National Department of Health

[This corrects the article DOI: 10.1016/j.lanwpc.2025.101674.].

In quantum mechanics (QM), the electron of spin-charge in probabilistic distribution about a nucleus of a hydrogen atom is described by non-relativistic Schrödinger’s wave equation. Its transformation to Dirac fermion of a complex four-component spinor is incorporated into relativistic quantum field theory (QFT). The quantum system in both cases is represented by a wave function but how it collapses to a point at observation omits out both the hidden variables of the spinor and their evolutionary paths into space-time. This presents an ontological dilemma that cannot be satisfactorily explained by conventional theories either driven by experiments or vice versa. In this study, the ontology of Dirac fermion within a proposed MP model of 4D quantum space-time of hydrogen atom type is examined. The electron of a point-particle and its transformation to Dirac fermion appears consistent with Dirac belt trick (DBT) for the generation of superposition states of spin-charge and their antimatter. Center of mass reference frame owed to DBT offers an alternative version of Newtonian gravity and this is assigned to a specific spherical point-boundary of the model as an emergent geometry. This offers an intricate dynamic tool compatible with basic aspects of both QM and QFT. Some of these are explored for non-relativistic wave function and its collapse, quantized Hamiltonian, Dirac spinors, Standard Model and Lorentz transformation. The space-time geometry of the MP model is presented in the last section and a multiverse of the models at a hierarchy of scales is suggested for a planet in orbit of the sun. These outcomes offer a dynamic intuitive tool that can be modelled and tested for the hydrogen atom in order to probe the fundamentals of physics.

In quantum mechanics (QM), the electron of spin-charge in probabilistic distribution about a nucleus of a hydrogen atom is described by non-relativistic Schrödinger’s wave equation. Its transformation to Dirac fermion of a complex four-component spinor is incorporated into relativistic quantum field theory (QFT). The quantum system in both cases is represented by a wave function but how it collapses to a point at observation omits out both the hidden variables of the spinor and their evolutionary paths into space-time. This presents an ontological dilemma that cannot be satisfactorily explained by conventional theories either driven by experiments or vice versa. In this study, the ontology of Dirac fermion within a proposed MP model of 4D quantum space-time of hydrogen atom type is examined. The electron of a point-particle and its transformation to Dirac fermion appears consistent with Dirac belt trick for the generation of superposition states of spin-charge and their antimatter. Center of mass reference frame relevant to Newtonian gravity is assigned to the spherical point-boundary of the model. This offers an intricate dynamic tool compatible with basic aspects of both QM and QFT. Some of these are explored for non-relativistic wave function and its collapse, quantized Hamiltonian, Dirac spinors, Weyl spinors, Majorana fermions and Lorentz transformation. How the model could further relate to space-time geometry for a body-mass in an elliptical orbit is plotted from an alternative interpretation of general relativity and a multiverse of the MP models at a hierarchy of scales is proposed for further considerations.

Background/Introduction:Papua New Guinea (PNG) faces significant challenges from recurring disasters and health emergencies. There are critical gaps in frontline staff knowledge, skills, and equipment for basic emergency care (BEC). The PNG EMT has delivered basic training to HCWs in provinces. Many deployed teams provided training to local HCWs.Objectives:PNG EMT strengthening Emergency Care Systems by;1.delivering accredited contextualized training during deployments, and2.maintaining standardized contextualized resources as an aid for international EMTs in PNG.Method/Description:PNG EMT currently has trainers in IITT, BEC and Oxygen delivery training (OSCAR-O2). There are locally contextualized, standardized resources available for use on deployment to train local health workers. Experiences training local health workers is an essential part of a pre-deployment orientation.Results/Outcomes:Since PNG EMT inception, a total of 7 trainings have been completed during deployments to provinces. Currently, 177 healthcare received training in oxygen delivery.For BEC in 2024, PNG has 3 master trainers and 30 trainers nationally. TOT done in April 2023 with 5 EMT team members.For IITT in 2024, PNG has 2 trainers for each of the 22 provinces. TOT done in Dec 2024. PNG EMT has 3 experienced trainers.Conclusion:Strengthening the EMT’s role as a delivery mechanism for “just-in-time” training further enhances national efforts in developing robust ECS. Contextualized standard teaching aids are essential for deployed teams.

ABSTRACTAimWe examine the phylogeographic genetic structure of the endangered pig‐nosed turtle Carettochelys insculpta, the last remaining member of a once globally widespread family, now restricted to northern Australia and southern New Guinea, a region with a complex geological and eustatic history. We examine their historical biogeography, demographic history and genetic status of threatened populations.LocationNorthern Australia, Southern New Guinea.MethodsWe reconstruct phylogenetic relationships and patterns of genetic diversity using a genome‐wide dataset of 15,081 single nucleotide polymorphisms and two mitochondrial loci from samples spanning the full species' range.ResultsThe Australian, Papua New Guinea and Indonesian Papua turtles are recovered as three distinct lineages; the Australian lineage diverged from the New Guinea lineages ca 660 Kya, while the Papua New Guinea and Indonesian Papua Province lineages diverged ca 564 Kya. Although the fossil record shows that C. insculpta has been a long‐standing representative of the Australia and New Guinea fauna (since at least the Miocene), extant lineages diverged later in the Middle Pleistocene. Both the Australian and Papua New Guinea lineages were likely shaped by bottlenecks, isolation and genetic drift, which in the Australian lineage greatly reduced effective population sizes to 48–88.Main ConclusionsThe contemporary genetic structure of C. insculpta is most consistent with a vicariance model whereby a large interchanging population occupying northern Australia and New Guinea came to be fragmented and diverged into Australian, Papua New Guinea and Indonesian Papua lineages. Subsequent dispersal via paleodrainages of the submerged continental shelf under the influence of Pleistocene sea‐level change is thought to have been impeded by the isolation of the Akimeugah and Arafura Basins. All populations of the Australian lineage show low genetic diversity without contemporary gene flow, suggesting they are vulnerable to inbreeding and reduced fitness, requiring the consideration of genetic rescue.

Abstract Introduction: Pakistan has one of the largest burdens of rifampicin-resistant/ multidrug-resistant TB according to the global estimates. Novel all oral treatment regimens containing new antibiotics with reduced treatment duration are available. World Health Organization guidelines recommend the use of shorter all-oral regimens under operational research. To guide recommendations, we will compare two all-oral, short (≤11 months) regimens for the outcomes of efficacy, safety, cost, and health-related quality of life under programmatic conditions in Pakistan. Methods: This is a stepped wedge, cluster randomized controlled trial with economic evaluation and health related quality of life sub-studies. Modified all-oral 9-month regimen will be sequentially rolled-out compared with the standard all-oral 11-month regimen at 12 sites in Punjab, Islamabad and Azad Jammu and Kashmir region, Pakistan. A total of 400 eligible participants will be enrolled in both study arms. The primary outcome is difference in efficacy as measured by the proportion of patients with treatment success without recurrence at 12 months after the end of treatment between regimens using a non-inferiority design with a margin of 12%. The intention to treat analysis principle will be employed and a marginal mean model with Poisson generalized estimation equations, and a log-link will be used to assess the relative risk. The economic evaluation will be carried out from the healthcare providers perspective; linear mixed models will be used to estimate differences in costs between arms. Health related quality of life will be measured with the EQ-5D-3L quality of life questionnaire at four time points during the study period. The impact will be assessed by calculating the changes for each participant between time points. Ethical approval for this study has been obtained from provincial bioethics committee in Punjab, Pakistan (Ref: No.4-87/NBC-491/20/48). Discussion: The study's findings will be disseminated to physicians, program implementers, scientific audiences, and policymakers on both a national and international level via reports, presentations, and scientific publications. Trial registration: ISRCTN registry. ISRCTN17334530, ‘retrospectively registered’ on 8th February 2021. ‘Clinical trial number: not applicable.’

BackgroundThe Highlands of Papua New Guinea are non-endemic for malaria compared to the rest of the country. This study aimed to explore the local transmission of malaria in the Highlands through a cross-sectional school survey coupled with reactive case detection.MethodsBetween July and November 2019, 5575 schoolchildren and 1048 household members were screened for malaria using Rapid Diagnostic Tests, subsequently validated by light microscopy. In addition, an analysis of malaria cases (2017 to 2019) was conducted across 33 health facilities within the catchment areas of the surveyed schools and households.ResultsThirteen individuals were diagnosed with malaria: eleven with Plasmodium falciparum (five schoolchildren, six household members) and two with Plasmodium vivax (one student, one household member); all were aged ten years or older. Malaria prevalence was 0.09% [95% CI 0.03, 0.3] among schoolchildren and 1.7% [95% CI 0.3, 9.1] among household members. Eleven positive individuals (84%) reported recent travel, mainly to lower-altitude endemic areas. Long-Lasting Insecticidal Nets were used by 34.8% [95% CI 28.7, 40.8] of household members. The average annual malaria incidence in the catchment areas was 3.7 cases per 1000 [95% CI 2.6, 5.3] among the general population, while children under 15 years accounted for 19% [95% CI 14, 27] of the positive cases.ConclusionsLocal malaria transmission appears to be minimal in the surveyed Highlands areas. Strengthening surveillance-response system to control imported cases and stop local foci could support malaria elimination in PNG. However, effective operational triggers for reactive case finding remain to be determined.

A substantial proportion of people with tuberculosis (TB)-one of the world's deadliest infectious diseases-live in resource-poor, food insecure settings. It is widely recognised that undernutrition significantly heightens vulnerability to TB, as well as contributes to poor treatment adherence and outcomes. However, more attention is needed to understand what shapes food insecurity and undernutrition in a particular setting. We use the concept of "foodscapes" to explore the distinct food environment on Daru Island, a recognised "hotspot" for multidrug-resistant TB in the Western Province of Papua New Guinea. Drawing on 128 qualitative interviews and 10 focus groups (conducted July 2019 and July 2020) with people with TB, family members, healthcare providers, community leaders and other stakeholders, we seek to elucidate the critical entwinement of food insecurity, people with TB, and their treatment experiences on Daru Island. We argue that potential solutions need to focus on the social and structural conditions that contribute to undernutrition in the first place, rather than on undernutrition itself.