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The determinants of infant mortality in Malaysia: a graphical chain modelling approach

Mohamed WN, Diamond I, Smith PW

J R Stat Soc Ser A Stat Soc, 1998;161(3):349-66.
PMID: 12348725

"A graphical chain modelling approach is used to study the determinants of neonatal and post-neonatal mortality in Malaysia. This approach provides an easily interpretable empirical description and illustrates explicitly the conditional independence structure between each pair of variables. The interpretation can be read directly from a mathematical graph. Besides examining the direct association of each determinant on mortality, we also examine the effects of socio-economic determinants on intermediate determinants to understand the pathways through which the socioeconomic determinants affect the chance of mortality. The data anlaysed come from the second Malaysian Family Life Survey, fielded between August 1988 and January 1989. "
Migration of women to cities: the Asian situation in comparative perspective

Khoo SE, Smith PC, Fawcett JT

Int Migr Rev, 1984;18(4 Special Issue):1247-63.
PMID: 12340237
Spray coverage and pest management efficacy of a solid set canopy delivery system in high density apples

Owen-Smith P, Perry R, Wise J, Jamil RZR, Gut L, Sundin G, et al.

Pest Manag Sci, 2019 Nov;75(11):3050-3059.
PMID: 30895726 DOI: 10.1002/ps.5421

BACKGROUND: Air blast sprayers are not optimized for spraying the short statured trees in modern apple orchards, resulting in off target drift and variable coverage. A solid set canopy delivery system (SSCDS) consisting of a microsprayer array distributed throughout the orchard was investigated as a replacement agrochemical application method in this study. SSCDS's have the potential to optimize coverage, rapidly spray applications, and remove the operator and tractor from the orchard.
RESULTS: Air blast and SSCDS applications were compared using water sensitive paper, bioassays, and pest damage assessments. Pest management and coverage were compared using application volumes of 700 and 795 L ha-1 , respectively. In 2013, adaxial coverage measurements showed no difference between the treatments, but air blast sprayers had higher coverage levels on the abaxial surfaces. There were no significant differences in coverage in 2014. Bioassays using Choristoneura rosaceana fed on leaf discs treated by the SSCDS displayed 95.8% mortality in 2013 and 94.2% mortality in 2014, and air blast treated larval mortality was 95% in 2013 and 100% in 2014. Damage evaluations in both years generally showed no significant differences between the air blast plots and the SSCDS plots, but significant differences between the treated plots and untreated control.
CONCLUSIONS: The prototype SSCDS was an effective pest management tool in high density apples, and offered a number of advantages over an air blast. Further engineering and research into coverage optimization would offer producers a novel tool for foliar agrochemical applications. © 2019 Society of Chemical Industry.
Fulltext Cost-Utility Analysis of Optimal Dosing of Oseltamivir Under Pandemic Influenza Using a Novel Approach: Linking Health Economics and Transmission Dynamic Models

Wu DB, Chaiyakunapruk N, Pratoomsoot C, Lee KK, Chong HY, Nelson RE, et al.

Value Health, 2014 Nov;17(7):A807.
PMID: 27203045 DOI: 10.1016/j.jval.2014.08.527
Fulltext Biogeographical variation in specific IgE recognition of temperate and subtropical grass pollen allergens in allergic rhinitis patients

Kailaivasan TH, Timbrell VL, Solley G, Smith WB, McLean-Tooke A, van Nunen S, et al.

Clinical & translational immunology, 2020;9(2):e01103.
PMID: 32025301 DOI: 10.1002/cti2.1103

Objective: Globally, grass pollens (GP) are major aeroallergen triggers of allergic rhinitis (AR) and asthma. However, patterns of allergic sensitisation to pollen of temperate (Pooideae: Lolium perenne) and subtropical (Chloridoideae: Cynodon dactylon and Panicoideae: Paspalum notatum) subfamilies in diverse climates remain unclear. This study aims to evaluate the level of allergic sensitisation and IgE specificity for major GP allergens representing the three subfamilies in biogeographically distinct regions.
Methods: Participants (GP-allergic with AR, 330; non-atopic, 29; other allergies, 54) were recruited in subtropical: Queensland, and temperate: New South Wales, Western and South Australia, regions. Clinical history, skin prick test (SPT), total and specific IgE to GP and purified allergens (ImmunoCAP) were evaluated. Cross-inhibition of sIgE with Pas n 1, Cyn d 1 and Lol p 1 by GP extracts was investigated.
Results: Queensland participants showed higher sensitisation to P. notatum and C. dactylon than L. perenne GP. sIgE was higher to Pas n 1 and Cyn d 1, and sIgE to Pas n 1 and Cyn d 1 was inhibited more by Panicoideae and Chloridoideae, respectively, than Pooideae GP. Conversely, participants from temperate regions showed highest sensitisation levels to L. perenne GP and Lol p 1, and sIgE to Lol p 1 was inhibited more by Pooideae than other GP.
Conclusion: Levels and patterns of sensitisation to subtropical and temperate GP in AR patients depended on biogeography. Knowledge of the specificity of sensitisation to local allergens is important for optimal diagnosis and choice of allergen-specific immunotherapy to maximise benefit.
Cost-utility analysis of antiviral use under pandemic influenza using a novel approach - linking pharmacology, epidemiology and heath economics

Wu DBC, Chaiyakunapruk N, Pratoomsoot C, Lee KKC, Chong HY, Nelson RE, et al.

Epidemiol Infect, 2018 03;146(4):496-507.
PMID: 29446343 DOI: 10.1017/S0950268818000158

Simulation models are used widely in pharmacology, epidemiology and health economics (HEs). However, there have been no attempts to incorporate models from these disciplines into a single integrated model. Accordingly, we explored this linkage to evaluate the epidemiological and economic impact of oseltamivir dose optimisation in supporting pandemic influenza planning in the USA. An HE decision analytic model was linked to a pharmacokinetic/pharmacodynamics (PK/PD) - dynamic transmission model simulating the impact of pandemic influenza with low virulence and low transmissibility and, high virulence and high transmissibility. The cost-utility analysis was from the payer and societal perspectives, comparing oseltamivir 75 and 150 mg twice daily (BID) to no treatment over a 1-year time horizon. Model parameters were derived from published studies. Outcomes were measured as cost per quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to examine the integrated model's robustness. Under both pandemic scenarios, compared to no treatment, the use of oseltamivir 75 or 150 mg BID led to a significant reduction of influenza episodes and influenza-related deaths, translating to substantial savings of QALYs. Overall drug costs were offset by the reduction of both direct and indirect costs, making these two interventions cost-saving from both perspectives. The results were sensitive to the proportion of inpatient presentation at the emergency visit and patients' quality of life. Integrating PK/PD-EPI/HE models is achievable. Whilst further refinement of this novel linkage model to more closely mimic the reality is needed, the current study has generated useful insights to support influenza pandemic planning.
Fulltext Knowledge, Attitudes, and Perceptions Associated With Antimicrobial Stewardship Among Veterinary Students: A Multi-Country Survey From Nigeria, South Africa, and Sudan

Fasina FO, LeRoux-Pullen L, Smith P, Debusho LK, Shittu A, Jajere SM, et al.

Front Public Health, 2020;8:517964.
PMID: 33194938 DOI: 10.3389/fpubh.2020.517964

In African countries, antimicrobial resistance (AMR) issue remains pertinent. Despite this, little efforts have been made to assess the future veterinary prescribers on their knowledge, attitudes and practices (KAP) related to antimicrobial usage. This multi-country survey attempts to explore the KAP of future veterinarians on stewardship of antimicrobial and identify knowledge gaps. Eight veterinary schools participated from Nigeria, Sudan and South Africa. Data regarding perceptions and knowledge were analyzed using Chi-square χ2 test, Spearman's (Rho) Rank order correlation and factor analysis using principal component factoring extraction method. Fifty-two percent of the study participants were final year veterinary students, respectively, and majority (77.2%) had no previous knowledge of biomedical sciences. Majority age were 22-27 years (24.7 ± 2.8) 79% and multiple career fields post-graduation were preferred. Overall, poor perceptions and knowledge of antimicrobial stewardship were observed with variations among countries and only 36.3% (n = 123) of the students were confident in their ability to choose the ideal antimicrobial agents for a specific patient/group of animals. The majority of the final year students were confident of their knowledge regarding AMR (68%), making of Gram staining (69.2%) and in choosing the most ideal route for administering a specific antimicrobial (74.7%). The final year students had significantly (p < 0.05) higher confidence level for knowledge compared with the pre-final year students. Tetracyclines, penicillins, and sulphonamides represent the three most abused veterinary antimicrobials with similar ranking across countries. South African (69.7 ± 20.5) and Sudanese (68.1 ± 15.4) had significantly (p < 0.0001) higher mean scores compared to the Nigerian students (44.3 ± 6.8) in the student's ability to correctly match some specific antimicrobials against their classes but Nigerian students performed better in ranking antimicrobials. This survey revealed poor to average knowledge of antimicrobial stewardship among veterinary students with significant knowledge gaps across the countries. It is recommended that the relevant regulatory and standardization authorities should make concerted efforts and interventions to regularly review curricula to ensure the delivery of targeted formative and normative training, and improved lectures on antimicrobial usage and stewardship in order to improve the awareness and behaviors of future prescribers. The identified knowledge gaps of veterinary medical students on antimicrobial stewardship must be bridge to safeguard the future.
Fulltext General neurology: Current challenges and future implications

Bassetti CLA, Accorroni A, Arnesen A, Basri HB, Berger T, Berlit P, et al.

Eur J Neurol, 2024 Jun;31(6):e16237.
PMID: 38545838 DOI: 10.1111/ene.16237

BACKGROUND AND PURPOSE: In the coming decades, the world will face an increasing burden of neurological disorders (ND) and an urgent need to promote brain health. These challenges contrast with an insufficient neurological workforce in most countries, as well as decreasing numbers of general neurologists and neurologists attracted to work in general neurology (GN). This white paper aims to review the current situation of GN and reflect on its future.
METHODS: The European Academy of Neurology (EAN) task force (TF) met nine times between November 2021 and June 2023. During the 2023 EAN annual meeting, attendees were asked to answer five questions concerning the future of GN. The document was sent for suggestions and eventually approval to the board and the presidents of the 47 national societies of the EAN.
RESULTS: The TF first identified four relevant current and future challenges related to GN: (i) definition, (ii) practice, (iii) education, and (iv) research. The TF then identified seven initiatives to further develop GN at both the academic and community level. Finally, the TF formulated 16 recommendations to promote GN in the future.
CONCLUSIONS: GN will remain essential in the coming decades to provide rapid, accessible, and comprehensive management of patients with ND that is affordable and cost-effective. There is also a need for research, education, and other initiatives aiming to facilitate improved working conditions, recognition, and prestige for those pursuing a career in GN.
Fulltext Setting research priorities for global respiratory medicine within the National Institute for Health Research (NIHR) Global Health Research Unit in Respiratory Health (RESPIRE)

Rudan I, Agrawal D, Hussein N, Cheong AT, Cunningham S, Dockerell D, et al.

J Glob Health, 2018 Dec;8(2):0201314.
PMID: 30603076 DOI: 10.7189/jogh.08.020314