The potential impact of declining development assistance for health on population health in Malawi: A modelling study.

Background: Development assistance for health (DAH) to Malawi will likely decrease as a fraction of Gross Domestic Product (GDP) in the next few decades. Given the country's significant reliance on DAH for the delivery of its healthcare services, estimating the impact that this could have on health projections for the country is particularly urgent.

Methods And Findings: We use the Malawi-specific, individual-based "all diseases-whole health-system" Thanzi La Onse model to estimate the impact that declining DAH could have on health system capacities, proxied by the availability of human resources for health, and consequently on population health outcomes, in the period 2019-2040.

The impact and cost-effectiveness of pulse oximetry and oxygen on acute lower respiratory infection outcomes in children in Malawi: a modelling study.

Background: acute lower respiratory infections (ALRIs) are the leading global cause of post-neonatal death in children younger than 5 years. The impact, cost, and cost-effectiveness of routine pulse oximetry and oxygen on ALRI outcomes at scale remain unquantified.

Methods: We evaluate the impact and cost-effectiveness of scaling up pulse oximetry and oxygen on childhood ALRI outcomes in Malawi using a new and detailed individual-based model, together with a comprehensive costing assessment for 2024 that includes both capital and operational expenditures.

Uncertainty quantification in cost-effectiveness analysis for stochastic-based infectious disease models: Insights from surveillance on lymphatic filariasis.

Cost-effectiveness analyses (CEA) typically involve comparing the effectiveness and costs of one or more interventions compared to the standard of care, in order to determine which intervention should be optimally implemented to maximise population health within the constraints of the healthcare budget. Traditionally, cost-effectiveness evaluations are expressed using incremental cost-effectiveness ratios (ICERs), which are compared with a fixed willingness-to-pay (WTP) threshold. Due to the inherent uncertainty in intervention costs and the overall burden of disease, particularly with regard to diseases in populations that are difficult to study, it becomes important to consider uncertainty quantification while estimating ICERs.

Modelling health outcomes of a decade of HIV, malaria and tuberculosis initiatives, Malawi.

Objective: To estimate the outcome of programmes on human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis and malaria in Malawi across multiple health domains.

Methods: We used an integrated epidemiological and health system model to estimate the impact of HIV/AIDS, tuberculosis and malaria programmes in Malawi from 2010 to 2019. We incorporated interacting disease dynamics, intervention effects and health system use in the model.

An individual-based modelling study estimating the impact of maternity service delivery on health in Malawi.

Maternal and perinatal morbidity and mortality remain high in Malawi, partially due to gaps in the coverage and quality of health services. We developed an individual-based model of maternal and perinatal health and healthcare in Malawi, situated in a 'whole-health system, all-disease' framework (Thanzi La Onse). We modelled sixteen scenarios estimating the impact of current and improved coverage and quality of antenatal, intrapartum, and postnatal services from 2023 to 2030.

A phoenix in the greenhouse: characterization and phylogenomics of complete chloroplast genomes sheds light on the putatively extinct-in-the-wild Solanum ensifolium (Solanaceae).

Background: The genus Solanum is a diverse group of flowering plants with significant economic importance. Within this genus, the subgenus Leptostemonum, comprising spiny solanums, is particularly noteworthy due to its high species diversity and endemism. Solanum ensifolium, a member of this subgenus, is a critically endangered species endemic to Puerto Rico and known locally as erubia.

Anti-Apartheid at the periphery: a case study of grassroots activism in Dundee, 1967-1990.

The histories of the global anti-apartheid struggle, and particularly the British Anti-Apartheid Movement (AAM), have predominantly been examined through a transnational and national prism, creating an inaccurate impression of a highly centralized and homogeneous movement. We argue, however, that refining the analysis to focus on the local setting reveals a more complex and diverse movement, which has not been fully captured in the existing scholarship. Using Dundee as a case study, this article charts the emergence, character, and evolution of anti-apartheid sentiment and activity in this small, peripheral industrial Scottish city.

Estimates of resource use in the public-sector health-care system and the effect of strengthening health-care services in Malawi during 2015-19: a modelling study (Thanzi La Onse).

Background: In all health-care systems, decisions need to be made regarding allocation of available resources. Evidence is needed for these decisions, especially in low-income countries. We aimed to estimate how health-care resources provided by the public sector were used in Malawi during 2015-19 and to estimate the effects of strengthening health-care services.

Prior exposure to racial discrimination and patterns of acute parasympathetic nervous system responses to a race-related stress task among Black adults.

Black adults' prior exposure to racial discrimination may be associated with their acute parasympathetic reactivity to and recovery from a new race-related stressor. Existing analytical approaches to investigating this link obscure nuances in the timing, magnitude, and patterns of these acute parasympathetic nervous system (PNS) responses. In a re-analysis of a prior study, we utilize an hidden Markov model (HMM) approach to examine how prior experiences of racial discrimination are associated with intraindividual patterns of (1) physiological states of PNS activity and (2) patterns of and variability in transitions between these physiological states.

A new approach to Health Benefits Package design: an application of the Thanzi La Onse model in Malawi.

An efficient allocation of limited resources in low-income settings offers the opportunity to improve population-health outcomes given the available health system capacity. Efforts to achieve this are often framed through the lens of "health benefits packages" (HBPs), which seek to establish which services the public healthcare system should include in its provision. Analytic approaches widely used to weigh evidence in support of different interventions and inform the broader HBP deliberative process however have limitations.

Health workforce needs in Malawi: analysis of the Thanzi La Onse integrated epidemiological model of care.

Background: To make the best use of health resources, it is crucial to understand the healthcare needs of a population-including how needs will evolve and respond to changing epidemiological context and patient behaviour-and how this compares to the capabilities to deliver healthcare with the existing workforce. Existing approaches to planning either rely on using observed healthcare demand from a fixed historical period or using models to estimate healthcare needs within a narrow domain (e.g.

Roadmap for low-carbon ultra-low temperature storage in biobanking.

Biobanks have become an integral part of health and bioscience research. However, the ultra-low temperature (ULT) storage methods that biobanks employ [ULT freezers and liquid nitrogen (LN2)] are associated with carbon emissions that contribute to anthropogenic climate change. This paper aims to provide a 'Roadmap' for reducing carbon emissions associated with ULT storage in biobanking.

Factors associated with medical consumable availability in level 1 facilities in Malawi: a secondary analysis of a facility census.

Background: Medical consumable stock-outs negatively affect health outcomes not only by impeding or delaying the effective delivery of services but also by discouraging patients from seeking care. Consequently, supply chain strengthening is being adopted as a key component of national health strategies. However, evidence on the factors associated with increased consumable availability is limited.

Improving the Cost-efficiency of Preventive Chemotherapy: Impact of New Diagnostics on Stopping Decisions for Control of Schistosomiasis.

Background: Control of schistosomiasis (SCH) relies on the regular distribution of preventive chemotherapy (PC) over many years. For the sake of sustainable SCH control, a decision must be made at some stage to scale down or stop PC. These "stopping decisions" are based on population surveys that assess whether infection levels are sufficiently low.

Can Salmonella typhi Cause Acute Appendicitis?

Salmonella typhi, commonly known for causing typhoid fever, is recognized as a bacterium responsible for a wide range of gastrointestinal and systemic infections. While its systemic manifestations have been well-documented, its association with localized gastrointestinal complications, such as appendicitis, remains relatively rare and less explored. This case report presents a compelling clinical case of a 55-year-old patient who presented with symptoms of gastrointestinal distress and was diagnosed with S.

Minutes-duration optical flares with supernova luminosities.

In recent years, certain luminous extragalactic optical transients have been observed to last only a few days. Their short observed duration implies a different powering mechanism from the most common luminous extragalactic transients (supernovae), whose timescale is weeks. Some short-duration transients, most notably AT2018cow (ref.

Uncovering a population of gravitational lens galaxies with magnified standard candle SN Zwicky.

Detecting gravitationally lensed supernovae is among the biggest challenges in astronomy. It involves a combination of two very rare phenomena: catching the transient signal of a stellar explosion in a distant galaxy and observing it through a nearly perfectly aligned foreground galaxy that deflects light towards the observer. Here we describe how high-cadence optical observations with the Zwicky Transient Facility, with its unparalleled large field of view, led to the detection of a multiply imaged type Ia supernova, SN Zwicky, also known as SN 2022qmx.

A rotating white dwarf shows different compositions on its opposite faces.

White dwarfs, the extremely dense remnants left behind by most stars after their death, are characterized by a mass comparable to that of the Sun compressed into the size of an Earth-like planet. In the resulting strong gravity, heavy elements sink towards the centre and the upper layer of the atmosphere contains only the lightest element present, usually hydrogen or helium. Several mechanisms compete with gravitational settling to change a white dwarf's surface composition as it cools, and the fraction of white dwarfs with helium atmospheres is known to increase by a factor of about 2.

Congruence between ultraconserved element-based matrices and phylotranscriptomic datasets in the scorpion Tree of Life.

Scorpions are ancient and historically renowned for their potent venom. Traditionally, the systematics of this group of arthropods was supported by morphological characters, until recent phylogenomic analyses (using RNAseq data) revealed most of the higher-level taxa to be non-monophyletic. While these phylogenomic hypotheses are stable for almost all lineages, some nodes have been hard to resolve due to minimal taxonomic sampling (e.

A radio-detected type Ia supernova with helium-rich circumstellar material.

Type Ia supernovae (SNe Ia) are thermonuclear explosions of degenerate white dwarf stars destabilized by mass accretion from a companion star, but the nature of their progenitors remains poorly understood. A way to discriminate between progenitor systems is through radio observations; a non-degenerate companion star is expected to lose material through winds or binary interaction before explosion, and the supernova ejecta crashing into this nearby circumstellar material should result in radio synchrotron emission. However, despite extensive efforts, no type Ia supernova (SN Ia) has ever been detected at radio wavelengths, which suggests a clean environment and a companion star that is itself a degenerate white dwarf star.