Improving access to diagnostics for schistosomiasis case management in oyo state, Nigeria:Barriers and opportunities

Schistosomiasis is one of the Neglected Tropical Diseases that affects over 200 million people worldwide, of which 29million people in Nigeria. The principal strategy for schistosomiasis in Nigeria is a control and elimination program which comprises a school-based Mass Drug Administration (MDA)with limitations of high re-infection rates and the exclusion of high-risk populations. TheWorld Health Organization (WHO) recommends guided case management of schistosomiasis (diagnostic tests or symptom-based detection plus treatment) at the Primary Health Care (PHC) level to ensure more comprehensive morbidity control. However, these require experienced personnel with sufficient knowledge of symptoms and functioning laboratory equipment. Little is known aboutwhere, bywhom and how diagnosis is performed at health facilities within the case management of schistosomiasis in Nigeria. Furthermore, there is a paucity of information on patients' health-seeking behaviour from the onset of disease symptoms until a cure is obtained. In this study, we describe both perspectives in Oyo state, Nigeria and address the barriers using adapted health-seeking stages and access framework. The opportunities for improving case management were identified, such as a prevalence study of high-risk groups, community education and screening, enhancing diagnostic capacity at the PHC through point-of-care diagnostics and strengthening the capability of health workers.</p

Comparing Performance of Biomass Gasifier Stoves:Influence of a Multi-Context Approach

Millions of people worldwide die prematurely or suffer from severe health ailments due to cooking equipment that causes unhealthy doses of (household) air pollution. Many attempts to address this have fallen short because technology was not improved sufficiently or the way it was introduced constituted an ill fit with the broader "cooking eco-system". In terms of technology, (biomass) gasifier stoves look promising on all three sustainability dimensions (people, planet, profit) but have not been adopted on a substantial scale across cultures and regions either. We therefore used a design approach that takes multiple contexts (target groups) into account and compared the performance of a gasifier stove that was developed following this multi-context approach with four previous gasifier versions. With the comparative assessment using criteria well beyond mere technological performance we found that it performed better than these versions as well as than what could be expected based on historical learning, while providing additional systemic advantages. These results encourage verification of the value of the multi-context approach in more settings while providing clues for refinement of the assessment method

Developing inclusive digital health diagnostic for schistosomiasis: a need for guidance via target product profiles

IntroductionThe INSPIRED project aims to develop inclusive Digital Optical Diagnostic Devices (DODDs) for schistosomiasis, to support disease management by enabling rapid diagnostic results, to improve efficient data management to guide decision-making and to provide healthcare workers with critical health information to facilitate follow-up action. Due to the non-availability of Target Product Profiles (TPPs) for guiding the development of digital diagnostics for schistosomiasis, we explored existing diagnostic TPPs.MethodsUsing a curated open access database (Notion database), we studied a selection of TPPs for diagnosing infectious diseases, focusing on specifications related to digital health products for Neglected Tropical Diseases (NTDs).ResultsEighteen TPPs originating from 12 documents, covering 13 specific diseases, were selected and their characteristics were labeled and entered into the database. Further exploration of the database revealed several gaps, including a lack of stakeholder input, sustainability, and TPP availability. Other significant gaps related to digital health platform interconnectivity and data stewardship specifically in relation to digital diagnostics, including DODDs.DiscussionThese findings reflect two possible scenarios: (1) there is currently no need for digital diagnostic devices for schistosomiasis and, by extension for other NTDs; or (2) those needs are not yet covered by TPPs. Therefore, we recommend that digital health diagnostics are included in the use cases for schistosomiasis control and elimination, at least in the ideal/desirable scenario, as this will guide research and incentivize investment in digital health diagnostics for schistosomiasis

The Atacama Cosmology Telescope: Millimeter Observations of a Population of Asteroids or: ACTeroids

We present fluxes and light curves for a population of asteroids at millimeter (mm) wavelengths, detected by the Atacama Cosmology Telescope (ACT) over 18, 000 deg2 of the sky using data from 2017 to 2021. We utilize high cadence maps, which can be used in searching for moving objects such as asteroids and trans-Neptunian Objects (TNOs), as well as for studying transients. We detect 160 asteroids with a signal-to-noise of at least 5 in at least one of the ACT observing bands, which are centered near 90, 150, and 220 GHz. For each asteroid, we compare the ACT measured flux to predicted fluxes from the Near Earth Asteroid Thermal Model (NEATM) fit to WISE data. We confirm previous results that detected a deficit of flux at millimeter wavelengths. Moreover, we report a spectral characteristic to this deficit, such that the flux is relatively lower at 150 and 220 GHz than at 90 GHz. Additionally, we find that the deficit in flux is greater for S-type asteroids than for C-type.Comment: 15 pages, 9 Figures, 4 Table

The Atacama Cosmology Telescope: Two-Season ACTPol Spectra and Parameters

We present the temperature and polarization angular power spectra measured by the Atacama Cosmology Telescope Polarimeter (ACTPol). We analyze night-time data collected during 2013-14 using two detector arrays at 149 GHz, from 548 deg$^2$ of sky on the celestial equator. We use these spectra, and the spectra measured with the MBAC camera on ACT from 2008-10, in combination with Planck and WMAP data to estimate cosmological parameters from the temperature, polarization, and temperature-polarization cross-correlations. We find the new ACTPol data to be consistent with the LCDM model. The ACTPol temperature-polarization cross-spectrum now provides stronger constraints on multiple parameters than the ACTPol temperature spectrum, including the baryon density, the acoustic peak angular scale, and the derived Hubble constant. Adding the new data to planck temperature data tightens the limits on damping tail parameters, for example reducing the joint uncertainty on the number of neutrino species and the primordial helium fraction by 20%.Comment: 23 pages, 25 figure

Competency-based (CanMEDS) residency training programme in radiology: systematic design procedure, curriculum and success factors

Based on the CanMEDS framework and the European Training Charter for Clinical Radiology a new radiology curriculum was designed in the Netherlands. Both the development process and the resulting new curriculum are presented in this paper. The new curriculum was developed according to four systematic design principles: discursiveness, hierarchical decomposition, systematic variation and satisficing (satisficing is different from satisfying; in this context, satisficing means searching for an acceptable solution instead of searching for an optimal solution). The new curriculum is organ based with integration of radiological diagnostic techniques, comprises a uniform national common trunk followed by a 2-year subspecialisation, is competency outcome based with appropriate assessment tools and techniques, and is based on regional collaboration among radiology departments. The application of the systematic design principles proved successful in producing a new curriculum approved by all authorities. The principles led to a structured, yet flexible, development process in which creative solutions could be generated and adopters (programme directors, supervisors and residents) were highly involved. Further research is needed to empirically test the components of the new curriculum

The Atacama Cosmology Telescope: Cosmology from cross-correlations of unWISE galaxies and ACT DR6 CMB lensing

We present tomographic measurements of structure growth using cross-correlations of Atacama Cosmology Telescope (ACT) DR6 and Planck CMB lensing maps with the unWISE Blue and Green galaxy samples, which span the redshift ranges $0.2 \lesssim z \lesssim 1.1$ and $0.3 \lesssim z \lesssim 1.8$, respectively. We improve on prior unWISE cross-correlations not just by making use of the new, high-precision ACT DR6 lensing maps, but also by including additional spectroscopic data for redshift calibration and by analysing our measurements with a more flexible theoretical model. An extensive suite of systematic and null tests within a blind analysis framework ensures that our results are robust. We determine the amplitude of matter fluctuations at low redshifts ($z\simeq 0.2-1.6$), finding $S_8 \equiv \sigma_8 (\Omega_m / 0.3)^{0.5} = 0.813 \pm 0.021$ using the ACT cross-correlation alone and $S_8 = 0.810 \pm 0.015$ with a combination of Planck and ACT cross-correlations; these measurements are fully consistent with the predictions from primary CMB measurements assuming standard structure growth. The addition of Baryon Acoustic Oscillation data breaks the degeneracy between $\sigma_8$ and $\Omega_m$, allowing us to measure $\sigma_8 = 0.813 \pm 0.020$ from the cross-correlation of unWISE with ACT and $\sigma_8 = 0.813\pm 0.015$ from the combination of cross-correlations with ACT and Planck. These results also agree with the expectations from primary CMB extrapolations in $\Lambda$CDM cosmology; the consistency of $\sigma_8$ derived from our two redshift samples at $z \sim 0.6$ and $1.1$ provides a further check of our cosmological model. Our results suggest that structure formation on linear scales is well described by $\Lambda$CDM even down to low redshifts $z\lesssim 1$.Comment: 73 pages (incl. 30 pages of appendices), 50 figures, 16 tables, to be submitted to ApJ. Watch G. S. Farren and A. Krolewski discuss the analysis and results under https://cosmologytalks.com/2023/09/11/act-unwis

The Atacama Cosmology Telescope: Detection of Patchy Screening of the Cosmic Microwave Background

Spatial variations in the cosmic electron density after reionization generate cosmic microwave background anisotropies via Thomson scattering, a process known as the ``patchy screening" effect. In this paper, we propose a new estimator for the patchy screening effect that is designed to mitigate biases from the dominant foreground signals. We use it to measure the cross-correlation between \textit{unWISE} galaxies and patchy screening, the latter measured by the Atacama Cosmology Telescope and \textit{Planck} satellite. We report the first detection of the patchy screening effect, with the statistical significance of the cross-correlation exceeding $7\sigma$. This measurement directly probes the distribution of electrons around these galaxies and provides strong evidence that gas is more extended than the underlying dark matter. By comparing our measurements to electron profiles extracted from simulations, we demonstrate the power of these observations to constrain galaxy evolution models. Requiring only the 2D positions of objects and no individual redshifts or velocity estimates, this approach is complementary to existing gas probes, such as those based on the kinetic Sunyaev-Zeldovich effect.Comment: See Schutt et al for a detailed comparison of patchy screening estimators. 17 pages with 8 figure