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Article ; Online: Efficacy of Medical Device Alarm Integration into a Simulated H-60 Integrated Communication System.

Kroening, Laura R / Kinsler, Rachel E / Molles, Jeffrey J / Lloyd, Amy L

2023 Volume 188, Issue Suppl 6, Page(s) 225–231

Abstract: Introduction: This study sought to examine the efficacy of integrating medical device alarms into the intercommunication set of a simulated HH-60, allowing medics to hear the alarms over the ambient noise of the aeromedical environment.: Materials and ...

Abstract	Introduction: This study sought to examine the efficacy of integrating medical device alarms into the intercommunication set of a simulated HH-60, allowing medics to hear the alarms over the ambient noise of the aeromedical environment. Materials and methods: U.S. Army critical care flight paramedics were recruited as subjects for this study. Subjects participated in two testing scenarios: One with patient monitor alarms integrated into their communication lines and one without integrated alarms (the control condition). Testing took place in a simulated HH-60 interior with two priority-level patients per testing scenario, one on either side of the interior. Subjects provided care to these two patients for 30 minutes per scenario. After both scenarios were complete, the subjects were given a questionnaire to obtain their feedback on alarm integration. Results: Six subjects took part in this study, so the results do not have sufficient power to represent the population. No statistically significant results were found. Looking at the trends in the data, implementing alarm integration showed the indications of reducing reaction time to alarms, decreasing or matching the amount of time spent with the patient monitor, and equivalent amounts of time dedicated to patient treatment when compared to the nonintegrated scenario.The feedback obtained from the subjects provided a list of perceived benefits, drawbacks, and improvements related to the integration of medical device alarms into the intercommunication set. Conclusions: Although the study was underpowered, the trends in the data indicate a benefit to the medics when integrating medical device alarms. When coupled with strongly favorable end-user feedback, the results provide justification for pursuing the effort of integrating alarms and performing future studies with improved integration systems to optimize the potential of the system.
MeSH term(s)	Humans ; Communication ; Hearing ; Reaction Time ; Monitoring, Physiologic
Language	English
Publishing date	2023-11-01
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usad096
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Article: Mathematical modeling of genetic pest management through female-specific lethality: Is one locus better than two?

Vella, Michael R / Gould, Fred / Lloyd, Alun L

Evolutionary applications

2021 Volume 14, Issue 6, Page(s) 1612–1622

Abstract: Many novel genetic approaches are under development to combat insect pests. One genetic strategy aims to suppress or locally eliminate a species through large, repeated releases of genetically engineered strains that render female offspring unviable ... ...

Abstract	Many novel genetic approaches are under development to combat insect pests. One genetic strategy aims to suppress or locally eliminate a species through large, repeated releases of genetically engineered strains that render female offspring unviable under field conditions. Strains with this female-killing characteristic have been developed either with all of the molecular components in a single construct or with the components in two constructs inserted at independently assorting loci. Strains with two constructs are typically considered to be only of value as research tools and for producing solely male offspring in rearing factories which are subsequently sterilized by radiation before release. A concern with the two-construct strains is that once released, the two constructs would become separated and therefore non-functional. The only female-killing strains that have been released in the field without sterilization are single-construct strains. Here, we use a population genetics model with density dependence to evaluate the relative effectiveness of female-killing approaches based on single- and two-construct arrangements. We find that, in general, the single-construct arrangement results in slightly faster population suppression, but the two-construct arrangement can eventually cause stronger suppression and cause local elimination with a smaller release size. Based on our results, there is no a priori reason that males carrying two independently segregating constructs need to be sterilized prior to release. In some cases, a fertile release would be more efficient for population suppression.
Language	English
Publishing date	2021-05-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2405496-3
ISSN	1752-4563 ; 1752-4571
ISSN (online)	1752-4563
ISSN	1752-4571
DOI	10.1111/eva.13228
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Article ; Online: Geographic disparities and predictors of COVID-19 vaccination in Missouri: a retrospective ecological study.

Lacy, Alexanderia / Khan, Md Marufuzzaman / Deb Nath, Nirmalendu / Das, Praachi / Igoe, Morganne / Lenhart, Suzanne / Lloyd, Alun L / Lanzas, Cristina / Odoi, Agricola

Frontiers in public health

2024 Volume 12, Page(s) 1329382

Abstract: Background: Limited information is available on geographic disparities of COVID-19 vaccination in Missouri and yet this information is essential for guiding efforts to improve vaccination coverage. Therefore, the objectives of this study were to (a) ... ...

Abstract	Background: Limited information is available on geographic disparities of COVID-19 vaccination in Missouri and yet this information is essential for guiding efforts to improve vaccination coverage. Therefore, the objectives of this study were to (a) investigate geographic disparities in the proportion of the population vaccinated against COVID-19 in Missouri and (b) identify socioeconomic and demographic predictors of the identified disparities. Methods: The COVID-19 vaccination data for time period January 1 to December 31, 2021 were obtained from the Missouri Department of Health. County-level data on socioeconomic and demographic factors were downloaded from the 2020 American Community Survey. Proportions of county population vaccinated against COVID-19 were computed and displayed on choropleth maps. Global ordinary least square regression model and local geographically weighted regression model were used to identify predictors of proportions of COVID-19 vaccinated population. Results: Counties located in eastern Missouri tended to have high proportions of COVID-19 vaccinated population while low proportions were observed in the southernmost part of the state. Counties with low proportions of population vaccinated against COVID-19 tended to have high percentages of Hispanic/Latino population ( Conclusion: The study findings confirm geographic disparities of proportions of COVID-19 vaccinated population in Missouri. Study findings are useful for guiding programs geared at improving vaccination coverage and uptake by targeting resources to areas with low proportions of vaccinated individuals.
MeSH term(s)	Humans ; COVID-19 Vaccines ; Missouri/epidemiology ; COVID-19/epidemiology ; COVID-19/prevention & control ; Retrospective Studies ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2024-03-11
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2024.1329382
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Article ; Online: Economic optimization of Wolbachia-infected Aedes aegypti release to prevent dengue.

Hollingsworth, Brandon D / Cho, Chanheung / Vella, Michael / Roh, Hyeongyul / Sass, Julian / Lloyd, Alun L / Brown, Zachary S

Pest management science

2024

Abstract: Background: Dengue virus, primarily transmitted by the Aedes aegypti mosquito, is a major public health concern affecting ≈3.83 billion people worldwide. Recent releases of Wolbachia-transinfected Ae. aegypti in several cities worldwide have shown that ... ...

Abstract	Background: Dengue virus, primarily transmitted by the Aedes aegypti mosquito, is a major public health concern affecting ≈3.83 billion people worldwide. Recent releases of Wolbachia-transinfected Ae. aegypti in several cities worldwide have shown that it can reduce dengue transmission. However, these releases are costly, and, to date, no framework has been proposed for determining economically optimal release strategies that account for both costs associated with disease risk and releases. Results: We present a flexible stochastic dynamic programming framework for determining optimal release schedules for Wolbachia-transinfected mosquitoes that balances the cost of dengue infection with the costs of rearing and releasing transinfected mosquitoes. Using an ordinary differential equation model of Wolbachia and dengue in a hypothetical city loosely describing areas at risk of new dengue epidemics, we determined that an all-or-nothing release strategy that quickly brings Wolbachia to fixation is often the optimal solution. Based on this, we examined the optimal facility size, finding that it was inelastic with respect to the mosquito population size, with a 100% increase in population size resulting in a 50-67% increase in optimal facility size. Furthermore, we found that these results are robust to mosquito life-history parameters and are mostly determined by the mosquito population size and the fitness costs associated with Wolbachia. Conclusions: These results reinforce that Wolbachia-transinfected mosquitoes can reduce the cost of dengue epidemics. Furthermore, they emphasize the importance of determining the size of the target population and fitness costs associated with Wolbachia before releases occur. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Language	English
Publishing date	2024-03-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2001705-4
ISSN	1526-4998 ; 1526-498X
ISSN (online)	1526-4998
ISSN	1526-498X
DOI	10.1002/ps.8086
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Article ; Online: Modeling county level COVID-19 transmission in the greater St. Louis area: Challenges of uncertainty and identifiability when fitting mechanistic models to time-varying processes.

Das, Praachi / Igoe, Morganne / Lacy, Alexanderia / Farthing, Trevor / Timsina, Archana / Lanzas, Cristina / Lenhart, Suzanne / Odoi, Agricola / Lloyd, Alun L

Mathematical biosciences

2024 Volume 371, Page(s) 109181

Abstract: We use a compartmental model with a time-varying transmission parameter to describe county level COVID-19 transmission in the greater St. Louis area of Missouri and investigate the challenges in fitting such a model to time-varying processes. We fit this ...

Abstract	We use a compartmental model with a time-varying transmission parameter to describe county level COVID-19 transmission in the greater St. Louis area of Missouri and investigate the challenges in fitting such a model to time-varying processes. We fit this model to synthetic and real confirmed case and hospital discharge data from May to December 2020 and calculate uncertainties in the resulting parameter estimates. We also explore non-identifiability within the estimated parameter set. We find that the death rate of infectious non-hospitalized individuals, the testing parameter and the initial number of exposed individuals are not identifiable based on an investigation of correlation coefficients between pairs of parameter estimates. We also explore how this non-identifiability ties back into uncertainties in the estimated parameters and find that it inflates uncertainty in the estimates of our time-varying transmission parameter. However, we do find that R
MeSH term(s)	COVID-19/transmission ; COVID-19/epidemiology ; Humans ; Missouri/epidemiology ; Uncertainty ; SARS-CoV-2 ; Basic Reproduction Number/statistics & numerical data ; Epidemiological Models
Language	English
Publishing date	2024-03-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1126-5
ISSN	1879-3134 ; 0025-5564
ISSN (online)	1879-3134
ISSN	0025-5564
DOI	10.1016/j.mbs.2024.109181
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Article ; Online: CRISPR/Cas9-based split homing gene drive targeting

Yadav, Amarish K / Butler, Cole / Yamamoto, Akihiko / Patil, Anandrao A / Lloyd, Alun L / Scott, Maxwell J

Proceedings of the National Academy of Sciences of the United States of America

2023 Volume 120, Issue 25, Page(s) e2301525120

Abstract: Genetic-based methods offer environmentally friendly species-specific approaches for control of insect pests. One method, CRISPR homing gene drive that target genes essential for development, could provide very efficient and cost-effective control. While ...

Abstract	Genetic-based methods offer environmentally friendly species-specific approaches for control of insect pests. One method, CRISPR homing gene drive that target genes essential for development, could provide very efficient and cost-effective control. While significant progress has been made in developing homing gene drives for mosquito disease vectors, little progress has been made with agricultural insect pests. Here, we report the development and evaluation of split homing drives that target the
MeSH term(s)	Female ; Animals ; CRISPR-Cas Systems ; Fruit ; Gene Drive Technology ; Gene Targeting ; Drosophila
Language	English
Publishing date	2023-06-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.2301525120
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Article: Gene Drive Dynamics in Natural Populations: The Importance of Density Dependence, Space, and Sex.

Dhole, Sumit / Lloyd, Alun L / Gould, Fred

Annual review of ecology, evolution, and systematics

2020 Volume 51, Issue 1, Page(s) 505–531

Abstract: The spread of synthetic gene drives is often discussed in the context of panmictic populations connected by gene flow and described with simple deterministic models. Under such assumptions, an entire species could be altered by releasing a single ... ...

Abstract	The spread of synthetic gene drives is often discussed in the context of panmictic populations connected by gene flow and described with simple deterministic models. Under such assumptions, an entire species could be altered by releasing a single individual carrying an invasive gene drive, such as a standard homing drive. While this remains a theoretical possibility, gene drive spread in natural populations is more complex and merits a more realistic assessment. The fate of any gene drive released in a population would be inextricably linked to the population's ecology. Given the uncertainty often involved in ecological assessment of natural populations, understanding the sensitivity of gene drive spread to important ecological factors is critical. Here we review how different forms of density dependence, spatial heterogeneity, and mating behaviors can impact the spread of self-sustaining gene drives. We highlight specific aspects of gene drive dynamics and the target populations that need further research.
Language	English
Publishing date	2020-08-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2131661-2
ISSN	1543-592X
ISSN	1543-592X
DOI	10.1146/annurev-ecolsys-031120-101013
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Article ; Online: After the honeymoon, the divorce: Unexpected outcomes of disease control measures against endemic infections.

Hollingsworth, Brandon / Okamoto, Kenichi W / Lloyd, Alun L

PLoS computational biology

2020 Volume 16, Issue 10, Page(s) e1008292

Abstract: The lack of effective vaccines for many endemic diseases often forces policymakers to rely on non-immunizing control measures, such as vector control, to reduce the massive burden of these diseases. Controls can have well-known counterintuitive effects ... ...

Abstract	The lack of effective vaccines for many endemic diseases often forces policymakers to rely on non-immunizing control measures, such as vector control, to reduce the massive burden of these diseases. Controls can have well-known counterintuitive effects on endemic infections, including the honeymoon effect, in which partially effective controls cause not only a greater initial reduction in infection than expected, but also large outbreaks during control resulting from accumulation of susceptibles. Unfortunately, many control measures cannot be maintained indefinitely, and the results of cessation are poorly understood. Here, we examine the results of stopped or failed non-immunizing control measures in endemic settings. By using a mathematical model to compare the cumulative number of cases expected with and without control, we show that deployment of control can lead to a larger total number of infections, counting from the time that control started, than without any control-the divorce effect. This result is directly related to the population-level loss of immunity resulting from non-immunizing controls and is seen in a variety of models when non-immunizing controls are used against an infection that confers immunity. Finally, we examine three control plans for minimizing the magnitude of the divorce effect in seasonal infections and show that they are incapable of eliminating the divorce effect. While we do not suggest stopping control programs that rely on non-immunizing controls, our results strongly argue that the accumulation of susceptibility should be considered before deploying such controls against endemic infections when indefinite use of the control is unlikely. We highlight that our results are particularly germane to endemic mosquito-borne infections, such as dengue virus, both for routine management involving vector control and for field trials of novel control approaches, and in the context of non-pharmaceutical interventions aimed at COVID-19.
MeSH term(s)	Animals ; Basic Reproduction Number ; COVID-19 ; COVID-19 Vaccines ; Communicable Disease Control/methods ; Coronavirus Infections/prevention & control ; Culicidae ; Dengue Vaccines/therapeutic use ; Endemic Diseases/prevention & control ; Health Policy ; Humans ; Immunization Programs ; Insect Vectors ; Models, Theoretical ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Public Health ; Rubella/prevention & control ; Rubella Vaccine/therapeutic use ; Seasons ; Severe Dengue/prevention & control ; Viral Vaccines/therapeutic use
Chemical Substances	COVID-19 Vaccines ; Dengue Vaccines ; Rubella Vaccine ; Viral Vaccines
Keywords	covid19
Language	English
Publishing date	2020-10-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2193340-6
ISSN	1553-7358 ; 1553-734X
ISSN (online)	1553-7358
ISSN	1553-734X
DOI	10.1371/journal.pcbi.1008292
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Article ; Online: Extensions of mean-field approximations for environmentally-transmitted pathogen networks.

Davies, Kale / Lenhart, Suzanne / Day, Judy / Lloyd, Alun L / Lanzas, Cristina

Mathematical biosciences and engineering : MBE

2022 Volume 20, Issue 2, Page(s) 1637–1673

Abstract: Many pathogens spread via environmental transmission, without requiring host-to-host direct contact. While models for environmental transmission exist, many are simply constructed intuitively with structures analogous to standard models for direct ... ...

Abstract	Many pathogens spread via environmental transmission, without requiring host-to-host direct contact. While models for environmental transmission exist, many are simply constructed intuitively with structures analogous to standard models for direct transmission. As model insights are generally sensitive to the underlying model assumptions, it is important that we are able understand the details and consequences of these assumptions. We construct a simple network model for an environmentally-transmitted pathogen and rigorously derive systems of ordinary differential equations (ODEs) based on different assumptions. We explore two key assumptions, namely homogeneity and independence, and demonstrate that relaxing these assumptions can lead to more accurate ODE approximations. We compare these ODE models to a stochastic implementation of the network model over a variety of parameters and network structures, demonstrating that with fewer restrictive assumptions we are able to achieve higher accuracy in our approximations and highlighting more precisely the errors produced by each assumption. We show that less restrictive assumptions lead to more complicated systems of ODEs and the potential for unstable solutions. Due to the rigour of our derivation, we are able to identify the reason behind these errors and propose potential resolutions.
MeSH term(s)	Models, Biological ; Environmental Microbiology ; Communicable Diseases/transmission
Language	English
Publishing date	2022-11-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2265126-3
ISSN	1551-0018 ; 1551-0018
ISSN (online)	1551-0018
ISSN	1551-0018
DOI	10.3934/mbe.2023075
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Article ; Online: Modeling impact of vaccination on COVID-19 dynamics in St. Louis.

Lacy, Alexanderia / Igoe, Morganne / Das, Praachi / Farthing, Trevor / Lloyd, Alun L / Lanzas, Cristina / Odoi, Agricola / Lenhart, Suzanne

Journal of biological dynamics

2023 Volume 17, Issue 1, Page(s) 2287084

Abstract: The region of St. Louis, Missouri, has displayed a high level of heterogeneity in COVID-19 cases, hospitalization, and vaccination coverage. We investigate how human mobility, vaccination, and time-varying transmission rates influenced SARS-CoV-2 ... ...

Abstract	The region of St. Louis, Missouri, has displayed a high level of heterogeneity in COVID-19 cases, hospitalization, and vaccination coverage. We investigate how human mobility, vaccination, and time-varying transmission rates influenced SARS-CoV-2 transmission in five counties in the St. Louis area. A COVID-19 model with a system of ordinary differential equations was developed to illustrate the dynamics with a fully vaccinated class. Using the weekly number of vaccinations, cases, and hospitalization data from five counties in the greater St. Louis area in 2021, parameter estimation for the model was completed. The transmission coefficients for each county changed four times in that year to fit the model and the changing behaviour. We predicted the changes in disease spread under scenarios with increased vaccination coverage. SafeGraph local movement data were used to connect the forces of infection across various counties.
MeSH term(s)	Humans ; COVID-19/prevention & control ; SARS-CoV-2 ; Models, Biological ; Vaccination ; Hospitalization
Language	English
Publishing date	2023-12-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2274786-2
ISSN	1751-3766 ; 1751-3758
ISSN (online)	1751-3766
ISSN	1751-3758
DOI	10.1080/17513758.2023.2287084
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