Population Coverage Research Articles

A randomized controlled study of the effects of targeted health education on uptake of contraceptives among women of reproductive age in Nnewi City, South-East Nigeria.

There is a need for contraception uptake among people to enable them to fulfil their right to determine the timing, number and spacing of their children. In regions with poor contraceptive prevalence rates, lack of effective education has been largely implicated, and Nigeria falls among such regions. Thus, the present study is designed to examine the impact of an educational intervention on uptake of contraceptives among women aged 18-49 years seeking care at the Nnamdi Azikiwe University Teaching Hospital Nnewi. Being an interventional study to underscore the effect of targeted health education on uptake of contraceptives, a randomized controlled trials design was adopted. A total of 275 women were randomly recruited and allocated into two groups-140 in intervention group and 135 in the control group. Data was collected by trained research assistants using a pretested structured interviewer-administered questionnaire and analyzed using Statistical Package for Social Sciences version 25. The level of significance was set at p < 0.05. At baseline, the level of uptake of contraceptives was similar in both the control and the intervention group (control = 2.48 points; intervention = 2.55 points). Overall, there were no statistically discernible differences between the two groups at baseline. The level of awareness and knowledge on contraceptives as well as the uptake of contraceptives significantly increased in both groups at the end of the study period. A statistically significantly higher increase was noted in the intervention group when compared to the control in level of awareness (t = 3.235; p < 0.05) and uptake of contraceptives (t = 2.628; p < 0.05). Significant positive changes in perceptions of contraceptives were observed more among the intervention group when compared to the control. Logistic regression analysis showed uptake of contraceptives was significantly influenced by occupation, monthly income, source of information, time of first use of contraceptives, level of knowledge on contraceptives as well as the targeted educational intervention. The targeted health educational intervention had a significant and positive effect on the level of awareness and uptake of contraceptives, as displayed in the intervention group. A significant and positive change in perception of contraceptives was also noted among the intervention group in almost all the questions. Certain factors were found to significantly impact the uptake of contraceptives. There is a need for studies with longer follow-up to ascertain sustained impact of health education on uptake of contraceptives. Further studies should be carried out in the other facilities in Nnewi to ensure a better coverage and representation of the target population. Finally, related studies should be carried out among men.

Prediction of promiscuous multiepitope-based peptide vaccine against RdRp of rotavirus using immunoinformatics studies.

Rotavirus, a dsRNA virus in the Reoviridae family, shows a segmented genome. The VP1 gene encodes the RNA-dependent RNA polymerase (RdRp). This study aims to develop a multiepitope-based vaccine targeting RdRp using immunoinformatic approaches. In this study, 100 available nucleotide sequences of VP1-Rotavirus belonging to different strains across the world were retrieved from NCBI database. The selected sequences were aligned, and a global consensus sequence was developed by using CLC work bench. The study involved immunoinformatic approaches and molecular docking studies to reveal the promiscuous epitopes that can be eventually used as active vaccine candidates for Rotavirus. In total, 27 highly immunogenic, antigenic, and non-allergenic T-cell and B-cell epitopes were predicted for the Multiepitope vaccine (MEV) against rotavirus. It was also observed that MEV can prove to be effective worldwide due to its high population coverage, demonstrating the consistency of this vaccine. Moreover, there is a high docking interaction and immunological response with a binding score of -50.2 kcal/mol, suggesting the vaccine's efficacy. Toll-like receptors (TLRs) also suggest that the vaccine is physiologically and immunologically effective. Collectively, our data point to an effective MEV against rotavirus that can effectively reduce viral infections and improve the health status worldwide.

The Influence of Self-Media on Mainstream Media News Dissemination in the Perspective of New Media

Abstract In this paper, web crawler technology is used to obtain research data on news dissemination of self media and mainstream media, data cleaning is performed on the initial data through Pandas package, and the processed research data is stored in the database. From the acquired research data of self media and mainstream media news dissemination, the independent variables and dependent variables are determined to complete the construction of linear regression model of mainstream media news dissemination, and the influence of self media on mainstream media news dissemination is judged by calculating the correlation coefficients of the linear regression model. The results show that compared with X1, X3 (Bate=0.223, p&lt;0.01) and X7 (Bate=−0.016, p&lt;0.01), have a significant positive effect on the overall communication effect of mainstream media, indicating that the comprehensive population coverage and communication speed of self media undoubtedly bring considerable influence on the news dissemination of mainstream media. This study hopes to provide theoretical support for the research of related workers. It significantly promotes the joint development of self media and mainstream media news dissemination.

Consequences of geographical accessibility to post-exposure treatment for rabies and snakebite in Africa: a mini review.

Rabies and snakebite envenoming are two zoonotic neglected tropical diseases (NTDs) transmitted to humans by animal bites, causing each year around 179,000 deaths and are most prevalent in Asia and Africa. Improving geographical accessibility to treatment is crucial in reducing the time from bite to treatment. This mini review aims to identify and synthesize recent studies on the consequences of distance and travel time on the victims of these diseases in African countries, in order to discuss potential joint approaches for health system strengthening targeting both diseases. A literature review was conducted separately for each disease using Pubmed, Google Scholar, and snowball searching. Eligible studies, published between 2017 and 2022, had to discuss any aspect linked to geographical accessibility to treatments for either disease in Africa. Twenty-two articles (8 on snakebite and 14 on rabies) were eligible for data extraction. No study targeted both diseases. Identified consequences of low accessibility to treatment were classified into 6 categories: (1) Delay to treatment; (2) Outcome; (3) Financial impacts; (4) Under-reporting; (5) Compliance to treatment, and (6) Visits to traditional healers. Geographical access to treatment significantly influences the burden of rabies and snakebite in Africa. In line with WHO's call for integrating approaches among NTDs, there are opportunities to model disease hotspots, assess population coverage, and optimize geographic access to care for both diseases, possibly jointly. This could enhance the management of these NTDs and contribute to achieving the global snakebite and rabies roadmaps by 2030.

Tendência de internações por condições sensíveis à atenção primária em Pelotas, Brasil, de 2000 a 2021

Abstract This article aims to describe the characteristics of hospitalizations for ambulatory care sensitive conditions (HACSC) in the municipality of Pelotas regarding occurrence by sex, age group and main causes in the period from 2000 to 2021. Additionally, a trend analysis of the HACSC in the municipality was carried out, comparing it with the rest of Rio Grande do Sul, its association with public expenditure per capita on health and with the population coverage of FHS. Ecological study using the ambulatory care sensitive conditions list from the Ministry of Health available in the Hospital Information System of the Unified Health System. Information on health expenditure was obtained from the Public Health Budget Information System. FHS coverage was available at the Primary Care Department. A decrease in HACSC was found in Pelotas and in the rest of the state. HACSC were more frequent in people aged 60 years or older. The main cause of hospitalization was heart failure. In Pelotas, FHS coverage and health expenditure were associated with HACSC. Despite the measures applied from 2017, policies implemented previously, the increase in health spending and the expansion of coverage may have influenced the decrease in HACSC.

Tobacco 21 Laws and Youth Tobacco Use: The Role of Policy Attributes.

Objectives. To estimate Tobacco-21 policies' relationships to 18- to 20 year-old youth cigarette, cigar, and electronic nicotine delivery system (ENDS) use, and to test for effect modification by policy attributes. Methods. In fall 2022, we used Tobacco 21 Population Coverage Database data to calculate the percentage of state residents covered by state or local Tobacco 21 (T21) laws monthly through June 2020. Matching T21 coverage to Population Assessment of Tobacco and Health and Behavioral Risk Factor Surveillance System data, we used 2-way fixed effect analyses to assess the relationship between T21 laws and 18- to 20-year-old youth cigarette, cigar, and ENDS use, and tested for differences by policy attributes: possession, use, or purchase (PUP) penalties, retailer noncompliance penalties, and compliance check requirements. Results. Increased T21 exposure yielded significant reductions in cigarette and cigar use, as well as in ENDS use, when accounting for policy attributes. These effects were dampened in T21 laws with PUP penalties relative to those without. Conclusions. Tobacco-21 laws yield reductions in 18- to 20-year-old youth cigarette, cigar, and ENDS use, with dampened effects when policies include PUP penalties. Public Health Implications. State policymakers should consider implementing T21 laws without PUP penalties to reduce underage nicotine and tobacco use. (Am J Public Health. 2024;114(1):90-97. https://doi.org/10.2105/AJPH.2023.307447).

Allele Frequency Net Database.

The allele frequency net database (AFND, http://www.allelefrequencies.net ) is an online web-based repository that contains information on the frequencies of immune-related genes and their corresponding alleles in worldwide human populations. At present, the website contains data from 1784 population samples in more than 14 million individuals from 129 countries on the frequency of genes from different polymorphic regions including data for the human leukocyte antigen (HLA) system. In addition, over the last four years, AFND has also incorporated genotype raw data from 85,000 individuals comprising 215 population samples from 39 countries. Moreover, more population data sets containing next generation sequencing data spanning >3 million individuals have been added. This resource has been widely used in a variety of contexts such as histocompatibility, immunology, epidemiology, pharmacogenetics, epitope prediction algorithms for population coverage in vaccine development, population genetics, among many others. In this chapter, we present an update of the most used searching mechanisms as described in a previous volume and some of the latest developments included in AFND.

Immunoinformatics-Based Design of Multi-epitope DNA and mRNA Vaccines Against Zika Virus.

In this study, we used an immunoinformatics approach to predict antigenic epitopes of Zika virus (ZIKV) proteins to assist in designing a vaccine antigen against ZIKV. We performed the prediction of CD8+ T-lymphocyte and antigenic B-cell epitopes of ZIKV proteins. The binding interactions of T-cell epitopes with major histocompatibility complex class I (MHC-I) proteins were assessed. We selected the antigenic, conserved, nontoxic, and immunogenic epitopes, which indicated significant interactions with the human leucocyte antigen (HLA-A and HLA-B) alleles and worldwide population coverage of 76.35%. The predicted epitopes were joined with the help of linkers and an adjuvant. The vaccine antigen was then analyzed through molecular docking with TLR3 and TLR8, and it was in silico cloned in the pVAX1 vector to be used as a DNA vaccine and designed as a mRNA vaccine.

Harnessing bioinformatics for the development of a promising multi-epitope vaccine against tuberculosis: The ZL9810L vaccine

BackgroundTuberculosis (TB) is a global infectious disease posing a serious threat to human health, caused by Mycobacterium tuberculosis (MTB) infection. Although vaccination is the most effective way to prevent and control TB, the existing Bacillus Calmette–Guérin (BCG) vaccine exhibits limited protective efficacy in adult pulmonary TB. Therefore, developing a novel TB vaccine is an urgent need. MethodsThis study designed a novel multi-epitope vaccine (MEV) to combat MTB infection, utilizing bioinformatics and immunoinformatics approaches. Dominant epitopes of helper T lymphocytes (HTL), cytotoxic T lymphocytes (CTL), and B lymphocytes were selected from antigens of MTB to construct the MEV. To enhance the targeting and immunogenicity of the vaccine, toll like receptor (TLR) agonists and PADRE helper peptides were incorporated into the design. In addition, comprehensive predictions have been made on the physicochemical properties, three-dimensional structure, spatial conformation, and molecular interactions with TLRs of MEVs. These evaluations also extend to the exploration of their immunological characteristics. ResultsA novel MEV named ZL9810L was successfully constructed, based on 8 HTL epitopes, 9 CTL epitopes, 10 B lymphocyte epitopes, Toll-like receptor agonists, and auxiliary peptides. Bioinformatics analysis demonstrated that the ZL9810L vaccine has excellent immunogenicity and antigenicity, non-toxicity, and non-sensitization capability, capable of significantly inducing a strong immune response and solubility, with scores of 2.21451, 0.8913, and 0.455 respectively. Moreover, the global population coverage of HLA class I and II allele genes by the ZL9810L vaccine reached 72.89 % and 81.49 %, respectively. Molecular docking analysis indicated good binding capacities of the ZL9810L vaccine to TLR2 and TLR4 receptors, with binding energies of −1028.5 kcal/mol and −1018.8 kcal/mol respectively. Immune simulation predicted that the vaccine could effectively activate innate and adaptive immune cells, including NK cells, macrophages, B lymphocytes, and T lymphocytes. ConclusionAs a candidate for a novel TB vaccine, the ZL9810L vaccine exhibits significant immunogenicity and antigenicity, with no toxicity or allergenicity. The ZL9810L vaccine designed in this study provides a new vaccine candidate for TB control and prevention.

Tetanus-diphtheria vaccine can prime SARS-CoV-2 cross-reactive T cells.

Vaccines containing tetanus-diphtheria antigens have been postulated to induce cross-reactive immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which could protect against coronavirus disease (COVID-19). In this work, we investigated the capacity of Tetanus-diphtheria (Td) vaccine to prime existing T cell immunity to SARS-CoV-2. To that end, we first collected known SARS-CoV-2 specific CD8+ T cell epitopes targeted during the course of SARS-CoV-2 infection in humans and identified as potentially cross-reactive with Td vaccine those sharing similarity with tetanus-diphtheria vaccine antigens, as judged by Levenshtein edit distances (≤ 20% edits per epitope sequence). As a result, we selected 25 potentially cross-reactive SARS-CoV-2 specific CD8+ T cell epitopes with high population coverage that were assembled into a synthetic peptide pool (TDX pool). Using peripheral blood mononuclear cells, we first determined by intracellular IFNγ staining assays existing CD8+ T cell recall responses to the TDX pool and to other peptide pools, including overlapping peptide pools covering SARS-CoV-2 Spike protein and Nucleocapsid phosphoprotein (NP). In the studied subjects, CD8+ T cell recall responses to Spike and TDX peptide pools were dominant and comparable, while recall responses to NP peptide pool were less frequent and weaker. Subsequently, we studied responses to the same peptides using antigen-inexperienced naive T cells primed/stimulated in vitro with Td vaccine. Priming stimulations were carried out by co-culturing naive T cells with autologous irradiated peripheral mononuclear cells in the presence of Td vaccine, IL-2, IL-7 and IL-15. Interestingly, naive CD8+ T cells stimulated/primed with Td vaccine responded strongly and specifically to the TDX pool, not to other SARS-CoV-2 peptide pools. Finally, we show that Td-immunization of C57BL/6J mice elicited T cells cross-reactive with the TDX pool. Collectively, our findings support that tetanus-diphtheria vaccines can prime SARS-CoV-2 cross-reactive T cells and likely contribute to shape the T cell responses to the virus.

Comparative Analysis of Primary and Monovalent Booster SARS-CoV-2 Vaccination Coverage in Adults with and without HIV in Catalonia, Spain.

People with HIV (PWH) may be more susceptible to SARS-CoV-2 infection and worse clinical outcomes. We investigated the disparity in SARS-CoV-2 vaccination coverage between PWH and those without HIV (PWoH) in Catalonia, Spain, assessing primary and monovalent booster vaccination coverage from December 2021 to July 2022. The vaccines administered were BNT162, ChAdOx1-S, mRNA-127, and Ad26.COV2.S. Using a 1:10 ratio of PWH to PWoH based on sex, age, and socioeconomic deprivation, the analysis included 201,630 individuals (183,300 PWoH and 18,330 PWH). Despite a higher prevalence of comorbidities, PWH exhibited lower rates of complete primary vaccination (78.2% vs. 81.8%, p < 0.001) but surpassed PWoH in booster coverage (68.5% vs. 63.1%, p < 0.001). Notably, complete vaccination rates were lower among PWH with CD4 <200 cells/μL, detectable HIV viremia, and migrants compared to PWoH (p < 0.001, all). However, PWH with CD4 < 200 cells/μL received more boosters (p < 0.001). In multivariable logistic regression analysis of the overall population, a prior SARS-CoV-2 diagnosis, HIV status, migrants, and mild-to-severe socioeconomic deprivation were associated with lower primary vaccination coverage, reflecting barriers to healthcare and vaccine access. However, booster vaccination was higher among PWH. Targeted interventions are needed to improve vaccine coverage and address hesitancy in vulnerable populations.

Process evaluations for the scale-up of complex interventions – A scoping review

Background: Process evaluation (PE) is an essential part of testing and adapting complex health interventions (CHIs) and involves evaluating what is implemented (and how), mechanisms of change, and how context affects implementation and health outcomes. To address complex health needs, the focus is on developing new CHIs, rather than on adapting and scaling up existing interventions to promote stronger integration, increased population coverage, or comprehensiveness. Therefore, more attention is needed to process evaluations conducted during the scale-up process as they may have distinctive features, stakeholders, or objectives. We aim to describe the current practice of process evaluations conducted during the scale-up of CHIs.&#x0D; Who is it for? The results of this review are relevant to all stakeholders involved in the scale-up of CHI.&#x0D; Who did you involve and engage with? All authors of this review have been involved in the scale-up of integrated care across multiple contexts.&#x0D; What did you do? Eight primary data sources (PubMed, Embase, CENTRAL, Web of Science, CINAHL, Global Health, Scielo and African Index Medicus) and grey literature were searched. Studies were screened following gold standard review procedures. Study demographics, scale-up dimensions (i.e., integration, coverage, comprehensiveness), features of the complex intervention and PE were charted. Process evaluation was further assessed in terms of stakeholders involved and proposed objectives of the PE. For this review, the United Kingdom Medical Research Council’s (MRC) definition of PE was adjusted in terms of “scale-up” instead of “delivery and functioning.”&#x0D; What results did you get? We identified 10303 unique records of which 34 were included after abstract (n=223) and full-text (n=91) screening. Twenty of the 34 studies were conducted in one or more low-middle income countries (LMICs). Most CHIs studied looked at scale-up of interventions for patient empowerment through digital health, strengthening primary care, or person-centered care models. In the absence of a guiding framework for PEs in the context of scale-up, a variety of other frameworks were often used including the RE-AIM framework (n=5), Consolidated Framework for Implementation Research (n=3), or MRC framework for the PE of CHIs (n=1). Some of these frameworks were subsequently adapted to facilitate unexpected pathways to impact or interactions with contextual factors to emerge as well. Interestingly, in 12 out of 34 studies, beneficiaries (e.g., patients) were not stakeholders in the PE.&#x0D; What is the learning for the international audience? Process evaluations specific to the process of scaling up is advertently different from implementing a CHI. In the absence of a gold standard framework to guide PE during scale-up, the development of such guidance could be considered.&#x0D; What are the next steps? We plan to seek further engagement, including with those funded under the “Global Alliance of Chronic Disease” scale-up program, to determine the value and content of a process evaluation framework for scale-up.&#x0D;

The impact of COVID-19 on healthcare coverage and access in racial and ethnic minority populations in the United States.

This study described spatiotemporal changes in health insurance coverage, healthcare access, and reasons for non-insurance among racial/ethnic minority populations in the United States during the COVID-19 pandemic using four national survey datasets. Getis-Ord Gi* statistic and scan statistics were used to analyze geospatial clusters of health insurance coverage by race/ethnicity. Logistic regression was used to estimate odds of reporting inability to access healthcare across two pandemic time periods by race/ethnicity. Racial/ethnic differences in insurance were observed from 2010 through 2019, with the lowest rates being among Hispanic/Latino, African American, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander populations. Pre-pandemic insurance coverage rates were geographically clustered. The percentage of adults citing change in employment status as the reason for non-insurance increased by about 7% after the start of the pandemic, with a small decrease observed among African American adults. Almost half of adults reported reduced healthcare access in June 2020, with 38.7% attributing reduced access to the pandemic; however, by May 2021, the percent of respondents reporting reduced access for any reason and due to the pandemic fell to 26.9% and 12.7%, respectively. In general, racial/ethnic disparities in health insurance coverage and healthcare access worsened during the pandemic. Although coverage and access improved over time, pre-COVID disparities persisted with African American and Hispanic/Latino populations being the most affected by insurance loss and reduced healthcare access. Cost, unemployment, and eligibility drove non-insurance before and during the pandemic.

Lessons Learned from the COVID-19 Pandemic: Simulation of the Tuberculosis Epidemic as a Function of Population Coverage with Screening

The COVID-19 pandemic has led to the discontinuation of many support programs for tuberculosis patients worldwide, and lower coverage of population with screening for tuberculosis.The objective: To build a model describing the spread of tuberculosis depending on the population coverage with preventive screening, and to obtain a long-term forecast of the infection spread using this model.Subjects and Methods. We analyzed official statistical data on incidence, mortality, preventive screening coverage (PSC), and revalence of sputum smear-positive tuberculosis in the Russian Federation from 2008 to 2021. The model was built up based on fluctuations in those rates in 2020, when there was a sharp reduction in tuberculosis control interventions due to the COVID-19 pandemic. Statistical analysis was performed using the R Software (v.4.2.1).Results. A simple mathematical model describing the dependence of incidence and sputum smear-positive tuberculosis in the current year on sputum smear-positive tuberculosis in the past year and population coverage with preventive screening in the current and past years was built up. The adjusted coefficient of determination of the model (adjusted R-squared) was 0.9969, which meant that the model contained almost no random components. It showed that tuberculosis cases missed due to low population coverage with preventive screening lead to future spread of tuberculous infection and a significant increase in the number of new tuberculosis cases. Comparison of projected rates and data for 2022 demontrated correct formation of models. However, the projected rates were slightly higher than the actual rates for 2022 due to the influence of factors other than the population coverage with preventive screening for tuberculosis.Conclusions. The findings demonstrate the need for mass screening of the population in the context of significant spread of tuberculosis infection for timely detection of patients with sputum smear-positive tuberculosis.

Exploring dengue genome to design effective multi epitope-based peptide vaccine by immunoinformatics approach against all serotypes of dengue virus

Dengue fever is an acute tropical disease that is spread by Aedes species mosquitoes. It is a virus-mediated illness that causes headaches, fever, severe joint and muscle pain, swollen glands (lymphadenopathy), and rashes. Every year, 390 million people around the world suffer from it and ∼20 % die from cases that are left untreated. The virus is transmitted to humans by mosquito bites of infected Aedes species. When it gets into the body, its envelope protein attaches to the host cell surface receptor and initiates the viral infection cycle by the formation of a smooth coat with icosahedral symmetry. Due to its high mutation-prone nature and differences in protein sequences among serotypes, it is difficult to develop a stable vaccine suitable against all serotypes. In this study, a software-based vaccinology approach was used to design a vaccine construct against the envelope protein of all four subtypes of the dengue virus. This construct was designed by joining two epitopes of the protein. One epitope was taken from the envelope protein of DEN-2 which was conserved for DEN-1, DEN-2, and DEN-3, and another epitope from the same protein of DEN-4 serotype as the sequence composition of the protein is slightly different in these two groups of serotypes. Here, firstly 18 epitopes for dengue virus-1, 2, 3, and 12 epitopes for dengue virus-4 were retrieved based on the highest combined score of NetCTL server analysis of human leukocyte antigen (HLA) supertypes. Among them, the epitope MAILGDTAW has shown 100 % conservancy in strains of dengue virus 1, 2, 3, and KLRIKGMSY, TTAKEVALL, TPRSPSVEV, FRKGSSIGK, KTWLVHKQW have shown 100 % conservancy in dengue virus 4. In population coverage analysis, MAILGDTAW has shown 88.63 % and FRKGSSIGK has shown 90.72 % (highest among other DEN-4 epitopes) population coverage of the entire world population. These two epitopes along with their 15-mer extensions (MHCII binding peptides) were found as non-allergen and non-toxic. Finally, the two different 15-mer extensions (to get 100 % sequence conservancy) of the epitope MAILGDTAW and the 15-mer extension of the epitope FRKGSSIGK were put together using an EAAAK linker to construct the multi-epitope vaccine. In-vivo analysis of the proposed vaccine construct would aid in the development of a functional immune response that would eradicate dengue complications worldwide.

Introduction of an Efficient Multiepitopic Vaccine Against Different SARS -CoV -2 Strains: Reverse Vaccinology

Introduction: In recent years, COVID -19 has been recognized as a health threat. Despite vaccination, people still get the disease because the new variants have mutations in their genomes that allow them to bind to host receptors and evade the immune system’s responses. Therefore, the main aim of this study was to use bioinformatics tools to introduce a rapid and practical vaccine to fight against these diverse mutations in different SARS -CoV-2 strains. Method: To epitopes mapping, 32 different spike protein variants were retrieved. We then used the Immune Epitope Database (IEDB), NetCTL, and NetMHCIIpan to predict T and B cell epitopes. The vaccine based on protected epitopes was evaluated in terms of antigenicity, allergenicity, toxicity, solubility, physicochemical properties, population coverage, and secondary structure with relevant servers. Modeling using Robetta and docking with Toll -like receptor (TLR3) were performed using Cluspro, PatchDock, and FireDock, respectively. Results: After detailed evaluations, all the results confirmed the optimal quality of the vaccine. According to further investigations, this structure is similar to native proteins and there is a stable and strong interaction between the vaccine and the receptor. Based on molecular dynamics simulation, structural compactness and stability in binding were also observed. In addition, the immune simulation showed that the vaccine can stimulate immune responses similar to real conditions. Finally, codon optimization and in silico cloning confirmed efficient expression in Escherichia coli . Conclusion: Based on the obtained results, the designed multi -epitope vaccine can serve as a prophylactic candidate against SARS -CoV-2.

CMAIS-WOA: An Improved WOA with Chaotic Mapping and Adaptive Iterative Strategy

This paper proposes an improved whale optimization algorithm with chaotic mapping and adaptive iteration strategy (CMAIS-WOA). This algorithm addresses the issues of the WOA algorithm that is prone to local optimal solutions with low stability. CMAIS-WOA utilizes chaotic mapping to enhance the diversity and coverage of the initial population. Also, it adaptively adjusts the weight values based on the current distribution of whale populations and the fitness of search agents. In addition, CMAIS-WOA uses an improved nonlinear convergence factor to adjust the breadth-first and depth-first search during the optimization process. The performance of the proposed CMAIS-WOA is evaluated by using 13 classical benchmark functions and IEEE CEC2014 test suite. The experimental results show that CMAIS-WOA effectively improves the stability of the optimal solution and helps the algorithm to approach the global optimal solution. The method proposed in this paper contributes to the field of optimization which solves problems more powerfully and efficiently.

Hard-to-reach population groups in administrative sources: main challenges and future work

The paper deals with the concept and the definitions of hard-to-reach groups and the ways of capturing them in administrative sources, providing a detailed discussion of the meaning of hard-to-reach in the context of administrative sources and in relation to the traditional hard-to-count groups in censuses and surveys. The review of country practices shows that hard-to-reach populations in administrative data can be interpreted in different ways and that their definition is dependent on countries’ circumstances, though there are two main reasons for identifying a group as hard-to-reach in administrative sources. One of the interpretations is selecting some groups, typically considered difficult to reach with traditional survey methods (such as homeless, illegal immigrants or indigenous people) and then trying to capture them in registers to overcome the challenges of traditional field collection or to get more complete information. At first glance, administrative data might offer the potential to improve frame coverage for some target populations, but may also lead to other hard-to-reach or “hidden” populations for different population groups. Indeed, another interpretation refers to the incompleteness of registers or linked administrative databases, which makes some groups, such as children or elders, hard-to-reach and hence describe with data, due to time lag in reporting of some events or to other accuracy problems with the source itself. The paper summarizes the experience of national statistical offices in accessing hard-to-reach groups and describes problems and challenges in capturing them. It also proposes further possible work to improve access to hard-to-reach groups using administrative data.

Availability of basic first aid training for cardiac arrest for people with disabilities

Aim. Basic first aid digital training for cardiac arrest opens up opportunities for mass dissemination of knowledge, popularization and motivation of the population to provide assistance, and can also replace the theoretical part of classroom training, reducing the cost of training. However, due to poor design, such training may not be available to people with disabilities (PWD), who constitute a large population of more than one billion potential participants in first aid. The aim was to study the digital accessibility (web accessibility) of massive open online courses in cardiopulmonary resuscitation (CPR) for PWD.Material and methods. A search was carried out for free English-language online courses teaching the principles and rules of providing first aid in cardiac arrest. In addition, the digital content of online courses was assessed for compliance with the international Web Content Accessibility Guidelines (WCAG) 2.1.Results. All basic CPR online courses analyzed (n=28) were characterized by poor web accessibility. For each course, between 26,9% and 51,3% of the WCAG 2.1 guideline success criteria were not met. All courses have web accessibility errors related to text contrast and visual issues, lack of alternative text descriptions for non-text content, missing abbreviations, and web page layout issues that prevent the use of assistive technologies (such as text-to-speech software). Overall, none of the courses meet all of the criteria for the minimum acceptable level of compliance with WCAG 2.1 guidelines. The discovered problems of web accessibility can serve as serious, sometimes insurmountable barriers to the mastery of courses by students (including older people) with visual impairments, hearing loss, motor, cognitive and neurological disorders.Conclusion. All free mass online courses on basic CPR have deficiencies in the availability of digital content, which significantly complicate the learning of educational materials by PWD. The development of uniform guidelines for accessible educational content, along with the intensification of research and the implementation of organizational and methodological measures to ensure the availability of educational resources on first aid for various categories of the population, should help create equal opportunities for quality training. In addition, this should significantly expand the population coverage with training, and increase the frequency and effectiveness of first aid.

Generation of a bank of clinical-grade, HLA-homozygous iPSC lines with high coverage of the Spanish population

BackgroundInduced pluripotent stem cell (iPSC)-derived cell therapies are an interesting new area in the field of regenerative medicine. One of the approaches to decrease the costs of iPSC-derived therapies is the use of allogenic homozygous human leukocyte antigen (HLA)-matched donors to generate iPSC lines and to build a clinical-grade iPSC bank covering a high percentage of the Spanish population.MethodsThe Spanish Stem Cell Transplantation Registry was screened for cord blood units (CBUs) homozygous for the most common HLA-A, HLA-B and HLA-DRB1 haplotypes. Seven donors were selected with haplotypes covering 21.37% of the haplotypes of the Spanish population. CD34-positive hematopoietic progenitors were isolated from the mononuclear cell fraction of frozen cord blood units from each donor by density gradient centrifugation and further by immune magnetic labeling and separation using purification columns. Purified CD34 + cells were reprogrammed to iPSCs by transduction with the CTS CytoTune-iPS 2.1 Sendai Reprogramming Kit.ResultsThe iPSCs generated from the 7 donors were expanded, characterized, banked and registered. Master cell banks (MCBs) and working cell banks (WCBs) from the iPSCs of each donor were produced under GMP conditions in qualified clean rooms.ConclusionsHere, we present the first clinical-grade, iPSC haplobank in Spain made from CD34 + cells from seven cord blood units homozygous for the most common HLA-A, HLA-B and HLA-DRB1 haplotypes within the Spanish population. We describe their generation by transduction with Sendai viral vectors and their GMP-compliant expansion and banking. These haplolines will constitute starting materials for advanced therapy medicinal product development (ATMP).