Increase In Coverage Research Articles

Spatial–Temporal Evolution Pattern of Soil Erosion and Its Dominant Factors on the Loess Plateau from 2000 to 2020

Global changes have led to significant changes in soil erosion on the Loess Plateau. Soil erosion leads to the degradation of land resources and a decline in soil fertility, adversely affecting agricultural production and the socioeconomic situation. Therefore, revealing the spatiotemporal evolution patterns of soil erosion in the Loess Plateau region and investigating the influencing factors that contribute to soil erosion are crucial for its management and restoration. In this study, the RUSLE monthly model and the Geodetector model were utilized to reveal the spatiotemporal trends of soil erosion in the Loess Plateau from 2000 to 2020 and to determine the dominant influencing factors in different periods. The main results are as follows: (1) From 2000 to 2020, the soil erosion in the Loess Plateau initially weakened and then intensified, indicating that precipitation and precipitation intensity have different effects on surface soil. (2) From 2000 to 2015, the area experiencing slight and mild erosion increased. This is attributed to the increase in vegetation coverage in the Loess Plateau region, which has alleviated soil erosion in the area. (3) From 2000 to 2020, zones of severe soil erosion were mainly located in the cities of Yan’an and Yulin and their surrounding areas. The gravity center of soil erosion shifted northwestward from Yan’an City overall, indicating an improvement in the soil erosion conditions in the Yan’an area. (4) The predominant level of soil erosion across different land-use types was slight erosion, accounting for over 40%. This may be a result of forestry ecological projects that effectively reduce soil loss. (5) In slope zones of 0–5°, slight erosion accounted for the largest area proportion. As the slope increased, the area proportion of severe and extremely severe erosion also increased. This is attributed to the protective role of vegetation on soil in gentle slope areas. (6) From 2000 to 2020, vegetation was the dominant single factor influencing the spatiotemporal changes in soil erosion, while the interactions between vegetation and land use had the largest explanatory power, indicating that changes in land-use types partially affect variations in vegetation coverage. Our research findings could provide important data support for soil erosion control and eco-environment restoration in the Loess Plateau region.

The Pfam protein families database: embracing AI/ML.

The Pfam protein families database is a comprehensive collection of protein domains and families used for genome annotation and protein structure and function analysis (https://www.ebi.ac.uk/interpro/). This update describes major developments in Pfam since 2020, including decommissioning the Pfam website and integration with InterPro, harmonization with the ECOD structural classification, and expanded curation of metagenomic, microprotein and repeat-containing families. We highlight how AlphaFold structure predictions are being leveraged to refine domain boundaries and identify new domains. New families discovered through large-scale sequence similarity analysis of AlphaFold models are described. We also detail the development of Pfam-N, which uses deep learning to expand family coverage, achieving an 8.8% increase in UniProtKB coverage compared to standard Pfam. We discuss plans for more frequent Pfam releases integrated with InterPro and the potential for artificial intelligence to further assist curation. Despite recent advances, many protein families remain to be classified, and Pfam continues working toward comprehensive coverage of the protein universe.

Trends and inequalities in adequate antenatal care coverage among women in Sierra Leone, 2008-2019.

Prenatal care is a critical component of maternal and child health, providing essential preventive, diagnostic, and therapeutic services to pregnant women. Adequate antenatal care has been linked to reduced maternal and infant mortality and improved birth outcomes. Despite its importance, disparities in antenatal care coverage persist globally, including Sierra Leone,with significant implications for maternal and child health. This study examined the trends and inequalities in antenatal care utilisation in Sierra Leone. We used data from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys. Simple inequality measures (Difference and Ratio) and complex measures (Population Attributable Risk and Population Attributable Fraction) were computed using the World Health Organization's Health Equity Assessment Toolkit software. Inequality in antenatal care was calculated on six stratefiers:age groups for women, birth order, educational levels, economic status, residential areas, and sub-national province. There was a significant increase in adequate antenatal care coverage from 2008 (15.2%) to 2013 (36.5%) but a decrease in 2019 (22.1%). The inequality in age increased over time from a Difference of2.7 percentage points in 2008 to a Difference of 5.3 percentage points in 2019, indicating age-related inequalities. The Population Attributable Fraction decreased from 2.7% in 2008 to zero in 2013, indicating no further improvement in the national average of adequate antenatal care coverage can be achieved in the absence of age-related inequalities. However, it increased to 7.7% in 2019, indicating that the national average of adequate antenatal care coverage would have increased by 7.7% in the absence of age-related inequalities. The birth order inequality increased from a Difference of - 5.2 percentage points in 2008 to 2.6 percentage points in 2019. The Population Attributable Fraction was zero in 2008 and3.4% in 2019, showing that the national average of adequate antenatal care coverage would have increased by 3.4% if there was no parity-based inequality. Inequality in economic status decreased from 32.1 percentage points in 2008(Difference = 32.1) to 2.8 percentage points in 2019(Difference = 2.8). The Population Attributable Fraction revealed that the national average could have been 164.4% higher in 2008 and 20.8% higher in 2013; however, it was zero in 2019, indicating that no further improvement can be achieved in the national average if there was no inequality related to economic status. Inequality for education decreased from 49.9 percentage points in 2008(Difference = 49.9) to 11.0 percentage points in 2019(Difference = 11.0). Inequality decreased from a Difference of20.8 percentage points in 2008 to a Difference of1.7 percentage points in 2019 for place of residence inequality, showing a reduction in inequality. Provincial inequality decreased from a Difference of 33.9 percentage points in 2008 to 8.5 percentage points in 2019. While there have been notable improvements in antenatal care coverage in Sierra Leone, adequate antenatal care coverage is still below the WHO target of 78% in 2016, and significant inequalities persist. Addressing these inequalities requires a multifaceted approach considering demographic, economic, educational, and geographic indicators considered in this study. Sustained efforts and targeted interventions are critical by the Sierra Leone government to ensure that all women, regardless of their background, have access to essential antenatal care services up to at least eight visits.

Assessing Chile's national expansion of urban and artificial coverages between 2000 and 2022

Abstract. This study investigates the national expansion of urban and artificial coverages in Chile between 2000 and 2022 using remote sensing techniques. The research employed Google Earth Engine and Landsat imagery to classify land use and land cover (LULC) changes. By analyzing annual cloud-free composites and employing random forest algorithms, the study produced detailed LULC maps, focusing on the 'infrastructure' class, which includes urban areas and major roads. Results indicate a significant 33% increase in infrastructure coverage, growing from approximately 380,000 hectares in 2000 to 510,000 hectares in 2022. This expansion was predominantly observed in seven regions, which accounted for 68% of the total infrastructure area and 83% of the national increase. A notable correlation (0.6) between urban growth and population growth was identified, suggesting that urban expansion is largely driven by demographic changes. However, regions with higher population growth exhibited more vertical urban development. The study highlights the complex interplay between urbanization, population dynamics, and regional planning, emphasizing the need for sustainable development strategies to manage urban growth effectively. Validation efforts showed high classification accuracies, with infrastructure class accuracies averaging 82% for the User and 87% for the Producer across the evaluated years.

Microfocused Ultrasound With Visualization (MFU-V) and Hyperdilute Calcium Hydroxylapatite (CaHA-CMC) of the Lower Face and Submentum to Treat Skin Laxity: A Pilot Study Demonstrating Superiority of MFU-V First Followed by Hyperdilute CaHA-CMC.

Microfocused ultrasound with visualization (MFU-V) and hyperdilute calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) dermal injections are effective for improving skin laxity in the lower face and submentum by stimulating neocollagenesis and neoelastogenesis. Combining these treatments in an optimal order may inform best practices in aesthetic dermatology. Despite their frequent concurrent use, no study has evaluated the impact of treatment order. This study aimed to determine the optimal sequence for administering MFU-V and hyperdilute CaHA-CMC. Twelve healthy women aged 35-65 were randomized into two groups. Group A received MFU-V followed by hyperdilute CaHA-CMC six weeks later, while Group B received the treatments in the opposite order. Evaluations included histological assessments, aesthetic outcomes, and safety measures. Group A showed greater improvements in subjective global aesthetic improvement scale (sGAIS), investigator global aesthetic improvement scale (iGAIS), and FACE-Q patient-perceived age visual analog scale (VAS) scores. Both groups exhibited similar improvements in FACE-Q Satisfaction with Lower Face and Jawline scores. Histologically, both groups demonstrated significant elastin production at the 120-day follow-up. Group A showed a 143% relative increase in elastin coverage, compared to a 63% increase in Group B. Consequently, Group A exhibited superior qualitative and histologic improvements. Administering MFU-V first, followed by hyperdilute CaHA-CMC six weeks later, is the optimal sequence for this combination therapy. Although both groups experienced increased elastin synthesis and aesthetic improvements, the order of treatments significantly impacted the outcomes, favoring the sequence used in Group A. This finding provides valuable insight for optimizing combination therapies in aesthetic dermatology.

Leveraging Ion-Ion and Ion-Photon Activation to Improve the Sequencing of Proteins Carrying Multiple Disulfide Bonds: The Human Serum Albumin Case Study.

Gas-phase sequencing of large intact proteins (>30 kDa) via tandem mass spectrometry is an inherently challenging process that is further complicated by the extensive overlap of multiply charged product ion peaks, often characterized by a low signal-to-noise ratio. Disulfide bonds exacerbate this issue because of the need to cleave both the S-S and backbone bonds to liberate sequence informative fragments. Although electron-based ion activation techniques such as electron transfer dissociation (ETD) have been proven to rupture disulfide bonds in whole protein ions, they still struggle to produce extensive sequencing when multiple, concatenated S-S bonds are present on the same large polypeptide chain. Here, we evaluate the increase in sequence coverage obtained by combining activated-ion ETD (AI-ETD) and proton transfer charge reduction (PTCR) in the analysis of 66 kDa human serum albumin, which holds 17 disulfide bridges. We also describe the combination of AI-ETD with supplemental postactivation of the ETD reaction products via higher-energy collisional dissociation─a hybrid fragmentation method termed AI-EThcD. AI-EThcD leads to a further improvement compared to AI-ETD in both the global number of cleaved backbone bonds and the number of ruptured backbone bonds from disulfide-protected regions. Our results also demonstrate that the full potential of AI-ETD and AI-EThcD is unveiled only when combined with PTCR: reduction in overlap of ion signals leads to a sequence coverage as high as 39% in a single experiment, highlighting the relevance of spectral simplification in top-down mass spectrometry of large proteins.

Effects of internals on macroscopic fluid dynamics in a bubble column

The effects of internals on liquid mixing and gas–liquid mass transfer have rarely been investigated in bubble columns, and the commonly used measurement method overestimates significantly overall gas holdup. Firstly, gas holdup measurement method is improved by conducting multi-point liquid level measurement and using net fluid volume instead of bed volume to calculate gas holdup. Then, a stable conductivity method for liquid macromixing has been established by shielding large bubbles using #16 nylon mesh. Subsequently, the influences of internal coverage (=12.6%, 18.9% and 25.1%) on macroscopic fluid dynamics in a bubble column with a free wall area are systematically investigated. It is found that the presence of internals has a notable effect on macroscopic fluid dynamics. The overall gas holdup and gas–liquid volumetric mass transfer coefficient decrease, and the macromixing time decreases with the increase of internal cross-sectional area coverage. These are mainly caused by the uneven distribution of airflow due to the low resistance in the free wall area. This design makes maintenance easier, but in reality, the reactor performance has decreased. Further improvements will be made to the reactor performance based on such a configuration through flow guidance using baffles.

Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants.

Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. We used data from 1108 population-representative studies with 141 million participants aged 18 years and older with measurements of fasting glucose and glycated haemoglobin (HbA1c), and information on diabetes treatment. We defined diabetes as having a fasting plasma glucose (FPG) of 7·0 mmol/L or higher, having an HbA1c of 6·5% or higher, or taking medication for diabetes. We defined diabetes treatment as the proportion of people with diabetes who were taking medication for diabetes. We analysed the data in a Bayesian hierarchical meta-regression model to estimate diabetes prevalence and treatment. In 2022, an estimated 828 million (95% credible interval [CrI] 757-908) adults (those aged 18 years and older) had diabetes, an increase of 630 million (554-713) from 1990. From 1990 to 2022, the age-standardised prevalence of diabetes increased in 131 countries for women and in 155 countries for men with a posterior probability of more than 0·80. The largest increases were in low-income and middle-income countries in southeast Asia (eg, Malaysia), south Asia (eg, Pakistan), the Middle East and north Africa (eg, Egypt), and Latin America and the Caribbean (eg, Jamaica, Trinidad and Tobago, and Costa Rica). Age-standardised prevalence neither increased nor decreased with a posterior probability of more than 0·80 in some countries in western and central Europe, sub-Saharan Africa, east Asia and the Pacific, Canada, and some Pacific island nations where prevalence was already high in 1990; it decreased with a posterior probability of more than 0·80 in women in Japan, Spain, and France, and in men in Nauru. The lowest prevalence in the world in 2022 was in western Europe and east Africa for both sexes, and in Japan and Canada for women, and the highest prevalence in the world in 2022 was in countries in Polynesia and Micronesia, some countries in the Caribbean and the Middle East and north Africa, as well as Pakistan and Malaysia. In 2022, 445 million (95% CrI 401-496) adults aged 30 years or older with diabetes did not receive treatment (59% of adults aged 30 years or older with diabetes), 3·5 times the number in 1990. From 1990 to 2022, diabetes treatment coverage increased in 118 countries for women and 98 countries for men with a posterior probability of more than 0·80. The largest improvement in treatment coverage was in some countries from central and western Europe and Latin America (Mexico, Colombia, Chile, and Costa Rica), Canada, South Korea, Russia, Seychelles, and Jordan. There was no increase in treatment coverage in most countries in sub-Saharan Africa; the Caribbean; Pacific island nations; and south, southeast, and central Asia. In 2022, age-standardised treatment coverage was lowest in countries in sub-Saharan Africa and south Asia, and treatment coverage was less than 10% in some African countries. Treatment coverage was 55% or higher in South Korea, many high-income western countries, and some countries in central and eastern Europe (eg, Poland, Czechia, and Russia), Latin America (eg, Costa Rica, Chile, and Mexico), and the Middle East and north Africa (eg, Jordan, Qatar, and Kuwait). In most countries, especially in low-income and middle-income countries, diabetes treatment has not increased at all or has not increased sufficiently in comparison with the rise in prevalence. The burden of diabetes and untreated diabetes is increasingly borne by low-income and middle-income countries. The expansion of health insurance and primary health care should be accompanied with diabetes programmes that realign and resource health services to enhance the early detection and effective treatment of diabetes. UK Medical Research Council, UK Research and Innovation (Research England), and US Centers for Disease Control and Prevention.

A mathematical model for the study of HIV/AIDS transmission with PrEP coverage increase and parameter estimation using MCMC with a Bayesian approach

In this article, we present a mathematical model for the study of HIV/AIDS considering the implementation of Pre-Exposure Prophylaxis (PrEP). As a novel element in the construction of the model, we consider the diagnosis of cases for attempting to enter the PrEP program, which allows us to study different forms of PrEP. The diagnosis of new infections helps to reduce transmission in the population because these patients are incorporated into the therapy and can achieve an undetectable viral load in blood which prevents them from infecting others. The model contains a compartment of infected persons with undetectable viral load in blood that is reached by adherence to treatment which is separated from those simply infected with the virus as they do not transmit it. Considering the structure of the model, we propose a method to study the effect of increased PrEP use and HIV incidence in a population. In the case of incidence, we took into account the stochasticity of the behavior. Besides, we find the basic reproduction number and present results that allow us to obtain the impact of the parameters associated with transmission, treatment and diagnosis on the basic reproduction number. We perform computational simulations, using demographic and HIV/AIDS data from Brazil, and utilize the Markov Chain Monte Carlo (MCMC) method with a Bayesian approach to estimate model parameters. We study two coverage increases at 25% and 35% that were selected according to the size of the Brazilian population and the daily use of PrEP. We compare the increases in coverage focused on HIV incidence, which is the number of new HIV cases infected and the number of HIV cases avoided, we conclude that by increasing PrEP coverage the incidence of HIV is reduced and the number of cases avoided increases.

RepeatsDB in 2025: expanding annotations of structured tandem repeats proteins on AlphaFoldDB.

RepeatsDB (URL: https://repeatsdb.org) stands as a key resource for the classification and annotation of Structured Tandem Repeat Proteins (STRPs), incorporating data from both the Protein Data Bank (PDB) and AlphaFoldDB. This latest release features substantial advancements, including annotations for over 34000 unique protein sequences from >2000 organisms, representing a fifteenfold increase in coverage. Leveraging state-of-the-art structural alignment tools, RepeatsDB now offers faster and more precise detection of STRPs across both experimental and predicted structures. Key improvements also include a redesigned user interface and enhanced web server, providing an intuitive browsing experience with improved data searchability and accessibility. A new statistics page allows users to explore database metrics based on repeat classifications, while API enhancements support scalability to manage the growing volume of data. These advancements not only refine the understanding of STRPs but also streamline annotation processes, further strengthening RepeatsDB's role in advancing our understanding of STRP functions.

Advancing Public Health Equity through Expanded Vaccination Services in prison: case studies from Italy and France

Abstract In Montpellier prison in France and San Vittore remand house in Italy, the provision of expanded, age-appropriate, coercion-free, and tailored vaccination services to PLP has emerged as a cornerstone in improving health outcomes within prison settings. The implementation of life course vaccination programs required the full integration of prison health into public health systems building on existing vaccination services covering HBV, flu and COVID-19. In San Vittore, a vaccination clinic aimed at people living in prison was set-up. Universal vaccination status assessment and vaccination catch-up was introduced targeting people admitted into prison. The vaccination clinic-related activities included information and awareness sessions on vaccination and health literacy offered regularly to PLP: increased vaccination knowledge is effective to enhance uptake. The vaccination clinic team consisted of infectious diseases physicians and a health assistant with an anthropological background, who ran the information and awareness sessions combining and adapting core content on vaccination with individual and community social and cultural contexts. Besides seasonal flu vaccination and anti-SARS-CoV-2 immunisation campaigns, vaccinations against pneumococcal pneumonia and herpes zoster were also offered to older and fragile individuals as per national immunization plan. One of the priority objectives of the vaccination clinic was the increase in vaccination coverage against HBV and HPV, not only as a tool for the prevention of infectious diseases, but as an innovative and effective tool of cancer prevention. As part of a more ambitious program to protect sexual health in prison and related to updated screening tools for the early diagnosis of lesions due to HPV infection, vaccination against HPV was also offered as part of a health empowerment project tailored to women in detention, with the aim of building self-awareness of their own health needs.

A CDSS based Integrated Pathway for Influenza Vaccination Across Primary and Secondary Care

Abstract Background In Italy, influenza vaccination coverage in people ≥ 65 years is unsatisfactory (56.7%), underlining the need to improve current vaccination strategies. The objectives of this study have been: to define a novel pathway to increase influenza vaccination adherence among ≥ 65 years population in the Lazio region; to provide a predictive estimate of the epidemiological and economic pathway’s potential impact. Methods A multidisciplinary working group (WG) featuring cross-sectoral expertise was created and WG periodic meetings were held to define the patient journey and its flow-chart representation. The pathway’s potential impact was assessed through epidemiological and economic indicators and scenario analyses. Results An integrated pathway across primary and secondary care was defined, based on the active patient in-Hospital recruitment and vaccination and enhanced by a Clinical Decision Support System relying on a digital algorithm to identify eligible patients. Assuming an increase of influenza vaccination coverage from the current rate of 60% (scenario 1) to 65% (scenario 2) in ≥ 65 years population in the Lazio region thanks to the pathway implementation, an increase of 8% in avoided influenza cases, influenza- or pneumonia-related hospitalizations and influenza-related outpatient visits was estimated with a relative increase in savings for hospitalizations and outpatients visits of up 2,367,310 euros. Setting the vaccination coverage at 70% (scenario 3), an increase of 16% in avoided influenza cases, hospitalizations and outpatient visits was estimated with a relative increase in savings for hospitalizations and outpatients’ visits of up to 4,833,259 euros. Conclusions Alongside offering a predictive estimate of the relevant pathway’s potential impact, both epidemiological and economic, this project, with its robust methodology, may serve as a scalable and transferable model for enhancing vaccination coverage at national and international level. Key messages • The proposed pathway, offering the option of receiving flu vaccination within the Hospital, supports the paradigm shift towards primary prevention pathways in secondary care settings. • Another relevant aspect of the integrated pathway is the adoption of an Artificial Intelligence tool to identify suitable patients and improve their recruitment and adherence to vaccination.

What if we could eradicate cervical cancer?

Abstract Introduction WHO wants to achieve the elimination of Cervical Cancer: all countries must achieve and maintain an incidence rate of less than 4 per 100,000 women. Three key pillars: 90% of girls fully vaccinated against HPV by 15 years of age; 70% of women aged 35-45 years screened; 90% of women with pre-tumour lesion and invasive tumour treated. Our study assessed the position of the Tuscany South East Local Health Authority(LHA TSE) with respect to these three pillars and how to improve it. Methods A retrospective observational study was conducted. The following were used: ISTAT data of incidence of cervical cancer standardised by age from 2013 to 2017;data from ISPRO on screening(PAP and HPV test)from 2013 to 2022;data of vaccination coverage taken from the Health Information System of Collective Prevention(SISPC) from 2012 to 2023 for children<12 years, Results The incidence rate of cervical cancer in LHA TSE is 9.4 per 100 thousand. About HPV vaccine coverage by age 12, for girls it has been rising from 80.5% in 2012 to a peak of 84.8% in 2019 and then progressively decreasing to 76.3% in 2023.Coverage for boys has also been progressively increasing from 0.8% in 2012 to a peak in 2019 of 74.9% and then decreasing to 69.8% in 2023. A total of 52 thousand children are vaccinated. As for the adjusted adherence to screening, we started from an average adherence of 51.8% in 2013 (75 thousand women invited with 102% coverage) to 53.2% in 2022 (54 thousand women invited with 107% coverage). In 2013, ASC-US+ lesions were found in 6.4 % of women by PAP Test and in 2022 in 6.3 % of women. In the examined period, more than 90% of women with pre-tumour lesion and more than 90% with invasive tumour were treated. Conclusions LHA TSE will have to implement actions to increase vaccination coverage and screening adherence rates through awareness campaigns and open days, also considering whether a change in the age range for starting screening is necessary as vaccination coverage increases. Key messages • Cervical cancer is one of the most preventable cancers, but too few young women are vaccinated against HPV infection, the main causative factor. • Prevention through adherence to screening enables early identification of lesions caused by HPV virus.

An assessment of adequate quality antenatal care and its determinants in India

BackgroundAntenatal care (ANC) is an important component in the continuum of care. Providing adequate quality ANC is necessary to prevent maternal and newborn mortality. The coverage of ANC has increased significantly in the last decade in India, but a mere increase in coverage is insufficient if the issue of quality is not simultaneously addressed. This study examines the change in each component of quality ANC between 2015-16 and 2019-21, highlights the factors associated with adequate quality ANC, and observes the state- and district-level distribution of adequate quality ANC during 2019-21.MethodsThis study is based on data from the two most recent rounds of the National Family Health Survey (NFHS), the Indian equivalent of the Demographic and Health Surveys (DHS). These rounds were conducted in 2015-16 and 2019-21 in selected households of India with a total of 190,797 and 176,843 sampled births, respectively. The dependent variable was quality antenatal care, a composite variable consisting of skilled healthcare providers, timeliness, sufficiency, and appropriateness of content. The independent variables were mother’s age, education, wealth quintile, birth order, mass media exposure, health insurance coverage, relationship with the head of household, facility exposure, intended pregnancy, history of adverse pregnancy outcomes, and other socio-demographic variables. Change in each component and dimension of quality antenatal care was assessed using data from both rounds of the survey. A multivariate multinomial logistic regression analysis was employed to identify the determinants of adequate quality ANC using the NFHS-5 data.ResultsThe findings revealed that 32 per cent of mothers received adequate quality antenatal care in 2019–2021, an increase of only 9% points compared to the 2015-16 period. Two significant barriers to achieving adequate quality antenatal care, in terms of appropriateness of content, were the provision of Iron and Folic Acid (IFA) tablets and counselling. The highest utilisation of adequate quality antenatal care was observed in the southern states. The utilisation of quality ANC increased with an increase in women’s education and wealth status; and was more prevalent among those with health insurance coverage and exposure to mass media.ConclusionDespite some improvements in the coverage of antenatal care, the quality of antenatal care continues to be very low and needs urgent attention. Achieving quality antenatal care in both content and experience requires addressing service gaps and developing better measures to capture and improve women’s care experiences.

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.

New Linked Employee-Employer Data Show Workforce Composition Is Associated With Health Insurance Offers Among Small Employers.

Decades of research shows that small firms are much less likely to offer health insurance than large firms, but less is known about differences among small employers. We examine this issue using the Medical Expenditure Panel Survey-Insurance Component with Administrative Records (MEPS-ICAR), a unique employer-employee linked data set that is constructed by matching the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to Internal Revenue Service administrative records and the Decennial Census. Multivariate analyses show that among firms with fewer than 50 workers, the probability that workers receive an insurance offer is positively associated with higher median workforce incomes, and conditional offers of dependent coverage increase when the majority of workers are married or from a family with at least three members. This first application of the MEPS-ICAR highlights the significance of workforce characteristics in shaping small employer insurance benefits and the data's usefulness for expanding analyses of policy changes, wage-benefit tradeoffs, and health insurance benefits.

The effects of Carpinus betulus expansion on soil properties under changing climatic conditions

Carpinus betulus (CB) is becoming increasingly important in the forests of Central Europe and is significantly increasing its proportion in various habitat types. We have analysed how the increase in CB affects soil properties. The study was conducted in the Białowieża Forest (BF). We monitored the changes in CB cover between 1962 and 2013 on 56 permanent plots and collected samples of the litter sub-horizons and the content of the underlying A horizons for laboratory analyses in 2014. During the study period, there was a significant increase in CB cover in the second tree layer by an average of 17.4 % (±1.8) and in the shrub layer by 3.8 % (±1.0), as well as an increase in species diversity from 41 % in the past to 59 % currently. The C/N ratio of the Oi sub-horizon was 32.0 (±0.9), and NH4+ compounds predominated over NO3-, with all nitrogen forms most closely associated with the C/N ratio. In the Oea sub-horizon, the C/N ratio was 23.4 (±0.4), and the sum of mineralised nitrogen reached 8%, with a clear predominance of NO3-. The characteristic most strongly associated with the increase in CB coverage was the NO3- content in the Oea sub-horizon. The MID analysis confirmed that the change in CB cover was not only significant, but also ecologically important. We suggest that there is a feedback loop in which the generally observed climate changes lead to trees occupying new habitats that supply the forest floor with high quality litter, which in turn affects the soil and promotes the persistence of changes in the species composition of the forest.

Investigating Gold Deposition with High-Power Impulse Magnetron Sputtering and Direct-Current Magnetron Sputtering on Polystyrene, Poly-4-vinylpyridine, and Polystyrene Sulfonic Acid.

Fabricating thin metal layers and particularly observing their formation process in situ is of fundamental interest to tailor the quality of such a layer on polymers for organic electronics. In particular, the process of high power impulse magnetron sputtering (HiPIMS) for establishing thin metal layers has sparsely been explored in situ. Hence, in this study, we investigate the growth of thin gold (Au) layers with HiPIMS and compare their growth with thin Au layers prepared by conventional direct current magnetron sputtering (dcMS). Au was chosen because it is an inert noble metal and has a high scattering length density. This allows us to track the growing nanostructures via grazing incidence scattering. In particular, Au deposition on the polymer polystyrene (PS) with the respective structural analogues poly-4-vinlypyridine (P4VP) and polystyrene sulfonic acid (PSS) is studied. Additionally, the nanostructured layers on these different polymer films are further probed by field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), X-ray reflectometry (XRR), and four-point probe measurements. We report that HiPIMS leads to smaller island-to-island distances throughout the whole sputter process. Moreover, an increased cluster density and an earlier percolation threshold are achieved compared to dcMS. Additionally, in the early stage, we observe a significant increase in coverage by HiPIMS, which is favorable for the improvement of the polymer-metal interface.

Effects of the continuous Medicaid coverage provision of the family first coronavirus response act on postpartum Medicaid coverage, depression symptoms, and birth control use.

The 2020 Family First Coronavirus Response Act (FFCRA) extended Medicaid coverage for enrollees without rechecking eligibility. Before that, women were eligible for Medicaid coverage up to 60 days postpartum. We examine the FFCRA's effect on Medicaid postpartum coverage, depression symptoms, and birth control use beyond 60 days after delivery. We use data from the 2016-2021 Pregnancy Risk Assessment Monitoring System (PRAMS). The primary sample includes 56,828 women who were income eligible up to 60 days postpartum or beyond in their state. We employ a difference-in-differences design comparing outcomes before and after the FFCRA between women who were not income eligible for Medicaid coverage beyond 60 days postpartum in their state and those who were income eligible. We estimate models without and with controlling for state-specific trends in outcomes over time. N/A. There is an 8.1 percentage-point increase in the likelihood of having Medicaid coverage without controlling for state-specific trends, and 5.4 percentage-points when controlling for state-specific trends (both p < 0.05). There is a decline in likelihood of being uninsured by 3 percentage-points (p < 0.05) without state-specific trends and a smaller and non-significant decline when including state-specific trends. Estimated effects on depression symptoms and birth control use are small and statistically non-significant. Following the FFCRA, there was an increase in Medicaid coverage beyond 60 days postpartum among women who would have been income ineligible for Medicaid after 60 days. However, there is a less pronounced effect on likelihood of being uninsured, which might be partly due to some switching from private to Medicaid coverage. There were no discernable effects on depression symptoms and birth control use. Examining additional health and health care utilization measures over a longer postpartum period is needed to further understand the FCCRA effects on these outcomes.

Impact of vegetation coverage and configuration on urban temperatures: a comparative study of 31 provincial capital cities in China

Urban vegetation plays a crucial role in regulating temperatures and heat waves in urban areas. However, the influence of vegetation coverage and its configuration on surface temperatures in different climate zones at a national scale is unclear. To address this, we utilized high-resolution data to detect spatial patterns for 31 provincial capital cities in China. We integrated day and night surface temperatures to determine the influence of vegetative coverage and configuration on urban temperatures across different climate zones and city sizes. Our study revealed that a subtropical monsoon climate and medium-sized cities had the highest vegetative coverage and shape complexity. The best connectivity and agglomeration of vegetation were found in a temperate monsoon climate and large cities. In contrast, small cities, especially those under a temperate continental climate, had low vegetation coverage, high fragmentation, and weak agglomeration and connectivity. In addition, vegetative coverage had a negative impact on daytime surface temperatures, especially in large cities in a subtropical monsoon climate. However, an increase in vegetation coverage could result in warming at night in small cities in temperate continental climates. Although urban vegetation configuration also contributed to moderating surface temperatures, especially at night, they did not surpass the influence of vegetation coverage. The effect on nighttime temperatures of the configuration of vegetation increased by 3–6% relative to that of daytime temperatures, especially in large cities in a temperate monsoon climate. The contribution vegetation coverage and configuration interaction to cooling efficiency decreased at night, especially in medium-sized cities in a temperate continental climate by 3–5%. In addition, this study identified several moderating effects of natural and social factors on the relationship between urban vegetation coverage and surface temperatures. High duration of sunshine, low humidity and high wind speed significantly enhanced the negative impact of vegetation coverage on surface temperatures. In addition, the moderating effect of vegetation coverage was more pronounced in low population density cities and high gross domestic product. This study enhances understanding of the ecological functions of urban vegetation and provides a valuable scientific basis and strategic recommendations for optimizing urban vegetation and improving urban environmental quality.