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Situational evaluation of diabetic person retinopathy remedy Services throughout Ghana.
This paper studies a class of multi-agent systems (MASs) subject to deception signal and communication interference. The objective of the present work is to establish a flexible and generalized distributed dynamic event-triggered control (DDETC) with impulsive signal to make the investigated MASs achieve secure consensus under redundant signal and communication interference. It is shown that Zeno behavior can be precluded with such a DDETC. The challenging but valuable new designed DDETC scheme shows the trigger is developed to achieve itself away from exceeding the data transmission load through parameter adjustment, to reduce redundant triggering, to flexibly adjust the triggered frequency, and even to replace sampled-data scheme as special cases. By the impulsive DDETC, anti-deception and anti-interference techniques, the secure consensus criteria of MASs are constructed cleverly. Numerical examples with simulations are given to illustrate the effectiveness of the proposed scheme and control protocol.Classical swine fever is an important swine disease in China, and sporadic outbreaks with mild clinical signs despite compulsory vaccination have raised questions about the virulence and pathogenicity of prevalent subgenotype 2.1 strains, and the ability of C-strain vaccines to cross-protect against them. To investigate this, three field isolates were evaluated in experimentally infected piglets and compared with the highly virulent reference Shimen strain. Clinical signs for the field strains ranged from mild to severe, and mortality ranged from 0 to 80 %. These data show differences in virulence among the subgenotype 2.1 field isolates and support the use of field strain GD191 as a genotype 2 challenge virus to assess efficacy of C-strain vaccines. In contrast to the historical genotype 1 strain, which caused acute infection with significant virus shedding in non-vaccinated animals, the subgenotype 2.1 GD191 strain produced different clinical manifestations in weaned piglets and adults. Adult pigs showed subclinical infection with viral shedding, whereas weaned piglets showed overt signs of infection. Efficacy of, and duration of immunity conferred by a C-strain vaccine were assessed using the reference Shimen strain and field isolate GD191 at 12 and 15 months after vaccination. A robust antibody response and sterilising protection were seen in all vaccinated animals and lasted up to 15 months post-vaccination. This study confirms that C-strain vaccines confer both clinical and virological protection against the historical genotype 1 Shimen strain and cross-protection against the prevalent genotype 2 field strain.Drawing on the traditions of environmental justice, intersectionality, and social determinants of health, and using data from the EPA's NATA 2014 estimates of cancer risk from air toxics, we demonstrate a novel quantitative approach to evaluate intersectional environmental health risks to communities Eco-Intersectional Multilevel (EIM) modeling. Results from previous case studies were found to generalize to national-level patterns, with multiply marginalized tracts with a high percent of Black and Latinx residents, high percent female-headed households, lower educational attainment, and metro location experiencing the highest risk. Overall, environmental health inequalities in cancer risk from air toxics are (1) experienced intersectionally at the community-level, (2) significant in magnitude, and (3) socially patterned across numerous intersecting axes of marginalization, including axes rarely evaluated such as gendered family structure. EIM provides an innovative approach that will enable explicit consideration of structural/institutional social processes in the social production of intersectional and geospatial inequalities.
Many low and middle-income countries in Asia experience greater food availability as their economies grow, potentially solving previous problems of undernutrition. However, economic growth may not sufficiently reduce undernutrition and instead increase over nutrition, creating a double burden of malnutrition. RepSox In this paper we investigate one of the most prevalent and seemingly paradoxical manifestations of the double burden, a stunted child and an overweight mother (SCOM) living in the same household. We use household-level data from 11 Asian countries from 2005 to 2018, as well as macroeconomic data on the Gross Domestic Product (GDP) and the GDP growth of these countries to estimate which household-level and macroeconomic factors predict SCOM. We also determine the relative predictive power of our variables for SCOM and investigate if predictors of SCOM also predict other forms of malnutrition. We find that the predictive power of household-level factors for SCOM is comparatively more important than that differs from other indicators of malnutrition. This supports explanations that suggest increasing consumption of high-energy but low-nutrient foods is the underlying cause of SCOM, leading to weight gain in adults and stunting in under-five children.We investigate the links between corruption and compliance with social distancing during COVID-19 pandemic in America. Both theory and empirical evidence point to a corrosive effect of corruption on trust/social capital which in turn determine people's behavior towards compliance with public health policies. Using data from 50 states we find that people who live in more corrupt states are less likely to comply with so called shelter in place/stay at home orders. Our results are robust to different measures of corruption.The English National Health Service (NHS) constitutes a unique institutional context, which combines elements of hierarchy, markets and networks. This has always raised issues about competing forms of accountability. Recent policy has emphasised a move from quasi market competition towards collaboration in the form of new regional organisational arrangements known as Sustainability and Transformation Partnerships (STPs). We explore accountability relationships in STPs, focusing on the challenges of increasing horizontal accountability given existing vertical accountabilities, most notably to national regulators. We utilize a case study approach concentrated on three Clinical Commissioning Groups (CCGs) in urban and rural settings in England. We conducted in-person interviews with 22 managers from NHS organisations and local authorities and examined local documents to obtain information on governance and accountability structures. The fieldwork was undertaken between November 2017 and July 2018. We analysed results by considering which actors were accountable to what forums and the nature of the obligation (vertical or horizontal).
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