Background
In August 2017, after a large influx of forcibly displaced Myanmar nationals (FDMN) in Cox’s Bazar, Bangladesh diarrhea treatment centers (DTCs) were deployed. This study aims to report ...the clinical, epidemiological, and laboratory characteristics of the hospitalized patients.
Methods
The study followed cross-sectional design. In total 1792 individuals were studied. Other than data, a single, stool specimen was subjected to one step rapid visual diagnostic test for
Vibrio cholerae
. The provisionally diagnosed specimens of cholera cases were inoculated into Cary-Blair Transport Medium; then sent to the laboratory of icddr,b in Dhaka to isolate the colony as well as perform antibiotic susceptibility tests. Data were analyzed by STATA and analyses included descriptive as well as analytic methods.
Results
Of the total 1792 admissions in 5 DTCs, 729 (41%) were from FDMN settlements; children <5 years contributed the most (n = 981; 55%). Forty percent (n = 716) were aged 15 years and above, and females were predominant (n = 453; 63%). Twenty-eight percent (n = 502) sought treatment within 24h of the onset of diarrhea. FDMN admissions within 24h were low compared to host hospitalization (n = 172, 24% vs. n = 330, 31%; p<0.001). Seventy-two percent (n = 1295) had watery diarrhea; more common among host population than FDMN (n = 802; 75% vs. n = 493; 68%; p<0.001). Forty-four percent admissions (n = 796) had some or severe dehydration, the later was common in FDMN (n = 46; 6% vs. n = 36; 3%, p = 0.005). FDMN often used public taps (n = 263; 36%), deep tube-well (n = 243; 33%), and shallow tube well (n = 188; 26%) as the source of drinking water. Nearly 96% (n = 698) of the admitted FDMN used pit latrines as opposed to 79% (n = 842) from the host community (p<0.001). FDMN children were often malnourished. None of the FDMN reported cholera.
Conclusion
No diarrhea outbreak was detected, but preparedness for surges and response readiness are warranted in this emergency and crisis setting.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We aimed to determine the levels of follicular helper T (Tfh) and follicular regulatory T (Tfr) cells in COVID-19 patients and determine whether their levels correlated with disease severity and ...presence of hyperglycemia. This study was carried out in 34 hospitalized COVID-19 patients and 20 healthy controls. Levels of total circulating Tfh, inducible T-cell costimulator (ICOS)+ activated Tfh, and Tfr cells were assessed in all participants by flow cytometry. Total CD4+CXCR5+ Tfh cells and ICOS+Foxp3-activated Tfh cells increased and ICOS+Foxp3+ Tfr cells decreased in COVID-19 patients, especially in diabetic patients and those with severe disease. Activated ICOS+ Tfh cells were directly correlated with lactate dehydrogenase, D-dimer, ferritin, and respiratory rate and inversely correlated with the partial pressure of carbon dioxide. COVID-19 is associated with marked activation of Tfh cells and a profound drop in Tfr cells, especially in severe and diabetic patients. Future studies on expanded cohorts of patients are needed to clarify the relationship between SARS-CoV-2 and acute-onset diabetes.
Bangladesh experienced a sudden, large influx of forcibly displaced persons from Myanmar in August 2017. A cholera outbreak occurred in the displaced population during September-December 2019. This ...study aims to describe the epidemiologic characteristics of cholera patients who were hospitalized in diarrhea treatment centers (DTCs) and sought care from settlements of Forcibly Displaced Myanmar Nationals (FDMN) as well as host country nationals during the cholera outbreak.
Diarrhea Treatment Center (DTC) based surveillance was carried out among the FDMN and host population in Teknaf and Leda DTCs hospitalized for cholera during September-December 2019.
During the study period, 147 individuals with cholera were hospitalized. The majority, 72% of patients reported to Leda DTC. Nearly 65% sought care from FDMN settlements. About 47% of the cholera individuals were children less than 5 years old and 42% were aged 15 years and more. Half of the cholera patients were females. FDMN often reported from Camp # 26 (45%), followed by Camp # 24 (36%), and Camp # 27 (12%). Eighty-two percent of the cholera patients reported watery diarrhea. Some or severe dehydration was observed in 65% of cholera individuals. Eighty-one percent of people with cholera received pre-packaged ORS at home. About 88% of FDMN cholera patients reported consumption of public tap water. Pit latrine without water seal was often used by FDMN cholera individuals (78%).
Vigilance for cholera patients by routine surveillance, preparedness, and response readiness for surges and oral cholera vaccination campaigns can alleviate the threats of cholera.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A computational study has been performed to evaluate the use of jet impingement for cooling applications in the automotive industry. The current study uses an entire internal combustion engine ...cylinder with its components as a computational domain. An unsteady numerical solution for the Navier-Stokes equations was carried out using Improved Delayed Detached Eddy Simulation (IDDES). The volume of fluid approach is proposed to track and locate the liquid jet surface that is in contact with the air. The conjugate heat transfer approach is used to link the heat transfer solution between the fluid and the solid. The boundary conditions that are employed in the study are provided from lab experiments and one-dimensional simulations. The cooling jet in this study targets the hottest region in the piston, i.e., the region underneath the exhaust valve. Three nozzle sizes with flows at different Reynolds numbers are chosen to examine the thermal characteristics of the cooling jet. The computational study reveals that for a specific Reynolds number, the smaller diameter nozzle provides the highest heat transfer coefficient around the impingement point. The maximum relative velocity location at the impingement point slightly leads the location of the maximum Nusselt number. The maximum temperature in the piston decreases by 7% to 11% as the nozzle diameter changes from 1.0 to 3.0 mm for a jet Reynolds number of 4,500. If a correct selection is made for the nozzle size, the cooling jet can be efficiently used to reduce the temperature and alleviate the thermal stresses in the piston in the region underneath the exhaust valve where the maximum temperature occurs.
Atrium is a modern architectural design of buildings that has an open space at the middle and contains several floors. In atrium structure the smoke due to fire can easily flow through the open ...spaces and causes smoke contamination. CFD simulation using fire dynamic simulator (FDS) software is conducted in this work, to investigate the effect of balcony open upstand on smoke contamination in atrium's balconies and compare it with balconies with solid upstand. It was found that in case of open upstand, the smoke contamination occurrence decreased inside the balcony comparing with balconies with solid upstand.
Providing appropriate care for people suffering from COVID-19, the disease caused by the pandemic SARS-CoV-2 virus, is a significant global challenge. Many individuals who become infected may have ...pre-existing conditions that may interact with COVID-19 to increase symptom severity and mortality risk. COVID-19 patient comorbidities are likely to be informative regarding the individual risk of severe illness and mortality. Determining the degree to which comorbidities are associated with severe symptoms and mortality would thus greatly assist in COVID-19 care planning and provision. To assess this we performed a meta-analysis of published global literature, and machine learning predictive analysis using an aggregated COVID-19 global dataset. Our meta-analysis suggested that chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CEVD), cardiovascular disease (CVD), type 2 diabetes, malignancy, and hypertension as most significantly associated with COVID-19 severity in the current published literature. Machine learning classification using novel aggregated cohort data similarly found COPD, CVD, CKD, type 2 diabetes, malignancy, and hypertension, as well as asthma, as the most significant features for classifying those deceased versus those who survived COVID-19. While age and gender were the most significant predictors of mortality, in terms of symptom-comorbidity combinations, it was observed that Pneumonia-Hypertension, Pneumonia-Diabetes, and Acute Respiratory Distress Syndrome (ARDS)-Hypertension showed the most significant associations with COVID-19 mortality. These results highlight the patient cohorts most likely to be at risk of COVID-19-related severe morbidity and mortality, which have implications for prioritization of hospital resources.
Carbamazepine intoxication is not uncommon and accounts for many cases of poisoning among anticonvulsive medications users. Since there is no specific antidote for carbamazepine overdose, management ...is limited to gastric decontamination and supportive therapy. With its high protein binding, the role of extracorporeal elimination in carbamazepine intoxication is still questionable. Here two cases of severe carbamazepine intoxication are presented; the cases were brought to the emergency department after the ingestion of 12,000 mg of controlled release carbamazepine for the first case, and unknown amounts of the same drug for the second case. Both cases were presented with altered mental status, convulsion, and high serum carbamazepine levels of more than 20 mcg/mL. They were intubated and treated with continuous venovenous hemofiltration, after which carbamazepine levels declined significantly along with subsequent clinical improvement and complete neurological recovery. Both cases were discharged home for further psychiatric care.
The present numerical study is an attempt to better understand the effect of the aspect ratio (AR) on the velocity field characteristics of the fully-developed turbulent flow in a straight open ...channel by contrasting a very low and very high aspect ratio cases (AR = 1 and 12). The AR is defined as the ratio of the width of the channel in a plane normal to the flow direction, to the flow depth. The bulk velocity and water depth considered in this study are 0.75 m/s and 30 mm, respectively, which yield a Reynolds number of ReH = 22,500. The transient three-dimensional Navier-Stokes equations were numerically solved using a finite-volume approach with improved-delayed detached-eddy simulation (IDDES) turbulence model. The results revealed that the normalized components of the normal stresses by the turbulent kinetic energy k are constant over most of the velocity field, although k varies in magnitude throughout the velocity field in both AR cases. In addition, the results also revealed a strong anisotropic flow which justifies the formation of secondary currents as a means for transporting the kinetic energy. The results also reveal that both vertical and transverse components of the normal stresses are correlated to the side-recirculation zone (SRZ) and bottom-recirculation zone (BRZ), respectively, which highlights the role of the mean recirculation zones (BRZ & SRZ) in the re-distribution of the turbulent kinetic energy k in the velocity field.
Structural stresses developed in an artificial bileaflet mechanical heart valve (BMHV) due to pulsed blood flow may cause valve failure due to yielding. In this paper, von-Mises stresses are computed ...and compared for BMHV placed in two types of aortic root geometries that are aortic root with axisymmetric sinuses and with axisymmetric bulb, at different physiological blood flow rates. With BMHV placed in an aortic root with axisymmetric sinuses, the von-Mises stresses developed in the valve were found to be up to 47% higher than BMHV placed in aortic root with axisymmetric bulb under similar physiological conditions. High velocity vectors and therefore high von-Mises stresses have been observed for BMHV placed in aortic root with axisymmetric sinuses, that can lead to valve failure.
The Neogene outcrops in Northwestern Argentina have provided many fossil mammals, particularly notoungulates. However, the fossil record of the early stages of the late Miocene is scarce. The present ...study describes two mesotheriine specimens from Las Arcas Formation (underlying the Chiquimil Formation dated at 9.14 ± 0.09 Ma; Catamarca Province) and Saladillo Formation (dated at 10 ± 0.3 Ma; Tucumán Province), represented by a left maxillary fragment with complete M1–3 and a right isolated M3, respectively. The main feature of these pieces is their small size, significantly smaller than that of the Miocene genera Eutypotherium, Typotheriopsis, and Pseudotypotherium, recorded in Argentina. In contrast, these mesotheriines are closer to specimens known from Bolivia. The comparative analysis allows us to refer the material herein described to Plesiotypotherium aff. P. achirense and Mesotheriinae indet., with all cautions inherent to the incompleteness of the material. In turn, the paleobiogeographic implication of these new records is approached. A relationship concerning phylogenetic aspects, size, temporal range, and distribution pattern is proposed, taking into account the small size of the studied material in a temporal context of medium to large-sized mesotheriines.
•Two small-sized mesotheriine specimens from the late Miocene of Northwestern Argentina are described extensively.•One of them is morphologically closer to specimens known from Bolivia, and it is assigned to Plesiotypotherium.•A relationship concerning phylogenetic aspects, size, temporal range, and distribution pattern is proposed.
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