Level Of Coverage Research Articles

Assessing yellow fever outbreak potential and implications for vaccine strategy.

Yellow fever (YF), a vector-borne viral hemorrhagic fever, is endemic in tropical regions of Africa and South America, with large vaccination programmes being used for control. However, significant outbreaks have occurred in recent years. Data on infection rates and seroprevalence is often sparse, requiring robust mathematical models to estimate the burden of yellow fever. In particular, modelling is required to estimate the risk of outbreaks and inform policy decisions regarding the targeting of vaccination. We present a dynamic, stochastic model of YF transmission which uses environmental covariates to estimate the force of infection due to spillover from the sylvatic (non-human primate) reservoir and the basic reproduction number for human-to-human transmission. We examine the potential for targets identified by the World Health Organization EYE Strategy (50%, 60% or 80% vaccination coverage in 1-60 year olds) to achieve different threshold values for the effective reproduction number. Threshold values are chosen to reflect the potential for seasonal and/or climatic variation in YF transmission even in a scenario where vaccination lowers the median reproduction number below 1. Based on parameter estimates derived from epidemiological data, it is found that the 2022 EYE Strategy target coverage is sufficient to reduce the static averaged annual effective reproduction number R below 1 across most or all regions in Africa depending on the effectiveness of reported vaccinations, but insufficient to reduce it below 0.5 and thereby eliminate outbreaks in areas with high seasonal range. Coverage levels aligned with the 2026 targets are found to significantly decrease the proportion of regions where R is greater than 0.5.

Drought disaster risk assessment and yield insurance pricing of maize: a case study of Liaoning Province, China

Starting from the ‘four-factors’ theory of natural disaster risk formation, the study first selects indices that represent hazard, vulnerability, exposure, and emergency response and recovery capability to construct the drought risk assessment index system. Then the natural disaster risk index method is employed to evaluate the risk of maize drought disasters in Liaoning. Finally, the pure premium rate for maize yield insurance is determined based on the risk assessment results and the Copula function. The results show that: (1) The hazard, vulnerability, and exposure index in northwestern Liaoning are high, while emergency response and recovery capability is relatively low. Therefore, northwestern Liaoning is identified as a high-risk area for drought risk. (2) There exists a negative correlation between the drought risk index and maize yield in most areas of Liaoning; that is, higher drought risk is associated with lower maize yield. (3) Under the same coverage level, pure rates are higher in the northwestern and eastern Liaoning and relatively lower in the southwestern and southeastern Liaoning. Under different coverage levels, higher coverage corresponds to increased pure rates. The results can offer valuable guidance and benchmarks for relevant departments in Liaoning Province to assess the impact of drought risk on agriculture.

Multidisciplinary models of primary health care for patients with chronic non-communicable diseases

Introduction. Chronic non-communicable diseases (CNCD) requires a variety of strategies from different perspectives and at different levels, including individual and country-specific. Comprehensive patient-oriented and proactive approaches play an important role in the provision of multidisciplinary teams of medical care to patients with established CNCD. The purpose of this study is to present the Moscow experience in managing multidisciplinary teams for the treatment of CND patients, using the example of arterial hypertension in the framework of a pilot project in the outpatient clinics of the Troitsk and Novomoskovsky administrative districts (TiNAO; were attached to the territory of Moscow in 2012). Materials and methods. The study was conducted in two stages: at the first, a literature review was carried out, at the second, the stages of launching a pilot project on the management of multidisciplinary teams for the treatment patients with CNCD, using the example of arterial hypertension in the outpatient clinic of TinAO, were developed and discussed. Results. The research analyzes approaches to the use of multidisciplinary teams in the world. Based on the analyzed current regulatory documents, adjustments were made to the foreign model for its possible adaptation to Moscow polyclinics, focusing on proactive dispensary dynamic monitoring. Research limitations. The results of the conducted research are based on operational data from Moscow and can be applied only to the formation of management decisions in Moscow. Conclusion. According to the results of the pilot project testing, an increase in the level of coverage of the attached population with medical care, accessibility of narrow specialists and provision of equal opportunities for obtaining medical care for Muscovites was noted.

Assessing the state of cognitive performance of employees and determining the range of thermal comfort of different genders in Ilam hospitals

Introduction: Thermal comfort is essential for a productive work environment and affects the well-being and performance of employees, so maintaining optimal levels of satisfaction, productivity, and efficiency, especially in indoor spaces, is essential. Therefore, the present study's aim is to evaluate the state of cognitive performance. Employees and determination of the thermal comfort range of different genders of employees in the hospitals of Ilam city were done. Methods and Materials: This research was conducted by survey and field method to identify the state of thermal comfort and cognitive performance of people in the real conditions of therapeutic spaces. For this purpose, the responses of 400 employees of five hospitals in Ilam City were recorded by simple sampling from the beginning of August to November 1402. The reliability status of the questionnaires was confirmed using Cronbach's alpha, and the thermal comfort status of the people was determined through the regression model. Linearity and correlation analysis between measured variables were analyzed through SPSS27 software. Results: The analysis of the linear regression model showed that the range of thermal comfort between men and women differs by 1.79 degrees Celsius, and this difference is a tendency for warmer temperatures in men and a tendency for colder temperatures in women, the average scores obtained at Zagros Hospital In the visual-spatial/executive component (7.00), attention (4.34), memory (3.08) has the best performance, Imam Khomeini Hospital (RA) has the best performance in the verbal component (2.95), Hazrat Qaim Hospital (A) In the abstraction component (2.02), it has the best performance and awareness of time and place in all hospitals equal to 6.00. Conclusion: The level of coverage and activity rate among women significantly affects the feeling of thermal comfort, cognitive performance, and productivity of employees at work. The results of this research show the need to revise the current standards of workplace clothing, attendance time, and employee activity rate. Moreover, changes in cognitive performance among hospital staff highlight the need to consider targeted cognitive enhancement strategies to increase staff efficiency.

Flight experimental analysis of largemulti-propeller airtanker dropping capability

Abstract In the absence of a dropping capability experiment of domestic airtankers, it is necessary to know the actual dropping capability of fixed-wing airtankers for data support to wildfire-fighting, improving fire-fighting efficiency, and reducing the loss of forest and grassland resources. According to the design characteristics of large multi-launch propeller airtankers in China, this experiment shall collect retardant samplesof the filled flame retardant with collection equipment on the flat ground after being dropped by the airtanker in the air. Then, the sample coverage was counted and contour maps of the ground patterns were plotted to compare the dropping coefficients, dropping heights, and dropping speeds of the different dropping modes. At the last, according to the comparison result, the best dropping strategy shall be shown in different requirements. The result shows that when the coverage level is required to be GPC-6, the maximum coverage shall be obtained by all compartments released simultaneously, with a maximum coverage coefficient of 0.16. When the coverage level is required to be GPC-1, it is better to release the retardant from the tank independently with a suitable interval for larger coverage, and the maximum coverage coefficient is 4.49.

Assessing Experiential Learning Program Design and Delivery Using Institutional Mission and Professional Standards

BackgroundHigh-impact practices (HIPs), such as mentored research, Capstone projects, study abroad, and field experiences, have been shown to improve college student engagement through experience-based learning. Research indicates that these practices can have high impact when they are intentionally designed and delivered to align with institutional mission and professional standards. The administrative structure of a HIP initiative may not consider how to assess program effectiveness. Few close examples exist in the literature to guide program staff to understand whether the HIPs supported by their programs are being designed and delivered for high impact. Our study details the efforts of one unit at a large private university to evaluate the implementation of an experiential learning initiative intended to support faculty to design and deliver high-impact practices to students. PurposeThis qualitative case study responds to the call for assessment to ensure that HIPs qualify as high impact. It illustrates a standards-based approach to evaluating a program of co-curricular, experientially based high-impact practices by determining how educational design and delivery aligns with the institution’s mission and professional standards for best practice. Methodology/approachTo qualitatively evaluate how well our HIP program aligned with institutional mission and HIP standards, we collected narrative data drawn from six faculty projects, faculty interviews, and reflections from 70 participating students. We used the institutional mission and established HIP professional standards as confirmatory themes to code the narrative and observe levels of coverage. Administrative directives were mapped against the confirmatory themes to identify areas of high and low emphasis and emergent themes that fell outside specific mission and standards language were considered for meaning. Findings/conclusionsOur qualitative assessment of a HIP program revealed program strengths and areas in need of improvement. By evaluating the concentration of institutional mission and professional standard themes across the project narratives and within the way the program was structured and administered, we found strong alignment existed in the areas of intellectual growth and interaction with faculty and peers. When we found that other mission themes and standards were present at lower levels, we mapped the administrative directives to the themes and discovered that the high concentration themes occurred more frequently in the directives. This insight led us to observe that addressing all mission and professional standard themes more clearly in the design phase could serve to align administrative directives more closely. In addition to the presence of confirmative themes across the data, we found emergent themes that had meaning to study participants but fell outside of the mission and industry standards. The evaluative process taught us important lessons around how administration-to-faculty program directives can impact the design and delivery of pedagogical practice. RecommendationsEducational leaders should consistently use institutional mission and professional standard language in directives to faculty and staff; training faculty in designing HIPs to meet professional standards can benefit underserved students; and recognizing meaningful themes that emerge through program evaluation can illuminate important unanticipated outcomes.

The Potential Impact of a Single-Dose HPV Vaccination Schedule on Cervical Cancer Outcomes in Kenya: A Mathematical Modelling and Health Economic Analysis

Background: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV vaccination strategies on health and economic outcomes in Kenya, where a two-dose schedule is the current standard. Methods: Using a validated compartmental transmission model of HPV and HIV in Kenya, we evaluated the costs from the payer’s perspective to vaccinate girls by age 10 with either one or two doses and increasing coverage levels (0%, 70%, 77%, 90%). Additionally, we modelled single-dose strategies supplemented with either catch-up vaccination of adolescent girls and young women or vaccination for all by age 10, funded with the first five-years of cost savings of switching from a two- to one-dose schedule. Costs and outcomes were discounted at 3% annually, and incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted-life-year (DALY) averted. Results: All one-dose and the two-dose 90% coverage strategies were on the efficiency frontier, dominating the remaining two-dose strategies. The two-dose 90% coverage strategy had a substantially higher ICER (US$6508.80/DALY averted) than the one-dose 90% coverage (US$197.44/DALY averted). Transitioning from a two- to one-dose schedule could result in US$21.4 Million saved over the first five years, which could potentially fund 2.75 million supplemental HPV vaccinations. With this re-investment, all two-dose HPV vaccination scenarios would be dominated. The greatest DALYs were averted with the single-dose HPV vaccination schedule at 90% coverage supplemented with catch-up for 11–24-year-old girls, which had an ICER of US$78.73/DALYs averted. Conclusions: Considering the logistical and cost burdens of a two-dose schedule, a one-dose schedule for girls by age 10 would generate savings that could be leveraged for catch-up vaccination for older girls and accelerate cervical cancer elimination in Kenya.

A dosimetric and robustness analysis of proton arc therapy with early energy layer and spot assignment for lung cancer versus conventional intensity modulated proton therapy.

Intensity Modulated Proton Therapy (IMPT) faces challenges in lung cancer treatment, like maintaining plan robustness for moving tumors against setup, range errors, and interplay effects. Proton Arc Therapy (PAT) is an alternative to maintain target coverage, potentially improving organ at risk (OAR) sparing, reducing beam delivery time (BDT), and enhancing patient experience. We aim to perform a systematic plan comparison study between IMPT and energy layer (EL) and spot assignment algorithm - Proton Arc Therapy (ELSA-PAT) to assess its potential for lung cancer treatment. A total of 14 Lung ELSA-PAT plans were compared retrospectively with IMPT plans. 4D worst-case minimax robust optimization was performed, including 84 scenarios (3%, 3 mm). Dosimetry assessment included target (clinical tumor volume [CTV]) and important OARs, on nominal and worst-case scenarios. Most relevant normal tissue complication probabilities (NTCP), target coverage robustness against interplay effect, and BDT were evaluated. CTV D95% and D98% showed no significant difference in comparison. PAT demonstrated better conformality by 66% (p = 0.00012) but delivered a higher heart mean dose (HMD, 23%). There was a 2% increase in NTCP 2-year mortality risk with PAT. Total BDT was comparable among techniques. IMPT was more robust than PAT against interplay effect, considering both D1% (1.0 ± 0.8 Gy vs 1.1 ± 1.4 Gy) and D98% bandwidths (0.9 ± 0.9 Gy vs 1.1 ± 1.3 Gy). Both techniques provide a similar level of dose coverage to the target volume. Although PAT improved dose conformality, higher HMD translated into increased heart toxicity, presumably due to chosen planning methodology and OAR proximity to target. Increased ELs and spots raised PAT BDT, although it could improve daily treatment workflow.

Using Legume-Enriched Cover Crops to Improve Grape Yield and Quality in Hillside Vineyards

Natural covering (NATC) has spread on hillside vineyards of central Italy as a replacement for tillage to reduce soil erosion, although it increased nitrogen and water needs. Therefore, in the current context of global warming, using cover crops (CCs) that require less water and provide nitrogen becomes crucial. The effects of two low-competition legume-enriched CCs in a rainfed hillside vineyard—a perennial legume–grass mixture (PLGM) and an annual legume cover crop of Trifolium alexandrinum (ALTA)—were compared with NATC over three years. PLGM and ALTA provided good levels of soil coverage, slightly lower than NATC, which had a negligible presence of legumes. PLGM and ALTA, due to low competition, enhanced vine vigor, resulting in thicker and wider canopies (as indicated by total leaf area and leaf layer number), higher pruning weight, and increased yield. PLGM and ALTA led to good qualitative levels, with higher grapes acidities, lower pH and total soluble solids content and, additionally, significantly higher yeast assimilable nitrogen content. In conclusion, implementing low-competition legume species in CCs is an effective tool to avoid soil erosion in a climate change scenario, leading to increased productivity, higher acidity, and improved nitrogen content in the grapes.

Pyrene‐Based Self‐Assembled Monolayer with Improved Surface Coverage and Energy Level Alignment for Perovskite Solar Cells

AbstractRecently, the efficiency of p‐i‐n perovskite solar cells drastically increased, a pivotal factor being the incorporation of self‐assembled monolayers (SAMs) as a hole‐transporting layer (HTL). SAMs offer many advantages over conventional HTLs, including minimal material requirements, low cost, and facile processing. Current research is mainly focused on the development of carbazole‐derived SAMs. However, the versatility of organic chemistry allows for the design of SAMs with alternative organic cores that may possess specific benefits. In this study, three novel SAMs are incorporated in p‐i‐n perovskite solar cells, each based on an aromatic core commonly used in organic semiconductors. The novel SAMs vary in their energy level alignment with the perovskite active layer. Optimal alignment is achieved with a pyrene‐based SAM (4PAPyr), resulting in solar cells that outperform the commercially available 2PACz. Moreover, due to improved surface coverage, the use of 4PAPyr leads to a significantly higher number of working solar cell devices when compared to 2PACz, which is of particular interest with regard to upscaling. After device optimization, a power conversion efficiency of 22.2% is achieved with 4PAPyr. This research underlines the importance of diversifying SAMs to unlock further advancements in perovskite solar cell efficiency and scalability.

Universal Health Coverage of Opioid Agonist Treatment in Norway: An Equity-Adjusted Economic Evaluation.

Detailed information on the efficiency of health services targeting opioid use disorder (OUD) and treatment with opioid agonist treatment (OAT) is sparse. Many countries, including Norway, are still falling short of universal health coverage (UHC) of OAT. This study aims to evaluate the incremental lifetime costs and effects of treating OUD with OAT as compared to no OAT in Norway and scaling up the treatment to a universal coverage level using equity-adjusted health economic evaluations. We conducted cost-utility and budget impact analyses and constructed a two-state Markov model to compare the lifetime costs and outcomes among patients with OUD with and without OAT. Model inputs were derived from routine health information systems and the literature, with costs reported in 2023 Norwegian Kroner (NOK). The analyses were conducted from a Norwegian extended health-service and societal perspectives, with a lifetime time horizon. Quality-adjusted life years (QALYs) was the metric of health benefits. Outcomes were reported as incremental cost-effectiveness ratios (ICERs). The willingness-to-pay (WTP) threshold was equity-adjusted according to the future prognostic healthy life year loss method in Norway (severity of disease criterion), which is sensitive to the size of future undiscounted healthy life year loss due to the affected conditions. The WTP threshold is NOK 825,000 per QALY gained in Norwegian policy for conditions with undiscounted future QALY loss > 20. Uncertainty in the parameters and robustness of the results were assessed with one-way and probabilistic sensitivity analyses and scenario analyses. The mean results from probabilistic sensitivity analysis estimated that OAT was associated with 3.03 additional discounted QALYs gain and incremental lifetime discounted cost of NOK 1.45 million, leading to an ICER of NOK 479,099 per QALY gained when compared with not providing OAT, with the extended health-service perspective. From a societal perspective, OAT was cost-saving, i.e. OAT produced greater health benefits while resulting in lower overall societal costs compared to no OAT. The mean undiscounted future health loss was estimated to be 21.34 QALYs for the Norwegian patient group with OUD. A total 5-year budget increase of NOK 1.208 billion was estimated if OAT was going to be scaled up from the current coverage level of 70% to UHC. Compared with the current coverage, 100% coverage of OAT was associated with an additional lifetime cost of NOK 4.332 billion but also an additional 6760 QALYs gained. Our analysis suggests that OAT is cost-effective in Norway and has the potential to be cost-saving from a societal perspective. Therefore, Norwegian policy should consider scaling up treatment to extend the coverage of OAT.

39 Impact of the COVID-19 pandemic on routine immunization coverage in Canada: Results from a novel national surveillance system

Abstract Background The COVID-19 pandemic has posed unprecedented challenges to routine immunization programs globally. There is a growing body of evidence highlighting the impact of the pandemic on other routinely administered public health services. Understanding vaccination trends for routinely administered vaccinations during the pandemic is crucial for addressing potential gaps in protection and devising targeted strategies to enhance routine immunization programs. Objectives This study investigates the impact of the pandemic on routine immunization coverage in Canada, focusing on DTaP (Diphtheria, Tetanus, and Pertussis) with at least 4 doses and MMR (Measles, Mumps, and Rubella) with at least 1 dose, among children at age 2. Design/Methods Data were collected from the Routine Childhood Vaccination Coverage Surveillance system (RCVCSS) a novel national surveillance based on standardized detailed reports prepared by participating provinces and territories using data from their immunization registries. This analysis covers the years 2019 to 2022, capturing pre-pandemic, pandemic, and post-pandemic phases with data from 4 reporting provinces and territories (Alberta, Saskatchewan, New Brunswick and Yukon). The primary objective was to assess any changes in vaccination coverage at age 2 for routinely administered immunizations from 2019 to 2022, i.e., before, during and after the COVID-19 pandemic. Results Analysis reveals a decline in routine immunization coverage from 2019 to 2022. DTaP vaccination coverage at age 2 decreased from 82.0% in 2019 to 71.8% in 2022. Likewise, MMR vaccination coverage at two years showed a decline from 90.8% in 2019 to 81.7% in 2022. Similar downward trends in coverage were observed for other sets of antigens vaccinated against at age 2 including Varicella, Rotavirus, Polio, Pneumococcal and Hepatitis B. No major differences were observed when looking at vaccination coverage over time by sex. There were regional variations, with certain jurisdictions experiencing more pronounced declines than others and an increase in coverage in 2022 the post pandemic year. Conclusion There was a sustained decline in DTaP and MMR vaccination coverage at age 2 from 2019 to 2022. Further research is imperative to ascertain whether there has been a catch-up in vaccination coverage and to identify the root causes of the observed declines, so these can be addressed, and targeted interventions can be undertaken to allow coverage level to recover to their pre-pandemic levels.

MethyLasso: a segmentation approach to analyze DNA methylation patterns and identify differentially methylated regions from whole-genome datasets.

DNA methylation is an epigenetic mark involved in the regulation of gene expression, and patterns of DNA methylation anticorrelate with chromatin accessibility and transcription factor binding. DNA methylation can be profiled at the single cytosine resolution in the whole genome and has been performed in many cell types and conditions. Computational approaches are then essential to study DNA methylation patterns in a single condition or capture dynamic changes of DNA methylation levels across conditions. Toward this goal, we developed MethyLasso, a new approach to segment DNA methylation data. We use it as an all-in-one tool to perform the identification of low-methylated regions, unmethylated regions, DNA methylation valleys and partially methylated domains in a single condition as well as differentially methylated regions between two conditions. We performed a rigorous benchmarking comparing existing approaches by evaluating the agreement of the regions across tools, their number, size, level of DNA methylation, boundaries, cytosine-guanine content and coverage using several real datasets as well as the sensitivity and precision of the approaches using simulated data and show that MethyLasso performs best overall. MethyLasso is freely available at https://github.com/bardetlab/methylasso.

State-level disparities in cervical cancer prevention and outcomes in the U.S.: A modeling study.

Despite HPV vaccines' availability for over a decade, coverage across the US varies. While some states have tried to increase HPV vaccination coverage, most model-based analyses focus on national impacts. We evaluated hypothetical changes in HPV vaccination coverage at the national and state levels for California, New York, and Texas using a mathematical model. We developed a new mathematical model of HPV transmission and cervical cancer, creating US and state-level models, incorporating country- and state-specific vaccination coverage and cervical cancer incidence and mortality. We quantified the national and state-level impact of increasing HPV vaccination coverage to 80% by 2025 or 2030 on cervical cancer outcomes and the time to elimination defined as <4 per 100k women. Increasing vaccination coverage to 80% in Texas over ten years could reduce cervical cancer incidence by 50.9% (95% credible interval [CrI]:46.6-56.1%) by 2100, from 1.58 (CrI:1.19-2.09) to 0.78 (CrI:0.57-1.02) per 100,000 women. Similarly, New York could see a 27.3% (CrI:23.9-31.5%) reduction, from 1.43 (CrI:0.93-2.07) to 1.04 (Crl:0.66-1.53) per 100,000 women, and California a 24.4% (CrI:20.0-30.0%) reduction, from 1.01 (Crl:0.66-1.44) to 0.76 (Crl:0.50-1.09) per 100,000 women. Achieving 80% coverage in five years will provide slightly larger and sooner reductions. If the vaccination coverage levels in 2019 continue, cervical cancer elimination could occur nationally by 2051 (Crl:2034-2064), but state timelines may vary by decades. Targeting an HPV vaccination coverage of 80% by 2030 will disproportionately benefit states with low coverage and higher cervical cancer incidence. Geographically focused analyses can better inform priorities.

Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten - United States, 2023-24 School Year.

In the United States, states and local jurisdictions set vaccination requirements for school attendance, conditions and procedures for exemptions from these requirements, grace periods for submitting documentation, and provisional enrollment for students who need more time to be vaccinated. States annually report data to CDC on the number of children in kindergarten who meet, are exempt from, or are in the process of meeting requirements. Data reported by 49 states and the District of Columbia (DC) for the 2023-24 school year were used for national- and state-level estimates of the following measures: complete vaccination with required doses of measles, mumps, and rubella vaccine (MMR), diphtheria, tetanus, and acellular pertussis vaccine (DTaP), poliovirus vaccine (polio), and varicella vaccine (VAR); exemptions from vaccination; and school attendance while meeting requirements. The 2023-24 kindergarten class became age-eligible to complete most state-required vaccinations during the COVID-19 pandemic, after schools had returned to routine in-person learning. Compared with approximated national coverage levels across all reported vaccines for the 2019-20 (95%) and 2022-23 (93%) school years, coverage dropped below 93% for the 2023-24 school year, ranging from 92.3% for DTaP to 92.7% for MMR. Exemptions increased to 3.3%, compared with those during the 2022-23 (3.0%) and 2021-22 school years (2.6%). Coverage with MMR, DTaP, polio, and VAR decreased in 35, 32, 33, and 36 jurisdictions, respectively, compared with the 2022-23 school year. Exemptions increased in 41 jurisdictions, with 14 reporting that >5% of kindergartners had an exemption from one or more vaccine. Efforts by health departments, schools, and providers are needed to ensure that students begin school fully vaccinated.

Solving large-scale instances of the urban transit routing problem with a parallel artificial bee colony-hill climbing optimization algorithm

Swarm Intelligence simulates the collective behavior of decentralized and self-organized swarms. One of the main relevant methods is the Artificial Bee Colony (ABC) algorithm which simulates the foraging behavior of bee swarms in a colony to produce efficient solutions to various problems. The Urban Transit Routing Problem (UTRP) involves finding an efficient set of routes in a transit network to satisfy travel demand subject to operational and budget constraints. It is a complex, NP-Hard problem, in which otherwise correct solutions can be rejected because of impracticability. In this study, a hybrid algorithm consisting of a parallel ABC and Hill Climbing was used to find quality solutions to the UTRP. Thorough comparative results on Mandl’s well-known instance and Mumford’s large-scale instances demonstrate that the proposed algorithm outperforms existing techniques, achieving high levels of direct trip coverage in small computational times. Remarkably, when applied to the most extensive benchmark comprising over 6 million trips and 60 bus routes, the proposed algorithm demonstrates an impressive 11 % enhancement in direct coverage over the previously best-reported results, allowing the design of real-world bus networks in under 3 hours.

Why does malaria transmission continue at high levels despite universal vector control? Quantifying persistent malaria transmission by Anopheles funestus in Western Province, Zambia

BackgroundSome settings continue to experience a high malaria burden despite scale-up of malaria vector control to high levels of coverage. Characterisation of persistent malaria transmission in the presence of standard control measures, also termed residual malaria transmission, to understand where and when individuals are exposed to vector biting is critical to inform refinement of prevention and control strategies.MethodsSecondary analysis was performed using data collected during a phase III cluster randomized trial of attractive targeted sugar bait stations in Western Province, Zambia. Two seasonal cohorts of children aged 1–14 years were recruited and monitored monthly during the malaria transmission season, concurrent with entomological surveillance using a combination of human landing catch (HLC) and Centres for Disease Control (CDC) light traps at randomly selected households in study clusters. Behavioural data from cohort participants were combined with measured Anopheles funestus landing rates and sporozoite positivity to estimate the human behaviour-adjusted entomological inoculation rate (EIR).ResultsBehavioural data from 1237 children over 5456 child-visits in 20 entomology surveillance clusters were linked with hourly landing rates from 8131 female An. funestus trapped by HLC. Among all An. funestus tested by enzyme-linked immunosorbent assay (ELISA), 3.3% were sporozoite-positive. Mean EIR directly measured from HLC was 0.07 infectious bites per person per night (ib/p/n). When accounting for child locations over the evening and night, the mean behaviour-adjusted EIR was 0.02 ib/p/n. Children not sleeping under insecticide-treated nets (ITNs) experienced 13.6 infectious bites per person per 6 month season, 8% of which occurred outdoors, while ITN users received 1.3 infectious bites per person per 6 month season, 86% of which were received outdoors. Sleeping under an ITN can prevent approximately 90% of potential An. funestus bites among children.ConclusionsIn this setting ITNs have a high personal protective efficacy owing to peak An. funestus biting occurring indoors while most individuals are asleep. However, despite high household possession of ITNs (>90%) and high individual use (>70%), children in this setting experience more than one infectious bite per person per 6 month transmission season, sufficient to maintain high malaria transmission and burden. New tools and strategies are required to reduce the malaria burden in such settings.Graphical

Cas9-targeted-based long-read sequencing for genetic screening of RPE65 locus.

Long-read sequencing (LRS) enables accurate structural variant detection and variant phasing. When a molecular diagnosis is suspected, target enrichment can reduce the cost and duration of sequencing. LRS was conducted in five inherited retinal dystrophy (IRD) patients harboring a monoallelic variant in RPE65 that remained uncharacterized after clinical exome sequencing (CES). CRISPR-Cas9 guide RNA probes were designed to target a 31kb region, including the entire RPE65 locus. The DNA was sequenced on a MinION platform. Short-read ×30 whole-genome sequencing (WGS) was performed for five patients to validate nanopore results. The nanopore sequencing process yielded a median of 271 reads within the targeted region, with a mean depth of 109 and a median read size of 8kb. All variants identified by CES have been detected using this approach, and no additional RPE65 gene causative variants were found. Nanopore variant detection demonstrated performance akin to short-read WGS at similar coverage levels, although exhibiting increased false positive calls at lower coverage. In this study, we explore the advantages of using a targeted approach together with long-read sequencing to identify variants associated with IRD. The results underscore the utility of targeted long reads for characterizing patients affected by rare diseases when first-tier diagnostic tests are non-conclusive.

Modeling the population-level impact of a third dose of MMR vaccine on a mumps outbreak at the University of Iowa

Mumps outbreaks among fully vaccinated young adults have raised questions about potential waning of immunity over time and need for a third dose of the measles, mumps, rubella (MMR) vaccine. However, there are currently limited data on real-life effectiveness of the third-dose MMR vaccine in preventing mumps. Here, we used a deterministic compartmental model to infer the effectiveness of the third-dose MMR vaccine in preventing mumps cases by analyzing the mumps outbreak that occurred at the University of Iowa between August 24, 2015, and May 13, 2016. The modeling approach further allowed us to evaluate the population-level impact of vaccination by different timing in relation to the start of the outbreak and varied coverage levels, and to account for potential sources of bias in estimating vaccine effectiveness. We found large uncertainty in vaccine effectiveness estimates; however, our models showed that early introduction of a third dose of MMR vaccine during a mumps outbreak can be effective in preventing transmission. School holidays, such as the winter break, likely played important roles in preventing mumps transmission.

Enhancing the Performance of Unmanned Aerial Vehicle-Based Estimation of Rape Chlorophyll Content by Reducing the Impact of Crop Coverage

Estimating leaf chlorophyll content (LCC) in a timely manner and accurately is of great significance for the precision management of rape. The spectral index derived from UAV images has been adopted as a non-destructive and efficient way to map LCC. However, soil background impairs the performance of UAV-based LCC estimation, limiting the accuracy and applicability of the LCC estimation model, and this issue remains to be addressed. Thus, this research was conducted to study the influence of soil pixels in UAV RGB images on LCC estimation. UAV campaigns were conducted from overwintering to flowering stages to cover the process of soil background being gradually covered by rapeseed plants. Three planting densities of 11.25, 18.75, and 26.26 g/m2 were chosen to further enrich the different soil background percentage levels, namely, the rape fractional vegetation coverage (FVC) levels. The results showed that, compared to the insignificant difference observed for the ground measured LCC at a certain growth stage, a significant difference was found for most of the spectral indices extracted without soil background removal, indicating the influence of soil background. Removing soil background during the extraction of the spectral index enhanced the LCC estimation accuracy, with the coefficient of determination (R2) increasing from 0.58 to 0.68 and the root mean square error (RMSE) decreasing from 5.19 to 4.49. At the same time, the applicability of the LCC estimation model for different plant densities (FVC levels) was also enhanced. The lower the planting density, the greater the enhancement. R2 increased from 0.53 to 0.70, and the RMSE decreased from 5.30 to 4.81 under a low planting density of 11.25 g/m2. These findings indicate that soil background removal significantly enhances the performance of UAV-based rape LCC estimation, particularly under various FVC conditions.