National Information System Research Articles

Large scale public health system transformation: Germany

Abstract The COVID-19 pandemic was a stress test for public health services in Germany. Decision making was complex (party lengthy and inconsistent) due to the divided responsibilities within the federal system. Some improvements on the public health system were already enacted during the pandemic. A “pandemic radar” was established to bundle up relevant infectious disease indicators with indicators of health services use. The national electronic notification and information system for infectious diseases was extended. Digital improvements were made in the public health offices. Laboratory capacity was strengthened, so was inter-science modelling to forecast pathogen spread. A nation-wide collaborative mechanism, the cloverleaf system, was introduced between regions to avoid the overburdening of hospitals. It is now established for times of excess need for inpatient services. In 2020, a 4 billion euros investment program, the “Pact of Public Health Services”, was adopted to strengthen and modernize the German public health service institutions. The pact is implemented until 2026. The human resources component is the largest. Further priorities include digitalization, improvement of the infrastructure (of designated ports and airports) for the implementation of the International Health Regulations, research and the creation of agile and resilient public health structures. Outputs so far include the establishment of more than 4800 new public health positions, the appointment of new professorships for public health services, the initiation of several research projects, and the roll-out of more than 300 digitalization projects. A new federal institute for prevention is planned. It aims to foster networking between public health services, strengthen health communication, data use, and evidence for public health services. In this process, WHO advised the federal ministry e.g. on behavioral insights; heat health action; prevention on noncommunicable diseases and others. Many public health actors have provided opinions. However, consensus building on how Germany can overcome fragmentation in public health is ongoing.

A cross-sectional study of data linkage and artificial intelligence practices across European countries

Abstract Background The availability of different data sources is increasing with the possibility to link them with each other. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the use of data linkage and artificial intelligence (AI) in routine public health activities and the constraints to linking different data sources. Methods A cross-sectional survey was performed across European countries to explore the current practices applied by national institutes of public health, health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or AI). Results In Europe, the use of data linkage and AI at national institutes of public health, health information and statistics varies. The use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes is common in majority of European countries. The use of AI to estimate health indicators is not frequent among these institutes. The complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as main constraints to routine data linkage for public health surveillance and research. Conclusions Our study showed that the majority of European countries have integrated data linkage in their routine public health activities but only a few use AI. A sustainable national health information system allowing to link different data sources are essential to contribute to public health research. Moreover, it supports evidence-informed health policy making processes with an overview of various aspects affecting population health and may contribute to European pandemic preparedness.

Incentives to attract and retain physicians to underserved areas - a case study from Portugal

Abstract Issue Physician shortages in underserved areas are a common challenge for governments and policymakers worldwide, including in Europe. Meanwhile, a knowledge gap exists on effective measures to address the issue. Description According to WHO Europe, one of ten actions to strengthen the healthcare workforce is to develop strategies to attract and retain health workers in rural and remote areas. Portugal faces geographical asymmetries in the distribution of physicians, and difficulties in retaining them in certain areas of the country. This case study seeks to describe and analyse the impact of an incentives package introduced in 2015 that aimed to attract and retain physicians in underserved areas. Financial incentives data was gathered via a national health human resources information system. Non-financial incentives data was reported by health institutions through an online form. Document analysis was conducted to understand the scope of the incentives package and its amendments. Results The incentives package implemented in Portugal effectively deployed physicians to underserved areas, since it led to a fourteen-fold increase in physicians settling in underserved areas. In terms of retention, an average of 59% of the physicians that took up the incentives package are still practicing in the same underserved area. However, the difference between the retention levels of physicians under the incentives package and those not covered is minimal. To further reduce health inequities and achieve universal health coverage, a need exists to review the financial and non-financial incentives to better suit physicians’ needs and expectations, as well as those of the National Health Service. Lessons The incentives package introduced in Portugal makes it clear that flexibility in the design of attraction and retention measures is crucial. It requires a long-term commitment and a recognition that each intervention should be assessed and adapted to local circumstances and context. Key messages • The incentives package introduced in Portugal attracted physicians to underserved areas and led to a fourteen-fold increase in physicians settling in underserved areas. • More than half of the physicians are still practicing in the same underserved health institution but the difference in retention against those not covered by the incentives package is minimal.

Trends in diabetes morbi-mortality and its association with abdominal obesity among Tunisian adults

Abstract Introduction Tunisia is undergoing rapid nutritional transition, with increasing rates of abdominal obesity. Coupled with rising diabetes prevalence, it poses significant challenges to public health. This study aimed to estimate the morbi-mortality prevalence and trends of diabetes among Tunisian adults, particularly examining its association with abdominal obesity. Methods We conducted a secondary data analysis on adults aged 35 to 70 from three national surveys in Tunisia, in 1996 (n = 3513), 2005 (n = 7700), and 2016 (n = 6007) respectively. Mortality data was sourced from the Tunisian National Information System on Causes of Death in 2020. The underlying cause of death was determined using the IRIS software, following WHO guidelines for tabulating mortality statistics. Diabetes was defined according to the American Association of Diabetes criteria. Abdominal obesity was defined as a waist-to-height ratio ≥ 0.6. We performed chi-squared test for trend analysis. Results A total of 17220 participants were analyzed. We found a significant upwards trend in diabetes prevalence (p < 10-3): it increased from 13.1%[11.9-14.3] in 1996 to 15.1% [12.5-17.4] in 2005, then to 20.5%[18.9-22.1] in 2016. Linear trend test concluded to significant increase in diabetes prevalence estimated at 56.6% in two decades. Diabetes was significantly associated with abdominal obesity (Odds ratio (OR)=2.17[2.11-2.21]). Diabetes was the leading cause of death among Tunisian adults in 2020 (n = 22715). The proportional mortality due to diabetes was estimated at 6.2% (n = 1407) (6.4% for men and 6% for women). The age group with the highest proportional mortality due to diabetes was 65-70 years old (44.6%). Conclusions Our findings highlight the burden of diabetes on public health in Tunisia and its association with abdominal obesity. Hence the urgency to strengthen comprehensive preventive and control measures to alleviate its repercussions among the Tunisian population. Key messages • The prevalence of diabetes increased significantly amongTunisian adults in the past two decades. • Immediate implementation of targeted interventions and policy measures is imperative to effectively address this issue.

Developing National Information Systems to Monitor COVID-19 Vaccination: A Global Observational Study.

Strong information systems are essential for safe and effective immunization programs. The COVID-19 vaccine rollout presented all immunization information systems (IIS) with challenging demands-requiring in-depth vaccine implementation data at all health system levels in real time. The system development approaches taken by countries were heterogeneous, with some countries opting to adapt existing systems and others implementing new ones. Using data reported by Member States to the World Health Organization (WHO), we aim to develop a global understanding of (1) the types of IIS used to monitor COVID-19 vaccination implemented in 2021 and (2) the approaches taken by countries to develop these systems. We conducted a descriptive analysis of data reported through a supplemental questionnaire of the WHO/United Nations Children's Emergency Fund (UNICEF) Joint Reporting Form on Immunization, collecting data for 2021 on (1) the use of and developmental approaches taken for 7 IIS functions (appointments, aggregate reporting, individual-level reporting, reminders, home-based records, safety surveillance, and stock management), and (2) modifications needed for digital health frameworks to permit COVID-19 vaccination monitoring. In total, 188 of 194 WHO Member States responded to the supplemental questionnaire, with 155 reporting on the IIS-related questions. Among those reporting, for each of the 7 IIS functions explored, greater than 85% of responding countries reported that the system was in place for COVID-19 vaccines. Among responding countries, "aggregate reporting system" was the system most frequently reported as being in place (n=116, 98.3%), while "reminder system" was the least (n=77, 89%). Among the countries reporting using a system, whether an existing system was adapted for COVID-19 vaccines or a new one was developed varied by system. Additionally, two-thirds (n=127, 67.6%) of countries reported establishing at least one new system, ranging from 72% (n=42) in high-income countries (HICs) to 62% (n=16) in low-income countries. Concurrently, 55.3% (n=104) of countries reported adapting at least one system already in place for COVID-19 vaccines, with 62% (n=36) of HICs reporting this compared to about 53% for other income groups. Of those reporting developing new systems, for each of the systems explored, more than 85% of countries reported that they intended to keep new systems specific to COVID-19 vaccines. Further, 147 of the 188 (78.2%) Member States responding to the supplemental questionnaire responded to the digital health frameworks question. Lastly, 31% (n=46) of responding countries reported needing to adapt them for COVID-19 vaccination systems. HICs had a higher percentage. Nearly all countries have adapted existing or developed new IIS to monitor COVID-19 vaccination. The approaches varied, notably by income group. Reflection is needed on how to sustain the investments made in IIS during the pandemic. Continued support for IIS is critical, given their essential role in program monitoring and performance.

Gender-specific correlates for suicide mortality in people with schizophrenia: a 9-year population-based study

BackgroundSchizophrenia is associated with a high mortality rate due to the high risk of suicide. However, there is still a lack of evidence on the gender-specific risk factors for suicide among people with schizophrenia. In this study, we aimed to measure the sociodemographic and clinical correlates of suicide deaths in different genders among people with schizophrenia.MethodsData on patients with schizophrenia from 2013 to 2021 in Guangzhou, China were obtained from the National Information System for Psychosis (NISP), involving a total of 33,080 patients. Cox regression and Fine-Gray models were used to explore the sociodemographic and clinical risk factors for suicide mortality in different genders.ResultsThe overall age-standardized mortality rates due to suicide were 133.89 (95% CI: 124.31-143.47) per 100,000 person-years for females and 163.25 (95% CI: 152.92-173.59) per 100,000 person-years for males. To be specific, lack of medical insurance, history of non-treatment, and history of suicidal behavior was associated with a higher risk for suicide mortality for females, while an age of 35–54, being hospitalized once, and the age of onset being > 28 years were linked to lower risk for suicide mortality for males. For both genders, a lower risk for suicide mortality was observed in patients at an older age (≥ 55 years) and with a history of hospitalization more than once, and a higher suicide mortality risk was found in married patients and those residing in rural areas.ConclusionThe present study found that gender differences should be taken into account in the development of suicide prevention programs for people with schizophrenia, and future research is still required to verify our preliminary results.

Infodemic Management in Senegal: Processes, Results and Community Contribution

This article examines Senegal's response to the Coronavirus Disease 2019 (Covid-19) pandemic, with a particular focus on the management of infodemic, or the proliferation of rumours and misinformation. The advent of social media has precipitated a surge in the proliferation of rumours, rendering it a significant challenge for effective management. In response, the Risk Communication and Community Engagement Commission (RCCE) devised a comprehensive rumour management guide and conducted training for key informants from the community. The primary outcomes demonstrate an enhancement in rumour management and the accessibility of the rumour register. These outcomes were attained through robust community involvement in all processes and elevated mobile connectivity. Integrating the infodemic management mechanism into the national health and social information system remains a significant challenge, as does mobilizing resources for nationwide implementation. The principal insight gained is that effective infodemic management necessitates community involvement and coordinated multi-sectoral efforts.. (Abstract)

Digital communication between mothers and community health workers to support neonatal health (CHV-NEO): study protocol for a randomized controlled trial

BackgroundProvision of essential newborn care at home, rapid identification of illness, and care-seeking by caregivers can prevent neonatal mortality. Mobile technology can connect caregivers with information and healthcare worker advice more rapidly and frequently than healthcare visits. Community health workers (CHWs) are well-suited to deliver such interventions. We developed an interactive short message service (SMS) intervention for neonatal health in Kenya, named CHV-NEO. CHV-NEO sends automated, theory-based, actionable, messages throughout the peripartum period that guide mothers to evaluate maternal and neonatal danger signs and facilitate real-time dialogue with a CHW via SMS. We integrated this intervention into Kenya’s national electronic community health information system (eCHIS), which is currently used at scale to support CHW workflow.MethodsThe effect of CHV-NEO on clinical and implementation outcomes will be evaluated through a non-blinded cluster randomized controlled trial. Twenty sites across Kisumu County in Western Kenya were randomized 1:1 to provide either the national eCHIS with integrated CHV-NEO messaging (intervention) or standard of care using eCHIS without CHV-NEO (control). We will compare neonatal mortality between arms based on abstracted eCHIS data from 7200 pregnant women. Secondary outcomes include self-reported provision of essential newborn care (appropriate cord care, thermal care, and timely initiation of breastfeeding), knowledge of neonatal danger signs, and care-seeking for neonatal illness, compared between arms based on questionnaires with a subgroup of 2000 women attending study visits at enrollment in pregnancy and 6 weeks postpartum. We will also determine CHV-NEO’s effect on CHW workflows and evaluate determinants of intervention acceptability, adoption, and fidelity of use through questionnaires, individual interviews, and messaging data.DiscussionWe hypothesize that the CHV-NEO direct-to-client communication strategy can be successfully integrated within existing CHW workflows and infrastructure, improve the provision of at-home essential newborn care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. The intervention’s integration into the national eCHIS tool will facilitate rapid scale-up if it is clinically effective and successfully implemented.Trial registrationClinicalTrials.gov, NCT05187897. The CHV-NEO study was registered on January 12, 2022.

TEMPORARY REMOVAL: Understanding gaps in early detection of and rapid response to invasive species in the United States: A literature review and bibliometric analysis

While concepts regarding invasive species establishment patterns and eradication possibilities have long been a topic of invasion biology, the specific terminology referring to early detection of and rapid response to (EDRR) invasive species emerged in scientific literature during the early 2000s. Since then, the EDRR approach has expanded to include a suite of detection, planning, and management tools. By conducting a systematic literature review, we attempt to characterize the field of EDRR in the United States and its territories as reflected by publication records. Specifically, we assessed publication data such as the number of publications per year, the most common journals where papers were published, and the relationship between author's keywords for studies focusing on aquatic and terrestrial habitats. For publications that used invasive species occurrence or abundance data (whether collected for the purposes of the respective publication or acquired from another data source), we manually vetted additional information such as focal taxa, data collection years and locations, sources of other data used, and whether data or code were deposited in open access formats. We also conducted network analyses for the author institutions that coauthored papers together most frequently and for the references most cited by EDRR publications. Overall, we found that silos existed in terms of which author institutions worked together, which existing literature was cited, and which topics were frequently explored. We also found evidence of substantial gaps in data access and use. For example, although a wide variety of data sources for invasive species occurrences are available, these sources were seldom cited by published literature, and newly collected data was not often deposited into invasive species databases or other open-source data repositories. Considering the continued advocation for a centralized national EDRR information system, our study suggests that facilitating access to data, decision support tools, and other informational resources represents a key opportunity for improving EDRR capabilities.

Long-term major events after hospital discharge for out-of-hospital cardiac arrest

BackgroundCardiac arrest remains a global health issue with limited data on long-term outcomes, particularly regarding recurrent cardiovascular events in patients surviving out-of-hospital cardiac arrest. (OHCA). We aimed to describe the long-term occurrence of major cardiac event defined by hospital admission for cardiovascular events or death in OHCA hospital survivors, whichever came first. Our secondary objective were to assess separately occurrence of hospital admission and death, and to identify the factors associated with major event occurrence. We hypothesized that patients surviving an OHCA has a protracted increased risk of cardiovascular events, due to both presence of the baseline conditions that lead to OHCA, and to the cardiovascular consequences of OHCA induced acute ischemia-reperfusion.MethodsConsecutive OHCA patients from three hospitals of Sudden Death Expertise Center (SDEC) Registry, discharged alive from 2011 to 2015 were included. Long-term follow-up data were obtained using national inter-regime health insurance information system (SNIIRAM) database and the national French death registry. The primary endpoint was occurrence of a major event defined by hospital admission for cardiovascular events and death, whichever came first during the follow-up. The starting point of the time-to-event analysis was the date of hospital discharge. The follow-up was censored on the date of the first event. For patients without event, follow-up was censored on the date of December, 29th, 2016.ResultsA total of 306 patients (mean age 57; 77% male) were analyzed and followed over a median follow-up of 3 years for hospital admission for cardiovascular event and 6 years for survival. During this period, 38% patients presented a major event. Hospital admission for cardiovascular events mostly occurred during the first year after the OHCA whereas death occurred more linearly during the all period. A previous history of chronic heart failure and coronary artery disease were independently associated with the occurrence of major event (HR 1.75, 95%CI[1.06-2.88] and HR 1.70, 95%CI[1.11-2.61], respectively), whereas post-resuscitation myocardial dysfunction, cardiogenic shock and cardiologic cause of cardiac arrest did not.ConclusionSurvivors from OHCA must to be considered at high risk of cardiovascular event occurrence whatever the etiology, mainly during the first year following the cardiac arrest and should require closed monitoring.

Impact of a ROP mentoring program in rural regions of Colombia

PurposeTo assess the impact of a retinopathy of prematurity (ROP) mentoring program in four rural regions with 31 neonatal units in Colombia between 2011 and 2019. MethodsIndicators recommended by the national program were used for assessment: screening coverage of eligible preterm newborns, proportion screened with any stage of ROP, and proportion of screened infants treated. Data were also collected on the number of units with ROP services and birth weight (BW) and gestational age (GA) of babies treated. Data on the number of preterm births, BWs of infants screened, and their ROP status (any/none) were extracted from the national health information system. Ophthalmologists in each region provided data on the number screened and treated. A linear-by-linear statistic was used to assess trends in the indicators before and during mentoring. ResultsOf the 31 neonatal units, the number providing ROP services increased from 7 (23%) to 26 (84%). The number of eligible infants born in the four regions (total 33,521) was stable over the study period, the proportion screened increased from 14% to 41%, the proportion of those screened who were found to have any ROP tended to decrease overtime, and the proportion of those screened who were treated declined from 9% to 3%, with some regional variation. By year 3 no infant with a BW ≥2000 g or GA of >36 weeks was treated. ConclusionsIn our study, mentoring rural providers proved a valuable strategy for inducing new screening programs, increasing coverage, and improving local capacities in neonatal care and ROP services.

Population size, HIV prevalence, and antiretroviral therapy coverage among key populations in sub-Saharan Africa: collation and synthesis of survey data, 2010–23

Key population HIV programmes in sub-Saharan Africa require epidemiological information to ensure equitable and universal access to effective services. We aimed to consolidate and harmonise survey data among female sex workers, men who have sex with men, people who inject drugs, and transgender people to estimate key population size, HIV prevalence, and antiretroviral therapy (ART) coverage for countries in mainland sub-Saharan Africa. Key population size estimates, HIV prevalence, and ART coverage data from 39 sub-Saharan Africa countries between 2010 and 2023 were collated from existing databases and verified against source documents. We used Bayesian mixed-effects spatial regression to model urban key population size estimates as a proportion of the gender-matched, year-matched, and area-matched population aged 15-49 years. We modelled subnational key population HIV prevalence and ART coverage with age-matched, gender-matched, year-matched, and province-matched total population estimates as predictors. We extracted 2065 key population size data points, 1183 HIV prevalence data points, and 259 ART coverage data points. Across national urban populations, a median of 1·65% (IQR 1·35-1·91) of adult cisgender women were female sex workers, 0·89% (0·77-0·95) were men who have sex with men, 0·32% (0·31-0·34) were men who injected drugs, and 0·10% (0·06-0·12) were women who were transgender. HIV prevalence among key populations was, on average, four to six times higher than matched total population prevalence, and ART coverage was correlated with, but lower than, the total population ART coverage with wide heterogeneity in relative ART coverage across studies. Across sub-Saharan Africa, key populations were estimated as comprising 1·2% (95% credible interval 0·9-1·6) of the total population aged 15-49 years but 6·1% (4·5-8·2) of people living with HIV. Key populations in sub-Saharan Africa experience higher HIV prevalence and lower ART coverage, underscoring the need for focused prevention and treatment services. In 2024, limited data availability and heterogeneity constrain precise estimates for programming and monitoring trends. Strengthening key population surveys and routine data within national HIV strategic information systems would support more precise estimates. UNAIDS, Bill & Melinda Gates Foundation, and US National Institutes of Health.

Governance and Efficiency in Brazilian Water Utilities: An Analysis Based on Revenue Collection Efficiency

This study analyzed the relevance of governance structure for efficient revenue collection by Brazilian water utilities (WUs). Data were collected from the National Information System on Sanitation (SNIS) for 127 Brazilian WUs, covering a balanced longitudinal panel from 2018 to 2022. The governance structures evaluated included ownership (public or private) and corporatization (publicly traded or not). We searched scientific databases and did not find any studies on the efficiency of specific WUs in collecting customer bills for services rendered and its relationship with this type of governance; thus, this is the main innovative contribution of this study to the literature. In the first stage, this study utilized the dynamic slack-based model (DSBM) to assess revenue collection efficiency. In the second stage, an econometric model with generalized estimating equation (GEE) was used to explain the efficiency. The findings revealed a global average inefficiency in revenue collection of 50.47%. Corporatization was linked to higher collection efficiencies, while ownership type was significantly linked with lower collection efficiency. Factors such as tariff accessibility, urbanization, and the COVID-19 pandemic also influenced efficiency. This study suggests that regulatory bodies should consider these insights to implement policies that prevent inefficiencies from affecting the tariff system for services.

Performances of the e-Nauka Portal in the Republic of Serbia and Its Significance for Researchers

In recent years, digitalization has been recognized as a significant and necessary process that leads to better results, both in the education and in the scientific research. The legal and strategic framework in the Republic of Serbia follows the modern trends of the concept of open science, open knowledge, digital transformation and a unique digital format of scientific production. The Ministry of science, technological development and innovation, in cooperation with the Office for information technology and electronic administration, created the necessary conditions for dynamic the development of the scientific research and innovation system, especially in relation to the digitalization process and the establishment of an information platform, in the form of a unified national information system of scientific research activities: eNauka [eScience]. The concept of eNauka is an innovative tool that improves the efficiency and transparency of scientific processes in Serbia. The eNauka portal in the Republic of Serbia is dedicated to promoting scientific research, innovation and academic achievements within the scientific community of the Republic of Serbia. This portal provides access to scientific articles, research papers and academic publications authored by researchers from Serbia, which enables the spread of knowledge and the encouragement of scientific cooperation within the country. The eNauka portal was opened in full capacity for all active researchers in Serbia on July 3, 2023, and contains data on scientific research organizations in the Republic of Serbia, researchers and their scientific results. The goal of this paper was to bring closer to the academic community the capabilities and performance of the eNauka portal, its structure, the way and importance of data editing, with special reference to issues related to researchers’ profiles and their editing. The paper is methodologically based on a theoretical, preliminary desk analysis of relevant contemporary standpoints in domestic and foreign theory, a normative analysis of current legislative sources, an inductive and deductive approach in researching the operational performance and advantages of the eNauka portal, as well as the quantitative analysis of relevant statistical indicators of relevant parameters regarding the profile that each researcher has on the eNauka portal. The results include the analysis of data related to editing the researcher’s profile and the opportunities offered by the eNauka portal. The conclusion refers to the importance and advantages of the eNauke portal. Finally, it should be noted that one of the key functions of eNauka is the evaluation of scientific results. More precisely, the system provides the possibility of monitoring and evaluating research results, which is of great importance for the academic community.

Plinian Core: A Data Specification for Species Pages in the Real World

Plinian Core (PliC), a standard in development by a Biodiversity Information Standards (TDWG) task group, is a set of vocabulary terms that can be used to describe different aspects of biological species information, including all kinds of properties or traits related to taxa—biological and non-biological. PliC incorporates terms pertaining to descriptions, legal aspects, conservation, management, uses, demographics, nomenclature, or related resources (Plinian Core Task Group 2021). Having a data specification is just a small part of what it takes to prepare and publish species information. The specification provides a structured way to describe species-related data, ensuring consistency and interoperability across different platforms and databases. Different aspects of Plinian Core and its development have been presented in the past (Pando 2018; Pando et al. 2022). In this contribution, we shift the focus out of the specification itself, to other key aspects of species information dissemination. Plinian Core has been already put to use in various real-world scenarios. Here we select three examples to present the most significant lessons learned: Cross-Nature Project This project developed a Resource Description Framework for PliC to create an ontology-based endpoint for the Species Information System of the Spanish Ministry for the Environment (EIDOS). It provides a structured framework for describing and integrating species data following the Linked Open Data principles. The system provides information for over 85,000 species. Biodiversity Catalogue of SiB Colombia This national catalogue provides information on the natural history, conservation, threats, and biology of Colombian species. Aimed at a broad audience, it maintains scientific rigor while being accessible to anyone interested in Colombia's biodiversity. PliC has been essential in this endeavor, enabling the inclusion of both highly structured technical information and rich, engaging textual descriptions for over 6,000 species. EncicloVida Developed by CONABIO, EncicloVida aims to publicize the Mexican biodiversity. The platform integrates biological species information on more than 114,000 species of plants, animals, fungi, bacteria, and protozoa that CONABIO has gathered through the National Information System on Biodiversity (SNIB) in collaboration with Mexican researchers. These implementations are based on the PliC Core abstract Model that is expressed as an XML Schema definitiion (XSD), and the supporting documentation is provided in the PliC Wiki. Automatic aggregation of species pages is challenging and often ineffective as differences in taxonomic treatments, or in local populations (either biological or otherwise: threat status, laws and regulations, etc.) frequently create inconsistencies or even render false information. Conversely, sharing a standard across projects offers immediate benefits, such as consistency of navigation and information, or the facility for sharing software solutions. Plinian Core terms, vocabularies and structure have been developed in collaboration with implementers and in response to real-world demands. That has resulted in a set of fairly large data specifications, but one flexible and easy to understand by domain experts who may not work comfortably with more technical approaches. Each implementation puts emphasis on different aspects, applying different levels of granularity depending on the requirements. This is done by choosing between "unstructured" terms (for low granularity) or the "atomized classes'' (for highly structured information). For instance, dispersal information can be recorded as a text block ("DispersalUnstructured") or using a set of specific terms: Purpose, DispersalMeans, StructureDisperse ("DispersalAtomized"). PliC reuses a number of terms from other standards (see Borrowed terms section) following a well-established best practice. Using XSD files as a basis, we link borrowed terms from external sources to their original specifications, which were also expressed as XSD files. This should provide consistency and reliability. However, this has proven to be problematic to maintain and validate, as links are broken and files changed. To keep the PliC XSD file valid, we opted for maintaining local copies of the XSD of the respective reused standards. We also aim to present some current and future developments of PliC, especially in the context of the Living Atlases community. Thus, we will explore other elements involved in sharing species information such as the Global Biodiversity Information Facility's Integrated Publishing Toolkit extensions, SPARQL Endpoints, Frictionless Data Packages, Research Object-Crates, and integration with Atlas of Living Australia modules.

The spatial interplay between productive and destructive entrepreneurship: do institutions meet expectations in rural areas?

ABSTRACT Little is known about the coexistence and possible substitutability of destructive and productive entrepreneurship in regions characterized by weak institutions. This study explores the role of institutions in the interplay between destructive entrepreneurial activity (i.e. new coca crops share) and productive entrepreneurship (i.e. new coffee crops share) in rural Colombia. Institutional economics is used to frame our analysis, which is supported by an empirical spatial Durbin model. Using data from the municipal level of the Coffee National Information System during the 2000–2010 period, we found that destructive entrepreneurship has directly displaced productive entrepreneurship and the other way around. Although it is hypothesized that the presence of coffee-supportive institutions such as extensionists (i.e. regional representation of the national coffee association) mitigates the relationship between these entrepreneurial activities in favour of productive entrepreneurship, our results show that institutions are insufficient to control the crowding-out effect of destructive on productive entrepreneurship. The theoretical and policy implications of the study are considered in light of these findings.

Improving Identification of Gig Workers in National Health and Behavior Surveys.

This paper describes the work-related information collected in several important U.S. national health and behavior surveys, to highlight data gaps that prevent identifying responses by vulnerable workers in the gig economy, with emphasis on the growing digital platform sector of the work force. The national information systems used to understand health status and health behaviors, including drug use, rely on outdated census categories for self-employed workers. This paper describes the importance of understanding the needs of this growing part of the labor sector and describes how some of the most well-known and utilized national surveys fail to meet this need. For the agencies conducting national health and behavior surveys, we propose revisions to the categories used to classify type of worker and recommend adoption of a new Worker-Employer Relationship Classification model.

Effect of indoor residual spraying on sandfly abundance and incidence of visceral leishmaniasis in India, 2016–22: an interrupted time-series analysis and modelling study

Efforts to eliminate visceral leishmaniasis in India mainly consist of early detection and treatment of cases and indoor residual spraying with insecticides to kill the phlebotomine sandfly Phlebotomus argentipes that transmits the causative Leishmania protozoa. In this modelling study, we aimed to estimate the effect of indoor residual spraying (IRS) on vector abundance and transmission of visceral leishmaniasis in India. In this time-series analysis and modelling study, we assessed the effect of IRS on vector abundance by using indoor vector-abundance data (from 2016 to 2022) and IRS quality-assurance data (from 2017-20) from 50 villages in eight endemic blocks in India where IRS was implemented programmatically. To assess a potential dose-response relation between insecticide concentrations and changes in sandfly abundance, we examined the correlation between site-level insecticide concentrations and the site-level data for monthly sandfly abundances. We used mathematical modelling to link vector data to visceral leishmaniasis case numbers from the national Kala-Azar Management Information System registry (2013-21), and to predict the effect of IRS on numbers of averted cases and deaths. IRS was estimated to reduce indoor sandfly abundance by 27% (95% CI 20-34). Concentrations of insecticides on walls were significantly-but weakly-associated with the degree of reduction in vector abundance, with a reduction of -0·0023 (95% CI -0·0040 to -0·0007) sandflies per mg/m2 insecticide (p=0·0057). Reported case numbers of visceral leishmaniasis were well explained by trends in vector abundance. Village-wide IRS in response to a newly detected case of visceral leishmaniasis was predicted to reduce disease incidence by 6-40% depending on the presumed reduction in vector abundance modelled. Indoor residual spraying has substantially reduced sandfly abundance in India, which has contributed to reductions in visceral leishmaniasis and related deaths. To prevent the re-emergence of visceral leishmaniasis as a public health problem, surveillance of transmission and sandfly abundance is warranted. Bill & Melinda Gates Foundation. For the Hindi translation of the abstract see Supplementary Materials section.

Assessing the integration of refugee health data into national health information systems in Jordan, Lebanon, and Uganda

BackgroundWith the increasing number of protracted refugee crises globally, it is essential to ensure strong national health information systems (HIS) in displacement settings that include refugee-sensitive data and disaggregation by refugee status. This multi-country study aims to assess the degree of integration of refugee health data into national HIS in Jordan, Lebanon, and Uganda and identify the strengths and weaknesses of their national HIS in terms of collecting and reporting on refugee-related health indicators.MethodsThe study employs a comparative country analysis approach using a three-phase framework. The first phase involved reviewing 4120 indicators compiled from global health organizations, followed by a multi-stage refinement process, resulting in 45 indicators distributed across five themes. The second phase consisted of selecting relevant criteria from the literature, including data sources, annual reporting, disaggregation by refugee status, refugee population adjustments, accuracy, and consistency. The third phase involved assessing data availability and quality of the selected indicators against these criteria.ResultsOur analysis uncovered significant challenges in assessing the health status of refugees in Jordan, Lebanon, and Uganda, primarily stemming from limitations in the available health data and indicators. Specifically, we identified significant issues including incomplete local data collection with reliance on international data sources, fragmented data collection from various entities leading to discrepancies, and a lack of distinction between refugees and host populations in most indicators. These limitations hinder accurate comparisons and analyses. In light of these findings, a set of actionable recommendations was proposed to guide policymakers in the three countries to improve the integration of refugee health data into their national HIS ultimately enhancing refugees’ well-being and access to healthcare services.ConclusionThe current status of refugee-related health data in Jordan, Lebanon, and Uganda indicates the need for improved data collection and reporting practices, disaggregation by refugee status and better integration of refugee health data into national HIS to capture the health status and needs of refugees in host countries. Key improvement strategies include establishing a centralized authority for consistent and efficient data management, fostering transparent and inclusive data governance, and strengthening workforce capacity to manage refugee health data effectively.

Recurrent neural network using LSTM for prediction of atmospheric pollutants in the State of Veracruz, Mexico

This article shows the use of a recurrent neural network LSTM whose objective was to make a 24-hour ozone forecast with data obtained from the INECC (National Institute of Ecology and Climate Change) and the validated database of the National Information System of Air Quality (SINAICA spanish acronym). The problem of air quality in the world is essential due to health problems. Currently, the techniques used to generate forecasts in monitoring stations are not accurate and do not allow generating alerts to avoid exposure to poor air quality. The state of Veracruz in Mexico has 7 air quality monitoring stations, showing that it is feasible to alternatively have a betterquality pollutant concentration forecasting system. The results obtained on the correlations of variables, although weak, positive or negative, allowed us to recognize their usefulness in the development of training in the RNN. The use of neural networks was demonstrated for the forecast of ozone concentration values in the metropolitan area of Poza Rica, using the LSTM using Python, Tensor Flow and Keras, with a good fit to the normalized pattern with an average RMSE of 0.0053 ppm of the days chosen for testing between the period from June 2019 to July 2020. Future work will consider PM10 and PM2.5.