A study on knowledge, attitude and practice regarding dengue among hospitalized patients from Northern Sri Lanka

Introduction and Objectives Dengue fever is recognized as one of the major vector borne diseases and causes significant morbidity in tropical countries. Thus, evaluation of knowledge, attitude and practices of the population is of great importance to improve integrated control measures. The aim of the study was to assess the level of knowledge, attitude and practices relating to dengue fever in 200 consecutive inward patients treated as having dengue fever in two medical units of Teaching Hospital, Jaffna.Methods A cross-sectional descriptive comparative study was carried out among dengue patients in two medical units of Teaching Hospital, Jaffna from January 2017 to April 2017. Dengue patients were recruited by convenient sampling, interviewed with validated questionnaires to assess their knowledge about dengue fever. Data were analyzed using SPSS (version 21) analytical package.Results Awareness that dengue fever is transmitted by mosquitoes was shown by 97% of respondents. The Media was an important tool to gain information about dengue. Among students, schools played a key role in conveying health information. More than 90% of the study population exhibited health seeking behavior and the majority used paracetamol as a home remedy. Practices regarding preventive methods were predominantly for prevention of mosquito bites in the form of using nets (46%) and mosquito coils (34%), rather than elimination of breeding sites.Conclusions Significant association was found between knowledge about dengue fever and educational level. Although knowledge regarding mosquito control measures was 80%, this knowledge of preventive measures was not demonstrable in practice. A change in the approach of the health education program should be focused based on these findings for effective prevention.program should be focused based on these findings for effective prevention.</p

Clinical history and management recommendations of the smooth muscle dysfunction syndrome due to ACTA2 arginine 179 alterations

Smooth muscle dysfunction syndrome (SMDS) due to heterozygous ACTA2 arginine 179 alterations is characterized by patent ductus arteriosus, vasculopathy (aneurysm and occlusive lesions), pulmonary arterial hypertension, and other complications in smooth muscle-dependent organs. We sought to define the clinical history of SMDS to develop recommendations for evaluation and management. Medical records of 33 patients with SMDS (median age 12 years) were abstracted and analyzed. All patients had congenital mydriasis and related pupillary abnormalities at birth and presented in infancy with a patent ductus arteriosus or aortopulmonary window. Patients had cerebrovascular disease characterized by small vessel disease (hyperintense periventricular white matter lesions; 95%), intracranial artery stenosis (77%), ischemic strokes (27%), and seizures (18%). Twelve (36%) patients had thoracic aortic aneurysm repair or dissection at median age of 14 years and aortic disease was fully penetrant by the age of 25 years. Three (9%) patients had axillary artery aneurysms complicated by thromboembolic episodes. Nine patients died between the ages of 0.5 and 32 years due to aortic, pulmonary, or stroke complications, or unknown causes. Based on these data, recommendations are provided for the surveillance and management of SMDS to help prevent early-onset life-threatening complications

Systematic categorization of optimization strategies for virtual power plants

Due to the rapid growth in power consumption of domestic and industrial appliances, distributed energy generation units face difficulties in supplying power efficiently. The integration of distributed energy resources (DERs) and energy storage systems (ESSs) provides a solution to these problems using appropriate management schemes to achieve optimal operation. Furthermore, to lessen the uncertainties of distributed energy management systems, a decentralized energy management system named virtual power plant (VPP) plays a significant role. This paper presents a comprehensive review of 65 existing different VPP optimization models, techniques, and algorithms based on their system configuration, parameters, and control schemes. Moreover, the paper categorizes the discussed optimization techniques into seven different types, namely conventional technique, offering model, intelligent technique, price-based unit commitment (PBUC) model, optimal bidding, stochastic technique, and linear programming, to underline the commercial and technical efficacy of VPP at day-ahead scheduling at the electricity market. The uncertainties of market prices, load demand, and power distribution in the VPP system are mentioned and analyzed to maximize the system profits with minimum cost. The outcome of the systematic categorization is believed to be a base for future endeavors in the field of VPP development

Case Report: Full recovery in severe ParvovirusB19 myocarditis with DCM phenotype: the impact of rASD and PAB

BackgroundThe incidence of parvovirus B19 (B19 V)-associated myocarditis progressing to dilated cardiomyopathy (DCM) is on the rise. We hypothesize that a comprehensive treatment regimen enables cardiac regeneration in young patients with life-threatening B19 V myocarditis.MethodsFour patients with clinical and imaging evidence of DCM were referred due to suspected myocarditis. An endomyocardial biopsy (EMB) confirmed the diagnosis. The diastolic dysfunction associated with heart failure and reduced left ventricular ejection fraction (HFrEF) was established invasively. Before surgical pulmonary artery banding (PAB), a transcatheter procedure was performed to create a restrictive atrial defect (rASD).ResultsThe drug-treated patients (ages 15–26 months) had a mean LV-EF of 22.5% (20%–25%), a left ventricular end-diastolic diameter (LVEDD) of 49 (45–51) mm (Z-score &gt;5), and elevated LVED pressures (&gt;18 mmHg). EMB revealed B19V-associated acute/subacute or chronic active myocarditis with characteristics of DCM. Drug therapy, including immunoglobulins and creating a rASD, resulted in clinical improvement and enhanced right ventricular function. However, LV enlargement and dysfunction persisted. Four weeks after surgical PAB, all patients showed improvement and were discharged home. The pressure gradient across the PAB ranged from 40 to 45 mmHg, and LVEDD decreased to a mean z-score of +3.5. Within three to six months, LVEDD normalized, and LV-EF increased to a mean of 63% (range: 57%–68%). Clinical and cardiac improvements were sustained over a median follow-up of 7.5 years.ConclusionA holistic treatment approach allows functional regeneration in B19 V myocarditis with obvious end-stage DCM. Restrictive ASD creation is required before surgical PAB when HFrEF is associated with a diastolic dysfunction component

A Uniform Description of Perioperative Brain MRI Findings in Infants with Severe Congenital Heart Disease:Results of a European Collaboration

BACKGROUND AND PURPOSE: A uniform description of brain MR imaging findings in infants with severe congenital heart disease to assess risk factors, predict outcome, and compare centers is lacking. Our objective was to uniformly describe the spectrum of perioperative brain MR imaging findings in infants with congenital heart disease. MATERIALS AND METHODS: Prospective observational studies were performed at 3 European centers between 2009 and 2019. Brain MR imaging was performed preoperatively and/or postoperatively in infants with transposition of the great arteries, single-ventricle physiology, or left ventricular outflow tract obstruction undergoing cardiac surgery within the first 6 weeks of life. Brain injury was assessed on T1, T2, DWI, SWI, and MRV. A subsample of images was assessed jointly to reach a consensus. RESULTS: A total of 348 MR imaging scans (180 preoperatively, 168 postoperatively, 146 pre- and postoperatively) were obtained in 202 infants. Preoperative, new postoperative, and cumulative postoperative white matter injury was identified in 25%, 30%, and 36%; arterial ischemic stroke, in 6%, 10%, and 14%; hypoxic-ischemic watershed injury in 2%, 1%, and 1%; intraparenchymal cerebral hemorrhage, in 0%, 4%, and 5%; cerebellar hemorrhage, in 6%, 2%, and 6%; intraventricular hemorrhage, in 14%, 6%, and 13%; subdural hemorrhage, in 29%, 17%, and 29%; and cerebral sinovenous thrombosis, in 0%, 10%, and 10%, respectively. CONCLUSIONS: A broad spectrum of perioperative brain MR imaging findings was found in infants with severe congenital heart disease. We propose an MR imaging protocol including T1-, T2-, diffusion-, and susceptibility-weighted imaging, and MRV to identify ischemic, hemorrhagic, and thrombotic lesions observed in this patient group

Hearing Feelings: Affective Categorization of Music and Speech in Alexithymia, an ERP Study

Background: Alexithymia, a condition characterized by deficits in interpreting and regulating feelings, is a risk factor for a variety of psychiatric conditions. Little is known about how alexithymia influences the processing of emotions in music and speech. Appreciation of such emotional qualities in auditory material is fundamental to human experience and has profound consequences for functioning in daily life. We investigated the neural signature of such emotional processing in alexithymia by means of event-related potentials. Methodology: Affective music and speech prosody were presented as targets following affectively congruent or incongruent visual word primes in two conditions. In two further conditions, affective music and speech prosody served as primes and visually presented words with affective connotations were presented as targets. Thirty-two participants (16 male) judged the affective valence of the targets. We tested the influence of alexithymia on cross-modal affective priming and on N400 amplitudes, indicative of individual sensitivity to an affective mismatch between words, prosody, and music. Our results indicate that the affective priming effect for prosody targets tended to be reduced with increasing scores on alexithymia, while no behavioral differences were observed for music and word targets. At the electrophysiological level, alexithymia was associated with significantly smaller N400 amplitudes in response to affectively incongruent music and speech targets, but not to incongruent word targets. Conclusions: Our results suggest a reduced sensitivity for the emotional qualities of speech and music in alexithymia during affective categorization. This deficit becomes evident primarily in situations in which a verbalization of emotional information is required

Music for a Brighter World: Brightness Judgment Bias by Musical Emotion

A prevalent conceptual metaphor is the association of the concepts of good and evil with brightness and darkness, respectively. Music cognition, like metaphor, is possibly embodied, yet no study has addressed the question whether musical emotion can modulate brightness judgment in a metaphor consistent fashion. In three separate experiments, participants judged the brightness of a grey square that was presented after a short excerpt of emotional music. The results of Experiment 1 showed that short musical excerpts are effective emotional primes that cross-modally influence brightness judgment of visual stimuli. Grey squares were consistently judged as brighter after listening to music with a positive valence, as compared to music with a negative valence. The results of Experiment 2 revealed that the bias in brightness judgment does not require an active evaluation of the emotional content of the music. By applying a different experimental procedure in Experiment 3, we showed that this brightness judgment bias is indeed a robust effect. Altogether, our findings demonstrate a powerful role of musical emotion in biasing brightness judgment and that this bias is aligned with the metaphor viewpoint