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Determining the optimal strategies to achieve elimination of transmission for Schistosoma mansoni
No full textBackground
In January 2021, the World Health Organization published the 2021–2030 roadmap for the control of neglected tropical diseases (NTDs). The goal for schistosomiasis is to achieve elimination as a public health problem (EPHP) and elimination of transmission (EOT) in 78 and 25 countries (by 2030), respectively. Mass drug administration (MDA) of praziquantel continues to be the main strategy for control and elimination. However, as there is limited availability of praziquantel, it is important to determine what volume of treatments are required, who should be targeted and how frequently treatment must be administered to eliminate either transmission or morbidity caused by infection in different endemic settings with varied transmission intensities.
Methods and Results
In this paper, we employ two individual-based stochastic models of schistosomiasis transmission developed independently by the Imperial College London (ICL) and University of Oxford (SCHISTOX) to determine the optimal treatment strategies to achieve EOT. We find that treating school-age children (SAC) only is not sufficient to achieve EOT within a feasible time frame, regardless of the transmission setting and observed age–intensity of infection profile. Both models show that community-wide treatment is necessary to interrupt transmission in all endemic settings with low, medium and high pristine transmission intensities.
Conclusions
The required MDA coverage level to achieve either transmission or morbidity elimination depends on the prevalence prior to the start of treatment and the burden of infection in adults. The higher the worm burden in adults, the higher the coverage levels required for this age category through community-wide treatment programmes. Therefore, it is important that intensity and prevalence data are collected in each age category, particularly from SAC and adults, so that the correct coverage level can be calculated and administered
Development and validation of manually modified and supervised machine learning clinical assessment algorithms for malaria in Nigerian children
No full textIt is currently estimated that 67% of malaria deaths occur in children under-five years (WHO, 2020). To improve the identification of children at clinical risk for malaria, the WHO developed community (iCCM) and clinic-based (IMCI) protocols for frontline health workers using paper-based forms or digital mobile health (mHealth) platforms. To investigate improving the accuracy of these point-of-care clinical risk assessment protocols for malaria in febrile children, we embedded a malaria rapid diagnostic test (mRDT) workflow into THINKMD's (IMCI) mHealth clinical risk assessment platform. This allowed us to perform a comparative analysis of THINKMD-generated malaria risk assessments with mRDT truth data to guide modification of THINKMD algorithms, as well as develop new supervised machine learning (ML) malaria risk algorithms. We utilized paired clinical data and malaria risk assessments acquired from over 555 children presenting to five health clinics in Kano, Nigeria to train ML algorithms to identify malaria cases using symptom and location data, as well as confirmatory mRDT results. Supervised ML random forest algorithms were generated using 80% of our field-based data as the ML training set and 20% to test our new ML logic. New ML-based malaria algorithms showed an increased sensitivity and specificity of 60 and 79%, and PPV and NPV of 76 and 65%, respectively over THINKD initial IMCI-based algorithms. These results demonstrate that combining mRDT "truth" data with digital mHealth platform clinical assessments and clinical data can improve identification of children with malaria/non-malaria attributable febrile illnesses
Assessing women’s preferences towards tests that may reveal uncertain results from prenatal genomic testing: Development of attributes for a discrete choice experiment, using a mixed-methods design
No full textPrenatal DNA tests, such as chromosomal microarray analysis or exome sequencing, increase the likelihood of receiving a diagnosis when fetal structural anomalies are identified. However, some parents will receive uncertain results such as variants of uncertain significance and secondary findings. We aimed to develop a set of attributes and associated levels for a discrete-choice experiment (DCE) that will examine parents’ preferences for tests that may reveal uncertain test results. A two phase mixed-methods approach was used to develop attributes for the DCE. In Phase 1, a “long list” of candidate attributes were identified via two approaches: 1) a systematic review of the literature around parental experiences of uncertainty following prenatal testing; 2) 16 semi-structured interviews with parents who had experienced uncertainty during pregnancy and 25 health professionals who return uncertain prenatal results. In Phase 2, a quantitative scoring exercise with parents prioritised the candidate attributes. Clinically appropriate levels for each attribute were then developed. A final set of five attributes and levels were identified: likelihood of getting a result, reporting of variants of uncertain significance, reporting of secondary findings, time taken to receive results, and who tells you about your result. These attributes will be used in an international DCE study to investigate preferences and differences across countries. This research will inform best practice for professionals supporting parents to manage uncertainty in the prenatal setting
Comment on “The influence of juvenile dinosaurs on community structure and diversity”
No full textSchroeder et al. (Reports, 26 February 2021, p. 941) reported a size gap among predatory dinosaur species. We argue that the supporting dataset is skewed toward Late Cretaceous North America and that the gap was likely absent during other intervals in most geographic regions. We urge broader consideration of this hypothesis, with quantitative evaluation of preservational and dataset biases
Double lockdown: the effects of digital exclusion on undocumented immigrants during the COVID-19 pandemic
No full text The COVID-19 pandemic shifted many activities online. However, there is little research on the digital inclusion of undocumented immigrants and their experience of the pandemic in the United States. We conducted 32 interviews with undocumented Latino immigrants in the United States to examine how digital technologies mediated their experiences of the pandemic. We find that undocumented immigrants (1) face barriers to telehealth services, (2) are at high risk of COVID-19 misinformation, (3) experience difficulties in assessing privacy risks, and (4) experienced heterogeneous outcomes of technology use during the pandemic. Our analysis shows that digital technologies both supported and further marginalized undocumented immigrants during the pandemic. Future research on the digital inclusion of vulnerable populations should pay particular attention to the interaction between their underlying vulnerabilities, on one hand, and attitudes, uses, and outcomes associated with technology, on the other. </jats:p
Τα Γλυπτά του Παρθενώνα
Full text linkΣχέδιο προετοιμασίας ανεξάρτητης επίσκεψης στο Μουσείο Ακρόπολης με θέμα: "Τα Γλυπτά του Παρθενώνα
Α Greek Temple...for kids!
No full textΤο εκπαιδευτικό έντυπο με τίτλο «Ένας αρχαίος ναός … για παιδιά» απευθύνεται σε παιδιά από 9 ετών και παρουσιάζει με κατανοητό κι ευχάριστο τρόπο το θέμα της αρχαίας ελληνικής αρχιτεκτονικής. Τα παιδιά ανακαλύπτουν τη λειτουργία ενός αρχαίου ελληνικού ναού αλλά και τη διαδικασία του σχεδιασμού, της κατασκευής και της διακόσμησής του ώστε οι άνθρωποι να προσφέρουν ένα τέλειο αφιέρωμα στους θεούς τους.The educational booklet “A Greek temple…for kids” is addressed to children from 9 years old and presents in a comprehensible and pleasant way the subject of the ancient Greek architecture. Children discover how the ancient temples functioned but also how they were designed, built and decorated so that people could offer a perfect dedication to their gods
Let's learn, play and create!
No full textΠεριλαμβάνει τρεις εκπαιδευτικές ενότητες που απευθύνονται σε παιδιά και γονείς αλλά και σε σχολικές ομάδες που έχουν τη διάθεση να μάθουν, να παίξουν και να δημιουργήσουν έργα αντλώντας έμπνευση από τα μνημεία της Ακρόπολης. Η πρώτη ενότητα έχει τίτλο: «Φάτνωμα! Τι περίεργη λέξη;», η δεύτερη «Κίονες και κιονόκρανα! Σημαντικά για τη στήριξη αλλά και για τη μορφή του κτηρίου» και η τρίτη "Και επάνω από τους κίονες, τι;". Τα έργα των παιδιών αναρτώνται στην ψηφιακή έκθεση της δράσης.It includes three educational units that are addressed to children and parents as well as schoolgroups that want to learn, play and create their own works of art getting inspired by the Acropolis monuments