1.84-16.35). Of the 204 farm-based respondents, a significantly higher proportion of index cases were involved in non-farming activities (logging) (POR 2.74, 95% CI 1.27-5.91). CONCLUSION: Investigative approaches employed in this study allowed for the effective recruitment and characterization of high-priority individuals frequently sleeping in remote forest and farm locations, providing relevant population and site-specific data that decision makers can use to design and implement targeted interventions to support malaria elimination.


Assuntos
Florestas , Malária/epidemiologia , Malária/transmissão , Adulto , Terapia Comportamental , Estudos Transversais , Fazendas , Feminino , Habitação , Humanos , Malária/tratamento farmacológico , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Mosquiteiros , Razão de Chances , Assunção de Riscos , Vietnã/epidemiologia , Vietnã/etnologia
4.
Malar J ; 18(1): 435, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31861988

RESUMO

BACKGROUND: The transition from malaria control to elimination requires understanding and targeting interventions among high-risk populations. In Vietnam, forest-goers are often difficult to test, treat and follow-up for malaria because they are highly mobile. If undiagnosed, forest-goers can maintain parasite reservoirs and contribute to ongoing malaria transmission. METHODS: A case-control study was conducted to identify malaria risk factors associated with forest-goers in three communes in Phu Yen Province, Vietnam. Cases (n = 81) were residents from the study area diagnosed with malaria and known to frequent forest areas. Controls (n = 94) were randomly selected forest-going residents from within the study area with no identified malaria infection. Participants were interviewed face-to-face using a standard questionnaire to identify malaria risk factors. Logistic regression was used to calculate odds ratios (ORs) and 95% CI for risk factors after adjusting for socio-demographic characteristics. RESULTS: Among the cases, malaria infection varied by species: 66.7% were positive for Plasmodium falciparum, 29.6% for Plasmodium vivax, and 3.7% were diagnosed as mixed infection. Cases were less likely than controls to use treated nets (aOR = 0.31; 95% CI 0.12-0.80), work after dark (aOR = 2.93; 95% CI 1.35, 6.34), bath in a stream after dark (aOR = 2.44; 95% CI 1.02-5.88), and collect water after dark (aOR = 1.99; 95% CI 1.02-3.90). CONCLUSIONS: As Vietnam moves toward malaria elimination, these findings can inform behaviour change communication and malaria prevention strategies, incorporating the risk of after-dark and water-related activities, in this priority and difficult-to-access population group.


Assuntos
Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Plasmodium falciparum/fisiologia , Plasmodium vivax/fisiologia , Adulto , Estudos de Casos e Controles , Feminino , Florestas , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Vietnã/epidemiologia , Adulto Jovem
5.
Pediatr Radiol ; 49(4): 517-525, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30923884

RESUMO

During the last 15 years, peer review has been widely incorporated into radiology quality improvement programs. However, current implementations are variable and carry concerns, including subjectivity of numerical scores and a sense of merely satisfying regulatory requirements. The Society for Pediatric Radiology (SPR) Quality and Safety Committee sought to evaluate the state of peer review programs in pediatric radiology practices, including implementation methods, perceived functions, strengths and weaknesses, and opportunities for improvement. We distributed an online 16-question survey to SPR members. Questions pertained to the type of peer review system, the use of numerical scores and comments, how feedback on discordances is given and received, and the use of peer learning conferences. We collected 219 responses (15% of survey invitations), 80% of which were from children's hospitals. Fifty percent of respondents said they use a picture archiving and communication system (PACS)-integrated peer review system. Comment-enhanced feedback for interpretive discordances was either very important or somewhat important to performance improvement in 86% of responses, compared to 48% with a similar perception of numerical scores. Sixty-eight percent of respondents said they either rarely or never check their numerical scores, and 82% either strongly or somewhat agreed that comments are more effective feedback than numerical scores. Ninety-three percent either strongly or somewhat agreed that peer learning conferences would be beneficial to their practice. Forty-eight percent thought that their current peer review system should be modified. Survey results demonstrate that peer review systems in pediatric radiology practices are implemented variably, and nearly half of respondents believe their systems should be modified. Most respondents prefer feedback in the form of comments and peer learning conferences, which are thought to be more beneficial for performance improvement than numerical scores.


Assuntos
Pediatria/normas , Revisão por Pares , Garantia da Qualidade dos Cuidados de Saúde/normas , Radiologia/normas , Comitês Consultivos , Humanos , Melhoria de Qualidade , Sociedades Médicas , Inquéritos e Questionários , Estados Unidos
6.
Malar J ; 17(1): 332, 2018 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-30223843

RESUMO

BACKGROUND: Viet Nam has made tremendous progress towards reducing mortality and morbidity associated with malaria in recent years. Despite the success in malaria control, there has been a recent increase in cases in some provinces. In order to understand the changing malaria dynamics in Viet Nam and measure progress towards elimination, the aim of this study was to describe and quantify spatial and temporal trends of malaria by species at district level across the country. METHODS: Malaria case reports at the Viet Nam National Institute of Malariology, Parasitology, and Entomology were reviewed for the period of January 2009 to December 2015. The population of each district was obtained from the Population and Housing Census-2009. A multivariate (insecticide-treated mosquito nets [ITN], indoor residual spraying [IRS], maximum temperature), zero-inflated, Poisson regression model was developed with spatial and spatiotemporal random effects modelled using a conditional autoregressive prior structure, and with posterior parameters estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling. Covariates included in the models were coverage of intervention (ITN and IRS) and maximum temperature. RESULTS: There was a total of 57,713 Plasmodium falciparum and 32,386 Plasmodium vivax cases during the study period. The ratio of P. falciparum to P. vivax decreased from 4.3 (81.0% P. falciparum; 11,121 cases) in 2009 to 0.8 (45.0% P. falciparum; 3325 cases) in 2015. Coverage of ITN was associated with decreased P. falciparum incidence, with a 1.1% (95% credible interval [CrI] 0.009%, 1.2%) decrease in incidence for 1% increase in the ITN coverage, but this was not the case for P. vivax, nor was it the case for IRS coverage. Maximum temperature was associated with increased incidence of both species, with a 4% (95% CrI 3.5%, 4.3%) and 1.6% (95% CrI 0.9%, 2.0%) increase in P. falciparum and P. vivax incidence for a temperature increase of 1 °C, respectively. Temporal trends of P. falciparum and P. vivax incidence were significantly higher than the national average in Central and Central-Southern districts. CONCLUSION: Interventions (ITN distribution) and environmental factors (increased temperature) were associated with incidence of P. falciparum and P. vivax during the study period. The factors reviewed were not exhaustive, however the data suggest distribution of resources can be targeted to areas and times of increased malaria transmission. Additionally, changing distribution of the two predominant malaria species in Viet Nam will require different programmatic approaches for control and elimination.


Assuntos
Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Humanos , Incidência , Análise Espaço-Temporal , Vietnã/epidemiologia
7.
Pediatr Radiol ; 47(5): 544-555, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28409252

RESUMO

Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. MR protocols should be tailored to the specific indication and reviewed by the supervising radiologist in real time. Targeted advanced imaging sequences can be added to provide information regarding tissue microstructure, perfusion, metabolism and function. In part 2 of this review, we highlight the utility of advanced imaging techniques for superior evaluation of pediatric neurologic disease. We focus on the following techniques, with clinical examples: phase-contrast imaging, perfusion-weighted imaging, vessel wall imaging, diffusion tensor imaging, task-based functional MRI and MR spectroscopy.


Assuntos
Encefalopatias/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Encéfalo/diagnóstico por imagem , Criança , Humanos
8.
Pediatr Radiol ; 47(5): 534-543, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28409254

RESUMO

Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. Standard MR techniques used in adult neuroimaging are suboptimal for imaging in pediatrics because there are significant differences in the child's developing brain. These differences include size, myelination and sulcation. MR protocols need to be tailored to the specific indication and reviewed by the supervising radiologist in real time, and the specialized needs of this population require careful consideration of issues such as scan timing, sequence order, sedation, anesthesia and gadolinium administration. In part 1 of this review, we focus on basic protocol development and anatomical characterization. We provide multiple imaging examples optimized for evaluation of supratentorial and infratentorial brain, midline structures, head and neck, and intracranial vasculature.


Assuntos
Encefalopatias/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Encéfalo/diagnóstico por imagem , Criança , Humanos
9.
Pediatr Radiol ; 47(6): 665-673, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28283728

RESUMO

BACKGROUND: Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists. OBJECTIVE: To assess the usage of GBCAs among SPR members. MATERIALS AND METHODS: An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations. RESULTS: A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations. CONCLUSION: Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects.


Assuntos
Meios de Contraste/administração & dosagem , Gadolínio/administração & dosagem , Imageamento por Ressonância Magnética , Padrões de Prática Médica/estatística & dados numéricos , Encéfalo/metabolismo , Criança , Meios de Contraste/farmacocinética , Gadolínio/farmacocinética , Humanos , Internacionalidade , Sociedades Médicas , Inquéritos e Questionários , Fluxo de Trabalho
10.
Org Biomol Chem ; 14(4): 1293-301, 2016 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-26647835

RESUMO

A series of new 7- and 4-azaindolo[1,2-f]phenanthridines were synthesized by a domino Pd(0)-catalyzed reaction, which involves three sequential steps: C-N coupling, hydroamination, and intramolecular C-H arylation. The products show promising fluorescence properties with high quantum yields (12-65%).

11.
Pediatr Neurosurg ; 51(2): 93-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26730985

RESUMO

Mature teratomas located solely in the posterior fossa are rare. We describe a girl who presented with hydrocephalus caused by a posterior fossa tumor that was ultimately diagnosed as a mature teratoma following complete extirpation. Unusual imaging characteristics which produced confusion preoperatively were, however, very consistent with mature teratomas that are encountered in the gonads. Immature elements were universally absent; therefore, extirpation was curative. Hydrocephalus is unlikely to resolve after tumor removal, and cerebrospinal fluid diversion may be required.


Assuntos
Fossa Craniana Posterior , Teratoma/diagnóstico , Adolescente , Craniotomia , Diagnóstico Diferencial , Feminino , Cefaleia/etiologia , Humanos , Hidrocefalia/etiologia , Neoplasias Infratentoriais/diagnóstico , Imageamento por Ressonância Magnética , Teratoma/complicações , Teratoma/cirurgia , Tomografia Computadorizada por Raios X , Derivação Ventriculoperitoneal
12.
Org Biomol Chem ; 13(11): 3321-30, 2015 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-25644637

RESUMO

A new and convenient method for the synthesis of indolo[1,2-f]phenanthridines via palladium-catalyzed domino C-N coupling/hydroamination/C-H arylation reactions was developed. The reactions allow for the synthesis of various phenanthridines in good yields from easily accessible starting materials using a single palladium catalyst.


Assuntos
Indóis/síntese química , Compostos Organometálicos/química , Paládio/química , Fenantridinas/síntese química , Aminação , Catálise , Indóis/química , Estrutura Molecular , Fenantridinas/química
13.
Org Biomol Chem ; 13(30): 8277-90, 2015 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-26140545

RESUMO

A highly selective and efficient method for the synthesis of 5-trifluoromethylated and 5-perfluoroalkylated pyrazoles has been developed which relies on the cyclization of hydrazine dianions with ethyl perfluorocarboxylates. The pyrazoles prepared were evaluated as potential inhibitors of alkaline phosphatases, namely human tissue non-specific alkaline phosphatase (h-TNAP) and tissue specific intestinal alkaline phosphatase (IAP). Most pyrazole derivatives inhibited h-IAP more markedly than h-TNAP and had minor effects on nucleotide pyrophosphatase/phosphodiesterases. Therefore, the compounds appear as potential selective inhibitors of h-IAP.


Assuntos
Química Orgânica/métodos , Hidrazonas/química , Pirazóis/síntese química , Agroquímicos/química , Fosfatase Alcalina/antagonistas & inibidores , Fosfatase Alcalina/metabolismo , Animais , Ânions , Células COS , Chlorocebus aethiops , Ciclização , Inibidores Enzimáticos/farmacologia , Humanos , Isoxazóis/síntese química , Isoxazóis/química , Preparações Farmacêuticas/química , Pirazóis/química , Pirofosfatases/antagonistas & inibidores , Pirofosfatases/metabolismo , Relação Estrutura-Atividade
14.
PLOS Glob Public Health ; 4(8): e0003443, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39106235

RESUMO

BACKGROUND: In Vietnam, multiple types of community-based malaria workers are recruited to promote access to malaria testing and treatment for at-risk mobile and migrant populations. However, as the country approaches elimination, these roles are at risk from declining investment. This article characterises the different types of workers and relevant health policy in Vietnam, and explores stakeholder perspectives on sustaining and expanding the roles of these workers in the malaria elimination context. METHODS: We conducted a rapid policy document review to describe the policy background of community-based health care in Vietnam and identify key informants. In-depth interviews were conducted with policymakers and implementers (n = 11) in different government sectors, international, and civil society organizations. We also conducted interviews (n = 8) and two focus group discussions with community members (n = 12), and interviews with health workers (n = 9) in 18 communities in Phu Yen and Binh Thuan provinces in the central region. RESULTS: Our study identified three main types of malaria workers: village health workers (VHWs), malaria post workers (MPWs) and other groups of workers supported by civil society organisations (CSO). Workers reported being willing to maintain their current roles and potentially provide additional services that respond to community needs, although they were concerned about excess workload and inadequate income. Besides working in a variety of jobs to secure their incomes, mainly in agriculture, VHWs in particular were primarily tasked with supporting the delivery of a wide range of health services from commune health stations. Faced with reduced patients, MPWs and CSO-supported workers could be tasked with the following potential roles: case notification for infectious diseases, real-time data collection and reporting, and screening for non-malaria illnesses using other rapid test kits. There was agreement that the community-based health network is crucial to health care delivery in remote communities and to ensure comprehensive access to care among vulnerable populations. However, policymakers and implementers stressed concerns about their limited skillsets, the inadequate budget to support these workers, and the regulation constraining them from performing diagnosis and treatment activities, highlighting the priority to maintain the capacity of workers and funding allocation through provincial advocacy and multi-programme collaboration. CONCLUSIONS: This study highlights the crucial role of community-based health workers in eliminating malaria in Vietnam. Sustained efforts are needed to maintain accessible case detection and treatment while addressing local health concerns beyond malaria. Implementing these strategies requires prioritizing the mapping of groups most in need and developing enablers to raise community awareness and maintain the capacity of these workers. Ensuring political advocacy, financial resources, and coordination between multiple groups are key to maximizing impact and integrating malaria activities into the broader health system.

15.
Artigo em Inglês | MEDLINE | ID: mdl-38082971

RESUMO

Due to its advantages in numerous industries, including healthcare, sports, rehabilitation, and wearable electronics, gender recognition has garnered a lot of attention in the last ten years. The gender recognition method described in this study uses a wearable sensor device with inertial measurement units to record a variety of activities. The system consists of five sensors that are mounted to the upper and lower bodies while performing seven standing, walking, and climbing exercises that are meant to replicate daily activity. To create a model for gender recognition, we carried out an extensive study based on supervised machine learning. This study identifies a collection of sensor locations and behaviours to better precisely classify gender. Gender classification based on single activity was performed using Random Forest Classifier (RFC) and Support Vector Machines (SVM). Maximum accuracy of 92.06% was gained using Random Forest Classifier for the sensor located at the ankle when walking. Multi-activity based gender classification outperformed former by achieving an accuracy of 94.13% using RFC. This was for the activity combination of Romberg test eyes open, Single leg stance eyes open and Staircase up and down.


Assuntos
Algoritmos , Dispositivos Eletrônicos Vestíveis , Humanos , Atividades Humanas , Atividades Cotidianas , Caminhada
16.
Artigo em Inglês | MEDLINE | ID: mdl-38082771

RESUMO

Cerebellar Ataxia (CA) is a neurological condition that affects coordination, balance and speech. Assessing its severity is important for developing effective treatment and rehabilitation plans. Traditional assessment methods involve a clinician instructing a person with ataxia to perform tests and assigning a severity score based on their performance. However, this approach is subjective as it relies on the clinician's experience, and can vary between clinicians. To address this subjectivity, some researchers have developed automated assessment methods using signal processing and data-driven approaches, such as supervised machine learning. These methods still rely on subjective ground truth and can perform poorly in real-world scenarios. This research proposed an alternative approach that uses signal processing to modify recurrence plots and compare the severity of ataxia in a person with CA to a control cohort. The highest correlation score obtained was 0.782 on the back sensor with the feet-apart and eyes-open test. The contributions of the research include modifying the recurrence plot as a measurement tool for assessing CA severity, proposing a new approach to assess severity by comparing kinematic data between people with CA and a control reference group, and identifying the best subtest and sensor position for practical use in CA assessments.


Assuntos
Ataxia Cerebelar , Humanos , Ataxia Cerebelar/diagnóstico , Ataxia , Fala , Fenômenos Biomecânicos
17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 4925-4928, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36086180

RESUMO

Cerebellar ataxia (CA) refers to the incoordination of movements of the eyes, speech, trunk, and limbs caused by cerebellar dysfunction. Conventional machine learning (ML) utilizes centralised databases to train a model of diagnosing CA. Despite the high accuracy, these approaches raise privacy concern as participants' data revealed in the data centre. Federated learning is an effective distributed solution to exchange only the ML model weight rather than the raw data. However, FL is also vulnerable to network attacks from malicious devices. In this study, we depict the concept of blockchained FL with individual's validators. We simulate the proposed approach with real-world dataset collected from kinematic sensors of CA individuals with four geographically separated clinics. Experimental results show the blockchained FL maintains competitive accuracy of 89.30%, while preserving both privacy and security.


Assuntos
Ataxia Cerebelar , Privacidade , Ataxia Cerebelar/diagnóstico , Segurança Computacional , Bases de Dados Factuais , Humanos , Aprendizado de Máquina
18.
Artigo em Inglês | MEDLINE | ID: mdl-35316188

RESUMO

Cerebellar ataxia (CA) is concerned with the incoordination of movement caused by cerebellar dysfunction. Movements of the eyes, speech, trunk, and limbs are affected. Conventional machine learning approaches utilizing centralised databases have been used to objectively diagnose and quantify the severity of CA. Although these approaches achieved high accuracy, large scale deployment will require large clinics and raises privacy concerns. In this study, we propose an image transformation-based approach to leverage the advantages of state-of-the-art deep learning with federated learning in diagnosing CA. We use motion capture sensors during the performance of a standard neurological balance test obtained from four geographically separated clinics. The recurrence plot, melspectrogram, and poincaré plot are three transformation techniques explored. Experimental results indicate that the recurrence plot yields the highest validation accuracy (86.69%) with MobileNetV2 model in diagnosing CA. The proposed scheme provides a practical solution with high diagnosis accuracy, removing the need for feature engineering and preserving data privacy for a large-scale deployment.


Assuntos
Ataxia Cerebelar , Aprendizado Profundo , Ataxia Cerebelar/diagnóstico , Humanos , Aprendizado de Máquina , Privacidade , Fala
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 3101-3104, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34891898

RESUMO

Cerebellar ataxia (CA) is defined by disrupted coordination of movement suffering from disease of the cerebellum. It reflects fragmented movements of the eyes, vocal, upper limbs, balance, gait, and lower limbs. This study aims to use a motion sensor to form a simple yet effective CA quantitative assessment framework. We suggest a pendant device to use a single kinematic sensor attached to the wearer's chest to investigate the balance capability. Via a standard neurological test (Romberg's standing), the device may reveal an early symptom of Cerebellar Ataxia tailoring toward rehabilitation or therapeutic program. We adopt a transformed-image based approach to leverage the advantage of state-of-the-art deep learning models into diagnosis CA. Three transform techniques are employed including recurrence plot, melspectrogram, and Poincaré plot. Experiment results show that melspectrogram transform technique performs best in implementation with MobileNetV2 to diagnose CA with an average validation accuracy of 89.99%.


Assuntos
Ataxia Cerebelar , Aprendizado Profundo , Fenômenos Biomecânicos , Ataxia Cerebelar/diagnóstico , Humanos , Movimento , Fatores de Tempo
20.
PLoS One ; 16(4): e0250045, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33861798

RESUMO

In-line with the World Health Organization's (WHO) Global Technical Strategy for Malaria (2016-2030), Vietnam is striving to eliminate malaria by 2030. Targeting appropriate interventions in high-risk populations such as forest and forest-fringe communities is a critical component of malaria elimination efforts in Vietnam. In 2016, a household-level malaria indicator survey was conducted in Phu Yen Province, Vietnam with the aim of assessing the knowledge, behaviors and associated risks of malaria infection among priority mobile and migrant populations (MMPs) working and sleeping in forests and on farms. A total of 4211 people were included in the survey, comprised of 1074 heads of households and 3137 associated household members. Of the 1074 head-of-household respondents, 472 slept in a forest, 92 slept on a farm, 132 slept in both forests and farms, and 378 slept at their villages within the last 12 months. Age, literacy, and occupation were significantly different among those who slept in a forest versus on a farm. Of 301 respondents who answered questions about malaria risk factors at sleeping sites, 35% were somewhat aware of malaria prevention practices, but only 4% could recall at least four malaria prevention messages. Among the same group of 301 respondents, only 29% used nets and only 11% used treated nets. Ownership and use of nets among forest-goers was significantly lower than those who slept on a farm or in their village. Huts without walls were significantly prominent forest sleeping site locations (POR = 10.3; 95% CI 4.67-22.7). All respondents who slept in a forest requested standby malaria drugs and one-third of them self-treated without blood testing. Results from this study highlight the importance of capturing relevant location-specific data among priority populations such as remote forest and farm going mobile and migrant populations in Vietnam. Data regarding behavioral practices, knowledge, preventative measures, and intervention coverage at remote-area transmission sites must be routinely captured to effectively monitor progress and refine targeted intervention strategies accordingly.


Assuntos
Malária/epidemiologia , Malária/prevenção & controle , Malária/transmissão , Adulto , Estudos Transversais , Biomarcadores Ambientais , Características da Família , Fazendas , Feminino , Florestas , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Migrantes/estatística & dados numéricos , Vietnã/epidemiologia
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