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1
Chu, Chung-ming. "Clinical aspects of severe acute respiratory syndrome (SARS)". Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31937925.
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Chu, Chung-ming, e 朱頌明. "Clinical aspects of severe acute respiratory syndrome (SARS)". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B31937925.
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3
Lau, Yik-Chung. "Numerical simulation of severe acute respiratory syndrome (SARS) epidemics /". View abstract or full-text, 2004. http://library.ust.hk/cgi/db/thesis.pl?PHYS%202004%20LAU.
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Thesis (M. Phil.)--Hong Kong University of Science and Technology, 2004.Includes bibliographical references (leaves 43-44). Also available in electronic version. Access restricted to campus users.
4
Chauhan, Vinita Singh. "Molecular characterization of severe acute respiratory syndrome (SARS) coronavirus - nucleocapsid protein". Diss., Manhattan, Kan. : Kansas State University, 2006. http://hdl.handle.net/2097/152.
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5
Ching, Chi-yun Johannes. "Study of host genetic susceptibility to severe acute respiratory syndrome (SARS) infection". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40687648.
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Ching, Chi-yun Johannes, e 程子忻. "Study of host genetic susceptibility to severe acute respiratory syndrome (SARS) infection". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40687648.
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7
Chow, Yan-ching Ken, e 周恩正. "Characterization of the apoptotic properties of severe acute respiratory syndrome coronavirus (SARS-CoV) structural proteins". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B30105493.
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Ng, Yuen-yi Fiona. "Assessment of quality of life in adults recovering from severe acute respiratory syndrome /". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972998.
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9
Leung, Hiu-lan Nancy, e 梁曉灡. "Mechanism of antibody-dependent enhancement in severe acute respiratory syndrome coronavirus infection". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B47327066.
Texto completo da fonteResumo:
Severe lymphopenia is a clinical feature of Severe Acute Respiratory Syndrome
(SARS) patients. However, lymphocytes do not express receptor for SARS-CoV,
neither the widely accepted viral receptor angiotensin converting enzyme 2 (ACE2)
nor the putative receptors Dendritic Cell- and Liver/lymph-Specific Intercellular
adhesion molecule-3-Grabbing Non-integrin (DC-SIGN and L-SIGN). Our group
previously showed in vitro that, SARS-CoV Spike pseudotyped particles (SARSCoVpp)
could infect human B cells only when inoculated in presence of anti-SARSCoV
Spike immune serum. Such observations raised concerns about the possible
occurrence of antibody-dependent enhancement (ADE) of infection, a phenomenon
during which a virus bounded by antibodies could gain entry into cells through
mechanisms involving complement receptors or Fc receptors. Recently, we have
demonstrated the participation of the human Fc gamma receptor II (hFcγRII)
molecules in granting SARS-CoV an opportunity to infect human immune cells.
The aim of this study was to decipher the molecular mechanism leading to antibodymediated,
FcγRII-dependent infection of immune cells by SARS-CoV. By using
transduction experiment, I highlighted that different members of the hFcγRII family
(namely hFcγRIIA, hFcγRIIB1 and hFcγRIIB2) could confer susceptibility to ADE of
SARS-CoVpp infection. I further demonstrated that purified anti-viral
immunoglobulin G, but not other soluble factor(s) from heat-inactivated immune
serum, was the determinant for occurrence of ADE infection. Additionally, with the
development of a cell-cell fusion assay, I illustrated that in contrast to the ACE2-
dependent pathway, ADE infection did not occur at the plasma membrane, but rather
require internalization of virus/antibodies immune complexes by the target cells. In
line with this hypothesis, my results using a panel of FcγRII-expressing mutants
demonstrated that binding of immune complexes to cell surface FcγRII was a
prerequisite but was not sufficient to trigger ADE infection. In these experiments,
only FcγRII signaling-competent constructions conferred susceptibility to ADE of
SARS-CoVpp infection.
Altogether my results point toward a role of the anti-SARS-CoV Spike IgG in vitro in
granting SARS-CoV an opportunity to infect cells bearing signaling-competent
FcγRII receptors. If further confirmed, such observations could have implications for
understanding SARS-CoV tropism and SARS pathogenesis, as well as warrant for
careful design of SARS vaccines and immunotherapy based on anti-viral antibodies.published_or_final_version
Microbiology
Master
Master of Philosophy
10
Xu, Meishu. "Association of DC-SIGN (CD209) gene polymorphisms with severe acute respiratory syndrome (SARS)". View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B3723125X.
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11
Xu, Meishu, e 徐美術. "Association of DC-SIGN (CD209) gene polymorphisms with severe acute respiratory syndrome (SARS)". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B38616142.
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Law, Ka-man. "Vaccine development against the severe acute respiratory syndrome-coronavirus (SARS-CoV) using SARS-CoV spike protein". Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B36774480.
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Law, Ka-man, e 羅嘉敏. "Vaccine development against the severe acute respiratory syndrome-coronavirus (SARS-CoV) using SARS-CoV spike protein". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B36774480.
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Yeung, Yin-shan. "Molecular characterization of apoptosis induced by severe acute respiratory syndrome coronavirus spike protein". Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B38302366.
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Yip, Ming-shum, e 葉名琛. "Severe acute respiratory syndrome coronavirus infection of human immune cells through antibody-mediated pathway". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46542139.
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Yeung, Yin-shan, e 楊燕珊. "Molecular characterization of apoptosis induced by severe acute respiratory syndrome coronavirus spike protein". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B38302366.
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Ooi, Gaik Cheng, e 黃玉清. "Role of imaging in evaluation of lung involvement in severe acute respiratory syndrome (SARS)". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B47468713.
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Diagnostic imaging played a substantial role in the management and treatment of
patients during the Severe Acute Respiratory Syndrome (SARS) outbreak when daily
chest radiographs were performed as a measure of disease severity and respiratory
status. This thesis was performed to address several issues relating to the
radiological spectrum of SARS, its temporal pattern on chest radiograph and high
resolution computed tomography (HRCT) during the course of disease, and
relationships between severity of opacities quantified on chest radiographs and
clinical parameters including treatment response. Radiological parameters that could
discriminate SARS from non-SARS community-acquired pneumonia (CAP) were
also studied.
Unifocal unilateral ground glass opacities was the dominant radiographic abnormality
at presentation that progressed rapidly to maximal disease within 9.35 ± 4.09
(median 9, range 3-21) days after onset of symptoms with bilateral consolidation in
62.5% of patients. Complete resolution and significant residual disease was noted in
50% and 20% of cases respectively at end of assessment period. There was a
temporal pattern of lung abnormalities on HRCT with ground glass opacity and
consolidation at presentation. Reticulation developed after the first week and was
present in 50% of patients at ?four weeks. HRCT was useful in illustrating
parenchymal abnormalities in patients with normal radiographs at presentation.
Severity of lung abnormalities quantified on chest radiograph at different time points
of disease correlated with clinical and laboratory parameters such as SaO2 and liver
transaminases ALT and AST. Significant relationships were also found between
radiographic parameters, and O2 supplementation and treatment response. There
are discriminating differences in the radiographic pattern, rate of radiographic
progression, and zone of involvement between SARS and non-SARS CAP.published_or_final_version
Medicine
Master
Doctor of Medicine
18
Ng, Yuen-yi Fiona, e 吳婉兒. "Assessment of quality of life in adults: recovering from severe acute respiratory syndrome". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31972998.
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Lam, Wai Yee. "Spatial dynamics of the severe acute respiratory syndrome (SARS) epidemic in Hong Kong in 2003". Thesis, Imperial College London, 2011. http://hdl.handle.net/10044/1/6332.
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The Severe Acute Respiratory Syndrome (SARS) epidemic in 2003 was the first infectious disease outbreak caused by a novel pathogen in the twenty-first century. The outbreak in Hong Kong was the second largest worldwide and was characterised by a large proportion of hospital infections and a super-spreading event caused by environmental factors in residential buildings. Hospitals treating SARS cases were at high risk for transmission. I found that hospital outbreaks triggered community transmission as well as the formation of spatial clusters of community cases. The size of the community outbreak in an area increased with the size of the outbreak in the nearest hospital treating SARS, and an area was more likely to have no community-infected cases if it was far from hospitals treating SARS, or had less hospital-infected cases within the area. To quantify the transmission between hospital and community, I developed a spatial epidemic-tree-reconstruction method that uses gravity models to spatially define the probability of contact between individuals in the community. From the reconstructed probabilistic infection tree, I estimated that 24% of community transmission was likely to be infected by cases infected in hospitals, with infected patients discharged during their incubation period and hospital visitors the most important drivers of transmission from healthcare settings to the community. Healthcare workers were key drivers of hospital transmission, with the hospital-to-hospital reproduction number, excluding a single hospital super-spreading event, estimated to be 0.8. A typical community-acquired case was estimated to generate 0.6 cases in the community and 0.2 cases in the hospital in which they were subsequently hospitalised. My findings suggest that hospital infection control could be improved. Restricted hospital visitor policies could have been imposed for longer time during the outbreak and quarantine could be considered for those who recently visited or have been discharged from hospitals treating SARS cases.
20
Wu, Ka-yin Christina. "An analysis of severe acute respiratory syndrome (SARS) and the management of Hong Kong's healthcare system". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31967644.
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Choi, Wai-yee Junet. "Serum neopterin for early assessment of severity of severe acute respiratory syndrome and Dengue virus infection". Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B32031579.
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Ho, Sheng-sheng, e 何湘霜. "A study of the clinical course of Severe Acute Respiratory Syndrome ina community hospital in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B45010031.
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Wu, Ka-yin Christina, e 鄔家燕. "An analysis of severe acute respiratory syndrome (SARS) and the management of Hong Kong's healthcare system". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31967644.
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Wong, Shan. "Psychological reaction of healthcare workers in the outbreak and aftermath of severe acute respiratory syndrome". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29760239.
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Choi, Wai-yee Junet, e 蔡偉儀. "Serum neopterin for early assessment of severity of severe acute respiratory syndrome and Dengue virus infection". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B32031579.
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Glowacka, Ilona [Verfasser]. "Bedeutung von Wirtszellproteasen für die Infektion mit dem Severe Acute Respiratory Syndrome-Coronavirus (SARS-CoV) / Ilona Glowacka". Hannover : Technische Informationsbibliothek und Universitätsbibliothek Hannover (TIB), 2011. http://d-nb.info/1013365224/34.
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au, johnbott@westnet com, e John Arthur Bottomley. "A mediated crisis : news and the national mind". Murdoch University, 2008. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20081113.143044.
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The thesis examines a mediated crisis and how The Straits Times and The Australian
approach the reporting of Severe Acute Respiratory Syndrome (SARS). It looks at how
this mediated crisis exemplifies the culture of the national newspaper and in turn how the
national newspaper has an historical influence on the national psyche. A total of 649
reports and headlines and 141 letters about SARS in The Straits Times (including The
Straits Time Interactive) were examined from April 2003 to November 2003 as were 125
headlines from The Australian.
The early sections of the thesis discuss how a crisis makes news; examine how the media
report a crisis and what emphasis is given to aspects such as: actors, primary definers,
vocabulary, lexical choices, subjects, themes, issues and value dimension or stance. The
first chapter defines crisis, journalism and crisis journalism and discusses where the latter
sits within the continuing expansion and development of major theoretical frameworks,
including living in a risk society. The implication here is that crisis and risk have a
symbiotic relationship.
Historical perspectives of news are discussed in Chapter 2, and the newspaper is placed
within the context of contemporary media. The chapter discusses how newspapers are
aligned with the concept of the national mind and demonstrates the roles and formations
of the two newspapers in relation to the SARS crisis.
Chapter 3 codes the headlines, article titles and subtitles of The Straits Times and The
Australian and using content analysis of the headlines, analyses the reporting of a serious
health crisis SARS that lasted from March to November, 2003. The quantification within
content analysis enables a researcher to read and interpret questions that relate to the
intensity of meaning in texts, their social impact, the relationships between media texts
and the realities and representations they reflect (Hansen et al, 1998). The theory and
method of content analysis is used in this chapter to consider differences between The
Straits Times and The Australian and to exemplify the medias representation of the
narratives of SARS as it happened in the countries of Singapore and Australia.
Aspects of crisis and risk, the newspaper and the national mind, narratives, presentations,
and post SARS events are discussed in the last chapter. It is concluded from these
discussions there is a world narrative that tells the story of how the human condition likes
to live and rely on a safe social environment always being available. The relationship
between a mediated crisis and risk are also discussed. In addition, it is maintained that
reporting in 2003 was not just about SARS but a way of reporting that allowed one to
view journalism as an aid to good governance, particularly with regard to living in a risk
and crisis-ridden society.
28
Fong, Ho-ching. "Longitudinal changes in community psycho-behavioural responses and impact on outbreak control during severe acute respiratory syndrome (SARS) epidemic in Hong Kong". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971714.
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Chafekar, Aasiyah. "Production of cytokines in human whole blood after incubation with the nucleocapsid protein of the NL63 Coronavirus". University of the Western Cape, 2012. http://hdl.handle.net/11394/4037.
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Masters of ScienceThe Coronaviridae family consists of RNA viruses within the order Nidovirales. The family is classified into two genera, namely the corona- and toroviruses. Coronaviruses are enveloped, single stranded, positive sense RNA viruses with genomes ranging between 27-32kb in size. The 5’ two-thirds of the genome encodes for the 1a/b polyprotein, while the 3’ one-third of the genome encodes for the structural proteins that mediate viral entry into the host cell. These structural proteins include the spike (S), envelope (E), membrane (M) and nucleocapsid (N) proteins. The nucleocapsid protein is expressed at high levels within an infected cell. Studies have shown that this protein plays a key regulatory role in different cellular pathways, including the inhibition of interferon production and the up-regulation of the AP1 signal transduction pathway, amongst others. Also, the N protein is vital in the formation of the ribonucleocapsid core by binding to the viral RNA during virion assembly. The focus of this study is the immune response in whole blood cultures to the presence of human coronavirus (HCoV) NL63 N protein. To characterise the stimulation of the immune activity against HCoV-NL63 N in blood cultures, the HCoV-NL63 N gene was expressed in a bacterial system. In this pilot study, GSTtagged N constructs were then purified and used to treat whole blood cultures from three volunteers. ELISAs were used to measure the cytokine response in these treated whole blood cultures. Results showed that the nucleocapsid protein has an inflammatory response on whole blood cultures. These results have generated vital information in the potential function of the HCoV-NL63 N protein on the immune system. It is suffice to say that the HCoV-NL63 N protein is able to elicit an effective inflammatory response within the host cell. Future studies into the cellular pathways affected by the HCoV-NL63 N protein will clarify its exact role in stimulating the host immune system.
30
Wong, W. M. Wendy. "A survey of nurses' preventive measures and health status in relation to the severe acute respiratory syndrome (SARS) epidemic in Hong Kong /". View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36397052.
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Gela, Anele. "Cloning and expression of human cyclophilin A and its interaction with human coronavirus NL63 nucleocapsid protein". University of the Western Cape, 2011. http://hdl.handle.net/11394/5360.
Texto completo da fonteResumo:
Magister Scientiae (Medical Bioscience) - MSc(MBS)Coronaviridae family is composed of a number of ribonucleic acid (RNA)-containing viruses currently classified into two genera, the coronavirus and torovirus. The family is classified together with the Arteviridae in the order Nidovirales. Coronaviruses are enveloped single stranded positive sense RNA viruses about 80-160 nm in diameter. The coronavirus is, as in the case of all positive sense RNA virus, a messenger, and the naked RNA is infectious. The 5′-two thirds of the genome encodes for a polyprotein that contains all the enzymes necessary for replication, whereas the 3′-one third encodes for all the structural proteins that mediate viral entry into the host cell. The structural proteins include spike (S), envelope (E), membrane (M) and nucleocapsid (N) proteins.Nucleocapsid protein is one of the most crucial structural components of coronaviruses;hence major attention has been focused on characterization of this protein. Some laboratories have demonstrated that this protein interferes with different cellular pathways, thus implying it to be a key regulatory component of the virus (Zakhartchouk, Viswanathan et al. 2005). Furthermore, it has been shown that severe acute respiratory syndrome (SARS)-N protein interacts with cellular proteins, including cyclophilin A (CypA), heterogenous nuclear ribonucleoprotein (hnRNP) A1, human ubiquitin-conjugating enzyme, cyclin dependent kinase (CDK)-cyclin complex protein, Ikappaßalpha (IkBα), cytochrome (Cyt) P450 etc. For the purpose of this study, the focus is based on CypA interaction with human coronavirus (HCoV) NL63-N protein. These interactions might play a role in the pathology of HCoV-NL63. Using glutathione-S-transferase (GST), the interaction of CypA with the nucleocapsid protein can be clearly demonstrated to be direct and specific. Since the N protein is involved in viral RNA packaging to form a helical core, it is suffice to say that both NL63-N and CypA are possibly within the HCoV-NL63 replication/transcription complex and NL63-N/human CypA interaction might function in the regulation of HCoV-NL63 RNA synthesis. In addition, the results will demonstrate that HCoV-NL63-N has only a specific domain for interacting with CypA.
32
Lam, Chun-yip. "Comparative molecular analysis of the binding between severe acute respiratory syndrome coronavirus (SARS-CoV) spike protein and angiotensin converting enzyme 2(ACE2)". Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/HKUTO/record/B39557017.
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Fong, Ho-ching, e 方浩澄. "Longitudinal changes in community psycho-behavioural responses and impact on outbreak control during severe acute respiratory syndrome(SARS) epidemic in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31971714.
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Lam, Chun-yip, e 林俊業. "Comparative molecular analysis of the binding between severe acute respiratory syndrome coronavirus (SARS-CoV) spike protein andangiotensin converting enzyme 2(ACE2)". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39557017.
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Chavez, Thomas David F. Luechai Sringernyuang. "The language of uncertainty in a new illness : hedging and modality in the biomedical discourse of severe acute respiratory syndrome (SARS) /". Abstract, 2004. http://mulinet3.li.mahidol.ac.th/thesis/2547/cd366/4537982.pdf.
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Wong, W. M. Wendy, e 黃慧雯. "A survey of nurses' preventive measures and health status in relation to the severe acute respiratory syndrome (SARS) epidemic in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45011941.
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Castaneda, Emily, e Cecilia Holmblad. "Sjuksköterskors upplevelser av att vårda personer med svår akut respiratorisk sjukdom [sars] på sjukhus : en litteraturöversikt". Thesis, Sophiahemmet Högskola, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3900.
Texto completo da fonteResumo:
Bakgrund Svår akut respiratorisk sjukdom [SARS] var en ny typ av atypisk lunginflammation som orsakades av ett coronavirus som tidigare enbart var känt att smittade mellan djur. År 2002 muterade detta virus och började infektera människor. 2000-talets första epidemi drog igång och över 8000 personer konstaterades smittade. Många personer som smittades blev svårt sjuka och behövde söka vård på grund av andningssvårigheter och hypoxi. Syfte Syftet var att belysa sjuksköterskans upplevelser av att vårda personer med svår akut respiratorisk sjukdom på sjukhus. Metod Den valda metoden för detta arbete var en icke-systematisk litteraturöversikt där 15 vetenskapliga artiklar inkluderades. Artiklarna som användes var både kvalitativa och kvantitativa och har kvalitetsgranskats med hjälp av Sophiahemmets Högskolas bedömningsunderlag. Insamling av artiklar har gjorts från databaserna Cinahl, PubMed och PsycINFO och analyserades med integrerad dataanalys. Resultat Resultatet visade att sjuksköterskorna upplevde stor stress, rädsla och maktlöshet. Adekvat skyddsutrustning och kunskap om smittan saknades. Sjuksköterskorna hamnade i en situation där de var tvungna att välja att antingen stanna kvar i sin profession eller leta efter arbete med mindre yrkesrisker. Många valde att stanna, detta för att de insåg att det inte fanns någon annan som kunde ta hand om dessa personer. Slutsats Trots de psykiska påfrestningarna som drabbade sjuksköterskorna kunde de med stöd av varandra ta sig igenom epidemin. Många kände att de växte i sin roll som sjuksköterska och kunde ta med sig nya lärdomar inför framtiden. Dock kunde stora brister uppdagas i sjukvården och dessa kunskapsluckor behöver fyllas med lärdomar från tidigare epidemier och pandemier inför framtida utbrott.Background Severe acute respiratory syndrome was a new type of atypical pneumonia caused by a coronavirus that previously was known only to spread amongst animals. During late 2002 the virus mutated and started to infect people. The 21st century’s first epidemic began and over 8000 people were confirmed infected with the new disease. A lot of people became severely ill and had to seek medical care due to breathing difficulties and hypoxia. Aim The purpose was to shed light on the nurse's experiences of caring for persons with severe acute respiratory syndrome in hospitals. Method The chosen method for this paper was a non-systematic literature review in which 15 scientific articles were included. The articles included were both qualitative and quantitative and were quality reviewed with the help of Sophiahemmets University’s assessment tool. The articles were collected using the databases CINAHL, PubMed and PsycINFO and analyzed with an integrated data analysis. Results The results show that nurses experienced a high level of stress, fear and powerlessness. There was a lack of adequate protective equipment and knowledge about the disease. The nurses were forced to choose, either to stay in their profession or search for a different occupation with less risk of getting infected. A lot of nurses chose to stay, they realized that there were no one else who could take care of the patients. Conclusions Despite the psychological symptoms that affected the nurses, they realized that they could get through the epidemic with the support of each other. Many nurses felt a growth in their profession and could bring a lot of new knowledge with them for the future. A lack of knowledge was discovered in the healthcare system and there are a lot off lessons to be learned for future epidemic and pandemic outbreaks.
38
Maguiña, Jorge L., Percy Soto-Becerra, Yamilee Hurtado-Roca e Roger V. Araujo-Castillo. "Laboratory tests for identification of sars-cov-2 during pandemic times in Peru: Some clarification regarding «diagnostic performance»". Instituto Nacional de Salud, 2020. http://hdl.handle.net/10757/655698.
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Attenborough, Frederick Thomas. "The singular case of SARS : medical microbiology and the vanishing of multifactorality". Thesis, Loughborough University, 2010. https://dspace.lboro.ac.uk/2134/22335.
Texto completo da fonteResumo:
This thesis is about the politics and the possibilities of aetiology. Firstly, the possibilities. Does an infectious disease have one, single pathogenic cause or many, interacting causes? In the medical microbiological sciences, there is no definitive answer, one way or another, to this question: there, the conditions of aetiological possibility exist in a curious tension. Ever since the birth of the 'germ theory of disease' and the concomitant birth of the singular aetiological object, these conditions have allowed for the co-existence of a very different, and far less well understood kind of object: the multifactorial object. That SARS was caused by one, singular viral agent, a coronavirus (CoV), is now entrenched as microbiological fact. And yet, the curious thing about SARS is that the history of the 2003 outbreak is littered with moments at which the possibility of the multifactorial object presented itself to, and was actively considered by, medical microbiologists. So how did we get here - to SARS-CoV, an infectious disease that could be understood and storied in this, the most singular of ways? And what happened along the way to deny the multifactorial aetiological object any kind of existence at all? In an attempt to grapple with these questions, the thesis seeks to recover the possibility of the multifactorial object through a deep, ethnomethodological reading of the moments at which it flared up precise/y as a possibility for medical microbiologists investigating the outbreak. What emerges from that recovery operation is a sense that the multifactorial object was never actually ruled out or disproved in any way, but rather, was vanished. Put another way, the suggestion is that various medical microbiological practices and interventions, whilst establishing singularity, were serving, at the same time, to create an illusion of multifactorality's non-existence; an illusion behind which the issue of multifactorality, its possibility, could be discarded without ever having to be resolved, one way or the other. In the closing sections of this thesis a move is made towards suggesting that SARS-Co V, the singular disease, was the product of a choice-, a choice that was made to explore one aetiological possibility at the expense of another. And that is where the politics comes in. For if politics, the realm of the political, can be taken to arise in situations where various possibilities exist but not all possibilities can be chosen, then it follows that what this thesis provides is an opportunity to foreground the politics bound up with the practical doing of aetiology. As a result, and based on the experience of attempting to recover the vanished multifactorial object from the 2003 SARS outbreak, the thesis concludes with an attempt to inhabit the present in such a way as to make it possible to think, in a little more detail, about where aetiology, as understood by medical microbiologists, might be heading in the future: might recent shifts in practical, everyday, seemingly innocuous microbiological technique, have begun to make it easier to coax the multifactorial object out into a space of visibility? Might those shifts actually herald the crossing of an epistemological threshold in the medical sciences? And might the conditions of aetiological possibility be changing, and changing in ways that would drastically alter what it meant to speak of a 'disease', an 'infection' and a 'pathogen'?
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Mnyamana, Yanga Eddie. "Expression of human coronavirus NL63 and SARS-CoV nucleocapsid proteins for antibody production". University of the Western Cape, 2012. http://hdl.handle.net/11394/2989.
Texto completo da fonteResumo:
>Magister Scientiae - MScHuman Coronaviruses (HCoVs) are found within the family Coronaviridae (genus, Coronavirus) and are enveloped, single-stranded, positive-sense RNA viruses. Infections of humans by coronaviruses are not normally associated with severe diseases. However, the identification of the coronavirus responsible for the outbreak of severe acute respiratory syndrome (SARS-CoV) showed that highly pathogenic coronaviruses can enter the human population. The SARS-CoV epidemic resulted in 8 422 cases with 916 deaths globally (case fatality rate: 10.9%). In 2004 a group 1 Coronavirus, designated Human Coronavirus NL63 (HCoV-NL63), was isolated from a 7 month old Dutch child suffering from bronchiolitis. In addition, HCoV-NL63 causes disease in children (detected in approximately 10% of respiratory tract infections), the elderly and the immunocompromised. This study was designed to express the full length nucleocapsid (N) proteins of HCoV-NL63 and SARS-CoV for antibody production in an animal model. The NL63-N/pFN2A and SARSN/ pFN2A plasmid constructs were used for this study. The presence of the insert on the Flexi ® vector was confirmed by restriction endonuclease digest and sequence verification. The sequenced chromatographs obtained from Inqaba Biotec were consistent with sequences from the NCBI Gen_Bank. Proteins were expressed in a KRX Escherichia coli bacterial system and analysed using 15% SDS-PAGE and Western Blotting. Thereafter, GST-tagged proteins were purified ith an affinity column purification system. Purified fusion proteins were subsequently cleaved with Pro-TEV Plus protease, separated on 15% SDS-PAGE gel and stained with Coomassie Brilliant Blue R250. The viral fusion proteins were subsequently used to immunize Balbc mice in order to produce polyclonal antibodies. A direct ELISA was used to analyze and validate the production of polyclonal antibodies by the individual mice. This is a preliminary study for development of diagnostic tools for the detection of HCoV-NL63 from patient samples collected in the Western Cape.
South Africa
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Martinelli, M. "SORVEGLIANZA DELLE INFEZIONI RESPIRATORIE ACUTE (ARI): APPROCCI INNOVATIVI PER L'IDENTIFICAZIONE E LA CARATTERIZZAZIONE DEGLI AGENTI VIRALI COINVOLTI". Doctoral thesis, Università degli Studi di Milano, 2014. http://hdl.handle.net/2434/232585.
Texto completo da fonteResumo:
Surveillance of acute respiratory infections (ARI): innovative approaches for the identification and characterization of viral agents
Introduction. Acute respiratory infections (ARI) are ubiquitous, air-borne transmitted and highly contagious infections, characterized by typical epidemic pattern. Though ARI causative agents may be bacterial or viral, viruses are by far the most common causes of ARI. In recent years, the global epidemiological scenario has been enlivened by the identification and emergence of many airborne pathogens (such as influenza viruses A/H5N1, A/H7N7, A/H7N9, coronaviruses SARS and MERS), which have been co-circulating along with the already known viral strains (i.e. seasonal influenza viruses, parainfluenza viruses, respiratory syncytial viruses, etc.), thus highlighting the public health concern about emerging infectious disease.
Objectives. The project aimed at applying new molecular biology techniques, "virus discovery" methodology and bioinformatics analyses to investigate the etiology of ARI.
The specific objectives were:
1) Identification of viral pathogens responsible of severe acute respiratory infections (SARI) and acute respiratory distress syndrome (ARDS) during the pandemic and post-pandemic (2009-2011). On purpose, the proportion of SARI/ARDS cases and deaths due to A(H1N1)pdm09 infection and the impact of other respiratory pathogens were evaluated during the pandemic and post-pandemic period in Lombardy. Additionally, unknown viruses were investigated in those cases for which diagnosis remained negative by using VIDISCA-454 methodology, a “virus discovery” technique. This analysis was performed at the Laboratory of experimental virology, Academic Medical Center (AMC), University of Amsterdam, where I completed an internship under the supervision of Prof. Lia van der Hoek.
2) Evaluating the genetic variability and molecular evolution of respiratory syncytial virus (RSV). In order to reconstruct the origin and phylodynamic history of RSV, the genetic diversity and evolutionary dynamics of RSV A and RSV B identified in respiratory specimens collected from children aged ≤ 3 years hospitalized in Lombardy for ARI over six epidemic seasons (2006 to 2012) were analyzed.
Materials and methods
1) From October 2009 to December 2011, 206 respiratory samples were collected from patients (61.2% males, median age: 44.3 years) hospitalized for SARI/ARDS. Nucleic acids were purified by NucliSENS® easyMAG® (bioMérieux, France), and analyzed by real-time RT-PCR assay to identify influenza virus. The clinical specimens that resulted negative to influenza virus detection were then screened by real-time RT-PCR/PCR for a panel of respiratory pathogens (Respiratory MWS r-gene™ Real-time PCR, bioMérieux, France) to detect: RSV A and B; human metapneumovirus (hMPV) A and B; human rhinovirus (hRV) and enterovirus (hEV); adenovirus (AdV); human bocavirus (hBoV) 1-4; human coronavirus (hCoV) 229E, NL63, OC43, HKU1; human parainfluenza virus (hPIV) 1-4; Chlamydophila pneumoniae; Mycoplasma pneumoniae. Cases resulted negative to all diagnostic assays were further investigated by VIDISCA-454 (virus discovery cDNA-AFLP) technique. This is a virus discovery method based on recognition of restriction enzyme cleavage sites, ligation of adaptors and subsequent amplification by PCR combined with high-throughput sequencing 454 FLX/Titanium system of Roche.
2) RSV A (n=23) and RSV B (n=12) sequences obtained from oro-pharyngeal swabs of RSV-infected children aged ≤3 years hospitalized for ARI from 2006 to 2012 were considered for molecular characterization. Sequences were obtained by multiplex-PCR to amplify a fragment of RSV G gene and several bioinformatic programs were used for the phylogenetic and phylodynamic analysis. Phylogenetic trees of RSV A and RSV B sequences were constructed by MEGA 5 program using the Neighbor-Joining method to identify RSV genotypes circulating and a bootstrap re-sampling analysis was performed to test tree robustness. To clarify RSV variability, amino acid mutations analysis was performed, and potential N-glycosylation and O-glycosylation sites were predicted by NetNGlyc 1.0 and NetOGlyc 3.1 programs, respectively. To evaluate site-specific selection pressure, different Maximum Likelihood approaches were applied (SLAC, FEL/IFEL, and MEME) by DATAMONKEY. To assess the evolutionary dynamics of RSV A and B, dated trees and evolutionary rates were estimated by BEAST with a Bayesian Markov Chain Monte Carlo (MCMC) approach. This analysis allowed identifying the time of the most recent common ancestor (tMRCA).
Results and discussion
1) During the pandemic and post-pandemic different pathogens have co-circulated and were associated with clinical cases in the study, but influenza virus A(H1N1)pdm09 showed the greatest impact. Influenza A(H1N1)pdm09 virus was detected in 58.3% (120/206) of SARI/ARDS cases (61.7% males; 13.3% aged ≤5 years, 67.5% aged 6-64 years). A(H1N1)pdm09 was identified in 77.8% of fatal ARDS cases. The impact of respiratory pathogens other than A(H1N1)pdm09 was 19.4% (40/206) (65% males; 30% aged ≤5 years, 47.5% aged 6-64 years). The influence of other respiratory viruses was significantly lower (19.4% vs. 58.3%, p<0.0000001): hRV/hEV were the most commonly detected viruses, but also A(H3N2) influenza virus has played a significant role. Forty-six (46/206: 22.3%) SARI/ARDS cases (including two fatalities) resulted negative to all diagnostic assays and were further investigated by VIDISCA-454 that revealed no sequence reads that could belong to a novel virus or viral variant; however it enabled the identification of one case of undiagnosed measles. VIDISCA-454 methodology proved to be a sensitive and specific method, successfully applied to the monitoring of viral respiratory infections. Anyway, nearly 22% of SARI/ARDS cases did not obtain a definite diagnosis. In clinical practice, great efforts should be devoted to improve diagnosis of severe respiratory infections and to reduce such “diagnostic gap”. The advantage from relying upon more accurate diagnosis could benefit the patient - in term of receiving the more appropriate antiviral drugs -, and could provide more detailed information on viruses circulating in the community, thus making public health authorities aware so as to adjust their policies accordingly.
2) From phylogenetic analysis resulted that 3 RSV A sequences clustered in genotype GA2 and all the other isolates clustered with NA1 genotype. Compared to the reference strain, 31 amino acid substitutions were identified. Phylogenetic analysis of RSV B sequences showed that study sequences were included in BA genotype tended to cluster within a clade including also reference sequence BA4 and 8 amino acid substitutions were identified among all of them. Similar mean evolutionary rates for RSV A and RSV B were estimated, 2.1x10-3 subs/site/year (95% highest density probability (HPD): 1.7-2.5x10-3) and 3.03x10-3 subs/site/year (95%HPD: 2.1-3.9x10-3), respectively. The tMRCA for the RSV A tree root was 71 years (95%HPD: 60-85), suggesting an origin of the currently circulating strains back to 1940s. The study strains within clade NA1 shared a single significant internal node with an estimated mean tMRCA of 7 years ago (2005). The three GA2 strains had a significant tMRCA dating back to 16 years ago (95%HPD = 14-18). The dated tree obtained with RSV B strains showed a temporal-structure similar to RSV A. In particular, the tree root had an estimated mean tMRCA of 55 years ago (1957). All the studying strains clustered within a significant subclade, having a tMRCA estimate of 9 years ago (2003), including also a single BA4 strain. The RSV A Bayesian skyline plots (BSP) showed a first pick of the number of effective infections in the second half of 1980s, followed by a decrease of transmission events ending in about 2005, when a sharp growth restored the original viral population size. The RSV B BSP showed a similar trend, with a decrease in the effective number of infections occurring between the mid-1980s and 1990s, followed by a rapid growth in early 2000s. The RSV A site-specific selection analysis identified 10 codons under positive selection and a total of 39 sites were found to be under negative selection. The RSV B codon-specific selection analysis identified only one positively selected site and 27 negatively selected. Different patterns of O- and N-glycosilation sites were found by analyzing RSV A and RSV B studied sequences.
Phylogenetic and phylodynamic analysis permitted to better understand the natural history of the virus, even if RSV remains difficult to control due to its antigenic diversity. G protein variability may play a significant role in RSV pathogenesis by allowing immune evasion. It is important monitoring changes in sequences coding this protein to permit the identification of future epidemic strains and to implement both vaccine and therapy strategies. This study thus contributed to have a better knowledge on the molecular epidemiology of RSV in Lombardy and provided data for a comparative analysis with other strains circulating in other regions of the world.
Conclusions. This project showed that respiratory virology needs a constant update of diagnostic procedures and surveillance scheme, essential support in the study and monitoring of viral infections of both classic and, above all, emerging or newly identified viruses. The application of cutting-edge technologies can be a successful tool for public health to face such emerging threats.
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Wu, Chia Jung. "Effectiveness of a specific infection control education program for Taiwanese nursing students". Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16541/1/Chia-Jung_Wu_Thesis.pdf.
Texto completo da fonteResumo:
The purpose of the study
The purpose of this research project was to develop and test an educational program for preparing Taiwanese nursing students for clinical practice.
Study background
The SARS outbreak revealed that health care professionals were ill-prepared for coping with the disease epidemic in terms of the rapid transmission of the infection, the high mortality and morbidity rate among health care workers, and the significant impacts on the public and health care personnel. Frontline nurses were the group at highest risk of becoming infected, as they are the health care personally that provide direct health care to infected patients. However, to date the ability of Taiwanese frontline nurses to respond to such a disease epidemic has not been examined.
Study design
This research project incorporated a three phase design, presented in the form of two separate studies. A small qualitative exploratory study was undertaken to validate the assumptions emerging from international literature regarding the preparedness nurses in managing an infection outbreak. The information gained was used to construct an infection control education program (Study I). A quasi-experimental design, using pre- and post-tests and experimental and control groups was then used to test the effectiveness of the education intervention (Study II).
Participants
A purposive sampling technique was used in the qualitative exploratory study, whereby six Taiwanese nurses who had provided direct nursing care to patients with SARS were interviewed. A convenience sampling approach was utilised in the quantitative study, which aimed to test the effectiveness of educational intervention. This, second study, had 175 participants in total, 80 in the experimental group and 95 in the control group. All participants were enrolled in the first semester of their fourth year in a five-year nursing program in two selected junior nursing colleges.
The education intervention
The purpose-designed standard and additional precautions (SnAP) program was the intervention. The experimental group received a SnAP program which consisted of 16 hours of classes over 16 weeks. The control group received a conventional education program.
Data collection and instrument
Data were collected at three time points during the study (baseline, four months, six month) using validated instrument. The reliability and validity of the instrument was established in a pilot study with a Taiwanese population prior to the present study.
Data analysis
t-tests and chi-square analyses were performed to assess any differences across demographic variables and baseline outcome variables between the experimental and control groups. Two-way repeated measures ANOVAs were used to examine the scores of the intervention and control groups across three time points.
Results
The data revealed that, at six months following the education program, there was a statistically significant improvement in the knowledge (F [2,180] =13.53, p=0.001) and confidence (F [2,94] =4.88, p= 0.01) of infection precautions in the intervention group compared to the control group. Also, the means of knowledge and confidence in intervention group showed a consistently increased across three time points; whereas, the mean of confidence relating infection control management in the control group resulted a drop at time 3. Although the application skills relating to infection control procedures did not show a statistically significant change during this period (F [2, 174] = 2.54, p=0.081), there were minor improvements in these scores at the six-month follow-up assessment.
Conclusion
The SnAP program had a positive impact on Taiwanese nursing students' readiness for clinical placement and potential outbreak of disease epidemics. Participation increased their knowledge about infection control precautions, their ability to properly use these specific precautions, and their confidence in solving infection-related issues in clinical practice.
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Wu, Chia Jung. "Effectiveness of a specific infection control education program for Taiwanese nursing students". Queensland University of Technology, 2007. http://eprints.qut.edu.au/16541/.
Texto completo da fonteResumo:
The purpose of the study The purpose of this research project was to develop and test an educational program for preparing Taiwanese nursing students for clinical practice. Study background The SARS outbreak revealed that health care professionals were ill-prepared for coping with the disease epidemic in terms of the rapid transmission of the infection, the high mortality and morbidity rate among health care workers, and the significant impacts on the public and health care personnel. Frontline nurses were the group at highest risk of becoming infected, as they are the health care personally that provide direct health care to infected patients. However, to date the ability of Taiwanese frontline nurses to respond to such a disease epidemic has not been examined. Study design This research project incorporated a three phase design, presented in the form of two separate studies. A small qualitative exploratory study was undertaken to validate the assumptions emerging from international literature regarding the preparedness nurses in managing an infection outbreak. The information gained was used to construct an infection control education program (Study I). A quasi-experimental design, using pre- and post-tests and experimental and control groups was then used to test the effectiveness of the education intervention (Study II). Participants A purposive sampling technique was used in the qualitative exploratory study, whereby six Taiwanese nurses who had provided direct nursing care to patients with SARS were interviewed. A convenience sampling approach was utilised in the quantitative study, which aimed to test the effectiveness of educational intervention. This, second study, had 175 participants in total, 80 in the experimental group and 95 in the control group. All participants were enrolled in the first semester of their fourth year in a five-year nursing program in two selected junior nursing colleges. The education intervention The purpose-designed standard and additional precautions (SnAP) program was the intervention. The experimental group received a SnAP program which consisted of 16 hours of classes over 16 weeks. The control group received a conventional education program. Data collection and instrument Data were collected at three time points during the study (baseline, four months, six month) using validated instrument. The reliability and validity of the instrument was established in a pilot study with a Taiwanese population prior to the present study. Data analysis t-tests and chi-square analyses were performed to assess any differences across demographic variables and baseline outcome variables between the experimental and control groups. Two-way repeated measures ANOVAs were used to examine the scores of the intervention and control groups across three time points. Results The data revealed that, at six months following the education program, there was a statistically significant improvement in the knowledge (F [2,180] =13.53, p=0.001) and confidence (F [2,94] =4.88, p= 0.01) of infection precautions in the intervention group compared to the control group. Also, the means of knowledge and confidence in intervention group showed a consistently increased across three time points; whereas, the mean of confidence relating infection control management in the control group resulted a drop at time 3. Although the application skills relating to infection control procedures did not show a statistically significant change during this period (F [2, 174] = 2.54, p=0.081), there were minor improvements in these scores at the six-month follow-up assessment. Conclusion The SnAP program had a positive impact on Taiwanese nursing students' readiness for clinical placement and potential outbreak of disease epidemics. Participation increased their knowledge about infection control precautions, their ability to properly use these specific precautions, and their confidence in solving infection-related issues in clinical practice.
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McBryde, Emma Sue. "Mathematical and statistical modelling of infectious diseases in hospitals". Queensland University of Technology, 2006. http://eprints.qut.edu.au/16330/.
Texto completo da fonteResumo:
Antibiotic resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE), are an increasing burden on healthcare systems. Hospital acquired infections with these organisms leads to higher morbidity and mortality compared with the sensitive strains of the same species and both VRE and MRSA are on the rise worldwide including in Australian hospitals. Emerging community infectious diseases are also having an impact on hospitals. The Severe Acute Respiratory Syndrome virus (SARS Co-V) was noted for its propensity to spread throughout hospitals, and was contained largely through social distancing interventions including hospital isolation. A detailed understanding of the transmission of these and other emerging pathogens is crucial for their containment. The statistical inference and mathematical models used in this thesis aim to improve understanding of pathogen transmission by estimating the transmission rates of contagions and predicting the impact of interventions. Datasets used for these studies come from the Princess Alexandra Hospital in Brisbane, Australia and Shanxi province, mainland China. Epidemiological data on infection outbreaks are challenging to analyse due to the censored nature of infection transmission events. Most datasets record the time on symptom onset, but the transmission time is not observable. There are many ways of managing censored data, in this study we use Bayesian inference, with transmission times incorporated into the augmented dataset as latent variables. Hospital infection surveillance data is often much less detailed that data collected for epidemiological studies, often consisting of serial incidence or prevalence of patient colonisation with a resistant pathogen without individual patient event histories. Despite the lack of detailed data, transmission characteristics can be inferred from such a dataset using structured HiddenMarkovModels (HMMs). Each new transmission in an epidemic increases the infection pressure on those remaining susceptible, hence infection outbreak data are serially dependent. Statistical methods that assume independence of infection events are misleading and prone to over-estimating the impact of infection control interventions. Structured mathematical models that include transmission pressure are essential. Mathematical models can also give insights into the potential impact of interventions. The complex interaction of different infection control strategies, and their likely impact on transmission can be predicted using mathematical models. This dissertation uses modified or novel mathematical models that are specific to the pathogen and dataset being analysed. The first study estimates MRSA transmission in an Intensive Care Unit, using a structured four compartment model, Bayesian inference and a piecewise hazard methods. The model predicts the impact of interventions, such as changes to staff/patient ratios, ward size and decolonisation. A comparison of results of the stochastic and deterministic model is made and reason for differences given. The second study constructs a Hidden Markov Model to describe longitudinal data on weekly VRE prevalence. Transmission is assumed to be either from patient to patient cross-transmission or sporadic (independent of cross-transmission) and parameters for each mode of acquisition are estimated from the data. The third study develops a new model with a compartment representing an environmental reservoir. Parameters for the model are gathered from literature sources and the implications of the environmental reservoir are explored. The fourth study uses a modified Susceptible-Exposed-Infectious-Removed (SEIR) model to analyse data from a SARS outbreak in Shanxi province, China. Infectivity is determined before and after interventions as well as separately for hospitalised and community symptomatic SARS cases. Model diagnostics including sensitivity analysis, model comparison and bootstrapping are implemented.
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McBryde, Emma Sue. "Mathematical and statistical modelling of infectious diseases in hospitals". Thesis, Queensland University of Technology, 2006. https://eprints.qut.edu.au/16330/1/Emma_McBryde_Thesis.pdf.
Texto completo da fonteResumo:
Antibiotic resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE), are an increasing burden on healthcare systems. Hospital acquired infections with these organisms leads to higher morbidity and mortality compared with the sensitive strains of the same species and both VRE and MRSA are on the rise worldwide including in Australian hospitals. Emerging community infectious diseases are also having an impact on hospitals. The Severe Acute Respiratory Syndrome virus (SARS Co-V) was noted for its propensity to spread throughout hospitals, and was contained largely through social distancing interventions including hospital isolation. A detailed understanding of the transmission of these and other emerging pathogens is crucial for their containment.
The statistical inference and mathematical models used in this thesis aim to improve understanding of pathogen transmission by estimating the transmission rates of contagions and predicting the impact of interventions. Datasets used for these studies come from the Princess Alexandra Hospital in Brisbane, Australia and Shanxi province, mainland China.
Epidemiological data on infection outbreaks are challenging to analyse due to the censored nature of infection transmission events. Most datasets record the time on symptom onset, but the transmission time is not observable. There are many ways of managing censored data, in this study we use Bayesian inference, with transmission times incorporated into the augmented dataset as latent variables. Hospital infection surveillance data is often much less detailed that data collected for epidemiological studies, often consisting of serial incidence or prevalence of patient colonisation with a resistant pathogen without individual patient event histories. Despite the lack of detailed data, transmission characteristics can be inferred from such a dataset using structured HiddenMarkovModels (HMMs).
Each new transmission in an epidemic increases the infection pressure on those remaining susceptible, hence infection outbreak data are serially dependent. Statistical methods that assume independence of infection events are misleading and prone to over-estimating the impact of infection control interventions. Structured mathematical models that include transmission pressure are essential. Mathematical models can also give insights into the potential impact of interventions. The complex interaction of different infection control strategies, and their likely impact on transmission can be predicted using mathematical models.
This dissertation uses modified or novel mathematical models that are specific to the pathogen and dataset being analysed. The first study estimates MRSA transmission in an Intensive Care Unit, using a structured four compartment model, Bayesian inference and a piecewise hazard methods. The model predicts the impact of interventions, such as changes to staff/patient ratios, ward size and decolonisation. A comparison of results of the stochastic and deterministic model is made and reason for differences given. The second study constructs a Hidden Markov Model to describe longitudinal data on weekly VRE prevalence. Transmission is assumed to be either from patient to patient cross-transmission or sporadic (independent of cross-transmission) and parameters for each mode of acquisition are estimated from the data. The third study develops a new model with a compartment representing an environmental reservoir. Parameters for the model are gathered from literature sources and the implications of the environmental reservoir are explored. The fourth study uses a modified Susceptible-Exposed-Infectious-Removed (SEIR) model to analyse data from a SARS outbreak in Shanxi province, China. Infectivity is determined before and after interventions as well as separately for hospitalised and community symptomatic SARS cases. Model diagnostics including sensitivity analysis, model comparison and bootstrapping are implemented.
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Du, Lanying. "Functional study of the spike protein of severe acute respiratory syndrome coronavirus". Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38602362.
Texto completo da fonte
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Du, Lanying, e 杜蘭英. "Functional study of the spike protein of severe acute respiratory syndrome coronavirus". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B38602362.
Texto completo da fonte
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Phan, Ngoc Minh Hien. "Perusing peripatetic pathogenic viruses: Hepatitis B virus and severe acute respiratory syndrome coronavirus 2". Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/226107/1/Ngoc%20Minh%20Hien_Phan_Thesis.pdf.
Texto completo da fonteResumo:
This project characterised the genetic diversity of hepatitis B virus (HBV) and SARS-CoV-2, which reflects viral evolution, and drives transmission, viral pathogenesis, and clinical outcomes. Genomes and coding genes of these viruses were analysed using next-generation sequencing, bioinformatic tools and publicly available viral sequences. HBV nucleotide diversity was identified amongst HBV sequences from Australian and non-Australian blood donors. In addition, the frequency of HBV mutants circulating in Southeast Asia, Australia and New Zealand was identified. Europe and East Asia were shown as major sources of Australian SARS-CoV-2 during the beginning of the pandemic in 2020.
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Sales, Raquel Pinto. "Acute Respiratory Distress Syndrome (ARDS) is an inflammatory disease characterized by pulmonary edema, stiff lungs and hypoxemia". Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=12672.
Texto completo da fonteResumo:
Acute Respiratory Distress Syndrome (ARDS) is an inflammatory disease characterized by pulmonary edema, stiff lungs and hypoxemia. Patients with ARDS are more susceptible to VILI (ventilator induced lung injury). Under mechanical ventilation, lung stress and strain are the main determinants of VILI and in patients with muscle effort patient-ventilator asynchrony may enhance this phenomenon. Ventilation modes PCV and VCV with auto-flow can minimize patient-ventilator asynchrony, but then can liberate the offer of flow and tidal volume, compromising the protective ventilatory strategy in ARDS. This study aimed to evaluate the influence of muscle effort and patient-ventilator asynchrony on pulmonary stress and strain in a mechanic lung model of acute respiratory distress syndrome. An experimental bench study was performed, using a lung simulator, ASL 5000TM, in which was configured a lung model with restrictive respiratory mechanics with complacency of 25ml/cmH2O and resistance of 10 cmH2O/L/sec. Muscle effort was adjusted in three situations: no muscular effort (Pmus = 0), with inspiratory muscle effort (Pmus = -5 cmH2O) and inspiratory and expiratory effort (Pmus = -5/+5 cmH2O), all with breathe rate (b) of 20 bpm. Five ventilators were connected to the simulator through and endotracheal tube No 8.0 mm and adjusted on VCV, VCV with Auto-flowTM (in the ventilator in which it was available) and PCV modes, all with tidal volume (VT): 420 ml, PEEP: 10 cmH2O and breath rate set in two situations: b = 15 bpm (lower than b of the respiratory muscle effort) and b = 25 bpm (higher than b of the respiratory muscle effort). Variables analyzed were: maximum VT, alveolar pressure at the end of inspiration, effective PEEP, driving pressure, transpulmonary pressure at the end of inspiration and expiration, average transpulmonary pressure, inspiratory peak flow and analysis of mechanic curves. In the studied lung model the b of the ventilator adjusted higher of the b of the patient and not the muscle effort was the main determinant for the development of patient-ventilator asynchrony, causing large variations of the VT and pulmonary pressures, intensifying the lung stress and strain. The ventilatory modes had similar behavior, although VCV Auto-flowTM and PCV have presented slightly higher values of VT and pulmonary pressures. Thus it is concluded that the proper adjustment of the programed breath rate in the assisted/controlled modes can minimize patient-ventilator asynchrony, reducing lung stress and strain.A SÃndrome da AngÃstia RespiratÃria Aguda (SARA) à uma doenÃa inflamatÃria caracterizada por edema pulmonar, pulmÃes rÃgidos e hipoxemia. Pacientes com SARA estÃo mais suscetÃveis à VILI (ventilator induced lung injury). Sob ventilaÃÃo mecÃnica, o stress e o strain pulmonares sÃo os principais determinantes da VILI e nos pacientes com esforÃo muscular a assincronia paciente-ventilador pode potencializar este fenÃmeno. Os modos ventilatÃrios PCV e VCV com AutoFlow podem minimizar a assincronia paciente-ventilador, mas por outro lado podem liberar a oferta de fluxo e volume corrente, comprometendo a estratÃgia ventilatÃria protetora na SARA. Objetivou-se avaliar as influÃncias do esforÃo muscular e da assincronia paciente-ventilador sobre o âstrainâ e o âstressâ pulmonares em modelo pulmonar mecÃnico de sÃndrome da angÃstia respiratÃria aguda. Foi realizado um estudo experimental de bancada, utilizando um simulador de pulmÃo, ASL 5000 no qual foi configurado um modelo pulmonar com mecÃnica respiratÃria restritiva, com complacÃncia de 25ml/cmH2O e resistÃncia de 10 cmH2O/L/sec. O esforÃo muscular foi ajustado em trÃs situaÃÃes: sem esforÃo muscular (Pmus=0), com esforÃo muscular inspiratÃrio (Pmus= -5cmH2O) e esforÃo inspiratÃrio e expiratÃrio (Pmus= -5/+5 cmH2O), todos com frequÃncia respiratÃria (f) de 20rpm. Ao simulador foram conectados cinco ventiladores atravÃs de um tubo orotraqueal n 8,0 mm e ajustados nos modos VCV, VCV com sistema AutoFlow (no ventilador que tinha o sistema disponÃvel) e PCV, todos com volume corrente (VC): 420 ml, PEEP: 10 cmH2O e frequÃncia respiratÃria programada em duas situaÃÃes: f=15rpm (< que a f de esforÃo muscular respiratÃrio) e f=25rpm (> que a f de esforÃo muscular respiratÃrio). As variÃveis analisadas foram: VC mÃximo, a pressÃo alveolar no final da inspiraÃÃo, PEEP efetiva, driving pressure, pressÃo transpulmonar no final da inspiraÃÃo e expiraÃÃo, pressÃo transpulmonar mÃdia, pico de fluxo inspiratÃrio e anÃlise das curvas de mecÃnica. No modelo pulmonar estudado a f do ventilador pulmonar ajustada acima da f do paciente e nÃo o esforÃo muscular o principal determinante para o desenvolvimento de assincronia paciente ventilador, causando grandes variaÃÃes de VC e pressÃes pulmonares, o que intensificou o stress e strain pulmonares. Os modos ventilatÃrios tiveram comportamento semelhante, embora os modos VCV AutoFlow e PCV tenham apresentado valores discretamente maiores de VC e pressÃes pulmonares. Desta forma conclui-se que o ajuste adequado da frequÃncia programada nos modos assistido/controlado podem pode minimizar a assincronia paciente ventilador reduzindo o stress e strain pulmonares. Palavras-
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"Severe acute respiratory syndrome (SARS): from diagnosis to clinical management". Thesis, 2006. http://library.cuhk.edu.hk/record=b6074339.
Texto completo da fonteResumo:
In part ONE of this thesis, including the most up to date information on SARS virology, disease transmission, pathogenesis and laboratory diagnosis will be summarized and presented, including the results of many studies in which I have participated (these references will be underlined as they appear in text). This of course summarizes knowledge that is now known in 2006 but was largely unknown during the initial outbreak. In part TWO, six original clinical studies performed at PWH will be presented: study (1) describes the clinical manifestations and severity of SARS, and its potential to cause major hospital outbreaks; (2) demonstrates the importance of epidemiological linkage in diagnosing SARS; (3) reports the clinical outcomes of a stepwise treatment protocol, which includes the use of corticosteroid therapy as an immunomodulant; (4) demonstrates that corticosteroid therapy can retard viral clearance, and should be used judiciously; (5) demonstrates that a more robust humoral response is associated with severe SARS, thus indicating that passive immunity treatment strategies seem only suitable either during early illness or as prophylaxis; and (6) shows that SARS has few early discriminating laboratory features compared to other causes of community-acquired pneumonia, thus a high index of suspicion is needed to recognize this infection in the absence of worldwide transmission. A thorough review of the relevant published material will be included in the discussion section of each study.Severe Acute Respiratory Syndrome (SARS) is an emerging infectious disease caused by a novel coronavirus. It caused a global outbreak in 2003, resulting in more than 8000 infections, 700 deaths, and major social and economic disruption. In the initial phase of the SARS outbreak, the medical profession had no knowledge regarding the responsible pathogen, nor the clinical manifestations of SARS and the course of illness. There was no reliable diagnostic tool and no known effective therapy. But for the first time in medical history, we witnessed the rapid accumulation of knowledge on a disease as it evolved, which in turn assisted its management and control.
Since conducting randomized-controlled trials during the 2003 crisis was almost impossible, most of the presented studies are either descriptive or case-controlled in design. However, these studies have laid foundations for recent and future research into the clinical diagnosis and management of SARS. Moreover, the construction of the SARS clinical database has contributed to the work of other investigators, which has resulted in over thirty-six publications. It is my hope that these research endeavors can contribute to the understanding of this emerging, deadly disease.
Lee Lai Shun, Nelson.
"April 2006."
Source: Dissertation Abstracts International, Volume: 69-01, Section: B, page: 0205.
Thesis (M.D.)--Chinese University of Hong Kong, 2007.
Includes bibliographical references (p. 264-292).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.