bluuebunny/crossref_metadata_2025 huggingface dataset:
Manipulating the optical beam width in topological pseudospin-dependent waveguides using all-dielectric photonic crystals
Authors: Hu Zhong , Qin Meibao , Lingjuan He , Liu Wenxing , Yu Tianbao , Xiao Shuyuan , Liao Qinghua
Published: September 2022

We propose a width-tunable topological pseudospin-dependent waveguide (TPDW) which can manipulate the optical beam width using a heterostructure of all-dielectric photonic crystals (PhCs). The heterostructure can be realized by introducing a PhC featuring double Dirac cones into the other two PhCs with different topological indices. The topological pseudospin-dependent waveguide states (TPDWSs) achieved from the TPDW exhibit unidirectional transport and immunity against defects. As a potential application of our work, using these characteristics of TPDWSs, we further design a topological pseudospin-dependent beam expander which can expand a narrow beam into a wider one at the communication wavelength of 1.55 µm and is robust against three kinds of defects. The proposed TPDW with widely adjustable width can better dock with other devices to achieve stable and efficient transmission of light. Meanwhile, all-dielectric PhCs have negligible losses at optical wavelengths, which provides the prospect of broad application in photonic integrated devices.
Fiber optic strain rate sensor based on a differentiating interferometer
Authors: Li Huicong , Huang Wenzhu , Zhang Wentao , Zhang Jianxiang
Published: September 2022

Strain rate is an important basic physical parameter in the fields of deformation observation, geodetic measurement, and geophysical monitoring. This paper proposes a novel fiber optic strain rate sensor (FOSRS) that can directly measure the strain rate through a differentiating interferometer that converts the strain rate to the optical phase. The sensing principle, sensitivity, resolution, and dynamic range of the proposed FOSRS are theoretically analyzed and verified by experiment. The experimental results show that the developed FOSRS with a 12.1 m sensing fiber has a flat sensitivity of 69.50 dB, a nanostrain rate (

n
ε
/
s

) resolution, and a dynamic range of better than 95 dB. An ultrahigh static resolution of 17.07

pε
/
s

can be achieved by using a 25.277 km sensing fiber for long baseline measurements. The proposed method significantly outperforms existing indirect measurement methods and has potential applications in geophysical monitoring and crustal deformation observation.
Omitting age-dependent mosquito mortality in malaria models underestimates the effectiveness of insecticide-treated nets
Authors: Iacovidou Melissa A. , Barreaux Priscille , Spencer Simon E. F. , Thomas Matthew B. , Gorsich Erin E. , Rock Kat S.
Published: September 2022

Mathematical models of vector-borne infections, including malaria, often assume age-independent mortality rates of vectors, despite evidence that many insects senesce. In this study we present survival data on insecticide-resistantAnopheles gambiae s.l. from experiments in Côte d’Ivoire. We fit a constant mortality function and two age-dependent functions (logistic and Gompertz) to the data from mosquitoes exposed (treated) and not exposed (control) to insecticide-treated nets (ITNs), to establish biologically realistic survival functions. This enables us to explore the effects of insecticide exposure on mosquito mortality rates, and the extent to which insecticide resistance might impact the effectiveness of ITNs. We investigate this by calculating the expected number of infectious bites a mosquito will take in its lifetime, and by extension the vectorial capacity. Our results show that the predicted vectorial capacity is substantially lower in mosquitoes exposed to ITNs, despite the mosquitoes in the experiment being highly insecticide-resistant. The more realistic age-dependent functions provide a better fit to the experimental data compared to a constant mortality function and, hence, influence the predicted impact of ITNs on malaria transmission potential. In models with age-independent mortality, there is a great reduction for the vectorial capacity under exposure compared to no exposure. However, the two age-dependent functions predicted an even larger reduction due to exposure, highlighting the impact of incorporating age in the mortality rates. These results further show that multiple exposures to ITNs had a considerable effect on the vectorial capacity. Overall, the study highlights the importance of including age dependency in mathematical models of vector-borne disease transmission and in fully understanding the impact of interventions.
Is cell segregation like oil and water: Asymptotic versus transitory regime
Authors: Franke Florian , Aland Sebastian , Böhme Hans-Joachim , Voss-Böhme Anja , Lange Steffen
Published: September 2022

Understanding the segregation of cells is crucial to answer questions about tissue formation in embryos or tumor progression. Steinberg proposed that separation of cells can be compared to the separation of two liquids. Such a separation is well described by the Cahn-Hilliard (CH) equations and the segregation indices exhibit an algebraic decay with exponent 1/3 with respect to time. Similar exponents are also observed in cell-based models. However, the scaling behavior in these numerical models is usually only examined in the asymptotic regime and these models have not been directly applied to actual cell segregation data. In contrast, experimental data also reveals other scaling exponents and even slow logarithmic scaling laws. These discrepancies are commonly attributed to the effects of collective motion or velocity-dependent interactions. By calibrating a 2D cellular automaton (CA) model which efficiently implements a dynamic variant of the differential adhesion hypothesis to 2D experimental data from Méhes et al., we reproduce the biological cell segregation experiments with just adhesive forces. The segregation in the cellular automaton model follows a logarithmic scaling initially, which is in contrast to the proposed algebraic scaling with exponent 1/3. However, within the less than two orders of magnitudes in time which are observable in the experiments, a logarithmic scaling may appear as a pseudo-algebraic scaling. In particular, we demonstrate that the cellular automaton model can exhibit a range of exponents ≤1/3 for such a pseudo-algebraic scaling. Moreover, the time span of the experiment falls into the transitory regime of the cellular automaton rather than the asymptotic one. We additionally develop a method for the calibration of the 2D Cahn-Hilliard model and find a match with experimental data within the transitory regime of the Cahn-Hilliard model with exponent 1/4. On the one hand this demonstrates that the transitory behavior is relevant for the experiment rather than the asymptotic one. On the other hand this corroborates the ambiguity of the scaling behavior, when segregation processes can be only observed on short time spans.
Challenges in reanalysis products to assess extreme weather impacts on agriculture: Study case in southern Sweden
Authors: Grusson Youen , Barron Jennie
Published: September 2022

The incidence of dry or wet day sequences has a great influence on crops management and development. The lack of spatialized observed data with appropriate temporal resolution to investigate the changes that has occurred during the last century regarding the length and frequencies of those sequences has led to reliance on reanalysis products. However, the question can be raised about the suitability of those products when evaluating such climate indices and their impacts on crop production. Different products are here investigated to evaluate how the succession of dry and wet days are depicted in Sweden. Results show that reanalysis product tends to overestimate the number of wet days and wet periods and underestimate dry periods. We also showed clearly that the frequency and intensity of dry and wet spells returned can differ widely between products. For instance, number of dry spell events can range from 1 to 11 over the same decade for two different products. This paper does not aim to classify the RPs regarding their goodness or efficiency but try to highlights the divergence between them in representation of spells which could generate substantial differences in climate impact analysis in agricultural modeling.
Daisy-chain gene drives: The role of low cut-rate, resistance mutations, and maternal deposition
Authors: Verkuijl Sebald A. N. , Anderson Michelle A. E. , Alphey Luke , Bonsall Michael B.
Published: September 2022

The introgression of genetic traits through gene drive may serve as a powerful and widely applicable method of biological control. However, for many applications, a self-perpetuating gene drive that can spread beyond the specific target population may be undesirable and preclude use. Daisy-chain gene drives have been proposed as a means of tuning the invasiveness of a gene drive, allowing it to spread efficiently into the target population, but be self-limiting beyond that. Daisy-chain gene drives are made up of multiple independent drive elements, where each element, except one, biases the inheritance of another, forming a chain. Under ideal inheritance biasing conditions, the released drive elements remain linked in the same configuration, generating copies of most of their elements except for the last remaining link in the chain. Through mathematical modelling of populations connected by migration, we have evaluated the effect of resistance alleles, different fitness costs, reduction in the cut-rate, and maternal deposition on two alternative daisy-chain gene drive designs. We find that the self-limiting nature of daisy-chain gene drives makes their spread highly dependent on the efficiency and fidelity of the inheritance biasing mechanism. In particular, reductions in the cut-rate and the formation of non-lethal resistance alleles can cause drive elements to lose their linked configuration. This severely reduces the invasiveness of the drives and allows for phantom cutting, where an upstream drive element cuts a downstream target locus despite the corresponding drive element being absent, creating and biasing the inheritance of additional resistance alleles. This phantom cutting can be mitigated by an alternative indirect daisy-chain design. We further find that while dominant fitness costs and maternal deposition reduce daisy-chain invasiveness, if overcome with an increased release frequency, they can reduce the spread of the drive into a neighbouring population.
Analysis of low-level somatic mosaicism reveals stage and tissue-specific mutational features in human development
Authors: Kim Ja Hye , Hwang Shinwon , Son Hyeonju , Kim Dongsun , Kim Il Bin , Kim Myeong-Heui , Sim Nam Suk , Kim Dong Seok , Ha Yoo-Jin , Lee Junehawk , Kang Hoon-Chul , Lee Jeong Ho , Kim Sangwoo
Published: September 2022

Most somatic mutations that arise during normal development are present at low levels in single or multiple tissues depending on the developmental stage and affected organs. However, the effect of human developmental stages or mutations of different organs on the features of somatic mutations is still unclear. Here, we performed a systemic and comprehensive analysis of low-level somatic mutations using deep whole-exome sequencing (average read depth ~500×) of 498 multiple organ tissues with matched controls from 190 individuals. Our results showed that early clone-forming mutations shared between multiple organs were lower in number but showed higher allele frequencies than late clone-forming mutations [0.54 vs. 5.83 variants per individual; 6.17% vs. 1.5% variant allele frequency (VAF)] along with less nonsynonymous mutations and lower functional impacts. Additionally, early and late clone-forming mutations had unique mutational signatures that were distinct from mutations that originated from tumors. Compared with early clone-forming mutations that showed a clock-like signature across all organs or tissues studied, late clone-forming mutations showed organ, tissue, and cell-type specificity in the mutation counts, VAFs, and mutational signatures. In particular, analysis of brain somatic mutations showed a bimodal occurrence and temporal-lobe-specific signature. These findings provide new insights into the features of somatic mosaicism that are dependent on developmental stage and brain regions.
Genome sequencing and comparative analysis of Wolbachia strain wAlbA reveals Wolbachia-associated plasmids are common
Authors: Martinez Julien , Ant Thomas H. , Murdochy Shivan M. , Tong Lily , da Silva Filipe Ana , Sinkins Steven P.
Published: September 2022

Wolbachia are widespread maternally-transmitted bacteria of arthropods that often spread by manipulating their host’s reproduction through cytoplasmic incompatibility (CI). Their invasive potential is currently being harnessed in field trials aiming to control mosquito-borne diseases. Wolbachia genomes commonly harbour prophage regions encoding the cif genes which confer their ability to induce CI. Recently, a plasmid-like element was discovered in wPip, a Wolbachia strain infecting Culex mosquitoes; however, it is unclear how common such extra-chromosomal elements are in Wolbachia. Here we sequenced the complete genome of wAlbA, a strain of the symbiont found in Aedes albopictus, after eliminating the co-infecting and higher density wAlbB strain that previously made sequencing of wAlbA challenging. We show that wAlbA is associated with two new plasmids and identified additional Wolbachia plasmids and related chromosomal islands in over 20% of publicly available Wolbachia genome datasets. These plasmids encode a variety of accessory genes, including several phage-like DNA packaging genes as well as genes potentially contributing to host-symbiont interactions. In particular, we recovered divergent homologues of the cif genes in both Wolbachia- and Rickettsia-associated plasmids. Our results indicate that plasmids are common in Wolbachia and raise fundamental questions around their role in symbiosis. In addition, our comparative analysis provides useful information for the future development of genetic tools to manipulate and study Wolbachia symbionts.
Exposure to wildfire-related PM2.5 and site-specific cancer mortality in Brazil from 2010 to 2016: A retrospective study
Authors: Yu Pei , Xu Rongbin , Li Shanshan , Yue Xu , Chen Gongbo , Ye Tingting , Coêlho Micheline S. Z. S. , Saldiva Paulo H. N. , Sim Malcolm R. , Abramson Michael J. , Guo Yuming
Published: September 2022

Background

Long-term exposure to fine particles ≤2.5 μm in diameter (PM2.5) has been linked to cancer mortality. However, the effect of wildfire-related PM2.5 exposure on cancer mortality risk is unknown. This study evaluates the association between wildfire-related PM2.5 and site-specific cancer mortality in Brazil, from 2010 to 2016.

Methods and findings

Nationwide cancer death records were collected during 2010–2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and non-wildfire-related PM2.5 concentrations, at a resolution of 2.0° latitude by 2.5° longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age ≥ 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM2.5 concentration was 2.38 μg/m3, and the annual non-wildfire-related PM2.5 concentration was 8.20 μg/m3. The RR for mortality from all cancers was 1.02 (95% CI 1.01–1.03, p < 0.001) per 1-μg/m3 increase of wildfire-related PM2.5 concentration, which was higher than the RR per 1-μg/m3 increase of non-wildfire-related PM2.5 (1.01 [95% CI 1.00–1.01], p = 0.007, with p for difference = 0.003). Wildfire-related PM2.5 was associated with mortality from cancers of the nasopharynx (1.10 [95% CI 1.04–1.16], p = 0.002), esophagus (1.05 [95% CI 1.01–1.08], p = 0.012), stomach (1.03 [95% CI 1.01–1.06], p = 0.017), colon/rectum (1.08 [95% CI 1.05–1.11], p < 0.001), larynx (1.06 [95% CI 1.02–1.11], p = 0.003), skin (1.06 [95% CI 1.00–1.12], p = 0.003), breast (1.04 [95% CI 1.01–1.06], p = 0.007), prostate (1.03 [95% CI 1.01–1.06], p = 0.019), and testis (1.10 [95% CI 1.03–1.17], p = 0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders.

Conclusions

Exposure to wildfire-related PM2.5 can increase the risks of cancer mortality for many cancer sites, and the effect for wildfire-related PM2.5 was higher than for PM2.5 from non-wildfire sources.
Longitudinal monitoring of prevalence and intensity of soil-transmitted helminth infections as part of community-wide mass drug administration within the Geshiyaro project in the Bolosso Sore district, Wolaita, Ethiopia
Authors: Landeryou Toby , Maddren Rosie , Rayment Gomez Santiago , Kalahasti Suprabhath , Liyew Ewnetu Firdawek , Chernet Melkie , Mohammed Hussein , Wuletaw Yonas , Truscott James , Phillips Anna E. , Ower Alison , Forbes Kathryn , Anjulo Ufaysa , Mengistu Birhan , Tasew Geremew , Salasibew Mihretab , Anderson Roy
Published: September 2022

Mass drug administration (MDA), targeted at school-aged children (SAC) is recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds, and research suggests that only treating SAC will not be sufficient to interrupt transmission of STH. In countries with endemic infection, such as Ethiopia, the coverage, community-groups targeted, and rates of reinfection will determine how effective MDA is in suppressing transmission in the long-term. In this paper, individually-linked longitudinal data from three epidemiological STH surveys conducted between November 2018 and November 2020 in the Wolaita region of Ethiopia are analysed to determine how STH prevalence and intensity changes according to individual level treatment data collected over two rounds of MDA. This study demonstrates that while community-wide MDA successfully reduces overall infection intensity across the villages treated, the observed levels of non-compliance to treatment by individuals acts to maintain levels of parasite abundance whereby transmission interruption is not possible at to, despite reasonable levels of MDA coverage in the communities studied (ranging from 65% to 84% of the village populations). This quantifies with substantial data the often-postulated difference between coverage (accepting treatment) and compliance (swallowing of treatment), the latter impacting the former to a previously unquantified level. The paper highlights the need to focus treatment to partially treated, or never treated groups of individuals within existing community wide MDA control activities to interrupt the transmission of STH, and to reduce the basic reproductive number, R0, of the parasites to less than unity in value.
Hospitalizations due to gastrointestinal Chagas disease: National registry
Authors: Bierrenbach Ana Luiza , Quintino Nayara Dornela , Moreira Carlos Henrique Valente , Damasceno Renata Fiúza , Nunes Maria do Carmo Pereira , Baldoni Nayara Ragi , de Oliveira da Silva Lea Campos , Ferreira Ariela Mota , Cardoso Clareci Silva , Haikal Desirée Sant’Ana , Sabino Ester Cerdeira , Ribeiro Antonio Luiz Pinho , Oliveira Claudia Di Lorenzo
Published: September 2022

Objectives

Analyze the hospitalizations of patients admitted for Chagas disease with gastro-intestinal involvement (CD-GI) in the Brazilian Unified Health System, describe the epidemiological profile, mortality and costs.

Methods

This is an observational study that uses secondary data from the National Hospital Information System (SIH-SUS) for the years 2017–2019. CD-GI admissions were defined by specific ICD-10 codes that identify the main diagnosis.

Results

From 2017 to 2019, there were 4,407 hospitalizations for CD-GI in Brazil, considering only public hospitals and those associated with the SUS. This corresponds to an average of 1,470 hospitalizations per year, or 0.6 per 100,000 inhabitants, with significant regional variation. Hospitalizations increased with age and were slightly higher in men. More than 60% were emergencies and in 50% the procedure performed was surgical. The most used code was the one for megaesophagus followed by megacolon. In-hospital mortality was 5.8% and 17.2% went to intensive care units. The median cost was USD$ 553.15 per hospitalization, and an overall cost of USD$ 812,579.98 per year to the SUS budget.

Conclusion

The numbers, rates and costs presented here are possibly underestimated but they give us an idea of the overall profile of hospitalizations due to CD-GI, which are not rare and are related to significant in-hospital mortality. CD-GI is a neglected manifestation of a neglected disease.
External drivers of BOLD signal’s non-stationarity
Authors: Ashourvan Arian , Pequito Sérgio , Bertolero Maxwell , Kim Jason Z. , Bassett Danielle S. , Litt Brian
Published: September 2022

A fundamental challenge in neuroscience is to uncover the principles governing how the brain interacts with the external environment. However, assumptions about external stimuli fundamentally constrain current computational models. We show in silico that unknown external stimulation can produce error in the estimated linear time-invariant dynamical system. To address these limitations, we propose an approach to retrieve the external (unknown) input parameters and demonstrate that the estimated system parameters during external input quiescence uncover spatiotemporal profiles of external inputs over external stimulation periods more accurately. Finally, we unveil the expected (and unexpected) sensory and task-related extra-cortical input profiles using functional magnetic resonance imaging data acquired from 96 subjects (Human Connectome Project) during the resting-state and task scans. This dynamical systems model of the brain offers information on the structure and dimensionality of the BOLD signal’s external drivers and shines a light on the likely external sources contributing to the BOLD signal’s non-stationarity. Our findings show the role of exogenous inputs in the BOLD dynamics and highlight the importance of accounting for external inputs to unravel the brain’s time-varying functional dynamics.
Efficacy and safety of temperature-sensitive acellular dermal matrix in prevention of postoperative adhesion after thyroidectomy: A randomized, multicenter, double-blind, non-inferiority study
Authors: Kim Jin Kyong , Lee Cho Rok , Kang Sang-Wook , Jeong Jong Ju , Nam Kee-Hyun , Cho Sung-Rae , Jo Seongmoon , Kim Eun Young , Yun Ji-Sup , Park Hee Jin , Kim Mi Sung , Kim Kwangsoon , Lee Sohee , Bae Ja Seong , Jun So Yeon , Park Jihye , Kim Jeong Soo
Published: September 2022

Introduction

MegaShield®is a newly developed temperature-sensitive anti-adhesive containing micronized acellular dermal matrix. The aim of this study was to investigate the efficacy and safety of MegaShield®compared with Guardix-SG®in the prevention of adhesions in patients undergoing bilateral total thyroidectomy.

Method

We conducted a multicenter trial between October 2018 and March 2020 in patients undergoing total thyroidectomy. The patients were randomly assigned to either the MegaShield®group or the Guardix-SG®group. The primary outcome was the esophageal movement using marshmallow six weeks after the surgery and the secondary outcome was the assessed adhesion score. The safety assessment was also evaluated.

Results

The study included 70 patients each in the MegaShield®and control (Guardix-SG®) groups. Baseline clinical characteristics, the mean score of marshmallow esophagography, and the sum of adhesion scores were not statistically different between the two groups. Inferiority test demonstrated that the efficacy of MegaShield®is not inferior to that of Guardix-SG®. There were no device-related complications in both groups.

Conclusion

The efficacy and safety of MegaShield®were not inferior than those of Guardix-SG®. MegaShield®demonstrated the potential of ADM as a potential future anti-adhesive agent.

Trial registration

The name of trial registry CRIS (Clinical Research Information Service)https://cris.nih.go.kr/cris/index.jsp. (The full trial protocol can be accessed) Registration number:KCT0003204.
A novel machine learning-based approach for the detection and analysis of spontaneous synaptic currents
Authors: Pircher Thomas , Pircher Bianca , Feigenspan Andreas
Published: September 2022

Spontaneous synaptic activity is a hallmark of biological neural networks. A thorough description of these synaptic signals is essential for understanding neurotransmitter release and the generation of a postsynaptic response. However, the complexity of synaptic current trajectories has either precluded an in-depth analysis or it has forced human observers to resort to manual or semi-automated approaches based on subjective amplitude and area threshold settings. Both procedures are time-consuming, error-prone and likely affected by human bias. Here, we present three complimentary methods for a fully automated analysis of spontaneous excitatory postsynaptic currents measured in major cell types of the mouse retina and in a primary culture of mouse auditory cortex. Two approaches rely on classical threshold methods, while the third represents a novel machine learning-based algorithm. Comparison with frequently used existing methods demonstrates the suitability of our algorithms for an unbiased and efficient analysis of synaptic signals in the central nervous system.
Acceptance of evolution by high school students: Is religion the key factor?
Authors: Oliveira Graciela da Silva , Pellegrini Giuseppe , Araújo Leonardo Augusto Luvison , Bizzo Nelio
Published: September 2022

The idea of biological evolution is not accepted by many people around the world, with a large disparity amongst countries. Some factors may act as obstacles to the acceptance of evolution, such as religion, a lack of openness to experience, and not understanding the nature of science. Although the strength of the association between evolution acceptance and non-scientific factors varies among studies, it is often assumed that resistance to evolution is the byproduct of a religious background. Some studies are even more specific and try to associate the acceptance of evolution with precise religious affiliations. We aimed to explore the strength of associations among nationality, religion, and the acceptance of evolution by students using multiple correspondence analysis (MCA) and statistical tools, with nationwide samples from two different countries. Here, we show that wider sociocultural factors predict the acceptance of evolution to a higher degree than a religious background. We carried out two nationwide data collections that allowed us to compare differences in the acceptance of evolution in Italy and Brazil by high school students who declare to belong to the same religion in the two countries. Roman Catholic students showed significant differences between the two countries, and the gap between them was wider than between Catholics and non-Catholic Christians within Brazil. Our conclusions support those who argue that religious affiliation is not the main factor in predicting the level of evolution acceptance. The sociocultural environment and the level of evolutionary knowledge seem to be more important in this regard. These results open up new interpretative perspectives and provide a better understanding of attitudes towards evolution.
Relationship between knowledge, attitude, and practice of COVID-19 precautionary measures and the frequency of infection among medical students at an Egyptian University
Authors: Wassif Ghada O. , El Din Dina Ahmed Gamal
Published: September 2022

Background

Medical undergraduates are at high risk of COVID-19 infection. Thus, conformance to healthy practices is advised to reduce disease transmission and control the current epidemic. The present study aimed to explore the relationship of knowledge, attitude, and practice (KAP) related to COVID-19 precautionary measures with the frequency of infection among medical students at an Egyptian University.

Methods

A comparative cross-sectional study was conducted on 404 undergraduate medical students from different grades using a web-based self-administered anonymous questionnaire.

Results

More than one-third of medical students (37.4%) were previously infected with COVID-19, where the majority (60.5%) were diagnosed with relevant signs and symptoms. Medical students with low levels of KAP experienced higher frequencies of infection than did other students. A statistically significant negative correlation was observed between the number of previous COVID-19 infections among medical students and their knowledge and attitude scores toward COVID-19. In addition, a statistically significant positive correlation was noted among KAP scores (P < 0.01).

Conclusion

Improving the knowledge, attitude, and conformance of medical students to precautionary measures toward COVID-19 may substantially reduce the risk and frequency of infection and, hence, reduce community transmission.
Understanding factors influencing uptake and sustainable use of the PINCER intervention at scale: A qualitative evaluation using Normalisation Process Theory
Authors: Laing Libby , Salema Nde-eshimuni , Jeffries Mark , Shamsuddin Azwa , Sheikh Aziz , Chuter Antony , Waring Justin , Avery Anthony , Keers Richard N.
Published: September 2022

Introduction

Medication errors are an important cause of morbidity and mortality. The pharmacist-led IT-based intervention to reduce clinically important medication errors (PINCER) has demonstrated improvements in primary care medication safety, and whilst now the subject of national roll-out its optimal and sustainable use across health contexts has not been fully explored. As part of a qualitative evaluation we aimed to identify factors influencing successful adoption, embedding and sustainable use of PINCER across primary care settings in England, UK.

Methods

Semi-structured face-to-face or telephone interviews, including follow-up interviews and an online survey were conducted with professionals knowledgeable of PINCER. Interview recruitment targeted four early adopter regions; the survey was distributed nationally. Initial data analysis was inductive, followed by analysis using a coding framework. A deductive matrix approach was taken to map the framework to the Normalisation Process Theory (NPT). Themes were then identified.

Results

Fifty participants were interviewed, 18 participated in a follow-up interview. Eighty-one general practices and three Clinical Commissioning Groups completed the survey. Four themes were identified and interpreted within the relevant NPT construct: Awareness & Perceptions (Coherence), Receptivity to PINCER (Cognitive Participation), Engagement [Collective Action] and Reflections & Adaptations (Reflexive Monitoring). Variability was identified in how PINCER awareness was raised and how staff worked to operationalise the intervention. Facilitators for use included stakeholder investment, favourable evidence, inclusion in policy, incentives, fit with individual and organisational goals and positive experiences. Barriers included lack of understanding, capacity concerns, operational difficulties and the impact of COVID-19. System changes such as adding alerts on clinical systems were indicative of embedding and continued use.

Conclusions

The NPT helped understand motives behind engagement and the barriers and facilitators towards sustainable use. Optimising troubleshooting support and encouraging establishments to adopt an inclusive approach to intervention adoption and utilisation could help accelerate uptake and help establish ongoing sustainable use.
Is there a place for a molecular diagnostic test for pelvic inflammatory disease in primary care? An exploratory qualitative study
Authors: Bittleston Helen , Hocking Jane S. , Goller Jane L. , Coombe Jacqueline , Bateson Deborah , Sweeney Sally , Fleming Kirsteen , Huston Wilhelmina M.
Published: September 2022

Introduction

There is currently no test for pelvic inflammatory disease (PID) that is non-invasive and sufficiently sensitive and specific. Clinicians must therefore diagnose PID clinically, ruling out medical emergencies and conducting pelvic examinations where possible. While guidelines state that clinicians should be prepared to over-diagnose PID, it remains an under-diagnosed condition, with severe reproductive health impacts when left untreated. This research is the first to consider the perspectives of end-users on the development of a diagnostic test for PID.

Methods

Semi-structured live video feed online (Zoom) interviews were conducted with 11 clinicians and nine women (aged 18–30 years) in Australia to understand how a diagnostic test might be used, and what characteristics a test would need for it to be acceptable to clinicians and young women. Participants were recruited via researcher and university student networks. Reflexive thematic analysis was used to identify key themes relating to the acceptability and characteristics of a diagnostic test for PID.

Results

Seven general practitioners, four clinicians working in sexual health clinics, and nine young women (aged 21–27 years) were interviewed. Clinicians were aged between 31–58 years and were predominantly female. Clinicians recognised that the development of an accurate test to diagnose PID would be valuable to themselves and other clinicians, particularly those who lack experience diagnosing PID, and those working in certain settings, including emergency departments. They discussed how they might use a test to enhance their clinical assessment but highlighted that it would not replace clinical judgement. Clinicians also considered how a test would impact the patient experience and time to treatment, emphasising that it should be minimally invasive and have a quick turnaround time. Young women said a test would be acceptable if endorsed by a trustworthy clinician.

Conclusions

PID remains a challenging diagnosis. Development of a minimally invasive and sufficiently accurate diagnostic test would be acceptable to young women and benefit some clinicians, although no test would completely replace an experienced clinician’s judgement in making a PID diagnosis.
Migration of Alpine Slavs and machine learning: Space-time pattern mining of an archaeological data set
Authors: Štular Benjamin , Lozić Edisa , Belak Mateja , Rihter Jernej , Koch Iris , Modrijan Zvezdana , Magdič Andrej , Karl Stephan , Lehner Manfred , Gutjahr Christoph
Published: September 2022

The rapid expansion of the Slavic speakers in the second half of the first millennium CE remains a controversial topic in archaeology, and academic passions on the issue have long run high. Currently, there are three main hypotheses for this expansion. The aim of this paper was to test the so-called “hybrid hypothesis,” which states that the movement of people, cultural diffusion and language diffusion all occurred simultaneously. For this purpose, we examined an archaeological Deep Data set with a machine learning method termed time series clustering and with emerging hot spot analysis. The latter required two archaeology-specific modifications: The archaeological trend map and the multiscale emerging hot spot analysis. As a result, we were able to detect two migrations in the Eastern Alps between c. 500 and c. 700 CE. Based on the convergence of evidence from archaeology, linguistics, and population genetics, we have identified the migrants as Alpine Slavs, i.e., people who spoke Slavic and shared specific common ancestry.
Why maternal continuum of care remains low in Northwest Ethiopia? A multilevel logistic regression analysis
Authors: Hailemariam Tesfahun , Atnafu Asmamaw , Gezie Lemma Derseh , Tilahun Binyam
Published: September 2022

Background

Non-adherence to the maternal continuum of care remains a significant challenge. Though early initiation and continuum of care are recommended for mothers’ and newborns’ well-being, there is a paucity of evidence that clarify this condition in resource-limited settings. This study aimed to assess the level of women’s completion of the maternal continuum of care and factors affecting it in Northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from October to November, 2020. Data were collected from 811 women who had a recent history of birth within the past one year. The random and fixed effects were reported using an adjusted odds ratio with a 95% confidence interval. The p-value of 0.05 was used to declare significantly associated factors with women’s completion of the maternal continuum of care.

Results

The study revealed that 6.9% (95%CI: 5.3–8.9%) of women were retained fully on the continuum of maternal care, while 7.89% of women did not receive any care from the existing healthcare system. Attending secondary and above education (AOR = 3.15; 95%CI: 1.25,7.89), membership in the women’s development army (AOR = 2.91; 95%CI: 1.56,5.44); being insured (AOR = 2.59; 95%CI: 1.33,5.01); getting health education (AOR = 2.44; 95%CI: 1.33,4.45); short distance to health facility (AOR = 4.81; 95%CI: 1.55,14.95); and mass-media exposure (AOR = 2.39; 95%CI: 1.11,5.15) were significantly associated with maternal continuum of care.

Conclusions

The maternal continuum of care is low in rural northwest Ethiopia compared to findings from most resource-limited settings. Therefore, the existing health system should consider multilevel intervention strategies that focus on providing maternal health education, facilitating insurance mechanisms, encouraging women’s participation in health clubs, and ensuring physical accessibility to healthcare facilities to be more effective in improving maternal health services.
Field evaluation of the effect of Aspergillus niger on lettuce growth using conventional measurements and a high-throughput phenotyping method based on aerial images
Authors: Silva Patrick Vieira , Pereira Lucas Medeiros , Mundim Gustavo de Souza Marques , Maciel Gabriel Mascarenhas , de Araújo Gallis Rodrigo Bezerra , Mendes Gilberto de Oliveira
Published: September 2022

Plant microbiome engineering is a promising tool to unlock crop productivity potential and exceed the yield obtained with conventional chemical inputs. We studied the effect of Aspergillus niger inoculation on in-field lettuce (Lactuca sativa) growth in soils with limiting and non-limiting P concentrations. Lettuce plants originating from inoculated seeds showed increased plant diameter (6.9%), number of leaves (8.1%), fresh weight (23.9%), and chlorophyll content (3.8%) as compared to non-inoculated ones. Inoculation of the seedling substrate just before transplanting was equally efficient to seed inoculation, while application of a granular formulation at transplanting did not perform well. Plant response to P addition was observed only up to 150 kg P2O5 ha-1, but A. niger inoculation allowed further increments in all vegetative parameters. We also employed a high-throughput phenotyping method based on aerial images, which allowed us to detect changes in plants due to A. niger inoculation. The visible atmospherically resistant index (VARI) produced an accurate prediction model for chlorophyll content, suggesting this method might be used to large-scale surveys of croplands inoculated with beneficial microorganisms. Our findings demonstrate that A. niger inoculation surpasses the yield obtained with conventional chemical inputs, allowing productivity gains not reached by just increasing P doses.
Accuracy of hepatitis B disease surveillance, Gannan prefecture, Gansu province, China; 2017
Authors: Wang Pinggui , Zhang Lijie , He Jian , Zhang Guomin , Ma Yvan , Lv Weimin , Zhang Xiaoshu , An Jin
Published: September 2022

Hepatitis B is a major global public health threat. According to China’s National Notifiable Disease Reporting System (NNDRS), Gannan Tibetan Autonomous Prefecture (Gannan) had the highest incidence of hepatitis B in Gansu Province during 2004 to 2016. We evaluated NNDRS hepatitis B case reports from Gannan to determine accuracy of diagnosis and to understand factors associated with inaccuracy. We reviewed medical records with hepatitis B diagnosis hospitalized in seven county hospitals in Gannan between January 1, 2016 and July 31, 2017. Using national "Classification and Diagnostic Procedures for Hepatitis B," we independently reclassified the diagnoses. We determined the positive predictive value (PPV) of reported hepatitis B cases. We investigate clinicians’ understanding of the diagnostic and reporting criteria for hepatitis B by questionnaire. We reviewed and re-categorized 400 inpatients reported. Sixteen cases had been reported as acute hepatitis B, but on re-categorization, none were acute hepatitis B cases. PPVs for chronic hepatitis B and unclassified hepatitis B cases were 66% and 15% respectively; 327 (82%) of the reported hepatitis B cases were inaccurately classified; 261 were carriers, 59 were reported previously, and 7 did not have hepatitis B. The actual incidence of hepatitis B in Gannan in 2016 was estimated to be 19/100,000, significantly below the reported incidence of 106/100,000. Among reported cases, 81% had been tested for Alanine aminotransferase, 52% for hepatitis C antibody, 80% with liver ultrasound, 32% for hepatitis A antibody, and 7% for hepatitis B virus (HBV) DNA. Not all cases were tested for anti-HBc IgM or hepatitis E antibody or had a liver biopsy. In the knowledge test, 56% of clinicians accurately diagnosed three simulated cases of acute hepatitis B, and 17% correctly diagnosed two simulated cases chronic hepatitis B; 22% knew that “a client with only HBsAg positivity need not be reported.” The falsely high incidence in Gannan was due to diagnostic and reporting inaccuracies. We recommend that clinicians and laboratorians receive additional training in hepatitis B diagnostic criteria and reporting standards, including appropriate use of IgM anti-HBc tests. Hepatitis B surveillance data should be periodically reviewed and evaluated for accuracy.
Preventive health resource allocation decision-making processes and the use of economic evidence in an Australian state government—A mixed methods study
Authors: Ananthapavan Jaithri , Sacks Gary , Moodie Marj , Nguyen Phuong , Carter Rob
Published: September 2022

Context

Recommended best practice for resource allocation decisions by governments include a stepwise process guided by economic evidence. However, the use of economic evidence in preventive health decision-making, which often impacts on multiple sectors of government, is under-researched. This study aimed to explore the resource allocation decision-making processes for preventive health interventions in the New South Wales (NSW) Government in Australia, and specifically examined the barriers and facilitators to the use of economic evidence from the perspective of multiple government departments.

Methods

This mixed methods study was conducted using semi-structured interviews with NSW Treasury representatives (n = 4), a focus group of NSW Ministry of Health representatives (n = 9), and a quantitative questionnaire of all participants. The schedule for the interviews and focus group was based on resource allocation guidance documents from Australian government agencies. Deductive content analysis was undertaken, guided by the Multiple Streams Framework.

Findings

NSW Treasury participants believed that decision-making processes where economic efficiency was the key guiding principle was the ideal approach. However, the NSW Ministry of Health participants identified that for preventive health decision-making, economic evidence was not used to inform their own choices but was typically only used to convince other agencies of the merits of proposed initiatives when seeking approval. The key barriers to the use of economic evidence were the lack of capacity within the NSW Ministry of Health to understand and undertake economic evaluations; a lack of collaboration between NSW Treasury and preventive health decision-makers within the NSW Ministry of Health; and deficient processes and governance mechanisms that do not facilitate or incentivise effective inter-sectoral decision-making.

Conclusions

Institutional structures for resource allocation decision-making regarding preventive health result in processes that contrast with best practice recommendations. The multiple challenges to collaborative decision-making across agencies require organisational change to promote a whole-of-government approach.
Aggregate population-level models informed by genetics predict more suitable habitat than traditional species-level model across the range of a widespread riparian tree
Authors: Bayliss Shannon L. J. , Papeş Monica , Schweitzer Jennifer A. , Bailey Joseph K.
Published: September 2022

Identifying and predicting how species ranges will shift in response to climate change is paramount for conservation and restoration. Ecological niche models are the most common method used to estimate potential distributions of species; however, they traditionally omit knowledge of intraspecific variation that can allow populations to respond uniquely to change. Here, we aim to test how population X environment relationships influence predicted suitable geographic distributions by comparing aggregated population-level models with species-level model predictions of suitable habitat within population ranges and across the species’ range. We also test the effect of two variable selection methods on these predictions–both addressing the possibility of local adaptation: Models were built with (a) a common set, and number, of predictors and, (b) a unique combination and number of predictors specific to each group’s training extent. Our study addresses the overarching hypothesis that populations have unique environmental niches, and specifically that (1) species-level models predict more suitable habitat within the ranges of genetic populations than individual models built from those groups, particularly when compared models are built with the same set of environmental predictors; and (2) aggregated genetic population models predict more suitable habitat across the species’ range than the species-level model, an = d this difference will increase when models are trained with individualized predictors. We found the species models predicted more habitat within population ranges for two of three genetic groups regardless of variable selection, and that aggregated population models predicted more habitat than species’ models, but that individualized predictors increased this difference. Our study emphasizes the extent to which changes to model predictions depend on the inclusion of genetic information and on the type and selection of predictors. Results from these modeling decisions can have broad implications for predicting population-level ecological and evolutionary responses to climate change.