Characterising extratropical near‐tropopause analysis humidity biases and their radiative effects on temperature forecasts

A cold bias in the extratropical lowermost stratosphere in forecasts is one of the most prominent systematic temperature errors in numerical weather prediction models. Hypothesized causes of this bias include radiative effects from a collocated moist bias in model analyses. Such biases would be expected to affect extratropical dynamics and result in the misrepresentation of wave propagation at tropopause level. Here the extent to which these humidity and temperature biases are connected is quantified. Observations from radiosondes are compared to operational analyses and forecasts from the European Centre for Medium-Range Weather Forecasts (ECMWF) Integrated Forecasting System (IFS) and Met Office Unified Model (MetUM) to determine the magnitude and vertical structure of these biases. Both operational models over-estimate lowermost stratospheric specific humidity, with a maximum moist bias around 1 km above the tropopause where humidities are around 170% of the observed values on average. This moist bias is already present in the initial conditions and changes little in forecasts over the first five days. Though temperatures are represented well in the analyses, the IFS forecasts anomalously cool in the lower stratosphere, relative to verifying radiosonde observations, by 0.2 K day –1. The IFS single column model is used to show this temperature change can be attributed to increased long-wave radiative cooling due to the lowermost stratospheric moist bias in the initial conditions. However, the MetUM temperature biases cannot be entirely attributed to the moist bias, and another significant factor must be present. These results highlight the importance of improving the humidity analysis to reduce the extratropical lowermost stratospheric cold bias in forecast models and the need to understand and mitigate the causes of the moist bias in these models

Defining discovery:is Google Scholar a discovery platform? An essay on the need for a new approach to scholarly discovery

This essay discusses the concept of discovery, intended as content discovery, and defines it in the new context of Open Science, with a focus on Social Sciences and Humanities (SSH). Starting from the example of Google Scholar, the authors show that this well established service does not address the current needs, practices, and variety of discovery. Alternatives in terms of technical choices, features, and governance, do however exist, offering richer and more open discovery. The paper presents in particular the implementations and research work of the H2020 project TRIPLE (Transforming Research through Innovative Practices for Linked Interdisciplinary Exploration). Dedicated to the building of a discovery platform for the SSH, the project is meant to address the specificities and evolution of discovery in this field. Prevailing scholarly resource platforms like Google Scholar limit discovery by focussing only on publications, and favouring through their algorithm well-cited papers, English content, and discipline-specific resources. A limitation in the context of cross-disciplinary and collaborative Open Science, such a service more specifically hinders discovery in the SSH. Characterized by a fragmented landscape, a variety of languages, data types, and outputs, research in the SSH requires services that fully exploit discovery potentialities. Moreover, a survey conducted within the TRIPLE project showed that most SSH researchers use Google Scholar as their starting point, and that they recognise the lack of control they have with this system. Beyond the extension of features and content, transparency is the other important criterion for the building of an Open Infrastructure actually serving the research community. In light of this, we present in some detail the GoTriple platform, which exploits today's technological potential and incorporates the best known functionalities in order to unveil more and innovative scholarly outputs and lead to international and interdisciplinary research project collaborations

Performance characteristics of an instrument-free point-of-care CD4 test (VISITECTVR CD4) for use in resource-limited settings

Objective: CD4þ T lymphocyte count remains the most common biomarker of immune status and disease progression in human immunodeficiency virus (HIV)-positive individuals. VISITECTVR CD4 is an instrument-free, low-cost point-of-care CD4 test with a cut-off of 350 CD4 cells/lL. This study aimed to evaluate VISITECTVR CD4 test’s diagnostic accuracy. Methods: Two hundred HIV-positive patients attending a tertiary HIV centre in South India were recruited. Patients provided venous blood for reference and VISITECTVR CD4 tests. An additional finger-prick blood sample was obtained for VISITECTVR CD4. VISITECTVR CD4’s diagnostic performance in identifying individuals with CD4 counts 350 cells/lL was assessed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) taking flow cytometry as the reference. Results: The overall agreement between VISITECTVR CD4 and flow cytometry was 89.5% using venous blood and 81.5% using finger-prick blood. VISITECTVR CD4 showed better performance using venous blood [sensitivity: 96.6% (95% confidence interval: 92.1%–98.9%), specificity: 70.9% (57.1%–82.4%), PPV: 89.7% (83.9%–94.0%) and NPV: 88.6% (75.4%–96.2%)] than using fingerprick blood [sensitivity: 84.8% (77.9%–90.2%), specificity: 72.7% (59.0%–83.9%), PPV: 89.1% (82.7%–93.8%) and NPV: 64.5% (51.3%–76.3%)]. Conclusion: VISITECTVR CD4 performed well using venous blood, demonstrating its potential utility in decentralization of CD4 testing services in resource-constrained settings

Be He@lthy - Be Mobile (A handbook on how to implement mAgeing)

The Be He@lthy, Be Mobile initiative is a global partnership led by the World Health Organization (WHO) and the International Telecommunication Union (ITU), representing the United Nations agencies for health and information and communications technologies (ICTs). The initiative supports the scale up of mobile health technology (mHealth) within national health systems to help combat noncommunicable diseases (NCDs) and support healthy ageing. Mobile health, or mHealth, is defined as "medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices” (1). The Be Healthy, Be Mobile initiative uses basic technologies common in most mobile phones. The BHBM initiative has overseen the development and implementation of several mHealth programmes, including mTobaccoCessation (2), mDiabetes, and mCervicalCancer. The mHealth programme-specific handbooks act as aids to policy-makers and implementers of national or large-scale mHealth programs. See Annex 1 for further information on the Be He@lthy, Be Mobile initiative. mHealth for Ageing, or mAgeing is a new programme under the initiative, the central objective of which is to assist older persons (a person whose age has passed the median life expectancy at birth) in maintaining functional ability and living as independently and healthily as possible through evidence-based self-management and self-care interventions. This handbook provides guidance for national programmes and organizations responsible for the care of older persons to develop, implement, monitor, and evaluate an mAgeing programme. The text messaging communication provided uses evidence-based behaviour change techniques to help older persons prevent and manage early declines in intrinsic capacity and functional ability. The mAgeing programme is based on WHO’s Integrated Care for Older People (ICOPE): Guidelines on community-level interventions to manage declines in intrinsic capacity (3) which include interventions to prevent declines in intrinsic capacity and functional abilities in older people, namely: mobility loss, malnutrition, visual impairment and hearing loss; as well as cognitive impairments and depressive symptoms. The messages are designed to encourage participation in activities, and to prevent, reduce, or even partly reverse, significant losses in capacity. The content of the mAgeing programme will complement routine care offered by health care professionals by supporting self-care and self-management. All content in this handbook is based on the WHO ICOPE Guidelines and other relevant WHO recommendations. The ICOPE Guideline recommendations were reached by the consensus of a guideline development group, convened by WHO, which based its decisions on a summary of systematic reviews of the best quality evidence most relevant to community-level care for older people, as well as the most up-to-date research on the effectiveness of mHealth

Virulence phenotypes of low-passage clinical isolates of Nontypeable Haemophilus influenzae assessed using the chinchilla laniger model of otitis media

<p>Abstract</p> <p>Background</p> <p>The nontypeable Haemophilus influenzae (NTHi) are associated with a spectrum of respiratory mucosal infections including: acute otitis media (AOM); chronic otitis media with effusion (COME); otorrhea; locally invasive diseases such as mastoiditis; as well as a range of systemic disease states, suggesting a wide range of virulence phenotypes. Genomic studies have demonstrated that each clinical strain contains a unique genic distribution from a population-based supragenome, the distributed genome hypothesis. These diverse clinical and genotypic findings suggest that each NTHi strain possesses a unique set of virulence factors that contributes to the course of the disease.</p> <p>Results</p> <p>The local and systemic virulence patterns of ten genomically characterized low-passage clinical NTHi strains (PittAA – PittJJ) obtained from children with COME or otorrhea were stratified using the chinchilla model of otitis media (OM). Each isolate was used to bilaterally inoculate six animals and thereafter clinical assessments were carried out daily for 8 days by blinded observers. There was no statistical difference in the time it took for any of the 10 NTHi strains to induce otologic (local) disease with respect to any or all of the other strains, however the differences in time to maximal local disease and the severity of local disease were both significant between the strains. Parameters of systemic disease indicated that the strains were not all equivalent: time to development of the systemic disease, maximal systemic scores and mortality were all statistically different among the strains. PittGG induced 100% mortality while PittBB, PittCC, and PittEE produced no mortality. Overall Pitt GG, PittII, and Pitt FF produced the most rapid and most severe local and systemic disease. A post hoc determination of the clinical origins of the 10 NTHi strains revealed that these three strains were of otorrheic origin, whereas the other 7 were from patients with COME.</p> <p>Conclusion</p> <p>Collectively these data suggest that the chinchilla OM model is useful for discriminating between otorrheic and COME NTHi strains as to their disease-producing potential in humans, and combined with whole genome analyses, point the way towards identifying classes of virulence genes.</p

Field Performance and Diagnostic Accuracy of a Low-Cost Instrument-Free Point-of-Care CD4 Test (Visitect CD4) Performed by Different Health Worker Cadres among Pregnant Women

Measuring CD4 counts remains an important component of HIV care. The Visitect CD4 is the first instrument-free low-cost point-of-care CD4 test with results interpreted visually after 40 min, providing a result of 350 CD4 cells/mm3. The field performance and diagnostic accuracy of the test was assessed among HIVinfected pregnant women in South Africa. A nurse performed testing at the point-ofcare using both venous and finger-prick blood, and a counselor and laboratory staff tested venous blood in the clinic laboratory (four Visitect CD4 tests/participant). Performance was compared to the mean CD4 count from duplicate flow cytometry tests on venous blood (FACSCalibur Trucount). In 2017, 156 patients were enrolled, providing a total of 624 Visitect CD4 tests (468 venous and 156 finger-prick samples). Of 624 tests, 28 (4.5%) were inconclusive. Generalized linear mixed modeling showed better performance of the test on venous blood (sensitivity 81.7%; 95% confidence interval [CI] 72.3 to 91.1]; specificity 82.6%, 95% CI 77.1 to 88.1) than on finger-prick specimens (sensitivity 60.7%; 95% CI 45.0 to 76.3; specificity 89.5%, 95% CI 83.2 to 95.8; P 0.001). No difference in performance was detected by cadre of health worker (P 0.113) or between point-of-care versus laboratory-based testing (P 0.108). Adequate performance of Visitect CD4 with different operators and at the point of care, with no need of electricity or instrument, shows the potential utility of this device, especially for facilitating decentralization of CD4 testing services in rural areas

Usability, acceptability, and safety analysis of a computer-tailored web-based exercise intervention (exerciseguide) for individuals with metastatic prostate cancer: Multi-methods laboratory-based study

Background: Digital health interventions such as tailored websites are emerging as valuable tools to provide individualized exercise and behavioral change information for individuals diagnosed with cancer. Objective: The aim of this study is to investigate and iteratively refine the acceptability and usability of a web-based exercise intervention (ExerciseGuide) for men with metastatic prostate cancer and determine how well individuals can replicate the video-based exercise prescription. Methods: A laboratory-based multi-methods design was used, incorporating questionnaires, think-aloud tests, interviews, and movement screening among 11 men aged 63 to 82 years with metastatic prostate cancer. Overall, 9 participants were undergoing androgen deprivation therapy, and 2 were completing chemotherapy. Data were collected in two waves, with changes made for quality improvement after participant 5. Results: The intervention\u27s usability score was deemed moderate overall but improved after modifications (from 60, SD 2.9 to 69.6, SD 2.2 out of 100). Overall, the participants found the intervention acceptable, with scores improving from wave 1 (24.2, SD 1.1 out of 30) to wave 2 (26.3, SD 2.1 out of 30). The personalized multimodal exercise prescription and computer-tailored education were seen as valuable. After wave 1, website navigation videos were added, medical terminology was simplified, and a telehealth component was included after expert real-time telehealth support was requested. Wave 2 changes included the added variety for aerobic exercise modes, reduced computer-tailoring question loads, and improved consistency of style and grammar. Finally, the participants could replicate the resistance exercise videos to a satisfactory level as judged by the movement screen; however, additional technique cueing within the videos is recommended to address safety concerns. Conclusions: The acceptability and usability of ExerciseGuide were deemed satisfactory. Various problems were identified and resolved. Notably, the participants requested the inclusion of personalized expert support through telehealth. The resistance training algorithms were shown to provide appropriate content safely, and the users could replicate the exercise technique unaided to a satisfactory level. This study has optimized the ExerciseGuide intervention for further investigation in this population

FNQ Connect: Connecting people, connecting care. A proposal for reform of disability, rehabilitation and lifestyle services for children, young people, adults and older people of FNQ

[Extract] FNQ Connect was created in response to a groundswell of interest and concern from FNQ people with lived experience of disability, their families and communities, together with stakeholders responsible for supporting them. They expressed an urgent need for service reform: current supply of services is outweighed by needs and is well below national standards; inaccuracies in national data conceal these inequities. Existing government, non-government and private services are largely fragmented; opportunities created by NDIS have added another layer of fragmentation. At the same time, demand for services is relentlessly increasing. To ensure quitable investment in services and continuity of care for the people of FNQ, accurate data and integration of services, were required

GOTRIPLE:a user-centric process to develop a discovery platform

Social sciences and humanities (SSH) research is divided across a wide array of disciplines, sub-disciplines and languages. While this specialization makes it possible to investigate the extensive variety of SSH topics, it also leads to a fragmentation that prevents SSH research from reaching its full potential. The TRIPLE project brings answers to these issues by developing an innovative discovery platform for SSH data, researchers’ projects and profiles. Having started in October 2019, the project has already three main achievements that are presented in this paper: (1) the definition of main features of the GOTRIPLE platform; (2) its interoperability; (3) its multilingual, multicultural and interdisciplinary vocation. These results have been achieved thanks to different methodologies such as a co-design process, market analysis and benchmarking, monitoring and co-building. These preliminary results highlight the need for respecting diversity of practices and communities through coordination and harmonization