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Early warning systems

Maja Kopczynska, Ben Sharif, Sian Cleaver, Naomi Spencer, Amit Kurani, Camilla Lee, Jessica Davis, Carys Durie, Jude Joseph-Gubral, Angelica Sharma, Lucy Allen, Billie Atkins, Alex Gordon, Llewelyn Jones, Amy Noble, Matthew Bradley, Henry Atkinson, Joy Inns, Harriet Penney, Carys Gilbert, Rebecca Walford, Louise Pike, Ross Edwards, Robyn Howcroft, Hazel Preston, Jennifer Gee, Nicholas Doyle, Charlotte Maden, Claire Smith, Nik Syakirah Nik Azis, Navrhinaa Vadivale, Ceri Battle, Ronan Lyons, Paul Morgan, Richard Pugh, Tamas Szakmany
Controversy exists regarding the best diagnostic and screening tool for sepsis outside the intensive care unit (ICU). Sequential organ failure assessment (SOFA) score has been shown to be superior to systemic inflammatory response syndrome (SIRS) criteria, however, the performance of "Red Flag sepsis criteria" has not been tested formally.The aim of the study was to investigate the ability of Red Flag sepsis criteria to identify the patients at high risk of sepsis-related death in comparison to SOFA based sepsis criteria...
December 2018: Medicine (Baltimore)
Candice Downey, Rebecca Randell, Julia Brown, David G Jayne
BACKGROUND: Vital signs monitoring is a universal tool for the detection of postoperative complications; however, unwell patients can be missed between traditional observation rounds. New remote monitoring technologies promise to convey the benefits of continuous monitoring to patients in general wards. OBJECTIVE: The aim of this pilot study was to evaluate whether continuous remote vital signs monitoring is a practical and acceptable way of monitoring surgical patients and to optimize the delivery of a definitive trial...
December 11, 2018: Journal of Medical Internet Research
Mohammad Zahirul Islam, Shannon Rutherford, Dung Phung, Md Nazim Uzzaman, Scott Baum, M Mamun Huda, Muhammad Asaduzzaman, Mohammad Radwanur Rahman Talukder, Cordia Chu
Dengue fever is a major public health concern in Bangladesh with increased incidence during monsoon. We aimed to assess the correlation of temperature, humidity, and rainfall on dengue fever in two dengue endemic cities in Bangladesh. It was a time series analysis of climate factors and dengue occurrence data in Dhaka and Chittagong cities from 1 January 2000 to 31 December 2009. Daily mean temperature, rainfall, and humidity data were obtained from the Bangladesh meteorological department and daily dengue cases data were obtained from the directorate general of health services (DGHS) of Bangladesh...
October 1, 2018: Curēus
Elizabeth R Hammond, Dean E Morbeck
STUDY QUESTION: Can embryology key performance indicators (KPIs) detect shifts in laboratory performance that precede changes in clinical outcomes? SUMMARY ANSWER: Day 5 usable blastocyst rate (D5BUR) is an important embryology KPI that complements total usable blastocyst rate (TBUR) in its ability to rapidly identify adverse embryology outcomes, prior to changes in clinical outcomes. WHAT IS KNOWN ALREADY: The hypothesis that monitoring performance of an IVF laboratory using statistical process controls (SPCs) can act as an early warning signal of shifts in laboratory conditions is a hypothesis that requires validation...
December 4, 2018: Human Reproduction
B Bett, J Lindahl, R Sang, M Wainaina, S Kairu-Wanyoike, S Bukachi, I Njeru, J Karanja, E Ontiri, M Kariuki Njenga, D Wright, G M Warimwe, D Grace
We implemented a cross-sectional study in Tana River County, Kenya, a Rift Valley fever (RVF)-endemic area, to quantify the strength of association between RVF virus (RVFv) seroprevalences in livestock and humans, and their respective intra-cluster correlation coefficients (ICCs). The study involved 1932 livestock from 152 households and 552 humans from 170 households. Serum samples were collected and screened for anti-RVFv immunoglobulin G (IgG) antibodies using inhibition IgG enzyme-linked immunosorbent assay (ELISA)...
December 5, 2018: Epidemiology and Infection
Reneé de Waal, Richard Lessells, Anthony Hauser, Roger Kouyos, Mary-Ann Davies, Matthias Egger, Gilles Wandeler
The prevalence of pretreatment resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) is >10% in many low-income countries. As a consequence, several sub-Saharan African countries have implemented, or are considering the introduction of, non-NNRTI-based first-line antiretroviral therapy (ART) for treatment-naïve and treatment-experienced patients. This is occurring at a time when ART programmes are expanding, in response to the World Health Organization guidelines, which recommend ART initiation regardless of CD4 cell count...
November 15, 2018: Journal of Virus Eradication
Johann Steiner, Harald Prüss, Stephan Köhler, Thomas Frodl, Alkomiet Hasan, Peter Falkai
OBJECTIVES: Despite intensive research, schizophrenia and schizoaffective disorders continue to be theoretical constructs that describe clinical syndromes and no pathophysiologically defined diseases. Moreover, there are no clear biomarkers at hand. Therefore, these diagnoses are still set up based on clinical ICD-10 / DSM-5 criteria and the exclusion of alcohol- / drug-associated, systemic or other brain organic causes. METHODS: Recently, autoimmune encephalitis with psychotic symptoms caused by specific antineuronal antibodies has been identified as rare, but potentially treatable differential diagnosis...
December 4, 2018: World Journal of Biological Psychiatry
Jinzhong Ma, Yong Xu, Jürgen Kurths, Haiyan Wang, Wei Xu
Early-warning signals for imminent regime shifts in multi-stable systems are highly desirable because it is often difficult to revert a system to the previous state once a transition has occurred. In this paper, two indicators, the phase lag and amplitude difference of the system's response, are extended to detect early-warning signals of a periodically driven, bistable complex system with noise. Our results show that both indicators can announce a regime shift of a complex system with small noise, namely, the critical point of the regime shift near a bifurcation point of the corresponding deterministic system...
November 2018: Chaos
Miguel Antonio Salazar, Ronald Law, Volker Winkler
The Zamboanga armed conflict was a 19-day long encounter in the Philippines in 2013 that displaced 119,000 people from their homes. This study describes the health consequences of this complex emergency in different age groups, time periods, and health facilities using data from Surveillance in Post Extreme Emergencies and Disasters (SPEED). This is a descriptive study of the SPEED database spanning 196 days of observation post-disaster and 1065 SPEED reports from 49 health facilities. Evacuation centers and village health centers, both primary care facilities, had the highest number of consults...
November 29, 2018: International Journal of Environmental Research and Public Health
Norohasina Rakotoarison, Nirivololona Raholijao, Lalao Madeleine Razafindramavo, Zo Andrianina Patrick Herintiana Rakotomavo, Alain Rakotoarisoa, Joy Shumake Guillemot, Zazaravaka Jacques Randriamialisoa, Victor Mafilaza, Voahanginirina Anne Marie Pierrette Ramiandrisoa, Rhino Rajaonarivony, Solonomenjanahary Andrianjafinirina, Venance Tata, Manuela Christophère Vololoniaina, Fanjasoa Rakotomanana, Volahanta Malala Raminosoa
Madagascar is cited as one of the most vulnerable countries to the effects of climate change, with significant impacts to the health of its population. In this study, the vulnerability of Madagascar's health sector to climate change was assessed and appropriate adaptation measures were identified. In order to assess climate risks, vulnerability and identify adaptation options, the Madagascar Ministry of Public Health as well as the National Meteorological and Hydrological Service worked in close collaboration with a team of local experts to conduct a literature review, field surveys, and analyses of current and future climate and health trends...
November 26, 2018: International Journal of Environmental Research and Public Health
Aleksandra Trajkovska, Munawar Farooq, Drew Richardson
OBJECTIVE: To assess utility and accuracy of general observation modified early warning score charts; and compare sensitivity and specificity of single- and multiple-parameter-based trigger scores on patient outcomes in the ED. METHODS: Retrospective cohort clinical audit of all adult Modified Early Warning Score charts in the ED of a mixed tertiary hospital over 4 weeks. Data extracted included recorded parameters required to calculate Modified Early Warning Score and evidence of response...
November 28, 2018: Emergency Medicine Australasia: EMA
Alexey Clara, Anh T P Dao, Trang T Do, Phu D Tran, Quang D Tran, Nghia D Ngu, Tu H Ngo, Hung C Phan, Thuy T P Nguyen, Christina Bernadotte-Schmidt, Huyen T Nguyen, Karen Ann Alroy, S Arunmozhi Balajee, Anthony W Mounts
Community event-based surveillance aims to enhance the early detection of emerging public health threats and thus build health security. The Ministry of Health of Vietnam launched a community event-based surveillance pilot program in 6 provinces to improve the early warning functions of the existing surveillance system. An evaluation of the pilot program took place in 2017 and 2018. Data from this evaluation were analyzed to determine which factors were associated with increased detection and reporting. Results show that a number of small, local events were detected and reported through community event-based surveillance, supporting the notion that it would also facilitate the rapid detection and reporting of potentially larger events or outbreaks...
2018: Health Security
M Schmedding, B R Adegbite, S Gould, J O Beyeme, A A Adegnika, M P Grobusch, M A M Huson
The quick sequential organ failure assessment (qSOFA) score has been proposed for risk stratification of emergency room patients with suspected infection. Its use of simple bedside observations makes qSOFA an attractive option for resource-limited regions. We prospectively assessed the predictive ability of qSOFA compared with systemic inflammatory response syndrome (SIRS), universal vital assessment (UVA), and modified early warning score (MEWS) in a resource-limited setting in Lambaréné, Gabon. In addition, we evaluated different adaptations of qSOFA and UVA in this cohort and an external validation cohort from Malawi...
November 26, 2018: American Journal of Tropical Medicine and Hygiene
Mengyue Guo, Wenjun Jiang, Jiaoyang Luo, Meihua Yang, Xiaohui Pang
Ziziphi Spinosae Semen (ZSS) has been widely used in traditional Chinese medicine system for decades. Under proper humidity and temperature, ZSS is easily contaminated by fungi and mycotoxins during harvest, storage, and transport, thereby posing a considerable threat to consumer health. In this study, we first used the Illumina MiSeq PE250 platform and targeted the internal transcribed spacer 2 sequences to investigate the presence of fungi in moldy and normal ZSS samples collected from five producing areas in China...
November 25, 2018: Toxins
Ren Zhong, Yongsheng Wu, Yunpeng Cai, Ruxin Wang, Jing Zheng, Denan Lin, Hongyan Wu, Ye Li
Hand, foot, and mouth disease (HFMD) is caused by a group of enteroviruses. It infects millions of children in the Southeast Asian area. An accurate forecasting of outbreaks of HFMD could facilitate public health officials to suggest public health actions earlier. Many researchers tried to develop an early warning system for HFMD to lower the damage caused by a HFMD outbreak. The research data based on daily level could help figure out the relationship between HFMD and environmental factors, but nevertheless is difficult to collect...
2018: Bioscience Trends
Claus Sixtus Jensen, Hanne Vebert Olesen, Hanne Aagaard, Marie Louise Overgaard Svendsen, Hans Kirkegaard
PURPOSE: Pediatric early warning systems (PEWS) are used to detect clinical deterioration in hospitalized children. Few PEWSs have been validated in multicenter studies and the performance in many single-center studies varies. We wanted to compare two PEWS in a multicenter study. DESIGN AND METHODS: Randomized multicenter unblinded trial conducted at all pediatric departments in the Central Denmark Region. A random sample of 16,213 pediatric patients (31,337 admissions) were enrolled from November 2014 to March 2017...
November 21, 2018: Journal of Pediatric Nursing
Omar A Usman, Asad A Usman, Michael A Ward
OBJECTIVES: The increasing use of sepsis screening in the Emergency Department (ED) and the Sepsis-3 recommendation to use the quick Sepsis-related Organ Failure Assessment (qSOFA) necessitates validation. We compared Systemic Inflammatory Response Syndrome (SIRS), qSOFA, and the National Early Warning Score (NEWS) for the identification of severe sepsis and septic shock (SS/SS) during ED triage. METHODS: This was a retrospective analysis from an urban, tertiary-care academic center that included 130,595 adult visits to the ED, excluding dispositions lacking adequate clinical evaluation (n = 14,861, 11...
November 7, 2018: American Journal of Emergency Medicine
El-Hacen M El-Hacen, Tjeerd J Bouma, Gregory S Fivash, Amadou Abderahmane Sall, Theunis Piersma, Han Olff, Laura L Govers
The theory of critical slowing down, i.e. the increasing recovery times of complex systems close to tipping points, has been proposed as an early warning signal for collapse. Empirical evidence for the reality of such warning signals is still rare in ecology. We studied this on Zostera noltii intertidal seagrass meadows at their southern range limit, the Banc d'Arguin, Mauritania. We analyse the environmental covariates of recovery rates using structural equation modelling (SEM), based on an experiment in which we assessed whether recovery after disturbances (i...
November 22, 2018: Scientific Reports
Ihsan Ullah, Muhammad Bilal Qureshi, Uzair Khan, Sufyan Ali Memon, Yifang Shi, Dongliang Peng
A localization and tracking algorithm for an early-warning tracking system based on the information fusion of Infrared (IR) sensor and Laser Detection and Ranging (LADAR) is proposed. The proposed Kalman filter scheme incorporates Out-of-Sequence Measurements (OOSMs) to address long-range, high-speed incoming targets to be tracked by networked Remote Observation Sites (ROS) in cluttered environments. The Rauch⁻Tung⁻Striebel (RTS) fixed lag smoothing algorithm is employed in the proposed technique to further improve tracking accuracy, which, in turn, is used for target profiling and efficient filter initialization at the targeted platform...
November 20, 2018: Sensors
Ke Li, Xiao-Rui Wang, Bing-Tao Guo, Wei-Guo Zhang, Hang Yuan, Xiong-Xiong Wu, Chen Zhao
The accurate generation of infrared (IR) imaging features of subpixel targets plays a very important role in the demonstration, verification, and optimization of system design schemes as well as in research into detection algorithms for small targets in the development of remote IR early warning systems. Based on the generation mechanism of target full-link IR imaging features, this study theoretically considers target radiation characteristics, the working environment, and the spatial response and energy-conversion characteristics of IR sensors, and an accurate deduction model of IR imaging features of subpixel targets is proposed and established...
November 1, 2018: Applied Optics
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