bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Hospital Care Scheduling During the SARS-CoV-2 Pandemic
Authors: D’Aeth Josh C. , Ghosal Shubhechyya , Grimm Fiona , Haw David , Koca Esma , Lau Krystal , Liu Huikang , Moret Stefano , Rizmie Dheeya , Smith Peter C. , Forchini Giovanni , Miraldo Marisa , Wiesemann Wolfram
Published: February 2023

The COVID-19 pandemic has seen dramatic demand surges for hospital care that have placed a severe strain on health systems worldwide. As a result, policy makers are faced with the challenge of managing scarce hospital capacity to reduce the backlog of non-COVID patients while maintaining the ability to respond to any potential future increases in demand for COVID care. In this paper, we propose a nationwide prioritization scheme that models each individual patient as a dynamic program whose states encode the patient’s health and treatment condition, whose actions describe the available treatment options, whose transition probabilities characterize the stochastic evolution of the patient’s health, and whose rewards encode the contribution to the overall objectives of the health system. The individual patients’ dynamic programs are coupled through constraints on the available resources, such as hospital beds, doctors, and nurses. We show that the overall problem can be modeled as a grouped weakly coupled dynamic program for which we determine near-optimal solutions through a fluid approximation. Our case study for the National Health Service in England shows how years of life can be gained by prioritizing specific disease types over COVID patients, such as injury and poisoning, diseases of the respiratory system, diseases of the circulatory system, diseases of the digestive system, and cancer.

This paper was accepted by Chung-Piaw Teo, optimization.

Funding: G. Forchini acknowledges funding from Jan Wallanders and Tom Hedelius Foundation and the Tore Browaldh Foundation, funding from MRC Centre for Global Infectious Disease Analysis [Reference MR/R015600/1], jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth and Development Office (FCDO), under the MRC/FCDO Concordat agreement, part of the EDCTP2 program supported by the European Union; and acknowledges funding by Community Jameel. D. Rizmie acknowledges partial funding from the MRC Centre for Global Infectious Disease Analysis [Reference MR/R015600/1]. J. C. D’Aeth acknowledges funding from the Wellcome Trust [Reference 102169/Z/13/Z]. S. Moret acknowledges partial support from the Swiss National Science Foundation (SNSF) under [Grant P2ELP2_188028]. S. Ghosal was funded by the Imperial College President’s PhD Scholarship. F. Grimm was funded by the Health Foundation as part of core staff member activity. This research was funded in whole, or in part, by the Wellcome Trust [Grant 102169/Z/13/Z].

Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.4679 .
Silicon Anodes to Push EV Range
Authors: Pitcher Graham
Published: February 2023

SILICON ANODE PROJECT SEEKS TO EXTEND EV RANGE.
Online and on Point
Authors: Grylls Bethan
Published: February 2023

NEW ELECTRONICS’ TOP READS ONLINE OF 2017, AS CHOSEN BY OUR READERS.
A Winning Team
Authors: Tyler Neil
Published: February 2023

Digi-Key’s president and COO Dave Doherty explains why the distributor’s culture is a winning differentiator.
Creating the Right Image
Authors: Cavazzana Max
Published: February 2023

CMOS image sensors have developed to the point where they can be used in most machine vision applications.
Careless Whispers
Authors: Edwards Chris
Published: February 2023

How timing, EMI and even sound can provide attackers with information about the secrets held by a supposedly secure system.
Ensuring Software Quality
Authors: Tyler Neil
Published: February 2023

As the software component in new products explodes, how can companies ensure code quality when they are faced by time-to-market challenges?
Next wave in Timing Innovation
Authors: Wilson James
Published: February 2023

Reducing development risks in communications applications with high-performance oscillators.
The Quest for Power
Authors: Pitcher Graham
Published: February 2023

The race is on to develop new battery chemistries and manufacturing processes - and the UK is looking to take the lead.
Voice Dominates
Authors: Tyler Neil
Published: February 2023

At this year’s CES in Las Vegas, voice took centre stage, with ‘big technology’ companies appearing to view it as the next major evolution in computing.
Providing A Head Start
Authors: Stutnik Rok
Published: February 2023

When looking to secure that all important competitive edge, more companies are turning to ‘ready to go’ partner solutions, as explains
An ‘Age of Light’ Envisaged
Authors: Pitcher Graham
Published: February 2023

PHOTONICS COULD CREATE ‘MILLION NEW JOBS’ IN EUROPE, ACCORDING TO INDUSTRY GROUP.
Talent is the Biggest Constraint
Authors: Grylls Bethan
Published: February 2023

A SHORTAGE OF SKILLS COULD THREATEN THE UK’S POTENTIAL IN TECHNOLOGY AND INNOVATION POST-BREXIT.
Serving a Purpose
Authors: Pitcher Graham
Published: February 2023

IT APPEARS THAT AMPERE HAS PICKED UP THE ARM BASED SERVER CHIP BATON FROM APPLIEDMICRO.
Security by Design
Authors: Parisien Darryl
Published: February 2023

How do digital signatures and certificates provide protection for embedded systems?
Embedded World 2018
Authors: Grylls Bethan
Published: February 2023

As the worlďs largest embedded systems Electronics previews some of the exhibits.
The ‘Magic’ of Virtual Channels
Authors: Jayamohan Umesh
Published: February 2023

Digital down converters can help to handle high data rates by creating virtual channels in A/D converters.
Small Cell Solutions
Authors: Moronva Xavier
Published: February 2023

As small cells are introduced to 4G networks so building efficient MMIC power amplifiers becomes more important
The Wealth of Health
Authors: Beck Chris
Published: February 2023

A focus on employee wellbeing could improve national productivity by as much as 10%, according to a new report. But the stigma surrounding mental health in manufacturing must be broken down first
Overseas Recruitment: Automotive’s Saviour?
Authors: Bridge Olivia
Published: February 2023

Around 8% of manufacturing’s workforce is from overseas. However, Brexit threatens to cut off this valuable labour supply - unless the industry takes action to counteract it
Can we Manufacture Leaders?
Authors: Gillespie Lisa
Published: February 2023

Strategic development of leadership and management skills is a key factor to consider when looking to boost productivity and foster innovation in manufacturing sites
Around the Regions: The North East
Authors: Carpenter Ben
Published: February 2023

The recent Great Exhibition of the North showcased the North East’s manufacturing past, but the region is home to a wealth of industry that has the potential to boost the UK’s economy today, say EEF, the manufacturers’ organisation, in their latest column
Data: The New Driving Force
Authors: Fletcher Mark
Published: February 2023

The Fourth Industrial Revolution is beginning to make waves in the materials handling industry – but its successful adoption is down to finding the right system
Risky Business
Authors: Turner Martin
Published: February 2023

For manufacturers, finding the right insurance to suit your needs can be a challenge. Fortunately, RSA are on hand to offer expert advice and help you navigate a changing threat landscape.
Let’s Talk Up Industry
Authors: Hague Tony
Published: February 2023

Business resilience is set to be a hot topic for 2019. However, manufacturers shouldn’t just be considering it as a way of guarding against potential downturns, but can actually be used to make sure UK industry is ready to seize new opportunities in an ever-changing world
Notes on the genus Sepsis Fallén, 1810 (Diptera: Sepsidae) from Pakistan with two new country records
Authors: HASSAN MUHAMMAD ASGHAR , SHEHZAD ANJUM , ALI MUHAMMAD , IQBAL ZAFAR , QASIM MUHAMMAD , MARYAM ZERSHINA
Published: February 2023

An overview of the genus Sepsis in Pakistan is presented. Two species are newly recorded for the country: S. coprophila de Meijere, 1906, and S. indica Wiedemann, 1824. A brief diagnosis and detailed photographs of the newly recorded species are provided. The dorsal and lateral habitus of the following four species are also presented: S. dissimilis Brunetti, 1910, S. nitens Wiedemann, 1824, S. orthocnemis Frey, 1908, and S. thoracica (Robineau-Desvoidy, 1830). An updated checklist, key to known species, and distribution data in Pakistan are summarized.
Long-term forecasting of thermal and humidity actions on buildings
Authors:   Central Ukrainian National Technical University, Faculty of Construction and Transport, Department of building, road machines and construction, Pashynskyi Mykola , Pashynskyi Victor ,   Central Ukrainian National Technical University, Faculty of Construction and Transport, Department of building, road machines and construction, Tykhyi Andrii ,   Central Ukrainian National Technical University, Faculty of Construction and Transport, Department of building, road machines and construction, Karpushyn Serhii ,   Central Ukrainian National Technical University, Faculty of Construction and Transport, Department of building, road machines and construction
Published: February 2023

Global warming leads to significant long-term changes in climate loads and effects on structures, which must be considered when designing buildings. In this study, loads on buildings and structures were examined to evaluate long-term changes in temperature and humidity of the atmospheric air and to develop a method for forecasting the estimated values of these effects. According to the data obtained via weather stations in Ukraine, it was determined that long-term changes in thermal and humidity actions at different weather stations are qualitatively similar but vary numerically by a significant extent. The increase in air temperature is generally consistent with the known trend of global warming, and relative humidity is characterized by a decrease in the variance at almost constant average annual value. The proposed method of identifying and describing trends in long-term changes in climatic influences can be used in the development of regulatory documents and in directly designing buildings and structures by considering the predicted changes in climatic influences during the future life of buildings.
La subordinación adverbial en las Cartas del viaje de Asturias (1782), de G.M. de Jovellanos
Authors: Alonso de la Torre Gutiérrez Francisco
Published: February 2023

En esta investigación de orientación sintáctica y discursiva se analiza la subordinación adverbial en las Cartas del viaje de Asturias (1782) de Jovellanos para aportar nuevos datos a la historia lingüística del «primer español moderno» y rastrear posibles elementos discursivo-tradicionales que caractericen el (macro)género de la literatura de viajes escrita en español. Se toma como marco teórico-metodológico la lingüística de variedades alemana a fin de explicar adecuadamente el funcionamiento de las estructuras sintácticas y su relación con el edificio variacional de su tiempo.
De la atenuación a la cohesión. La polifuncionalidad de los mecanismos pragmático-discursivos más allá de los marcadores
Authors: Fernández Madrazo Carmen , López Serena Araceli
Published: February 2023

Este artículo se propone mostrar cómo en la interacción dialógica se utilizan expresiones que contribuyen simultáneamente a dos macrofunciones muy distintas: la interaccional, dentro de la que se sitúa la atenuación de la fuerza ilocutiva del enunciado, y la metadiscursiva, con la que se relacionan el establecimiento de cohesión o la segmentación estructural o informativa del discurso. El principal objetivo que se persigue con ello es el de alimentar el hasta ahora escaso interés que la lingüística especializada en el análisis de la lengua hablada ha mostrado tanto por el análisis conjunto de cohesión y atenuación como por el estudio de la polifuncionalidad, que, más allá de los marcadores del discurso, es posible detectar en otros muchos mecanismos pragmático-discursivos. En concreto, en los ejemplos que se analizan se presta especial atención a las recuperaciones anafóricas propiciadas por movimientos de concesión en secuencias argumentativas, a la reformulación, a expresiones construidas sobre la base de no sé que sirven tanto para fingir ignorancia como para ceder el turno y a un conjunto de expresiones de acotación de una determinada expresión al ámbito de la opinión personal que parecen estar especializándose para la toma de turno
El caso oblicuo de las preposiciones: raíces, constituyentes y concordancia
Authors: Fábregas Alfaro Antonio
Published: February 2023

Este trabajo propone un análisis configuracional al hecho de que para muchos hablantes preposiciones como según o bajo no puedan asignar caso oblicuo al pronombre y a que en español actual la asignación de caso oblicuo sea imposible con dos pronombres coordinados (*a ti y mí). Se argumenta que en las variedades más restrictivas el pronombre oblicuo materializa un constituyente sintáctico que contiene una capa relacional (SK) junto al SD pronombre. Los casos donde es imposible esta asignación corresponden a estructuras donde el SK y el pronombre no forman un constituyente sintáctico en exclusión del resto de núcleos. La variación a la que está sometida esta combinatoria se explica proponiendo que en las variedades que admiten el caso oblicuo en contextos donde SK y SD no forman un constituyente el caso oblicuo se puede asignar mediante concordancia, que en general exige una relación de especificador-núcleo entre K y el SD. Este resultado sugiere que en español el caso oblicuo ha sufrido un proceso, incompleto en algunas variedades, desde un caso estructural a un caso inherente.
Orthogonal polarization multi-wavelength Brillouin random fiber laser with triple Brillouin frequency shift space
Authors: Gu Xiang , Wang Chunhua , Wu Keshuai , Fang Nian , Chen Liang , Bao Xiaoyi
Published: February 2023

A novel multi-wavelength Brillouin random fiber laser with the channel space of triple Brillouin frequency shift and high polarization orthogonality between adjacent wavelengths (TOP-MWBRFL), to the best of our knowledge, is experimentally demonstrated. The TOP-MWBRFL is structured in a ring form by cascading two Brillouin random cavities of single-mode fiber (SMF) and one Brillouin random cavity of polarization-maintaining fiber (PMF). Based on polarization pulling properties of stimulated Brillouin scattering in long-distance SMFs and PMFs, the states of polarization (SOPs) of lasing light from SMF random cavities are linearly bounded to the SOPs of local pump light, whereas the SOP of lasing light from the PMF random cavity is strictly clamped on one of the principal axes of the PMF. Thus, the TOP-MWBRFL can stably emit multi-wavelength light with high polarization extinction ratio (>35dB) between adjacent wavelengths without precise polarization feedback. In addition, the TOP-MWBRFL can also work in one polarization mode to stably lase multi-wavelength light with SOP uniformity as high as 37 dB.
Infrared detector module for airborne hyperspectral LiDAR: design and demonstration
Authors: Qian Liyong , Wu Decheng , Liu Dong , Zhong Liujun , Shi Shuo , Song Shalei , Gong Wei
Published: February 2023

Realizing the integrated acquisition and identification of the elevation information
and spectral information of the observation target is at the frontier
and a future trend of Earth observation technology. This study designs
and develops a set of airborne hyperspectral imaging lidar optical
receiving systems and investigates the detection of the infrared band
echo signal of the lidar system. A set of avalanche photodiode (APD)
detectors is independently designed to detect the weak echo signal
of  800–900 nm band. The actual radius of the
photosensitive surface of the APD detector is 0.25 mm. We
design and demonstrate the optical focusing system of the APD detector
in the laboratory and obtain that the image plane size of the optical
fiber end faces of the APD detector from channel 47 to channel 56 is
close to 0.3 mm. Results show that the optical focusing system
of the self-designed APD detector is reliable. On the basis of the
focal plane splitting technology of the fiber array, we couple the
echo signal of  800–900 nm band to the corresponding APD
detector through the fiber array and conduct a series of test
experiments for the APD detector. Field test results of the
ground-based platform show that the APD detectors in all channels can
complete the remote sensing measurement of 500 m. The
development of this APD detector solves the problem of hyperspectral
imaging under weak light signals and realizes the accurate detection
of ground targets in the infrared band by airborne hyperspectral
imaging lidar.
Power scaling of fiber-optic parametric oscillators using higher-order modes
Authors: Lægsgaard J.
Published: February 2023

The use of higher-order radially symmetric (Bessel) modes in large-core optical fibers to provide intramodal phase matching for four-wave mixing in parametric oscillators pumped at 1030 nm is investigated numerically. It is shown that a suitable choice of core diameter in a 4 cm fiber piece can lead to broad tunability of signal/idler bands in the range of 1120–1500 nm (signal) and 780–950 nm (idler), only by adjusting the recirculation timing, while keeping the pump wavelength fixed. Power scaling to the MW level appears feasible, ultimately limited by nonlinear intermodal coupling. The oscillator performance is insensitive to the exact method of fiber recirculation and back-coupling, but highly sensitive to the purity of pump mode excitation.
Multi-functional terahertz metamaterials based on nano-imprinting
Authors: Li Xinyu , Cui Tiansheng , Zhuang Shulei , Qian Wenqi , Lin Lie , Su Wenming , Gong Cheng , Liu Weiwei
Published: February 2023

This paper reports a multi-functional terahertz (THz) metamaterial based on a nano-imprinting method. The metamaterial is composed of four layers: 4 L resonant layer, dielectric layer, frequency selective layer, and dielectric layer. The 4 L resonant structure can achieve broadband absorption, while the frequency selective layer can achieve transmission of specific band. The nano-imprinting method combines electroplating of nickel mold and printing of silver nano-particle ink. Using this method, the multilayer metamaterial structures can be fabricated on ultrathin flexible substrates to achieve visible light transparency. For verification, a THz metamaterial with broadband absorption in low frequency and efficient transmission in high frequency is designed and printed. The sample’s thickness is about 200 µm and area is 65 × 65 mm2. Moreover, a fiber-based multi-mode terahertz time-domain spectroscopy system was built to test its transmission and reflection spectra. The results are consistent with the expectations.
Cooling colors below the ambient temperature
Authors: Wang Wanlin , Xing Hongyun , Shu Xiaochi , Zhao Xinkun , Yan Xiaoyuan , Hong BinBin , Sun Lei , Zhang Wang , Wang Guo Ping
Published: February 2023

The colors of objects are generally originated from reflecting desired light in the desired direction and absorbing the undesired light, which will substantially produce heating. Many efforts have been made to focus on cooling the colorful objects. However, a cooling strategy to cool colorful objects beyond a limit of temperature below the ambient temperature while fully preserving the excellent color properties of high saturation and large viewing field is still a great challenge, as it is rather difficult to independently control the four light bands simultaneously: high diffusion of desired light, low absorption of undesired complementary visible light, low absorption of near-IR light, and high emission of mid-IR light. Inspired by Morpho butterflies, we reported here a robust configure consisting of a multilayer, a disorder structure, and a total reflection layer to cool colorful objects to overcome the challenge. Numerical simulations and experimental measurements demonstrated that our configure can cool a class of colorful objects to not only a temperature of around 2 °C below the ambient temperature, but also with ultra-high saturations (100%) and a wide range of viewing angles (±60°), indicating a great potential for energy sustainability of colorful objects such as buildings, vehicles, facilities, and equipment.
Phenotypic pliancy and the breakdown of epigenetic polycomb mechanisms
Authors: Lambros Maryl , Sella Yehonatan , Bergman Aviv
Published: February 2023

Epigenetic regulatory mechanisms allow multicellular organisms to develop distinct specialized cell identities despite having the same total genome. Cell-fate choices are based on gene expression programs and environmental cues that cells experience during embryonic development, and are usually maintained throughout the life of the organism despite new environmental cues. The evolutionarily conserved Polycomb group (PcG) proteins form Polycomb Repressive Complexes that help orchestrate these developmental choices. Post-development, these complexes actively maintain the resulting cell fate, even in the face of environmental perturbations. Given the crucial role of these polycomb mechanisms in providing phenotypic fidelity (i.e. maintenance of cell fate), we hypothesize that their dysregulation after development will lead to decreased phenotypic fidelity allowing dysregulated cells to sustainably switch their phenotype in response to environmental changes. We call this abnormal phenotypic switching phenotypic pliancy. We introduce a general computational evolutionary model that allows us to test our systems-level phenotypic pliancy hypothesis in-silico and in a context-independent manner. We find that 1) phenotypic fidelity is an emergent systems-level property of PcG-like mechanism evolution, and 2) phenotypic pliancy is an emergent systems-level property resulting from this mechanism’s dysregulation. Since there is evidence that metastatic cells behave in a phenotypically pliant manner, we hypothesize that progression to metastasis is driven by the emergence of phenotypic pliancy in cancer cells as a result of PcG mechanism dysregulation. We corroborate our hypothesis using single-cell RNA-sequencing data from metastatic cancers. We find that metastatic cancer cells are phenotypically pliant in the same manner as predicted by our model.
Knowledge, attitude and practices of community health workers on managing and preventing childhood malaria and diarrhea in Fako Division, South West Region, Cameroon; A mixed method study
Authors: Chi Ndum Naomi , Nyasa Raymond Babila , Jane-Francis Akoachere
Published: February 2023

In developing countries, childhood malaria and diarrhea are among the 5 leading causes of death among children under five years; the use of community health workers (CHWs) to manage these diseases has shown some degree of success. A descriptive cross-sectional study was conducted to assess knowledge, attitude and practices (KAP) of CHWs on the management and prevention of childhood malaria and diarrhea in Fako Division, South-West Region, Cameroon. A pretested questionnaire was administered to eighty CHWs in Fako Division. Three focus group discussions (FGDs) were conducted with 29 CHWs. The Chi-Square and Spearman Correlation tests were used to investigate the association between socio-demographic characteristics with CHWs’ KAP on childhood malaria and diarrhea management and prevention. A total of 52.5% of the participants had good knowledge, negative attitudes (65.0%), and carried out poor practices (60.0%) on the management and prevention of childhood malaria. Up to 8.75% CHWs did not know the first-line antimalarial drug used in Cameroon. More than half (57.5%) of participants had poor knowledge, 70.0% had a negative attitude and 82.25% carried out good practices on the management and prevention of childhood diarrhea. 47.6% of CHWs used a mixture of guava leaves and ‘masepo’ (Ocimum gratissimum) as treatment for childhood diarrhea. Level of education (p = 0.028) and Health District (p = 0.026) were significantly associated with practices on management and prevention of childhood diarrhea. CHWs had inadequate knowledge, poor attitude, and practices on childhood malaria management. Even though a majority of CHWs carried out good practices for diarrhea management, their knowledge and attitude were poor. Therefore, there is a need for training to improve CHWs’ knowledge, attitude and practices on childhood malaria and diarrhea management.
Stool biomarkers as measures of enteric pathogen infection in infants from Addis Ababa informal settlements
Authors: Espira Leon M. , Lee Gwenyth O. , Baye Kaleab , Jones Andrew D. , Love Nancy G. , Eisenberg Joseph N. S.
Published: February 2023

Frequent enteric infections in children may be an important cause of growth faltering; however, we do not fully understand the mechanisms by which pathogen infections and the physiological responses to these infections result in poorer growth. Commonly used protein fecal biomarkers (anti-alpha trypsin, neopterin, and myeloperoxidase) provide broad immunological information on an inflammatory response; however, they do not provide information on non-immune processes (e.g., gut integrity) that may be important indicators of chronic end states such as environmental enteric dysfunction (EED). To explore how additional biomarkers will better inform which physiological pathways (both immune and non-immune) are impacted by pathogen exposure we added to the traditional panel of 3 protein fecal biomarkers 4 novel fecal mRNA transcript biomarkers (sucrase isomaltase, caudal homeobox 1, S100A8, and mucin 12) and analyzed stool samples from infants living in informal settlements in Addis Ababa, Ethiopia. To test how this expanded biomarker panel captures distinct pathogen exposure processes we used two different scoring systems. First, we used a theory-based approach to assign each biomarker to specific physiological attributes based on prior understanding of each biomarker. Second, we used data reduction methods to categorize biomarkers and then assign physiological attributes to those categories. We used linear models to examine the association between the derived biomarker scores (based on mRNA and protein levels) and stool pathogen gene counts to determine pathogen specific effects on gut physiology and immune responses. Inflammation scores were positively associated with Shigella and enteropathogenic E.Coli (EPEC) infection, while gut integrity scores were negatively associated with Shigella, EPEC and, shigatoxigenic E.coli (STEC) infection. Our expanded panel of biomarkers hold promise as tools to measure systemic outcomes of enteric pathogen infection. mRNA biomarkers complement established protein biomarkers by providing important cell-specific physiological and immunological consequences of pathogen carriage that can lead to chronic end states such as EED.
Challenges of implementation of the preventive chemotherapy neglected tropical diseases programme in Ghana
Authors: Otoo Desmond Dzidzornu , Agbenu Ivy Akushika , Nyamekye Mary Adebi , Appiah-Agyekum Nana Nimo
Published: February 2023

Purpose

The Neglected Tropical Diseases programme since its implementation has improved the lives of many in the tropical and sub-tropical areas. Though witnessed many successes, the programme is continually facing challenges thus, preventing the attainment of various objectives. This study seeks to assess the challenges of implementation of the neglected tropical diseases programme in Ghana.

Design/Methodology/Approach

The thematic analysis approach was used to analyze qualitative data collected from 18 key public health managers selected through purposive and snowballing procedures from the national, regional and district levels of Ghana Health Service. Data collection was done through in-depth interviews using semi-structured interview guides in line with the objective of the study.

Findings

The Neglected Tropical Diseases Programme though received funding from external sources, faces multiple challenges which cut across financial, human and capital resources to external control. Specifically, inadequate resources, dwindling volunteerism, poor social mobilization, weak governmental commitment and weak monitoring were major challenges to implementation. These factors work individually and in combination to impede effective implementation. Ensuring state ownership, re-structuring implementation approaches to include top-down and bottom-up approaches and building capacity in monitoring and evaluation are recommended in order to meet the programme objectives and ensure sustainability.

Originality

This study forms part of an original study on Implementation of the NTDs programme in Ghana. Aside the key issues discussed, it presents first-hand information on major implementation challenges that are relevant to researchers, students, practitioners and the general public and will apply widely to vertically implemented programmes in Ghana.
Borrelia miyamotoi a neglected tick-borne relapsing fever spirochete in Thailand
Authors: Takhampunya Ratree , Longkunan Asma , Somchaimongkol Sakbuncha , Youngdech Nittayaphon , Chanarat Nitima , Sakolvaree Jira , Tippayachai Bousaraporn , Promsathaporn Sommai , Phanpheuch Bhakdee , Poole-Smith Betty K. , McCardle Patrick W. , Lindroth Erica J.
Published: February 2023

Borrelia miyamotoi is a relapsing fever spirochete that shares the same vector as Lyme disease causing Borrelia. This epidemiological study of B. miyamotoi was conducted in rodent reservoirs, tick vectors and human populations simultaneously. A total of 640 rodents and 43 ticks were collected from Phop Phra district, Tak province, Thailand. The prevalence rate for all Borrelia species was 2.3% and for B. miyamotoi was 1.1% in the rodent population, while the prevalence rate was quite high in ticks collected from rodents with an infection rate of 14.5% (95% CI: 6.3–27.6%). Borrelia miyamotoi was detected in Ixodes granulatus collected from Mus caroli and Berylmys bowersi, and was also detected in several rodent species (Bandicota indica, Mus spp., and Leopoldamys sabanus) that live in a cultivated land, increasing the risk of human exposure. Phylogenetic analysis revealed that the B. miyamotoi isolates detected in rodents and I. granulatus ticks in this study were similar to isolates detected in European countries. Further investigation was conducted to determine the serological reactivity to B. miyamotoi in human samples received from Phop Phra hospital, Tak province and in rodents captured from Phop Phra district using an in-house, direct enzyme-linked immunosorbent assay (ELISA) assay with B. miyamotoi recombinant glycerophosphodiester-phosphodiesterase (rGlpQ) protein as coated antigen. The results showed that 17.9% (15/84) of human patients and 9.0% (41/456) of captured rodents had serological reactivity to B. miyamotoi rGlpQ protein in the study area. While a low level of IgG antibody titers (100–200) was observed in the majority of seroreactive samples, higher titers (400–1,600) were also detected in both humans and rodents. This study provides the first evidence of B. miyamotoi exposure in human and rodent populations in Thailand and the possible roles of local rodent species and Ixodes granulatus tick in its enzootic transmission cycle in nature.
Adherence to the test, treat and track strategy for malaria control among prescribers, Mfantseman Municipality, Central Region, Ghana
Authors: Agbemafle Ernestina Esinam , Addo-Lartey Adolphina , Odikro Magdalene Akos , Frimpong Joseph Asamoah , Kubio Chrysantus , Ameme Donne Kofi , Sackey Samuel Oko , Bonful Harriet Affran
Published: February 2023

Background

The test, treat, and track (T3) strategy is directed at ensuring diagnosis and prompt treatment of uncomplicated malaria cases. Adherence to T3 strategy reduces wrong treatment and prevents delays in treating the actual cause of fever that may otherwise lead to complications or death. Data on adherence to all three aspects of the T3 strategy is sparse with previous studies focusing on the testing and treatment aspects. We determined adherence to the T3 strategy and associated factors in the Mfantseman Municipality of Ghana.

Methods

We conducted a health facility based cross-sectional survey in Saltpond Municipal Hospital and Mercy Women’s Catholic Hospitals in Mfantseman Municipality of the Central Region, Ghana in 2020. We retrieved electronic records of febrile outpatients and extracted the testing, treatment and tracking variables. Prescribers were interviewed on factors associated with adherence using a semi-structured questionnaire. Data analyses was done using descriptive statistics, bivariate, and multiple logistic regression.

Results

Of 414 febrile outpatient records analyzed, 47 (11.3%) were under five years old. About 180 (43.5%) were tested with 138 (76.7%) testing positive. All positive cases received antimalarials and 127 (92.0%) were reviewed after treatment. Of 414 febrile patients, 127 (30.7%) were treated according to the T3 strategy. Higher odds of adherence to T3 were observed for patients aged 5–25 years compared to older patients (AOR: 2.5, 95% CI: 1.27–4.87, p = 0.008). Adherence was low among physician assistants compared to medical officers (AOR 0.004, 95% CI 0.004–0.02, p<0.001). Prescribers trained on T3 had higher adherence (AOR: 99.33 95% CI: 19.53–505.13, p<0.000).

Conclusion

Adherence to T3 strategy is low in Mfantseman Municipality of the Central Region of Ghana. Health facilities should perform RDTs for febrile patients at the OPD with priority on low cadre prescribers during the planning and implementation of interventions to improve T3 adherence at the facility level.
Anti-proliferative and immunomodulatory properties of kaffir lime leaves and bioactive compounds on macrophages co-cultured with squamous cell carcinoma
Authors: Luetragoon Thitiya , Thongsri Yordhathai , Daotak Krai , Potup Pachuen , Usuwanthim Kanchana
Published: February 2023

Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide. Late-stage patients have a significant chance of local recurrence and distant metastasis, as well as poor prognosis. Therapeutic goals for patients must be improved and personalized to reduce adverse effects. This study explored the anti-proliferative activity and immunomodulation potential of the constituents of crude kaffir lime leaf extract (lupeol, citronellal and citronellol) under co-culture. Results showed high cytotoxicity to human SCC15 cell line but not to human monocyte-derived macrophages. Treatment with crude extract and the contained compounds also suppressed cell migration and colony formation of SCC15 compared to the untreated control group, while high levels of intracellular ROS production were detected in the treatment group of SCC15. The MuseTM cell analyzer revealed cell cycle arrest at G2/M phase and apoptosis induction. Inhibition of Bcl-2 and activation of Bax, leading to induction of the downstream caspase-dependent death pathway were confirmed by Western blot analysis. Co-culture with activated macrophages, kaffir lime extract and its constituents enhanced the development of pro-inflammatory (M1) macrophages and boosted TNF-α production, resulting in SCC15 apoptosis. Findings revealed novel potential activities of kaffir lime leaf extracts and their constituents in inducing M1 polarization against SCC15, as well as direct anti-proliferative activity.
Multi‑objective optimization of nitrile rubber and thermosets modified bituminous mix using desirability approach
Authors: Chopra Avani , Singh Sandeep , Kanoungo Abhishek , Singh Gurpreet , Gupta Naveen Kumar , Sharma Shubham , Joshi Sanjeev Kumar , Eldin Sayed M.
Published: February 2023

A variety of materials, including waste and rubber products, have been used in road construction to improve the performance of bituminous pavements. The present investigation is focused on modifying bitumen using Nitrile rubber (NBR) with different thermosets namely Bakelite (B), Furan Resin (FR), and Epoxy resin (ER). The emphasis of the problem is to arrive at a mix to achieve maximum Marshall Stability (MS) and minimum flow value of Modified Bituminous Concrete. Taguchi DOE technique has been used to design the experiments using Minitab software. Analysis of Variance (ANOVA) and Multi-objective optimization has been performed using the desirability approach in Design expert software. ANOVA analysis predicts that NBR, B, ER, and FR are the major significant parameters for Marshall Stability (MS) and Flow Value (FV). It has also been analyzed from SEM and EDS images of modified bitumen that sample S1 (5% NBR, 10% Bakelite, 10% FR, 2.5% ER) has a fine surface with small pores as compared to sample S34 (10% NBR, 0% Bakelite 10% FR, 2.5% ER). Multi-optimization results suggested the optimal conditions are achieved at NBR-7.6%, Bakelite-4.8%, FR-2.5%, and ER-2.6% for MS and FV. The maximum MS is 14.84 KN and the minimum FV is 2.84 mm is obtained using optimum conditions. To validate the optimization results, the confirmation runs have been conducted, and obtained results are within 5% error with optimal conditions.
Protocol for pragmatic randomized clinical trial to evaluate the completion of treatment of latent Mycobacterium tuberculosis infection with Isoniazid in the 300 mg formulation
Authors: Cola João Paulo , Prado Thiago Nascimento do , Campos Bárbara Almeida , Borges Bárbara Juliana Pinheiro , Alves Bárbara Manuella Cardoso Sodré , Jezus Sonia Vivian de , Sales Carolina Maia Martins , Araújo Wildo Navegantes de , Tavares Noemia Urruth Leão , Noia Maciel Ethel Leonor
Published: February 2023

Introduction

It is essential to strengthen the treatment of latent tuberculosis infection (LTBI) to break the chain of transmission. The drug used worldwide for the treatment of LTBI is Isoniazid. A clinical trial conducted in Brazil has demonstrated the bioequivalence of Isoniazid in the 300 mg formulation with 3 tablets in the 100 mg formulation. Further studies are needed to evaluate the completion of treatment with Isoniazid 300 mg single tablet.

Objective

Describing a protocol for a clinical trial to evaluate the completion of treatment of LTBI with the drug Isoniazid in 300 mg tablet formulation compared to the use of Isoniazid in 100 mg tablet formulation.

Methods

This is a pragmatic, multicenter, randomized, open-label clinical trial registered on the Rebec RBR-2wsdt6 platform. Individuals 18 years of age or older with an indication for treatment of LTBI will be included, with only 1 individual per family nucleus. Individuals whose index case of active TB is categorized as retreatment, multidrug-resistant and extremely resistant, individuals transferred from the original center two or more weeks after the onset of treatment, and persons deprived of liberty will be excluded. The study intervention will be the treatment of LTBI with 1 tablet of Isoniazid 300 mg. The control group will receive the treatment of LTBI with 3 tablets of Isoniazid 100 mg. Follow-up will be performed at month 1, month 2 and at the end of treatment. The primary outcome will be completion of treatment.

Conclusion

It is expected that with the treatment with the 300 mg formulation, more patients will complete the treatment based on the complexity index of pharmacotherapy. Our study intends to substantiate theoretical and operational strategies that respond to the demand for incorporation of a new formulation of the drug for the treatment of LTBI in the Unified Health System network.
Oncometabolic role of mitochondrial sirtuins in glioma patients
Authors: Haq Maria Fazal Ul , Hussain Muhammad Zahid , Mahjabeen Ishrat , Akram Zertashia , Saeed Nadia , Shafique Rabia , Abbasi Sumaira Fida , Kayani Mahmood Akhtar
Published: February 2023

Mitochondrial sirtuins have diverse role specifically in aging, metabolism and cancer. In cancer, these sirtuins play dichotomous role as tumor suppressor and promoter. Previous studies have reported the involvement of sirtuins in different cancers. However, till now no study has been published with respect to mitochondrial sirtuins and glioma risks. Present study was purposed to figure out the expression level of mitochondrial sirtuins (SIRT3,SIRT4,SIRT5) and related genes (GDH,OGG1-2α,SOD1,SOD2,HIF1αandPARP1) in 153 glioma tissue samples and 200 brain tissue samples from epilepsy patients (taken as controls). To understand the role of selected situins in gliomagenesis, DNA damage was measured using the comet assay and oncometabolic role (oxidative stress level, ATP level and NAD level) was measured using the ELISA and quantitative PCR. Results analysis showed significant down-regulation ofSIRT4(p = 0.0337),SIRT5(p<0.0001),GDH(p = 0.0305),OGG1-2α(p = 0.0001),SOD1(p<0.0001) andSOD2(p<0.0001) in glioma patients compared to controls. In case ofSIRT3(p = 0.0322),HIF1α(p = 0.0385) andPARP1(p = 0.0203), significant up-regulation was observed. ROC curve analysis and cox regression analysis showed the good diagnostic and prognostic value of mitochondrial sirtuins in glioma patients. Oncometabolic rate assessment analysis showed significant increased ATP level (p<0.0001), NAD+ level [(NMNAT1 (p<0.0001), NMNAT3 (p<0.0001) and NAMPT (p<0.04)] and glutathione level (p<0.0001) in glioma patients compared to controls. Significant increased level of damage ((p<0.04) and decrease level of antioxidant enzymes include superoxide dismutase (SOD, p<0.0001), catalase (CAT, p<0.0001) and glutathione peroxidase (GPx, p<0.0001) was observed in patients compared to controls. Present study data suggest that variation in expression pattern of mitochondrial sirtuins and increased metabolic rate may have diagnostic and prognostic significance in glioma patients.
Clinical practice guideline recommendation summaries for pediatric oncology health care professionals: A qualitative study
Authors: Santesso Nancy , Beauchemin Melissa , Robinson Paula D. , Walsh Alexandra M. , Sugalski Aaron J. , Lo Tammy , Dang Ha , Fisher Brian T. , Grimes Allison C. , Wrightson Andrea Rothfus , Yu Lolie C. , Sung Lillian , Dupuis L. Lee
Published: February 2023

Objective

To develop a summary format of clinical practice guideline (CPG) recommendations to improve understandability among health care professionals.

Methods

We developed a summary format based on current research and used the “Think Aloud” technique in one-on-one cognitive interviews to iteratively improve it. Interviews of health care professionals from Children’s Oncology Group-member, National Cancer Institute Community Oncology Research Program sites were conducted. After every five interviews (a round), responses were reviewed, and changes made to the format until it was well understood and no new, substantive suggestions for revision were raised. We took a directed (deductive) approach to content analysis of the interview notes to identify concerns related to recommendation summary usability, understandability, validity, applicability and visual appeal.

Results

During seven rounds of interviews with 33 health care professionals, we identified important factors that influenced understandability. Participants found understanding weak recommendations more challenging than strong recommendations. Understanding was improved when the term ‘conditional’ recommendation was used instead of ‘weak’ recommendation. Participants found a Rationale section to be very helpful but desired more information when a recommendation entailed a practice change. In the final format, the recommendation strength is clearly indicated in the title, highlighted, and defined within a text box. The rationale for the recommendation is in a column on the left, with supporting evidence on the right. In a bulleted list, the Rationale section describes the benefits and harms and additional factors, such as implementation, that were considered by the CPG developers. Each bullet under the supporting evidence section indicates the level of evidence with an explanation and the supporting studies with hyperlinks when applicable.

Conclusions

A summary format to present strong and conditional recommendations was created through an iterative interview process. The format is straightforward, making it easy for organizations and CPG developers to use it to communicate recommendations clearly to intended users.
Fertility trends by HIV status in a health and demographic surveillance study in Magu District, Tanzania, 1994–2018
Authors: Mkwashapi Denna , Renju Jenny , Mahande Michael , Changalucha John , Urassa Mark , Todd Jim
Published: February 2023

Background

Sub-Saharan Africa (SSA) has the highest fertility rates and highest HIV disease burden globally. However, it is not clear how the rapid expansion of anti-retroviral therapy (ART) for HIV has impacted the fertility gap between HIV-infected and uninfected women. We used data from a Health and Demographic Surveillance System (HDSS) in north-western Tanzania to explore trends in fertility rates and the relationship between HIV and fertility over the 25-year period.

Methods

From 1994 to 2018, births and population denominators from the HDSS population were used to obtain age-specific fertility rates (ASFRs) and total fertility rates (TFRs). HIV status was extracted from eight rounds of epidemiologic serological surveillances (1994–2017). Fertility rates by HIV status and in different levels of ART availability were compared over time. Independent risk factors for fertility changes were examined using Cox proportional hazard models.

Results

There were 24,662 births from 36,814 women (15–49) who contributed a total of 145,452.5 Person-Years of follow-ups. The TFR declined from 6.5 births per woman in 1994–1998 to 4.3 births per woman in 2014–2018. The number of births per woman was 40% lower in women living with HIV than in HIV-uninfected women (4.4 vs. 6.7), although this difference narrowed over time. The fertility rate in HIV-uninfected women was 36% lower in 2013–2018 than in 1994–1998(age-adjusted HR = 0.641; 95% CI 0.613–0.673). In contrast, the fertility rate in women living with HIV was relatively unchanged over the same follow up period (age-adjusted HR = 1.099; 95% CI 0.870–1.387).

Conclusions

There was a notable fertility decline among women in the study area from 1994 to 2018. Fertility remained lower in women living with HIV than in HIV-uninfected women, but the difference continued to narrow over time. These results highlight the need for more research into fertility changes, fertility desire and family planning use in Tanzanian rural communities.