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A paper-based device (PAD) capable of colorimetric detection was developed to determine the presence of glutamate in various food samples. The PAD employs an enzymatic reaction with glutamate followed by an oxidation reaction with N-benzoyl leucomethylene blue (BLMB) in the presence of horseradish peroxidase. The designed PAD consists of a sample introduction zone connected to a channel that transports a sample solution to three detection zones. The detection zones contain pre-deposited reagents: glutamate oxidase, horseradish peroxidase, BLMB, a phosphate buffer, and poly(acrylic acid). The PAD is perpendicularly immersed into a sample solution and bent at a right angle using a 3D-printed holder to allow the sample to simultaneously flow into three different detection zones. When the PAD is immersed into a sample containing glutamate, glutamate oxidase produces hydrogen peroxide, which changes the pale blue color of BLMB to a deep blue color in the presence of horseradish peroxidase. Under the optimum conditions, the calibration curve between the logarithm of the glutamate concentrations and the color intensity was linear within a range of from 5 x 10(-6) mol L-1 to 10(-2) and with a correlation coefficient of 0.994. Using this system, the PAD successfully determined glutamate in soup stocks, sauces, snacks, and tomato juice without the need of complicated sample pretreatment. These results agreed with those of a commercially available glutamate assay kit, which was employed as a certification method (t(stat )= 1.95, t(crit )= 2.57). The developed PAD is simple, easy to fabricate, portable, and could be used outside of equipped laboratories to determine the presence of glutamate in food samples.

Graphical abstract, Highlights • Detection of cytokine storm biomarkers with mobile biosensors. • Immunosensors are made solely of cellulose modified with antibody-decorated nanoparticles. • Turnaround time under 10 min. • Detection of biomarkers in respiratory samples allows monitoring local inflammation. • Compatible with decentralized health care schemes., Decentralizing COVID-19 care reduces contagions and affords a better use of hospital resources. We introduce biosensors aimed at detecting severe cases of COVID-19 in decentralized healthcare settings. They consist of a paper immunosensor interfaced with a smartphone. The immunosensors have been designed to generate intense colorimetric signals when the sample contains ultralow concentrations of IL-6, which has been proposed as a prognosis biomarker of COVID-19. This is achieved by combining a paper-based signal amplification mechanism with polymer-filled reservoirs for dispensing antibody-decorated nanoparticles and a bespoken app for color quantification. With this design we achieved a low limit of detection (LOD) of 10−3 pg mL-1 and semi-quantitative measurements in a wide dynamic range between 10−3 and 102 pg mL-1 in PBS. The assay time is under 10 min. The low LOD allowed us to dilute blood samples and detect IL-6 with an LOD of 1.3 pg mL-1 and a dynamic range up to 102 pg mL-1. Following this protocol, we were able to stratify COVID-19 patients according to different blood levels of IL-6. We also report on the detection of IL-6 in respiratory samples (bronchial aspirate, BAS) from COVID-19 patients. The test could be easily adapted to detect other cytokines such as TNF-α and IL-8 by changing the antibodies decorating the nanoparticles accordingly. The ability of detecting cytokines in blood and respiratory samples paves the way for monitoring local inflammation in the lungs as well as systemic inflammation levels in the body.

In this work, a microfluidic paper-based analytical device (μPAD) was developed for magnesium determination in saliva samples. The idea was to develop a fast and simple method for biological magnesium quantification targeting saliva as an easy to collect and non-invasive alternative to blood or urine samples. The μPAD approach was chosen due to its advantages, namely ideally suited to conduct on-location determinations, and not requiring trained operators or specialized laboratory equipment. The developed μPAD was based on the colorimetric reaction between eriochrome cyanine and magnesium to form an intense orange/reddish colour product. The colour intensity was determined by image processing after digital scanning, made within 10 to 90 min after sample loading. Under optimal conditions, the dynamic concentration range was 82–247 μM, with detection and quantification limits of 62 μM and 81 μM, respectively. The device is stable for up to 3 months when stored in vacuum or in a modified nitrogen atmosphere. An accuracy assessment was made by comparing the results obtained using the developed μPAD with those from atomic absorption spectrometry (AAS). The relative difference between the two sets of results was below 5%.

Objective Communication in healthcare has influenced and been influenced by the COVID-19 pandemic. In this position paper, we share observations based on the latest available evidence and experiential knowledge that have emerged during the pandemic, with a specific focus on policy and practice. Methods This is a position paper that presents observations relating to policy and practice in communication in healthcare related to COVID-19. Results Through our critical observations as experts in the field of healthcare communication, we share our stance how healthcare communication has occured during the pandemic and suggest possible ways of improving policy and professional practice. We make recommendations for policy makers, healthcare providers, and communication experts while also highlighting areas that merit further investigation regarding healthcare communication in times of healthcare crises. Conclusion We have witnessed an upheaval of healthcare practice and the development of policy on-the-run. To ensure that policy and practice are evidence-based, person-centred, more inclusive and equitable, we advocate for critical reflection on this symbiotic relationship between COVID-19 and the central role of communication in healthcare. Practice implications This paper provides a summary of the key areas for development in communication in healthcare during COVID-19. It offers recommendations for improvement and a call to review policies and practice to build resilience and inclusive and equitable responsiveness in communication in healthcare.

A group of senior doctors with vast clinical experience met on 19th July’20 under the aegis of Academy of Advanced Medical Education. The panel looked at Ivermectin, one of the old molecule and evaluated it's use in COVID 19 (Novel Coronavirus Disease 2019) management. After critical panel discussion, all the attending doctors came to a conclusion that Ivermectin can be a potential molecule for prophylaxis and treatment of people infected with Coronavirus, owing to its anti-viral properties coupled with effective cost, availability and good tolerability and safety., Highlights “Ivermectin in the dose of 12 mg BD alone or in combination with other therapy for 5–7 days may be considered as safe therapeutic option for mild moderate or severe cases of Covid-19 infection. It is cost effective especially when the other drugs are very costly & not easily available”.

Summary: The quality of healthcare services and outcomes in the Pacific vary widely, with some countries enjoying some of the world's longest life expectancies, others have high rates of maternal and child mortality and relatively low life expectancy. Nurses and midwives make up more than two thirds of the regional regulated healthcare workforce. This paper argues that if countries are to meet Universal Health Coverage nursing and midwifery leaders need to be explicitly involved in shaping policy at the highest levels of government to optimise individual and community health both now and in the future. Using United Nations 2019 declaration towards building a healthier world, this paper provides a rationale for inclusion of these leaders into national and regional decisionmaking forums related to health policy to provide an informed voice in ministerial deliberations on health policy. We suggest that following several comprehensive regional and global studies, South Pacific Chief Nursing and Midwifery Officer Alliance and the newly developed Pacific Heads of Nurses and Midwifery provide a vehicle for this to occur. As outlined in the WHO Strategic Directions, it is now time to embed Chief Nurses in national and regional health policy development.

Paper Spray (PS) is an ambient ionisation technique that is conceptually simple, economical, direct and versatile. In its simplest form, the procedure for operation relies on the application of an electric potential to a triangular-shaped paper substrate with the addition of an extraction/spray solvent to generate charge droplets, without requiring any pneumatic assistance. Despite its promise and rapidly growing popularity, there are some practical challenges associated with PS implementation with scope to enhance its performance further. One such challenge relates to only a small fraction of the Taylor cone expansion being sampled at the MS inlet. In this work we propose a new arrangement for PS, which retains the inherent advantages of this popular technique without introducing additional variables, by using an ambient ion focusing lens that is held at the same potential as the paper substrate. A thorough investigation, consisting of visual spray inspection, electric field simulations and analytical evaluation, including analysis of paracetamol from saliva, shows that ambient ion focusing can provide up to a 50% improvement in spray stability, 60% increase in signal intensity and a 30% improvement in detection limits for routine paper spray mass spectrometry analysis.

To advance our understanding of the molecular biochemistry of fungi which impact cultural heritage in libraries, museums and archives we investigated the diagnostic capacity of Raman spectroscopy to identify the composition of colored chromophores of fungi on paper. In this study we explored the diagnostic capacity of resonant Raman to distinguish chromophores in fungal filaments stimulated to grow on paper under high humidity with a focus on characterizing chromophores of Alternaria group species. To facilitate molecular analysis, we conducted quantum chemistry calculations of representative metabolites having optical absorption in the ultraviolet–visible spectral range. Comparing theory and experiment we show that fonsecin, erythroglaucin and aurasperone type chromophores occur in mature hyphal filaments with β-carotene dominant in yeast depositions on paper surfaces. Resonant Raman of mature filaments suggests a further contribution of carotenes longer than β-carotene to the spectral signature. Using microscopic resolution, we distinguish rich sets of Raman signatures that we assign to lignin, flavoglaucin, riboflavin, cycloleucomelon(e) and asperyellone molecular components in the spatial regions where filaments initiate from yeast depositions. In such regions, where filament microstructures stimulate development of a mature three-dimensional scaffold, the diversity of Raman resonances confirms a rich biochemistry of the developing structures. The library of computed optical and spectroscopic responses of characteristic fungal chromophores and metabolites presented here is essential for understanding the effect of fungi on a wide range of objects made from paper including books, prints, drawings, watercolors, engravings and even sculptures as well as designing next generation materials based on fungal hyphal mats.

Since Nicolle, Manceaux and Splendore first described Toxoplasma gondii as a parasite of rodents and rabbits in the early 20th century, a diverse and vigorous research community has been built around studying this fascinating intracellular parasite. In addition to its importance as a pathogen of humans, livestock and wildlife, modern researchers are attracted to T. gondii as a facile experimental system to study many aspects of evolutionary biology, cellular biology, host-microbe interactions, and host immunity. For new researchers entering the field, the extensive literature describing the biology of the parasite, and the interactions with its host, can be daunting. In this review, we examine four foundational studies that describe various aspects of T. gondii biology, presenting a 'journal club'-style analysis of each. We have chosen a paper that established the beguiling life cycle of the parasite (Hutchison et al., 1971), a paper that described key features of its cellular biology that the parasite shares with related organisms (Gustafson et al., 1954), a paper that characterised the origin of the unique compartment in which the parasite resides within host cells (Jones and Hirsch, 1972), and a paper that established a key mechanism in the host immune response to parasite infection (Pfefferkorn, 1984). These interesting and far-reaching studies set the stage for subsequent research into numerous facets of parasite biology. As well as providing new researchers with an entry point into the literature surrounding the parasite, revisiting these studies can remind us of the roots of our discipline, how far we have come, and the new directions in which we might head.

Breastfeeding offers one of the most fundamental global health benefits for babies. Breastmilk is lifesaving, providing not only nutrition but immunologic benefits and as such is strongly supported by the World Health Organization and leading healthcare associations worldwide. When the COVID-19 pandemic started in 2020, the impact of the restrictions to prevent the spread of the disease created challenges and questions about provision of safe, quality care, including breastfeeding practices, in a new 'normal' environment. Mothers were temporarily separated from their babies where infection was present or suspected, parents were prevented from being present on neonatal units and vital breastfeeding support was prevented. This discussion paper provides an overview of essential areas of knowledge related to practice for neonatal nurses and midwives who care for breastfeeding mothers and babies, in the context of the COVID-19 pandemic and the latest global guidance. Three areas will be discussed; the protective benefits of breastfeeding, keeping breastfeeding mothers and babies together and supporting mothers to breastfeed their babies. Finally, care recommendations are presented to serve as a summary of key points for application to practice for neonatal nurses and midwives.

During the COVID-19 pandemic, parents with sick or premature babies have faced challenges following admission to a neonatal unit due to the imposed lock-down restrictions on social contact, hospital visitation and the wearing of personal protective equipment. The negative short-term impact on neonatal care in relation to the prevention of close proximity, contact and bonding between parents and babies is potentially significant. However, an interesting finding has been reported of a reduction in premature birth admissions to the neonatal intensive care unit during the pandemic, raising important questions. Why was this? Was it related to the effect of the modifiable risk-factors for premature birth? This discussion paper focuses on an exploration of these factors in the light of the potential impact of COVID-19 restrictions on neonatal care. After contextualising both the effect of premature birth and the pandemic on neonatal and parental short-term outcomes, the discussion turns to the modifiable risk-factors for premature birth and makes recommendations relevant to the education, advice and care given to expectant mothers.

OBJECTIVE: We evaluated reporting completeness and transparency in randomized controlled trials (RCTs) conducted using administrative data based on 2021 CONSORT Extension for Trials Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE) criteria. STUDY DESIGN AND SETTING: MEDLINE and the Cochrane Methodology Register were searched (2011 and 2018). Eligible RCTs used administrative databases for identifying eligible participants or collecting outcomes. We evaluated reporting based on CONSORT-ROUTINE, which modified eight items from CONSORT 2010 and added five new items. RESULTS: Of 33 included trials (76% used administrative databases for outcomes, 3% for identifying participants, 21% both), most were conducted in the United States (55%), Canada (18%), or the United Kingdom (12%). Of eight items modified in the extension; six were adequately reported in a majority (>50%) of trials. For the CONSORT-ROUTINE modification portion of those items, three items were reported adequately in >50% of trials, two in

COVID-19 has changed the way that newborn babies are cared for within the neonatal setting due to the introduction of social distancing and wearing of face masks to limit the spread of the infection. Potential implications exist related to the normal development of bonding and connections with others. This paper discusses the importance of face to face interactions for early attachment between babies and parents within the context of relevant underpinning developmental theory. Mask wearing can also potentially impact relational communication, requiring us to change our current ways of working. Decreasing face to face interactions and relational communication, along with key recommendations for both parents and health professionals are further highlighted to mitigate the potential negative effects of masks on long-term development related to human connection and attachment.

With first cases noted towards the end of 2019 in China, COVID-19 infection was rapidly become a devastating pandemic. Even if most patients present with a mild to moderate form of the disease, the estimated prevalence of COVID-19-related severe acute respiratory failure (ARF) is 15-20% and 2-12% needed intubation and mechanical ventilation. In addition to mechanical ventilation some other techniques of respiratory support could be used in some forms of COVID-19 related ARF. This position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases is intended to help respiratory clinicians involved in care of COVID-19 pandemic in the rational use of non-invasive techniques such as oxygen therapy, CPAP, non-invasive ventilation and high flow oxygen therapy in managing patients outside intensive care unit (ICU). The aims are: (1) to focus both on the place of each technique and in describing practical tips (types of devices and circuit assemblies) aimed to limit the risk of caregivers when using those techniques at high risk spreading of viral particles; (2) to propose a step-by-step strategy to manage ARF outside ICU.

This paper reports on a study evaluating the value of a documentary as a key medium to communicate design research. We present information from the evaluation of a second screen application using video as well as a scientific paper, in order to assess how the efficacy and usefulness of using such a documentary for science communication is perceived when compared to a scientific paper. Techniques of a method called Design Documentary, developed to inspire design research teams through video, combined with science journalism were the basis of the production. Twelve researchers and students were shown the documentary and asked to read the paper in counter-balanced order. Our qualitative results show that the documentary as a complementary means of communication can bring benefits to research communication, since it delivers information the paper cannot provide. However, the fact the video is not suited for peer review might restrict its place when compared to the paper. On the overall, participants thought both formats are valuable and are complementary. ispartof: pages:747-754 ispartof: Procedia Computer Science vol:100 pages:747-754 ispartof: CENTERIS location:PORTUGAL, Porto 2016 status: published

Effective food packaging is a major factor in the current global drive to minimise food waste. Starch is an excellent oxygen barrier for packaging but it is brittle and moisture sensitive. The addition of layered minerals and plasticizers can significantly improve the moisture barrier and flexibility of the resulting composite. Some combinations of starch and plasticizer are incompatible but our results show that the addition of bentonite ensures the formation of coherent starch films with much improved moisture barrier regardless of the starch-plasticizer compatibility. It was clearly demonstrated that improvement of the moisture barrier was critically dependent on the layer charge of the bentonite used. Starch was readily accommodated in the interlayer space of bentonites with a layer charge of

Since 2004, the Active Living Research (ALR) Conference has focused on advancing knowledge and practice related to the creation of communities that increase opportunities for physical activity. Communities designed for active living are better for health, economic vitality, and environmental sustainability. The Annual ALR Conference serves as a premier venue for cross-disciplinary learning, as over 30 disciplines are represented among participants. This commentary serves as an introduction to a virtual Special Section of Journal of Transport and Health that includes several of the best transport-related studies that were presented at ALR 2017. The theme of the 2017 ALR Conference, Active Living across the Life Span, placed emphasis on the importance of promoting physical activity from childhood through mature adulthood and offered solutions for achieving this goal. The theme challenged attendees to consider the myriad needs across age cohorts and the ways that community design, policies, and programs affect opportunities for active living. The conference highlighted the importance of policy-relevant research and facilitated cross-sector exchange among scientists, practitioners, and policymakers to create and sustain active living environments where residents can grow, live, and thrive at any age. Jana Lyncott from the AARP Public Policy Institute delivered the Keynote Address on creating environments for active and engaged living for all ages. The presentation provided examples from communities across the United States that are promoting livability and fostering healthy, active, and engaged lifestyles. The presentation highlighted AARP's Livability Index, which scores neighborhoods and communities for the services and amenities that have a significant impact on residents. The featured panel included Drs. Adrian Bauman, NiCole Keith, and David Bann and focused on the challenges of integrating equity perspectives in research on active living across the lifespan. Dr. Bauman, from Australia, shared lessons from his research on middle-age-to-older adults and his international collaborations. Dr. Keith, from the United States, described the effort to ensure disadvantaged populations were given high priority in developing the multi-sector strategies of the US National Physical Activity Plan. Dr. Bann, from the UK, presented findings on active living across the lifespan from a large, long-term birth cohort study. The second panel featured Deputy Commissioner Adetokunbo 'Toks' Omishakin, (Tennessee Department of Transportation), Councillor Kristyn Wong-Tam (City of Toronto, Canada), and Otis Johnson (Former Mayor of Savannah, Georgia) and provided local and state examples of active transportation and lessons learned. A clear takeaway from the keynote and panelists was the need to integrate and apply life-course research and practice/policy lessons learned to most effectively create activity-supportive cities. The concept of active living includes physical activity for all purposes, including transport, recreation, occupation, and household. Active transport continues to be a dominant theme at ALR Conferences, and the link between transport and health outcomes is rising on research and policy agendas internationally, as shown by extensive coverage in Journal of Transport and Health and the 2016 Lancet Series on Urban Design, Transport, and Health. In the Lancet Series, Giles-Corti and colleagues (2016) reviewed a wide range of physical, mental, and social health problems linked with motorized transport. Stevenson and colleagues (2016) reported models that revealed a shift of just 10% of motorized trips to active modes could produce important reductions in mortality in cities as diverse as Copenhagen and Delhi. Thus, as co-chairs of the ALR 2017 Conference we want to thank Dr. Jennifer Mindell, Editor-in-Chief of Journal of Transport and Health, for facilitating this virtual special section of papers that will further advance evidence on active transport and health.

We present Open Review, a web-based platform aimed at stimulating executable papers by means of post-publication peer-review. Its goal is to bring computer science researchers to collaboratively build their work upon previous research results, in such a way that transparency, reproducibility and sustainability of research results are greatly improved. The main design goals of the platform are clarity, conciseness, and reproducibility. Its main features are to: (i) provide incentives for making research communities to participate, (ii) make papers executable by means of boards' annotations, without necessarily involving the authors of an article, and (iii) give snapshots of the current research state on any given article.

A review is presented of Lifschitz's collection of seventeen papers written by McCarthy on the subject of common sense. The book opens with a fine overview of McCarthy's research in artificial intelligence (AI). Lifschitz offers an admirably succinct account of the development of McCarthy's ideas on common sense from the early days of AI to his current work. Lifschitz's introduction is especially useful in appreciating the dramatically original and permanently influential nature of McCarthy's work. While McCarthy's papers collected in this volume were written over the span of almost three decades, Lifschitz correctly observes that the underlying concern has always been the same: to understand and model the intellectual ability realized by human common sense.

Copyright © 2021 The Author(s). At the beginning of this year, the UK government released a White Paper on Reforms of the 1983 Mental Health Act (MHA) aiming to achieve higher quality, accessible mental health care, as well as empowering people detained under MHA during the process and continuation of detention. In this piece, we focus on the potential impact of the proposal around appropriate care, management and detention of people with Personality Disorder (PD) within the criminal justice system (CJS), psychiatric service provision and community routes. We briefly review the historical context of reforms of PD services in the UK and discuss the proposed changes and issues in relation to the criteria of least restriction, detention and therapeutic benefit. We highlight the complexity around referral routes and logistics barriers for secure PD services that might hamper speeded referral routes and raise concerns around responsibility for authorisation of transfers in the context of risk of serious harm to the public. We emphasise the complex treatment needs of individuals with PDs and how these are potentially not met. We also discuss the shift of focus from reactive care to preventative measures and early intervention in the community for individuals with mild-to-moderate levels of PD. We highlight the need for appropriate integrative services in the community to facilitate assessment across services, identification of complex needs and support options including earlier routine screening and potential digital interventions to optimise specialised care for PD.

Impacts of coronavirus disease 2019 (COVID-19) on the transport sector and the corresponding policy measures are becoming widely investigated. Considering the various uncertainties and unknowns about this virus and its impacts (especially long-term impacts), it is critical to understand opinions and suggestions from experts within the transport sector and related planning fields. To date, however, there is no study that fills this gap in a comprehensive way. This paper is an executive summary of the findings of the WCTRS COVID-19 Taskforce expert survey conducted worldwide between the end of April and late May 2020, obtaining 284 valid answers. The experts include those in the field of transport and other relevant disciplines, keeping good balances between geographic regions, types of workplaces, and working durations. Based on extensive analyses of the survey results, this paper first reveals the realities of lockdowns, restrictions of out-of-home activities and other physical distancing requirements, as well as modal shifts. Experts' agreements and disagreements to the structural questions about changes in lifestyles and society are then discussed. Analysis results revealed that our human society was not well prepared for the current pandemic, reaffirming the importance of risk communication. Geographical differences of modal shifts are further identified, especially related to active transport and car dependence. Improved sustainability and resilience are expected in the future but should be supported by effective behavioral intervention measures. Finally, policy implications of the findings are discussed, together with important future research issues.

Based on complex adaptive system theory and information theory for investigating heterogeneous situations, this paper develops an outlier knowledge management framework based on three aspects—dimension, object, and situation—for dealing with extreme public health events. In the context of the COVID-19 pandemic, we apply advanced natural language processing (NLP) technology to conduct data mining and feature extraction on the microblog data from the Wuhan area and the imported case province (Henan Province) during the high and median operating periods of the epidemic. Our experiment indicates that the semantic and sentiment vocabulary of words, the sentiment curve, and the portrait of patients seeking help were all heterogeneous in the context of COVID-19. We extract and acquire the outlier knowledge of COVID-19 and incorporate it into the outlier knowledge base of extreme public health events for knowledge sharing and transformation. The knowledge base serves as a think tank for public opinion guidance and platform suggestions for dealing with extreme public health events. This paper provides novel ideas and methods for outlier knowledge management in healthcare contexts., Highlights • Develop an outlier knowledge management framework for dealing with extreme public health events. • Conduct data mining and feature extraction on the microblogs from Wuhan and nearby areas. • Analyze the semantic and sentiment vocabulary, the sentiment curve, and the portraits of patients. • Acquire outlier knowledge of COVID-19 and incorporate it into the outlier knowledge base.

Summary: Introduction: Neglected tropical diseases control programmes run separately. For settings with more than one endemic disease, combined mass drug administration (MDA) has potential practical advantages compared with separate programmes but needs confirmation of safety. We assessed the safety of combined MDA for multiple neglected tropical diseases using ivermectin, diethylcarbamazine, albendazole (IDA) and azithromycin (AZI). Methods: We conducted an open-label, cluster-randomized trial involving individuals living in 34 wards (smaller administrative division) in two study sites, Namatanai District and Lihir Island, Papua New Guinea. We randomly assigned wards to the combined treatment arm (which received a single dose of the triple combination IDA and a single dose of AZI at the same visit) or the control arm (which received IDA separately followed by AZI separately one week after). All participants underwent safety assessments one day after drug administration. Methodology for collecting the adverse events (AEs) was a general question (in Namatanai) and individual questions about specific AEs (in Lihir). The primary endpoint was the prevalence of AEs. Safety of combined treatment was taken to be non-inferior to that of IDA if the upper limit of the two-sided CI for the difference in rates was equal or lower than 5%. Findings: The study enrolled 15,656 participants. Of those enrolled, 7,281 (46.3%) received the combined regimen and 8,375 (53.3%) received standard treatment with IDA for lymphatic filariasis between Nov 1, 2018, and Apr 15, 2019. Of the individuals in the control group, 4,228 (50.5%) attended a second visit one week apart to receive AZI for yaws. In Namatanai, the proportion of AEs was similar in the combined group (0.8%) compared to the IDA group (1.3%, difference 0.5% [95CI -2.5% to 1.4%]) or the AZI group (3.6%, d -2.8% [95CI -8.6% to 2.8%]). In Lihir, the proportion of AEs was higher in the combined group (23.0%) compared to the IDA group (12.2%, d 10.8% [95% CI 1.5% to 20.2%]) or the AZI group (11.1%, d 11.9% [95% CI 2.7% to 21.1%]).We observed 21 (0.3%) grade-2 AEs in the combined treatment group, 33 (0.4%) in the IDA separately group, and 18 (0.2%) in the AZI separately group. No participants required treatment for any AE. We observed no deaths, serious AEs, or AEs of special interest. Interpretation: In the largest trial so far involving coadministration of regimens based on IDA and AZI, the combination was safe and feasible in a population of more than 15,000 people. Combined MDA based on these two regimens opens up new potential for the control of neglected tropical diseases in the Western Pacific region. Funding: International Trachoma Initiative, “la Caixa” Foundation, Kern Pharma.

Summary: Background: Menstrual health is essential for gender equality and achieving the sustainable development goals. Though currently lacking, understanding and addressing menstrual health and social related inequalities requires comparison of experiences between menstruators with and without disabilities. Methods: We completed a mixed-methods population-based study of water, sanitation and hygiene, disability and menstrual health in TORBA and SANMA Provinces, Vanuatu. Methods included a census, nested case-control study, in-depth interviews (IDIs), focus group discussions (FGDs), PhotoVoice and structured observations. We undertook a population census of 11,000+ households and recruited 164 menstruators with and 169 without disabilities (aged 10-45) into a nested case-control study. 20 menstruators across both groups were selected for the qualitative component. Findings: Menstruators with disabilities were five times (adjusted Odds Ratio [aOR] 5.5, 95% Confidence Interval 1.8 – 16.5) more likely to use different bathing facilities to others in the household, nearly twice as likely (1.8, 1.1 – 3.1) to miss social activities, and three times (3.0, 1.6 – 5.7) more likely to eat alone during menstruation. Menstrual restrictions were widespread for all, but collecting water and managing menstrual materials was harder for menstruators with disabilities, particularly those requiring caregivers’ support. These factors negatively impacted menstruators with disabilities’ comfort, safety and hygiene, yet they reported less interference of menstruation on participation. Interpretation: Negative factors affecting all menstruators disproportionately impact those with disabilities, compounding existing inequalities. Menstruators with disabilities may have reported less interference because they are accustomed to greater participation restrictions than others. Funding: Australian Government's Water for Women fund and public donations.

© 2021 Elsevier B.V. Minimal liquid discharge (MLD) in greenhouses minimizes the volume of discharged wastewater, thereby increasing the volume of effluent that may be reused. Sodium accumulation in wastewater is often considered the main bottleneck to achieving 100% reuse. Consequently, greenhouses have begun adopting reverse osmosis (RO), the most commonly used desalination technology for wastewater treatment. RO removes ions from wastewater indiscriminately, including multivalent nutrients to crops (Ca[superscript 2+], Mg[superscript 2+], SO[subscript 4][superscript 2−], PO[subscript 4][superscript 3−]). In contrast, monovalent selective electrodialysis (MSED) selectively removes monovalent sodium while retaining multivalent nutrients in solution. For greenhouses that have not achieved MLD, MSED has an alternative application of reducing levels of nitrate, a monovalent ion and agricultural pollutant, in wastewater for disposal. This paper investigates the monovalent selectivity and potential of the widely-used Neosepta MSED membranes and the new Fujifilm MSED membranes to treat wastewater in greenhouses for reuse or discharge. Eight effluent compositions are tested as feedwater in a laboratory MSED system. Both membranes demonstrate selectivity towards sodium and nitrate across the tested compositions. Fujifilm cation-exchange membranes remove two to six sodium ions, compared to Neosepta's two to eight, for every magnesium ion. Fujifilm anion-exchange membranes remove two to seven nitrate ions, compared to Neosepta's two to six, for every sulfate ion.

Highlights • Delivery service contributed to the sales of restaurants during the COVID-19 pandemic. • Casual and fast casual dining restaurants had more benefit from delivery service than fine dining ones after COVID-19 restrictions were eased. • Discount options failed to increase sales during the pandemic. • Brand effects on restaurant financial performance were stronger after the COVID-19 outbreak., To contain the pandemic of coronavirus (COVID-19), social distancing, self-isolation and travel restrictions have been imposed globally. To shed light on how COVID-19 is affecting restaurant industry, this study aims to explore the factors that affect restaurant firms’ financial turnaround for their sustainability after the business shutdowns amid the COVID-19 pandemic. By utilizing a total of 86,507 small- and medium-sized restaurant firms’ sales data collected from nine cities in Mainland China, the exploratory approach of this study successfully determines positive impacts of three aspects of operational characteristics (i.e., delivery, discounts, and service type) and brand effects as uncertainty minimizing factors amid distinctive business shutdowns and restrictions. This is the first empirical study in the management realm on the impacts of COVID-19 on restaurant industry. This paper strengthens the extant literature by highlighting the impact of COVID-19 on the restaurant industry after the business restrictions are lifted.

Biodiesel as a renewable fuel is made from renewable materials such as animal fats, plant oils, and can be used in compression ignition (diesel) engines by mixing with conventional diesel. Recently, nanocatalysts are being used to generate biodiesel, as they are able to make these reactions more sufficient by having a large surface-to-volume ratio. TiO2 and ZnO nanoparticles are categorized as metal oxide nanoparticles. Each of them has its own special characteristics. Besides, they show a level of cooperation which is discussed below. In this paper, in addition to the surface method employed for numerical analysis, the experiments on the biodiesel production from waste sunflower oil are implemented by transesterification method using TiO2ZnO nanocatalyst. Effective process parameters, including the reaction temperature, oil: alcohol molar ratio, catalyst percentage, and optimal conditions are determined and optimized accordingly. The highest product yield was 96.4% in the ratio of 1–6 methanol to oil, 60 °C, and 200 mg/L TiO2–ZnO nanocatalyst. An optimization study shows that the highest biodiesel production is possible using nanocatalysts of 264 mg/L at a temperature of 66 °C.

Highlights • Quarantine decisions during a pandemic directly affect the hospitality industry. • A DEMATEL method is proposed for quarantine decision due to COVID-19 Pandemic. • A real life case study in Turkey is conducted in this paper. • Istanbul has an essential impact on the rest of all regions in Turkey., Countries' most effective methods to reduce the impact of outbreaks are quarantine the regions during the pandemic periods. Quarantine decisions during a pandemic directly affect the hospitality industry. There is no universal guideline regarding the quarantine decision during a pandemic. There is a gap in the literature on making the right quarantine decisions to decrease the negative effect of a pandemic on the hospitality industry. To fill this gap, this study uses a decision-making trial and evaluation laboratory (DEMATEL) method to help countries for quarantine decisions due to the COVID-19 pandemic. One of the critical hospitality industry indicators is the inter-regional travel flow between regions for local tourism. Data from the household domestic tourism survey obtained from the Turkish Statistical Institute (TurkStat) is used to acquire the number of people entering and exiting among regions. This study's findings indicate that Istanbul has an essential impact on Turkey's rest. The results also demonstrate that the DEMATEL method provides convenient solutions for quarantine decisions during a pandemic. The DEMATEL application results concerning the COVID-19 pandemic effect might shed light on the hospitality industry’s prospects and challenges. This study's findings might be adopted to prepare the hospitality industry for the COVID-19 pandemic and similar pandemic.

Process optimization is a popular strategy to improve efficiency, reduce the energy consumption and total cost of the seawater reverse osmosis (SWRO). Forward osmosis (FO) process with a nanofiltration (NF)-like membrane has emerged as a cost-effective technology for seawater desalination pretreatment, due to its high water permeability and low energy consumption compared to RO-like FO membrane. The present work comprehensively evaluated the potential of using an NF-like FO membrane for SWRO pretreatment and analyzed the feasibility of the NF-like membrane-based FO-NF-RO process for seawater desalination. The performance of the FO-NF-RO integrated process was investigated with MgSO4, Na2SO4, and Mg(CH3COO)2 as draw solute, respectively. Besides, the energy consumption and total cost of the hybrid process were also estimated on the laboratory and large scale. The NF-like membrane-based FO process could effectively remove organic molecules and divalent ions effectively. The hybrid process product water could reach the drinking water standard in China (TDS ≤ 1000 mg/L). When water recovery was 42.0%, the hybrid process could produce freshwater with specific energy consumption of 2.99 kWh/m3 and specific water cost of 0.92 $/m3, which were comparable with the conventional SWRO process. Overall, our study revealed the feasibility of the FO-NF-RO process for seawater desalination.

Background: The UK Government is considering the introduction of vaccine passports for domestic use and to facilitate international travel for UK residents. Although vaccine incentivisation has been cited as a motivating factor for vaccine passports, it is unclear whether vaccine passports are likely to increase inclination to accept a COVID-19 vaccine. Methods: We conducted a large-scale national survey in the UK of 17,611 adults between 9 and 27 April 2021. Bayesian multilevel regression and poststratification is used to provide unbiased national-level estimates of the impact of the introduction of vaccine passports on inclination to accept COVID-19 vaccines and identify the differential impact of passports on uptake inclination across socio-demographic groups. Findings: We find that a large minority of respondents report that vaccination passports for domestic use (46.5%) or international travel (42.0%) would make them no more or less inclined to accept a COVID-19 vaccine and a sizeable minority of respondents also state that they would 'definitely' accept a COVID-19 vaccine and that vaccine passports would make them more inclined to vaccinate (48.8% for domestic use and 42.9% for international travel). However, we find that the introduction of vaccine passports will likely lower inclination to accept a COVID-19 vaccine once baseline vaccination intent has been adjusted for. This decrease is larger if passports were required for domestic use rather than for facilitating international travel. Being male (OR 0.87, 0.76 to 0.99) and having degree qualifications (OR 0.84, 0.72 to 0.94) is associated with a decreased inclination to vaccinate if passports were required for domestic use (while accounting for baseline vaccination intent), while Christians (OR 1.23, 1.08 to 1.41) have an increased inclination over atheists or agnostics. Change in inclination is strongly connected to stated vaccination intent and will therefore unlikely shift attitudes among Black or Black British respondents, younger age groups, and non-English speakers. Interpretation: Our findings should be interpreted in light of sub-national trends in uptake rates across the UK, as our results suggest that passports may be viewed less positively among socio-demographic groups that cluster in large urban areas. We call for further evidence on the impact of vaccine certification and the potential fallout for routine immunization programmes in both the UK and in wider global settings, especially those with low overall trust in vaccinations. Funding: This survey was funded by the Merck Investigator Studies Program (MISP). (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

The forward osmosis (FO) process was suggested as a pretreatment to a multi-stage flashing (MSF) plant to reduce the environmental impact of brine discharge and the chemicals used. Yet, there is no study investigating the performance of the FO process pretreatment to the MSF plant using tertiary sewage effluent (TSE) as a feed solution. Combining MSF brine with the TSE generates a considerable permeation flux, reducing the membrane area and capital cost. This study evaluated the performance of the FO process for indirect desalination of the MSF brine, considering membrane fouling, cleaning, required membrane area and the specific power consumption. The FO process used a thin-film composite (TFC) membrane to dilute the brine reject from the MSF plant by the TSE and hence converting waste solutions into a feasible water resource. A considerable high water flux (±35 L/m2h) was generated and slightly decreased throughout each experiment's 4 cycles. An enhancement in the water permeability was observed in the FO tests with a prefiltration of the brine reject and the wastewater with 20 μm and an osmotic backwash cleaning of the used membrane. The prefiltration of the draw and feed solutions was effective in minimizing the impact of fouling. Maximum power consumption of 0.007 kWh/m³ was consumed in the forward osmosis process without prefiltration and decreased to 0.006 kWh/m³ in the FO process. The proposed FO system successfully diluted the brine reject’ divalent ions, reducing their concentration to 43% in some cases. Depending on the FO membrane orientation, the TSE feed solution resulted in a 276%–473% reduction in the number of FO elements required in the FO process compared to the seawater feed solution. This publication was supported by NPRP grant 10-0117-170176 from the Qatar National Research Fund (a member of Qatar Foundation ). Scopus

Graphical abstract, Highlights • Antivirals against SARS-CoV-2 are needed. • The papain-like protease represents an important target for antivirals. • We investigated tropane alkaloids from Schizanthus porrigens. • By molecular docking and MS simulations we identified two leads. • Shizanthine Z has favorable ADME properties and can be considered a lead., This paper presents identification of potential inhibitors of SARS-CoV-2 papain-like protease from tropane alkaloids from Schizanthus porrigens, using molecular docking method. Binding affinities were compared with those obtained with Lopinavir as a SARS-CoV-2 papain-like protease inhibitor. Overall, our findings indicate that Schizanthine Z binds to the SARS-CoV-2 papain-like protease with relatively high affinity and favorable ADME properties. Therefore, Schizanthine Z may represent an appropriate compound for further evaluation in antiviral assays.

Brazilian Federal Government created an emergency aid to face the COVID19 emergency. This aid provides monthly payments to low-income or unemployed citizens, informal workers, or individual micro-entrepreneurs. An intricate set of criteria made too complex the identification of all citizens eligible for emergency aid, considering there is no an integrated database to which they could apply these criteria. Consequently, lots of people who fulfilled the criteria were not able to receive the aid, and lots of people who were not supposed to get it ended up receiving it. In this context, the goal of this opinion paper is to discuss the process effectiveness and which issues related to information management hindered the positive program impact. Additionally, a less complex but relevant case of Rio Grande do Sul State is discussed. Both cases – the Federal Government and the state government – show the importance of effective information management to face very demanding situations and avoid the high social price to be paid by those who need this aid the most.

Background: \ud Understanding trends in the incidence and outcomes of myocardial infarction and stroke, and how these are influenced by changes in cardiovascular risk factors can inform health policy and healthcare provision.\ud \ud Methods: \ud We identified all patients 30 years or older with myocardial infarction or stroke in Scotland. Risk factor levels were determined from national health surveys. Incidence, potential impact fractions and burden attributable to risk factor changes were calculated. Risk of subsequent fatal and non-fatal events (myocardial infarction, stroke, bleeding and heart failure hospitalization) were calculated with multi-state models.\ud \ud Findings: \ud From 1990 to 2014, there were 372,873 (71±13 years) myocardial infarctions and 290,927 (74±13 years) ischemic or hemorrhagic strokes. Age-standardized incidence per 100,000 fell from 1,069 (95% confidence interval, 1,024-1,116) to 276 (263-290) for myocardial infarction and from 608 (581-636) to 188 (178-197) for ischemic stroke. Systolic blood pressure, smoking and cholesterol decreased, but body-mass index increased, and diabetes prevalence doubled. Changes in risk factors accounted for a 74% (57-91%) reduction in myocardial infarction and 68% (55-83%) reduction in ischemic stroke. Following myocardial infarction, the risk of death decreased (30% to 20%), but non-fatal events increased (20% to 24%) whereas the risk of both death (47% to 34%) and non-fatal events (22% to 17%) decreased following stroke.\ud \ud Interpretation: \ud Over the last 25 years, substantial reductions in myocardial infarction and ischemic stroke incidence are attributable to major shifts in risk factor levels. Deaths following the index event decreased for both myocardial infarction and stroke, but rates remained substantially higher for stroke.\ud \ud Funding: \ud British heart foundation.

Intermittent water supplies (IWS) are routinely experienced by drinking water distribution systems around the world, either due to ongoing operational practices or due to one off interruptions. During IWS events changing conditions may impact the endemic biofilms leading to hydraulic mobilisation of organic and inorganic materials attached to pipes walls with a resulting degradation in water quality. To study the impact of IWS on the microbiological and physico-chemical characteristics of drinking water, an experimental full-scale chlorinated pipe facility was operated over 60 days under realistic hydraulic conditions to allow for biofilm growth and to investigate flow resumption behaviour post-IWS events of 6, 48 and 144 hours.\ud \ud \ud \ud Turbidity and metal concentrations showed significant responses to flow restarting, indicating biofilm changes, with events greater than 6 hours generating more turbidity responses and hence discolouration risk. The increase in pressure when the system was restarted showed a substantial increase in total cell counts, while the subsequent increases in flow led to elevated turbidity and metals concentrations. SUVA254 monitoring indicated that shorter times of non-water supply increased the risk of aromatic organic compounds and hence risk of disinfection-by-products formation. DNA sequencing indicated that increasing IWS times resulted in increased relative abundance of potential pathogenic microorganisms, such as Mycobacterium, Sphingomonas, and the fungi Penicillium and Cladosporium.\ud \ud \ud \ud Overall findings indicate that shorter IWS result in a higher proportion of aromatic organic compounds, which can potentially react with chlorine and increase risk of disinfection-by-products formation. However, by minimising IWS times, biofilm-associated impacts can be reduced, yet these are complex ecosystems and much remains to be understood about how microbial interactions can be managed to best ensure continued water safe supply.

Background Pulmonary arterial hypertension (PAH) is a rare but life shortening disease, the diagnosis of which is often delayed, and requires an invasive right heart catheterisation. Identifying diagnostic biomarkers may improve screening to identify patients at risk of PAH earlier and provide new insights into disease pathogenesis. MicroRNAs are small, non-coding molecules of RNA, previously shown to be dysregulated in PAH, and contribute to the disease process in animal models. Methods Plasma from 64 treatment naive patients with PAH and 43 disease and healthy controls were profiled for microRNA expression by Agilent Microarray. Following quality control and normalisation, the cohort was split into training and validation sets. Four separate machine learning feature selection methods were applied to the training set, along with a univariate analysis. Findings 20 microRNAs were identified as putative biomarkers by consensus feature selection from all four methods. Two microRNAs (miR-636 and miR-187-5p) were selected by all methods and used to predict PAH diagnosis with high accuracy. Integrating microRNA expression profiles with their associated target mRNA revealed 61 differentially expressed genes verified in two independent, publicly available PAH lung tissue data sets. Two of seven potentially novel gene targets were validated as differentially expressed in vitro in human pulmonary artery smooth muscle cells. Interpretation This consensus of multiple machine learning approaches identified two miRNAs that were able to distinguish PAH from both disease and healthy controls. These circulating miRNA, and their target genes may provide insight into PAH pathogenesis and reveal novel regulators of disease and putative drug targets. Funding This work was supported by a National Institute for Health Research Rare Disease Translational Research Collaboration (R29065/CN500) and British Heart Foundation Project Grant (PG/11/116/29288).

Background: Food insecurity concerns have featured prominently in the UK response to the COVID-19 pandemic. We assess changes in the prevalence of food-related hardships in the UK population from April to July 2020. Method: We analysed longitudinal data on food-related hardships for 11,104 respondents from the April-July 2020 waves of the Understanding Society COVID-19 web survey with linked data from the 2017-9 wave of the annual Understanding Society survey. Outcome variables were reports of being hungry but not eating and of being unable to eat healthy and nutritious food in the last week, which were adapted from the Food Insecurity Experience Scale. We used unadjusted estimates to examine changes in population prevalence and logistic regression to assess the association between employment transitions and both outcomes at the individual level. Findings: The prevalence of reporting an inability to eat healthy or nutritious food rose from 3•2% in April to 16•3% in July 2020. The largest increases in being unable to eat healthy or nutritious food were among Asian respondents, the self-employed, and 35-44-year-olds. The prevalence of being hungry but not eating rose from 3•3% in April to 5•1% in July, with the largest increases observed among unemployed individuals below age 65. Those moving from employment to unemployment had higher odds of being hungry but not eating in the last week relative to furloughed individuals (OR = 2•2; p < 0•05; 95% CI: 1•1 to 4•2) and to the persistently employed (OR = 3•5; p < 0•001; 95% CI: 1•8 to 6•9), adjusting for age, highest qualification in 2017-19, net household income in 2017-19 (equivalized), gender, race/ethnicity, number children at home (aged 0-4, 5-15, and 16-18), cohabitation status, and government office region. Respondents moving from employment to unemployment also had higher odds of reporting an inability to eat healthy and nutritious food relative to furloughed individuals (OR = 1•9; p < 0•05; 95% CI: 1•4 to 3•2) and to the persistently employed (OR = 2•0; p < 0•01; 95% CI: 1•2 to 3•4). No statistically significant differences were found between furloughed individuals and the persistently employed in their probability of reporting either outcome. Interpretation: Food-related hardships increased substantially in the UK between April and July 2020, largely driven by reports of an inability to eat healthy and nutritious food. The Coronavirus Job Retention Scheme and Self-Employment Income Support Scheme appeared to have conferred some protection, but more could have been done to mitigate the problems we describe in obtaining affordable food. Funding: DS is funded by the Wellcome Trust investigator award. JK and DS are funded by the European Research Council n. 313590 – HRES. VT is funded by the European Research Council n. 694145- IFAMID.

This study investigated the possibility of biogas recirculation-driven anaerobic granular sludge system for sewage sludge treatment, aiming to develop an energy sufficient and multifunctional anaerobic digestion (AD) system for sewage sludge with biogas upgrading, sludge stabilization and self-aggregation. Results show that biogas recirculation could enhance the CH4 production rate by 31–44% and shorten the lag-phase duration to 0.08–0.2 day with simultaneous increment of CH4 content (> 83% in this study). The reason is mainly associated with the stronger interspecies electron transfer under the biogas recirculation condition. In addition, 37–40% better dewaterability of the digested sludge was achieved, implying the occurrence of self-aggregation of microbial cells induced by biogas recirculation. Energy balance analysis reflects that this sewage sludge treatment system could enhance the net energy recovery by 78–85%. Moreover, almost no obvious influence was noticed on the seed granules’ composition and properties. These findings suggest that the biogas recirculation-driven anaerobic granular sludge system could be a promising alternative for sewage sludge treatment, which can improve biogas quality and sludge dewaterability simultaneously towards sludge self-aggregation with no addition of other chemicals.

COVID-19 has now spread to all the continents of the world with the possible exception of Antarctica. However, Africa appears different when compared with all the other continents. The absence of exponential growth and the low mortality rates contrary to that experienced in other continents, and contrary to the projections for Africa by various agencies, including the World Health Organization (WHO) has been a puzzle to many. Although Africa is the second most populous continent with an estimated 17.2% of the world's population, the continent accounts for only 5% of the total cases and 3% of the mortality. Mortality for the whole of Africa remains at a reported 19,726 as at August 01, 2020. The onset of the pandemic was later, the rate of rise has been slower and the severity of illness and case fatality rates have been lower in comparison to other continents. In addition, contrary to what had been documented in other continents, the occurrence of the renal complications in these patients also appeared to be much lower. This report documents the striking differences between the continents and within the continent of Africa itself and then attempts to explain the reasons for these differences. It is hoped that information presented in this review will help policymakers in the fight to contain the pandemic, particularly within Africa with its resource-constrained health care systems.

During the COVID-19 pandemic, unusual consumer behavior, such as hoarding toilet paper, was reported globally. We investigated this behavior when fears of consumer market disruptions started circulating, to capture human behavior in this unique situation. Based on the stimulus-organism-response (S-O-R) framework, we propose a structural model connecting exposure to online information sources (environmental stimuli) to two behavioral responses: unusual purchases and voluntary self-isolation. To test the proposed model, we collected data from 211 Finnish respondents via an online survey, and carried out analysis using PLS-SEM. We found a strong link between self-intention to self-isolate and intention to make unusual purchases, providing empirical evidence that the reported consumer behavior was directly linked to anticipated time spent in self-isolation. The results further revealed exposure to online information sources led to increased information overload and cyberchondria. Information overload was also a strong predictor of cyberchondria. Perceived severity of the situation and cyberchondria had significant impacts on people's intention to make unusual purchases and voluntarily self-isolate. Future research is needed to confirm the long-term effects of the pandemic on consumer and retail services., Highlights • We investigate people's purchase and isolation behavior during the COVID19 pandemic. • Information source exposure leads to information overload (IO) and cyberchondria. • IO had a negative effect on perceived severity, whereas cyberchondria had a positive impact. • Perceived severity (PS) positively affected intentions to self-isolate and unusual purchases. • Purchase self-efficacy reinforces the influence of PS on unusual purchases.