Higher Proportion Research Articles

A real-time energy dispatch strategy based on the energy cooperative optimization complementarity model of multi-microgrids

With the wide application of high proportion of distributed clean energy in regional microgrids, the issue of maximizing the utilization of renewable energy among multi-microgrids has become a research hotspot. Based on the proposed multi-microgrids' energy collaborative optimization and complementation model, a multi-microgrids' energy real-time optimization management and dispatch strategy is proposed that fully considers the real-time complementarity of renewable energy between multi-microgrids and achieves the best coordinated dispatch of energy. Two typical scenarios were set up in the IEEE 33-bus network model for verification, and the synergistic effects of different schemes were compared and set up. The data obtained demonstrate that the dispatch and management strategy proposed in this paper can achieve the maximum integration of renewable energy and the lowest operating cost among multi-microgrids, and it also validates the real-time, feasibility, and effectiveness of the proposed strategy.

The Integrated Atlas of Dementia Care in the Australian Capital Territory: A Collective Case Study of Local Service Provision.

This study evaluates the dementia care system in a local area and aimed to include all specialised services designed to provide health and social services to people with dementia or age-related cognitive impairment, as well as general services with a high or very high proportion of clients with dementia. The study used an internationally standardised service classification instrument called Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) to identify and describe all services providing care to people with dementia in the Australian Capital Territory (ACT). A total of 47 service providers were eligible for inclusion. Basic information about the services was collected from their websites, and further information was obtained through interviews with the service providers. Of the 107 services offered by the 47 eligible providers, 27% (n = 29) were specialised services and 73% (n = 78) were general services. Most of the services were residential or outpatient, with a target population mostly of people aged 65 or older, and 50 years or older in the case of Aboriginal and Torres Strait Islander Australians. There were government supports available for most types of care through various programmes. Dementia care in the ACT relies heavily on general services. More widespread use of standardised methods of service classification in dementia will facilitate comparison with other local areas, allow for monitoring of changes over time, permit comparison with services provided for other health conditions and support evidence-informed local planning.

Vertical Coopetition: Effect of Supplier Relationship Management Strategies on Supplier Involvement in New Product Development

In the complex “vertical coopetition” relationship, this article aims to explore how manufacturers develop supplier relationship management (SRM) strategies to motivate supplier involvement in their new product development (NPD) activities. It investigates the influence of two competitive and cooperative SRM strategies (introducing competition for suppliers and holding supplier shares) on coinnovation performance which is the result of supplier involvement measured in a time-lagged manner. This article used the panel data on the Japanese automobile industry from 1994 to 2016 with fixed-effect negative binomial regression analysis. The results shed light on the inverted U-shaped effect of introducing competition for suppliers and the positive effect of holding supplier shares on coinnovation performance. They also indicate that holding supplier shares can weaken the curved role of introducing competition in coinnovation, but the inverted U-shape persists. Holding a high proportion of a supplier's shares and simultaneously introducing moderate competition for the supplier would be a relatively better strategy for increasing supplier involvement in NPD and coinnovation. The findings provide insights into strategic sourcing and contribute to the interfirm coopetition literature by focusing on vertical buyer-SRM strategies and their roles in supplier involvement in NPD.

Road-traffic-related air pollution contributes to skin barrier alteration and growth defect of sensory neurons.

The effects of air pollution on health are gaining increasing research interest with limited data on skin alterations available. It was suggested that air pollution is a trigger factor for sensitive skin (SS). However, this data was based on surveys with a lack of experimental data. SS is related to altered skin nerve endings and cutaneous neurogenic inflammation. TTe present study was to assess the invitro effect of particulate matter (PM) on epidermis and nerve ending homeostasis. PM samples were collected according to a validated protocol. Reconstructed human epidermis (RHE, Episkin®) was exposed to PM and subsequently the supernatants were transferred to a culture of PC12 cells differentiated into sensory neurons (SN). Cell viability, axonal growth and neuropeptide-release were measured. The modulation of the expression of different inflammatory, keratinocytes differentiation and neurites growth markers was assessed. PM samples contained a high proportion of particles with a size below 1 μm and a complex chemical composition. Transcriptomic and immunohistochemical analyses revealed that PM altered keratinocytes terminal differentiation and induced an inflammatory response. While viability and functionality of the SN were not modified, their outgrowth was significantly decreased after incubation with PM-exposed Episkin® supernatants. This was closely related to the modification of nerve growth factor/semaphorin 3A balance. This study showed that air pollutants have negative effects on keratinocytes and sensory nerve endings including inflammatory responses. These effects are probably involved in the SS pathophysiology and might be involved in inflammatory skin disorders.

Rozšíření myšivky horské (Sicista betulina) v Pošumaví na základě rozboru potravy sov (Rodentia: Zapodidae)

Distribution of Sicista betulina in the Šumava Mts. (Bohemian Forest, SW Bohemia, Czech Republic) based on owl diet analysis (Rodentia: Zapodidae). The Šumava Mountains are one of the three areas of a relict occurrence of the northern birch mouse (Sicista betulina) in the Czech Republic. The present study summarises all records of this species obtained there by the analysis of diet of three species of owls, the Tengmalm’s owl (Aegolius funereus), to a lesser extent of the Ural owl (Strix uralensis) and tawny owl (Strix aluco). A total of 355 sample sets from 228 localities was processed, positive findings concern 57 localities where the northern birch mouse was found (322 individuals). The presence of the species was confirmed in an area of approximately 1,400 km2, which corresponds to 13 mapping fields of the KFME, four of which extend into the territories of Germany and Austria (field numbers 7047, 7148, 7249, 7350). More than a third of the localities (37.0%) and nearly two thirds of the individuals (62.4%) come from four mapping fields (7048, 7049, 7148, 7149) covering mainly a peaty alluvial plain of the upper stream of the Vltava river and its surroundings. Data obtained by observation or capturing of the northern birch mouse give a similar picture. Thus, this territory with the high proportion of relict vegetation can be considered as the core area of the current occurrence of the mouse in the Šumava Mts. The altitude range of the northern birch mouse records from owl pellets is 680–1160 m a. s. l. with a mean of 871.7 m a. s. l. Almost a third of the localities (32.0%) lie in the altitudinal range of 700–800 m a. s. l., and more than four fifths of the records (82.7%) fall within the range of 700–1000 m a. s. l. However, these are only indicative values that can be influenced by the size of the individual hunting territories of owls (especially in a landscape with a steep mountainous relief). Our results confirm the previously described zoogeographical profile of the northern birch mouse in the Šumava Mts., i.e., that its distribution is limited only to the south-eastern half of this mountain range and ends roughly in the Kvildské pláně region in the north-west. Records of the northern birch mouse on the Bavarian side of the mountain range are in full agreement with this. It can be assumed that the species occurrence in the whole Bohemian Forest is primarily shaped by its Holocene history. Furthermore, it has been confirmed that the analysis of the diet composition of the Tengmalm’s owl is an effective method of study of the geographical distribution of the northern birch mouse.

КЛИНИКО-ГИГИЕНИЧЕСКАЯ ХАРАКТЕРИСТИКА АГРЕССИВНЫХ И ВРАЖДЕБНЫХ РЕАКЦИЙ ДЕТЕЙ И ПОДРОСТКОВ С ГИПЕРАКТИВНОСТЬЮ

The work was carried out using a verbal communication method of psychological research, the participants of which were minors 12–17 years old both with signs of attention deficit hyperactivity disorder (ADHD) and without this pathology, in order to identify the characteristics of their aggressive behavior, taking into account lifestyle risk factors for the subsequent justification of medical prevention measures. Statistically significant differences were established in the prevalence of aggressive and hostile reactions in the study groups with lower values in the group of healthy respondents and higher – among children and adolescents undergoing inpatient treatment according to the profile of behavioral disorders. In the study participants with signs of ADHD, the pathology of the circulatory and digestive systems was more often noted than among respondents without signs of hyperactivity and tendency to deviant behavior, and the presence of aggressive behavior models significantly increases the risk of developing the above diseases. A high proportion of children and adolescents who consume alcoholic beverages has been established. At the same time, the risk of physically aggressive behavior is 1.16 times higher against the background of alcohol-containing products consumption and the elimination of this risk factor makes it possible to reduce the likelihood of physical aggression by 13.8%.

Multi-step power forecasting for regional photovoltaic plants based on ITDE-GAT model

With the integration of high proportion of distributed photovoltaic(PV), high-accuracy regional PV power forecasting technology can enhance the regional coordinated scheduling capability of the new power system. This paper proposes a regional PV power forecasting model based on an improved time-series dense encoder and graph attention network (ITDE-GAT), which takes into account the spatio-temporal correlations among the regional PV plants. Firstly, an improved complete ensemble empirical mode decomposition with adaptive noise(ICEEMDAN) is used to extract the clear-sky and fluctuation components from PV data. Secondly, the combined ITDE-GAT is applied to perform the regional PV power forecasting. Considering the static information, an improved dense encoder network (ITDE) is constructed to extract the temporal and spatial relationships of regional PV. Graph attention network (GAT) is then utilized to explore the spatial correlations among the regional PV. Finally, case study from two actual PV region datasets shows that the proposed model achieves higher forecasting accuracy and exhibits stronger generalization capabilities. The results demonstrate that compared to various advanced deep learning methods, the R2 evaluation metric of the approach proposed in this paper demonstrates, respectively, maximum improvements of 3.4 %, 6.5 %, and 7.8 % for the 1 h, 3 h, and 6 h ahead predictions.

An APT Attack Detection Method of a New-type Power System Based on STSA-transformer

Background: Complex structures such as a high proportion of power electronic equipment has brought new challenges to the safe and stable operation of new-type power system, increasing the possibility of the system being attacked, especially the more complex Advanced Persistent Threat (APT). This kind of attack has a long duration and strong concealment. Objective: Traditional detection methods target a relatively single attack mode, and the time span of APT processed is relatively short. None of them can effectively capture the long-term correlation in the attack, and the detection rate is low. These methods can’t meet the safety requirements of the new-type power system. In order to solve this problem, this paper proposes an improved transformer model called STSA-transformer algorithm, and applies it to the detection of APT in new-type power systems. Methods: In the STSA-transformer model, the network traffic collected from the power system is first converted into a sequence of feature vectors, and the location information and local feature of the sequence, is extracted by combining position encoding with convolutional embedding operations, and then global characteristics of attack sequences is captured using the multi-head selfattention mechanism of the transformer encoder, the higher-frequency features of the attention are extracted through the self-learning threshold operation, combined with the PowerNorm algorithm to standardize the samples, and finally classify the network traffic of the APT. Results: After multiple rounds of training on the model, the expected effect can be achieved and applied to the APT detection of a new-type power system. Conclusion: The experimental results show that the proposed STSA-transformer algorithm has better detection accuracy and lower detection false-alarm rate than traditional deep learning algorithms and machine learning algorithms.

A coordinated planning model for power system source-network-load-storage considering multiple types of energy storage

Conventional power systems often neglect the amalgamation of planning and scheduling during their preparatory phases, and their methodologies of construction and operation may fall short of the requisites posed by a future characterized by a high proportion of renewable energy integration. In this paper, an integrated planning and scheduling methodology has been developed for the source-network-load-storage power system, factoring in a diverse array of energy storage modalities. Initially, cost models and operational models are formulated encompassing unit retrofitting, line expansion, demand response (DR), energy storage configuration and operation, and penalties related to solar curtailment. Subsequently, the optimization functions and operational constraints of each facet are harmonized, culminating in a comprehensive coordinated planning and scheduling framework for the ‘source-network-load-storage’ power system. The final phase involves simulation analysis conducted on an IEEE-30 nodes power system case. Results illustrate that the integrated ‘source-network-load-storage’ approach exhibits varied efficacies in exploiting system flexibility resources, contingent upon the distinctive capacity-power configurations of multiple types of energy storage. Prudent calibration of energy storage parameters demonstrates the potential to mitigate network underutilization and enhance overall system economics. This corroborates the viability of the proposed ‘integrated planning and scheduling’ model for the power systems.

Keratitis in patients with corneal foreign bodies: a cross-sectional study in Cali, Colombia.

To describe the clinical characteristics and factors associated with keratitis in patients with corneal foreign bodies in Colombia. This cross-sectional study was based on a clinical records review of patients who had corneal foreign bodies and were admitted to the emergency department between June 2018 and June 2019 in Cali, Colombia. The primary outcome was the presence of keratitis diagnosed based on clinical criteria. Univariate and multivariate logistic regression models were used to identify associated factors. A total of 381 corneal foreign bodies in 372 patients were analyzed (median age, 40.0; interquartile range, 29.0-53.0 years; male, 94.7% (n=352). Ninety-five patients developed keratitis (24.9%, 95% confidence interval [CI] 20.8%-29.5%). In the multivariate analysis, age 30 years (odds ratio [OR] 2.15, 95% CI 1.06-4.36), finding of aqueous flare (OR 2.81, 95% CI 1.39-5.66]), and a foreign body in the peripheral cornea (OR 2.05, 95% CI 1.19-3.50] were associated with an increased risk for keratitis. Sex, time between injury and admission, and corneal edema were not related to keratitis (p>0.05). In Cali, Colombia, a high proportion of keratitis was reported in patients with corneal foreign body. Age, an aqueous flare, and a foreign body in the peripheral cornea were the factors associated with keratitis.

Burden of Hidradenitis Suppurativa: A Systematic Literature Review of Patient Reported Outcomes.

Hidradenitis suppurativa (HS) has a profound negative impact on patients' health-related quality of life (HRQoL). Here we summarize the evidence on HRQoL and Patient Reported Outcomes (PROs) in patients with HS in real-world settings by conducting a systematic literature review (SLR) of observational studies. Data sources included MEDLINE, Embase & PsycINFO between January1, 2010 and August29, 2021, and conference proceedings between 2019 and 2021. Identified abstracts were reviewed and screened independently by two reviewers. Eligibility criteria included patients with HS of any severity, sample size ≥ 100, reporting PROs including HRQoL measures. Included studies were critically appraised. Fifty-eight observational studies matched inclusion criteria. Dermatology Life Quality Index (DLQI) was the most commonly utilized instrument: 57% of included studies reported mean baseline DLQI scores, ranging between 8.4 and 16.9, indicating a very large impact on the patients' HRQoL. Higher scores were reported with increasing disease severity and among female patients. Pain was assessed mostly by an 11-point (0-10) numeric rating scale (NRS) with a mean baseline score ranging from 3.6 to 7.7 indicating moderate to high pain levels. There was a negative impact of HS on patients' psychological well-being, based on PRO scores related to depression and anxiety. A high proportion of sexual dysfunction was reported, with a larger impact on women than men. Work productivity and leisure activity were consistently found to be impaired in patients with HS. All included studies reported a negative impact of HS on patients' lives. A diverse set of disease- and non-disease-specific PRO instruments were utilized highlighting the need for more consistent use of HS-specific validated PRO instruments to assess the impact of HS on the different aspects of patients' HRQoL to allow for data to be more meaningfully interpreted and compared in real-world settings. Patients with HS need better disease management approaches that address the observed low quality of life.

Two-stage robust programming model for active distribution network with a high proportion of renewable energy

To reduce operating costs and obtain the optimal location and capacity of renewable energy access, a two-stage robust planning model is studied for active distribution networks with a high proportion of renewable energy access. To build a function to minimize annual comprehensive costs, the constraints of power flow, branch power, and node voltage of the active distribution network are studied. Considering the characteristics and properties of power flow safety constraints, the mixed integer second-order cone transformation is used to construct a mixed integer convex programming model, which is convenient for efficiently obtaining the global optimal solution. To avoid the influence of uncertainty, a two-stage robust model is constructed. The explicit maximum value method is used to obtain the solution results that satisfy the planning model of all uncertain problems. Experiments show that the model can obtain the optimal access position and capacity of renewable energy. After application, it can reduce the annual comprehensive cost of the distribution network and ensure the stable and safe operation of the active distribution network.

Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019.

To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.

Clinically significant macular edema in an underserved population: Association with demographic factors and hemoglobin A1c.

Suspected clinically significant macular edema (SCSME) from exudates differed among ethnic groups in our underserved population. African American and Asian subjects had higher prevalence than Hispanics and non-Hispanic Caucasians, from the same clinics. Men had higher prevalence than women. Highly elevated blood glucose was frequent and associated with SCSME. We investigated the association between the presence of SCSME from exudates and hemoglobin A1c (HbA1c), as well as demographic factors such as age, sex, and ethnic group. Our population was underserved diabetic patients from the same geographic locations. Ethnic groups were White Hispanic, non-Hispanic Caucasian, African American, and Asian, with a high proportion of underrepresented minorities. In a diabetic retinopathy screening study at four community clinics in Alameda County, California, nonmydriatic 45° color fundus images were collected from underserved diabetic subjects following the EyePACS imaging protocol. Images were analyzed for SCSME from exudates by two certified graders. Logistic regression assessed the association between SCSME from exudates and age, sex, ethnic group, and HbA1c. Of 1997 subjects, 147 (7.36%) had SCSME from exudates. The mean ± standard deviation age was 53.4 ± 10.5 years. The mean ± standard deviation HbA1c level was 8.26 ± 2.04. Logistic regression analysis indicated a significant association between presence of SCSME from exudates and HbA1c levels (p<0.001), sex (p=0.027), and ethnicity (p=0.030). African Americans (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.06 to 2.50; p=0.025) and Asians (OR, 1.63; 95% CI, 1.05 to 2.54; p=0.029) had a higher risk than Hispanics. After adjusting for ethnicity, sex, and age, the odds of developing SCSME from exudates increased by 26.5% with every 1% increase in HbA1c level (OR, 1.26; 95% CI, 1.18 to 1.36; p<0.001). In our underserved population, many diabetic patients had very high HbA1c values. Ethnic background (African American > Asians > Hispanics), sex (male > female), and HbA1c level were strong indicators for identifying who is at increased risk of developing SCSME from exudates.

Iterative estimating equations for disease mapping with spatial zero‐inflated Poisson data

Spatial epidemiology often involves the analysis of spatial count data with an unusually high proportion of zero observations. While Bayesian hierarchical models perform very well for zero‐inflated data in many situations, a smooth response surface is usually required for the Bayesian methods to converge. However, for infectious disease data with excessive zeros, a Wombling issue with large spatial variation could make the Bayesian methods infeasible. To address this issue, we develop estimating equations associated with disease mapping by including over‐dispersion and spatial noises in a spatial zero‐inflated Poisson model. Asymptotic properties are derived for the parameter estimates. Simulations and data analysis are used to assess and illustrate the proposed method.

Results of the study on the antimicrobial activity of probiotic strains of lactobacilli and their potential application in feed formulations for aquaculture species

A comparative analysis of the antibacterial activity of authentic strains of lactobacilli was conducted. Primary data on the antibacterial activity of Lactobacillus acidophilus, L. brevis, and L. plantarum were obtained, as well as the impact of L. brevis in the composition of the extruded feed «BioMar» on the physiological condition of juvenile rainbow trout. The supplement was orally introduced into the main diet at a concentration of 2×108 cells of L. brevis per milligram of feed for 30 days. The obtained results were evaluated based on changes in the growth indicators, survival rates, and the diversity of the background microflora in the intestinal contents of trout fry in the experimental and control groups. According to the experiment results, the physiological indicators of trout fry receiving the premix with lactobacilli in the feed were higher than those in the control group. In the intestinal contents of the experimental group, a high proportion of lactobacilli (9.4%) was maintained, unlike the control group, which was on a diet without any additives (average values of lactobacilli in the intestinal contents did not exceed 0.6%). The studied biological properties of the Lactobacillus brevis strain make it a potential probiotic culture for use in therapeutic and prophylactic feed formulations for aquaculture.

Tracheostomies for respiratory failure are associated with a high inpatient mortality: a potential trigger to reconsider goals of care

IntroductionAcute care surgeons are frequently consulted for tracheostomy placement in the intensive care unit (ICU). Tracheostomy may facilitate ventilator weaning and improve physical comfort. Short-term outcomes after tracheostomy are not...

Laparoscopic surgical treatment for sliding hiatal hernia is associated with an owner-perceived improvement in clinical outcome in dogs

Abstract OBJECTIVE To report perioperative complications and client-perceived outcome following laparoscopic surgical treatment for sliding hiatal hernia (SHH) in dogs. ANIMALS Client-owned dogs (n = 9). METHODS Medical records were reviewed and perioperative data collected including preoperative diagnostic imaging, operative details, complications, and need for conversion to open celiotomy. A single-incision, multicannulated port was inserted in the subumbilical region followed by placement of an additional 2 or 3 instrument portals. Hiatal plication, esophagopexy, and left-sided gastropexy were performed laparoscopically. Follow-up information was collected with telephone interview with the owners and/or referring veterinarian. A standardized questionnaire was completed by dog owners postoperatively. RESULTS Intraoperative pneumothorax occurred in 5 of 9 (55.6%) dogs and resulted in conversion to open celiotomy in 2 (22.2%) dogs. In 4 dogs, pneumothorax was suspected to be the result of progressive leakage of capnoperitoneum through the suture bite holes of the esophageal hiatal plication sutures. Hiatal plication was performed using intracorporeal simple interrupted sutures (n = 4) or a simple continuous pattern with barbed suture (4). Esophagopexy was performed using barbed suture in all dogs. Gastropexy was performed using a total laparoscopic technique (n = 4) or laparoscopic-assisted technique (3). Using a standardized questionnaire, dog owners perceived a postoperative improvement in regurgitation after eating and regurgitation after excitement/increased activity. CLINICAL RELEVANCE Laparoscopic treatment of SHH resulted in owner-perceived improvement in clinical signs. Intraoperative pneumothorax occurred in a high proportion of dogs but did not result in long-term sequelae.

Diverse sedimentary organic matter within the river-aquifer interface drives arsenic mobility along the Meghna River Corridor in Bangladesh

In alluvial aquifers with near-neutral pH and high dissolved arsenic (As) concentrations, the presence and character of sedimentary organic matter (SOM) regulates As mobility by serving as an energetically variable source of electrons for redox reactions or forming As–Fe-OM complexes. Near tidally and seasonally fluctuating rivers, the hyporheic zone (HZ), which embodies the mixing zone between oxic river water and anoxic shallow groundwater, may precipitate (or dissolve) iron (Fe)-oxides which sequester (or mobilize) As. To understand what is driving the mobilization of As within a shallow aquifer and riverbank sands adjacent to the tidally fluctuating Meghna River, we characterized the chemical reactivity of SOM from the sands, and a silt and clay layer, underlying the HZ and aquifer, respectively. Dissolved As (50–500 μg/L) and Fe (1–40 mg/L) concentrations increase with depth within the shallow aquifer. Similar vertical As and Fe concentration gradients were observed within the riverbank sands where concentrations of the products of reductive dissolution of Fe-oxides increase with proximity to the silt layer. Compared to all other sediments, the SOM in the clay aquitard contains older, more recalcitrant, terrestrially-derived material with high proportions of aromatic carboxylate functional groups. The shallow silt layer contains fresher SOM with higher proportions of amides and more labile polysaccharide moieties. The SOM in both the riverbank and aquifer is terrestrially-derived and humic-like. The labile SOM from the silt layer drives the microbially mediated reductive dissolution of As-bearing Fe-oxides in the HZ. In contrast, the carboxylate-rich SOM from the clay aquitard maintains dissolved As concentrations at the base of the aquifer by complexing with soluble As and Fe. This highlights that SOM-rich fine (silt or clay) layers in the Bengal basin drive As and Fe mobility, however, the specific processes mobilizing As and Fe depend on the lability of the SOM.

Risk of vaccine preventable diseases in UK migrants: A serosurvey and concordance analysis

BackgroundVaccine preventable diseases (VPDs) such as measles and rubella cause significant morbidity and mortality globally every year. The World Health Organization (WHO), reported vaccine coverage for both measles and rubella to be 71 % in 2019, indicating an immunity gap. Migrants in the EU/EEA may be at high risk of VPDs due to under-immunisation and poor living conditions. However, there are limited data on VPD seroprotection rates amongst migrants living in the United Kingdom (UK). MethodsWe conducted an exploratory cross-sectional serosurvey amongst a sample of adult migrants living in Leicester, UK to: (a) determine seroprotection rates for measles, varicella zoster, and rubella in this group; (b) identify risk factors associated with seronegativity and, (c) understand if self-reported vaccine or diseases history is an effective measure of seroprotection. Participants gave a blood sample and completed a questionnaire asking basic demographic details and vaccine and disease history for the three VPDs. We summarised the data using median and interquartile range (IQR) for non-parametric continuous variables and count and percentage for categorical variables. We used logistic regression to establish predictors of seroprotection against these diseases. We examined the reliability of self-reported vaccination/disease history for prediction of seroprotection through a concordance analysis. Results149 migrants were included in the analysis. Seroprotection rates were: varicella zoster 98 %, rubella 92.6 % and measles 89.3 %. Increasing age was associated with seroprotection (OR 1.07 95 % CI 1.01–1.13 for each year increase in age). Migrants from Africa and the Middle East (aOR 15.16 95 % CI 1.31 - 175.06) and South/East Asia and Pacific regions (aOR 15.43 95 %CI 2.38 - 100.00) are significantly more likely to be seroprotected against measles as compared to migrants from Europe and Central Asia. The proportions of migrants unsure about their vaccination and disease history combined were 53.0 % for measles; 57.7 % for rubella; 43.0 % for varicella. There was no agreement between self-reported vaccination/disease history and serostatus. ConclusionOur findings suggest lower levels of seroprotection against measles in migrants living in Leicester, UK, with younger migrants and those from Europe and Central Asia more likely to lack seroprotection. A high proportion of surveyed migrants were unaware of their vaccination/disease history and self-reported vaccine/disease was a poor predictor of seroprotection against VPDs which is important for clinical decision-making regarding catch-up vaccination in this population. Our results, although derived from a small sample, suggest that there may be gaps in seroimmunity for certain VPDs in particular migrant populations. These findings should inform future qualitative studies investigating barriers to vaccine uptake in migrants and population-level seroprevalence studies aimed at determining individualised risk profiles based on demographic and migration factors.