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At the onset of the COVID-19 pandemic, and to this day, US state, tribal, local, and territorial health departments lacked comprehensive case investigation and contact tracing (CI/CT) guidelines that clearly define the capabilities and capacities of CI/CT programs and how to scale up these programs to respond to outbreaks. This research aims to identify the capabilities and capacities of CI/CT programs and to develop a conceptual framework that represents the relationships between these program components.
Methods:
This study conducted a narrative literature review and qualitative interviews with 10 US state and local health departments and 4 public health experts to identify and characterize the capacities and capabilities of CI/CT programs.
Results:
This research resulted in the first comprehensive analysis of the capabilities and capacities of CI/CT programs and a conceptual framework that illustrates the interrelationships between the capacities, capabilities, outcomes, and impacts of CI/CT programs.
Conclusions:
Our findings highlight the need for further guidance to assist jurisdictional health departments in shifting CI/CT program goals as outbreaks evolve. Training the public health workforce on making decisions around CI/CT program implementation during outbreaks is critical to ensure readiness for a variety of outbreak scenarios.
Research indicates that green tea extract (GTE) supplementation is beneficial for a range of conditions, including several forms of cancer, CVD and liver diseases; nevertheless, the existing evidence addressing its effects on body composition, oxidative stress and obesity-related hormones is inconclusive. This systematic review and meta-analysis aimed to investigate the effects of GTE supplementation on body composition (body mass (BM), body fat percentage (BFP), fat mass (FM), BMI, waist circumference (WC)), obesity-related hormones (leptin, adiponectin and ghrelin) and oxidative stress (malondialdehyde (MDA) and total antioxidant capacity (TAC)) markers. We searched proper databases, including PubMed/Medline, Scopus and Web of Science, up to July 2022 to recognise published randomised controlled trials (RCT) that investigated the effects of GTE supplementation on the markers mentioned above. A random effects model was used to carry out a meta-analysis. The heterogeneity among the studies was assessed using the I2 index. Among the initial 11 286 studies identified from an electronic database search, fifty-nine studies involving 3802 participants were eligible to be included in this meta-analysis. Pooled effect sizes indicated that BM, BFP, BMI and MDA significantly reduced following GTE supplementation. In addition, GTE supplementation increased adiponectin and TAC, with no effects on FM, leptin and ghrelin. Certainty of evidence across outcomes ranged from low to high. Our results suggest that GTE supplementation can attenuate oxidative stress, BM, BMI and BFP, which are thought to negatively affect human health. Moreover, GTE as a nutraceutical dietary supplement can increase TAC and adiponectin.
Preference for functional and nutritious food capable of meeting consumers' demand and health is on the increase. The present preliminary study seeks to assess physico-chemical and nutraceutical diversity in the cocoa bean powder of 77 genotypes present in four Nigerian cocoa field banks. Twenty ripe pods/genotypes in each of the four active breeding field banks at the Cocoa Research Institute of Nigeria (CRIN), Ibadan, Nigeria were utilized. Composite beans from the 20 pods of each genotype were singly fermented, sun-dried and milled. Duplicate samples of the powder of each genotype were analysed for physico-chemical and nutraceutical components. Twenty-one polymorphic variables distinguished the 77 cocoa genotypes. Grouping by dendogram identified four clusters, three differently and uniquely captured 100% of the genotype membership in the local clone, international clone and the regional varieties field bank but 86% of the genotypes in the hybrid trial field bank were grouped in cluster I. Prominent traits with highest values in each clusters were: protein, pH, Ca, K and Fe (Cluster I), Zn and Mg (Cluster II), crude fat and P (Cluster III) and crude fibre, ash, theobromine, flavonoids and caffeine (Cluster IV). Exploitable diversity for nutritional quality improvement is present in the active breeding and working collections of Nigerian cocoa field banks.
We study the local convergence of critical Galton–Watson trees under various conditionings. We give a sufficient condition, which serves to cover all previous known results, for the convergence in distribution of a conditioned Galton–Watson tree to Kesten’s tree. We also propose a new proof to give the limit in distribution of a critical Galton–Watson tree, with finite support, conditioned on having a large width.
Learning finite automata (termed as model learning) has become an important field in machine learning and has been useful realistic applications. Quantum finite automata (QFA) are simple models of quantum computers with finite memory. Due to their simplicity, QFA have well physical realizability, but one-way QFA still have essential advantages over classical finite automata with regard to state complexity (two-way QFA are more powerful than classical finite automata in computation ability as well). As a different problem in quantum learning theory and quantum machine learning, in this paper, our purpose is to initiate the study of learning QFA with queries (naturally it may be termed as quantum model learning), and the main results are regarding learning two basic one-way QFA (1QFA): (1) we propose a learning algorithm for measure-once 1QFA (MO-1QFA) with query complexity of polynomial time and (2) we propose a learning algorithm for measure-many 1QFA (MM-1QFA) with query complexity of polynomial time, as well.
While Kant’s position concerning human freedom and divine foreknowledge is perhaps the least Molinist element of his multifaceted take on free will, Kant’s Molinism (minimally defined) is undeniable when it comes to the threat ensuing from the idea of creation. In line with incompatibilism and with careful qualifications in place, he ultimately suggests regarding free agents as uncreated. Given the limitations of our rational insight, this assumption is indispensable for granting that finite free agents can acquire their intelligible characters by themselves. Nonetheless, Kant concedes that creation may, as a matter of fact, be compatible with what for Molina is the pre-volitionality of the counterfactuals of freedom.
Far from being limited to denunciations of modernity, nineteenth-century Catholic thought had a programmatic and visionary side. This article deals with the models of community put forward by Lamennais in L'Avenir, Antonio Rosmini, Luigi Taparelli d'Azeglio, and Wilhelm Ketteler. These writers reimagined the foundations of public life against the claims of self-interested individualism and state omnipotence. Three theses in particular capture their vision of the future polity: 1) societies, which were not “mechanisms,” needed Catholicism as animating spirit; 2) political representation should be “organic”; and 3) whereas the liberal elites imposed their vested interests on the common people, the Catholic polity reflected their needs and beliefs. The four writers envisaged a community of the gentle and caring, which, like the family, was hierarchical, self-governed, local, and supportive. In contrast, it was argued that the people had no voice under liberalism because the elite's values were not the people's and because the political system was a mere arena for the clash of special interests. This was a communitarian and populist Catholicism, prizing self-government, denouncing parliamentary politics, and siding with “the people.”
In continuation of our earlier work (Chen & Sreenivasan, J. Fluid Mech., vol. 908, 2021, R3; Chen & Sreenivasan, J. Fluid Mech., vol. 933, 2022a, A20 – together referred to as CS hereafter), we present a self-consistent Reynolds number asymptotics for wall-normal profiles of variances of streamwise and spanwise velocity fluctuations as well as root-mean-square pressure, across the entire flow region of channel and pipe flows and flat-plate boundary layers. It is first shown that, when normalized by peak values, the Reynolds number dependence and wall-normal variation of all three profiles can be decoupled, in excellent agreement with available data, sharing the common inner expansion of the type $\phi (y^+)=f_0(y^+)+f_1(y^+)/Re^{1/4}_\tau$, where $\phi$ is one of the quantities just mentioned, the functions $f_0$ and $f_1$ depend only on $y^+$, and $Re_\tau$ is the friction Reynolds number. Here, the superscript $+$ indicates normalization by wall variables. We show that this result is completely consistent with CS. Secondly, by matching the above inner expansion and the outer flow similarity form, a bounded variation $\phi (y^\ast )=\alpha _\phi -\beta _{\phi }y^{{\ast {1}/{4}}}$ is derived for the outer region where, for each $\phi$, the constants $\alpha _\phi$ and $\beta _{\phi }$ are independent of $Re_\tau$ and $y^\ast$$\equiv y^+/Re_\tau$ – also in excellent agreement with simulations and experimental data. One of the predictions of the analysis is that, for asymptotically high Reynolds numbers, a finite plateau $\phi \approx \alpha _\phi$ appears in the outer region. This result sheds light on the intriguing issue of the outer shoulder of the variance of the streamwise velocity fluctuation, which should be bounded by the asymptotic plateau of approximately 10.
A novel boundary integral approach for the recovery of overhanging (or not) rotational water waves (with constant vorticity) from pressure measurements at the bottom is presented. The method is based on the Cauchy integral formula and on an Eulerian–Lagrangian formalism to accommodate overturning free surfaces. This approach eliminates the need to introduce a priori a special basis of functions, thus providing a general means of fitting the pressure data and, consequently, recovering the free surface. The effectiveness and accuracy of the method are demonstrated through numerical examples.
We consider the evolution of a spatially periodic, perturbed vortex sheet for small times after the formation of a curvature singularity at time $t=t_c$ as demonstrated by Moore (Proc. R. Soc. Lond. A, vol. 365, issue 1720, 1979, pp. 105–119). The Moore analysis is extended to provide the small-amplitude, full-sheet structure at $t=t_c$ for a general single-mode initial condition in terms of polylogarithmic functions, from which its asymptotic form near the singular point is determined. This defines an intermediate evolution problem for which the leading-order, and most singular, approximation is solved as a Taylor-series expansion in $\tau = t-t_c$, where coefficients are calculated by repeated differentiation of the defining Birkhoff–Rott (BR) equation. The first few terms are in good agreement with numerical calculation based on the full-sheet solution. The series is summed, providing an analytic continuation which shows sheet rupture at circulation $\varGamma =0^+$, $\tau >0^+$, but with non-physical features owing to the absence of end-tip sheet roll up. This is corrected by constructing an inner solution with $\varGamma < \tau$, as a perturbed similarity form with small parameter $\tau ^{1/2}$. Numerical solutions of both the inner, nonlinear zeroth-order and first-order linear BR equations are obtained whose outer limits match the intermediate solution. The composite solution shows sheet tearing at $\tau =0^+$ into two separate, rolled up algebraic spirals near the central singular point. Branch separation distance scales as $\tau$ with a non-local, $\tau ^{3/2}$ correction. Properties of the intermediate and inner solutions are discussed.
The occurrence of behavioral health emergencies (BHEs) in children is increasing in the United States, with patient presentations to Emergency Medical Services (EMS) behaving similarly. However, detailed evaluations of EMS encounters for pediatric BHEs at the national level have not been reported.
Methods:
This was a secondary analysis of a national convenience sample of EMS electronic patient care records (ePCRs) collected from January 1, 2018 through December 31, 2021. Inclusion criteria were all EMS activations documented as 9-1-1 responses involving patients < 18 years of age with a primary or secondary provider impression of a BHE. Patient demographics, incident characteristics, and clinical variables including administration of sedation medications, use of physical restraint, and transport status were examined overall and by calendar year.
Results:
A total of 1,079,406 pediatric EMS encounters were present in the dataset, of which 102,014 (9.5%) had behavioral health provider impressions. Just over one-half of BHEs occurred in females (56.2%), and 68.1% occurred in patients aged 14-17 years. Telecommunicators managing the 9-1-1 calls for these events reported non-BHE patient complaints in 34.7%. Patients were transported by EMS 68.9% of the time, while treatment and/or transport by EMS was refused in 12.5%. Prehospital clinicians administered sedation medications in 1.9% of encounters and applied physical restraints in 1.7%. Naloxone was administered for overdose rescue in 1.5% of encounters.
Conclusion:
Approximately one in ten pediatric EMS encounters occurring in the United States involve a BHE, and the majority of pediatric BHEs attended by EMS result in transport of the child. Use of sedation medications and physical restraints by prehospital clinicians in these events is rare. National EMS data from a variety of sources should continue to be examined to monitor trends in EMS encounters for BHEs in children.
The application of integrative taxonomic approaches is useful to species delineation based on a combination of distinct types of characters, here morphological features and ribosomal DNA sequences. In this study, we surveyed ectoparasitic nematodes of the subfamily Merliniinae in cultivated and natural environments in Iran. Results of morphological and morphometrical studies, light and scanning electron microscopic observations, and molecular analyses allowed us the identification of fourteen known and one unknown species including representatives of the genera Amplimerlinius (five species), Geocenamus (one species), Merlinius (three species), Nagelus (two species), Paramerlinius (one species), Scutylenchus (two species), and Telomerlinius (one species). The unknown species, Scutylenchus sp., characterized by having 35–50 incisures at mid-body; lateral field with 6 longitudinal incisures; lip region slightly offset by a constriction, flattened at front end; bearing 5–7 annuli; cephalic framework not refractive; stylet robust, 18.3–27 μm long; post anal intestinal sac absent; tail elongate conical, dorsally convex, with 24 (19–28) annuli in ventral side, ending to a smooth terminus and males common; spicules 24.5–31 μm long. The phylogenetic analyses were carried out using molecular data from nuclear ribosomal DNA (rDNA) genes viz. D2–D3 expansion segments of the large ribosomal subunit (28S rRNA), partial small ribosomal subunit (18S rRNA), and internal transcribed spacer (ITS). The molecular variability of D2–D3 expansion segments of the 28S rRNA and partial 18S rRNA was low in this family in comparison to the ITS region, which could be a more helpful molecular marker in species and genus identification.
Coronary cameral fistula is a rare congenital anomaly and clinical presentation depends on the location of the defect, degree of shunting, and associated complications. We present a case of coronary cameral fistula where segmental analysis by echocardiogram helped us to avoid misdiagnosis as a ventricular septal defect.
This research work presents an implantable antenna that operates at 5.8 GHz. By using a radiator with a loop-based design, the antenna can be made smaller. Radiator is made up of three connected rectangular loops. On the substrate’s back side, an I-shaped ground plane is used. As substrate and superstrate, polydimethylsiloxane (PDMS) with dimensions of 7 mm × 5 mm × 0.3 mm is used. The conducting sections are made using copper foil that is 30 µm thick. The suggested antenna is examined by the implantable medical device using realistic human scalp phantom models and a homogenous skin box. Simulated study revealed that it operates around 5.8 GHz with a bandwidth from 5.69 to 5.92 GHz. The specific absorption rate was 0.28 and 0.26 W/kg for skin box and human scalp phantoms, respectively, at 1 mW input power across 1 g volume tissue.
In recent years, Western governments have invoked the values of universal human rights to justify large-scale military operations. Critical theorists have often responded that these campaigns serve not to promote peace, stability, or prosperity, but to entrench Western economic and political power, often in ways that have been devastating for local populations. However, Russia’s 2022 invasion of Ukraine casts doubt on whether assumptions about Western dominance will continue to furnish adequate accounts of global armed conflict. Critical theorists base many of their views on what is sometimes called ‘memory politics’, meaning that they cite histories of Western militarism, colonialism, racism and economic exploitation as backdrops to current policies. In this article it is argued that they will only be able to explain a conflict like the Ukraine war with credibility by incorporating into their memory politics the left’s own histories of supporting autocratic regimes.
An ultra-wideband (UWB) and compact-size four-port multiple input multiple output (MIMO) antenna with a footprint of 34 mm × 34 mm fed by an asymmetric coplanar strip (ACS) is investigated. The proposed antenna is composed of four orthogonally placed identical modified elliptical-shaped radiators and achieves an impedance bandwidth of 3.4–12.2 GHz. By etching two inverted L-shaped slots in the radiator element, WLAN band and X-band are rejected in the operating communication range. Because of the usage of a meander line decoupler, the isolation enhancement at the 8–12 GHz band is achieved and the isolation is more than 18 dB for most of the UWB range. The performance of the proposed antenna is studied in terms of isolation between each port, radiation pattern, current distribution, gain, envelope correlation coefficient, diversity gain, and total active reflection coefficient. The compact size and reduced complexity make the proposed design highly suitable for portable devices.