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Modelling the daily risk of Ebola in the presence and absence of a potential vaccine

Infectious Disease Modelling 2020年第1期5卷 905-917页

作者： Stéphanie M.C.Abo Robert Smith Department of Applied Mathematics The University of WaterlooWaterlooCanada Department of Mathematics and Faculty of Medicine The University of Ottawa150 Louis-Pasteur PvtOttawaONK1N6N5Canada

Ebola virus d one of the deadliest viral diseases,with a mortality rate around 90%d damages the immune system and organs,with symptoms including episodic fever,chills,malaise and *** Recombinant Vesicular Stomatitis Virus-based candidate vaccine(rVSV-ZEBOV)has demonstrated clinical efficacy against Ebola in ring-vaccination clinical *** order to evaluate the potential effect of this candidate vaccine,we developed risk equations for the daily risk of Ebola infection both currently and after *** risk equations account for the basic transmission probability of Ebola and the lowered risk due to various protection protocols:vaccination,hazmat suits,reduced contact with the infected living and dead *** space was sampled using Latin Hypercube Sampling,a statistical method for generating a near-random sample of parameter *** found that at a high transmission rate of Ebola(i.e.,if the transmission rate is greater than 90%),a large fraction of the population must be vaccinated(>80%)to achieve a 50%decrease in the daily risk of *** a vaccine is introduced,it must have at least 50%efficacy,and almost everyone in the affected areas must receive it to effectively control outbreaks of *** results indicate that a low-efficacy Ebola vaccine runs the risk of having vaccinated people be overconfident in a weak vaccine and hence the possibility that the vaccine could make the situation worse,unless the population can be sufficiently educated about the necessity for high vaccine uptake.

关键词： Ebola virus disease Mathematical model risk equations Latin hypercube sampling Eradication

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Guidelines for the Prevention of Symptomatic Cardiovascular Disease, Based upon the Presence of Coronary Artery Calcified Plaque—Provided by the Society for the Prevention of Symptomatic Heart Disease

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World Journal of Cardiovascular Diseases 2022年第6期12卷 320-341页

作者： David S. Schade Scott Obenshain Martin Hickey Jennifer Febbo Samuel Wann Robert Philip Eaton University of New Mexico School of Medicine Albuquerque NM USA

Introduction: The epidemic of atherosclerotic cardiovascular disease in the Western World accounts for the majority of morbidity and mortality in adults. This disease is on the increase, and previous recommendations using “risk equations” to prescribe preventive treatment have not been successful in reducing the prevalence of cardiovascular disease. Furthermore, compliance with statin medication has been limited, with approximately 50% of individuals being non-compliant within five years. This situation is unacceptable since atherosclerosis is both preventable and reversible. Methods: The guidelines presented in this article utilize coronary artery calcium scanning as the basis for preventative therapeutic decisions and identifying the presence of asymptomatic cardiovascular disease. This radiographic technique is superior to “risk equations” in predicting future cardiovascular events. It provides a comprehensive assessment of the lifelong insults to the coronary artery vascular endothelium and the resulting inflammation. Coronary artery calcium scanning is widely available, inexpensive, safe, and reproducible. It has the major advantage of increasing treatment compliance in patients with positive coronary artery calcium scores. Results: All suggested guidelines are supported by published scientific data. Citations are provided to allow the reader to obtain further information. The authors are available for further consultation. Each guideline provides specific recommendations that the primary caregiver can discuss with the patient. Patient involvement in decision-making is strongly recommended. Both treatment costs and adverse effects are minimal. Conclusion: It is anticipated that the early identification of asymptomatic cardiovascular disease and its aggressive treatment will result in regression of subclinical atherosclerosis. Adoption of these guidelines will stop the epidemic of symptomatic heart disease and result in healthier and more satisfied patients.

关键词： Symptomatic Cardiovascular Disease Coronary Artery Calcium Scan Myocardial Infarction Cardiovascular risk Atherosclerosis risk equations

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Improving Cardiovascular risk Assessment to Optimize Therapy

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World Journal of Cardiovascular Diseases 2023年第1期13卷 7-20页

作者： Allen Adolphe Shane Wilder Teodor Duro Robert Philip Eaton David S. Schade Division of General Internal Medicine University of New Mexico School of Medicine Albuquerque USA Division of Endocrinology University of New Mexico School of Medicine Albuquerque USA

Background: Quantifying ten-year cardiovascular risk can be challenging. Different online risk calculators provide different risk estimates and online risk calculators use only one point in time. However, risk factors occur over the lifetime of the individual. Purpose: This manuscript provides three solutions to improving ten-year cardiovascular risk assessment in individuals at intermediate risk. Methods: Measuring Lipoprotein(a)—Lp(a) is recommended for assessing cardiovascular risk in all individuals who are in the intermediate risk category by standard online risk calculators. Lp(a) is primarily determined by genetic inheritance. It has the undesirable properties of being proatherosclerotic, proinflammatory, and prothrombotic. Measuring apolipoprotein B (apo B) provides a good index of the number of atherosclerotic particles present. Studies have demonstrated that small, dense LDL cholesterol particles are more atherogenic than larger, less dense LDL cholesterol particles. Measuring high sensitivity C-reactive protein (hsCRP) provides a good estimation of the degree of inflammation in the vascular system. Inflammation is a critical component of heart attacks and strokes. It is increased in diabetes and obesity. Treatment to reduce inflammation results in a reduction of cardiovascular events, independent of lipid values. Results: The above three risk factors should be measured in all patients with an intermediate risk score. Routine assays are readily available at a reasonable cost. They are independent risk factors for cardiovascular disease. Their recommendation is based on the pathophysiology of atherosclerotic cardiovascular disease. Successful therapy will result in the decrease of each of these risk factors. Conclusion: The recommended approach will improve the assessment of cardiovascular risk and guide the physician and patient to the correct treatment recommendations.

关键词： Cardiovascular Disease Atherosclerosis risk equations Apolipoprotein B Lipoprotein(a) High Sensitivity C-Reactive Protein

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