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Background: Dengue is the most important vector-borne viral infection of man, with approximately 2 billion people living in areas at risk. Infection results in a range of manifestations from asymptomatic infection through to life-threatening shock and haemorrhage. One of the hallmarks of severe dengue is vascular endothelial disruption. There is currently no specific therapy and clinical management is limited to supportive care. Statins are a class of drug initially developed for lipid lowering. There has been considerable recent interest in their effects beyond lipid lowering. These include anti-inflammatory effects at the endothelium. In addition, it is possible that lovastatin may have an anti-viral effect against dengue. Observational data suggest that the use of statins may improve outcomes for such conditions as sepsis and pneumonia. This paper describes the protocol for a randomised controlled trial investigating a short course of lovastatin therapy in adult patients with dengue. Methods/design: A randomised, double-blind, placebo-controlled trial will investigate the effects of lovastatin therapy in the treatment of dengue. The trial will be conducted in two phases with an escalation of dose between phases if an interim safety review is satisfactory. This is an exploratory study focusing on safety and there are no data on which to base a sample size calculation. A target sample size of 300 patients in the second phase, enrolled over two dengue seasons, was chosen based on clinical judgement and feasibility considerations. In a previous randomised trial in dengue, about 10% and 30% of patients experienced at least one serious adverse event or adverse event, respectively. With 300 patients, we will have 80% power to detect an increase of 12% ( from 10% to 22%) or 16% (from 30% to 46%) in the frequency of adverse events. Furthermore, this sample size ensures some power to explore the efficacy of statins. Discussion: The development of a dengue therapeutic that can attenuate disease would be an enormous advance in global health. The favourable effects of statins on the endothelium, their good safety profile and their low cost make lovastatin an attractive therapeutic candidate. [ABSTRACT FROM AUTHOR]

During the rainy season in extensive river floodplains and deltaic lowlands, floods lasting several months render the land unavailable for crop production for several months each year. These waters are considerably underutilized in terms of managed aquatic productivity. This raises the opportunity to enclose parts of these annually occurring floodwater areas to produce a crop of specifically stocked aquatic organisms aside from the naturally occurring `wild' species that are traditionally fished and are not affected by the culture activity, overall resulting in more high-quality, nutrient-dense food production and enhanced farm income for all stakeholders, notably the poor. The WorldFish Center and its national partners recently tested two systems in a community based management approach in Bangladesh and Vietnam: (i) concurrent rice-fish culture in shallower flooded areas, and (ii) alternating rice and fish culture in the deep-flooded areas. Results indicate that community-based fish culture in rice fields is technically feasible, economically viable and socially acceptable. It can increase fish Production to about 600kg/ha/year in shallow flooded areas and up to 1.5 t/ ha/year in deep-flooded areas, without reduction in rice yield and wild fish catch. For the overall system and in the trials conducted, an additional income of US$135 per ha in southern Vietnam, and up to US$437 per ha in Bangladesh were achieved, which is an increase of 20% to 85% over the previous profitability. The communities neighboring the trial sites have been adopting the technologies widely. [ABSTRACT FROM AUTHOR]

Electrocardiogram (ECG) and photoplethysmogram (PPG) are commonly used to determine the vital signs of heart rate, respiratory rate, and oxygen saturation in patient monitoring. In addition to simple observation of those summarized indexes, waveform signals can be analyzed to provide deeper insights into disease pathophysiology and support clinical decisions. Such data, generated from continuous patient monitoring from both conventional bedside and low-cost wearable monitors, are increasingly accessible. However, the recorded waveforms suffer from considerable noise and artifacts and, hence, are not necessarily used prior to certain quality control (QC) measures, especially by those with limited programming experience. Various signal quality indices (SQIs) have been proposed to indicate signal quality. To facilitate and harmonize a wider usage of SQIs in practice, we present a Python package, named vital_sqi, which provides a unified interface to the state-of-the-art SQIs for ECG and PPG signals. The vital_sqi package provides with seven different peak detectors and access to more than 70 SQIs by using different settings. The vital_sqi package is designed with pipelines and graphical user interfaces to enable users of various programming fluency to use the package. Multiple SQI extraction pipelines can take the PPG and ECG waveforms and generate a bespoke SQI table. As these SQI scores represent the signal features, they can be input in any quality classifier. The package provides functions to build simple rule-based decision systems for signal segment quality classification using user-defined SQI thresholds. An experiment with a carefully annotated PPG dataset suggests thresholds for relevant PPG SQIs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Le, Ho, Karolcik, Hernandez, Greeff, Nguyen, Phan, Le, Thwaites, Georgiou and Clifton.)