Sociocultural and behavioural features of anticipated COVID-19 vaccine acceptance in Papua New Guinea: a mixed methods study proposal

BACKGROUND: Coronavirus disease 2019 (COVID-19) was characterised by the World Health Organisation (WHO) as a pandemic in 2020. Papua New Guinea (PNG) has remained on high alert ever since its National Control Centre continues to coordinate national preparedness and response measures guided by its Emergency Preparedness and Response Plan for COVID-19. As part of the WHO, Gavi and other global partners' COVAX program, PNG received several COVID-19 vaccine doses. A national-wide vaccine roll-out for COVID-19 was initiated in PNG in May 2021. Despite the availability of vaccines and the capacity of health systems to vaccinate frontline workers and community members, including high-risk groups, questions on vaccine safety, confidence, and acceptance remain critical for the effectiveness of the COVID-19 vaccination campaign. Evidence from studies on COVID-19 vaccine acceptance and demand in low- and middle-income countries (LMICs) suggests that sociocultural factors of the community and behaviours of different vaccine stakeholders, including vaccine recipients, vaccine providers and policymakers, determine the effectiveness of vaccination interventions or strategies. OBJECTIVE: This study will examine sociocultural determinants of anticipated acceptance of the COVID-19 vaccine in the population of urban and rural areas of different regions in PNG, and healthcare providers' views on vaccine acceptance. METHODS: The study design includes a mixed methods approach to implement in PNG's coastal and highlands regions. The first research activity will use a qualitative methodology in which the epistemological foundation is based on constructivism. This design elicits and listens to community members' accounts of ways culture as a rich source provides meaning to the COVID-19 pandemic, adherence to 'niupela pasin' (New normal) and vaccination acceptance. The second activity will be a cross-sectional survey to assess the distribution of features of vaccine acceptance, priorities and practices. The third activity will be in-depth interviews of healthcare providers actively involved in either COVID-19 clinical management or public health-related pandemic control activities. RESULTS: The project proposal has been reviewed and approved by the Medical Research Advisory Committee of Papua New Guinea. The qualitative data collection started in December 2022 and the survey will begin in May 2023. The findings will be disseminated to the participated communities later this year followed by the publications. CONCLUSIONS: Proposed research on community views and experience concerning sociocultural and behavioural features of anticipated acceptance of the vaccine will provide a better understanding of communication and education needs for vaccine action for COVID-19 control in PNG and other LMICs. The research also considers the influence of healthcare providers' and policymakers' roles in the awareness and use of the COVID-19 vaccine. INTERNATIONAL REGISTERED REPORT: PRR1-10.2196/44664

Memory Performance is Related to Language Dominance as Determined by the intracarotid amobarbital procedure

Objective The goal of this study was to explore the relationship between language and memory lateralization in patients with epilepsy undergoing the intracarotid amobarbital procedure. Methods In 386 patients, language lateralization and memory lateralization as determined by laterality index (LI) were correlated with each other. Results Language lateralization and memory lateralization were positively correlated (r = 0.34, P \u3c 0.01). Correlations differed depending on the presence and type of lesion (χ2 = 7.98, P \u3c 0.05). LIs correlated significantly higher (z = 2.82, P \u3c 0.05) in patients with cortical dysplasia (n = 41, r = 0.61, P \u3c 0.01) compared with the group without lesions (n = 90, r = 0.16, P \u3e 0.05), with patients with hippocampal sclerosis falling between these two groups. Both memory (P \u3c 0.01) and language (P \u3c 0.01) LIs were higher in right- compared with left-sided lesions. Conclusion Correlation of language and memory is more pronounced in patients with structural lesions as compared with patients without lesions on MRI

Importance of access to epilepsy monitoring units during the COVID-19 pandemic: Consensus statement of the International League against epilepsy and the International Federation of Clinical Neurophysiology

Restructuring of healthcare services during the COVID-19 pandemic has led to lockdown of Epilepsy Monitoring Units (EMUs) in many hospitals. The ad-hoc taskforce of the International League Against Epilepsy (ILAE) and the International Federation of Clinical Neurophysiology (IFCN) highlights the detrimental effect of postponing video-EEG monitoring of patients with epilepsy and other paroxysmal events. The taskforce calls for action to continue functioning of Epilepsy Monitoring Units during emergency situations, such as the COVID-19 pandemic. Long-term video-EEG monitoring is an essential diagnostic service. Access to video-EEG monitoring of the patients in the EMUs must be given high priority. Patients should be screened for COVID-19, before admission, according to the local regulations. Local policies for COVID-19 infection control should be adhered to during the video-EEG monitoring. In cases of differential diagnosis where reduction of antiseizure medication is not required, consider home video-EEG monitoring as an alternative in selected patients

Direct Classification of All American English Phonemes Using Signals From Functional Speech Motor Cortex

Although brain-computer interfaces (BCIs) can be used in several different ways to restore communication, communicative BCI has not approached the rate or efficiency of natural human speech. Electrocorticography (ECoG) has precise spatiotemporal resolution that enables recording of brain activity distributed over a wide area of cortex, such as during speech production. In this study, we investigated words that span the entire set of phonemes in the General American accent using ECoG with 4 subjects. We classified phonemes with up to 36% accuracy when classifying all phonemes and up to 63% accuracy for a single phoneme. Further, misclassified phonemes follow articulation organization described in phonology literature, aiding classification of whole words. Precise temporal alignment to phoneme onset was crucial for classification success. We identified specific spatiotemporal features that aid classification, which could guide future applications. Word identification was equivalent to information transfer rates as high as 3.0 bits/s (33.6 words min), supporting pursuit of speech articulation for BCI control

Visual Naming Performance after ATL Resection: Impact of Atypical Language Dominance.

Purpose- To characterize the interaction between language dominance and lateralization of the epileptic focus for pre- and postoperative Boston Naming Test (BNT) performance in patients undergoing anterior temporal lobectomy (ATL). Methods- Analysis of pre- and postoperative BNT scores depending on lateralization of language as measured by the intracarotid amobarbital procedure (IAP) versus lateralization of the temporal lobe epileptic focus. Results- Changes between pre- and postoperative BNT performance depended on epilepsy lateralization (effect size = 0.189) with significant decrease in patients undergoing left ATL. Subgroup analysis in these showed that postoperative decline in BNT scores was significant in patients with atypical (n = 14; p \u3c 0.05), but did not reach statistical significance in patients with left language dominance (n = 36; p = 0.09). Chi-square test revealed a trend of higher proportions of patients experiencing significant postsurgical deterioration in naming performance in atypical (57.1%) as compared to left language dominance (30.6%; p = 0.082). Surgical failure was also associated with greater decline of BNT scores and was more common in atypical than in left language dominant patients (χ2 (1, n = 98) = 4.62, p = 0.032). Age of onset, duration of epilepsy, and seizure frequency had no impact on changes in BNT performance. Conclusion- Atypical language dominance is a predictor of change in visual naming performance after left ATL and may also impact postsurgical seizure control. This should be considered when counseling surgical candidates