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Cislunar L 4 or L 5 axial orbit families are continuous asymmetrical periodic orbits from the figure-8 orbit around L 4 or L 5 Lagrange point of the Earth–Moon system to the halo-family around the Moon. They provide special locations of lunar relay satellites for the lunar south pole due to their offset locations. In this paper, we investigate the orbital characters and applications of cislunar L 4 and L 5 axial orbits. A construction method of cislunar L 4 and L 5 axial orbit families is proposed according to their topological feature in the torus space. Then, lunar relay performances, including coverage and eclipse, are analyzed for different cislunar L 4 and L 5 axial orbits. Numerical computation indicates that 3:1 resonant L 4 and L 5 axial orbits are the optimal options in terms of the stability, coverage and eclipse avoidance. Lunar relay performances of a two-satellite constellation deployed in these orbits are compared with that in a near rectilinear halo orbit (NRHO). Numerical results show that the constellation of axial orbits can provide longer contact duration to the lunar equator and southern hemisphere than that of the NRHO. Finally, a station-keeping strategy and a transfer design of cislunar L 4 and L 5 axial orbits are developed, and their fuel costs are studied. • Cislunar axial orbits are studied for relay mission of the lunar exploration. • The 3:1 cislunar axial orbit is selected for the eclipse avoidance. • A constellation on axial orbits has longer contact duration than NRHOs. • The corresponding station-keeping method and transfer design are proposed. [ABSTRACT FROM AUTHOR]

In this work, a numerical approach is presented to reconstruct the ionomer three-dimensional distribution in the microstructure of the cathode catalyst layer (CCL) of a polymer electrolyte membrane fuel cell (PEMFC) from a 3D segmented image of the CCL obtained by focused ion beam-scanning electron microscopy (FIB-SEM). Three forms of ionomer are distinguished: the ionomer filaments, the coating ionomer and the inter-carbon grains ionomer. The ionomer filaments are identified by applying a filtering procedure to the size distribution in the segmented solid phase obtained via a maximum sphere inscription algorithm. The coating ionomer is reconstructed via a filtering procedure of the curvature distribution computed over the interface between the two segmented phases from the consideration that concave regions are preferential ionomer accumulation zones during the drying step of the CCL fabrication procedure. This procedure of coating controlled by the local curvature is applied until a desired value of coverage is reached. In a last step, catalyst nanoparticles, also not visible in the FIB-SEM image, are reconstructed in the image. • Ionomer coating is numerically reconstructed in a FIB-SEM image. • The ionomer coating is of variable thickness. • A small fraction of the ionomer forms protrusions in the pore space. • A significant fraction of the ionomer is in between the carbon grains. [ABSTRACT FROM AUTHOR]

• Regaining momentum for global cervical cancer elimination will require new partnerships. • Partnerships need to extend beyond health or education sectors. • We propose a simple framework to help countries identify potential multi-sectoral partners. [ABSTRACT FROM AUTHOR]

Mackinawite FeS is the most common corrosion product in the early stage of steel in H 2 S environment and also has an effective catalysis for hydrodesulfurization, hydrogen release reactions and heavy metal ion removal since its high specific surface area and reactive surface like other van der Waals materials. In this paper, ab initio molecular dynamics (AIMD) is used to study the interactions between small molecules (H 2 S, H 2 O and H) and FeS at 300 K. The calculation results show that the primary dissociation of H 2 S only occurs on the FeS(111) surface and H 2 S is chemically adsorbed on the (011) and (100) surfaces but physically adsorbed on the (001) surface. It will dissociate and generate H atoms when different amounts H 2 S or H 2 O molecules appear in the interlayer of FeS, in which H 2 S is more prone to dissociation. The dissociated H atoms will be "captured" by Fe/S atoms in mackinawite FeS, leading to the shrink of layer. Moreover, H atoms could combine into H 2 , which suggests that layered FeS has great potential for hydrogen generation. The diffusion coefficient of H atoms in mackinawite FeS layer is estimated about 1.67 × 10−8 m2/s. These findings have significant meaning for application of mackinawite FeS in corrosion science, hydrogen generation, hydrogen storage and other fields. • Visually show the adsorption, dissociation and diffusion of wet H 2 S on different mackinawite surface. • Clarify the effect when different molecules (H 2 S, H 2 O, H) appear in the interlayer of FeS. • Demonstrate the barrier properties of layered mackinawite to H atoms. • Give new insights into the application of mackinawite in hydrogen production and storage. [ABSTRACT FROM AUTHOR]

Measles remains a critical public health concern causing significant morbidity and mortality globally. Despite the success of measles vaccination programs, challenges persist, particularly in India. This study investigates dose-wise measles vaccination coverage and explores gaps in immunization focusing on zero-dose, one-dose, and two-dose coverage among children aged 24–35 months. The National Family Health Survey 2019–21 (NFHS-5) served as the data source and the study analyzed information from 43,864 children aged 24–35 months. Sociodemographic variables such as birth order, wealth quintile, gender, social group, religion, residence, mother education, delivery-related factors, and media exposure were considered. Statistical analysis involved weighted estimates, chi-square tests, and multivariate multinomial logistic regression. The study revealed that challenges persist in achieving optimal measles vaccination coverage. Analysis by sociodemographic factors highlighted disparities in coverage, with variations in zero dose prevalence across states and districts. The percentage of zero-dose children was significantly higher, with 11.5% of children in India remaining to receive any measles vaccination. Factors influencing vaccine coverage include birth order, age, wealth quintile, social group, religion, residence, maternal education, place of delivery, media exposure, and mode of delivery. The findings from the spatial analysis show the clustering of zero-dose children is high in the northeastern states of India. Measles zero-dose children pose a significant obstacle to achieving elimination goals. Spatial analysis identifies clusters of unvaccinated populations guiding targeted interventions. The study aligns with global initiatives such as the Immunization Agenda 2030 emphasizing equitable vaccine access and discusses how India can tailor its strategies to achieve the goal. Lessons from polio eradication efforts inform strategies for measles elimination, stressing the importance of high-quality data and surveillance. The study underscores the urgency of addressing last-mile measles vaccination gaps in India. Spatially targeted interventions informed by sociodemographic factors can enhance immunization coverage. Achieving measles elimination requires sustained efforts and leveraging lessons from successful vaccination campaigns. The study findings have the potential to contribute to informed decision-making, supporting India's roadmap for the measles and rubella elimination goal. [ABSTRACT FROM AUTHOR]

Demand for imaging of large area targets by space-based assets such as constellations of Earth Observation Satellites (EOS) is on the rise for different applications. The area targets coverage cannot be achieved by a single satellite in a single observation opportunity, as the region for imaging spreads wider than the coverage swaths of imaging sensors. Hence, the imaging satellites are scheduled in a cooperative way to achieve maximum coverage of the area in a given planning time horizon. The scheduling algorithms also aim to maximize or minimize some specific objectives of interest while simultaneously complying with all resource constraints for an efficient use of precious space resources. As the current generation satellites are highly agile, there are many ways of choosing an imaging location in the target area for each single observation opportunity of a satellite. Even though the possible imaging region in continuous space is discretized into a finite number of strips for each observation, the huge combinatorial search space formed with all satellites' imaging opportunities makes the problem intractable. Thus, the area target imaging scheduling is a complex combinatorial NP-hard optimization problem. Many exact and heuristic methods were evolved to provide a solution to this scheduling problem. Even though the exact methods solve the problem to optimality, they are limited to smaller problem instances because of the high computational complexities involved in those methods. More focus is seen in the literature on heuristic approaches as they guarantee scheduling performance with feasible solutions within an acceptable computational complexity. This paper presents our efficient heuristic approach proposed for the scheduling problem for imaging a large area target using a constellation of multiple satellites. Our approach is an extension of a widely used greedy approach in combination with insights from dynamic programming. In this paper, first we addressed the scheduling problem by describing it in detail and formulating it into a non-linear integer programming problem, considering the multi-objectives of achieving maximum coverage and minimum imaging resolution. The solution to the problem comprises two phases, namely the area decomposition phase and the scheduling phase. In the area decomposition phase, the area target is divided into strips dynamically for each observation opportunity of a satellite. Then exact observation period of each strip is computed using a simplified semi-analytical computational method. In the scheduling phase, we applied our heuristic search strategy, namely Forward and Backward Heuristic Search (FBHS) to obtain a near optimal solution within an acceptable computational time. Through the extensive simulations conducted under various scenarios, the effectiveness of the proposed method is verified in comparison with the baseline greedy approach. • The large area target imaging scheduling for multiple satellites is a complex combinatorial NP hard optimization problem. • Greedy algorithm, which guarantee the scheduling performance, is a widely used method. • Forward and Backward Heuristic Search method is proposed for area target image scheduling. [ABSTRACT FROM AUTHOR]

Combining Unmanned Aerial Vehicles (UAVs) and close-range photogrammetry has become a safer, more efficient, and cost-effective solution for bridge inspection compared to conventional methods. However, close-range bridge images captured by UAVs often suffer from severe quality issues, such as blurriness, improper exposure, limited coverage, or insufficient resolution. These issues can adversely affect subsequent damage identification and bridge condition assessment, thereby hindering the widespread application of UAVs in bridge inspection. This paper presents a novel in-flight image quality check (IIQC) framework for rapidly assessing UAV-captured images against bridge inspection requirements. This framework incorporates (1) a new coarse-to-fine image pose estimation approach for precisely estimating the relative poses of UAV images with respect to a reference model, (2) a comprehensive set of refined image quality metrics for assessing image quality across various aspects, and (3) an Image Quality Metrics (IQM)-embedded bridge representation model for visualising the evaluation results. All components within this framework have been validated through extensive simulation and real-world experiments, encompassing various bridge structures (i.e., girder, arch, and truss bridges) and different weather conditions. The results show that: (1) the average root mean square error (RMSE) of the estimated image poses by the coarse-to-fine method across multiple structures reached 0.189 m in position and 0.203° in orientation, showcasing an improvement over 50 % than the image poses retrieved from the UAV; (2) the image quality metrics offer comprehensive insights into image blurriness probability and exposure intensity at the pixel level and can effectively identifying missing and insufficient captured areas; (3) the bridge representation model is capable of delivering valuable and user-friendly feedback of the assessment results to the pilot; (4) the IIQC framework can offer a rapid and comprehensive assessment of close-range UAV images in near real-time by leveraging an existing Building Information Model (BIM) of the target bridge, serving as a novel and efficient solution to thoroughly tackle image quality issues in UAV-enabled bridge inspection. Its versatility can potentially be extended to encompass other structural types, including buildings and dams. [ABSTRACT FROM AUTHOR]

[Display omitted] • Acidification, coverage, microbe N conversion, adsorption combined for NH 3 reduction. • Rich H 2 SO 4 and sulfate remained on the vermiculite (VM) after 5 M H+ modification. • Giant CO 2 bubbles due to initial slurry acidification promoted the cover floating. • Vermiculite after 5 M H+ modification performed highest NH 3 reduction (68 %). • NH 4 +/ NH 3 adsorption by VM contributed little (4.7%) to the overall NH 3 mitigation. Animal slurry storage is an important ammonia (NH 3) emission source. Sulfuric acid (H 2 SO 4)-modified vermiculite coverage is a new promising technology for controlling NH 3 emission from slurry storage. However, the underlying mechanisms in controlling the mitigation effect remain unclear. Here, a series of experiments to determine the effect of H 2 SO 4 on the modified vermiculite properties, floating persistence, and NH 3 mitigation effect was conducted. Results showed that abundant H 2 SO 4 and sulfate remained on the outer surface and in the extended inner pores of the vermiculite with acidifying H+ concentrations higher than 5 M. An initial strong instantaneous acidification of surface slurry released rich carbon dioxide bubbles, strengthening cover floating performance. An acidification in the vermiculite cover layer and a good coverage inhibition interacted, being the two leading mechanisms for mitigating NH 3 during initial 40–50 days of storage. The bacterial-amoA gene dominated the conversion of NH 3 to nitrous oxide after 50 days of storage. Vermiculite with 5 M H+ modification reduced the NH 3 emissions by 90 % within the first month of slurry storage and achieved a 64 % mitigation efficiency throughout the 84 days period. With the development of the aerial spraying equipment such as agricultural drones, acidifying vermiculite coverage hold promise as an effective method for reducing NH 3 emission while absorbing nutrients from liquid slurry storage tank or lagoon. This design should now be tested under field conditions. [ABSTRACT FROM AUTHOR]

There has been increasing recognition of vaccine access challenges in middle-income countries and the need for increased action, particularly in countries that are not eligible for or have transitioned out of Gavi, the Vaccine Alliance support. These countries' immunization systems are more vulnerable than ever as the COVID-19 pandemic exacerbates existing programme challenges, increasing the risk of delayed vaccine introductions, backsliding immunization coverage rates, and increased coverage inequity. The potential health and equity impact of improving immunization outcomes in middle-income countries is substantial. Modelling suggests that the introduction of pneumococcal conjugate vaccine and vaccines for rotavirus and human papillomavirus in this set of Gavi-transitioned and non-Gavieligible middle-income countries in 2020 could have saved an estimated 70,000 lives if 90 % coverage had been reached. Further, increasing coverage for already-introduced vaccines to 90 % could have saved an additional estimated 16,000 lives. Over the past decade, stakeholders have made considerable efforts to identify immunization challenges in middle-income countries as documented in the 2015 SAGE-endorsed Shared Partner Middle-Income Country Strategy. In the coming decade, new global platforms like Gavi 5.0 and the Immunization Agenda 2030 provide opportunities to align on MIC strategies and provide coordinated global support to middle-income countries. The international COVID-19 pandemic response has the potential to lay the foundation for long term support beyond the scope of COVID-19 to non-Gavi eligible middle-income countries. Meanwhile regional mechanisms to address immunization barriers in middle-income countries have grown in number and strength, offering sustainable platforms for cross-country collaboration and the provision of tailored technical support. To ensure that these opportunities are successfully acted upon and that middle-income countries achieve the Immunization Agenda 2030 goals, comprehensive, multi-stakeholder consultations were conducted to identify areas of action with the greatest potential to accelerate immunization progress. Stakeholders should work together to put these findings, highlighted in this paper, into action, adapting their approaches to specific country contexts and learning from and building on existing efforts. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has experienced various phases including outbreaks, a global health crisis, and eventual de-escalation from a public health emergency of international concern, significantly affecting the delivery and utilization of healthcare services. This study aimed to evaluate the impact of the COVID-19 pandemic on the coverage rate of routine immunization in children under varying prevalence conditions. We conducted a retrospective, population-based cohort study in Beijing, China, utilizing stratified random sampling by birthdate to obtain a sample of 29,811 participants. Subjects were categorized into four cohorts based on when they became eligible for vaccination: the Pre-COVID Period cohort, the COVID-19 Low Epidemic Period cohort, the COVID-19 Surging Period cohort, and the COVID-19 Slowing Down Period cohort. A one-month follow-up was conducted. Cox proportional hazards model was employed to examine associations between the COVID-19 epidemic status and timely vaccination. Participants age-eligible for vaccination during the COVID-19 Low Epidemic Period demonstrated higher rates of timely vaccination (HR 1.18, 95% CI 1.15–1.22) compared to those eligible during the Pre-COVID Period. Conversely, those eligible during the COVID-19 Surging Period displayed lower rates (HR 0.73, 95% CI 0.66–0.82). No significant difference in vaccination timeliness was observed for those eligible during the COVID-19 Slowing Down Period in comparison to the Pre-COVID Period (HR 0.99, 95% CI 0.91–1.09). By the end of May 2023, DTP3 rate among eligible children during the COVID-19 Surging Period had surpassed 90%. Significantly declining rates of timely vaccination were observed during the COVID-19 Surging Period, which lasted two months, but not during the nearly three-year-long COVID-19 Low Epidemic Period. An upward trend in vaccination timeliness followed, culminating in a return to baseline levels over the subsequent 3–4 months. Our findings suggested that the pandemic exerted a decreasing and recoverable impact on the coverage rate of routine immunizations in China. [ABSTRACT FROM AUTHOR]

• High heterogeneity in the first-dose vaccine coverage within immigrant's population. • Immigrants from Eastern Europe showed lowest first-dose vaccine coverage. • Gender differences in first-dose vaccine coverage emerged for migrants from Africa. Immigrants are commonly considered disadvantaged and at high risk of not receiving appropriate care, including vaccination. This study aimed to evaluate the access to SARS-CoV-2 vaccination in immigrants, by geographical area of origin, compared with Italian citizens. We also evaluated sex differences in vaccine's coverage by geographical area of origin. We performed a retrospective observational study in four Italian regions, including all resident subjects aged 5–69 years, and undergoing first dose SARS-CoV-2 vaccination in the period 28th December 2020- 3rd April 2022. We estimated cumulative coverage percentages, by age class and geographical area. To compare first-dose vaccine coverage by geographical area of origin, we estimated, through a Poisson analysis, Vaccine Coverage Ratios (VCR) with 95 % confidence intervals (95 %CI), adjusting for age and sex. We included 16,294,785 Italian citizens and 2,534,351 immigrants aged 5–69 years and resident in the four regions considered. Regarding the geographical area of origin, 40.7 % of immigrants came from Eastern Europe, 13.5 % from North Africa and 13.1 % from Western Asia. A great variability in the first dose vaccine coverage emerged. We documented substantial heterogeneity in the first-dose vaccine coverage within immigrant's population, expressed with Italy as a reference, ranging from 0,768 (95 %CI: 0,766–0,769) in Eastern Europe countries to 1,013 (95 %CI: 1,009 – 1,018) in Eastern Asia. The chance of being vaccinated was found higher in males compared with females for African countries (VCR 1.07, 95 %CI 1.06–1.08) and Western Asian countries (VCR 1.08, 95 %CI 1.07–1.09). We observed substantial heterogeneity in first-dose SARS-CoV-2 vaccination coverage in immigrants, suggesting a different propensity to vaccines according to the geographical area of origin. These data can help define appropriate and tailored strategies in order to improve vaccine coverage in some specific immigrant groups at the local health district level. [ABSTRACT FROM AUTHOR]

Many western countries are challenged by delayed and insufficient vaccination coverage rates in children, and thus missing WHO coverage targets. This study aimed to estimate vaccination coverage and timeliness in Swiss children over a decade. Furthermore, we evaluated the impact of COVID-19, regional variations, and the adherence to the amended vaccination schedule in 2019. Retrospective observational study with Swiss health insurance claims data including birth cohorts 2012–2021 of children continuously observed until ages 13, 25, and 48 months respectively. We used population-weighted proportions and time-to-event analyses to describe coverage and timeliness of diphtheria/tetanus/pertussis/poliomyelitis/haemophilus influenzae type b (DTaP-IPV-Hib), measles/mumps/rubella (MMR), hepatitis B (HBV), pneumococcal (PCV), and meningococcal (MCV) vaccinations according to the national schedule. The potential impact of COVID-19 and vaccination schedule adherence were evaluated descriptively. Logistic regression was used to investigate regional factors potentially associated with non-vaccination. 120,073 children, representing between 12 and 17 % of all Swiss children born in corresponding years, were included. Coverage remained stable or improved over the years. The 2019 amendment of the national immunization schedule was associated with an increase of ~10 % points in full coverage in Swiss children for DTaP-IPV-Hib, MMR and HBV despite the concurrent COVID-19 pandemic. Nonetheless, full vaccination coverage remained below 90 % with many vaccination series being delayed or not completed. The comparison across the different vaccines revealed large differences in coverage. Moreover, we observed large regional differences in non-vaccination with children living in rural and German-speaking areas more likely to be entirely unvaccinated. Full vaccination coverage in Swiss children is still below 90 % with many vaccinations administered delayed. Given regional differences, missed or delayed booster vaccinations, and differences in vaccine-specific acceptability, more effort may be needed to achieve national vaccination targets. [ABSTRACT FROM AUTHOR]

• Building resilience in vaccination demand is essential to continue to save lives. • Developed the Vaccination Demand Resilience (VDR) framework. • Incongruence between vaccination attitudes/beliefs, behavior, and status can arise. • For vaccination demand to be resilient, attitudes/beliefs, behavior, and status should align. • Framework for program managers and policy makers to improve vaccination resilience. Resilience in vaccination demand is ever more critical as the COVID-19 pandemic has increased our understanding of the importance of vaccines on health and well-being. Yet timid demand for COVID-19 vaccines where available and reduced uptake of routine immunizations globally further raise the urgent need to build vaccination resilience. We demonstrate the complexity of vaccination demand and resilience in a framework where relevant dimensions are intertwined, fluid, and contextual. We developed the Vaccination Demand Resilience (VDR) framework based on a literature review on vaccination demand and expert consultation. The matrix framework builds on three main axes: 1) vaccination attitudes and beliefs; 2) vaccination seeking behavior; and 3) vaccination status. The matrix generated eight quadrants, which can help explain people's levels of vaccination demand and resilience. We selected four scenarios as examples to demonstrate different interventions that could move people across quadrants and build vaccination resilience. Incongruence between individuals' attitudes and beliefs, vaccination behavior, and vaccination status can arise. For example, an individual can be vaccinated due to mandates but reject vaccination benefits and otherwise avoid seeking vaccination. Such incongruence could be altered by interventions to build resilience in vaccination demand. These interventions include information, education and communication to change individuals' vaccination attitudes and beliefs, incentive programs and reminder-recalls to facilitate vaccination seeking, or by strengthening healthcare provider communications to reduce missed opportunities. Vaccination decision-making is complex. Individuals can be vaccinated without necessarily accepting the benefits of vaccination or seeking vaccination, threatening resilience in vaccination demand. The VDR framework can provide a useful lens for program managers and policy makers considering interventions and policies to improve vaccination resilience. This would help build and sustain confidence and demand for vaccinations, and help to continue to prevent disease, disability, and death from vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

• In 2007, Mexico switched pertussis vaccines from whole-cell (wP) to acellular (aP). • There was increased pertussis notifications over the period 2000–2019 in Mexico. • Effectiveness was comparable (>95%) for 3 and 4 doses of wP and aP vaccines. • Vaccine coverage was >90% for dose 1, but decreased for each subsequent dose. • There is high protection against pertussis in children up to 4 years in Mexico. The national immunization program in Mexico includes a 3-dose primary series of pertussis vaccine and a toddler booster dose. In Mexico, whole-cell pertussis vaccines (wP) were switched in 2007 to acellular pertussis vaccines (aP). This retrospective study using Mexican National Databases of Health and population surveillance (2000–2019) assessed the incidence of pertussis, infant pertussis vaccination coverage, and vaccine effectiveness (VE) against clinically-diagnosed and/or laboratory-confirmed pertussis in children aged 6.5–18.5 or 24.5 months for the primary series, and children aged 18.5 or 24.5–48.5 months for the toddler booster. The incidence of pertussis sharply increased in 2012 and was highest in 2012, 2015, and 2016 (0.84–0.94/100,000 person-years). Coverage was highest for the first dose in the primary series, decreasing for each subsequent dose. The VE against notified pertussis was 96.4% (95% CI: 94.7, 97.6) for the first three doses of wP vaccine (2000–2007) and 95.7% (95% CI: 95.1, 96.2) for the first three doses of aP vaccine (2008–2019). Our findings suggested high levels of vaccine effectiveness overall were achieved for the aP and wP vaccines in Mexico between 2000 and 2019. [ABSTRACT FROM AUTHOR]

• Intersectionality theory is rarely applied (20 of 78 studies) in vaccine coverage studies in Canada. • No Canadian vaccine coverage studies explicitly describe using intersectionality theory. • Individual-level characteristics are most studied in Canadian vaccine coverage studies. • Sex and gender are often incorrectly applied in vaccine coverage studies in Canada. Intersectionality refers to the interconnectedness of various social locations creating unique experiences for individuals and groups, in the context of systems of privilege and oppression. As part of immunization coverage research, intersectionality allows healthcare professionals and policymakers to become aware of the constellation of characteristics contributing to low vaccine uptake. The objective of this study was to examine the application of intersectionality theory or concepts, and the appropriate use of sex and gender terminology, in Canadian immunization coverage research. The eligibility criteria for this scoping review included English or French language studies on immunization coverage among Canadians of all ages. Six research databases were searched without date restrictions. We searched provincial and federal websites, as well as the Proquest Dissertations and Theses Global database for grey literature. Of 4725 studies identified in the search, 78 were included in the review. Of these, 20 studies included intersectionality concepts, specifically intersections of individual-level characteristics influencing vaccine uptake. However, no studies explicitly used an intersectionality framework to guide their research. Of the 19 studies that mentioned "gender", 18 had misused this term, conflating it with "sex". Based on our findings, there is an evident lack of intersectionality framework utilization in immunization coverage research in Canada, as well as misuse of the terms "gender" and "sex". Rather than only focusing on discrete characteristics, research should explore the interaction between numerous characteristics to better understand the barriers to immunization uptake in Canada. [ABSTRACT FROM AUTHOR]

Background: Biofortification, the process of enhancing the micronutrient content of staple crops, is a nutrition-sensitive agricultural intervention with the potential to increase micronutrient intakes and improve health outcomes, especially among vulnerable populations. Although data are available on the number of farming households that grow biofortified crops, information on the coverage of biofortified foods in the general population is limited. Such information is critical to assess the performance of biofortification programs and guide decisions related to program implementation while ascertaining progress toward achieving expected impacts. Objective: This study aimed to assess the household coverage of iron-biofortified beans (IBBs) in rural areas of the Northern Province of Rwanda. Methods: We applied methods previously used to assess coverage in large-scale food fortification programs to develop coverage indicators for IBBs. These indicators were 1) consumption of beans in any form; 2) awareness of IBBs; 3) availability of IBBs; 4) consumption of IBBs (ever); and 5) consumption of IBBs (current). Results: Of the 535 households surveyed, 98% consumed beans in any form and 79% were aware of IBBs. Among the 321 households that provided bean samples, only 40% of the samples were biofortified (as determined by a breeding specialist) and only 21% of respondents were able to correctly identify IBBs. Although 52% of households reported to be ever consuming biofortified beans, only 10% of households were currently consuming these beans. Conclusions: Despite relatively high awareness of IBBs among surveyed households, a few households currently consume IBBs, highlighting the need to explore strategies to promote consumption. More research is also required to investigate factors hindering the consumption of IBBs. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the functional and cosmetic results of an innovative procedure for modified Colson flap-graft consisting of immediate defatting of the flap by a liposuction cannula. A cross-sectional study was performed among patients with deep hand burns requiring a modified Colson flap between 2018 and 2021. Outcomes included functional and cosmetic assessment of the hand through a quality-of-life questionnaire, a sensitivity scale and a scar assessment scale. During this period, 7 patients were operated on using our technique. One patient was lost to follow-up; 7 patients with a median age of 44 years were included, with a total of 10 burned hands. The burns were thermal in 5 out of 7 cases and the coverage concerned the whole hand in 50% of the cases. The flaps all received cannula defatting. The median time to flap weaning was 23 days (20 to 30 days). The median follow-up was 16 months. One case required remote flap weaning. The median POSAS (Patient and Observer Scar Assessment Scale) per patient was 4 and 2 per observer. The median BMRCSS (British Medical Research Council Sensory Scale) was 122. One case had recovered S2 sensitivity, the other cases had S3 or S4 sensitivity. Immediate defatting is one of the factors in tegumental quality allowing rapid functional recovery of the hand. The cannula defatting technique does not appear to require additional defatting time. The use of the liposuction cannula allows a one-step, homogeneous, and easier defatting, with a lower risk of devascularization. [ABSTRACT FROM AUTHOR]

Conventional teaching in the management of partial hand amputations prioritizes residual limb length, often through local, regional, or distant flaps. While multiple options exist to provide durable soft tissue coverage, only a few flaps are thin and pliable enough to match that of the dorsal hand skin. Despite debulking, excessive soft tissues from previous flap reconstructions can interfere with residual limb function, prosthesis fit, and surface electrode recording for myoelectric prostheses. With rapid advances in prosthetic technology and nerve transfer techniques, patients can achieve very high levels of function following prosthetic rehabilitation that rival, or even outpace, traditional soft tissue reconstruction. Therefore, our reconstruction algorithm for partial hand amputations has evolved to the thinnest coverage possible, providing adequate durability. This evolution has provided our patients with faster and more secure prosthesis fitting with better surface electrode detection, enabling earlier and improved use of simple and advanced partial hand prostheses. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused unprecedented disruption in health service delivery, globally. This study sought to provide evidence on the impact of the pandemic on vaccine coverage in Kilifi County, Kenya. We conducted a vaccine coverage survey between April and June 2021 within the Kilifi Health and Demographic Surveillance System (KHDSS). Simple random sampling was used to identify 1500 children aged 6 weeks–59 months. Participants were grouped into three retrospective cohorts based on when they became age-eligible for vaccination: before the pandemic, during the first year, or during the second year of the pandemic. Survival analysis with Cox regression was used to evaluate the association between the time-period at which participants became age-eligible for vaccination and the rate of vaccination within a month of age-eligibility for the third dose of pentavalent vaccine (Pentavalent-3) and within three months of age-eligibility for the first dose of Measles vaccine (MCV-1). A total of 1,341 participants were included in the survey. Compared to the pre-COVID-19 baseline period, the rate of vaccination within a month of age-eligibility for Pentavalent-3 was not significantly different in the first year of the pandemic (adjusted hazard ratio [aHR] 1.03, 95 % confidence interval [CI] 0.90–1.18) and was significantly higher during the second year of the pandemic (aHR 1.33, 95 % CI 1.07–1.65). The rate of vaccination with MCV-1 within three months of age-eligibility was not significantly different among those age-eligible for vaccination during the first year of the pandemic (aHR 1.04, 95 % CI 0.88–1.21) and was 35 % higher during the second year of the pandemic (95 % CI 1.11–1.64), compared to those age-eligible pre-COVID-19. After adjusting for known determinants of vaccination, the COVID-19 pandemic did not adversely affect the rate of vaccination within the KHDSS. [ABSTRACT FROM AUTHOR]

Supplementary immunization activities (SIAs) aim to interrupt measles transmission by reaching susceptible children, including children who have not received the recommended two routine doses of MCV before the SIA. However, both strategies may miss the same children if vaccine doses are highly correlated. How well SIAs reach children missed by routine immunization is a key metric in assessing the added value of SIAs. Children aged 9 months to younger than 5 years were enrolled in cross-sectional household serosurveys conducted in five districts in India following the 2017–2019 measles-rubella (MR) SIA. History of measles containing vaccine (MCV) through routine services or SIA was obtained from documents and verbal recall. Receipt of a first or second MCV dose during the SIA was categorized as "added value" of the SIA in reaching un- and under-vaccinated children. A total of 1,675 children were enrolled in these post-SIA surveys. The percentage of children receiving a 1st or 2nd dose through the SIA ranged from 12.8% in Thiruvananthapuram District to 48.6% in Dibrugarh District. Although the number of zero-dose children prior to the SIA was small in most sites, the proportion reached by the SIA ranged from 45.8% in Thiruvananthapuram District to 94.9% in Dibrugarh District. Fewer than 7% of children remained measles zero-dose after the MR SIA (range: 1.1–6.4%) compared to up to 28% before the SIA (range: 7.3–28.1%). We demonstrated the MR SIA provided considerable added value in terms of measles vaccination coverage, although there was variability across districts due to differences in routine and SIA coverage, and which children were reached by the SIA. Metrics evaluating the added value of an SIA can help to inform the design of vaccination strategies to better reach zero-dose or undervaccinated children. [ABSTRACT FROM AUTHOR]

Wireless Sensor Network (WSN) is built with the wireless interconnection of Sensor Nodes (SNs) generally deployed to monitor the changes within the environment of hostile, rugged, and unreachable target regions. The optimal placement of SNs is very important for the efficient and effective operation of any WSN. Unlike small and reachable regions, the deployment of the SNs in large-scale regions (e.g., forest regions, nuclear radiation affected regions, international border regions, natural calamity affected regions, etc.) is substantially challenging. Present paper deals with an autonomous air-bone scheme for the precise placement of SNs in such large-scale regions. It uses an Omni-directional Circular Glider (OCG) per SN. After being aerially dropped, SN pilots the OCG to glide itself to the predetermined locations (PL) within a target region. The major advantage of using OCG is its capability to quickly update the direction, during the flight (with turning radius = 0) toward its PL. The proposed uses a recursive path correction model to maintain the orientation of the gliding SN towards the PL. The simulation results, and the hardware implementation, indicate that the proposed model is effectively operational in the environmental winds. It is time-efficient and more accurate in the deployment of the SNs in comparison to existing state of art SN deployment models. [ABSTRACT FROM AUTHOR]

Fuzz testing serves as a key technique in software security aimed at identifying unexpected program behaviors by repeatedly executing the target program with auto-generated random inputs. Testing is integral to IoT device security but is hampered by the minimal observability features of typical in-market IoT devices. Moreover, the slow nature of a RISC-V software emulation on x86 host CPUs and the inaccuracies introduced by compiling IoT applications to a different ISA for execution on host systems pose significant challenges. Our software-hardware co-design surmounts these hurdles. Fuzzing jobs are prepared and evaluated on a host computer, while the actual execution with high-throughput tracing is performed on an FPGA. Advances in the host-to-FPGA interface together with an accelerated reset procedure between Fuzzer jobs effectively hide the costly host-FPGA communication, increasing the single-thread fuzzing performance by up to factor 11.7x that of the leading QEMU-based fuzzer AFL++ running on a very fast x86 CPU. We demonstrate practical usability by evaluating our framework on a collection of applications in a bare-metal environment. [ABSTRACT FROM AUTHOR]

In this study, martensitic high-strength steel serves as the subject of investigation, with both conventional and severe shot peening experiments being conducted. The coverage levels for conventional shot peening (CSP) are set at 100 % and 200 %, while severe shot peening (SSP) sees levels of 800 % and 1200 %. For the first time, the use of kernel average misorientation (KAM) enables the calculation of geometrically necessary dislocation (GND) density after peening, facilitating the study of GND density distribution across different coverage and offering a method for the visual assessment of peening degree. Results reveal that, under CSP, the gradient distribution of grain size is relatively uniform, whereas SSP leads to a pronounced gradient in grain size distribution. Taking into account the heterogeneous distribution of the initial material microstructure, a gradient in grain size from the surface to the interior of the material will appear after the coverage reaches a certain value, which is 400 % for AISI 9310 steel. Compared with CSP, SSP will further reduce the surface roughness Sa and improve the surface quality. The research presented further understands the relationship between shot peening process parameters and martensitic steel microstructure, providing an important reference for revealing the strengthening mechanism and selecting reasonable process parameters. • Increasing the coverage level not only can obtain finer grains, but also easier to obtain gradient grain size. • The 400 % coverage level is the critical coverage of graded grain of AISI 9310 steel. • Significantly increasing the coverage can reduce the surface roughness of AISI 9310 steel. • When the coverage exceeds 800 %, the surface layer of AISI 9310 steel will form submicron grain. [ABSTRACT FROM AUTHOR]

In 2016, the Kenya National Immunization Technical Advisory Group requested additional programmatic and cost effectiveness data to inform the choice of strategy for a national influenza vaccination program among children aged 6–23 months of age. In response, we conducted an influenza vaccine demonstration project to compare the performance of a year-round versus campaign-mode vaccination strategy. Findings from this demonstration project will help identify essential learning lessons for a national program. We compared two vaccine delivery strategies: (i) a year-round vaccination strategy where influenza vaccines were administered throughout the year at health facilities. This strategy was implemented in Njoro sub-county in Nakuru (November 2019 to October 2021) and Jomvu sub-county in Mombasa (December 2019 to October 2021), (ii) a campaign-mode vaccination strategy where vaccines were available at health facilities over four months. This strategy was implemented in Nakuru North sub-county in Nakuru (June to September 2021) and Likoni sub-county in Mombasa (July to October 2021). We assessed differences in coverage, dropout rates, vaccine wastage, and operational needs. We observed similar performance between strategies in coverage of the first dose of influenza vaccine (year-round strategy 59.7 %, campaign strategy 63.2 %). The coverage obtained in the year-round sub-counties was similar (Njoro 57.4 %; Jomvu 63.1 %); however, more marked differences between campaign sub-counties were observed (Nakuru North 73.4 %; Likoni 55.2 %). The campaign-mode strategy exceeded the cold chain capacity of participating health facilities, requiring thrice monthly instead of once monthly deliveries, and was associated with a two-fold increase in workload compared to the year-round strategy (168 vaccines administered per day in the campaign strategy versus 83 vaccines administered per day in the year-round strategy). Although both strategies had similar coverage levels, the campaign-mode strategy was associated with considerable operational needs that could significantly impact the immunization program. [ABSTRACT FROM AUTHOR]

Background: Kenya introduced a monovalent rotavirus vaccine administered orally at 6 and 10 weeks of age into her National Immunization Program in July 2014. The study evaluated the long-term impact of the vaccine on hospitalization for all-cause and rotavirus-specific acute gastroenteritis (AGE) and strain epidemiology in Kenya. Methods: Data on all-cause and rotavirus-specific AGE and strain distribution were derived from an eleven-year hospital-based surveillance of AGE among children aged <5 years at Kiambu County Teaching and Referral Hospital (KCTRH) in Central Kenya between 2009 and 2020. Fecal samples were screened for group A rotavirus using ELISA and genotyped using multiplex semi-nested RT-PCR. Trends in all-cause and rotavirus-related AGE and strain distribution were compared between the pre-vaccine (July 2009–June 2014), early post-vaccine (July 2014–June 2016) and late post-vaccine (February 2019–October 2020) periods. Results: Rotavirus-specific AGE was detected at 27.5% (429/1546, 95% CI: 25.5–30.1%) in the pre-vaccine period; 13.8% (91/658, 95% CI: 11.3–16.6%) in the early post-vaccine period (July 2014–June 2016); and 12.0% (229/1916, 95% CI: 10.6–13.5%) in the late post-vaccine period (February 2019–October 2020). This amounted to a decline of 49.8% (95% CI: 34.6%–63.7%) in rotavirus-specific AGE in the early post-vaccine period and 53.4% (95% CI: 41.5–70.3%) in the late post-vaccine period when compared to the pre-vaccine period. All-cause AGE hospitalizations declined by 40.2% (95% CI: 30.8%–50.2%) and 75.3% (95% CI: 65.9–83.1%) in the early post-vaccine and late post-vaccine periods, respectively, when compared to the pre-vaccine period. G3P [8] was the predominant strain in the late post-vaccine period, replacing G1P[8] which had predominated in the pre-vaccine and early post-vaccine periods. Additionally, we detected considerable proportions of uncommon strains G3P[6] (4.8%) and G12P[6] (3.5%) in the post-vaccine era. Conclusion: Rotavirus vaccination has resulted in a significant decline in all-cause and rotavirus-specific AGE, and thus, provides strong evidence for public health policy makers in Kenya to support the sustained use of the rotavirus vaccine in routine immunization. However, the shift in strain dominance and age distribution of rotavirus AGE in the post-vaccine era underscores the need for continued surveillance to assess any possible vaccine-induced selective pressure that could diminish the vaccine effectiveness over time. • Rotavirus vaccination led to significant reductions in all-cause and rotavirus diarrhoea in Kenya over a period of 6 years. • The reductions were most pronounced among the children aged <12 months (vaccine-eligible children). • Data provide compelling evidence for the public health benefits of rotavirus vaccination in Kenya. • The shift in rotavirus diarrhoea to older age groups and the changing rotavirus strain epidemiology call for continued surveillance. [ABSTRACT FROM AUTHOR]

Urban greenways enhance the social, environmental, and ecological facets of city life by offering accessible and engaging spaces for residents. Despite their significance, the route selection for these urban greenways often hinges on suitability analysis, which can be influenced by a planner's subjective judgment, thus potentially introducing bias. Spatial optimization is a potential solution for determining optimal urban greenway routes. However, urban greenway route planning poses a distinct spatial optimization challenge that is not addressed by existing models. While urban greenways are inherently linear features, there are generally no specific start or end points dictated in their planning, which contrasts with many existing line-based spatial optimization models. Moreover, the way that coverage for urban greenways is measured—by taking into account the area encompassed within a particular distance from the entire urban greenway—deviates from the method used in conventional coverage optimization models, which works through discrete point-based evaluations. To address these gaps, our study introduces the maximal covering location problem for lines (MCLP-Line) model, which is designed to determine the optimal single-line-shaped urban greenway route with maximum coverage of nearby residents. In this paper, we utilize a line graph data structure to transform the candidate road network into a graph where road segments become nodes and junctions are treated as edges. We delineate the mixed integer linear programming formulation for the MCLP-Line model and discuss approaches for eliminating subtours in the MCLP-Line model in detail. The study provides simulation tests using both randomly generated data and an empirical dataset from Lhasa to demonstrate the practicality and computational efficiency of the proposed model. • Unique spatial optimization challenges in urban greenway route planning are not adequately addressed by current models. • Our research introduces the MCLP-Line model for maximizing the coverage of a continuous single line. • The MCLP-Line model considers the entire area surrounding the proposed greenway rather than the node-proximate area considered. • The MCLP-Line model does not necessitate setting predefined starting or ending nodes that are mandatory in the existing models. [ABSTRACT FROM AUTHOR]

• Surface and subsurface quality of LPBFed steel after varying coverages were investigated. • Strengthening mechanisms for tensile and fatigue properties were identified. • Saturated micro-defect density compromised fatigue properties. • Shot peening process-microstructure-performance relationship was established. Developing effective strategies for enhancing the damage tolerance of laser powder bed fusion (LPBF) components remains a formidable challenge in the disruptive additive manufacturing field. The typical shot-peening (SP) is a promising and efficient post-treatment procedure owing to its capability to introduce compressive residual stress, enhance the surface integrity, shrinkage the subsurface lack-of-fusion (LoF) defects of LPBF components. However, there is still a significant gap in understanding the appropriate utilization of the SP procedure to enhance fatigue performance, hindering its full potential in practical applications. This study systematically investigated the influence of surface coverage (150 %, 300 %, and 450 %) on surface characteristics, subsurface characteristics, and mechanical properties of LPBF 304L austenitic steel. Though evaluating the feasibility of severe shot peening and observing post-deformed microstructures, the process-microstructure-performance relationship of shot-peened LPBF austenitic steel was preliminarily established for the first time. The results indicated that increasing surface coverage up to a threshold (300 % in this work) could effectively enhance the strength and fatigue performance without significantly sacrificing ductility, primarily attributed to the increased gradient strain generated by the gradient deformation structures as well as the shrinkage of detrimental near-the-surface defects. The excessive surface coverage may be detrimental to ductility and fatigue performance, as it directly increases the severe plastic deformation and near-saturated micro-defects in the gradient deformation layer, substantially weakening the strain gradient's capability to accommodate dislocation flow during deformation. The findings suggested careful selection of shot peening coverage to balance enhanced mechanical properties and minimal introduction of detrimental defects. [Display omitted] [ABSTRACT FROM AUTHOR]

To estimate HZ vaccine coverage in Australia among older Australians and to identify potential barriers to vaccination. Analysis of data from three cross-sectional surveys administered online between 2019 and 2020. Adults aged 65 and over residing in Australia. Self-reported herpes zoster vaccination. Among the 744 adults aged 65 and over in this sample, 32% reported being vaccinated for HZ, including 23% of participants aged 65–74, 55% of participants aged 75–84, and 0% for participants aged 85 and above. Those who are vaccinated with other immunisations are more likely to have received HZ vaccine, including seasonal influenza (OR = 4.41, 95 % CI: 2.44–7.98) and pneumococcal vaccines (OR = 4.43, 95 % CI: 2.92 – 6.75). Participants with a history of certain conditions, such as stroke (OR = 2.26, 95 % CI: 1.13–4.49), were more likely to be vaccinated against HZ. Participants that reported smoking tobacco daily were less likely to be vaccinated against HZ (OR = 0.48, 95 % CI: 0.26–0.89). Participants were less likely to be vaccinated against HZ if they preferred to develop immunity 'naturally' (OR = 0.29, 95 % CI: 0.15 – 0.57) or expressed distrust of vaccines (OR = 0.34, 95 % CI: 0.13–0.91). Further research is required to understand the barriers to HZ vaccine uptake. Increasing the funding eligibility for those who are at risk of complications from shingles, or lowering the age of eligibility, may increase vaccine coverage. [ABSTRACT FROM AUTHOR]

• Turnbull estimator to account for censoring of vaccination dates in India. • Analyzed national and state-level coverage and timeliness using two national surveys conducted in 2005–06 and 2015–16 spanning over a decade. • National coverage (range: 3.6–11.3%) and timeliness increased (11.2–63.9%) • Increase in timeliness (range: 8.4–94.2%) was greater than coverage (3.4–9.8%) • The results emphasize the importance of timeliness in predicting outbreaks. India has experienced a substantial increase in the coverage of routine childhood vaccines in recent years. However, a large fraction of these vaccines is not delivered in a timely manner, i.e., at the recommended age. Further, substantial disparities exist in both coverage and timeliness across states. We aim to quantify the changes in coverage and timeliness of routine childhood vaccination in India over time, their variation across states, and changes in these variations over time. We used data from two rounds of India's National Family Health Surveys, NFHS-3 (2005–06) and NFHS-4 (2015–16) on bacille Calmette–Guerin vaccine (BCG), three doses of diphtheria, pertussis, and tetanus vaccine (DPT1, DPT2, DPT3), and measles-containing vaccine (MCV). We used the Turnbull estimator to estimate the cumulative distribution function (CDF) of administering each vaccine by a certain age while accounting for two-sided censoring in the survey data. We then used these estimated CDFs to calculate coverage and timeliness at the national and state levels. At the national level, both vaccination coverage and timeliness estimates increased from NFHS-3 to NFHS-4 for all vaccines. The increase in timeliness ranging from 27.3% for DPT3 to 74.0% for MCV continued to be lower than coverage, ranging from 75.3% (95% CI 57.7–87.2) for DPT3 to 74.0% (95% CI 42.2–33.0) for MCV, for all vaccines. Cross-state variation in timeliness was greater than the variation in coverage. Variation in both timeliness and coverage reduced from NFHS-3 to NFHS-4. However, this reduction was greater for timeliness than for coverage. A large fraction of the children in India receive vaccines later than the recommended age thereby keeping them exposed to vaccine-preventable diseases. Interventions that specifically focus on improving the timely delivery of vaccines are needed to improve the overall effectiveness of the routine immunization program. [ABSTRACT FROM AUTHOR]

• Hand hygiene technique was assessed using a thermal camera attached to a smartphone. • Thermal images showed if an alcohol hand sanitizer was applied to fingers and thumb. • Thermal camera readings revealed temperature changes due to sanitizer application. • Thermal imaging shows promise as a method of assessing hand hygiene technique. Currently, there is no standard method for assessing hand hygiene (HH) technique. We explored the use of thermal imaging to determine if alcohol-based sanitizer (ABHS) has been applied to fingertips and thumbs, areas often missed by healthcare personnel. A FLIR thermal camera attached to an iPhone with FLIR app was used to obtain thermal images of volunteers' dominant hand before and after performing HH with an ABHS. Temperature readings of the mid-palm area, and tips of 3rd finger and thumb were recorded before and at multiple time points after hand hygiene. In 11 of 12 volunteers, thermal images revealed significant decreases in mid-palm, finger and thumb temperatures after performing HH (P <.01 for all sites), confirming visual assessment of coverage. When HH was performed without including the thumb, a lack of colorimetric change in the thumb was visible. For persons with "cold" fingers at baseline, assessing ABHS coverage of the fingers was more difficult. Thermal imaging of HH performance shows promise for assessing HH technique. Additional studies involving a larger number of persons under varying conditions are needed to establish if thermal imaging can be a practical modality for teaching or monitoring HH technique. [ABSTRACT FROM AUTHOR]

• Pneumococcal vaccination is recommended for adult patients with axial spondyloarthritis (axSpA) treated with biological drugs. • Little is known about vaccination status of this specific patient population. • First study to assess pneumococcal vaccination rate for this population in Switzerland. • Large online survey by the ankylosing spondylitis association of Switzerland (SVMB). • Low adherence to pneumococcal vaccination was found. • Most were vaccinated by their general practitioner, but vaccine does not seem to be offered systematically. While in Switzerland, pneumococcal vaccination is recommended for adult patients with axial spondyloarthritis (axSpA) treated with biological drugs, since 2014, little is known about the vaccination status of this specific patient population. This study assessed their vaccination status as part of a larger online survey by the ankylosing spondylitis association of Switzerland (SVMB). Out of 1560 who participated in the survey, 834 (53.5%) were eligible for the analysis. Vaccine coverage was low at 32.5% (271/834). Women and patients who got a flu shot every year were more likely to be covered. Age was negatively associated with being vaccinated. Most (54.2%; 147/271) were vaccinated by their general practitioner. Almost two-thirds of those who had not received the vaccine stated that it had not been offered to them (64.1%; 302/471). In summary, the vaccination coverage is low, but might be increased if the vaccine was offered systematically by general practitioners and specialists. [ABSTRACT FROM AUTHOR]

• Dose two MenB vaccine coverage at 12 months is >92% but this varies by ethnicity. • Ethnicities with lowest dose one coverage have highest drop-out rates for dose two. • Variation in drop-out rates reduced but remained after adjusting for other factors. • Drop-out rates (dose one to dose two) increased with increasing deprivation. In England, the Meningitis B (MenB) vaccine is scheduled at eight and 16 weeks with a booster dose at one year of age and protects children against invasive bacterial meningococcal disease caused by Neisseria meningitidis serogroup B. Coverage of the second dose of MenB vaccine at 12 months was >92% in 2017/18, but this may mask inequalities in coverage in particular population groups. MenB vaccination records for children aged six, 12 and 18 months of age from December 2016 to May 2018 were routinely extracted from GP patient management systems every month in England via a web-based platform for national monitoring of vaccine coverage. We determined the association between ethnicity, deprivation and area of residence, vaccine coverage and drop-out rates (between dose one and dose two), using binomial regression. After adjusting for other factors, ethnic groups with lowest dose one coverage (Black or Black British-Caribbean, White-Any other White background, White-Irish) also had lowest dose two coverage, but in addition, these ethnic groups also had the largest drop-out rates between dose one and dose two. The drop-out rate for Black or Black British-Caribbean children was 5.7 percentage points higher than for White-British children. Vaccine coverage decreased with increasing deprivation quintile, and this was most marked for the booster coverage (6.2 percentage points lower in the most deprived compared to least deprived quintile, p < 0.001). To achieve high coverage for completed courses across all ethnic groups and deprivation quintiles both high initiation rates and a reduction in drop-out rates for ethnic groups with lowest coverage is necessary. A qualitative approach to better understand reasons behind lower coverage and higher drop-out rates in the most underserved ethnic groups is required to develop tailored approaches addressing these inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Management of soft tissue defects around the ankle is a difficult and challenging situation for all reconstructive surgeons. A microsurgical free flaps coverage can solve this problematic situation especially with large defects that is not available in all trauma centers. Moreover, long operating time and suitable operative demands are considered obstacles.Materials and Method: Eighty five patients having soft tissue defects around ankle were included in this study. They underwent various reconstructions in our specialized hand and reconstructive microsurgery unit from 2015 to 2019. Fifty two were males and thirty three patients were females. Road traffic accident was the main cause of injury in 66 patients followed by implant exposure in 15 patients and chronic osteomyelitis in 4 patients. Distally based superficial sural artery flap was used to reconstruct the defects in 21 cases, free flap was used in 32 cases, Rotational local flap was used in 8 cases, contralateral distally based superficial sural artery flap was used in 2 cases, full or partial skin flaps were used in 10 cases and Propeller flap was used in 12cases.Results: All flaps survived except for one modified sural flap with 98% success rate and average follow up of 48 months. All patients were satisfied with the functional capacity of operated limbs. Average time of bone healing postoperative was 3 months with gradual return to original work with acceptable degrees for cosmotic appearance of the limbs.Conclusion: Many treatment options are available to cover defects around the ankle. Propeller and rotational flaps are fast and easy but cover small defects, distally-based modified sural artery flap is an excellent reliable flap. Microsurgical free flaps provide good contour, color, texture and cover large defects but require microsurgery facilities to execute. [ABSTRACT FROM AUTHOR]

• We modelled expected DTP1, DTP3, and MCV1 coverage in 2020 based on historical trends from publicly-available vaccination coverage data. • We report a 2·9% (95 % CI : [2·2%; 3·6%]) global decline in DTP3 coverage from an expected 89·2% to a reported 86·3%; and similar results for DTP1 and MCV1. • These declines translate to levels of coverage last observed in 2005, thus suggesting a potential 15-years setback in RI improvements. • These declines are less than previous modelling – compatible with the hypothesis that coverage fell more acutely in early 2020 and then rebounded. Whilst COVID-19 vaccination strategies continue to receive considerable emphasis worldwide, the extent to which routine immunisation (RI) has been impacted during the first year of the pandemic remains unclear. Understanding the existence, extent, and variations in RI disruptions globally may help inform policy and resource prioritisation as the pandemic continues. We modelled historical, country-specific RI trends using publicly available vaccination coverage data for diphtheria, tetanus and pertussis-containing vaccine first-dose (DTP1) and third-dose (DTP3) from 2000 to 2019. We report a 2·9% (95 % CI : [2·2%; 3·6%]) global decline in DTP3 coverage from an expected 89·2% to a reported 86·3%; and a 2·2% decline in DTP1 coverage (95 % CI : [1·6%; 2·8%]). These declines translate to levels of coverage last observed in 2005, thus suggesting a potential 15-years setback in RI improvements. Further research is required to understand which factors – e.g., health seeking behaviours or non-pharmaceutical interventions – linked to the COVID-19 crisis impacted vaccination coverage. [ABSTRACT FROM AUTHOR]

The observed difference in the selectivity towards alkane, ketone, and alcohol hydrodeoxygenation products over Ru and Rh catalysts is explored using a combination of density functional theory and microkinetics. Using γ -valerolactone as a model compound, we investigate the reaction mechanism in order to identify selectivity determining species. The effect of the coadsorbed water molecule as well as the higher adsorbate surface coverage on reaction barriers and energies is explored as well. The performed calculations suggest that the desired alkane product is formed from a ketone intermediate on Ru, and through both ketone and alcohol on Rh, although the selectivity towards alkane on Rh is much lower than on Ru. • Hydrodeoxygenation reaction of γ -valerolactone is explored on Ru(0001) and Rh(111) • The mechanism is studied computationally with DFT and microkinetic modeling • Two parallel alkane pathways with alcohol and ketone intermediates are identified • On Ru(0001) significant amounts of alkane are produced through the ketone pathway • Alcohols and ketones could be important intermediates for the reaction on Ru and Rh [ABSTRACT FROM AUTHOR]

In summary, changes in coverage have a significant impact on O H and C H bond broken, especially on the energy barrier of C H bond broken. When the coverage is 1/6, the reaction of CH 3 OH → CH 2 O* is the most advantageous in dynamics. [Display omitted] • It is found that the adsorption energy of CH 3 OH, CH 3 O and CH 2 O on Pt(1 1 1) increased with the increase of coverage. • 1/6 coverage is the optimal reaction choice for the dehydrogenation of CH 3 OH to CH 2 O. Platinum metal exhibits excellent catalytic activity and selectivity in many important chemical reactions. In this paper, density functional theory is used to study the adsorption configurations of oxygen in methanol on Pt(1 1 1) surface and dehydrogenation reaction (CH 3 OH → CH 2 O) at different coverage. It is found that methanol molecules prefer to adsorb at the top position of Pt(1 1 1) at various coverage levels. With the coverage increases, the adsorption capacity of methanol decreases rapidly, and then tends to flatten until the coverage reaches 1/6. The product of CH 2 O is formed by two-step dehydrogenation process. The energy barrier for both dehydrogenations increase first and then decreases with increasing coverage. The lowest energy barrier for both dehydrogenations occurs on the Pt(1 1 1) surface with coverage of 1/6 (E a, O H = 0.66 eV, E a, C H = 0.16 eV). Therefore, coverage of 1/6 is the optimal coverage for CH 3 OH generating CH 2 O on the Pt(1 1 1) surface. [ABSTRACT FROM AUTHOR]

Metal M 1 /metal oxide M 2 O x (M 1 M 2 O x) inverse catalysts, where the oxide layer rests atop metal, have gained attention for their distinct catalytic performance. They are intensively studied in biomass upgrading, e.g., the hydrogenolysis of tetrahydrofurfuryl alcohol to produce 1,5-pentanediol. Pt and MO x (M = W, Mo, Re, Nb) exhibit remarkable synergism in activity and selectivity, but the active sites remain poorly understood. Here, we examine the influence of oxide loading on PtMO x inverse catalysts and introduce a high-pressure wash treatment to leach the excess oxide from carbon and optimize their structure. The findings reveal a saturation sub-monolayer MO x coverage with 2D atomic structure on Pt that is crucial for performance; excessive loading leads to nanocrystalline of lower activity, and low loading exposes unselective metal sites. Wash treatment selectively removes MO x from carbon, enhances their dispersion on Pt, and improves, in most cases, the performance. Tuning the inverse structure advances structure-reactivity understanding. [Display omitted] • Submonolayer MO x coverage with 2D atomic structure on Pt is optimal. • Excessive MO x loading leads to nano-crystallites of lower activity. • Low loading exposes unselective metal sites. • Wash treatment removes MO x from the carbon and enhances its dispersion on Pt. • This study improves structure-reactivity understanding of inverse catalysts. [ABSTRACT FROM AUTHOR]

Objectives: Healthcare policy makers should ensure optimal patient access to medical nutrition (MN) as part of the management of nutrition-related disorders and conditions. Questions remain whether current healthcare policies reflect the clinical and economic benefits of MN. The objective of this article is to characterize coverage and reimbursement of MN, defined as food for special medical purposes/medical food for a diverse set of countries, including Australia, Belgium, Brazil, Canada, China, France, Germany, Hong Kong, Italy, Japan, The Netherlands, Singapore, Spain, United Kingdom, and United States.Methods: Data sources included published literature and online sources. ISPOR's Nutrition Economics Special Interest Group developed a data collection form to guide data extraction that included reimbursement coverage, years that reimbursement policies were established, and presence of a formal health technology assessment (HTA) for MN technologies.Results: Reimbursement coverage of MN technologies varied across the countries that were reviewed. All but 3 countries limited coverage to specific formulations of products, regardless of demonstrated clinical benefit. The year that reimbursement policies were established varied across countries (ranging from 1984 to 2017), and only 4 countries regularly update policies. France and Brazil are the only countries with a formal HTA process for MN technologies.Conclusions: Most countries have limited MN reimbursement, have not updated reimbursement policies, and lack HTA for MN technologies. These limitations may lead to suboptimal access to MN technologies where they are indicated to manage nutrition-related disorders and conditions, with the potential of negatively affecting patient and healthcare system outcomes. [ABSTRACT FROM AUTHOR]

Considering the lack of adequate cycling infrastructure networks in many cities, decision makers must face the challenge of designing connected bicycle facility networks to ensure safe and comfortable access to urban opportunities for cyclists and the usability of infrastructure. This paper addresses the maximal covering bicycle network design problem (MCBNDP). MCBNDP involves making investment decisions to build a cycling network that is aimed at maximizing the coverage of cyclists, while maintaining a minimum total network cost at its minimum. The derived network is subject to a budget limit and accounts for the entire connectivity and directness as fundamental bicycle network design criteria. Cyclists who are located at a given origin are considered covered by the network if a connected path of dedicated cycling infrastructure links them to their desired destination, within a maximum travel distance. We propose a mixed-integer linear programming (MILP) formulation, including a two-phase solution approach to solving the MCBNDP. In addition, using a commercial solver, our MILP formulation allows exact solutions to be obtained for large-scale instances with reasonable computing times for these types of problems. This MILP formulation is employed to solve a real instance that is applied to a wide territory of analysis in Medellin city (Colombia). The findings of this paper will contribute to existing literature and support urban policymakers to better spatially allocate the resources and, consequently, maximize the impact of their investments on connected cycling infrastructure networks. Our findings indicate that access to opportunities for cyclists can be easily favored by making small improvements to the existing infrastructure to guarantee safe, direct, and comfortable cycling infrastructure. Because we specify a maximum travel distance rather than a shortest path limitation, our problem ensures that cyclists may have several possibilities for their routes, which may go along the shortest path or any other alternative, however, without exceeding the maximum travel distance. In this direction, our findings confirm that prioritizing coverage, while accounting for full network connectivity, will benefit more cyclists because of the flexible configuration of the new network, which also may ensure its usability. [ABSTRACT FROM AUTHOR]

Recent trends indicate the rapid growth of nature-inspired techniques in the field of optimization. Salp Swarm Algorithm (SSA) is a recently introduced stochastic algorithm that is inspired by the navigational capability and foraging behavior of Salps. However, classical SSA gives unsatisfactory results on higher dimension problems depicting poor convergence rate. The search process of SSA lacks exploration and exploitation resulting in convergence inefficiency. This paper proposes a strategy based on the weighted distance position update called Weighted Salp Swarm Algorithm (WSSA) to enhance the performance and convergence rate of the SSA. The proposed WSSA is validated using different benchmark functions and analyzed against seven different stochastic algorithms. The validation results confirmed enhanced performance and convergence rate of WSSA. Moreover, the proposed variant is applied for optimal sensor deployment task. WSSA approach is applied on probabilistic sensor model to maximize coverage and radio energy model to minimize energy consumption. This strategy is a trade-off between coverage and energy efficiency of the sensor network. It was observed that WSSA algorithm outperformed all the other stochastic algorithms in optimizing coverage and energy efficiency of Wireless Sensor Network (WSN). [ABSTRACT FROM AUTHOR]

• Zimbabwe achieved 75-86% HPV vaccine coverage among all 10 to 14 year old girls. • HPV vaccine coverage was slight lower in older aged girls compared to younger. • Cervical cancer protection and trust in vaccines were reasons for high acceptance. Zimbabwe has one of the highest incidence rates of cervical cancer in the world – 61.7 per 100,000 women. The government of Zimbabwe introduced bivalent HPV vaccine with a 0,12 month schedule to all 10–14 year old girls using a pulsed-campaign approach in May 2018 (dose 1) and May 2019 (dose 2). In August 2019, we conducted a population-based, two-stage cluster survey of households with girls who were eligible for the national HPV vaccination program to determine two-dose HPV vaccination coverage in three districts of Zimbabwe. All households with girls currently aged 11 to 15 years were line-listed through a census conducted in the pre-selected clusters from each district prior to survey administration. A simple random sample of eligible households was selected from these lists to estimate HPV vaccine coverage at sufficient power with a margin of error of +/- 5%. Criteria for district selection included estimated vaccine uptake (low, medium, high), rural/urban/ peri -urban, geographic area, estimated number of girls not in school, and recent natural disasters or disease outbreaks. We oversampled households with girls aged 13 or 14 years at the time of dose 1. On-time dose 1 uptake ranged from 88 to 94% and two-dose HPV vaccine coverage ranged from 75 to 86% across the three districts. Nearly all vaccinations occurred in schools, and less than 2% of girls did not attend school. There were challenges assessing ages of girls at schools prior to vaccination – 9% of girls vaccinated were less than 10 years old at time of dose 1. Zimbabwe has demonstrated that high uptake and successful completion of 2-dose HPV vaccination can be achieved with an annual dosing schedule. Efforts going forward will need to focus on minimizing dropout between doses and routinizing annual vaccinations in schools for every subsequent new cohort of eligible girls in the country. [ABSTRACT FROM AUTHOR]

Vaccination is the most important mechanism to improve childhood survival. However, immunization coverage is very low and unevenly distributed throughout the country. Therefore, this study was aimed to investigate the spatiotemporal distribution of immunization coverage in Ethiopia. Immunization coverage data and geospatial covariates data were obtained from EDHS 2000 to 2019 and different publicly available sources. A Bayesian geostatistic model was used to estimate the national immunization coverage at a pixel level and to identify factors associated with the spatial clustering of immunization coverages. The overall immunization coverage in Ethiopia was 38.7%, 36.55%, 51.8%, 67.1% and 66.9% for 2000, 2005, 2011, 2016 and 2019 respectively. Spatial clustering of low immunization coverage was observed in Eastern, Southern, Southwestern, Southeastern and Northeastern parts of Ethiopia in EDHSs. The altitude of the area was positively associated with immunization coverage in 2000, 2005 and 2019 EDHS. The population density was positively associated with immunization coverage in 2000, 2005, 2011 and 2016. Precipitation is also positively associated with immunization coverage in 2016. Moreover, mean annual temperature was positively associated with immunization coverage in 2000, 2005 and 2019 EDHSs. Travel time to the nearest city is negatively associated with immunization coverage in 2000, 2005, 2011 and 2016. Likewise, distance to health facilities was negatively associated with immunization coverage in all the five EDHSs. This study found that immunization coverage in Ethiopia substantially varied across the subnational and local levels. Spatial clustering of low immunization coverage was observed in Southern, Southeastern, Southwestern, Northeastern, and Eastern parts of the country. Altitude, population density, precipitation, temperature, travel time to the nearest city in minutes, and distance to the health facilities were factors that affect the spatial clustering of immunizations coverage. These findings can guide policymakers in Ethiopia to design geographically targeted interventions to increase programs to achieve maximum immunization coverage. [ABSTRACT FROM AUTHOR]

• Almost 40% of NY State practices have immunization policies for pediatric patients. • Formal policies require vaccination or have a consequence for not fully vaccinating. • Informal policies express support for childhood vaccination without a requirement. • Policies contain language that target specific reasons for vaccine hesitancy. • Majority-pediatrician practices are more likely to have immunization policies. Practice immunization policies may reflect how their physicians and nurses approach vaccine hesitant parents. This study utilized New York State primary care practices' websites to locate immunization policies for pediatric patients and collect practice-level data. For this cross-sectional study, we extracted website data in February/March of 2019. We first conducted a qualitative content analysis using the policy text and developed definitions of practice policy types (i.e., formal, informal, or no policy). Two authors independently reviewed and coded the text, and employed consensus meetings and feedback from the third author to finalize the content analysis. We then examined associations between practice-level characteristics and immunization policy presence through categorical data analysis. Of the 254 practice websites identified, 36 referred to formal immunization policies that may include consequences (e.g., dismissal) for refusing to vaccinate or not fully vaccinating, and 64 referred to informal policy statements supporting immunization. Most (89%) policies included appeals to scientific and/or professional authority. Almost all (92%) contained language tailored to potential reasons for parents' vaccine hesitancy. Our categorical analyses indicate that majority-pediatrician practices are associated with the presence of either formal or informal immunization policies (p < 0.001). Our results also suggest regional variation in the presence of such policies across New York state, although statistical significance is not achieved. Vaccine hesitancy in the pediatric population has become a global concern due to infectious disease outbreaks, most recently the COVID-19 pandemic. Future studies may examine whether practice-level policies are effective in improving local immunization rates. [ABSTRACT FROM AUTHOR]

Background: Coverage of iron-folic acid (IFA) supplementation is a key indicator for tracking programmatic progress within and across countries. However, the validity of maternal report of this information during household surveys has yet to be determined.Objectives: This study aimed to examine the validity of maternal recall of receipt of IFA supplementation during antenatal care (ANC) and factors associated with accuracy of maternal recall.Methods: A longitudinal cohort design was employed. The direct observation of the IFA received during all ANC visits at the 5 study health posts served as the "gold standard" to the maternal report of IFA received during the postpartum interview. Individual-level validity was assessed by calculating indicator sensitivity, specificity, and AUC. The inflation factor (IF) measured population-level bias. A multivariable log-binomial model was used to assess factors associated with accurate recall.Results: The majority (95.8%) of women were observed receiving IFA during pregnancy. Women overreported the number of IFA tablets received compared with what was observed during ANC visits (mean difference: 45 tablets). Maternal report of any IFA receipt was moderate (AUC = 0.60; 95% CI: 0.50, 0.71), and population bias was low (IF = 1.01). However, the individual-level validity was poor across the 7 IFA tablet count categories; the AUC for categories ranged from misleading to moderate. Driven by the trend of maternal overreport, the IF indicated that maternal report drastically underestimated the coverage of lower tablet categories and overestimated the coverage of higher tablet counts. Accuracy of maternal report was not associated with months since last ANC observation nor any maternal characteristics.Conclusions: Maternal report of the amount of IFA supplementation received during pregnancy produced extremely biased population coverage and performed poorly to moderately for individual-level validity. It is imperative to improve this indicator because it is used in global frameworks and national program planning. [ABSTRACT FROM AUTHOR]

Objective: Although the Affordable Care Act eliminated cost sharing for screening mammography, a concern is that grandfathered plans, diagnostic mammograms, and follow-up testing may still lead to out-of-pocket (OOP) spending. Our study examines how OOP spending among women at their baseline screening mammogram may impact the decision to receive subsequent screening.Methods: The study included commercially insured women aged 40 to 41 years with a screening mammogram between 2011 and 2014. We estimated multivariate linear probability models of the effect of OOP spending at the baseline mammogram on subsequent screening 12 to 36 months later.Results: Having any OOP payments for the baseline screening mammogram significantly reduced the probability of screening in the subsequent 12 to 24 months by 3.0 percentage points (pp) (95% confidence interval [CI]: 1.1-4.8 pp decrease). For every $100 increase in the OOP expenses for the baseline mammogram, the likelihood of subsequent screening within 12 to 24 months decreased by 1.9 pp (95% CI: 0.8-3.1 pp decrease). Similarly, any OOP spending for follow-up tests resulting from the baseline screening led to a 2.7 pp lower probability of screening 12 to 24 months later (95% CI: 0.9-4.1 pp decrease). Higher OOP expenses were associated with significantly lower screening 24 to 36 months later (coefficient = -0.014, 95% CI: -0.025 to -0.003).Discussion: Although cost sharing has been eliminated for screening mammograms, OOP costs may still arise, particularly for diagnostic and follow-up testing services, both of which may reduce rates of subsequent screening. For preventive services, reducing or eliminating cost sharing through policy and legislation may be important to ensuring continued adherence to screening guidelines. [ABSTRACT FROM AUTHOR]

All WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on improving vaccination coverage with the first routine dose of (monovalent) measles (MCV1) at 9 months, providing measles vaccine through supplemental immunization activities (children 9–59 months), and intensified measles case-based surveillance system. We reviewed measles immunization coverage from population-based surveys conducted in 2010, 2013 and 2017–18. Additionally, we analyzed measles case-based surveillance reports from 2008–2018 to determine annual, regional and age-specific incidence rates. Survey results indicated low MCV1 coverage (54.0% in 2018); with lower coverage in the North (mean 45.5%). Of the 153,097 confirmed cases reported over the studied period, 85.5% (130,871) were from the North. Moreover, 70.8% (108,310) of the confirmed cases were unvaccinated. Annual measles incidence varied from a high of 320.39 per 1,000,000 population in 2013 to a low of 9.80 per 1,000,000 in 2009. The incidence rate is higher among the 9–11 months (524.0 per million) and 12–59 months (376.0 per million). Between 2008 and 2018, the incidence rate had showed geographical variation, with higher incidence in the North (70.6 per million) compare to the South (17.8 per million). The aim of this study was to provide a descriptive analysis of measles vaccine coverage and incidence in Nigeria from 2008 to 2018 to assess country progress towards measles elimination. Although the total numbers of confirmed measles cases had decreased over the time period, measles routine coverage remains sub-optimal, and the incidence rates are critically high. The high burden of measles in the North highlight the need for region-specific interventions. The measles program relies heavily on polio resources. As the polio program winds down, strong commitments will be required to achieve elimination goals. [ABSTRACT FROM AUTHOR]

Testing is the process of evaluating a system by manual or automated means. While Regression Test Selection (RTS) discards test cases and Test Suite Minimization (TSM) shows diminution in fault detection rate, Test Case Prioritization (TCP) does not discard test cases. Test Case Prioritization techniques can be coverage or historical information based or model based. It can also be cost-time aware or requirement-risk aware. GUI/Web applications need special prioritization mechanism. In this paper, 90 scholarly articles ranging from 2001 to 2018 have been reviewed. We have explored IEEE, Wiley, ACM Library, Springer, Taylor & Francis and Elsevier database. We have also described each prioritization method with their findings and subject programs. This paper includes a chronological catalogue listing of the reviewed papers. We have framed three research questions which sum up the frequently used prioritization metrics, regularly used subject programs and the distribution of different prioritization techniques. To the best of our knowledge, this is the first review with a detail report of the last 18 years of TCP techniques. We hope this article will be beneficial for both beginners and seasoned professionals. [ABSTRACT FROM AUTHOR]

Pneumococcal vaccines have been developed to protect infants and young children from pneumococcal diseases. Vaccination coverage studies are important in determining a population's vaccination status and strategically adjusting national immunization programs (NIP). In this paper, we aim to describe the coverage of pneumococcal conjugate vaccines (PCVs) immunization for birth cohorts from 2012 to 2020 and discussed the factors influencing the coverage. Vaccination data were collected via the vaccination information database in Shanghai, China, for children born from 2012 to 2020. The population data used in this study were collected from each community from 2012 to 2020. The coverage of initial immunization (1st dose), basic immunization (three doses) and full immunization (3 + 1 doses) for PCVs was calculated according to the number of doses received. As vaccination coverage was assessed each year, Annual Growth Rate (AGR) was used to describe the variation trend of vaccination coverage. Immunization time and completeness of different PCVs were also analyzed. The total number of births from 2012 to 2020 was 38,268 in Huangpu District, Shanghai, China. The initial immunization coverage of PCVs increased from 12.26% in 2012 to 49.65% in 2020, and the highest coverage was 50.61% in 2019. The cumulative vaccination coverage of PCVs was 19.4% for initial immunization and 16.8% for basic immunization from 2012 to 2020. And cumulative full immunization coverage of PCVs was 12.3% from 2012 to 2019. The PCVs coverage of most vaccination statuses showed an obvious upward trend from 2017 to 2020. Despite an upward trend in vaccination coverage of PCVs, the vaccination coverage of initial, basic and full immunization among children is still low. And given the heavy burden of Streptococcus pneumoniae (Sp) among children in China and the fact that the current vaccination coverage cannot effectively protect children, it is recommended that the government include PCVs into the NIP as soon as possible. [ABSTRACT FROM AUTHOR]