Matteelli A.,University of Brescia |
Schlagenhauf P.,University of Zürich |
Carvalho A.C.C.,University of Brescia |
Davis X.M.,Centers for Disease Control and Prevention |
And 7 more authors.
The Lancet Infectious Diseases | Year: 2013
Background: Travel is thought to be a risk factor for the acquisition of sexually transmitted infections (STIs), but no multicentre analyses have been done. We aimed to describe the range of diseases and the demographic and geographical factors associated with the acquisition of travel-related STIs through analysis of the data gathered by GeoSentinel travel medicine clinics worldwide. Methods: We gathered data from ill travellers visiting GeoSentinel clinics worldwide between June 1, 1996, and Nov 30, 2010, and analysed them to identify STIs in three clinical settings: after travel, during travel, or immigration travel. We calculated proportionate morbidity for each of the three traveller groups and did logistic regression to assess the association between STIs and demographic, geographical, and travel variables. Findings: Our final analysis was of 112 180 ill travellers-64 335 patients seen after travel, 38 287 patients seen during travel, and 9558 immigrant patients. 974 patients (0·9%) had diagnoses of STIs, and 1001 STIs were diagnosed. The proportionate STI morbidities were 6·6, 10·2, and 16·8 per 1000 travellers in the three groups, respectively. STIs varied substantially according to the traveller category. The most common STI diagnoses were non-gonococcal or unspecified urethritis (30·2%) and acute HIV infection (27·6%) in patients seen after travel; non-gonococcal or unspecified urethritis (21·1%), epididymitis (15·2%), and cervicitis (12·3%) in patients seen during travel; and syphilis in immigrant travellers (67·8%). In ill travellers seen after travel, significant associations were noted between diagnosis of STIs and male sex, travelling to visit friends or relatives, travel duration of less than 1 month, and not having pretravel health consultations. Interpretation: The range of STIs varies substantially according to traveller category. STI preventive strategies should be particularly targeted at men and travellers visiting friends or relatives. Our data suggest target groups for pretravel interventions and should assist in post-travel screening and decision making. Funding: US Centers for Disease Control and Prevention, and International Society of Travel Medicine. © 2013 Elsevier Ltd.
Tinley K.E.,Creighton University |
Loughlin A.M.,Center for Pediatric and Vaccine Research |
Jepson A.,Inverness Medical |
Barnett E.D.,Maxwell Laboratory
American Journal of Tropical Medicine and Hygiene | Year: 2010
Rapid determination of glucose-6-phosphate dehydrogenase (G6PD) status is desirable when it is necessary to use a drug contraindicated in G6PD-deficient persons, such as use of primaquine for malaria prevention or treatment. The purpose of this study was to compare a new, rapid, qualitative enzyme chromatographic test for deficiency of G6PD to a standard reference method. Samples from 196 G6PD-normal persons and 50 G6PD-deficient persons were evaluated. The sensitivity of the experimental rapid test was 0.98 and the specificity was 0.98 using specimens preserved in heparin, and 0.98 and 0.97, respectively, for specimens preserved in EDTA. Positive and negative predictive values were 0.72 and 1.00, respectively, for the test for heparinized specimens and 0.65 and 1.00, respectively, for the EDTA-preserved samples. This rapid test for G6PD deficiency is a sensitive method for screening of G6PD deficiency that requires minimal training and equipment and enables rapid identification of G6PD-deficient persons. Copyright ©2010 by The American Society of Tropical Medicine and Hygiene.
Hagmann S.,Yeshiva University |
Neugebauer R.,Columbia University |
Schwartz E.,Tel Aviv University |
Perret C.,Pontifical Catholic University of Chile |
And 3 more authors.
Pediatrics | Year: 2010
OBJECTIVE: By using a large, multicenter database, we investigated the characteristics and morbidities of 1591 children returning from 218 global destinations and presenting for care in 19 countries. METHODS: Data reported to the GeoSentinel Surveillance Network between January 1997 and November 2007 were analyzed, to assess demographic features, travel characteristics, and clinical diagnoses of ill pediatric travelers. Data were compared between children and adults and among 3 pediatric age groups (0-5 years, 6-11 years, and 12-17 years). RESULTS: Children were predominantly tourist travelers returning from Asia, sub-Saharan Africa, or Latin America. Compared with adults, children disproportionately presented within 7 days after return, required hospitalization, lacked pretravel health advice, and had traveled for the purpose of visiting friends and relatives. Diarrhea (28%), dermatologic conditions (25%), systemic febrile illnesses (23%), and respiratory disorders (11%) accounted for the majority of diagnoses reported for children. No fatalities were reported. Diarrhea occurred disproportionately among children after exposure to the Middle East/North Africa, dermatologic conditions after exposure to Latin America, systemic febrile illnesses after exposure to sub-Saharan Africa or Asia, and respiratory disorders after exposure to Europe or North America. The proportionate morbidity rates of travel-associated diseases differedamongthe pediatric age groups and between children and adults. CONCLUSIONS: The health care utilization patterns before and after travel and the profiles of travel-associated health problems differed between children and adults. Health professionals providing pretravel advice need to consider destination- and age-specific susceptibility to travel-related morbidities and develop prevention strategies accordingly. © 2010 by the American Academy of Pediatrics.
Pelton S.I.,Maxwell Laboratory
Journal of Adolescent Health | Year: 2016
Invasive meningococcal disease (IMD) caused by Neisseria meningitidis is associated with high morbidity and mortality. Although IMD incidence is highest in infants, a second peak occurs in adolescents/young adults. The incidence of IMD and the predominant disease-causing meningococcal serogroups vary worldwide. Epidemiologic data have guided the development of meningococcal vaccines to reduce the IMD burden. In Europe, serogroup C IMD has been substantially reduced since the introduction of a serogroup C conjugate vaccine. Serogroup B predominates in Europe, although cases of serogroup Y IMD have been increasing in recent years. In the United States, declines in serogroup C and Y disease have been observed in association with the introduction of quadrivalent (serogroups ACWY) meningococcal conjugate vaccines; serogroup B persists and is now the most common cause of outbreak associated disease. In the African meningitis belt, a conjugate vaccine for serogroup A has been effective in decreasing meningitis associated with that serogroup. Outbreaks of the previously rare serogroup X disease have been reported in this region since 2006. In recent years, outbreaks of serogroup B IMD, for which vaccines have only recently been approved by the U.S. Food and Drug Administration and the European Medicines Agency, have occurred in Europe and the United States. Targeting meningococcal vaccination to adolescents/young adults may reduce the morbidity and mortality associated with IMD and has the potential to impact the larger community through herd benefits. © 2016 Society for Adolescent Health and Medicine
Barnett E.D.,Maxwell Laboratory
Current Infectious Disease Reports | Year: 2013
Children are traveling internationally with increasing frequency, and some are traveling at young ages. While excellent sources of information exist about travel vaccines, malaria prevention, and general advice for children, clinicians may face situations where evidence-based recommendations are lacking. This article discusses some common challenging travel vaccine scenarios and approaches to malaria prevention and general travel advice for children. © 2013 Springer Science+Business Media New York.
Sabharwal V.,Maxwell Laboratory |
Figueira M.,Maxwell Laboratory |
Pelton S.I.,Maxwell Laboratory |
Pettigrew M.M.,Yale University
Microbes and Infection | Year: 2012
Increases in colonization with serotypes of Streptococcus pneumoniae not contained within the 7-valent pneumococcal conjugate vaccine (PCV) have been reported among children following introduction. Serotype 6C has emerged as prevalent in nasopharyngeal colonization and acute otitis media (AOM), though it is uncommonly recovered from children with invasive pneumococcal disease. Vaccine serotypes within PCV7 have been replaced by nonvaccine serotypes without significant changes in the overall carriage rate. We hypothesize 1) that serotypes vary in their ability to evade host defenses and establish AOM following colonization and 2) the observed reduction in pneumococcal otitis results from a reduced disease potential by some 'replacement serotypes'. We compared the capacity of S. pneumoniae serotypes 6C and 19A to produce experimental otitis media (EOM) in a chinchilla model. The proportion of chinchillas that developed culture positive EOM and density of middle ear infection was evaluated. EOM was found in 28/82 (34%) ears challenged with 6C compared to 13/18(72.2%) with 19A [. p = 0.0003]. When disease due to 6C did occur, it was characterized by low-density infection. Our findings demonstrate that challenge with serotype 6C results in EOM less frequently than 19A. These data support the need for greater knowledge regarding differences among serotypes to produce AOM. © 2012 Institut Pasteur.
Tinoco J.C.,Maxwell Laboratory |
Raskin J.-P.,Maxwell Laboratory
International Journal of Numerical Modelling: Electronic Networks, Devices and Fields | Year: 2010
The modeling of MOS transistors used for RF applications needs the definition of a lumped equivalent circuit where the intrinsic device and series extrinsic resistances are properly evaluated. The model accuracy depends on the extraction precision of each intrinsic lumped element. In order to determine the intrinsic device behavior, it is necessary to first remove the series extrinsic resistances. For this reason their extraction becomes critical for the modeling of MOS transistors in RF circuit design. Several extraction methods have been proposed; nevertheless, the measurement noise strongly affects the obtained results. The method proposed by Bracale and co-workers is the most robust extraction procedure against measurement noise, but fails to predict correctly the series extrinsic resistances for deep-submicron devices. For those reasons, we deeply analyze the method proposed by Bracale in order to understand and then overcome its limitations. Based on those analyses, a robust extraction method for deep-submicron devices is proposed. © 2009 John Wiley & Sons, Ltd.
Maxwell Laboratory | Date: 2014-03-14
The present invention relates to thermoplastic products. In particular, the present invention relates to systems and methods for providing a thermoplastic product that includes one or more recycled materials. In some non-limiting implementations, the recycled materials are selected from eggshells, slag, solid output from an incinerator, and/or asphalt shingles. In some cases, the recycled materials comprise between about 0.1% and about 95%, by weight, of the thermoplastic product. In some cases, the recycled materials have a particle size between about one inch and about 300 mesh. Other implementations are also described.
Maxwell Laboratory | Date: 2015-07-14
A system includes one or more traffic guidance nodes (TGNs) and one or more mobile traffic navigating entities (TNEs). The traffic guidance nodes transmit updated information about the local traffic to the one or more mobile traffic navigating entities when the one or more mobile traffic navigating entities are within a range of the one or more traffic guidance nodes.
Maxwell Laboratory | Date: 2013-03-01
A memory apparatus comprising a pathway for conducting electrical energy; a plurality of even number of inverters, each inverter having an input and an output, the inverters being arranged along the pathway such that electrical energy from the output of an inverter is directed into the input of an adjacent inverter; a plurality of nodes coupling the inverters in series to form a closed loop to permit stable storage of a memory state by allowing the inverters to dissipate an amount of transient energy from a level that otherwise would result in a failure to below that level in order to maintain a stable memory state.