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Health is one of the basic needs of human life. If this need cannot be fulfilled, then nothing can compensate for the loss. Often in Bangladesh, we observe that the economic ability of mass people can hardly ensure proper health care. The poor are being deprived of proper health care and even though the rich class can afford quality health care, but it comes with many compromises with their valuable time and labor. To meet the gap, we thought of a smartphone-based health care system that will assist people, especially the underprivileged, to attain health care easily and effectively. To effectively use the ICT facility that the government and non-government sectors are providing, we made a mobile application that will have several features including online appointment and cabin booking, prescription generator, hospital, and doctor's information displayed along with the suggestion, medicinal and disease information, etc. Since there is a great need for a system that can alarm people of emerging diseases in their area, we made a system to alarm people about that. Moreover, in the world of continuous changes, there is a great need for communication to acquire the latest knowledge. Hence a social network where doctors can discuss cures and medication will be of great benefit. Along with this, the need for continuous observation of medicinal side effects is not negligible. So, we need a proper channel for communication between patient and doctor, especially when a patient encounters some trouble when he takes the pre-scribed medications because of their side effects.

Background Understanding the burden of influenza is necessary to optimize recommendations for influenza vaccination. We describe the epidemiology of severe influenza in 50- to 64-year-old residents of metropolitan Toronto and Peel region, Canada, over 7 influenza seasons. Methods Prospective population-based surveillance for hospitalization associated with laboratory-confirmed influenza was conducted from September 2010 to August 2017. Conditions increasing risk of influenza complications were as defined by Canada's National Advisory Committee on Immunization. Age-specific prevalence of medical conditions was estimated using Ontario health administrative data. Population rates were estimated using Statistics Canada data. Results Over 7 seasons, 1228 hospitalizations occurred in patients aged 50–64 years: 40% due to A(H3N2), 30% A(H1N1), and 22% influenza B. The average annual hospitalization rate was 15.6, 20.9, and 33.2 per 100 000 in patients aged 50–54, 55–59, and 60–64 years, respectively; average annual mortality was 0.9/100 000. Overall, 33% of patients had received current season influenza vaccine; 963 (86%) had ≥1 underlying condition increasing influenza complication risk. The most common underlying medical conditions were chronic lung disease (38%) and diabetes mellitus (31%); 25% of patients were immunocompromised. The average annual hospitalization rate was 6.1/100 000 in those without and 41/100 000 in those with any underlying condition, and highest in those with renal disease or immunocompromise (138 and 281 per 100 000, respectively). The case fatality rate in hospitalized patients was 4.4%; median length of stay was 4 days (interquartile range, 2–8 days). Conclusions The burden of severe influenza in 50- to 64-year-olds remains significant despite our universal publicly funded vaccination program. These data may assist in improving estimates of the cost-effectiveness of new strategies to reduce this burden.

In this paper, we have given a practical solution for solving the problem of visually impaired people using a android based mobile platform. An application is created for detecting obstacles, ups & downs in front of the user. It also detects safe zone in pedestrian lane & gives audio feedback. Using techniques of hough transform and segmentation a real time outdoor navigational system is implemented at the least expenses. It detects line in real time video and make use of OpenCV library.

OBJECTIVETo describe the frequency, characteristics, and exposure associated with influenza in hospitalized patients in a Toronto hospitalDESIGN/METHODProspective data collected for consenting patients with laboratory-confirmed influenza and a retrospective review of infection control charts for roommates of cases over 3 influenza seasonsRESULTSOf the 661 patients with influenza (age range: 1 week–103 years), 557 were placed on additional precautions upon admission. Of 104 with symptoms detected after admission, 57 cases were community onset and 47 were nosocomial (10 nosocomial were part of outbreaks). A total of 78 cases were detected after admission exposing 143 roommates. Among roommates tested for influenza after exposure, no roommates of community-onset cases and 2 of 16 roommates of nosocomial cases were diagnosed with influenza. Of 637 influenza-infected patients, 25% and 57% met influenza-like illness definitions from the Public Health Agency of Canada (PHAC) and Centers for Disease Control and Prevention (CDC), respectively, and 70.3% met the Provincial Infectious Diseases Advisory Committee (PIDAC) febrile respiratory illness definition. Among the 56 patients with community-onset influenza detected after admission, only 13%, 23%, and 34%, met PHAC, CDC, and PIDAC classifications, respectively.CONCLUSIONSIn a setting with extensive screening and testing for influenza, 1 in 6 patients with influenza was not diagnosed until patients and healthcare workers had been exposed for >24 hours. Only 30% of patients with community-onset influenza detected after admission met the Ontario definition intended to identify cases, hampering efforts to prevent patient and healthcare worker exposures and reinforcing the need for prevention through vaccination.Infect Control Hosp Epidemiol 2017;38:387–392

Background Numerous factors that affect the presentation and severity of pneumococcal disease. Several studies in the pre-PCV era demonstrated that organism characteristics, including serotype, are associated with variability in disease presentation and severity. We undertook an analysis of population based surveillance for invasive pneumococcal disease (IPD) to assess whether herd immunity from PCVs will change the presentation and severity of IPD in adults Methods TIBDN has performed population-based surveillance for IPD in Toronto and Peel region (pop’n 4.5M) since 1995. All sterile site isolates of S. pneumoniae are reported to a central study laboratory, isolates are serotyped, and clinical and vaccination data are collected via patient and physician interview and chart review. Population data are obtained from Statistics Canada. Backwards stepwise logistic regression assessed patient characteristics, illness features, and isolate factors associated with clinical presentation and case fatality. Results Between 1995 and 2018, 8815 episodes of IPD were identified in adults. Patients infected with PCV10not7 serotypes were younger, more likely male and without underlying illness. Patients with infections due to non-vaccine types were more likely to be immunocompromised. Case fatality in IPD declined from 177/754 in 1995/6 to 113/554 in 2017/8; OR 0.67, 95%CI0.51-0.86, P< .0001) and in all serotype groups (Figure). In multivariable models adjusted for host factors, relative to infections caused PCV7 serotypes, those caused by PCV10not7 were less likely to be fatal (OR 0.65, 95%CI 0.46–0.91); those caused by PCV13not10 were more likely to be fatal (OR 1.6, 95%CI 1.3–1.9). Bacteremic pneumonia as a proportion of presentations is highest in IPD due to PCV10not7 and PCV13not10 serotypes (85% and 83%, respectively), and lowest in IPD due to non-vaccine serotypes and PCV20not15 (59% and 68%, P< .0001). Meningitis is least common in IPD due to PCV10not7 serotypes (2.6%), and highest in cases due to non-vaccine types and PCV20not15 (9.0% and 8.0%, respectively, P< .0001). FIgure Conclusion In our population, herd immunity from PCVs will result in a higher proportion of adult IPD occurring in immunocompromised cases, and a shift from bacteremic pneumonia to bacteremia without focus and meningitis. Disclosures Allison McGeer, MD, FRCPC, GlaxoSmithKline (Advisor or Review Panel member, Research Grant or Support)Merck (Advisor or Review Panel member, Research Grant or Support)Pfizer (Research Grant or Support)

In present era demand for small and portable electronic devices which supports internet connectivity is increasing all around the world and across all industries. These IoT based devices are gaining popularity because of their ease of use. These devices also provide powerful interoperability and feasibility in almost all situation. We can use Internet of Things (IoT) as a great instrument for achieving the desire of connecting people and devices everywhere all the time and in all situations. IoT builds a network of different types of devices such as small handheld devices, vehicles, home appliances etc. that are connected together. This network is incorporated with small sensor nodes, wireless connectivity and actuators for collecting data from adjacent environment and transfer data seamlessly to the base station without any computer or human interaction. Though Internet of Things (IoT) is a primitive term which has greatly attracted the attentions of researchers and academicians it is now getting limited by a number of factors such as flexibility, interoperability, concurrency, scalability and addressing issues. In this paper we will discuss how to make approach when we will go for IoT based solutions considering several parameters such as cost effectiveness, profit generation, maintenance, security etc. In which projects IoT based solutions will be feasible considering. Its network infrastructure, architecture, processing power and scalability.

This paper explores the current trends in audio-visual translation, in particular, movie subtitling from English into Sorani Kurdish in the Kurdistan Region of Iraq. It is hypothesized that subtitling English movies into Sorani Kurdish is performed using various methods, i.e. there is no one standard method that is adopted. This is based on the second hypothesis that the majority of subtitled movies into Sorani Kurdish are carried out by unprofessional subtitlers. The results of the study show that the majority of the subtitlers replace the English captions of previously subtitled movies by Kurdish translations, using different devices and word processors. Thus, the study exhibits that there is no one standard established method for subtitling English movies into Sorani Kurdish. It further shows that Kurdish subtitlers lack professionalism in terms of English-Kurdish subtitling.

Data on factors associated with the use of antiviral medication to treat influenza in both children and adults are limited.To describe trends in antiviral use, analyze factors associated with antiviral treatment of hospitalized patients with influenza, and to compare use based on guidelines.A retrospective observational cohort of hospitalized patients with laboratory confirmed influenza in southern Ontario hospitals for the 2004/05-2013/14 seasons.Of the 7967 patients, 18% of the 1779 children (15 years) and 66% of the 6188 adults received antiviral therapy. The percentage treated increased from 29% pre-pandemic to 74% during the pandemic, decreased to 55% in 2011/12 and then increased to 65% in 2013/14. Factors significantly associated with antiviral prescription across all age groups during the non-pandemic seasons include influenza type, disease severity, interval between symptom onset and test sample submission, and clinician suspicion of influenza. Rate of treatment of patients meeting guideline criteria was low for children and moderate for adults.Since the pandemic, there has been a sustained increase in the use of antiviral medication for all age groups of hospitalized patients with influenza, but much higher for adults than children. The odds of treatment are higher for patients with more severe disease as well as for those tested within 48 h of symptom onset, both of which are part of the guidelines for treatment with anti-influenza medications.

Typically, the analysis and design of fluvial flood defence schemes is based on a single N year extreme flow event using a single survey of the river channel and flood plains. Adopting this approach assumes that the channel capacity is identical for all subsequent N year events. If one assumes that the typical design life for a flood defence scheme is of the order of 50 years, then such an approach is flawed because river channel morphology, and hence flood conveyance, may change considerably over this time scale. Therefore, to provide a more robust estimate of future flood inundation, a sensitivity analysis of these changes should be undertaken. This paper proposes a modeling methodology that combines a stochastic model, for estimating streamflow throughout the design period, and a 1D sediment transport model (HEC-RAS), to enable this sensitivity to be included in flood inundation modeling and defence scheme design. The methodology is demonstrated through conceptual implementation to evaluate the...

Background As indications for testing for influenza broaden, influenza is increasingly being diagnosed in association with hospitalization in adults. We report data on the burden of illness associated with laboratory confirmed influenza requiring hospitalization (LCI-H) in Toronto, Canada from 2010–2011 to 2015–2016. Methods TIBDN has performed population-based surveillance for LCI-H in adults (≥15years) in Toronto and Peel Region, Canada since 2005. All positive tests for influenza are reported, patients are approached for consent and data collected by chart review and patient/physician interview. Death within 30 days of hospitalization was considered associated with influenza. Population data were obtained from Statistics Canada, with data by underlying condition obtained from literature review and provincial health administrative data. Results Over 6 seasons, 5,591 LCI-H episodes were identified: 1,094 (20%) H1N1, 2,847 (51%) H3N2, 415 (7%) A(not typed), 1A(H3N2 and H1N1) and 1,235 (22%) B. The median age of patients was 71.4 years, with 69.3% of patients over 65 years of age; 3,015 (53.4%) were female, 2,618 (46.8%) had been vaccinated against influenza, and 683 (12.2%) were admitted from nursing homes. Incidence by age, influenza subtype and season is shown in Figures 1 and 2. The average annual incidence in healthy adults was 5 per 100,000, compared with 0.8 per 1,000 in adults with COPD or diabetes, 1.7 per 1,000 in adults with cardiac disease, and >2 per 1,000 in those with underlying kidney disease or immunosuppression. Overall, 12.8% of patients had a significant non-respiratory complication (eg. myocarditis, stroke, C. difficile infection). 720 (12.9%) required ICU admission, and 414 (7.4%) required mechanical ventilation. The median hospital length of stay was 9.58 days (IQR 3-11). None of 226 cases aged Conclusion Despite vaccination programs, influenza is a very common cause of hospitalization and death in our adult population. While surveillance for LCI-H underestimates the overall burden of influenza, it may nonetheless help to appropriately prioritize preventive programs. Disclosures J. Powis, Merck: Grant Investigator, Research grant. GSK: Grant Investigator, Research grant. Roche: Grant Investigator, Research grant. Synthetic Biologicals: Investigator, Research grant. A. Mcgeer, Hoffman La Roche: Investigator, Research grant. GSK: Investigator, Research grant. sanofi pasteur: Investigator, Research grant.

Background Once considered primarily a pediatric concern, respiratory syncytial virus (RSV) infection is gaining recognition as a cause of significant morbidity and mortality in adults. A better understanding of RSV epidemiology and disease in adults is needed to guide patient management and to assess the need for prophylaxis, vaccines, and treatments. Methods We conducted a retrospective cohort study of adults admitted to four hospitals in Toronto, Canada, between September 2012 and June 2013 with RSV identified by a qualitative real-time reverse-transcriptase polymerase chain reaction assay in nasopharyngeal swab or bronchoscopy specimens. Main outcomes were hospital length of stay, need for intensive care unit (ICU) or mechanical ventilation, and all-cause mortality. Results Eighty-six patients were identified as requiring hospitalization for RSV infection (56% female). Median age was 74 (range 19–102) years; 29 (34%) were

Introduction: There is a paucity of data about the clinical characteristics that help identify patients at high risk of influenza infection upon ICU admission. We aimed to identify predictors of influenza infection in patients admitted to ICUs during the 2007/2008 and 2008/2009 influenza seasons and the second wave of the 2009 H1N1 influenza pandemic as well as to identify populations with increased likelihood of seasonal and pandemic 2009 influenza (pH1N1) infection. Methods: Six Toronto acute care hospitals participated in active surveillance for laboratory-confirmed influenza requiring ICU admission during periods of influenza activity from 2007 to 2009. Nasopharyngeal swabs were obtained from patients who presented to our hospitals with acute respiratory or cardiac illness or febrile illness without a clear nonrespiratory aetiology. Predictors of influenza were assessed by multivariable logistic regression analysis and the likelihood of influenza in different populations was calculated. Results: In 5,482 patients, 126 (2.3%) were found to have influenza. Admission temperature ≥38°C (odds ratio (OR) 4.7 for pH1N1, 2.3 for seasonal influenza) and admission diagnosis of pneumonia or respiratory infection (OR 7.3 for pH1N1, 4.2 for seasonal influenza) were independent predictors for influenza. During the peak weeks of influenza seasons, 17% of afebrile patients and 27% of febrile patients with pneumonia or respiratory infection had influenza. During the second wave of the 2009 pandemic, 26% of afebrile patients and 70% of febrile patients with pneumonia or respiratory infection had influenza. Conclusions: The findings of our study may assist clinicians in decision making regarding optimal management of adult patients admitted to ICUs during future influenza seasons. Influenza testing, empiric antiviral therapy and empiric infection control precautions should be considered in those patients who are admitted during influenza season with a diagnosis of pneumonia or respiratory infection and are either febrile or admitted during weeks of peak influenza activity.