Stratified Design Research Articles

Prevalence and risk factors for hepatitis E virus infection in blood donors: a nationwide survey in Italy, 2017 to 2019.

BackgroundIn high-income countries, hepatitis E virus (HEV) infection is mainly a zoonosis. However, it is also transfusion-transmissible and some countries, but not Italy, have introduced HEV screening for blood donations.AimWe assessed HEV infection prevalence and risk factors in a nationwide sample of Italian blood donors.MethodsWe selected 107 blood establishments (BE) distributed in the 20 Italian regions by a stratified two-stage design and invited them to participate in the study. Donors were tested for anti-HEV IgG and IgM and HEV RNA. Sociodemographic data and risk factors were collected through a questionnaire.ResultsOverall, 60 BE from 60 provinces in 19 Italian regions joined the study. We assessed HEV markers in 7,172 blood donors, of whom 6,235 completed the questionnaire. Overall crude and adjusted anti-HEV IgG prevalences were 8.3% and 5.5%, respectively. Overall anti-HEV IgM prevalence was 0.5%, while no blood donor was HEV RNA-positive. Anti-HEV IgG prevalence varied widely among regions (range: 1.3%–27.20%) and hyperendemic prevalences (> 40%) were detected in some provinces in two regions. Older age (AOR = 1.81; 95% CI: 1.36–2.41), foreign nationality (AOR = 2.77; 95% CI: 1.06–7.24), eating raw pork liver sausages (AOR = 2.23; 95% CI: 1.55–3.20) and raw homemade sausages (AOR = 3.63; 95% CI: 2.50–5.24) were independent infection predictors.ConclusionItalian blood donors showed a low to moderate HEV seroprevalence. High levels in some regions and/or provinces were mainly attributable to eating habits. Prevention should include avoiding consumption of raw or undercooked meat and safe production of commercial pork products.

Efficacy of Qizi Yusi Pill on Pregnancy Outcomes in Women of Advanced Reproductive Age: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.

To evalvate efficacy of Qizi Yusi Pills (QYP), a Chinese medicine compound preparation, on in vitro fertilization-embryo transfer (IVF-ET) in women of advanced reproductive age. This multicenter, randomized, double-blind, placebo-controlled trial was conducted from June 2018 to October 2019. A total of 124 patients were randomly allocated to either the QYP group or the placebo group using a stratified block randomization design, with 62 patients in each group. All patients completed controlled ovarian stimulation using a standard gonadotropin-releasing hormone agonist (GnRH-a) long protocol. As the QYP group, QYP was administered while the control group received placebo. QYP and placebo were administered for a total of 24 to 30 days from the day of GnRH-a pituitary downregulation to transvaginal oocyte retrieval. Both medications were taken orally at doses of 10 g three times each day. The primary outcome was cumulative pregnancy rate, and the secondary outcomes were periodic medication, follicular status, serum hormone and endometrial receptivity. Follow-up continued until 4 weeks after delivery. Maternal and neonatal complications, such as gestational diabetes, were also observed. Overall, 119 patients completed the study, 60 in the QYP group and 59 in the placebo group. Per protocol (PP) analysis revealed that 6-month cumulative pregnancy rate in the QYP group was significantly higher than that in the placebo group [43.33% (26/60) vs. 25.42% (15/59), P=0.040). Additionally, more oocytes were retrieved from the QYP group than those from the placebo group (8.95 ± 3.12 vs. 7.85 ± 1.91, P=0.022). Moreover, the endometrial thickness of HCG day in the QYP group was significantly higher than that in the placebo group (11.78 ± 2.27 mm vs. 10.68 ± 2.07 mm, P=0.012). Maternal and neonatal complications between the two groups were not significantly different (P>0.05). Intention-to-treat analysis was in line with PP results. QYP can enhance ovarian reserve capacity and ovarian response, and possibly promote endometrial receptivity. QYP effectively improves cumulative pregnancy rates in older patients (⩾35 years) undergoing IVF-ET. (Registration No. ChiCTR1800014427).

Preventing erosion of oral polio vaccine acceptance: A role for vaccinator visits and social norms

BackgroundWith continued challenges to the timeline for polio transmission interruption in Pakistan, including COVID-19, there is a risk of oral polio vaccine campaign fatigue among caregivers of young children. Renewed efforts to minimize oral polio vaccine acceptance erosion may be needed. This study examines the possible role of social norms in protecting against acceptance erosion and the role of vaccinators in promoting these social norms. MethodsData were analyzed from a poll conducted by local interview teams between February 23 and April 5, 2016, among 4,070 parents and other caregivers of children under age 5 living in areas at high-risk for polio transmission in Pakistan. The sample was drawn via a stratified multistage cluster design utilizing random route methods at the household level. We calculated the prevalence of subjective and descriptive social norms around vaccine acceptance; vaccine acceptance and commitment to vaccinate in future; and experiences and views of polio vaccinators across the population. We examined the relationship between these social norms and vaccination behaviors as well as the relationship between experiences with and views of vaccinators and social norms using uncontrolled comparisons (t-tests of proportion) and logistic repressions to control for demographics. ResultsBoth descriptive and subjective positive social norms were associated with vaccine acceptance and future commitment. Positive experiences with and views of vaccinators (trust, perceived technical knowledge, compassion, and overall pleasantness of the interaction) were associated with both descriptive and subjective positive social norms. ConclusionsThese data support the idea that positive social norms could be protective against erosion of oral polio vaccine acceptance and that positive experiences with, and views of, vaccinators could help promote these positive social norms. Creative community engagement efforts may be able to leverage positive experiences with vaccinators to help foster social norms and protect against the risk of acceptance erosion.

Race, the Vaginal Microbiome, and Spontaneous Preterm Birth.

ABSTRACTPrevious studies have investigated the associations between the vaginal microbiome and preterm birth, with the aim of determining whether differences in community patterns meaningfully alter risk and could therefore be the target of intervention. We report on vaginal microbial analysis of a nested case-control subset of the Pregnancy, Infection, and Nutrition (PIN) Study, including 464 White women (375 term birth and 89 spontaneous preterm birth, sPTB) and 360 Black women (276 term birth and 84 sPTB). We found that the microbiome of Black women has higher alpha-diversity, higher abundance of Lactobacillus iners, and lower abundance of Lactobacillus crispatus. However, among women who douche, there were no significant differences in microbiome by race. The sPTB-associated microbiome exhibited a lower abundance of L. crispatus, while alpha diversity and L. iners were not significantly associated with sPTB. For each order of magnitude increase in the normalized relative abundance of L. crispatus, multivariable adjusted odds of sPTB decreased by approximately 20% (odds ratio, 0.81; 95% confidence interval, 0.70, 0.94). When we considered the impact of douching, associations between the microbiome and sPTB were limited to women who do not douche. We also observed strong intercorrelations between a range of maternal factors, including poverty, education, marital status, age, douching, and race, with microbiome effect sizes in the range of 1.8 to 5.2% in univariate models. Therefore, race may simply be a proxy for other socially driven factors that differentiate microbiome community structures. Future work will continue to refine reliable microbial biomarkers for preterm birth across diverse cohorts.IMPORTANCE Approximately 10% of all pregnancies in the United States end in preterm birth, and over 14% of pregnancies end in preterm birth among Black women. Knowledge on the associations between vaginal microbiome and preterm birth is important for understanding the potential cause and assessing risk of preterm birth. Our study is one of the largest studies performed to date to investigate the associations between vaginal microbiome and spontaneous preterm birth (sPTB), with stratified design for Black and White women. We found that the vaginal microbiome was different between Black and White women. The vaginal microbiome was associated with sPTB, and a lower abundance of L. crispatus increased the risk of sPTB independent of racial differences in microbial community structures. Furthermore, we also found that vaginal douching obscured the associations between vaginal microbiome, race, and preterm birth, suggesting that vaginal douching is an important factor to consider in future studies.

A comparison of monitoring designs to assess wildlife community parameters across spatial scales.

Dedicated long-term monitoring at appropriate spatial and temporal scales is necessary to understand biodiversity losses and develop effective conservation plans. Wildlife monitoring is often achieved by obtaining data at a combination of spatial scales, ranging from local to broad, to understand the status, trends, and drivers of individual species or whole communities and their dynamics. However, limited resources for monitoring necessitates tradeoffs in the scope and scale of data collection. Careful consideration of the spatial and temporal allocation of finite sampling effort is crucial for monitoring programs that span multiple spatial scales. Here we evaluate the ability of five monitoring designs-stratified random, weighted effort, indicator unit, rotating panel, and split panel-to recover parameter values that describe the status (occupancy), trends (change in occupancy), and drivers (spatially varying covariate and an autologistic term) of wildlife communities at two spatial scales. Using an amphibian monitoring program that spans a network of US national parks as a motivating example, we conducted a simulation study for a regional community occupancy sampling program to compare the monitoring designs across varying levels of sampling effort (ranging from 10% to 50%). We found that the stratified random design outperformed the other designs for most parameters of interest at both scales and was thus generally preferable in balancing the estimation of status, trends, and drivers across scales. However, we found that other designs had improved performance in specific situations. For example, the rotating panel design performed best at estimating spatial drivers at a regional level. Thus, our results highlight the nuanced scenarios in which various design strategies may be preferred and offer guidance as to how managers can balance common tradeoffs in large-scale and long-term monitoring programs in terms of the specific knowledge gained. Monitoring designs that improve accuracy in parameter estimates are needed to guide conservation policy and management decisions in the face of broad-scale environmental challenges, but the preferred design is sensitive to the specific objectives of a monitoring program.

An OECD TG 428 study ring trial with 14C-Caffeine demonstrating repeatability and robustness of the dermal absorption in vitro method

The dermal absorption potential of 14C-Caffeine applied as a 4 mg/mL concentration (10 μL/cm2 finite dose) was investigated in six laboratories under Good Laboratory Practice conditions using an OECD TG 428-compliant in vitro assay with flow-through cells and split-thickness human skin. Potential sources of variation were reduced by a standardized protocol, test item and skin source. Particularly, skin samples from same donors were distributed over two repeats and between labs in a non-random, stratified design. Very similar recovery was achieved in the various assay compartments between laboratories, repeats and donors, demonstrating that the assay can be robustly and reliably performed. The absorption in one laboratory was 5-fold higher than in the others. This did not clearly correlate with skin integrity parameters but might be associated with an accidental COVID-19 pandemic-related interruption in sample shipment. It is possible that other factors may affect dermal absorption variation not routinely assessed or considered in the current method. The mean receptor fluid recovery, potential absorption (recovery in receptor fluid and skin except tape strips 1 and 2) and mass balance of caffeine was 6.99%, 7.14% and 99.13%, respectively, across all and 3.87%, 3.96% and 99.00% in the subset of five laboratories.

Stratified Design Strategy of Mathematics Homework in Primary School under Core Literacy

Stratified Design Strategy of Mathematics Homework in Primary School under Core Literacy

Short-term effects of exposure to ambient PM1, PM2.5, and PM10 on ischemic and hemorrhagic stroke incidence in Shandong Province, China

BackgroundShort-term exposure to ambient PM2.5 and PM10 is associated with increased risk of mortality and hospital admissions for stroke. However, there is less evidence regarding the effect of exposure to PM1 on stroke incidence. We estimated the incidence risk of stroke and the attributable fractions related to short-term exposure to ambient PM1, PM2.5 and PM10 in China. MethodsCounty-specific incidence of stroke was obtained from health statistics in years 2014–2019. We linked county-level mean daily concentrations of PM1, PM2.5 and PM10 with stroke incidence. We used the time stratified case-crossover design to estimate the associations between stroke incidence and exposure to PM1, PM2.5 and PM10. We also estimated the disease burden fractions attributable to PM1, PM2.5, and PM10. ResultsThe study included a total of 2,193,954 stroke, from which 1,861,331 were ischemic and 332,623 were hemorrhagic stroke. PM1, PM2.5, and PM10 levels were associated with increased risks of total stroke and ischemic stroke at when assessing the associations in exposure at lag0−4 days. The increase of 10 μg/m3 in PM1, PM2.5, and PM10 was associated with total stroke, and the relative risks were 1.012 (95% confidence interval: 1.008, 1.015), 1.006 (1.004, 1.007) and 1.003 (1.002, 1.004), while the associations with ischemic stroke were 1.013 (1.010, 1.017), 1.006 (1.005, 1.008) and 1.003 (1.002, 1.004), respectively. There was no significant association between PM and risk of hemorrhagic stroke. The attributable fractions of total stroke were 6.9% (5.1%, 8.5%), 5.6% (4.2%, 6.8%) and 5.6% (3.9%, 7.1%) for PM1, PM2.5, and PM10, respectively. ConclusionsPM1 showed a stronger association with stroke, with a larger attributable fraction of outcomes, than PM2.5 and PM10. Clean air policies should target the whole scope of PM, including PM1.

Generating unbiased estimates of burrowing seabird populations

Maximising survey efficiency can help reduce the tradeoff between spending limited conservation resources on identifying population changes and responding to those changes through management. Burrow‐nesting seabirds are particularly challenging to survey because nests cannot be counted directly. We evaluated a stratified random survey design for generating unbiased population estimates simultaneously for four petrel species nesting on Macquarie Island, Australia, where the survey cue, burrow entrances, is similar for all species. We also compared the use of design‐based and model‐based analyses for minimising uncertainty in estimates. We recorded 2845 Antarctic prion burrows, 306 white‐headed petrel burrows and two blue petrel burrows while distance‐sampling along 154 km of transects. For blue petrels and grey petrels, we completed nocturnal searches along a further 71 km and searched 249 km of tracks during follow‐up ground searches. We failed to generate unbiased population estimates for two rare and localised species, blue and grey petrels, from our stratified random survey. Only for the most widespread and abundant species, Antarctic prion, did the estimate have reasonable power to detect a rapid population change. Model‐based analyses of the stratified random survey data did not improve upon traditional design‐based analyses in terms of uncertainty in population estimates, but they did provide useful spatial representation of current populations. Models that used the targeted survey data did not reflect current population sizes and distributions of the two rare and localised species. We found that when species ecologies, distributions and abundances vary, a multi‐method approach to surveys is needed. Species with low abundance that occur patchily across large islands are likely to be best estimated using targeted surveys, whereas widespread and abundant species can be accurately and precisely estimated from randomised surveys using informative model‐based analyses.

Individual and community-level factors associated with animal source food consumption among children aged 6-23 months in Ethiopia: Multilevel mixed effects logistic regression model.

Diversified diet in childhood has irreplaceable role for optimal growth. However, multi-level factors related to low animal source food consumption among children were poorly understood in Ethiopia, where such evidences are needed for decision making. To investigate the magnitude and individual- and community-level predictors of animal source food (ASF) consumption among children aged 6-23 months in Ethiopia. We utilized a cross-sectional pooled data from 2016/19 Ethiopia Demographic and Health Surveys. A stratified two-stage cluster design was employed to select households with survey weights were applied to account for complex sample design. We fitted mixed-effects logit regression models on 4,423 children nested within 645 clusters. The fixed effect models were fitted and expressed as adjusted odds ratio with their 95% confidence intervals and measures of variation were explained by intra-class correlation coefficients, median odds ratio and proportional change in variance. The deviance information criterion and Akaike information Criterion were used as model fitness criteria. in Ethiopia, only 22.7% (20.5%-23.9%) of children aged 6-23 months consumed ASF. Younger children aged 6-8 months (AOR = 3.1; 95%CI: 2.4-4.1), home delivered children (AOR = 1.8; 1.4-2.3), from low socioeconomic class (AOR = 2.43; 1.7-3.5); low educational level of mothers (AOR = 1.9; 95%CI: 1.48-2.45) and children from multiple risk pregnancy were significant predictors of low animal source consumption at individual level. While children from high community poverty level (AOR = 1.53; 1.2-1.95); rural residence (AOR = 2.2; 95%CI: 1.7-2.8) and pastoralist areas (AOR = 5.4; 3.4-8.5) significantly predict animal source food consumption at community level. About 38% of the variation of ASF consumption is explained by the combined predictors at the individual and community-level while 17.8% of the variation is attributed to differences between clusters. This study illustrates that the current ASF consumption among children is poor and a multiple interacting individual- and community level factors determine ASF consumption. In designing and implementing nutritional interventions addressing diversified diet consumption shall give a due consideration and account for these potential predictors of ASF consumption.

Habitat selection and density of common pheasant (Phasianus colchicus) in Northern Italy: effects of land use cover and landscape configuration

Knowing the ecology of game species is important to define sustainable hunting pressure and to plan management actions aimed to maintain viable populations. Common pheasant (Phasianus colchicus) is one of the main gamebird species in Europe and North America, despite its native range extending from the Caucasus to Eastern China. This research aimed to define the environmental variables shaping the spatial distribution of male pheasants and to estimate their breeding density in an agroecosystem of northern Italy. During the breeding season, 2015, we carried out 372 point counts with unlimited distances, randomly placed following a stratified sampling survey design. The habitat requirements of the pheasant were evaluated following a presence vs. availability approach, using environmental variables related to land use cover and landscape configuration. We built generalized linear models with a binary distribution, selecting variables following an information-theoretic approach. Densities were estimated through both conventional and multiple-covariate distance sampling. We estimated a density of 1.45 males/km2, with 4.26 males/km2 in suitable areas and 0.91 males/km2 in unsuitable ones. We found pheasants in areas with meadows and tree plantations, which were used to find food and refuges from predators and bad weather conditions. Similarly, woodlands have a positive effect on species occurrence, whereas arable lands were avoided, specifically maize and paddy fields. We found little evidence that landscape configuration affects pheasant occurrence. We found pheasants to be negatively affected by the length of edges between woodlands and arable lands, whereas edges between woodlands and grasslands seem to be beneficial for the species. These findings could help landscape and wildlife managers to plan habitat improvement actions useful to maintain self-sustaining populations of this species, by increasing cover of woodlands, meadows, and tree plantations.

Species‐level CWM values mask contrasting intra‐ versus interspecific trait shifts at subtropical forest edges

Altered microclimatic conditions and higher disturbance at forest edges create environmental stress and modify resource gradients from edge to interior, changing the selection pressures acting on individuals. Although community‐weighted trait‐mean (CWM) shifts along edge gradients have been widely documented at the species level, it is unclear how edge effects act at the individual level, and whether the direction of intraspecific trait shifts mirrors that of CWM shifts in response to edge effects. On 20 islands in the Thousand Island Lake, China, we established 484 plots (2 × 2 m) in a stratified random design across distances of 0–128 m from the forest edge. Within each plot, we sampled leaves (n = 34 768) from within and among all 2993 individuals of 68 species and measured five leaf traits (leaf area, LA; specific leaf area, SLA; leaf dry matter content, LDMC; thickness, LT; chlorophyll content, LCC). Using generalized linear mixed models, we found that different leaf traits exhibited contrasting shifts in inter‐ versus intraspecific trait variation in response to edge effects. For SLA, LT and LCC, negative covariance between inter‐ and intraspecific trait shifts resulted in dampening of community‐wide trends compared to CWM response to edge effects. In contrast, the community‐wide trend for LDMC was reinforced due to positive covariance between inter‐ and intraspecific trait shifts, while for LA the direction of covariance shifted from negative to positive on small versus large islands. Together, edge effects alter selection regimes in reassembling plant communities. Predicting the community‐wide consequences depends on the degree to which there is negative versus positive covariance between species sorting and within‐species adaptation. The widely‐used CWM approach can mask contrasting trait selection pressures acting on individuals within local populations. Individual‐level trait variation can improve understanding of community re‐assembly trajectories in response to global environmental change.

Relationship between the distribution of vegetation and the environment in the coastal embryo dunes of Jalisco, México.

BackgroundThe poorly developed soils of the embryo dunes imply little capacity for plant support, however, the adaptation mechanisms of plants respond sensitively to environmental variations, even when these variations are small, which results in a set of specialized habitats and flora that are rarely shared with other terrestrial ecosystems. The coastal dunes of the Mexican Pacific remain vaguely studied, this is why this research explored the relationship between environmental properties and the presence of plant species in the embryo dunes of the coast of Jalisco, Mexico.MethodsTwenty-nine sites were sampled, one or two sites per embryo dune, with a random stratified design. Geomorphological and vegetation data were collected at site. Laboratory determinations included soil color, particle size, organic matter, pH, electrical conductivity, magnetite content, and moisture retention. Statistical analysis included correlation analysis to identify relationships between environmental variables; principal component analysis (PCA) and cluster analysis to group dune sites by environmental properties; canonical correspondence analysis (CCA) to determine a possible significant relationship between the presence of plant species and environmental variables; cluster analysis to group dune sites by presence/absence of plant species and correlate both clusters to validate the relationship between them, the salient aspects of this relationship were described and the spatial distribution of the groups was mapped.ResultsEleven plant species were identified, six of them exclusive to the embryo dunes and the rest ubiquitous. The incipient development of these soils is reflected in a low content of organic matter, silt, clay, and moisture retention, with scattered data on granulometry, electrical conductivity, organic matter, and magnetite. Some significant correlations were found between some environmental properties, and the CCA showed a significant relationship between the presence of plant species and environmental variables (p-value of the Monte Carlo test = 0.026). The cluster analysis of dune sites according to environmental variables and the cluster analysis by presence/absence of plant species produces the formation of five groups of sites with significant environmental differences and five groups of sites with significant floristic differences. A significant connection (r = 0.471, p = 0.01) between the two clustering schemes also evidences the meaningful relationship between the presence of plant species and the environmental characteristics of the embryo dunes of Jalisco, Mexico. Differences in habitat preferences were observed among plant species exclusive to the embryo dunes; thus, Abronia maritima, Uniola pittieri, and Pectis arenaria showed a preference for embryo dunes with poor edaphic conditions, in contrast to Okenia hypogaea, Canavalia rosea, and Scaevola plumieri, which were mostly found in embryo dunes with higher fertility.

Investigating Incidence, Correlates, and Consequences of Child Marriage Among Syrian Refugees Residing in the South of Lebanon: A Cross-Sectional Study

PurposeResearch on child marriage has increased in volume but remains scarce in humanitarian settings. This study aimed to investigate rates, correlates, and consequences of child marriage among Syrian refugees in South Lebanon. MethodsA sample of 1,593 female adolescents and 893 adults was selected using a multistage stratified cluster survey design. We quantified the cumulative incidence of child marriage among age cohorts of female refugees and identified risk factors associated with child marriage using survival methods. We also presented sexual and reproductive health measures among child brides. ResultsWe found evidence that child marriage was widely practiced among adolescent girls, with Kaplan–Meier curves showing that 32.56% of girls aged 10–19 transitioned to marriage by age 17. Although high, this was lower than rates among women aged 25–29 (p < .005), indicating that child marriage was already widely practiced in prewar Syria. Our Cox models indicated that several factors, which mirror drivers of child marriage in stable settings, are associated with hazard of child marriage in this context. We additionally found important sexual and reproductive health gaps among child brides, such as low levels of knowledge of the dangers of early childbearing and closely spaced births as well as high rates of early and multiple births. ConclusionsChild marriage is a pervasive practice among Syrian refugees residing in this setting. Our results suggest that a confluence of factors at different levels of the social ecology increase refugee girls’ vulnerability to child marriage. They also demonstrate the pressing need for interventions that target refugee child brides.

Blood transcriptome profiling identifies 2 candidate endotypes of atopic dermatitis

Few studies have analyzed the blood transcriptome in atopic dermatitis (AD). We explored blood transcriptomic features of moderate to severe AD. Blood messenger RNA sequencing on 60 adults from the TREATgermany registry including 49 patients before and after dupilumab treatment, as well as from an independent cohort of 31 patients and 43 controls was performed. Patient clustering, differential expression, correlation and coexpression network analysis, and unsupervised learning were conducted. AD patients showed pronounced inflammatory expression signatures with increased myeloid and IL-5-related patterns, and clearly segregated into 2 distinct clusters, with striking differences in particular for transcripts involved in eosinophil signaling. The eosinophil-high endotype showed a more pronounced global dysregulation, a positive correlation between disease activity and signatures related to IL-5 signaling, and strong correlations with several target proteins of antibodies or small molecules under development for AD. In contrast, the eosinophil-low endotype showed little transcriptomic dysregulation and no association between disease activity and gene expression. Clinical improvement with receipt of dupilumab was accompanied by a decrease of innate immune responses and an increase of lymphocyte signatures including B-cell activation and natural killer cell composition and/or function. The proportion of super responders was higher in the eosinophil-low endotype (32% vs 11%). Continued downregulation of IL18RAP, IFNG, and granzyme Ain the eosinophil-high endotype suggests a residual disturbance of natural killer cell function despite clinical improvement. AD can be stratified into eosinophilic and noneosinophilic endotypes; such stratification may be useful when assessing stratified trial designs and treatment strategies.

Recent estimate of Asian elephants in Borneo reveals a smaller population

Asian elephants occurring in northern Borneo form a geographically isolated and genetically distinct population. Of this, the subpopulation of Central Sabah holds the greatest opportunity for long‐term survival, due to a relatively large population size and occurrence over a vast, contiguous and protected habitat. We surveyed this subpopulation in 2015 using advanced methods to obtain a population size estimate. We used the distance‐sampling framework and laid out transects following a stratified random design for counting elephant dung piles; measured dung decay following the ‘retrospective' method; and used Bayesian analysis to estimate dung decay rate and dung pile density. Thus, we estimated a posterior mean dung decay rate of 212 days (95% BCI: 133–319), an overall elephant density of 0.07 per km2(95% BCI: 0.03–0.11) and a population size of 387 elephants (95% BCI: 169–621). These estimates were far lower than the population size of 1132 individuals and density of 1.18 per km2estimated in 2008. It is unlikely that there has been a steep population decline, as there were no drastic land‐use changes between 2008 and 2015, nor were there other identifiable causes for a population decline. Therefore, it appears that the methodological and analytical flaws in the previous estimate are the most plausible reason for this observed difference. Given that the new estimate suggests a much smaller population, it is prudent and precautionary to use the new estimate as the basis for all policy decisions and conservation actions for elephants in Sabah.

Teachers and School Administrators on Public Service Motivation and their Relationship with Work Ethic Attitudes

The aim of this study was to determine the views of primary and secondary school teachers and school administrators from different generations related to public service motivation and work ethics attitudes in terms of various variables and the relationship between public service motivation and work ethics. The research was carried out with single and relational survey models, which are quantitative research methods. A total of 384 teachers and 370 school administrators were included in the two-sample stratified design. Data of the study was collected with the “Public Service Motivation Scale” and “Work Ethics Scale” developed by the researchers. The Public Service Motivation scale consists of three dimensions as "commitment to the public interest", "public awareness" and "responsibility towards society", while the Work Ethics scale consists of two subscales as "study orientation" and "pleasure orientation". According to the results, public school teachers and school administrators have a high level of public service motivation. In the teachers’ and school administrators’ work ethics attitudes, Work-oriented attitudes were more dominant than pleasure-oriented tendencies. Lastly, there is a relationship between the public service motivations of teachers and school administrators and their work ethics attitudes. According to this, as the teachers’ “being work-oriented” values strengthen, their “public service motivation” increases and as their “being pleasure-oriented” values strengthen, their public service motivations decrease. To this end, it would be useful to organize trainings for teachers and administrators to develop their awareness related to the values and obligations of public service. In addition, future study, which examines the views of public and private school teachers comparatively, can shed light on how education, which is a public service, resembles or differs from the principles of the public and private sector, which have their own rules.

Early life migration and undernutrition among circular migrant children: An observational study in the brick kilns of Bihar, India.

BackgroundIndia holds the world's largest burden of chronic and acute child undernutrition. Poverty and systemic inequities are basic causes of undernutrition that also drive households to engage in circular migration for livelihood. Short-term, temporary movement of the whole family, including young children, is common; yet, the nutritional implications of recurrent movements beginning in early life has not been studied. We sought to estimate the association of repeat and early life migration with stunting and wasting outcomes among circular migrant children under three.MethodsUsing a stratified cluster design, we conducted two waves of primary data collection among 2564 randomly selected circular migrant children under three years of age temporarily residing across 1156 brick kilns in Bihar, India. We conducted multilevel modeling to estimate the association of the number of migration episodes and age at first migration with stunting (<-2 standard deviations (SD) height-for-age z scores (HAZ)) and wasting (<-2 SD weight-for-height z-scores (WHZ)) and examined the determinants of nutrition status among migrant children, including diet, illness, food security and the health environment.ResultsThe overall prevalence of stunting was 51.6%. Among children who were either born during migration or first migrated before six months of age, those who experienced multiple episodes of migration were more likely to be stunted compared to those who migrated once (adjusted odds ratio (aOR) = 2.10; 95% confidence interval (CI) = 1.30-3.41). Children were over three times as likely to be wasted in the summer compared to the winter (aOR = 3.28; 95% CI = 2.68-4.01); in the summer, the overall prevalence of wasting was 38.8%. Public health access indicators such as interaction with frontline health workers at the destination was low (5.3%), whereas feeding indicators such as exclusive breastfeeding among 0-5 months was high (81.1%).ConclusionsPolicy efforts should ensure continuity of social protection and welfare entitlements between home and destinations for circular migrant families, with an explicit focus on rural-to-rural movement.

Impact of Covid-19 on Residency Training in Tertiary Health Institutions in Nigeria: A National Survey.

The emergence of COVID-19 had a massive impact on the health system globally. While there are many kinds of literature reporting the impact on postgraduate medical training in other parts of the world, this cannot be said about Nigeria. This was a national cross-sectional study among Resident doctors via an online google form survey for 8-months. Stratified cluster design where the entire country was stratified into the six geopolitical zones, and Tertiary Health Institutions (THI) were randomly selected from each of these zones. Data from the 47-item google form were analysed with Statistical Package for Social Science (SPSS) version 23, and internal consistency reliability was measured by Cronbach's alpha coefficient. Categorical variables were compared using chi-square, and the p-value was <0.05. A total of 239 residents from THI in all six geopolitical zones completed the survey. The mean± standard deviation of the age of respondents, years in practice, and years in residency were 36.3±4.4); 10.2±7.6 years, and 4.2±2.6 years, respectively. The Cronbach's alpha coefficient was 0.95. Less than half had delayed the progression of residency (44.4%). The least strongly positive impacts were related to recruitments (4.2%), laboratory testing (4.2%), and ward rounds (4.2%); and the more strongly positive disruptive impact was on postgraduate seminars (9.2%), research (8.4%), professional examinations (8.0%) and residents' clinical schedules (8.0%). COVID-19 has caused a considerable delay in residents' training programs, and resident doctors have great concerns regarding the pandemic. This impact is perceived by them in almost all aspects of the training.

A field experiment characterizing variable detection rates during plant surveys.

Surveys aimed at finding threatened and invasive species can be challenging due to individual rarity and low and variable individual detection rates. Detection rate in plant surveys typically varies due to differences among observers, among the individual plants being surveyed (targets), and across background environments. Interactions among these 3 components may occur but are rarely estimated due to limited replication and control during data collection. We conducted an experiment to investigate sources of variation in detection of 2 Pilosella species that are invasive and sparsely distributed in the Alpine National Park, Australia. These species are superficially similar in appearance to other yellow‐flowered plants occurring in this landscape. We controlled the presence and color of flowers on target Pilosella plants and controlled their placement in plots, which were selected for their variation in cover of non‐target yellow flowers and dominant vegetation type. Observers mimicked Pilosella surveys in the plots and reported 1 categorical and 4 quantitative indicators of their survey experience level. We applied survival analysis to detection data to model the influence of both controlled and uncontrolled variables on detection rate. Orange‐ and yellow‐flowering Pilosella in grass‐ and heath‐dominated vegetation were detected at a higher rate than nonflowering Pilosella. However, this detection gain diminished as the cover of other co‐occurring yellow‐flowering species increased. Recent experience with Pilosella surveys improved detection rate. Detection experiments are a direct and accessible means of understanding detection processes and interpreting survey data for threatened and invasive species. Our detection findings have been used for survey planning and can inform progress toward eradication. Interaction of target and background characteristics determined detection rate, which enhanced predictions in the Pilosella eradication program and demonstrated the difficulty of transferring detection findings into untested environments.