Red Alert Research Articles

A Red Alert for Eye Conjunctivitis in Pakistan: A Call for Action and Awareness

For the recent upsurge in the cases of conjunctivitis particularly in Punjab, Pakistan has reached an alarming level. Till September 2023, almost 395,929 cases have been reported only in Punjab because of such an endemic condition schools have been temporarily closed. About 17000 cases were reported alone in Bahawalpur nearly doubling the figures from the previous month but currently, the epicenter of the break is Lahore as the recent outbreaks have also been seen worldwide like Malaysia, Taiwan, Japan, Brazil, and India. The primary cause of the epidemic is coxsackievirusA24 confirmed through genomic analysis. Coxsackievirus A24 is a non-enveloped, positive-stranded RNA virus which produces a polyprotein that forms a structural and non-structural component. This is responsible for acute hemorrhage conjunctivitis which is a viral disease and can spread rapidly as the virus belongs to a highly contagious genotype 4. Its symptoms are redness, pain, irritation discharge from the eye, and light sensitivity with an incubation period of 24 to 48 hours. Transmission can occur through hand-to-eye and eye-to-hand contact of the infected person as well as through contaminated surfaces. As the virus has the belated to evolved rapidly preventive measures are a necessity which include prevention from touching the eyes, practicing regular hand washing, cleaning contact lenses frequently, avoiding the sharing of personal items and using protective eyewear.

Policy Focus: RED ALERT - Why the UK needs a National Heat Resilience Strategy

Policy Focus: RED ALERT - Why the UK needs a National Heat Resilience Strategy

Forensic Hypoglycaemia & Neuroglycopenia — A Clinical Legal Social Endocrinology Challenge for 2024, Forensic Law in Hypoglycaemia 4

Forensic Hypoglycaemia & Neuroglycopenia — A Clinical Legal Social Endocrinology Challenge for 2024, Forensic Law in Hypoglycaemia 4

Healthcare providers beliefs about the meanings and impacts of prescription drug monitoring program alerts

Background Addiction and overdose death associated with high-risk prescription medications such as benzodiazepines and opioids, are significant global issues. Prescription Drug Monitoring Programs (PDMP), which allow healthcare providers to track and monitor patients’ high-risk medication history have been implemented widely throughout North America and recently in Victoria, Australia. Australia’s PDMP uses a red alert notification to notify healthcare providers to patients at ‘high risk’ of medication related harm. Very little is known about healthcare providers beliefs about the meaning of these notifications and what impact these meanings have on the clinical encounter and patient outcome. Methods Twenty-nine interviews with Victorian healthcare providers (15 prescribers and 14 pharmacists) were thematically analyzed. Results Red alerts were understood as being both synonymous with addiction, as well as a single data point with further investigation required to draw conclusion from. The red alert both disrupted and exposed underlying addiction stigma. Healthcare providers assumptions about patient’s readiness to change influenced their decision to discuss the red alert with patients. Conclusions How healthcare providers make sense of and response to PMDP generated red alerts can impact upon the clinical encounter, including clinical decision-making and the care that patients receive. By identifying and understanding the social factors and forces driving beliefs, attitudes and behaviors toward people who use addictive prescription medications, healthcare providers may be able to pause, assess and reflect on how these factors shape their decision making in unhelpful or unethical ways.

Bloomin’ Ridiculous: Climate Change, Water Contamination and Algal Blooms in a Land Down Under

Climate and anthropogenic change, particularly agricultural runoff, increase blue-green algae/cyanobacteria blooms. This article researches cyanobacteria alert-level identification, management, and risk communication in Lake Hume, Australia. Two methods, document and content analysis, evidence contamination events and risk communication, reflect water governance and data management limitations. Results found that Lake Hume had amber or red alerts for only one week, December 2021–December 2022. This failed to prevent government tourism promotion of recreational usage, contravening water authority red alert advice. Lake-use restrictions lacked compliance enforcement. Events during amber alerts lacked risk communication to vulnerable populations (children). Lake Hume’s governance by the Murray–Darling Basin Authority restricted risk communication to one authority that reproduced generic advice in minimal outlets/time points. Geophysical signage failed to address diversity needs (language, literacy, age, and disabilities). No risk communication was found for residents with diseases exacerbated by aerosolization. Despite WHO promoting cyanotoxin investigation, Australian research is absent in international literature. Further, Lake Hume cyanobacteria produce potentially carcinogenic microcystein. This coexists with census data revealing cancer rates higher than the national average in a waterside town. The results demonstrate the need to incorporate robust public health risk assessments, communication, and management into water management and advocate international legislation changes based on evidence-based research to reduce blooms and prevent agricultural runoff.

Patient-reported symptoms after minimally invasive hysterectomy and association with postoperative complications

ObjectiveTo describe patient-reported postoperative symptoms and to evaluate the use of digital symptom tracking and alerts to detect postoperative complications. MethodsWe retrospectively reviewed patients who underwent a minimally invasive hysterectomy and enrolled in our Recovery Tracker program from 4/5/17–12/31/21. The Recovery Tracker is an at-home virtual tool used to track patient-reported postoperative symptoms for 10 days. Predefined thresholds for “red” and “yellow” alerts are based on symptom severity and timing. Data on patient demographics, surgery, and postoperative course were collected to evaluate the association of alerts with complications and compare outcomes of patients who did/did not enroll in the program. ResultsOf 2362 eligible patients, 1694 (71.7%) enrolled in the Recovery Tracker program. Pain was the most severe symptom, followed by fatigue. Eighty-seven patients experienced 102 complications (5.1% complication rate) and 32 experienced 39 grade ≥ 2 complications (1.9% severe complication rate).Excluding complications that occurred prior to Recovery Tracker use, 1673 patients experienced 28 grade ≥ 2 complications. Of 345 patients (20.6%) who triggered a red alert, 13 (3.8%) had a grade ≥ 2 complication. Of 1328 patients (79.4%) with no red alerts, 15 (1.13%) had a grade ≥ 2 complication. Relative risk of a grade ≥ 2 complication if a red alert was triggered was 3.25 (95% CI: 1.6–6.9, P = .002). Rate of severe complications was significantly higher among patients who did not use the tool (3.3% vs 1.9%; P = .04). ConclusionsThe Recovery Tracker tool may assist in early identification of postoperative symptoms after minimally invasive hysterectomy.

In an era where the Chemistry has to be Green! Red Alert!

The line dividing green chemistry from pseudo-green chemistry becomes fragile. The pressures to present as quickly as possible results in scientific and business spheres, associated with the incessant search for funding in strategic areas, such as the Environment and Health, leads to the development of “fast science”, which is not always accurate.

Stress and Coping among College Students during a COVID-19 Red Alert Status on Campus

ABSTRACT Background High rates of stress have been found among college students during the COVID-19 pandemic and research on students’ use of coping strategies during the pandemic is needed, particularly during periods of extensive restrictions on campus. Purpose The current study examined stress and coping during a campus red alert at a mid-sized U.S. university. Methods Data collected from an online survey sent out to undergraduate students 30 days after a COVID-19 red alert status (akin to a campus lockdown) was instituted on a college campus in the Fall of 2020 were analyzed. The survey included scales assessing coping strategies and perceived stress. Results Regression analyses indicated that stress during the red alert was associated with several maladaptive coping strategies, such as denial, substance use and behavioral disengagement. Whereas stress was inversely associated with positive coping strategies, such as active coping, planning, and acceptance. Discussion Health education efforts during campus lockdowns should include screening for stress, increased access to mental health services, coping skills-related informational workshops, and virtual recreational and social opportunities. Translation to Health Education Practice The study highlights how assessing stress and coping among college students during public health events can guide health education activities for college students.

Forensic Law in Hypoglycaemia-1

Hypoglycaemia, low Blood Glucose BG when BG falls below 3.0mmol/l exhibits Physiological Symptoms of Tremor, Sweating and Hunger, requiring prompt glucose treatment input which if not corrected leads to Confusion, Sensory Disturbance and Behaviour Change at 2.0mmol/l described as Neuroglycopenia. If Blood Glucose BG falls to 1.0mmol/l or 18mg/dl Diabetic Coma is likely to occur leading to unconsciousness and without fast acting glucose severe risk of death. An estimated 600 million patients with Diabetes are thought to exist in the World in 2022 and an estimated 4.5 million in the UK. It is estimated 10% of Diabetes patients are T1D Type 1 Diabetes Insulin Dependent and 90% T2D Type 2 Diabetes Patients Non-Insulin Dependent. Many T2D Patients may require Insulin Treatment several years after diagnosis. Does society really understand the daily burden the diabetes patient faces and the need if things go wrong to provide emergency patient support or the need for A1 Red Alert Emergency support in a hospital, and Paramedic Ambulance support in the Community? This is identified in the UK alone as over 95,000 Emergency Diabetes Hypoglycaemia Calls every year, many of which are potentially avoidable with better understanding and education with family and/or friend witness support.

From Italy to Little Italy to Big ’merica and Beyond: Thoughts on Italian Diaspora Studies

From Italy to Little Italy to Big ’merica and Beyond: Thoughts on Italian Diaspora Studies

Smartphone-based application and nurses' interventions for symptoms monitoring in patients treated with oral anticancer agents: A 1-year follow-up in a tertiary cancer center.

The increasing use of oral anticancer agents over the past years has necessitated changes in monitoring toxicities to ensure patients' adherence and tolerance at home. The aim of this study was to describe nurses' interventions and medical changes after alerts triggered by a web-based platform designed to support the management of oral anticancer agents-related toxicities. This retrospective study included patients undergoing oral anticancer agents in a cancer center from September 2018 to September 2019 (excluding hormonal therapy). In this cancer center, the standard of care included symptoms' collections for 1 month thanks to a web platform based on patient-reported outcomes. Patients had to fill a weekly questionnaire (Q1 to Q4). The web-based platform triggered orange alerts when patients reported moderate symptoms and red alerts when severe toxicities were declared. The rate of orange and red alerts, the rate of patients with medical changes consecutively to an orange or a red alert, and the different types of nurses' interventions and medical changes were assessed. A total of 524 patients were extracted but the final number of 436 patients were included in this study and 1488 questionnaires were filled in. More than 90% of patients declared that they took their medication as prescribed. Up to 60% of patients recorded all grade symptoms, including 8% of patients who recorded Grades 3-4 symptoms during the month, mostly anorexia, fatigue, and diarrhea. The web platform system triggered 700 orange and 212 red alerts: 305/700 (44%) of orange alerts resulted in nurses' interventions, most frequently phone counseling (78%), and 65/212 (31%) of red alerts resulted in medical changes, most frequent treatment interruptions (48%). Implementing an e-health (electronic-health) system can be helpful for monitoring symptoms in patients under oral anticancer agents, enhancing that this organization should be a standard of care in every cancer centers.

Haematological Monitoring in Clozapine Use: Blood Best Sampled in the Afternoon?

AimsClozapine is an atypical antipsychotic used in the management of Treatment-Resistant Schizophrenia (TRS). Despite its efficacy, Clozapine is associated with rare but clinically important haematological side effects of neutropenia and agranulocytosis, thus warranting regular monitoring of full blood count (FBC) white blood count (WBC) and neutrophil count (NC).Clozaril Patient Monitoring service (CPMS) supervises the prescribing of Clozapine and haematological testing for patients. Amber and Red alerts are issued by the CPMS when WBC and NC values fall below specified levels, Clozapine treatment is either suspended or discontinued completely.MethodsWe present a case of 35-year-old Caucasian lady with a history of schizophrenia who was maintained on Clozapine treatment for 10 years and whose Clozapine was necessarily stopped because of red alerts. This lead to a significant deterioration in her mental state and level of functioning necessitating a prolonged hospital admission.Results•Detailed retrospective review of this patient's CPMS results over a 2-year period identified consistently higher levels of WBC and NC, when the blood tests were conducted in the afternoon compared to mornings.•Literature review supported the phenomenon of a diurnal variation of WBC and NC levels in a proportion of patients prescribed Clozapine.•With clear knowledge of this patient's diurnal trends in WBC and NC count, it was possible to liaise with CPMS and restart her Clozapine treatment, leading to a significant improvement in her mental state and level of functioning.Conclusion•We recommend that clinicians consider this phenomenon of diurnal variation in blood parameters in patients with frequent amber and red alert results who are at risk of having their Clozapine medication discontinued.•Close collaboration with CPMS and haematological advice may lead to a more nuanced approach to blood sampling, whereby afternoon samples are used in certain at-risk patients.

Impact of Omicron surge in community setting in greater Paris area

IntroductionThe SARS-CoV-2 Omicron variant of concern (VOC) was first identified in South Africa during November 2021, and has now become the dominant variant in Europe and worldwide. However, as the number of Omicron COVID-19 cases increased rapidly in South Africa, the rate of hospitalization due to Omicron infections seemed lower than that of Delta infections.The Greater Paris area has experienced five COVID-19 surges. We aimed to assess the impact and clinical severity of patients infected during the Omicron surge compared with the previous surges in community setting in this area.Matériels et méthodesWe performed a cohort study including adult patients, with confirmed COVID-19 diagnosis (RT-PCR or antigen), managed from 9 March 2020 until 11 January 2022 with Covidom, a telesurveillance solution for home monitoring of patients with COVID-19 in the greater Paris area. When included, the patients completed on a daily basis self-administered questionnaires until 10 to 30 days according to symptom course. According to predefined thresholds, questionnaires could generate 2 types of alerts: orange alert (mild priority), and red alert (top priority alert). Outcome was recorded: unplanned hospitalization (including in intensive care unit), contact with national emergency number, or admission to Emergency department.RésultatsOverall, 225,248 patients were included in the study, including 72,394 from the last surge, which is more numerous compared to the previous surges. Patients included during the Delta and Omicron waves were younger (mean age 35.6 ± 13.0 and 38.4 ± 13.0 versus maximum 44.5 ± 14.5 years in surge 1; p<0.001). Significantly fewer patients with comorbidities were included in surge 5 (p<0.001), and the proportion presenting with respiratory signs was lower (49.8% in surge 5 vs maximum 86.5% in surge 1; p<0.001). During surge 5, while the number of patients included was high compared to previous surges, the rate of orange and red alerts was significantly lower (p<0.0001), as the number of hospitalizations, national emergency contact and emergency unit requirement (p<0.0001).ConclusionThese data confirm that the Omicron surge is highly significant considering the number of cases but presents with a low rate of severe presentation and worsening.Aucun lien d'intérêt

Analysis of a Remote Monitoring Program for Symptoms Among Adults With Cancer Receiving Antineoplastic Therapy

Electronic patient-reported outcomes (ePROs) may have the potential to improve cancer care delivery by enhancing patient quality of life, reducing acute care visits, and extending overall survival. However, the optimal cadence of ePRO assessments is unknown. To determine patient response preferences and the clinical value associated with a daily cadence for ePROs for patients receiving antineoplastic treatment. This quality improvement study of adult patients undergoing antineoplastic treatment assessed a remote monitoring program using ePROs that was developed to manage cancer therapy-related symptoms. ePRO data submitted between October 16, 2018 to February 29, 2020, from a single regional site within the Memorial Sloan Kettering Cancer Center network were included. Data were analyzed from April 2020 to January 2022. While undergoing active treatment, patients received a daily ePRO assessment that, based on patient responses, generated yellow (moderate) or red (severe) symptom alerts that were sent to clinicians. The main outcomes assessed included patient response rate, symptom alert frequency, and an analysis of the clinical value of daily ePROs. A total of 217 patients (median [range] age, 66 [31-92] years; 103 [47.5%] women and 114 [52.5%] men) initiating antineoplastic therapy at high risk for symptoms were monitored for a median (range) of 91 (2-369) days. Most patients had thoracic (59 patients [27.2%]), head and neck (48 patients [22.1%]), or gastrointestinal (43 patients [19.8%]) malignant neoplasms. Of 14 603 unique symptom assessments completed, 7349 (50.3%) generated red or yellow symptom alerts. Symptoms commonly generating alerts included pain (665 assessments [23.0%]) and functional status (465 assessments [16.1%]). Most assessments (8438 assessments [57.8%]) were completed at home during regular clinic hours (ie, 9 am-5 pm), with higher response rates on weekdays (58.4%; 95% CI, 57.5%-59.5%) than on weekend days (51.3%; 95% CI, 49.5%-53.1%). Importantly, 284 of 630 unique red alerts (45.1%) surfaced without a prior yellow alert for the same symptom within the prior 7 days; symptom severity fluctuated over the course of a week, and symptom assessments generating a red alert were followed by an acute care visit within 7 days 8.7% of the time compared with 2.9% for assessments without a red alert. These findings suggest that daily ePRO assessments were associated with increased insight into symptom management in patients undergoing antineoplastic treatment and symptom alerts were associated with risk of acute care.

Red Alert: It Is Time to Strengthen the Medical Knowledge of Noncompressible Torso Hemorrhage Among Health-Care Workers.

Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China. A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue. A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%). Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.

Value and use of patient reported outcomes in sarcoma clinic through GetWell Loop app.

179 Background: Symptom monitoring in cancer care through patient reported outcomes has been used as an approach to improve symptom detection and communication. Through monitoring of patient symptoms via a systematic way, previous studies have shown a reduction in ED visits and hospital admissions, an enhancement in patient-clinician communication and overall patient satisfaction and wellbeing. In this study, we evaluated outcomes of patient reported data by using the GetWell Loop app to help determine if it facilitates cancer care and improves clinical outcomes. Methods: We performed a retrospective, single-center analysis of sarcoma patients age &gt; 18 who between December 2019 to January 2021 received systemic treatment and were enrolled to use GetWell Loop app to report their treatment related outcomes. We asked patients how they are feeling on a systematic basis post treatment by using a series of questions related to their therapy and potential symptoms. Through the use of GetWell Loop, patients are able to record symptoms information and prompt evaluation by a healthcare provider if they report severe or rapidly changing symptoms. Descriptive statistics were used to summarize use of the GetWell Loop through patient surveys, app generated data, and data available in EPIC electronic medical record. We noted the number of yellow (moderate) and red (severe) alerts generated by patient responses and the corresponding alert trigger to health care provider response. Healthcare provider communication and interventions were recorded, as were hospitalizations and ED visits while using the app. Results: A total of 75 patients were invited to join enrollment. Of those, 54 activated the app, with an activation rate of 72%. Engagement rate was 61% and 74 total alerts were generated. Of the severity of symptoms leading to an alert, 28% were red alters and 72% were yellow alerts. Red alerts most commonly comprised of decreased fluid intake, constipation, and fevers. The majority of red alert symptoms lead to an intervention from nursing staff that started with a phone call, while a minority of interventions were in app messages with the patient. Five red alerts led to an ED visit. The majority of yellow alert symptoms were addressed through in app messages. Both clinical staff and patients felt it helped them stay connected. Patients were most adherent with the first treatment. Patient satisfaction was 87.5% with the app usage. Conclusions: Using patient reported outcomes by using the GetWell Loop app yielded an overall positive patient experience. It provides an opportunity to intervene early with high risk patients and prevent ED visits. Focusing on the first cycle of a regiment and subsequent cycles if high risk seemed to provide the most benefit. There is utility to expand to other disease teams and use the app for survivorship support as well.

The Use of Telemonitoring in Managing the COVID-19 Pandemic: Pilot Implementation Study.

BackgroundMost people with COVID-19 self-manage at home. However, the condition can deteriorate quickly, and some people may develop serious hypoxia with relatively few symptoms. Early identification of deterioration allows effective management with oxygen and steroids. Telemonitoring of symptoms and physiological signs may facilitate this.ObjectiveThe aim of this study was to design, implement, and evaluate a telemonitoring system for people with COVID-19 who are self-managing at home and are considered at significant risk of deterioration.MethodsA multidisciplinary team developed a telemonitoring protocol using a commercial platform to record symptoms, pulse oximetry, and temperature. If symptoms or physiological measures breached targets, patients were alerted and asked to phone for an ambulance (red alert) or for advice (amber alert). Patients attending COVID-19 assessment centers, who were considered fit for discharge but at risk of deterioration, were shown how to use a pulse oximeter and the monitoring system, which they were to use twice daily for 2 weeks. Patients could interact with the system via app, SMS, or touch-tone phone. Written guidance on alerts was also provided. Following consent, patient data on telemonitoring usage and alerts were linked to data on the use of service resources. Subsequently, patients who had either used or not used the telemonitoring service, including those who had not followed advice to seek help, agreed to brief telephone interviews to explore their views on, and how they had interacted with, the telemonitoring system. Interviews were recorded and analyzed thematically. Professionals involved in the implementation were sent an online questionnaire asking them about their perceptions of the service.ResultsWe investigated the first 116 patients who used the service. Of these patients, 71 (61.2%) submitted data and the remainder (n=45, 38.8%) chose to self-monitor without electronic support. Of the 71 patients who submitted data, 35 (49%) received 152 alerts during their 2-week observation. A total of 67 red alerts were for oxygen saturation (SpO2) levels of ≤93%, and 15 red alerts were because patients recorded severe breathlessness. Out of 71 patients, 14 (20%) were admitted to hospital for an average stay of 3.6 (SD 4.5) days. Of the 45 who used written guidance alone, 7 (16%) were admitted to hospital for an average stay of 4.0 (SD 4.2) days and 1 (2%) died. Some patients who were advised to seek help did not do so, some because parameters improved on retesting and others because they felt no worse than before. All patients found self-monitoring to be reassuring. Of the 11 professionals who used the system, most found it to be useful and easy to use. Of these 11 professionals, 5 (45%) considered the system “very safe,” 3 (27%) thought it “could be safer,” and 3 (27%) wished to have more experience with it before deciding. In total, 2 (18%) felt that SpO2 trigger thresholds were too high.ConclusionsSupported self-monitoring of patients with COVID-19 at home is reassuring to patients, is acceptable to clinicians, and can detect important signs of deterioration. Worryingly, some patients, because they felt well, occasionally ignored important signs of deterioration. It is important, therefore, to emphasize the importance of the early investigation and treatment of asymptomatic hypoxia at the time when patients are initiated and in the warning messages that are sent to patients.

How to Manage Red Alert in Emergency and Disaster Unit in the Hospital? Evidence From London.

This research gave an overview of coordinated hospital planning issues. In these issues, patients desire an arrangement for different source types, ideally as quickly as time permits. This field of context has just picked up academic interest, despite its reality since 1995. The way may discover a clarification for the above aspect that managing the hospital sources is regularly performed separately without taking a bigger picture. Therefore, it is particularly valid if the sources are situated in different departments. Another subsequent clarification may be related to the notoriety of the patient flow context. Hence, patients shouldn't be planned in these issues to be queued for another source or leave the system in case of their satisfaction of solicitation for the services at a particular source. The primary contribution of the present research is assisting present and new scholars via enumeration for every progression of the study of accessible decisions in the present context. Such means could be represented by major references for scientists to discover such studies endeavors tailored to their respective requirements. This principle removes the message: scientists ought to consistently coordinate their decisions concerning the setting, the capacity, and the approaches, as not all blends are conceivable.

Nanosilver/hydrogel: Synthesis and application in delaying senescence of cut flower

The superabsorbent Aquasorb hydrogel enriched with silver ion solutions was exerted with sodium borohydride (NaBH4) and glucose/ sodium hydroxide (NaOH) in various concentrations as reducing agents. Scanning electron microscopy (SEM), and transmission electron microscopy (TEM) images confirmed the presence of silver nanoparticles (SN) in the amorphous structure of hydrogel. The results showed that the swelling of hydrogel increased by glucose (5 mM) / sodium hydroxide (10 mM) 298.5 g water/g hydrogel, while atomic absorption analysis showed that the amount of SN (0. 1054 mg/ mg hydrogel) was in the reduced sample by glucose (10 mM)/ sodium hydroxide (10 mM). The highest antibacterial activity on Escherichia coli and Bacillus cereus was observed in reduced samples by NaBH4. Then the efficacy of this sample containing SN 1–3 nm sized particles (50 mg L−1) was evaluated in the preservative solution of rose cut flower cv. ‘Red Alert’. The results indicated positive effects of hydrogel enriched with silver nanoparticles on relative fresh water, membrane stability index, and the vase life extended (14.26 days) in cut flowers, and did not result in any evident toxic effects, so that the highest chlorophyll content was observed in the hydrogel containing silver nanoparticles (86.4%). The results indicated that the expression level of two senescence-associated genes (RhAA and RhCG) were decreased in rose petals, and the RhCTR1 as a negative regulator in the ethylene signaling pathway was induced at higher levels in the hydrogel- containing SN treatment. As our findings showed, the nanocomposite hydrogel containing silver nanoparticles can be used to control the toxicity of SN in the preservative solution with higher efficiency, and the ability to use multiple times for senescence delay in the cut flowers industry.

Improving Detection of Disease Re-emergence Using a Web-Based Tool (RED Alert): Design and Case Analysis Study

BackgroundCurrently, the identification of infectious disease re-emergence is performed without describing specific quantitative criteria that can be used to identify re-emergence events consistently. This practice may lead to ineffective mitigation. In addition, identification of factors contributing to local disease re-emergence and assessment of global disease re-emergence require access to data about disease incidence and a large number of factors at the local level for the entire world. This paper presents Re-emerging Disease Alert (RED Alert), a web-based tool designed to help public health officials detect and understand infectious disease re-emergence.ObjectiveOur objective is to bring together a variety of disease-related data and analytics needed to help public health analysts answer the following 3 primary questions for detecting and understanding disease re-emergence: Is there a potential disease re-emergence at the local (country) level? What are the potential contributing factors for this re-emergence? Is there a potential for global re-emergence?MethodsWe collected and cleaned disease-related data (eg, case counts, vaccination rates, and indicators related to disease transmission) from several data sources including the World Health Organization (WHO), Pan American Health Organization (PAHO), World Bank, and Gideon. We combined these data with machine learning and visual analytics into a tool called RED Alert to detect re-emergence for the following 4 diseases: measles, cholera, dengue, and yellow fever. We evaluated the performance of the machine learning models for re-emergence detection and reviewed the output of the tool through a number of case studies.ResultsOur supervised learning models were able to identify 82%-90% of the local re-emergence events, although with 18%-31% (except 46% for dengue) false positives. This is consistent with our goal of identifying all possible re-emergences while allowing some false positives. The review of the web-based tool through case studies showed that local re-emergence detection was possible and that the tool provided actionable information about potential factors contributing to the local disease re-emergence and trends in global disease re-emergence.ConclusionsTo the best of our knowledge, this is the first tool that focuses specifically on disease re-emergence and addresses the important challenges mentioned above.