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Background: Listening difficulties may frequently occur in school settings, but so far there were no tools to identify them for both hearing and hearing-impaired Italian students. This study performed cross-cultural adaptation and validation of the Listening Inventory for Education-Revised for Italian students (LIFE-R-ITA). Methods: The study procedure followed the stages suggested by the Guidelines for the Process of Cross-cultural Adaptation of Self-Report Measures. For the content validation, six cochlear implanted students (8–18 years old) pre-tested the initial version. Whenever any situation did not occur in Italy, the item was adapted to more typical listening situations in Italy. The final version of LIFE-R-ITA was administered to a sample of 223 hearing students from different school settings and educational degrees in order to collect normative data. Results: For the LIFE-R-ITA, hearing students showed an average score of 72.26% (SD = 11.93), reflecting some listening difficulties. The subscales (LIFE total, LIFE class, and LIFE social) indicated good internal consistency. All items were shown to be relevant. Most challenging situations happened when listening in large rooms, especially when other students made noise. LIFE social scores were significantly worse than those of LIFE class (p < 0.001). Conclusions: The present study provides cross-cultural adaptation and validation for the LIFE-R-ITA along with the normative data useful to interpret the results of students with hearing loss. The LIFE-R-ITA may support teachers and clinicians in assessing students’ self-perception of listening at school. Such understanding may help students overcome their listening difficulties, by planning and selecting the most effective strategies among classroom interventions.

ABSTRACTThe Himalayan alpine zone (HAZ)—a high-altitude zone above approximately 4,100 m.a.s.l., is projected to experience strong eco-environmental changes with climate change. As plants expand their range in this region, other processes are likely to be impacted; for example, flows and stores of water. A first vital step in conceptualizing HAZ ecohydrology is to understand the distribution pattern of HAZ vegetation communities. Satellite remote sensing provides one means of doing so, but the often patchy distribution of alpine vegetation creates challenges when using coarse-grained satellite data whose pixels are typically coarser than the grain of vegetation pattern. Here we use fine spatial resolution satellite imagery from WorldView-2 (2 m2 per pixel) coupled with elevation model data from the Copernicus GLO-30 product to produce a land cover classification for the HAZ. Field data captured during in situ surveys in the Gokyo valley, Nepal, were used to drive and then test a random forest classifier. Grassy meadows and dwarf shrubs belonging to the Rhododendron and Juniperus families dominate the ecology of the alpine zone in this region, so we created three vegetation classes for mapping indicative major plant communities dominated by these species. We found that altitude and aspect were dominant drivers of vegetation distribution in the HAZ and that the average vegetation cover of Rhododendron spp. and Juniperus spp. reduces with increasing altitude, as expected. South- and east-facing slopes were dominated by Juniperus spp., whereas north- and west-facing slopes were dominated by Rhododendron spp., and the growth extent of Rhododendron spp. (between 4,010 and 4,820 m.a.s.l.) and meadow (between 4,010 and 4,680 m.a.s.l.) were vertically wider than that of Juniperus spp. (between 4,010 and 4,660 m.a.s.l.). Results from this study demonstrate the vegetation distribution pattern in HAZ at the plant community level and provide an impetus for further studies that seek to understand ecohydrological interactions between dwarf plants and water flows and stores in the HAZ.

Objectives: The accuracy of malaria rapid diagnostic tests is threatened by Plasmodium falciparum with pfhrp2/3 deletions. This study compares gene deletion prevalence determined by multiplex real time polymerase chain reaction (qPCR) and conventional polymerase chain reaction (cPCR) using existing samples with clonality previously determined by microsatellite genotyping. Methods: Multiplex qPCR was used to estimate prevalence of pfhrp2/3 deletions in three sets of previously collected patient samples from Eritrea and Peru. The qPCR was validated by multiplex digital polymerase chain reaction. Sample classification was compared with cPCR, and receiver operating characteristic curve analysis was used to determine the optimal ΔCq threshold that aligned the results of the two assays. Results: qPCR classified 75% (637 of 849) of samples as single, and 212 as mixed-pfhrp2/3 genotypes, with a positive association between clonality and proportion of mixed-pfhrp2/3 genotype samples. The sample classification agreement between cPCR and qPCR was 75.1% (95% confidence interval [CI] 68.6-80.7%) and 47.8% (95% CI 38.9-56.9%) for monoclonal and polyclonal infections. The qPCR prevalence estimates of pfhrp2/3 deletions showed almost perfect (κ = 0.804, 95% CI 0.714-0.895) and substantial agreement (κ = 0.717, 95% CI 0.562-0.872) with cPCR for Peru and 2016 Eritrean samples, respectively. For 2019 Eritrean samples, the prevalence of double pfhrp2/3 deletions was approximately two-fold higher using qPCR. The optimal threshold for matching the assay results was ΔCq = 3. Conclusions: Multiplex qPCR and cPCR produce comparable estimates of gene deletion prevalence when monoclonal infections dominate; however, qPCR provides higher estimates where multi-clonal infections are common.

IntroductionAmerican Indian/Alaska Native (AI/AN) communities are more likely to suffer negative consequences related to substance misuse. The COVID-19 pandemic exacerbated the opioid poisoning crisis, in combination with ongoing treatment barriers resulting from settler-colonialism, systemic oppression and racial discrimination. AI/AN adults are at greatest risk of COVID-19 related serious illness and death. In collaboration with an Indigenous community advisory board and Tribal leadership, this study explored AI/AN treatment provider perceptions of client-relatives’ (i.e., SUD treatment recipients) experiences during the pandemic from 2020 to 2022.MethodsProviders who underwent screening and were eligible to participate (N = 25) represented 6 programs and organizations serving rural and urban areas in Washington, Utah, and Minnesota. Participants engaged in audio-recorded 60–90 min semi-structured individual interviews conducted virtually via Zoom. The interview guide included 15 questions covering regulatory changes, guidance for telemedicine, policy and procedures, staff communication, and client-relatives’ reactions to implemented changes, service utilization, changes in treatment modality, and perceptions of impact on their roles and practice. Interview recordings were transcribed and de-identified. Members of the research team independently reviewed transcripts before reaching consensus. Coding was completed in Dedoose, followed by analyses informed by a qualitative descriptive approach.ResultsFive main domains were identified related to client-relative experiences during the COVID-19 pandemic, as observed by providers: (1) accessibility, (2) co-occurring mental health, (3) social determinants of health, (4) substance use, coping, and harm reduction strategies, and (5) community strengths. Providers reported the distinctive experiences of AI/AN communities, highlighting the impact on client-relatives, who faced challenges such as reduced income, heightened grief and loss, and elevated rates of substance use and opioid-related poisonings. Community and culturally informed programming promoting resilience and healing are outlined.ConclusionFindings underscore the impact on SUD among AI/AN communities during the COVID-19 pandemic. Identifying treatment barriers and mental health impacts on client-relatives during a global pandemic can inform ongoing and future culturally responsive SUD prevention and treatment strategies. Elevating collective voice to strengthen Indigenous informed systems of care to address the gap in culturally-and community-based services, can bolster holistic approaches and long-term service needs to promote SUD prevention efforts beyond emergency response efforts.

Accurately quantifying rates of soil erosion requires capturing both the volumetric nature of the visible, convergent fluvial pathways (also known as rills) and the subtle nature of the less-visible, diffuse pathways (interrill areas). The aim of this study was to use Rare Earth Oxide (REO) tracers and Structure-from-Motion (SfM) photogrammetry to elucidate retrospective information about soil erosion rates and sediment sources during different soil erosion conditions, within a controlled laboratory environment. The experimental conditions created erosion events consistent with diffuse and convergent erosion processes. REO tracers allowed the sediment transport distances of over 2 m to be described, and helped resolved the relative contribution of diffuse and convergent soil erosion; interrill areas were also identified as a significant sediment sources soil loss under convergent erosion conditions. While the potential for SfM photogrammetry to resolve sub-millimetre elevations changes was demonstrated, under some conditions non-erosional changes in surface elevation, such as compaction, exceeded volumes of soil loss via diffuse erosion. The discrepancies between SfM Photogrammetry calculations and REO tagged sediment export were beneficial, identifying that during soil erosion events sediment in both aggregate and particle form is deposited within the convergent features, even when the rill extended the full length of the soil surface. The combination of SfM photogrammetry and REO tracers has provided a novel platform for building a spatial understanding of patterns of soil loss and source apportionment between rill and interrill erosion.

Abstract Peatland restoration is experiencing a global upsurge as a tool to protect and provide various ecosystem services. As the range of peatland types being restored diversifies, do previous findings present overly optimistic restoration expectations? In an eroding and restored upland peatland we assessed short-term (0–4 year) effects of restoration on ecohydrological functions. Restoration significantly reduced discharge from the site, transforming peat pans into pools. These retained surface water over half the time and were deeper during wet periods than before. In the surrounding haggs water tables stabilised, as drawdown during dry conditions reduced, increasing the saturated peat thickness. Despite these changes, there were no effects on photosynthesis, ecosystem respiration or dissolved organic carbon loads leaving the site. Soil respiration did not decrease as water tables rose, but methane emissions were higher from rewet pools. Restoration has had a dramatic effect on hydrology, however, consequent changes in other ecosystem functions were not measured in the 4 years after restoration. Whilst restoration is crucial in halting the expansion of degraded peatland areas, it is vital that practitioners and policymakers advocating for restoration are realistic about the expected outcomes and timescales over which these outcomes may manifest.

O estudo do Eletromagnetismo exige um grau de abstração para a compreensão de alguns conceitos, como a capacidade de interpretar a linguagem própria da Física repleta de signos específicos e sistematizar esses símbolos em operações de cálculo ou em explicações conceituais. A dificuldade de visualização geralmente motiva certo desinteresse de grande parte dos alunos. Entretanto, o interesse discente em aprender é um dos fatores para uma aprendizagem significativa, bem como para uma formação mais crítica. Nesse contexto, é importante que se criem condições para instigar a curiosidade dos estudantes, buscando novos caminhos que estimulem a elaboração de hipóteses, a pesquisa, a solução de problemas contextualizados dentro e fora do ambiente escolar. Neste trabalho, é apresentada uma proposta didática baseada no modelo híbrido Rotação por Estações para o ensino de conceitos de Eletromagnetismo em aulas de Física, para fins de facilitação da aprendizagem. Tal proposta desenvolve-se em oito encontros com dois tempos de aula cada, tendo como público-alvo alunos da terceira série do Ensino Médio. Espera-se que seja um instrumento que colabore com a prática docente para o desenvolvimento de aulas diferenciadas, com a utilização de tecnologia, experimentos, entre outros recursos didáticos e que possibilite uma participação ativa e crítica dos alunos com autonomia no processo de aprendizagem.

Abstract We outline the principles of the natural capital approach to decision making and apply these to the contemporary challenge of very significantly expanding woodlands as contribution to attaining net zero emissions of greenhouse gases. Drawing on the case of the UK, we argue that a single focus upon carbon storage alone is likely to overlook the other ‘net zero plus’ benefits which woodlands can deliver. A review of the literature considers the wide variety of potential benefits which woodlands can provide, together with costs such as foregone alternative land uses. We argue that decision making must consider all of these potential benefits and costs for the right locations to be planted with the right trees. The paper closes by reviewing the decision support systems necessary to incorporate this information into policy and decision making. Read the free Plain Language Summary for this article on the Journal blog.

IntroductionDissemination and Implementation (D&I) science is growing among Indigenous communities. Indigenous communities are adapting and implementing evidence-based treatments for substance use disorders (SUD) to fit the needs of their communities. D&I science offers frameworks, models, and theories to increase implementation success, but research is needed to center Indigenous knowledge, enhancing D&I so that it is more applicable within Indigenous contexts. In this scoping review, we examined the current state of D&I science for SUD interventions among Indigenous communities and identified best-practice SUD implementation approaches.MethodsPubMed and PsycINFO databases were queried for articles written in English, published in the United States, Canada, Australia, and New Zealand. We included key search terms for Indigenous populations and 35 content keywords. We categorized the data using the adapted and extended Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework that emphasizes equity and sustainability. RE-AIM has also been used as a primary model to consistently identify implementation outcomes.ResultsTwenty articles were identified from the original unduplicated count of over 24,000. Over half the articles discussed processes related to Reach, Adoption, and Implementation. Effectiveness was discussed by 50% of the studies (n = 10), with 25% of the articles discussing Maintenance/sustainability (n = 4). Findings also highlighted the importance of the application of each RE-AIM domain for meaningful, well-defined community-engaged approaches.ConclusionFinding indicated a need to prioritize Indigenous methods to culturally center, re-align and adapt Western treatments and frameworks to increase health equity and improve SUD treatment outcomes. Utility in the use of the modified RE-AIM and the continued modification for Indigenous communities was also noted.

Drone-based multispectral sensing is a valuable tool for dryland spatial ecology, yet there has been limited investigation of the reproducibility of measurements from drone-mounted multispectral camera array systems or the intercomparison between drone-derived measurements, field spectroscopy, and satellite data. Using radiometrically calibrated data from two multispectral drone sensors (MicaSense RedEdge (MRE) and Parrot Sequoia (PS)) co-located with a transect of hyperspectral measurements (tramway) in the Chihuahuan desert (New Mexico, USA), we found a high degree of correspondence within individual drone data sets, but that reflectance measurements and vegetation indices varied between field, drone, and satellite sensors. In comparison to field spectra, MRE had a negative bias, while PS had a positive bias. In comparison to Sentinel-2, PS showed the best agreement, while MRE had a negative bias for all bands. A variogram analysis of NDVI showed that ecological pattern information was lost at grains coarser than 1.8 m, indicating that drone-based multispectral sensors provide information at an appropriate spatial grain to capture the heterogeneity and spectral variability of this dryland ecosystem in a dry season state. Investigators using similar workflows should understand the need to account for biases between sensors. Modelling spatial and spectral upscaling between drone and satellite data remains an important research priority.

Summary This journal (Drone Systems and Applications; DSA) conducted a targeted “horizon scan” during 2022 within our team of editors and associate editors. We asked—Which research areas currently under-represented in Drone Systems and Applications would you like to see more heavily represented in the future? The process highlighted five areas of interest and potential growth: Drones in the geosciences Aquatic drones Ground drones Drones within calibration/validation experiments Drones and computer vision Over the past two years (2020–22), the journal has published over 50 papers with a strong leaning towards aerial drones for ecology and also with an engineering focus. DSA is keen to receive new submissions addressing the five highlighted areas, which lie firmly within the aims and scope of the journal. Further to the horizon scan, we propose two special collections for the coming year—one addressing drone applications (drones in geoscience applications) and a second addressing drone systems (aquatic drone systems). We would like to hear from scientists and practitioners in these fields as both contributors and (or) collection editors.

Abstract Peru was the first country where pfhrp2 and pfhrp3 gene deletions were detected despite the fact that rapid diagnostics tests are not commonly used for confirmatory malaria diagnosis. This context provides a unique scenario to study the dynamics of pfhrp2 and pfhrp3 gene deletions without apparent RDTs selection pressure. In this study we characterized the presence of pfhrp2 and pfhrp3 genes on 325 P. falciparum samples collected in Iquitos and surrounding communities between 2011 and 2018 in order to understand the dynamics of gene deletion prevalence, potential associations with clinical symptomatology and parasite genetic background. P. falciparum presence was confirmed by microscopy and PCR of 18 s rRNA, pfmsp1 and pfmsp2. Gene deletions were assessed by amplification of exon1 and exon2 of pfhrp2 and pfhrp3 using gene specific PCRs. Confirmation of absence of HRP2 expression was assessed by ELISA of HRP2 and pLDH. Genotyping of 254 samples were performed using a panel of seven neutral microsatellite markers. Overall, pfhrp2 and pfhrp3 dual gene deletions were detected in 67% (217/324) parasite samples. Concordance between pfhrp2 deletion and negligible HRP2 protein levels was observed (Cohen's Kappa = 0.842). Prevalence of gene deletions was heterogeneous across study sites (adjusted p

Abstract Background: The Midlands has amongst the highest rates of neonatal and infant mortality in the UK. A public health parent education and empowerment programme, aimed at reducing key risks associated with this mortality was established and evaluated in the region. This was undertaken in an attempt to identify areas for optimal delivery of the public health messages around reducing risks for neonatal and infant mortality. Method: Qualitatively assessment, using the software package Dedoose®, was undertaken. This involved analysis of reflections by the programme trainers, after the delivery of their training sessions to parents, families and carers, between 01 January and 31 December 2021. These were intended to capture insights from the trainers on parent, family, carer and staff perspectives, perceptions/misperceptions around reducing risks for infant mortality. Potential areas for improvement in delivery of the programme were identified from this analysis. Results: A total of 323 programmes, comprising 524 parents, family members and carers were offered the programme. Analysis of 167 reflections around these interactions and those of staff (n = 29) are reported. The programme was positively received across parents, families, carers and staff. Four overall themes were identified: (a) reach and inclusion, (b) knowledge, (c) practical and emotional support and (d) challenges for delivery of the programme. Recommendations for improved delivery of the programme were identified, based on qualitative analysis. Conclusion: This novel approach to empowerment and education around neonatal public health messaging is a valuable tool for parents, families, carers and staff in the Midlands. Key practical recommendations for enhancing delivery of these critical public health messages were identified from this qualitative research. These are likely to be of value in other parts of the UK and globally.

Engagement in take-home naloxone (THN) programs by people receiving opioid substitution treatment (OST) in Australia is low despite methadone being a significant contributor to opioid overdose deaths. Our aim was to explore barriers and facilitators for OST patients to engage in THN. We used a descriptive qualitative design with thematic analysis to gain insight into naloxone uptake by people engaged in an OST program in regional Australia. Eleven participants were interviewed; eight had previously engaged with THN. Barriers to THN included limited knowledge and understanding, lack of information, and not personally experiencing an overdose. Facilitators included having a traumatic experience of overdose, knowledge and understanding of THN and overdose, empowerment in carrying naloxone, and expanding THN programs. Support for the expansion of THN programs is desired among participants, and widespread peer distribution is understood to be the key to success. This study found that prior traumatic experience of overdose facilitates acceptance of THN, and being offered THN was the most important factor in engagement. Less clear is how to engage people who lack a traumatic overdose experience.

Dravet syndrome (DS), an intractable childhood epileptic encephalopathy with a high fatality rate, is typically caused by loss-of-function mutations in one allele of SCN1A, which encodes NaV1.1, a 250-kDa voltage-gated sodium channel. In contrast to other epilepsies, pharmaceutical treatment for DS is limited. Here, we demonstrate that viral vector–mediated delivery of a codon-modified SCN1A open reading frame into the brain improves DS comorbidities in juvenile and adolescent DS mice (Scn1aA1783V/WT). Notably, bilateral vector injections into the hippocampus and/or the thalamus of DS mice increased survival, reduced the occurrence of epileptic spikes, provided protection from thermally induced seizures, corrected background electrocorticographic activity and behavioral deficits, and restored hippocampal inhibition. Together, our results provide a proof of concept for the potential of SCN1A delivery as a therapeutic approach for infants and adolescents with DS-associated comorbidities.

Considerando o perfil dos alunos inseridos na era tecnológica, discussões no que tange à utilização de tecnologias digitais na construção de narrativas variadas no processo de ensino e aprendizagem são fundamentais. Diante disso, este artigo relata um trabalho desenvolvido que teve como objetivo geral analisar as contribuições da utilização do modelo de Ensino Híbrido de Rotação por Estações, no processo de ensino e aprendizagem de Indução Eletromagnética, tendo como público alvo alunos do terceiro ano do Ensino Médio. Como base teórica para a elaboração da proposta, apropriou-se de alguns pressupostos da metodologia híbrida, sendo escolhido o modelo de Rotação por Estações. A pesquisa desenvolvida, qualitativa do tipo intervenção pedagógica, utilizou como instrumentos de coletas de dados questionário e observação da sequência didática. A aplicação da sequência ocorreu em três tempos de aula. Na intervenção, apresentou-se o conteúdo de forma a familiarizar os alunos quanto aos conceitos abordados posteriormente nas estações. A partir disso, foi aplicado o modelo de Ensino Híbrido de Rotação por Estações, utilizando-se atividade experimental, simulação computacional e questões objetivas. A turma foi dividida em grupos e organizada em estações independentes, tendo que até o final passar por todas. Como resultados da pesquisa, observou-se que a proposta contribuiu para despertar o interesse dos alunos pelo conteúdo abordado, ao trabalhar de forma colaborativa em grupo, além disso destaca-se o desenvolvimento da autonomia de tais sujeitos num ambiente criativo e dinâmico, com utilização de diferentes estratégias, permitindo assim o protagonismo no processo de ensino e aprendizagem, em consonância com as demandas da sociedade tecnológica.

Abstract In the UK, tree, hedgerow, and woodland (THaW) habitats are key havens for biodiversity and support many related ecosystem services. The UK is entering a period of agricultural policy realignment with respect to natural capital and climate change, meaning that now is a critical time to evaluate the distribution, resilience, and dynamics of THaW habitats. The fine‐grained nature of habitats like hedgerows necessitates mapping of these features at relatively fine spatial resolution—and freely available public archives of airborne laser scanning (LiDAR) data at 90%. It was also possible to combine LiDAR mapping data and Sentinel‐1 SAR data to rapidly track canopy change through time (i.e., every 3 months) using, cloud‐based processing via Google Earth Engine. The resultant toolkit is also provided as an open‐access web app. The results highlight that whilst nearly 90% of the tallest trees (above 15 m) are captured within the National Forest Inventory (NFI) database only 50% of THaW with a canopy height range of 3–15 m are recorded. Current estimates of tree distribution neglect these finer‐grained features (i.e., smaller or less contiguous THaW canopies), which we argue will account for a significant proportion of landscape THaW cover.

Abstract Non‐forest ecosystems, dominated by shrubs, grasses and herbaceous plants, provide ecosystem services including carbon sequestration and forage for grazing, and are highly sensitive to climatic changes. Yet these ecosystems are poorly represented in remotely sensed biomass products and are undersampled by in situ monitoring. Current global change threats emphasize the need for new tools to capture biomass change in non‐forest ecosystems at appropriate scales. Here we developed and deployed a new protocol for photogrammetric height using unoccupied aerial vehicle (UAV) images to test its capability for delivering standardized measurements of biomass across a globally distributed field experiment. We assessed whether canopy height inferred from UAV photogrammetry allows the prediction of aboveground biomass (AGB) across low‐stature plant species by conducting 38 photogrammetric surveys over 741 harvested plots to sample 50 species. We found mean canopy height was strongly predictive of AGB across species, with a median adjusted R2 of 0.87 (ranging from 0.46 to 0.99) and median prediction error from leave‐one‐out cross‐validation of 3.9%. Biomass per‐unit‐of‐height was similar within but different among, plant functional types. We found that photogrammetric reconstructions of canopy height were sensitive to wind speed but not sun elevation during surveys. We demonstrated that our photogrammetric approach produced generalizable measurements across growth forms and environmental settings and yielded accuracies as good as those obtained from in situ approaches. We demonstrate that using a standardized approach for UAV photogrammetry can deliver accurate AGB estimates across a wide range of dynamic and heterogeneous ecosystems. Many academic and land management institutions have the technical capacity to deploy these approaches over extents of 1–10 ha−1. Photogrammetric approaches could provide much‐needed information required to calibrate and validate the vegetation models and satellite‐derived biomass products that are essential to understand vulnerable and understudied non‐forested ecosystems around the globe.

Structural competency is used to train health professionals on how social, political, and economic dynamics create conditions that negatively impact a population’s health. In the Global South, this approach has historical roots in social movements, popular education, social medicine, and human rights. In 1982, during a time of extreme poverty, inequality, and violence under the Chilean military dictatorship, Educación Popular en Salud (EPES), developed a programme for training community health promoters to address common illnesses and analyse the underlying causes of poor health. In 2010, EPES began using the same model to train international and Chilean health professionals. The approach advanced four competencies. Evaluations show that training contributes to transforming health professionals’ mindsets and leads them to question their practices. However, educating practitioners does not change the underlying structures that generate poor health. This article examines the intersection between EPES’ competencies and the structural competency framework, highlighting two major contributions of EPES to structural competency: a methodology that narrows the gap between a theoretical analysis of social determinants of health and implementing action plans; and organic long-term links with social movements that strengthen collective action in poor neighbourhoods to advance social justice.

Abstract Eritrea was the first African country to complete a nationwide switch in 2016 away from HRP2-based RDTs due to high rates of false-negative RDT results caused by Plasmodium falciparum parasites lacking hrp2/hrp3 genes. A cross-sectional survey was conducted during 2019 enrolling symptomatic malaria patients from nine health facilities across three zones consecutively to investigate the epidemiology of P. falciparum lacking hrp2/3 after the RDT switch. Molecular analyses of 715 samples revealed the overall prevalence of hrp2-, hrp3-, and dual hrp2/3-deleted parasites as 9.4% (95%CI 7.4–11.7%), 41.7% (95% CI 38.1–45.3%) and 7.6% (95% CI 5.8–9.7%), respectively. The prevalence of hrp2- and hrp3-deletion is heterogeneous within and between zones: highest in Anseba (27.1% and 57.9%), followed by Gash Barka (6.4% and 37.9%) and Debub zone (5.2% and 43.8%). hrp2/3-deleted parasites have multiple diverse haplotypes, with many shared or connected among parasites of different hrp2/3 status, indicating mutant parasites have likely evolved from multiple and local parasite genetic backgrounds. The findings show although prevalence of hrp2/3-deleted parasites is lower 2 years after RDT switching, HRP2-based RDTs remain unsuitable for malaria diagnosis in Eritrea. Continued surveillance of hrp2/3-deleted parasites in Eritrea and neighbouring countries is required to monitor the trend.

Abstract Quantifying the timing of vegetation phenology is critical for monitoring and modelling ecosystem responses to environmental change. Phenological processes have been studied from landscape to global scales using Earth observing satellite data, and at local scale by in situ surveys of individual plants. Now, data acquired from multi‐spectral sensors on drone platforms provide flexible opportunities for monitoring phenology from individual plants to small ecosystem scales efficiently, allowing community and species level information to be derived. We captured a time‐series of drone‐acquired normalized difference vegetation index (NDVI) data with a multi‐spectral sensor (Parrot Sequoia, (Parrot, France)) over a highly heterogeneous ecosystem in Cornwall, UK, during a period of spring green‐up. We monitored NDVI trajectories at the individual crown and species’ level. For deciduous crowns, we derived metrics representative of spring phenological stages: Start‐of‐spring (SOS), middle‐of‐spring green‐up (MOG) and start‐of‐peak greenness (SOP) using a logistic function. While the exact timing of SOS, MOG and SOP appeared susceptible to understorey effects and saturation of the NDVI, relative timing of green‐up for a subset of species was plausible in relation to phenological observations from an extended geographic region and in situ plant area index (PAI) measurements. In evergreen vegetation (Pinus spp.) subtle changes were also detected through the growing season. The impact of illumination differences was analysed for image pairs during leaf‐off and leaf‐on conditions. While significant, these effects were small (mean absolute NDVI deviation of up to 0.034 for leaf‐off, 0.013 for leaf‐on conditions), meaning that data captured under both constant direct and diffuse irradiance conditions can be used together and that cloudy conditions should not lead to data gaps. We conclude that the capability of drone‐mounted multi‐spectral instruments for spatio‐temporal characterization of crown‐level phenology shows great promise for improving the understanding of intra‐ and inter‐species differences in strategy, and offers an efficient means of doing so over areas of a few hectares.

Abstract Eurasian beaver (Castor fiber) were nearly hunted to extinction but have recovered to occupy much of their former range. Beaver were extirpated from Great Britain c. 400 years ago but have recently been reintroduced. The River Otter catchment, Devon was the site of the first licensed wild release of beavers in England. With further releases being considered, there is a need to better understand population dynamics of this native, keystone species to inform conservation and management. Field signs were surveyed from 2015 to 2021. A semi‐automated territory detection method was adopted to estimate territory counts. A spatially explicit model was developed to estimate the ecological territory capacity of the catchment. Future territory expansion was modelled using logistic growth curves; initial growth rate was estimated from observed territory counts and the estimated territory capacity range was used to define the limiting value of the growth curve. Beaver territory removal was simulated, across a range of management intensities and start times, to determine potential impacts of translocation or lethal control upon population dynamics. Territory numbers increased from four to 18, inclusive of four additionally released individuals, during study period. In the absence of population management, the territory capacity of the catchment was estimated to range between 120 and 183; this may be reached between 2028 and 2057. Simulated territory removal, where territories were removed at a fixed rate from the sum of the estimated total population and the population increase for that year, demonstrated large uncertainties in predicted population responses. Simulations with territory removals >3/year all predicted potential population collapse. This finding emphasizes the need for caution when considering population management strategies; translocation of animals out of the catchment or culling should be considered only when populations are established and all alternatives have been considered. These results provide critical information for the expected rate and magnitude of beaver population change in the River Otter catchment. The methods provide a reproducible and generalizable approach for understanding beaver population change, which can inform policy on the reintroduction of beavers and the potential timing and intensity of future beaver population management.

Abstract Accurate and up‐to‐date land cover maps are vital for underpinning evidence‐based landscape management decision‐making. However, the technical skills required to extract tailored information about land cover dynamics from these open‐access geospatial data often limit their use by those making landscape management decisions. Using Dartmoor National Park as an example, we demonstrate an open‐source toolkit which uses open‐source software (QGIS and RStudio) to process freely available Sentinel‐2 and public LiDAR data sets to produce fine scale (10 m2 grain size) land cover maps. The toolbox has been designed for use by staff within the national park, for example, enabling land cover maps to be updated as required in the future. An area of 945 km2 was mapped using a trained random forest classifier following a classification scheme tailored to the needs of the national park. A 2019 land cover map had an overall user's accuracy of 79%, with 13 out of 17 land cover classes achieving greater than 70% accuracy. Spatially, accuracy was related via logistical regression to blue band surface reflectance in the spring and topographic slope derived from LiDAR (1 m resolution), with greater accuracy in steeper terrain and areas exhibiting higher blue reflectance. Between an earlier (2017–2019) and later (2019–2021) time frame, 8% of pixels changed, most of the change by area occurred in the most common classes. However, the largest proportional increase occurred in Upland Meadows, Lowland Meadows and Blanket Bog, all habitats subject to restoration efforts. Identifying areas of change enables future field work to be better targeted. We discuss the application of this mapping to land management within the Dartmoor national park and of the potential of tailored land cover and land cover change mapping, via this toolbox, to evidence‐based environmental decision‐making more widely.

Abstract Background Genetic diversity and parasite relatedness are essential parameters for assessing impact of interventions and understanding transmission dynamics of malaria parasites, however data on its status in Plasmodium falciparum populations in Uganda is limited. Microsatellite markers and DNA sequencing were used to determine diversity and molecular characterization of P. falciparum parasite populations in Uganda. Methods A total of 147 P. falciparum genomic DNA samples collected from cross-sectional surveys in symptomatic individuals of 2–10 years were characterized by genotyping of seven highly polymorphic neutral microsatellite markers (n = 85) and genetic sequencing of the Histidine Rich Protein 2 (pfhrp2) gene (n = 62). ArcGIS was used to map the geographical distribution of isolates while statistical testing was done using Student's t-test or Wilcoxon's rank-sum test and Fisher’s exact test as appropriate at P ≤ 0.05. Results Overall, 75.5% (95% CI 61.1–85.8) and 24.5% (95% CI14.2–38.9) of parasites examined were of multiclonal (mixed genotype) and single clone infections, respectively. Multiclonal infections occurred more frequently in the Eastern region 73.7% (95% CI 48.8–89.1), P

Abstract Background Oral diseases place a significant burden on individual and population health. These diseases are largely preventable; health promotion initiatives have been shown to decrease the disease rates. However, there is limited implementation of health promotion in dentistry, this could be due to a number of factors; the ethos and philosophy of dentistry is focused on a curative, individualised approach to oral diseases, confusion around health promotion as a concept. Oral health academics are well placed to implement health promotion, training of these professionals needs to include prevention, as training influences dental practice. However, there is a little understanding about how oral health academics (dental professionals who educate dental and oral health students) view health promotion. The aim of this exploratory study is to understand how oral health academics conceptualise health promotion and perceive the barriers and possible opportunities for health promotion implementation in dental practice. Methods Nominal group technique (NGT), a highly structured face-to-face meeting, was conducted with 24 oral health academics to explore how they conceptualize health promotion and the barriers and opportunities for health promotion in practice. An additional 4 questions were emailed to oral health educators after the NGT meeting to gather additional data, 6 oral health academics were involved. The data was analyzed using thematic analysis. Results Three board themes were identified: “Knowledge, ideas and concepts of health promotion”, “Challenges to health promotion”, “Opportunities for health promotion practice”. The oral health academics in this study discussed health promotion in a holistic way, however, health education and behaviour change were mentioned more than other aspects of health promotion. The structure of dental practice specifically the curative approach that underpins dentistry and the lack of funding, and value placed on health promotion could act as a challenge to health promotion being implemented in practice. There has been a shift towards prevention in dentistry, however the participants acknowledge there needs to be a change in the curative culture of the profession. Collaboration with other health professionals and using a common risk factor approach were the identified opportunities for health promotion practice. Conclusions Oral health academics have a holistic understanding of health promotion, but still focus more on behavioural approaches which is common within dentistry. For a change to occur in health promotion practice a change in the structure, curative approach and funding model of dentistry is required. Collaboration with other health professionals is an opportunity to be capitalised on. Training of future dental professionals is the perfect place to start to implement the changes and opportunities for health promotion presented in this paper.

Deletion of histidine-rich protein genes pfhrp2/3 in Plasmodium falciparum causes infections to go undetected by HRP2-based malaria rapid diagnostic tests. We analyzed P. falciparum malaria cases imported to Australia (n = 210, collected 2010–2018) for their pfhrp2/3 status. We detected gene deletions in patients from 12 of 25 countries. We found >10% pfhrp2-deletion levels in those from Nigeria (13.3%, n = 30), Sudan (11.2%, n = 39), and South Sudan (17.7%, n = 17) and low levels of pfhrp3 deletion from Sudan (3.6%) and South Sudan (5.9%). No parasites with pfhrp2/3 double deletions were detected. Microsatellite typing of parasites from Nigeria, Sudan, and South Sudan revealed low relatedness among gene-deleted parasites, indicating independent emergences. The gene deletion proportions signify a risk of false-negative HRP2-RDT results. This study’s findings warrant surveillance to determine whether the prevalence of gene-deleted parasites justifies switching malaria rapid diagnostic tests in Nigeria, Sudan, and South Sudan.

Insect pollinators are affected by the spatio-temporal distribution of floral resources, which are dynamic across time and space, and also influenced heavily by anthropogenic activities. There is a need for spatial data describing the time-varying spatial distribution of flowers, which can be used within behavioral and ecological studies. However, this information is challenging to obtain. Traditional field techniques for mapping flowers are often laborious and limited to relatively small areas, making it difficult to assess how floral resources are perceived by pollinators to guide their behaviors. Conversely, remote sensing of plant traits is a relatively mature technique now, and such technologies have delivered valuable data for identifying and measuring non-floral dynamics in plant systems, particularly leaves, stems and woody biomass in a wide range of ecosystems from local to global scales. However, monitoring the spatial and temporal dynamics of plant floral resources has been notably scarce in remote sensing studies. Recently, lightweight drone technology has been adopted by the ecological community, offering a capability for flexible deployment in the field, and delivery of centimetric resolution data, providing a clear opportunity for capturing fine-grained information on floral resources at key times of the flowering season. In this review, we answer three key questions of relevance to pollination science – can remote sensing deliver information on (a) how isolated are floral resources? (b) What resources are available within a flower patch? And (c) how do floral patches change over time? We explain how such information has potential to deepen ecological understanding of the distribution of floral resources that feed pollinators and the parameters that determine their navigational and foraging choices based on the sensory information they extract at different spatial scales. We provide examples of how such data can be used to generate new insights into pollinator behaviors in distinct landscape types and their resilience to environmental change.

Drylands cover ca. 40% of the land surface and are hypothesised to play a major role in the global carbon cycle, controlling both long-term trends and interannual variation. These insights originate from land surface models (LSMs) that have not been extensively calibrated and evaluated for water-limited ecosystems. We need to learn more about dryland carbon dynamics, particularly as the transitory response and rapid turnover rates of semi-arid systems may limit their function as a carbon sink over multi-decadal scales. We quantified aboveground biomass carbon (AGC; inferred from SMOS L-band vegetation optical depth) and gross primary productivity (GPP; from PML-v2 inferred from MODIS observations) and tested their spatial and temporal correspondence with estimates from the TRENDY ensemble of LSMs. We found strong correspondence in GPP between LSMs and PML-v2 both in spatial patterns (Pearson’s r = 0.9 for TRENDY-mean) and in inter-annual variability, but not in trends. Conversely, for AGC we found lesser correspondence in space (Pearson’s r = 0.75 for TRENDY-mean, strong biases for individual models) and in the magnitude of inter-annual variability compared to satellite retrievals. These disagreements likely arise from limited representation of ecosystem responses to plant water availability, fire, and photodegradation that drive dryland carbon dynamics. We assessed inter-model agreement and drivers of long-term change in carbon stocks over centennial timescales. This analysis suggested that the simulated trend of increasing carbon stocks in drylands is in soils and primarily driven by increased productivity due to CO2 enrichment. However, there is limited empirical evidence of this 50-year sink in dryland soils. Our findings highlight important uncertainties in simulations of dryland ecosystems by current LSMs, suggesting a need for continued model refinements and for greater caution when interpreting LSM estimates with regards to current and future carbon dynamics in drylands and by extension the global carbon cycle.

PurposeTo assess the pathological aging effect on caudate functional connectivity among mild cognitive impairment (MCI) participants and examine whether and how sex and amyloid contribute to this process.Materials and MethodsTwo hundred and seventy-seven functional magnetic resonance imaging (fMRI) sessions from 163 cognitive normal (CN) older adults and 309 sessions from 139 participants with MCI were included as the main sample in our analysis. Pearson's correlation was used to characterize the functional connectivity (FC) between caudate nuclei and each brain region, then caudate nodal strength was computed to quantify the overall caudate FC strength. Association analysis between caudate nodal strength and age was carried out in MCI and CN separately using linear mixed effect (LME) model with covariates (education, handedness, sex, Apolipoprotein E4, and intra-subject effect). Analysis of covariance was conducted to investigate sex, amyloid status, and their interaction effects on aging with the fMRI data subset having amyloid status available. LME model was applied to women and men separately within MCI group to evaluate aging effects on caudate nodal strength and each region's connectivity with caudate nuclei. We then evaluated the roles of sex and amyloid status in the associations of neuropsychological scores with age or caudate nodal strength. An independent cohort was used to validate the sex-dependent aging effects in MCI.ResultsThe MCI group had significantly stronger age-related increase of caudate nodal strength compared to the CN group. Analyzing women and men separately revealed that the aging effect on caudate nodal strength among MCI participants was significant only for women (left: P = 6.23 × 10−7, right: P = 3.37 × 10−8), but not for men (P > 0.3 for bilateral caudate nuclei). The aging effects on caudate nodal strength were not significantly mediated by brain amyloid burden. Caudate connectivity with ventral prefrontal cortex substantially contributed to the aging effect on caudate nodal strength in women with MCI. Higher caudate nodal strength is significantly related to worse cognitive performance in women but not in men with MCI.ConclusionSex modulates the pathological aging effects on caudate nodal strength in MCI regardless of amyloid status. Caudate nodal strength may be a sensitive biomarker of pathological aging in women with MCI.

Abstract Background Histidine-rich protein-2 (HRP2)-based rapid diagnostic tests (RDTs) are the only RDTs recommended for malaria diagnosis in Uganda. However, the emergence of Plasmodium falciparum histidine rich protein 2 and 3 (pfhrp2 and pfhrp3) gene deletions threatens their usefulness as malaria diagnostic and surveillance tools. The pfhrp2 and pfhrp3 gene deletions surveillance was conducted in P. falciparum parasite populations in Uganda. Methods Three-hundred (n = 300) P. falciparum isolates collected from cross-sectional malaria surveys in symptomatic individuals in 48 districts of eastern and western Uganda were analysed for the presence of pfhrp2 and pfhrp3 genes. Presence of parasite DNA was confirmed by PCR amplification of the 18s rRNA gene, msp1 and msp2 single copy genes. Presence or absence of deletions was confirmed by amplification of exon1 and exon2 of pfhrp2 and pfhrp3 using gene specific PCR. Results Overall, pfhrp2 and pfhrp3 gene deletions were detected in 29/300 (9.7%, 95% CI 6.6–13.6%) parasite isolates. The pfhrp2 gene was deleted in 10/300 (3.3%, 95% CI 1.6–6.0%) isolates, pfhrp3 in 9/300 (3.0%, 95% CI 1.4–5.6%) while both pfhrp2 and pfhrp3 were deleted in 10/300 (3.3%, 95% CI 1.6–6.0%) parasite isolates. Proportion of pfhrp2/3 deletions was higher in the eastern 14.7% (95% CI 9.7–20.0%) compared to the western region 3.1% (95% CI 0.8–7.7%), p = 0.001. Geographical location was associated with gene deletions aOR 6.25 (2.02–23.55), p = 0.003. Conclusions This is the first large-scale survey reporting the presence of pfhrp2/3 gene deletions in P. falciparum isolates in Uganda. Roll out of RDTs for malaria diagnosis should take into consideration the existence of pfhrp2/3 gene deletions particularly in areas where they were detected. Periodic pfhrp2/3 surveys are recommended to inform future decisions for deployment of alternative RDTs.

Abstract Image‐based modeling, and more precisely, Structure from Motion (SfM) and Multi‐View Stereo (MVS), is emerging as a flexible, self‐service, remote sensing tool for generating fine‐grained digital surface models (DSMs) in the Earth sciences and ecology. However, drone‐based SfM + MVS applications have developed at a rapid pace over the past decade and there are now many software options available for data processing. Consequently, understanding of reproducibility issues caused by variations in software choice and their influence on data quality is relatively poorly understood. This understanding is crucial for the development of SfM + MVS if it is to fulfill a role as a new quantitative remote sensing tool to inform management frameworks and species conservation schemes. To address this knowledge gap, a lightweight multirotor drone carrying a Ricoh GR II consumer‐grade camera was used to capture replicate, centimeter‐resolution image datasets of a temperate, intensively managed grassland ecosystem. These data allowed the exploration of method reproducibility and the impact of SfM + MVS software choice on derived vegetation canopy height measurement accuracy. The quality of DSM height measurements derived from four different, yet widely used SfM‐MVS software—Photoscan, Pix4D, 3DFlow Zephyr, and MICMAC, was compared with in situ data captured on the same day as image capture. We used both traditional agronomic techniques for measuring sward height, and a high accuracy and precision differential GPS survey to generate independent measurements of the underlying ground surface elevation. Using the same replicate image dataset (n = 3) as input, we demonstrate that there are 1.7, 2.0, and 2.5 cm differences in RMSE (excluding one outlier) between the outputs from different SfM + MVS software using High, Medium, and Low quality settings, respectively. Furthermore, we show that there can be a significant difference, although of small overall magnitude between replicate image datasets (n = 3) processed using the same SfM + MVS software, following the same workflow, with a variance in RMSE of up to 1.3, 1.5, and 2.7 cm (excluding one outlier) for “High,” “Medium,” and “Low” quality settings, respectively. We conclude that SfM + MVS software choice does matter, although the differences between products processed using “High” and “Medium” quality settings are of small overall magnitude.

Abstract Background Integrating mental health providers into primary care clinics improves access to and outcomes of mental health care. In the Veterans Health Administration (VA) Primary Care Mental Health Integration (PCMHI) program, mental health providers are co-located in primary care clinics, but the implementation of this model is challenging outside large VA medical centers, especially for rural clinics without full mental health staffing. Long wait times for mental health care, little collaboration between mental health and primary care providers, and sub-optimal outcomes for rural veterans could result. Telehealth could be used to provide PCMHI to rural clinics; however, the clinical effectiveness of the tele-PCMHI model has not been tested. Based on evidence that implementation facilitation is an effective implementation strategy to increase uptake of PCMHI when delivered on-site at larger VA clinics, it is hypothesized that this strategy may also be effective with regard to ensuring adequate uptake of the tele-PCMHI model at rural VA clinics. Methods This study is a hybrid type 2 pragmatic effectiveness-implementation trial of tele-PCMHI in six sites over 24 months. Tele-PCMHI, which will be delivered by clinical staff available in routine care settings, will be compared to usual care. Fidelity to the care model will be monitored but not controlled. We will use the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to evaluate the patient-level clinical effectiveness of tele-PCMHI in rural VA clinics and also to evaluate the fidelity to and outcomes of the implementation strategy, implementation facilitation. The proposed study will employ a stepped-wedge design in which study sites sequentially begin implementation in three steps at 6-month intervals. Each step will include (1) a 6-month period of implementation planning, followed by (2) a 6-month period of active implementation, and (3) a final period of stepped-down implementation facilitation. Discussion This study will evaluate the effectiveness of PCMHI in a novel setting and via a novel method (clinical video telehealth). We will test the feasibility of using implementation facilitation as an implementation strategy to deploy tele-PCMHI in rural VA clinics. Trial registration ClinicalTrials.gov registration number NCT02713217. Registered on 18 March 2016

Dravet syndrome (Dravet) is a rare, severe childhood-onset epilepsy, caused by heterozygous de novo mutations in the SCN1A gene, encoding for the alpha subunit of the voltage-gated sodium channel, NaV1.1. The neuronal basis of Dravet is debated, with evidence favoring reduced function of inhibitory neurons, that might be transient, or enhanced activity of excitatory cells. Here, we utilized Dravet mice to trace developmental changes in the hippocampal CA1 circuit, examining the properties of CA1 horizontal stratum-oriens (SO) interneurons and pyramidal neurons, through the pre-epileptic, severe and stabilization stages of Dravet. Our data indicate that reduced function of SO interneurons persists from the pre-epileptic through the stabilization stages, with the greatest functional impairment observed during the severe stage. In contrast, opposing changes were detected in CA1 excitatory neurons, with a transient increase in their excitability during the pre-epileptic stage, followed by reduced excitability at the severe stage. Interestingly, alterations in the function of both inhibitory and excitatory neurons were more pronounced when the firing was evoked by synaptic stimulation, implying that loss of function of NaV1.1 may also affect somatodendritic functions. These results suggest a complex pathophysiological mechanism and indicate that the developmental trajectory of this disease is governed by reciprocal functional changes in both excitatory and inhibitory neurons.

Across the semiarid ecosystems of the southwestern USA, there has been widespread encroachment of woody shrubs and trees including Juniperus species into former grasslands. Quantifying vegetation biomass in such ecosystems is important because semiarid ecosystems are thought to play an important role in the global land carbon (C) sink, and changes in plant biomass also have implications for primary consumers and potential bioenergy feedstock. Oneseed juniper (Juniperus monosperma) is common in desert grasslands and pinyon–juniper rangelands across the intermountain region of southwestern North America; however, there is limited information about the aboveground biomass (AGB) and sapwood area (SWA) for this species, causing uncertainties in estimates of C stock and transpiration fluxes. In this study, we report on canopy area (CA), stem diameter, maximum height, and biomass measurements from J. monosperma trees sampled from central New Mexico. Dry biomass ranged between 0.4 kg and 625 kg, and cross-sectional SWA was measured on n = 200 stems using image analysis. We found a strong linear relationship between CA and AGB (r2 = 0.96), with a similar slope to that observed in other juniper species, suggesting that this readily measured attribute is well suited for upscaling studies. There was a 9% bias between different approaches to measuring CA, indicating care should be taken to account for these differences to avoid systematic biases. We found equivalent stem diameter (ESD) was a strong predictor of biomass, but that existing allometric models underpredicted biomass in larger trees. We found SWA could be predicted from individual stem diameter with a power relationship, and that tree-level SWA should be estimated by summing the SWA predictions from individual stems rather than ESD. Our improved allometric models for J. monosperma support more accurate and robust measurements of C storage and transpiration fluxes in Juniperus-dominated ecosystems.

BackgroundPlasmodium falciparum histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs) are exclusively recommended for malaria diagnosis in Uganda; however, their functionality can be affected by parasite-related factors that have not been investigated in field settings.MethodsUsing a cross-sectional design, we analysed 219 RDT-/microscopy+ and 140 RDT+/microscopy+ dried blood spots obtained from symptomatic children aged 2-10 years from 48 districts in Uganda between 2017 and 2019. We aimed to investigate parasite-related factors contributing to false RDT results by molecular characterization of parasite isolates. ArcGIS software was used to map the geographical distribution of parasites. Statistical analysis was performed using chi-square or Fisher's exact tests, with P ≤ 0.05 indicating significance. Odds ratios (ORs) were used to assess associations, while logistic regression was performed to explore possible factors associated with false RDT results.ResultsThe presence of parasite DNA was confirmed in 92.5% (332/359) of the blood samples. The levels of agreement between the HRP2 RDT and PCR assay results in the (RDT+/microscopy+) and (RDT-/microscopy+) sample subsets were 97.8% (137/140) and 10.9% (24/219), respectively. Factors associated with false-negative RDT results in the (RDT-/microscopy+) samples were parasite density (ConclusionThis is the first evaluation and report of the contributions of pfhrp2/3 gene deletion, non-P. falciparum species, and low-density infections to false-negative RDT results under field conditions in Uganda. In view of these findings, the use of HRP2 RDTs should be reconsidered; possibly, switching to combination RDTs that target alternative antigens, particularly in affected areas, may be beneficial. Future evaluations should consider larger and more representative surveys covering other regions of Uganda.

Alzheimer's disease (AD), including its mild cognitive impairment (MCI) phase that may or may not progress into the AD, is the most ordinary form of dementia. It is extremely important to correctly identify patients during the MCI stage because this is the phase where AD may or may not develop. Thus, it is crucial to predict outcomes during this phase. Thus far, many researchers have worked on only using a single modality of a biomarker for the diagnosis of AD or MCI. Although recent studies show that a combination of one or more different biomarkers may provide complementary information for the diagnosis, it also increases the classification accuracy distinguishing between different groups. In this paper, we propose a novel machine learning-based framework to discriminate subjects with AD or MCI utilizing a combination of four different biomarkers: fluorodeoxyglucose positron emission tomography (FDG-PET), structural magnetic resonance imaging (sMRI), cerebrospinal fluid (CSF) protein levels, and Apolipoprotein-E (APOE) genotype. The Alzheimer's Disease Neuroimaging Initiative (ADNI) baseline dataset was used in this study. In total, there were 158 subjects for whom all four modalities of biomarker were available. Of the 158 subjects, 38 subjects were in the AD group, 82 subjects were in MCI groups (including 46 in MCIc [MCI converted; conversion to AD within 24 months of time period], and 36 in MCIs [MCI stable; no conversion to AD within 24 months of time period]), and the remaining 38 subjects were in the healthy control (HC) group. For each image, we extracted 246 regions of interest (as features) using the Brainnetome template image and NiftyReg toolbox, and later we combined these features with three CSF and two APOE genotype features obtained from the ADNI website for each subject using early fusion technique. Here, a different kernel-based multiclass support vector machine (SVM) classifier with a grid-search method was applied. Before passing the obtained features to the classifier, we have used truncated singular value decomposition (Truncated SVD) dimensionality reduction technique to reduce high dimensional features into a lower-dimensional feature. As a result, our combined method achieved an area under the receiver operating characteristic (AU-ROC) curve of 98.33, 93.59, 96.83, 94.64, 96.43, and 95.24% for AD vs. HC, MCIs vs. MCIc, AD vs. MCIs, AD vs. MCIc, HC vs. MCIc, and HC vs. MCIs subjects which are high relative to single modality results and other state-of-the-art approaches. Moreover, combined multimodal methods have improved the classification performance over the unimodal classification.

Abstract Drawing on interviews with 204 participants in two studies of privately sponsored refugee resettlement in Ontario, Canada, we explore the resettlement effects of pre-arrival contact on the interactional dynamics between private sponsors and privately sponsored Syrian refugees. Those who had regular pre-arrival contact via digital applications such as Facebook, Skype, and Whatsapp reported more positive, “successful” resettlement experiences than those who had not. This pre-arrival interactive dynamic has theoretical/conceptual implications beyond an understanding of the benefits of “information exchange.” Pre-arrival sponsor-sponsored interaction is not bound by the contexts of displacement or resettlement, but constitutes a “third space” of reception, co-created through trusted contact. We develop the concept of “resettlement knowledge assets” and report on how these assets emerge through pre-arrival trust building, modify the resettlement expectations of both sponsors and sponsored, and reduce resettlement uncertainty.

Mild cognitive impairment (MCI) is a transitional state between the cognitive changes in normal aging and Alzheimer’s disease (AD), which induces abnormalities in specific brain regions. Previous studies showed that paired helical filaments Tau (PHF-Tau) protein is a potential pathogenic protein which may cause abnormal brain function and structure in MCI and AD patients. However, the understanding of the PHF-Tau protein network in MCI patients is limited. In this study, 225 subjects with PHF-Tau Positron Emission Tomography (PET) images were divided into four groups based on whether they carried Apolipoprotein E ε4 (APOE 4) or abnormal cerebrospinal fluid Total-Tau (CSF T-Tau). They are two important pathogenic factors that might cause cognitive function impairment. The four groups were: individuals harboring CSF T-Tau pathology but no APOE 4 (APOE 4−T+); APOE 4 carriers with normal CSF T-Tau (APOE 4+T−); APOE 4 carriers with abnormal CSF T-Tau (APOE 4+T+); and APOE 4 noncarriers with abnormal CSF T-Tau (APOE 4−T−). We explored the topological organization of PHF-Tau networks in these four groups and calculated five kinds of network properties: clustering coefficient, shortest path length, Q value of modularity, nodal centrality and degree. Our findings showed that compared with APOE 4−T− group, the other three groups showed different alterations in the clustering coefficient, shortest path length, Q value of modularity, nodal centrality and degree. Simultaneously, voxel-level analysis was conducted and the results showed that compared with APOE 4−T− group, the other three groups were found increased PHF-Tau distribution in some brain regions. For APOE 4+T+ group, positive correlation was found between the value of PHF-Tau distribution in altered regions and Functional Assessment Questionnaire (FAQ) score. Our results indicated that the effects of APOE 4 and abnormal CSF T-Tau may induce abnormalities of PHF-Tau protein and APOE 4 has a greater impact on PHF-Tau than abnormal CSF T-Tau. Our results may be particularly helpful in uncovering the pathophysiology underlying the cognitive dysfunction in MCI patients.

BackgroundNon-invasive brain stimulation (NIBS) has been widely used to treat mild cognitive impairment (MCI). However, there exists no consensus on the best stimulation sites.ObjectiveTo explore potential stimulation locations for NIBS treatment in patients with MCI, combining meta- and resting state functional connectivity (rsFC) analyses.MethodsThe meta-analysis was conducted to identify brain regions associated with MCI. Regions of interest (ROIs) were extracted based on this meta-analysis. The rsFC analysis was applied to 45 MCI patients to determine brain surface regions that are functionally connected with the above ROIs.ResultsWe found that the dorsolateral prefrontal cortex (DLPFC) and inferior frontal gyrus (IFG) were the overlapping brain regions between our results and those of previous studies. In addition, we recommend that the temporoparietal junction (including the angular gyrus), which was found in both the meta- and rsFC analysis, should be considered in NIBS treatment of MCI. Furthermore, the bilateral orbital prefrontal gyrus, inferior temporal gyrus, medial superior frontal gyrus, and right inferior occipital gyrus may be potential brain stimulation sites for NIBS treatment of MCI.ConclusionOur results provide several potential sites for NIBS, such as the DLFPC and IFG, and may shed light on the locations of NIBS sites in the treatment of patients with MCI.

Collecting multiple modalities of neuroimaging data on the same subject is increasingly becoming the norm in clinical practice and research. Fusing multiple modalities to find related patterns is a challenge in neuroimaging analysis. Canonical correlation analysis (CCA) is commonly used as a symmetric data fusion technique to find related patterns among multiple modalities. In CCA-based data fusion, principal component analysis (PCA) is frequently applied as a preprocessing step to reduce data dimension followed by CCA on dimension-reduced data. PCA, however, does not differentiate between informative voxels from non-informative voxels in the dimension reduction step. Sparse PCA (sPCA) extends traditional PCA by adding sparse regularization that assigns zero weights to non-informative voxels. In this study, sPCA is incorporated into CCA-based fusion analysis and applied on neuroimaging data. A cross-validation method is developed and validated to optimize the parameters in sPCA. Different simulations are carried out to evaluate the improvement by introducing sparsity constraint to PCA. Four fusion methods including sPCA+CCA, PCA+CCA, parallel ICA and sparse CCA were applied on structural and functional magnetic resonance imaging data of mild cognitive impairment subjects and normal controls. Our results indicate that sPCA significantly can reduce the impact of non-informative voxels and lead to improved statistical power in uncovering disease-related patterns by a fusion analysis.

Kidney transplant patients in our regional centre travel long distances to attend routine hospital follow-up appointments. Patients incur travel costs and productivity losses as well as adverse environmental impacts. A significant proportion of these patients, who may not require physical examination, could potentially be managed through telephone consultations (tele-clinic). We adopted a Quality Improvement approach with iterative Plan–Do–Study–Act (PDSA) cycles to test the introduction of a tele-clinic service. We codesigned the service with patients and developed a prototype delivery model that we then tested over two PDSA improvement ramps containing multiple PDSA cycles to embed the model into routine service delivery. Nineteen tele-clinics were held involving 168 kidney transplant patients (202 tele-consultations). 2.9% of tele-clinic patients did not attend compared with 6.9% for face-to-face appointments. Improving both blood test quality and availability for the tele-clinic was a major focus of activity during the project. Blood test quality for tele-clinics improved from 25% to 90.9%. 97.9% of survey respondents were satisfied overall with their tele-clinic, and 96.9% of the patients would recommend this to other patients. The tele-clinic saved 3527 miles of motorised travel in total. This equates to a saving of 1035 kgCO2. There were no unplanned admissions within 30 days of the tele-clinic appointment. The service provided an immediate saving of £6060 for commissioners due to reduced tele-clinic tariff negotiated locally (£30 less than face-to-face tariff). The project has shown that tele-clinics for kidney transplant patients are deliverable and well received by patients with a positive environmental impact and modest financial savings. It has the potential to be rolled out to other renal centres if a national tele-clinic tariff can be negotiated, and an integrated, appropriately reimbursed community phlebotomy system can be developed to facilitate remote monitoring of patients.

Recent developments of tau Positron Emission Tomography (PET) allows assessment of regional neurofibrillary tangles (NFTs) deposition in human brain. Among the tau PET molecular probes, 18F-AV1451 is characterized by high selectivity for pathologic tau aggregates over amyloid plaques, limited non-specific binding in white and gray matter, and confined off-target binding. The objectives of the study are (1) to quantitatively characterize regional brain tau deposition measured by 18F-AV1451 PET in cognitively normal older adults (CN), mild cognitive impairment (MCI), and AD participants; (2) to evaluate the correlations between cerebrospinal fluid (CSF) biomarkers or Mini-Mental State Examination (MMSE) and 18F-AV1451 PET standardized uptake value ratio (SUVR); and (3) to evaluate the partial volume effects on 18F-AV1451 brain uptake.Methods: The study included total 115 participants (CN = 49, MCI = 58, and AD = 8) from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Preprocessed 18F-AV1451 PET images, structural MRIs, and demographic and clinical assessments were downloaded from the ADNI database. A reblurred Van Cittertiteration method was used for voxelwise partial volume correction (PVC) on PET images. Structural MRIs were used for PET spatial normalization and region of interest (ROI) definition in standard space. The parametric images of 18F-AV1451 SUVR relative to cerebellum were calculated. The ROI SUVR measurements from PVC and non-PVC SUVR images were compared. The correlation between ROI 18F-AV1451 SUVR and the measurements of MMSE, CSF total tau (t-tau), and phosphorylated tau (p-tau) were also assessed.Results:18F-AV1451 prominently specific binding was found in the amygdala, entorhinal cortex, parahippocampus, fusiform, posterior cingulate, temporal, parietal, and frontal brain regions. Most regional SUVRs showed significantly higher uptake of 18F-AV1451 in AD than MCI and CN participants. SUVRs of small regions like amygdala, entorhinal cortex and parahippocampus were statistically improved by PVC in all groups (p < 0.01). Although there was an increasing tendency of 18F-AV-1451 SUVRs in MCI group compared with CN group, no significant difference of 18F-AV1451 deposition was found between CN and MCI brains with or without PVC (p > 0.05). Declined MMSE score was observed with increasing 18F-AV1451 binding in amygdala, entorhinal cortex, parahippocampus, and fusiform. CSF p-tau was positively correlated with 18F-AV1451 deposition. PVC improved the results of 18F-AV-1451 tau deposition and correlation studies in small brain regions.Conclusion: The typical deposition of 18F-AV1451 tau PET imaging in AD brain was found in amygdala, entorhinal cortex, fusiform and parahippocampus, and these regions were strongly associated with cognitive impairment and CSF biomarkers. Although more deposition was observed in MCI group, the 18F-AV-1451 PET imaging could not differentiate the MCI patients from CN population. More tau deposition related to decreased MMSE score and increased level of CSF p-tau, especially in ROIs of amygdala, entorhinal cortex and parahippocampus. PVC did improve the results of tau deposition and correlation studies in small brain regions and suggest to be routinely used in 18F-AV1451 tau PET quantification.

Striving to achieve a diverse and inclusive workplace has become a major goal for many organisations around the world [...]