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Many examples exist in the chemical education literature of individual experiments, whole courses or even entire year levels that have been completely renewed under the tenets of context-based, inquiry-based or problem-based learning. The benefits of these changes are well documented and include higher student engagement, broader skill development and better perceived preparation for the workforce. However, no examples appear to have been reported in which an entire school's teaching laboratory programme has been significantly redesigned with these concepts in mind. Transforming Laboratory Learning (TLL) is a programme at Monash University that sought to incorporate industry inspired context-based, inquiry-based and problem-based learning into all the laboratory components of the School of Chemistry. One of the ways in which the effect of the programme was evaluated was through the use of an exit survey delivered to students at the completion of seven experiments that existed before the TLL programme as well as seven that were generated directly by the TLL programme. The survey consisted of 27 closed questions alongside three open questions. Overall, students found the new experiments more challenging but recognised that they were more contextualised and that they allowed students to make decisions. The students noted the lack of detailed guidance in the new laboratory manuals but raised the challenge, context and opportunity to undertake experimental design as reasons for enjoying the new experiments. Students' perceptions of their skill development shifted to reflect skills associated with experimental design when undertaking the more investigation driven experiments. These results are consistent with other literature and indicate the large scale potential success of the TLL programme, which is potentially developing graduates who are better prepared for the modern workforce.

Abstract Background Heterogeneous clinical features and prognosis in neuroblastoma (NB) children are frequently dominated by immune elements. Dysfunction and apoptosis in immune cells result from the exposure to continuous tumor-related antigen stimulation and coinhibitory signals. To date, key factors pointing to the restriction of NB-specific CD8+ T cells remain elusive. Methods We performed bulk-RNA sequencing and lipidomic analyses of children with mediastinal NB. Bioinformatics analysis and biological validation were applied to uncover the underlying mechanism. Results Three subtypes were identified using nonnegative matrix factorization (NMF), among which we highlighted an apoptotic status of infiltrated CD8+ T cells, along with the highest CD52 and EDF1 expression in Cluster3 (C3) subtypes. It was verified that high EDF1 expression in NB cells led to Lactosylceramide (LacCer) accumulation, as well as downstream ganglioside-GD3, which subsequently increased the expression of CD52 and immune checkpoint genes, chemotaxis, and apoptosis-related events in activated CD8+T cells. Mechanistically, EDF1 was recruited as a coactivator to form the NF-κB/RelA/EDF1 complex, which further prevented the promoter region methylation of ST8SIA1, to elevate its transcription. Conclusion These findings characterize abundant GD3 in NB cells, which regulated by the EDF1/RelA/ST8SIA1 axis, is responsible for CD8+ T cell dysfunction. Inhibition of EDF1 may reduce suppressive factors and prevent immune escape of NB cells. Modulating NB-associated GD3 levels through metabolic intervention is beneficial for tuning the depth and duration of responses to current NB therapies. The integration of transcriptomic and lipidomic data offers a more comprehensive understanding of the interaction between LacCer metabolites and the immune status in NB. Graphical Abstract

Clinical registries are multicenter prospective observational datasets that have been used to examine current perioperative practices in pediatric anesthesia. These datasets have proven useful in quantifying the incidence of rare adverse outcomes. Data from registries can highlight associations between severe patient safety events and patient and procedure‐related risk factors. Registries are an effective tool to delineate practices and outcomes in niche patient populations. They have been used to quantify uncommon complications of medications and procedures. Registries can be used to generate knowledge and to support quality improvement. Multicenter engagement can promote best clinical practices and foster professional networks. Registries are limited by their observational nature, which entails a lack of randomization as well as selection and treatment bias. The maintenance of registries over time can be challenging due to difficulties in modifying the included variables, collaborator fatigue, and continued outlay of resources to maintain the database and onboard new sites. These latter issues can lead to decreased data quality. In this article, we discuss key insights from several pediatric anesthesia registries and propose a new type of registry that addresses some shortcomings of the current paradigm. [ABSTRACT FROM AUTHOR]

Abstract Background Wolbachia incompatible insect technique (IIT) programs have been shown in field trials to be highly effective in suppressing populations of mosquitoes that carry diseases such as dengue, chikungunya, and Zika. However, the frequent and repeated release of Wolbachia-infected male mosquitoes makes such programs resource-intensive. While the need for optimization is recognized, potential strategies to optimize releases and reduce resource utilization have not been fully explored. Results We developed a process-based model to study the spatio-temporal metapopulation dynamics of mosquitoes in a Wolbachia IIT program, which explicitly incorporates climatic influence in mosquito life-history traits. We then used the model to simulate various scale-down and redistribution strategies to optimize the existing program in Singapore. Specifically, the model was used to study the trade-offs between the intervention efficacy outcomes and resource requirements of various release program strategies, such as the total number of release events and the number of mosquitoes released. We found that scaling down releases in existing sites from twice a week to only once a week yielded small changes in suppression efficacy (from 87 to 80%), while requiring 44% fewer mosquitoes and release events. Additionally, redistributing mosquitoes from already suppressed areas and releasing them in new areas once a week led to a greater total suppressive efficacy (83% compared to 61%) while also yielding a 16% and 14% reduction in the number of mosquitoes and release events required, respectively. Conclusions Both scale-down and redistribution strategies can be implemented to significantly reduce program resource requirements without compromising the suppressive efficacy of IIT. These findings will inform planners on ways to optimize existing and future IIT programs, potentially allowing for the wider adoption of this method for mosquito-borne disease control.

BackgroundWith increased survival of infants born with esophageal atresia (EA), there is a knowledge gap regarding neurodevelopmental outcomes. We aimed to quantify the frequency of (1) documented developmental delay, and (2) implementation of early intervention services in the first and the second year of life following repair of short- and long-gap EA.MethodWe retrospectively analyzed term-born (n = 44) and premature infants (n = 26) following EA repair at a single institution (2009–2020). Infants with anomalies associated with known neurological disorders were excluded. Clinical data was obtained from the electronic medical record, and presented as means and percentages. Developmental delay included clinically documented motor, speech/language, and cognitive delays that were stratified according to a surgical group: short- and long-gap EA.ResultsNearly half of short-gap (24/54; 44%) and most of long-gap EA patients (12/16; 75%) had documented developmental delay in the first year of life that persisted into the second year of life [52% [28/54] short-gap; 69% [11/16] long-gap EA]. Developmental delay was noted irrespective of gestational age at birth, co-existing cardiac anomalies, or presence of cranial/brain findings on imaging. By age 2, 70% (38/54) of short-gap and 69% (11/16) of long-gap EA patients had received early intervention.InterpretationInfants born with EA are at high-risk for developmental delay. Early neurodevelopmental assessments and intervention is recommended for EA patients.

Summary: Background: More data is required to contextualise respiratory-syncytial-virus (RSV) disease burden, versus other vaccine-preventable respiratory-viral-infections (RVIs) in older adults. We aimed to compare severity of RSV in hospitalized adults versus influenza/boosted COVID-19. Methods: Retrospective population-based cohort study, including all adult RSV hospitalizations (2021–2023) in Singapore. Disease severity (28-day mortality/intensive-care-unit [ICU] admission) and healthcare utilization in RSV hospitalizations were compared with contemporaneous influenza hospitalizations and COVID-19 hospitalizations in 2023. Outcomes for COVID-19 were stratified by type/receipt of boosters. Comparative severity of RSV versus COVID-19/influenza was evaluated using multivariate logistic regression, adjusted for confounders. Generalized linear models were utilized to estimate excess length-of-stay/costs of RSV hospitalization versus COVID-19/influenza as a rate-ratio. Findings: 12,811 hospitalized adults were included (RSV: N = 1332; influenza: N = 3999; COVID-19: N = 7480). Amongst RSV hospitalizations, 5.4% (72/1332) died within 28 days; 3.8% (51/1332) required ICU. Median length-of-stay (RSV) was 5.0 days (IQR = 3.0–8.0). Older age/diabetes were associated with greater odds of 28-day mortality in RSV hospitalizations. Higher odds of 28-day mortality/ICU admission and higher healthcare utilization was observed in RSV hospitalizations versus influenza. Conversely, RSV was less severe than unboosted COVID-19, with lower odds of 28-day mortality (adjusted-odds-ratio, aOR = 0.56 [95% CI = 0.40–0.79]) and rate-ratio for length-of-stay/costs significantly

BackgroundGonorrhea is the second most common sexually transmitted disease notified in Singapore in 2023. Evidence suggests that the 4CMenB vaccine designed to protect against Neisseria meningitidis infection may offer partial cross-protection against gonorrhea. This generated interest in using 4CMenB for the purpose of staving gonorrhea transmission. We explored the efficacy of potential gonorrhea vaccination strategies in the context of historically declining gonorrhea incidence.Methods and findingsWe employed an integrated transmission-dynamic model, calibrated using Bayesian methods to local surveillance data to understand the potential public health impact of 4CMenB in reducing gonorrhea acquisition and transmission in men who have sex with men (MSM) in Singapore. We explored the efficacy of implementing six vaccination programmes: (1) offering vaccination to all male adolescents in schools (vaccination before entry [VbE]), (2) offering vaccination to individuals attending sexual health clinics for testing (vaccination on attendance [VoA]), (3) offering vaccination to individuals attending sexual health clinics and who were diagnosed with gonorrhea (vaccination on diagnosis [VoD]), or (4) vaccination according to risk (VaR), by offering vaccination to patients who were diagnosed with gonorrhea plus individuals who tested negative, but report having more than five sexual partners per year. We further examined how altering (5) VoA and (6) VoD strategies changed if the strategies only targeted high risk groups (VoA(H),VoD(H)). We assessed efficacy by examining vaccination impact relative to no vaccination and when behavioral parameters were held constant. We further ascertained the effects of varying vaccine uptake (10%, 33%, 100%), vaccine efficacy (22%, 31%, 47%), and duration of protection (1.5, 4, 7.5 years) on the effectiveness of each vaccination strategy. For a hypothetical 10-year vaccination programme, VbE had 14.18% of MSM gonorrhea cases averted over the time the programme was implemented. VoA had the highest protective impact on the MSM population with 40.26% averted cases (95% credible interval (CrI): 18.32%-52.57%), but required more vaccine doses than any other strategy. VoD had a smaller impact (12.04% averted cases (95% CrI: 7.12%-15.00%)), but was three times more efficient than VoA in terms of averted cases per dose. VoA(H) and VoD(H) improved the efficiency of VoA and VoD strategies by increasing averted cases per dose to 0.22 and 0.24 respectively, but conferred similar protective effects as VoA (VoA(H): 40.10% averted cases (95% CrI: 18.14%-52.55%)) and VoD (VoD(H): 12.04% averted cases (95% CrI: 7.12%-15.00%)), respectively. VaR (40.10% averted cases (95% CrI: 18.14%-52.55%)) had almost the same impact as VoA, but was more efficient by requiring administration of fewer doses than VoA, with 0.21 (95% CrI: 0.12-0.27) averted cases per dose. Sensitivity analyses indicated that VaR had the greatest public health impact with the highest number of averted cases per dose for vaccines of any efficacy or duration of protection (or both), although VoD and VoD(H) saved more vaccine resource and had the highest number averted MSM cases per dose for highly protective vaccines of long protection.ConclusionsVaccination of MSM against gonorrhea, according to risk in sexual health clinics in Singapore, can be considered to reduce gonorrhea acquisition and transmission. Development of gonorrhea-specific vaccines which focuses on protective efficacy and the implementation of efficient vaccination programmes can maximize public health impact.

Background Heavy reliance on container shipping during the COVID-19 pandemic with lockdown implementation and air travel bans placed substantial pressure on shipping crews and ports. Long waiting times at ports, substantial economic losses and massive supply chain disruption of essential and medical goods were observed. To minimise this for future pandemic preparedness, we explore the use of quarantining and testing of crews preboarding instead of quarantining at port calls or during voyages.Methods Using a microsimulation model of 10 000 vessels and 300 000 crew, we examine the effectiveness of nine predeparture control strategies in reducing COVID-19 outbreak sizes, from no control to the use of 7-day and 14-day quarantining, and addition of polymerase chain reaction (PCR) or antigen rapid test (ART) testing. To assess different infection parameters, we explored three variants (Alpha, Delta and Omicron), four prevalences (0.1%, 0.5%, 1% and 2%) and three quarantine compliances (50%, 90% and 100%).Results Across the prevalences with no intervention, our modelled simulations estimate that approximately 3%, 15%, 28% and 47% of crews are infected, totalling around 9400, 44 900, 82 600 and 141 300 infections. At 2% prevalence, averaged across variants and compliances, when 7-day predeparture quarantining (7DQ) is introduced, 23 900 (range: 21 500–25 200) estimated cases are averted, rising up to 40 900 (40 200–41 600) for 14DQ. With additional predeparture PCR testing, this increases further to 102 100 (100 100–104 500) and 106 800 (106 100–108 100) respectively. Should ART testing be used instead, 92 600 (92 200–93 200) and 100 000 (98 900–101 100) estimated cases are averted. The use of predeparture PCR testing and PCR testing 1 week before departure has the greatest reduction at 108 200 (106 400–110 600) and 111 600 (110 500–113 000).Conclusion In our simulation model, we show that preboarding control measures can be effective in limiting outbreaks, reducing the number of active cases on marine vessels without access to adequate medical care while simultaneously reducing port congestion and facilitating for the greater global transport of essential goods.

Abstract The active distribution network (ADN) can obtain measurement data, estimate system states, and control distributed energy resources (DERs) and flexible loads to ensure voltage stability. However, the ADN is more vulnerable to cyber attacks due to the recent wave of digitization and automation efforts. In this article, false data injection (FDI) attacks are focused on and they are classified into two types, that is, type I attacks on measurement data and type II attacks on control commands. After studying the impact of these two FDI attacks on the ADN, a new threat is revealed called coordinated FDI attack, which can maximize the voltage deviation by coordinating type I and type II FDI attacks. From the attacker's perspective, the scheme of CFDI is proposed and an algorithm is developed to find the optimal attack strategy. The feasibility of CFDI attacks has been validated on a smart distribution testbed. Moreover, simulation results on an ADN benchmark have demonstrated that CFDI attacks could cause remarkable voltage deviation that may deteriorate the stability of the distribution network. Moreover, the impact of CFDI attacks is higher than pure type I or type II attacks. To mitigate the threat, some countermeasures against CFDI attacks are also proposed.

Abstract Background Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial–temporal impact of Wolbachia interventions on dengue incidence using a large battery of quasi-experimental methods and assesses each method’s validity. Methods A systematic search for Wolbachia intervention data was conducted via PubMed. Efficacy was reassessed using commonly-used quasi-experimental approaches coupled with extensive robustness checks, including geospatial placebo tests and a simulation study. Intervention efficacies across multiple study sites were computed using high-resolution aggregations to examine heterogeneities across sites and study periods. We further designed a stochastic simulation framework to assess the methods’ ability to reproduce true intervention efficacies (IE). Results Wolbachia interventions in Singapore, Malaysia, and Brazil were associated to significant decreases in dengue incidence, with reductions ranging from 48.17% to 69.19%. IEs varied with location and duration. Malaysia showed increasing efficacy over time, while Brazil exhibited initial success with subsequent decline, hinting at operational challenges. Singapore's strategy was highly effective despite partial saturation. Simulations identified Synthetic Control Methods (SCM) and its variant, count Synthetic Control Method (cSCM), as superior in precision, with the smallest percentage errors in efficacy estimation. These methods also demonstrated robustness in placebo tests. Conclusions Wolbachia interventions exhibit consistent protective effects against dengue. SCM and cSCM provided the most precise and robust estimates of IEs, validated across simulated and real-world settings.

Summary: Background: Dengue remains a global health challenge with limited treatment options, highlighting the need for effective vector control strategies. The introduction of Wolbachia pipientis into Aedes aegypti populations has shown success in reducing dengue transmission across global field trials. However, the spillover effectiveness of the technology on untreated areas is not well-known. This study estimates the spillover protective effectiveness (PE) of Wolbachia-mediated introgression on dengue. Methods: We used the synthetic control method (SCM) under assumption of partial interference to evaluate the direct and spillover PEs of Wolbachia-mediated introgression in a long-running operational trial of the intervention in Malaysia. Synthetic controls (SCs), which comprise of a weighted sum of non-spillover controls, were constructed for each directly-treated and spillover site in the pre-intervention period to account for historical imbalances in dengue risk and risk trajectories. SCs were compared to directly/spillover-treated sites to estimate the impact of Wolbachia-introgression on dengue incidence across each site, calendar year and intervention time. Robustness checks, including visual inspections, root-mean-square error (RMSE) calculations, in-space and in-time placebo checks, and permutation tests, were used to inspect the model's ability in attributing dengue incidence reductions to the Wolbachia interventions. Findings: The direct and spillover PEs of Wolbachia on dengue incidence were expressed as a percentage reduction of dengue incidence, or the absolute case reductions, by comparing SCs to actual intervention/spillover sites. Findings indicate a direct reduction in dengue incidence by 64.35% (95% CI: 63.50–66.71, p

Abstract Background This trial is a parallel, two-arm, non-blinded cluster randomised controlled trial that is under way in Singapore, with the aim of measuring the efficacy of male Wolbachia-infected Aedes aegypti deployments in reducing dengue incidence in an endemic setting with all four dengue serotypes in circulation. The trial commenced in July 2022 and is expected to conclude in September 2024. The original study protocol was published in December 2022. Here, we describe amendments that have been made to the study protocol since commencement of the trial. Methods The key protocol amendments are (1) addition of an explicit definition of Wolbachia exposure for residents residing in intervention sites based on the duration of Wolbachia exposure at point of testing, (2) incorporation of a high-dimensional set of anthropogenic and environmental characteristics in the analysis plan to adjust for baseline risk factors of dengue transmission, and (3) addition of alternative statistical analyses for endpoints to control for post hoc imbalance in cluster-based environmental and anthropogenic characteristics. Discussion The findings from this study will provide the first experimental evidence for the efficacy of releasing male-Wolbachia infected mosquitoes to reduce dengue incidence in a cluster-randomised controlled trial. The trial will conclude in 2024 and results will be reported shortly thereafter. Trial registration ClinicalTrials.gov, identifier: NCT05505682. Registered on 16 August 2022. Retrospectively registered. Last updated 11 November 2023.

Abstract Unpredictable emergency department (ED) admissions challenge healthcare systems, causing resource allocation inefficiencies. This study analyses associations between air pollutants, meteorological factors, and 2,655,861 cause‐specific ED admissions from 2014 to 2018 across 12 categories. Generalized additive models were used to assess non‐linear associations for each exposure, yielding Incidence Rate Ratios (IRR), while the population attributable fraction (PAF) calculated each exposure's contribution to cause‐specific ED admissions. IRRs revealed increased risks of ED admissions for respiratory infections (IRR: 1.06, 95% CI: 1.01–1.11) and infectious and parasitic diseases (IRR: 1.09, 95% CI: 1.03–1.15) during increased rainfall (13.21–16.97 mm). Wind speeds >12.73 km/hr corresponded to increased risks of ED admissions for respiratory infections (IRR: 1.12, 95% CI: 1.03–1.21) and oral diseases (IRR: 1.58, 95% CI: 1.31–1.91). Higher concentrations of air pollutants were associated with elevated risks of cardiovascular disease (IRR: 1.16, 95% CI: 1.05–1.27 for PM10) and respiratory infection‐related ED admissions (IRR: 2.78, 95% CI: 1.69–4.56 for CO). Wind speeds >12.5 km/hr were predicted to contribute toward 10% of respiratory infection ED admissions, while mean temperatures >28°C corresponded to increases in the PAF up to 5% for genitourinary disorders and digestive diseases. PM10 concentrations >60 μg/m3 were highly attributable toward cardiovascular disease (PAF: 10%), digestive disease (PAF: 15%) and musculoskeletal disease (PAF: 10%) ED admissions. CO concentrations >0.6 ppm were highly attributable to respiratory infections (PAF: 20%) and diabetes mellitus (PAF: 20%) ED admissions. This study underscores protective effects of meteorological variables and deleterious impacts of air pollutant exposures across the ED admission categories considered.

Introduction: The transmission dynamics of the recent mpox outbreak highlights the lack of infrastructure available to rapidly respond to novel STI outbreaks, of which Asia and Oceania remains particularly susceptible. Here, we simulate outbreaks in this setting and propose the use of pre-emptive vaccination within the men who have sex with men (MSM) community before the arrival and establishment of the virus. Materials and methods: Using data driven heterogeneous sexual contact networks, we simulated outbreaks of mpox in Singapore, Hong Kong, and Sydney. An individual based SEIR compartmental model was used to simulate epidemic trajectories and the impact of different vaccination uptakes was assessed in their ability to avert or suppress outbreaks upon the arrival of mpox within the MSM populations. Results: The highly dense sexual networks of Singapore and Sydney experience rapid outbreaks, with infection peaks occurring at day 41 and 23 respectively, compared to Hong Kong which occurs at day 77. Across the simulations with no vaccination, 68.2%–89.7% of the MSM community will become infected with mpox across the different cities, over a simulation period of 1 year. By implementing vaccination strategies, the infection rate across the cities can be reduced to as low as 3.1% of the population (range: 3.1%–82.2%) depending on the implementation and uptake of the vaccine. Vaccination is also extremely effective in slowing the start of the epidemic, delaying the epidemic peak by 36–50 days in Hong Kong, or even preventing the outbreak of mpox. Discussion: With extremely dense and well-connected sexual contact networks, where 65.2%–83.2% of the population are connected to a super-spreader in the different contact networks, pre-emptive or immediate vaccination upon identification of the first case is strongly recommended to help better manage the outbreak of mpox and prevent potential straining of healthcare systems.

Bronchoscopy‐guided diagnostic and interventional airway procedures are gaining in popularity and prominence in pediatric surgery. Many of these procedures have been used successfully in the adult population but have not been used in children due to a lack of appropriately sized instruments. Recent technological advances have led to the creation of instruments to enable many more diagnostic and therapeutic procedures to be done under bronchoscopic guidance. These procedures vary significantly in their length and invasiveness and require vastly different anesthetic plans that must be easily adapted to situational and procedural changes. In addition to close communication between the anesthesiology and procedural teams; an understanding of the type of procedure, anesthetic requirements, and potential patient risks is paramount to a successful anesthetic. This review will focus on new rigid bronchoscopic procedures, goals for their respective anesthetic management, and unique tips and trick for how to maintain adequate oxygenation and ventilation in each scenario. [ABSTRACT FROM AUTHOR]

This is an essay in the field of mining engineering. In the current new energy development strategy under the new situation, lithium is an indispensable key raw material to support the development of the new energy vehicle industry and promote the new energy revolution. It is positioned as one of China's 24 national strategic mineral resources, and its strategic position is extremely important. The safety of lithium resources and the continuous supply of lithium mineral products are related to the healthy and stable development of many industries and the national economy in China. China is rich in lithium resources. However as the world's largest consumer of lithium resources and producer of lithium batteries, lithium is highly dependent on foreign countries, and there are hidden dangers in the supply system. It is urgent to improve the safety and security of China's lithium resources. Based on the combing and research on the distribution of lithium resources at home and abroad and the supply and demand situation of lithium mineral products, this paper analyzes and elaborates on the main problems and causes faced by China's lithium resources. This paper analyzes the main problems faced by China's lithium resources and their causes, and puts forward opinions and suggestions on the development and utilization, scientific and technological research, industrial structure, institutional mechanism, personnel construction, market regulation, overseas strategy and other aspects in order to increase production of lithium resources and maintain supply and stability, which provides useful reference for ensuring the safety and stability of China's lithium resources and the healthy and orderly development of lithium mining industry.

Transmission potential of a pathogen, often quantified by the time-varying reproduction number Rt, provides the current pace of infection for a disease and indicates whether an emerging epidemic is under control. In this study, we proposed a novel method, EpiMix, for Rt estimation, wherein we incorporated the impacts of exogenous factors and random effects under a Bayesian regression framework. Using Integrated Nested Laplace Approximation, EpiMix is able to efficiently generate reliable, deterministic Rt estimates. In the simulations and case studies performed, we further demonstrated the method's robustness in low-incidence scenarios, together with other merits, including its flexibility in selecting variables and tolerance of varying reporting rates. All these make EpiMix a potentially useful tool for real-time Rt estimation provided that the serial interval distribution, time series of case counts and external influencing factors are available.

Abstract Background A pertinent risk factor of upper respiratory tract infections (URTIs) and pneumonia is the exposure to major ambient air pollutants, with short term exposures to different air pollutants being shown to exacerbate several respiratory conditions. Methods Here, using disease surveillance data comprising of reported disease case counts at the province level, high frequency ambient air pollutant and climate data in Thailand, we delineated the association between ambient air pollution and URTI/Pneumonia burden in Thailand from 2000 – 2022. We developed mixed-data sampling methods and estimation strategies to account for the high frequency nature of ambient air pollutant concentration data. This was used to evaluate the effects past concentrations of fine particulate matter (PM2.5), sulphur dioxide (SO2), and carbon monoxide (CO) and the number of disease case count, after controlling for the confounding meteorological and disease factors. Results Across provinces, we found that past increases in CO, SO2, and PM2.5 concentration were associated to changes in URTI and pneumonia case counts, but the direction of their association mixed. The contributive burden of past ambient air pollutants on contemporaneous disease burden was also found to be larger than meteorological factors, and comparable to that of disease related factors. Conclusions By developing a novel statistical methodology, we prevented subjective variable selection and discretization bias to detect associations, and provided a robust estimate on the effect of ambient air pollutants on URTI and pneumonia burden over a large spatial scale.

Abstract As the particularly popular green energy, geothermal resources are gradually favored by countries around the world, and the development model centered on geothermal dew point cannot meet the increasing geothermal demand. In this paper, a GIS model combining PCA and AHP is proposed, aiming to select the advantages of geothermal resources at the regional scale and analyze the main influencing indicators. Through the combination of the two methods, both data and empirical can be considered, then the geothermal advantage distribution on the area can be displayed through GIS software images. A multi-index evaluation system is established to qualitatively and quantitatively evaluate the mid-high temperature geothermal resources in Jiangxi Province, and carry out the evaluation of the dominant target areas and the analysis of geothermal impact indicators. The results show that it is divided into 7 geothermal resource potential areas and 38 geothermal advantage targets, and the determination of deep fault is the most critical index of geothermal distribution. This method is suitable for large-scale geothermal research, multi-index and multi-data model analysis and precise positioning of high-quality geothermal resource targets, which can meet the needs of geothermal research at the regional scale.

Abstract Objective To explore the return-to-work adaptation experience and coping resources used by cancer patients. Methods With the help of the Nantong Cancer Friends Association, from June 2019 to January 2020, this study recruited 30 cancer patients who had returned to work using purpose sampling, snowball sampling and theoretical sampling. The researchers analyzed the data using initial-, focusing-, and theoretical coding. Results The adaptation of cancer patients to return-to-work is a rebuilding process by taking advantage of the available personal and external coping resources. The adaptation experience includes: focusing on rehabilitation, rebuilding self-efficacy, and adjusting plans. Conclusion Medical staff should help patients mobilize coping resources to adapt to return to work.

BackgroundTransmission intensity for mosquito-borne diseases are highly heterogenous and multi-factorial. Understanding risk factors associated to disease transmission allow the optimization of vector control. This study sets out to understand and compare the combined anthropogenic and environmental risk factors of four major mosquito-borne diseases, dengue, malaria, chikungunya and Japanese encephalitis in Thailand.MethodsAn integrated analysis of mosquito-borne diseases, meteorological and ambient air pollutants of 76 provinces of Thailand was conducted over 2003-2021. We explored the use of generalized linear models and generalized additive models to consider both linear and non-linear associations between meteorological factors, ambient air pollutants and mosquito-borne disease incidence. Different assumptions on spatio-temporal dependence and nonlinearity were considered through province-specific and panel models, as well as different spline functions. Disease-specific model evidence was assessed to select best-fit models for epidemiological inference downstream.ResultsAnalyses indicated several findings which can be generally applied to all diseases explored: (1) higher AH above mean values was positively associated with disease case counts (2) higher total precipitation above mean values was positively associated with disease case counts (3) extremely high temperatures were negatively associated with disease case counts (4) higher SO2 and PM2.5 surface concentrations were negatively associated with disease case counts. However, the relationships between disease and RH, non-extreme temperatures and CO surface concentration were more mixed, with directions of associations changing across the different diseases considered.ConclusionsThis study found protective and enhancing effects of meteorological and ambient air pollutant factors on mosquito-borne diseases burdens in Thailand. Further studies should employ these factors to understand and predict risk factors associated with mosquito-borne disease transmission.

Abstract Background Dengue is a severe environmental public health challenge in tropical and subtropical regions. In Singapore, decreasing seroprevalence and herd immunity due to successful vector control has paradoxically led to increased transmission potential of the dengue virus. We have previously demonstrated that incompatible insect technique coupled with sterile insect technique (IIT-SIT), which involves the release of X-ray-irradiated male Wolbachia-infected mosquitoes, reduced the Aedes aegypti population by 98% and dengue incidence by 88%. This novel vector control tool is expected to be able to complement current vector control to mitigate the increasing threat of dengue on a larger scale. We propose a multi-site protocol to study the efficacy of IIT-SIT at reducing dengue incidence. Methods/design The study is designed as a parallel, two-arm, non-blinded cluster-randomized (CR) controlled trial to be conducted in high-rise public housing estates in Singapore, an equatorial city-state. The aim is to determine whether large-scale deployment of male Wolbachia-infected Ae. aegypti mosquitoes can significantly reduce dengue incidence in intervention clusters. We will use the CR design, with the study area comprising 15 clusters with a total area of 10.9 km2, covering approximately 722,204 residents in 1713 apartment blocks. Eight clusters will be randomly selected to receive the intervention, while the other seven will serve as non-intervention clusters. Intervention efficacy will be estimated through two primary endpoints: (1) odds ratio of Wolbachia exposure distribution (i.e., probability of living in an intervention cluster) among laboratory-confirmed reported dengue cases compared to test-negative controls and (2) laboratory-confirmed reported dengue counts normalized by population size in intervention versus non-intervention clusters. Discussion This study will provide evidence from a multi-site, randomized controlled trial for the efficacy of IIT-SIT in reducing dengue incidence. The trial will provide valuable information to estimate intervention efficacy for this novel vector control approach and guide plans for integration into national vector control programs in dengue-endemic settings. Trial registration ClinicalTrials.gov, identifier: NCT05505682 . Registered on 16 August 2022. Retrospectively registered.