Primary Units Research Articles

Factors Associated With Home Births in Benin and Mali: Evidence From the Recent Demographic and Health Surveys.

IntroductionIdentifying and understanding the factors associated with homebirths can contribute to improving maternal and child health and achieving the Sustainable Development Goals (SDGs). This study aimed to perform a comparative analysis of the factors associated with homebirths in Benin and Mali.MethodThis study is based on the most recent data from the Demographic Health Surveys conducted in Mali and Benin in 2018. The dependent variable was homebirth, and the explanatory variables were the individual characteristics of the woman, the distance to the health center, the place of residence, the number of prenatal consultations had, the frequency of media exposure, and the use of the Internet. The primary survey unit (PSU) was considered in the analysis to measure the effect of context on the choice of the place of delivery. Further, descriptive statistics and multilevel logistic regression analysis were used in the study.ResultsEducational level was associated with homebirth in Benin and Mali; Women with either no education or primary education are more likely to give birth at home. Women who didn't live close to a health facility were more likely to give birth at home than those who didn't face this problem in both countries. Not making visits for antenatal care (ANC) increases the odds of having a homebirth by 31.3 times (CI = 24.10–40.70) in Benin and 12.91 times (CI = 10.21–16.33) in Mali. Similarly, women who went on 1–2 ANC visits were more likely to give birth at home compared with women who made five or more ANC visits in both countries. The number of children per woman was also a significant factor in both countries. Women who often or regularly paid attention to the media messages were less likely to give birth at home compared with those who did not follow relevant media inputs (aOR = 0.42 [CI = 0.26–0.67] in Benin and aOR = 0.65 [CI = 0.50–0.85] in Mali).ConclusionIncreasing the demand and uptake of women's health services by improving the availability and quality of services and establishing community health centers could help reduce the incidence of homebirths that can be risky and, thus, combat maternal and infant mortality.

Mapping the prevalence of severe acute malnutrition in Papua, Indonesia by using geostatistical models

BackgroundSevere acute malnutrition (SAM) is the most life-threatening form of malnutrition, and in 2019, approximately 14.3 million children under the age of 5 were considered to have SAM. The prevalence of child malnutrition is recorded through large-scale household surveys run at multi-year intervals. However, these surveys are expensive, yield estimates with high levels of aggregation, are run over large time intervals, and may show gaps in area coverage. Geospatial modelling approaches could address some of these challenges by combining geo-located survey data with geospatial data to produce mapped estimates that predict malnutrition risk in both surveyed and non-surveyed areas.MethodsA secondary analysis of cluster-level program evaluation data (n = 123 primary sampling units) was performed to map severe acute malnutrition (SAM) in Papuan children under 2 years (0–23 months) of age with a spatial resolution of 1 × 1 km in Papua, Indonesia. The approach used Bayesian geostatistical modelling techniques and publicly available geospatial data layers.ResultsIn Papua, Indonesia, SAM was predicted in geostatistical models by using six geospatial covariates related primarily to conditions of remoteness and inaccessibility. The predicted 1-km spatial resolution maps of SAM showed substantial spatial variation across the province. By combining the predicted rates of SAM with estimates of the population under 2 years of age, the prevalence of SAM in late 2018 was estimated to be around 15,000 children (95% CI 10,209–26,252). Further tests of the predicted levels suggested that in most areas of Papua, more than 5% of Papuan children under 2 years of age had SAM, while three districts likely had more than 15% of children with SAM.ConclusionsEradication of hunger and malnutrition remains a key development goal, and more spatially detailed data can guide efficient intervention strategies. The application of additional household survey datasets in geostatistical models is one way to improve the monitoring and timely estimation of populations at risk of malnutrition. Importantly, geospatial mapping can yield insights for both surveyed and non-surveyed areas and can be applied in low-income country contexts where data is scarce and data collection is expensive or regions are inaccessible.

2-D Heterometallic Pb-Iodoargentate Framework [PbAg2I6]n with a Diskoid [Pb(18-crown-6)]2+ Linker and Cocatalyst for Synergistically Enhanced Photocatalytic Properties via g-C3N4 Doping.

The heterometallic Pb-iodoargentate hybrid [Pb(18-crown-6)(PbAg2I6)]n (1; 18-crown-6 = 1,4,7,10,13,16-hexaoxacyclooctadecane) was prepared via self-assembly of the tetrahedal AgI4 and octahedral PbI6 primary units using crown ether 18-crown-6 as an organic ligand in DMF solvent. The hybrid heterocomposite cocatalyst based on 1 and graphitic carbon nitride (g-C3N4) was prepared by a facile solvothermal method. In 1, the dimeric units Ag2I6 and Pb2I10 are joined via face sharing, leading to a ternary heterometallic 1-D [PbAg2I62-]n chain containing novel Ag2Pb2I4 cubes. The 1-D chains are joined by the discoid [Pb(18-crown-6)]2+ complex cations, forming the 2-D [Pb(18-crown-6)(PbAg2I6)]n hybrid with the skeleton of [Pb2Ag2I6]n. Compound 1 shows photocatalytic activity in the degradation of MB at room temperature under visible-light irradiation. The photoelectric response measurement showed that the photocurrent of 1 increased from 1.41 to 2.43 μA/cm-2 when g-C3N4 was loaded, indicating that the introduction of a certain amount of g-C3N4 on the surface of 1 improves the separation and migration rate of photoinduced electrons and holes. The 1/g-C3N4 composite showed much higher photocatalytic efficiency in comparison to pristine 1 and g-C3N4 for MB degradation, which suggests the synergistic effect between 1 and g-C3N4 toward visible-light-driven photocatalytic performance. Meanwhile, the 1/g-C3N4 composite exhibited good reusability and stability in the photocatalytic reaction. Free radical quenching experiments showed that the •O2- radical is the main reactive substance over catalyst 1, while h+, •OH, and •O2- species have synergistic effects over the 1/g-C3N4 composite catalyst in the process of photodegradation.

Evaluation of effluent post-treatment by slow filtration and adsorption with activated carbon produced from spent coffee grounds in surfactant removal in sewage treatment

Environmental pollution is a worldwide concern, especially when caused by sewage dumping into water bodies. Many substances are present in industrial or domestic wastewater, causing contamination in superficial water collection. Surfactants stand out for being widely used both industrially and domestically. The use of detergents and many types of surfactants was increased during the Covid-19 pandemic period, a fact observed in the levels in the effluent sample analysis from a Sewage Treatment Plant (STP) - Vila City around 21 and 39 mg L-1 in this period. This work evaluated the surfactant concentrations in the primary and secondary treatment units of the Vila City STP, in the city of Paranavaí-PR.-Brazil. In addition, the use of a post-treatment by slow sand filtration and adsorption by activated carbon produced from spent coffee grounds in the complementary removal of surfactants was proposed. A mixed bed with sand and activated carbon columns was made on a pilot scale, and filtration/adsorption runs were performed simulating slow filtration with rates of approximately 15 m3 m-2 day-1. The parameters used for the efficiency removal evaluation in a pilot plant run were: turbidity (NTU) and surfactant concentrations. The removal of surfactant concentrations was about 9% and 7% in the Upflow Anaerobic Sludge Bed reactors (UASB-RALF) and in the secondary treatment, respectively, at the STP – Vila City units. In the post-treatment proposed by filtration/adsorption, bed columns on a pilot scale plant obtained a reduction of approximately 94% in terms of turbidity (NTU) and 95% in terms of surfactant removal.
 Keywords: activated carbono, coffee poder, effluent, surfactants.

Evaluation of the National Electronic Disease Surveillance System Amid the COVID-19 Pandemic in Elsahel District, Cairo Governorate, Egypt, 2020

Background The Egypt National Disease Surveillance is a routine system established in 2002. The system electronically reports on 41 infectious diseases including COVID-19. Reporting sites include all Egyptian governorates, districts, governmental infectious disease hospitals, and primary health units. Surveillance is essential during the pandemic to detect cases early, describe the epidemiology of health problems, guide priority setting, and plan and evaluate public health policy and strategies. Objective This study aims to evaluate the surveillance system during the pandemic to assess its effectiveness in achieving its objectives and to find and fill the gaps. Methods The evaluation was performed using the Centers for Disease Control and Prevention guidelines. A structured questionnaire was used to evaluate the qualitative attributes including simplicity, flexibility, and acceptability through interviewing surveillance teams at the central level, health directorate, and Sahel district. Quantitative attributes, including completeness, timeliness, and predictive positive value, were performed using COVID-19 surveillance data of Sahel district in March-December 2020. Data were assessed for completeness and accuracy. The usefulness of surveillance was assessed in terms of achieving its objectives and use of data. Results Of 33 respondents, 90% thought that the system was simple, and 77% thought it was acceptable; work overload reduced the acceptability rate. The system is funded by the Ministry of Health and Population and was operational 53% of the time due to connectivity problems. The system was flexible when adapting to include COVID-19 in a short time with minimal cost. It is quite representative, as it covers 60% of the population. Completeness was 82%, positive value predictive was 58%, and data validity was 86%. The median duration between patient admissions and reporting was 2.7 days. Conclusions The evaluation of the Egypt COVID-19 surveillance system indicated that the system partly achieved its objectives in the area of simplicity and flexibility with adequate data quality. There is a need to improve acceptability and timeliness through increasing manpower and to enhance stability through effective connectivity. Expansion of the system to cover all of the Egyptian population is recommended to improve representativeness.

A Hybrid SDN Architecture for IDS Using Bio-Inspired Optimization Techniques

Software-defined networking (SDN) is a networking paradigm of subsequent generation where various network components are used by a centralized controller that allows reliability in network system configuration, execution of policy decisions, and management via a primary programmable network infrastructure unit. SDN is known to deny DDoS attacks despite the default security protocols. State-of-the-art researches have shown that SDN intrusion is possible in diverse layers of its generalized architecture. Addressing this problem, this work presents an optimized intrusion detection system for SDN to mitigate the effect of DDoS attacks. This article’s main contribution comprises the development of a voting strategy-based ensemble classifier, which is established based on bio-inspired particle swarm optimization and salp swarm optimization in the context of optimized classification of DDoS attack-prone traffic SDN. Experimental analysis of the proposed SDN-IDS depicts that the proposed strategy outperforms existing classifiers in terms of accuracy.

Working conditions in primary healthcare during the COVID-19 pandemic: an interview study with physicians in Sweden

ObjectiveThe aim of this study was to explore how the COVID-19 pandemic changed the working conditions of physicians in Swedish primary healthcare.DesignThis is a descriptive, qualitative study with individual semistructured...

Research protocol for a before-after comparison of the Impact of COVID-19 on Physical Activity, sedentary and dietary behaviour of School-going Adolescents in Punjab, India (ICPASA study)

Background: The COVID-19 pandemic has exacerbated the already existing pandemic of physical inactivity. In adolescents, the effect of COVID-19 related governmental measures may be even more pronounced, as they experience school closures, home confinement, social distancing and possible mental health issues as a result. The current study uses the COVID-19 pandemic and associated governmental measures as a natural experiment to understand the impact on the lifestyle of adolescents with relation to physical activity, sedentary and dietary behaviour. We also aim to describe the determinants of change in lifestyle behaviours. Methods/Design: A before-after experimental study design will be followed in which baseline measurements have been undertaken in 2018-19 before the COVID-19 pandemic, and the follow-up measurements will be repeated during the COVID-19 pandemic. Twenty schools of Punjab, India form the primary unit of participation from which 1086 adolescents participated in the study. Validated questionnaires are used to measure physical activity, sedentary behaviour, and dietary behaviour. Additionally, objective measures of physical activity will be performed using accelerometer over a 7-day period on a sub-sample. Body mass index (BMI) and waist circumference will be assessed objectively as a measure of central obesity. Qualitative interviews and focus group discussions will be conducted to have a better understanding for reasons of change in physical activity, sedentary and dietary behaviour or any possible differences between groups. Discussion: The study aims to reveal the impact of COVID-19 related governmental measures on physical activity, sedentary and dietary behaviour of adolescents. It is one of the first studies to show both subjective and objective measures of physical activity levels and sedentary time of school-going adolescents during COVID-19. Due to the mixed method approach we will be able to identify reasons for changes in lifestyle behaviours and possibly find innovative ways of staying physically active during the era of physical distancing.

The methodology of the Italian Health Behaviour in School-aged Children (HBSC) 2018 study and its development for the next round

SummaryIntroductionThe Italian “Health Behaviour in School-aged Children” (HBSC) is a national surveillance system that collects data on health and well-being among adolescents aged 11, 13 and 15 years attending school. It is part of the HBSC Research Network, an international alliance of researchers from 45 European and North American countries and regions started in 1982.MethodsAll countries and regions participating in HBSC must adhere to a common international standard protocol developed and systematically updated by the entire HBSC Network. Data collection occurs every four years. Italy joined the international Network in 2000 and, to date, five waves (in 2002, 2006, 2010, 2014 and 2018) have been carried out. From 2010 the Italian HBSC is representative at regional level and in 2017 the base of the “Surveillance system for risk behaviours in 11-17 year-olds” became part of the Prime Ministerial Decree “Identification of surveillance systems and registries of mortality, tumours and other diseases”. Cluster sampling is used, with school class as primary sampling unit, and two validated questionnaires are used to collect the information.ResultsIn 2018, the Italian HBSC involved 3,608 classes and 58,976 students. The average response rates were 86% of sampled classes and 97% of students achieving a national and regional representative sample for youths of all age groups (19,504 eleven-year-old, 20,554 thirteen-year-old and 18,918 fifteen-year-old). The national coordination group prepared a standardized format for disseminating the results locally and indicating areas for intervention A national report and some articles have been published. The next round, which will take place in the 2021-2022 school year, will also involve a representative sample of students of grade four of secondary schools (adolescents aged 17 years) and use on line questionnaires.ConclusionsOver 3 decades at international and 2 decades at national level 35 years have demonstrated that HBSC methodology and its results are useful for monitoring and deepening the knowledge on the most critical issues of adolescents’ well-being.

Magnetostratigraphy of the Cenozoic Lulehe section in the Qaidam Basin: Implications for the tectonic deformationon the northeastern Tibetan Plateau

<p indent="0mm">The Qaidam Basin is the largest Cenozoic basin located on the northeastern margin of the Tibetan Plateau. The extremely thick Cenozoic sedimentary strata in the basin recorded regional tectonic deformation and associated climate change when the Tibetan Plateau grew outward to its margins. The Cenozoic strata in the Qaidam Basin have been historically subdivided into seven primary stratigraphic units: The Lulehe, Xia Ganchaigou, Shang Ganchaigou, Xia Youshashan, Shang Youshashan, Shizigou, and Qigequan formations. Although many studies have been performed in recent decades, the Qaidam Basin’s inception, development and extinction are still unclear, which requires more work, such as high-resolution magnetostratigraphies. This paper focuses on the Lulehe section, which is the type section of the Lulehe Formation on the northern margin of the Qaidam Basin. The Lulehe section encompasses the Lulehe to Shizigou Formations, and the section was previously estimated to have been initially deposited 52 Ma. We collected paleomagnetic samples from 2041 sites in the Lulehe section to establish magnetic polarity sequences of the section. Constrained by the regional stratigraphic correlation, the recognized magnetic polarity sequences of the Lulehe section were anchored to chrons C12n–C3n.4n (31–5 Ma). Our correlation places the age of the Lulehe Formation at 30.9–23.7 Ma, suggesting that the onset of sediment accumulation in the Qaidam Basin occurred ca. 31 Ma. Overlying the Lulehe Formation, the Xia Ganchaigou Formation was deposited from 23.7 to18.1 Ma, the Shang Ganchaigou Formation spans from 18.1 to 12.9 Ma, the Xia Youshashan Formation spans from 12.9 to 9.9 Ma, the Shang Youshashan Formation spans from 9.9 to 6.9 Ma, and Shizigou Formation is younger than 6.9 Ma. To characterize the sedimentary environments of strata within the Lulehe section, we undertook a detailed stratigraphic analysis. At the bottom of the section, the Lulehe Formation is characterized by alluvial facies (30.9–23 Ma). Upward, the Xia Ganchaigou Formation and Shang Ganchaigou Formation (23–13 Ma) are interpreted to have formed in braided river, meandering river, and lacustrine environments. The sedimentary environments of the Xia Youshashan Formation and Shang Youshasahn Formation are interpreted as delta-fan and braided river facies. An abrupt sedimentary environmental change from lacustrine to delta-fan occurred ca. 13 Ma in the Lulehe section. This lithofacies change in the section may represent tectonic deformation of the South Qilian Shan in the northern Qaidam Basin. From ca. 11 Ma, coarse-grained clasts significantly increased upward in the section, and the sedimentary environment changed to braided river. This phenomenon suggests that the northern Qaidam Basin fault system propagated southward to the region adjacent to the Lulehe section. At the top of the Lulehe section, the Shizigou Formation is characterized by an alluvial fan system. Sediment accumulation rates in the Lulehe section from ca. 31 to ca. 5 Ma were calculated based on the Lulehe magnetostratigraphy. We found that the Lulehe section almost maintained a stable accumulation rate from ca. 31 to ca. 15 Ma with an accumulation rate of 170.6 m/Ma. From ca. 15 Ma, the accumulation rate in the study area increased significantly to 271.2 m/Ma, and the accumulation rate in the section decreased slightly to 204.3 m/Ma from 11 Ma. The variations in the accumulation rate ca. 15 and ca. 11 Ma in the Lulehe section are consistent with the sedimentary environment changes ca. 13 and ca. 11 Ma. The increase in the sedimentation rate ca. 15 Ma again suggests that the northern Qaidam Basin fault system began to be active. The decrease in the sedimentation accumulation rate ca. 11 Ma indicates that the Lulehe section was involved in tectonic deformation related to southward propagation of the northern Qaidam Basin fault system, which may have reduced the accommodation space in the Lulehe region on the northern basin margin. Overall, our results indicate that the Qaidam Basin experienced two-stage tectonic deformation beginning ca. 31 Ma and subsequently ca. 15 Ma. The Oligocene (31 Ma) deformation led to the formation of the Qaidam Basin. The northern basin margin has been intensively deformed by anticlines and synclines as a result of fault thrusting since the middle Miocene.

A Microporous Metal-Organic Framework Incorporating Both Primary and Secondary Building Units for Splitting Alkane Isomers.

We demonstrate the assembly of a mononuclear metal center, a hexanuclear cluster, and a V-shaped, trapezoidal tetracarboxylate linker into a microporous metal-organic framework featuring an unprecedented 3-nodal (4,4,8)-c lyu topology. The compound, HIAM-302, represents the first example that incorporates both a primary building unit and a hexanuclear secondary building unit in one structure, which should be attributed to the desymmetrized geometry of the organic linker. HIAM-302 possesses optimal pore dimensions and can separate monobranched and dibranched alkanes through selective molecular sieving, which is of significant value in the petrochemical industry.

Analyzing the influence of short-term rental platforms on housing affordability in global urban destination neighborhoods

In the last decade, global urban destinations have witnessed an unprecedented wave of tourism growth based on the development of short-term rental platforms (STAP) and of a particular platform, Airbnb. Literature has demonstrated this growth’s influence in different contexts, highlighting its impact on housing markets, mostly at the city level and through correlation or regression analyses. This study goes a step further, focusing on the neighborhood level for the case of Barcelona (Spain) and using k-means clustering. Results show how the concentration of Airbnb listings in “highly touristified” and “trendy” neighborhoods has been associated with an increase in rental prices in these areas. Moreover, the subsequent increase in the demand for tourism-related services in these neighborhoods has led to a displacement of residents to peripheral neighborhoods, which has also put pressure on these areas’ housing prices. These processes have been accompanied by an increasing reaction from local anti-tourism movements. Based on these findings, we suggest that global urban destinations managers need to manage STAP and tourism-related service development not only in relation to the tourism industry but also regarding its impact on the conditions of residents and should consider the neighborhood as a primary management unit when designing the necessary regulations.

Career resilience and self-efficacy of Greek primary school leaders in times of socioeconomic crisis

PurposeThis paper investigates the levels of career resilience and self-efficacy of the principals of primary school units, identifies the relationship between them and determines the effect of the demographic elements of the sample on their career resilience and self-efficacy.Design/methodology/approachThe convenient sample of this study was 165 principals from public schools across the prefecture of Central Macedonia. A total of 422 questionnaires were mailed to all principals of kindergarten and elementary schools, accompanied by a personal letter to inform them about the procedure and the purpose of the survey. A pilot survey took place to check the adequacy of and get feedback on the questionnaire. The questionnaire used in the study consisted of three parts: The Career Resilience Scale (CRS) by Kodama (2015), the Principal Self-Efficacy Scale (PSES) by Tschannen-Moran and Gareis (2004) and demographic questions.FindingsThe results of the survey showed that principals have high levels of career resilience and very high levels of self-efficacy. There are four factors that form the levels of career resilience: (a) problem-solving skills (b) social skills (c) interest in innovation and (d) optimism for the future. Demographic factors play a role in shaping career resilience as they affect two of the four factors. There are two factors that shape levels of self-efficacy: (a) self-efficiency in administration and (b) self-efficiency in moral leadership. Demographic factors play a role in shaping the factor of self-efficacy that refers to administration. Finally, there was a high positive correlation and a causal relationship between career resilience and self-efficacy.Research limitations/implicationsThe convenient sample used in the present study is a limiting factor, as it may not be representative of Greek primary school principals. Also, research is based on self-evaluation questionnaires, which may show a lack of objectivity, as the answers may reflect the personal worldviews of leaders and particular needs of educational institutions (Sarid, 2021). This fact may not allow us to generalize the results.Practical implicationsThe present study showed that resilience and self-efficacy have a causal relationship and that one enhances another, making their relation pivotal for a successful educational leadership. Regarding the professional development of school leaders, educational leadership training programs could be designed and offered by the Greek Ministry of Education (Dexter et al., 2020). Coaching programs and practices that help principals develop social skills, coping mechanisms, emotional capacities and confidence in one's knowledge should be widely introduced. Governments have to take the necessary initiative to ensure that, particularly in adverse contexts, education stimulate and nurture resilience and self-efficacy among citizens, by promoting appropriate lifelong learning programs and by ensuring the continuous training of employees (Renko et al., 2020).Social implicationsCareer resilience and self-efficacy ensures economic prosperity in times of crisis, globalization and rapid technology development and may be the best way to create strong and successful leaders. Coaching programs and practices that help principals develop social skills, coping mechanisms, emotional capacities and confidence in one's knowledge should be widely introduced. The results of the present research could prove helpful in developing strategic plans, building networks between organizations to improve communication and flow of information, through employee exchange programs.Originality/valueThis research, which combined career resilience and self-efficacy, took place for the first time in Greece. The CRS by Kodama (2015) was also used for the first time in Greek population.

Temporal trends in reperfusion therapy for patients with acute ischemic stroke.

ObjectivesTo analyze the temporal trends in thrombolysis rates after implementation of a regional emergency network for acute ischemic stroke (AIS).MethodsWe conducted a retrospective study based on a prospective multicenter observational registry. The AIS benefited from reperfusion therapy included in 1 of the 5 primary stroke units or 1 comprehensive stroke center and 37 emergency departments were included using a standardized case report form. The population covers 3 million inhabitants.ResultsIn total, 32,319 AIS was reported in the regional hospitalization database of which 2215 thrombolyzed AIS patients were included in the registry and enrolled in this study. The annual incidence rate of thrombolysis continuously and significantly increased from 2010 to 2018 (10.2% to 17.3%, P‐trend = 0.0013). The follow‐up of the onset‐to‐door and the door‐to‐needle delays over the study period showed stable rates, as did the all‐cause mortality rate at 3‐months (13.2%).ConclusionAlthough access to stroke thrombolysis has increased linearly since 2010, the 3‐month functional outcome has not evolved as favorably. Further efforts must focus on reducing hospital delays.

Performance Efficiency of Conventional Treatment Plants and Constructed Wetlands towards Reduction of Antibiotic Resistance.

Domestic and industrial wastewater discharges harbor rich bacterial communities, including both pathogenic and commensal organisms that are antibiotic-resistant (AR). AR pathogens pose a potential threat to human and animal health. In wastewater treatment plants (WWTP), bacteria encounter environments suitable for horizontal gene transfer, providing an opportunity for bacterial cells to acquire new antibiotic-resistant genes. With many entry points to environmental components, especially water and soil, WWTPs are considered a critical control point for antibiotic resistance. The primary and secondary units of conventional WWTPs are not designed for the reduction of resistant microbes. Constructed wetlands (CWs) are viable wastewater treatment options with the potential for mitigating AR bacteria, their genes, pathogens, and general pollutants. Encouraging performance for the removal of AR (2–4 logs) has highlighted the applicability of CW on fields. Their low cost of construction, operation and maintenance makes them well suited for applications across the globe, especially in developing and low-income countries. The present review highlights a better understanding of the performance efficiency of conventional treatment plants and CWs for the elimination/reduction of AR from wastewater. They are viable alternatives that can be used for secondary/tertiary treatment or effluent polishing in combination with WWTP or in a decentralized manner.

Evaluation of effectiveness of mass screening for tuberculosis infection in children from 1 to 7 years old in Moscow

The objective: to evaluate effectiveness of mass screening for tuberculosis infection in children aged 1 to 7 years in different periods – before and after the use of tuberculosis recombinant allergen skin test (TRA) in primary health care as an additional diagnostic method.Subjects and Methods. The study was designed as continuous observational prospective-retrospective study. Two different periods were assessed: the first one was 2014-2016 when screening for tuberculosis infection was performed in all children from 1 to 17 years (inclusive) using Mantoux test with 2 TU PPD-L in pediatric primary health care, and then children suspected to have a positive reaction were referred to TB dispensary where they were examined with a skin test with TRA if necessary. The second period was from 2018 to 2020 when children of 1-7 years old were given Mantoux test and if tuberculosis infection was suspected, a skin test with TRA was done both in primary health care network and TB units. In the first 3 years, 1,864,137 children were examined and in the second 3 years, 2,078,800 children from 1 to 7 years old were examined.Results. Among children of 1-7 years old who were screened by two stages (initial Mantoux test, and then in those who had a positive reaction, the TRA test was used), only 10-12% of those referred to a phthisiologist were subject to dispensary follow-up. Thus, with the implementation of the new edict on screening for tuberculosis infection in children with two tests, this proportion has not changed compared to previous years, when screening was carried out only with one Mantoux test. The reason why almost 90% of the children who were referred to TB Dispensary were not subject to dispensary follow-up is the following: children who have had previous conversion of tuberculin tests, along with everyone else are again screened with Mantoux test despite being previously followed up by TB dispensary due to the primary infection.Recommendations:Currently, there is no division of Group VI into Subgroups A, B, C in the dispensary follow up grouping. Why should conversion of Mantoux test reaction from negative into positive not be considered an infection, and the increase in the reaction must be at least 6 mm.Since Order No. 124n of the Russian Ministry of Health allows testing with TRA in the primary health care in case of suspected infection, it is advisable to refer those who have already had this test to a phthisiologist.A child with conversion of Mantoux test should not be re-screened with Mantoux test but the TRA test should be used. If a positive reaction to the TRA test occurs for the first time, it should be considered as conversion of this test, and in this case the child should be examined by computed tomography (CT), and preventive therapy should be prescribed. If in subsequent years the TRA reaction increases by at least 6 mm after previous preventive therapy, the child should be re-referred for CT to rule out the development of active tuberculosis.

Determining the Microbial Source of Methane Production in Anaerobic Digestion Systems Through High-Throughput Sequencing Technology

Anaerobic digestion is widely used to simultaneously generate biogas while treating different organic wastes. It is difficult to determine the source of CH4 from the complex microbial community structure using traditional microbiological pure culture techniques. Therefore, this study aimed to elucidate the microbial source of CH4 in low-temperature anaerobic digestion systems using the recently developed high-throughput sequencing technology. Herein, anaerobic digestion microbes were domesticated at 15°C and then inoculated into pig manure-containing raw materials in a batch anaerobic digester to form a low-temperature anaerobic digestion system with fermentation controlled at 15°C. Several analytical approaches including abiotic factor analysis and biotic factor analysis (high-throughput sequencing) were applied to investigate the abiotic factors, bacterial communities, and archaeal communities in the low-temperature anaerobic digestion system. The results showed that: 1) The anaerobic digestion lasted for 120 days, with 68.65 L total gas production and 31.19 L CH4 production. 2) The relative abundances of the primary and secondary dominant bacterial operational taxonomic units ranged from 8.02 to 22.84% and 5.62–17.09%, respectively, with 99% similarities to Clostridium cellulovorans (a typical cellulose- and hemicellulose-degrading bacterium) and Terrisporobacter petrolearius (a representative fermentation bacterium), respectively. Moreover, the relative abundance of the primary dominant methanogenic archaeal operational taxonomic unit ranged from 1.03 to 16.85%, with 98% similarity to Methanobacterium beijingense, which is a typical hydrogenotropic methanogen. Based on the low-temperature CH4-producing metabolic pathways of bacterial and methanogenic operational taxonomic units, Methanobacterium beijingense was found to be the primary functional microbe for CH4 production in the 15°C anaerobic digestion system.

Mapping of additive and epistatic QTLs linked to seed longevity in bread wheat (Triticum aestivum L.)

Plant genetic resources are stored and regenerated in > 1750 gene banks storing > 7,000,000 accessions. Since seeds are the primary storage units, research on seed longevity is of particular importance. Quantitative trait loci (QTL) analysis of 15 traits related to seed longevity and dormancy using 7584 high-quality SNPs recorded across 2 years and originated from five production years revealed a total of 46 additive QTLs. Exploration of the QTLs with epistatic effect resulted in the detection of 29 pairs of epistatic QTLs. To our information, this is only the second report of epistatic QTLs for seed longevity in bread wheat. We conclude that in addition to dense genetic maps, the epistatic interaction between loci should be considered to capture more variation which remained unnoticed in additive mapping.

Implementing an online program to change benzodiazepine prescription in Portugal: a cluster randomized trial

Background: The excessive prescription of benzodiazepines (BZD) has long been considered a worldwide public health issue. Despite the existence of a large body of literature regarding interventions to change BZD prescription patterns, most fail to report significant or long-term effects. Objective: To study the effect of the implementation of a Digital Behaviour Change Intervention (DBCI) online platform – named ePrimaPrescribe – on the BZD prescription pattern. Secondarily, to determine the effect of the platform implementation on diagnosis registration coded in the same months as BZD prescription and the costs for the NHS with co-payment. Methods: We followed a cluster-randomised design to allocate 18 primary healthcare units, from a region in Portugal. The study included BZD prescriptions from 250 general practitioners (GP) for a period of 12 months before and after intervention implementation. Results: BZD was more frequently prescribed to elders and females. The most frequently prescribed BZD was alprazolam. Most prescribed BZD had a medium half-life. In most analyses, we did not find any significant change in the BZD prescription pattern. Regarding secondary outcomes, the depressive disorder was the first, anxiety disorder the second, and dementia the fifth most frequently registered diagnosis associated with BZD prescription. BZD’s co-payment represented an average expenditure of approximately 1,300 € per unit per month. Conclusion: We could not find any significant difference in the BZD prescription pattern after ePrimaPrescribe implementation. Further work is required to explore the factors influencing resistance to BZD prescription patterns.

Work of a stroke team: experience of transferring ischemic stroke patients from district hospitals to Krasnoyarsk Regional Vascular Center for thrombectomy

Modern high-technology methods for ischemic stroke treatment (systemic thrombolysis, mechanical thrombectomy, thrombaspiration, stenting of cerebral arteries) can improve the rehabilitation potential and survival of patients. Important tasks here are selection for reperfusion and its performance on the greatest possible number of peracute patients. Mechanical thrombectomy combined with systemic thrombolysis is the most effective reperfusion strategy in the therapeutic window, but the availability of endovascular methods is limited to highly specialized centres. One way to solve this problem is to organize effective logistics with stroke patients, which will provide high-tech care for patients living far from large treatment centers due to regulated interaction between institutions at different levels.The aim of the study was to improve emergency interaction related to transfer of peracute stroke patients from primary vascular units and district hospitals of the Krasnoyarsk region to Krasnoyarsk Regional Vascular Center for thrombectomy.