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Open source Geographic Information System (GIS) have been fostering spatial data research such as Earth observation and environmental monitoring for more than 30 years. More recently, globally available geospatial information combined with web technologies are providing new environments and tools for data handling. Thus, binding the mapping and processing capabilities of traditional GIS to the accessibility and reliability of web-based data providers can bring new opportunities for research. In this paper, we built a QGIS plugin to explore the integration of different public data providers in Brazil along with field data produced by the BONDS project. The biOdiversity conservatioN with Development in Amazon wetlandS project (BONDS) proposes to develop biodiversity scenarios for the Amazonian floodplains aiming to support solutions to preserve biodiversity and ecosystem services. The use of web services enabled dynamic and fast access to several products ranging from remote sensing images, land use and land cover, territorial cartography, water quality, to COVID-19 health data, and more. © 2022 National Institute for Space Research, INPE. All rights reserved.
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Introduction Diagnosis delay leads to an increased risk of coronary artery aneurysms in Kawasaki disease. In multisystem inflammatory syndrome in children (MIS-C), diagnosis delay could worsen heart failure. Objective This study aims to test the hypothesis that a long time to diagnosis is associated with heart failure severity in MIS-C. Methods A retrospective single-center observational study was conducted between May 2020 and April 2022. Children with a MIS-C diagnosis meeting WHO criteria were included. A long time to diagnosis was defined as 6 days or more. Outcomes were assessed on severity of heart failure, including peak NT-proBNP, minimal left ventricular ejection fraction (LVEF) and need for inotropes (dobutamine, milrinone, adrenaline). Results Thirty-two children were included in the study. One child was excluded due to previous vaccination against COVID-19. The median age [1st–3rd interquartile range] was 8 [5–10] years old. The median time to diagnosis was 5.3 [4.0–6.3] days. Children with a long time to diagnosis (n=13), compared with those with a short time to diagnosis (n=18), had a higher peak NT-proBNP (22304 [13859–47889] ng/L versus 5555 [2384–10227] ng/L, respectively, P<0.001), lower LVEF (40 [30–50] % versus 45 [45-55,5] %, respectively, P=0.02), and were more often treated with inotropes (8 children (57%) versus 0 child (0%) respectively, P<0.001). Conclusion Diagnosis delay is associated with heart failure severity in MIS-C. Early diagnosis and treatment are crucial to avoid the use of inotropes and limit morbidity.
ABSTRACT
Tuberculous meningitis (TBM) is the most severe and disabling form of tuberculosis (TB), with at least 100,000 cases per year and a mortality rate of up to 50% in individuals co-infected with human immunodeficiency virus type 1 (HIV-1). To evaluate the efficacy and safety of an intensified anti-tubercular regimen and an anti-inflammatory treatment, the INTENSE-TBM project includes a phase III randomised clinical trial (TBM-RCT) in four countries in sub-Saharan Africa (SSA). Within this framework, we designed a comprehensive capacity-building work package ensuring all centres had, or would acquire, the ability to conduct the TBM-RCT and developing a network of skilled researchers, clinical centres and microbiology laboratories. Here, we describe these activities, identify strengths/challenges and share tools adaptable to other projects, particularly in low- and lower-middle income countries with heterogeneous settings and during the coronavirus disease 2019 (COVID-19) pandemic. Despite major challenges, TBM-RCT initiation was achieved in all sites, promoting enhanced local healthcare systems and encouraging further clinical research in SSA. In terms of certified trainings, the achievement levels were 95% (124/131) for good clinical practice, 91% (39/43) for good clinical laboratory practice and 91% (48/53) for infection prevention and control. Platform-based research, developed as part of capacity-building activities for specific projects, may be a valuable tool in fighting future infectious diseases and in developing high-level research in Africa.
The INTENSE-TBM project aimed to design a comprehensive work-package on capacity building, ensuring all centres would acquire the ability to conduct a phase III randomised clinical trial on TBM in sub-Saharan Africa, to reduce tuberculous meningitis mortality and morbidity in patients with/without HIV-1 co-infection. Therefore, the INTENSE-TBM project is an example of how an international clinical research consortium can provide opportunities to enhance local capacity building and promote centres without previous experience in clinical research. This article provides practical approaches for implementing effective capacity-building programmes. We highlight how to overcome limitations imposed by the COVID-19 pandemic to successfully complete clinics, laboratory set-ups and personnel training, so as to optimise resources and empower African institutions on a local level. At the same time, our experience shows how capacity-building programmes can deliver long-lasting impact that extends beyond the original aims of the project (e.g. HIV and TB), and support local health systems in fighting other infectious disease (e.g. COVID-19). Research projects in low- and lower-middle income countries with heterogeneous settings could stand to benefit the most.
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Nursing homes were particularly impacted by the COVID-19 pandemic during the two waves of contamination in 2020. Caregivers had no previous support and knowledge to think this crisis. The confinement, the sanitary rules came to reinforce the split between the external world and the interior of these establishments. Everyone was active, in an almost maniacal movement, to reject the death's anxiety. It is in a transitional space between inside and outside that the role and the practice of the psychologist have found their full meaning, by trying to maintain a fragile link with the familiar. From a clinical situation illustrating the evolution of the link between an elderly resident in nursing home, Mrs. O. and her daughter, this article attempts to show how the psychologist needs to reorient his intervention framework, by flirting with limits of it. Not only did this crisis provide irrefutable proof of our vulnerability, but it also allowed us to exploit new resources in our practices. © 2022 Les établissements d'hébergement pour personnes âgées dépendantes (Ehpad) ont été particulièrement touchés par la pandémie de COVID-19 lors des deux vagues de contamination de 2020. L'ensemble du personnel n'avait aucun appui antérieur et connu pour penser cet état de crise. Le confinement, les règles sanitaires sont venus renforcer la scission entre le monde extérieur et l'intérieur de ces établissements où tous s'activaient, dans un mouvement quasi maniaque, à rejeter les angoisses de mort. C'est dans un espace transitionnel à créer entre dedans et dehors que la pratique du psychologue a trouvé tout son sens en tentant de maintenir un lien fragile avec le familier. À partir d'une situation clinique illustrant l’évolution du lien entre une résidente âgée en Ehpad, madame O. et sa fille, cet article s'emploie à montrer que cette épreuve inédite a forcé le psychologue, non seulement à réorienter son cadre d'intervention, mais à flirter un peu plus avec les contours et les limites de celui-ci. Cette crise nous a apporté non seulement la preuve irréfutable de notre vulnérabilité, mais elle nous a aussi permis d'exploiter un panel de ressources nouvelles dans nos pratiques. © 2022
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Résumé Les établissements d’hébergement pour personnes âgées dépendantes (Ehpad) ont été particulièrement touchés par la pandémie de COVID-19 lors des deux vagues de contamination de 2020. L’ensemble du personnel n’avait aucun appui antérieur et connu pour penser cet état de crise. Le confinement, les règles sanitaires sont venus renforcer la scission entre le monde extérieur et l’intérieur de ces établissements où tous s’activaient, dans un mouvement quasi maniaque, à rejeter les angoisses de mort. C’est dans un espace transitionnel à créer entre dedans et dehors que la pratique du psychologue a trouvé tout son sens en tentant de maintenir un lien fragile avec le familier. À partir d’une situation clinique illustrant l’évolution du lien entre une résidente âgée en Ehpad, madame O. et sa fille, cet article s’emploie à montrer que cette épreuve inédite a forcé le psychologue, non seulement à réorienter son cadre d’intervention, mais à flirter un peu plus avec les contours et les limites de celui-ci. Cette crise nous a apporté non seulement la preuve irréfutable de notre vulnérabilité, mais elle nous a aussi permis d’exploiter un panel de ressources nouvelles dans nos pratiques. Nursing homes were particularly impacted by the COVID-19 pandemic during the two waves of contamination in 2020. Caregivers had no previous support and knowledge to think this crisis. The confinement, the sanitary rules came to reinforce the split between the external world and the interior of these establishments. Everyone was active, in an almost maniacal movement, to reject the death's anxiety. It is in a transitional space between inside and outside that the role and the practice of the psychologist have found their full meaning, by trying to maintain a fragile link with the familiar. From a clinical situation illustrating the evolution of the link between an elderly resident in nursing home, Mrs. O. and her daughter, this article attempts to show how the psychologist needs to reorient his intervention framework, by flirting with limits of it. Not only did this crisis provide irrefutable proof of our vulnerability, but it also allowed us to exploit new resources in our practices.
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Background: Especially during the COVID-19 pandemic, implementation and development of whole slide scanning lead to an active growth of digital pathology and image analysis (IA). In the present study, we retrospectively conducted a global evaluation of three Breast cancer markers: ER, PR and Ki67 with the aim to study the correlation between pathologist conventional semi quantitative scoring method on glass and scanned slides versus artificial intelligence-based IA. Methods: Study samples were scored independently either by five independent pathologists on scanned images and glass slides, or using supervised IA algorithms (IA results validated by pathologists). The readout for the three markers was the percentage of tumor positives stained cells. The correlation between the pathologist evaluation on glass slides versus scanned images was calculated using Pearson’s correlation coefficient. Pathologist’s evaluations and IA results were compared using Intraclass Correlation Coefficient (ICC). Additionally, the average time spent by the pathologist per sample was measured for each evaluation method. Results: The correlation of pathologist evaluation between glass slide and scanned image showed a Pearson’s correlation coefficient ≥ 0.90 for each marker. The ICC between IA algorithm and pathologist was on average over 0.8 for the three markers, showing a good agreement between the different scoring method. However, some challenges were identified related to the detection of tumor area that needed some additional pathologist review for specific complex cases. Overall, time required by the pathologist for a complete evaluation decreased by roughly 3 times when supported by image analysis tools. Conclusions: Based on the Pearson’s correlation coefficient and the ICC results, we observe an equivalence in the pathologist conventional scoring (Image or glass slides) and the use of IA. In an era where regulations are still being discussed for the use of algorithm by the FDA (AI-Based or not), we can mitigate regulatory requirements by having pathologists reviewing the results of a digital analysis. We conclude here to a benefit from the combination of pathologist evaluation and IA in terms of time with at least equivalent results in terms of accuracy. Legal entity responsible for the study: Covance. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
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Background and importance The COVID-19 epidemic led to a reduction in travel for fragile patients to the hospital's pharmacy in our teaching hospital. We applied the ministerial procedure which ensured the continuity of patient treatment by delivering drugs to the patient's pharmacy of their choice.1 Aim and objectives This was enabled in Reims by means of an email address used by pharmacies to send prescriptions to the hospital pharmacy.2 Based on a questionnaire of satisfaction intended for patients and pharmacies, we evaluated this system, set up from 23 March to 10 July 2020. Material and methods We conducted a prospective satisfaction survey of patients and pharmacies who participated in the hospital-city ministerial procedure. Data collection was carried out by telephone for patients and by an anonymised questionnaire for pharmacies. The criteria evaluated were the quality of the service, speed of delivery, if treatment was interrupted, difficulties in supplying the treatment, need for advice and overall satisfaction (score out of 10). Results 134 patients and 52 pharmacies participated in the study. 186 dispensations were performed (27% of activity). 95% of patients and 96% of pharmacies judged the quality of the information as satisfactory. The speed of the procedure was satisfactory (96% for pharmacies and 90% for patients). 92% of pharmacies did not have any supply problems and there were four treatment breaks during the study period. The average overall satisfaction rating for pharmacies was 8.5/ 10. 89% of pharmacies were in favour of continuing the procedure and 90% considered that it was involved in strengthening the city-hospital link. Conclusion and relevance The results tended towards a high overall satisfaction rate. However, the occurrence of treatment breaks and lower patient satisfaction with the speed of treatment delivery (90%) are areas for improvement. While making the procedure more flexible and improving the delivery of treatment, patients and pharmacies have expressed a desire to continue the procedure, which is deemed more practical and beneficial for strengthening the city-hospital link.
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The ID NOW COVID-19 assay is a promising tool for the rapid identification of COVID-19 patients. However, its performances were questioned. We evaluate the ID NOW COVID-19 in comparison to a reference RT-PCR using a collection of 48 fresh nasopharyngeal swabs sampled on universal transport media (UTM). Only 2 false negatives of the ID NOW COVID-19 were identified. They display PCR cycle threshold values of 37.5 and 39.2. The positive percent agreement and the negative percent agreement were 94.9% and 100%, respectively. The Kappa value was 0.88. The ID NOW COVID-19 combines high-speed and accurate processing. Using UTM, the ID NOW COVID-19 could be repeated in the case of invalid result. Further analyses, such as screening of genetic variants or genome sequencing, could also be performed with the same sample. As for all tests, the results should be interpreted according to clinical and epidemiological context.