Prior research has shown that climate literacy is sparse among low- and middle-income countries. Additionally, no standardized questionnaire exists for researchers to measure climate literacy among general populations, particularly with regards to climate change effects on vector-borne diseases (VBDs). We developed a comprehensive literacy scale to assess current knowledge, attitudes, and behaviors towards climate change and VBD dynamics among women enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort in Suriname. Items were generated by our research team and reviewed by a group of six external climate and health experts. After the expert review, a total of 31 climate change and 21 infectious disease items were retained. We estimated our sample size at a 10:1 ratio of participants to items for each scale. In total, 301 women were surveyed. We validated our scales through exploratory (n = 180) and confirmatory factor analyses (n = 121). An exploratory factor analysis for our general Climate Change Scale provided a four-construct solution of 11 items. Our chi-squared value (X² = 74.32; p = 0.136) indicated that four factors were sufficient. A confirmatory factor analysis reinforced our findings, providing a good model fit (X² = 39.03; p = 0.23; RMSEA = 0.015). Our Infectious Disease Scale gave a four-construct solution of nine items (X² = 153.86; p = 0.094). A confirmatory factor analysis confirmed these results, with a chi-squared value of 19.16 (p = 0.575) and an RMSEA of 0.00. This research is vitally important for furthering climate and health education, especially with increases in VBDs spread by Aedes mosquitoes in the Caribbean, South America, and parts of the southern United States.

Climate literacy assesses general understanding of climate, climate change, and its effects on the environment as well as human health. Despite vast scientific evidence to support climate change and its associated consequences, particularly with regards to vector-borne diseases, climate change knowledge, attitudes, and behaviors among the general population is relatively poor. In this study, we conducted a thorough review of the current literature to evaluate the scope of global climate and health literacy studies and identify key areas for improvement. We found that very few climate and health literacy studies were based in low- and middle-income countries, and those that were did not make mention of significant regional climate change impacts and specifically those that increase mosquito-borne disease transmission in high-risk areas. We also noted that of the twenty-three studies included in our final review, most focused their assessments on general climate and climate change knowledge, and not on literacy of the relationships between climate change and environmental impacts or subsequent health outcomes. Our findings make it clear that moving forward, there is a major need for climate and health literacy research to expand upon existing climate literature to include additional assessments of the relationships between certain climate change impacts and infectious diseases in particular, as well as to make available a more comprehensive overview of climate and health information to the public in the future.

Surgical mitral valve repair is the gold standard for severe primary mitral regurgitation (MR), yet when repairs fail, open reintervention carries substantial perioperative risk. Following band annuloplasty, minimally invasive options, such as transcatheter mitral valve replacement (TMVR), remain largely unexplored due to a hypothetical concern around the lack of circumferential radial support. We report the first transcatheter mitral valve-in-band (ViB) replacement in a large-animal model of failed mitral repair. A 68 kg, 20-month-old female Yucatan mini pig underwent placement of a 28 mm mitral annuloplasty band, oversized to create MR, via clamshell sternotomy under cardiopulmonary bypass; a simulated dilated left atrium enabled transcatheter access. A 23 mm Edwards Sapien Ultra valve was deployed within the band using the Commander delivery system under fluoroscopic guidance. The valve achieved stable fixation without embolization, paravalvular leak (PVL), or left ventricular outflow tract (LVOT) obstruction with resolution of MR on echocardiography. The native anterior leaflet and annulus contributed circumferential radial support, and the animal tolerated the procedure without complications. This first-in-animal study demonstrates the technical feasibility and acute safety of TMVR within a mitral annuloplasty band and supports further investigation of percutaneous band modification strategies to optimize ViB outcomes.

Surgical mitral valve repair is the gold standard for severe primary mitral regurgitation (MR), yet when repairs fail, open reintervention carries substantial perioperative risk. Following band annuloplasty, minimally invasive options, such as transcatheter mitral valve replacement (TMVR), remain largely unexplored due to a hypothetical concern around the lack of circumferential radial support. Although transapical transcatheter mitral valve-in-band (ViB) replacement has been reported in a single human case, we report the first controlled large-animal model of ViB. A 68 kg, 20-month-old female Yucatan mini pig underwent placement of a 28 mm mitral annuloplasty band, oversized to create MR, via clamshell sternotomy under cardiopulmonary bypass; a simulated dilated left atrium enabled transcatheter access. A 23 mm Edwards SAPIEN 3 Ultra valve was deployed within the band using the Commander delivery system under fluoroscopic guidance. The valve achieved stable fixation without embolization, paravalvular leak (PVL), or left ventricular outflow tract (LVOT) obstruction with resolution of MR on echocardiography. The stable position was consistent with a contribution from the native anterior leaflet and annulus, although radial forces were not directly measured. The animal tolerated the procedure without complications. This first-in-animal study suggests the acute technical feasibility of TMVR within a mitral annuloplasty band and supports further investigation of percutaneous band modification strategies to optimize ViB outcomes.

Background: Infectious disease computational modeling studies have been widely published during the coronavirus disease 2019 (COVID-19) pandemic, yet they have limited reproducibility. Developed through an iterative testing process with multiple reviewers, the Infectious Disease Modeling Reproducibility Checklist (IDMRC) enumerates the minimal elements necessary to support reproducible infectious disease computational modeling publications. The primary objective of this study was to assess the reliability of the IDMRC and to identify which reproducibility elements were unreported in a sample of COVID-19 computational modeling publications. Methods: Four reviewers used the IDMRC to assess 46 preprint and peer reviewed COVID-19 modeling studies published between March 13 ^th , 2020, and July 31 ^st , 2020. The inter-rater reliability was evaluated by mean percent agreement and Fleiss’ kappa coefficients (κ). Papers were ranked based on the average number of reported reproducibility elements, and average proportion of papers that reported each checklist item were tabulated. Results: Questions related to the computational environment (mean κ = 0.90, range = 0.90–0.90), analytical software (mean κ = 0.74, range = 0.68–0.82), model description (mean κ = 0.71, range = 0.58–0.84), model implementation (mean κ = 0.68, range = 0.39–0.86), and experimental protocol (mean κ = 0.63, range = 0.58–0.69) had moderate or greater (κ > 0.41) inter-rater reliability. Questions related to data had the lowest values (mean κ = 0.37, range = 0.23–0.59). Reviewers ranked similar papers in the upper and lower quartiles based on the proportion of reproducibility elements each paper reported. While over 70% of the publications provided data used in their models, less than 30% provided the model implementation. Conclusions: The IDMRC is the first comprehensive, quality-assessed tool for guiding researchers in reporting reproducible infectious disease computational modeling studies. The inter-rater reliability assessment found that most scores were characterized by moderate or greater agreement. These results suggests that the IDMRC might be used to provide reliable assessments of the potential for reproducibility of published infectious disease modeling publications. Results of this evaluation identified opportunities for improvement to the model implementation and data questions that can further improve the reliability of the checklist.