, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Although non-Hispanic American Indian and Alaska Native (AI/AN) persons account for 0.7% of the U.S. population,* a recent analysis reported that 1.3% of coronavirus disease 2019 (COVID-19) cases reported to CDC with known race and ethnicity were among AI/AN persons (1). To assess the impact of COVID-19 among the AI/AN population, reports of laboratory-confirmed COVID-19 cases during January 22 †-July 3, 2020 were analyzed. The analysis was limited to 23 states § with >70% complete race/ethnicity information and five or more laboratory-confirmed COVID-19 cases among both AI/AN persons (alone or in combination with other races and ethnicities) and non-Hispanic white (white) persons. Among 424,899 COVID-19 cases reported by these states, 340,059 (80%) had complete race/ethnicity information; among these 340,059 cases, 9,072 (2.7%) occurred among AI/AN persons, and 138,960 (40.9%) among white persons. Among 340,059 cases with complete patient race/ethnicity data, the cumulative incidence among AI/AN persons in these 23 states was 594 per 100,000 AI/AN population (95% confidence interval [CI] = 203-1,740), compared with 169 per 100,000 white population (95% CI = 137-209) (rate ratio [RR] = 3.5; 95% CI = 1.2-10.1). AI/AN persons with COVID-19 were younger (median age = 40 years; interquartile range [IQR] = 26-56 years) than were white persons (median age = 51 years; IQR = 32-67 years). More complete case report data and timely, culturally responsive, and evidencebased public health efforts that leverage the strengths of AI/AN communities are needed to decrease COVID-19 transmission and improve patient outcomes.

The intensive research in the fifth generation (5G) technology is a clear indication of technological revolution to meet the ever-increasing demand and needs for high speed communication as well as Internet of Thing (IoT) based applications. The timely upgradation in 5G technology standards is released by third generation partnership project (3GPP) which enables the researchers to refine the research objectives and contribute towards the development. The 5G technology will be supported by not only smartphones but also different IoT devices to provide different services like smart building, smart city, and many more which will require a 5G antenna with low latency, low path loss, and stable radiation pattern. This paper provides a comprehensive study of different antenna designs considering various 5G antenna design aspects like compactness, efficiency, isolation, etc. This review paper elaborates the state-of-the-art research on the different types of antennas with their performance enhancement techniques for 5G technology in recent years. Also, this paper precisely covers 5G specifications and categorization of antennas followed by a comparative analysis of different antenna designs. Till now, many 5G antenna designs have been proposed by the different researchers, but an exhaustive review of different types of 5G antenna with their performance enhancement method is not yet done. So, in this paper, we have attempted to explore the different types of 5G antenna designs, their performance enhancement techniques, comparison, and future breakthroughs in a holistic way.

The increasing proliferation of advanced devices for UWB, 5G communication, micrometerwave, and millimeter-wave communication demands an antenna which can handle huge data rates, provides high gain and stable radiation pattern as a panacea of most of the current wireless communication problems. Many different antenna designs have been proposed by the researchers but, Antipodal Vivaldi Antenna (AVA) has drawn the attention of most of the researchers because of its high gain, wide bandwidth, less radiation loss, and stable radiation pattern. Different methods are presented to make AVA more compact while maintaining the performance of an antenna to an acceptable level. These different methods are substrate choice, flare shape, slots, and feeding connectors. Also, AVA performance can be enhanced by incorporating corrugation, dielectric lens, patch in between two flares of AVA, balanced AVA (BAVA), metamaterial, computational intelligence (CI), and AVA array. The AVA performance enhancement techniques modify the electrical and physical properties of an antenna which in turn improves its performance. A large number of performance enhancement methods of AVA design have been proposed, however, no comprehensive study exists to categorize these performance enhancement techniques and outline their concepts, advantages, disadvantages, and applications. So, in this paper, we have attempted to outline all methods available for enhancing and optimizing the parameters of AVA. Additionally, to validate some of the important performance enhancement methods, they are incorporated in the basic conventional AVA design and further simulation results are obtained for the same which are in line with the surveyed literature. Each method is explained in detail by incorporating its key points, merits, and demerits. Moreover, illustrations from the literature are given to demonstrate improvement in the parameters as a result of applying a particular performance enhancement technique. INDEX TERMS Antipodal Vivaldi antenna (AVA), AVA array, balanced antipodal Vivaldi antenna (BAVA), corrugations, dielectric lens, metamaterial, parasitic patch, slots.

BackgroundThe effective measures for the control of malaria and filariasis vectors can be achieved by targeting immature stages of anopheline and culicine mosquitoes in productive habitat. To design this strategy, the mechanisms (like biotic interactions with conspecifc and heterospecific larvae) regulating mosquito aquatic stages survivorship, development time and the size of emerging adults should be understood. This study explored the effect of co-habitation between An. gambiae s.s. and Cx. quinquefasciatus on different life history traits of both species under different densities and constant food supply in the habitats of the same size under semi-natural conditions.MethodsExperiments were set up with three combinations; Cx. quinquefasciatus alone (single species treatment), An. gambiae s.s. alone (single species treatment); and An. gambiae s.s. with Cx. quiquefasciatus (co-habitation treatment) in different densities in semi field situation.ResultsThe effect of co-habitation of An. gambiae s.s. and Cx. quinquefasciatus was found to principally affect three parameters. The wing-lengths (a proxy measure of body size) of An. gambiae s.s. in co-habitation treatments were significantly shorter in both females and males than in An. gambiae s.s single species treatments. In Cx. quinquefasciatus, no significant differences in wing-length were observed between the single species and co-habitation treatments. Daily survival rates were not significantly different between co-habitation and single species treatments for both An. gambiae s.s. and Cx. quinquefasciatus. Developmental time was found to be significantly different with single species treatments developing better than co-habitation treatments. Sex ratio was found to be significantly different from the proportion of 0.5 among single and co-habitation treatments species at different densities. Single species treatments had more males than females emerging while in co-habitation treatments more females emerged than males. In this study, there was no significant competitive survival advantage in co-habitation.ConclusionThese results suggest that co-habitation of An. gambiae s.s. and Cx. quinquefasciatus in semi-natural conditions affect mostly An. gambiae s.s. body size. Hence, more has to be understood on the effects of co-habitation of An. gambiae s.s. and Cx. quinquefasciatus in a natural ecology and its possible consequences in malaria and filariasis epidemiology.

Abstract.Antimalarial drug resistance has threatened global malaria control since chloroquine (CQ)-resistant Plasmodium falciparum emerged in Asia in the 1950s. Understanding the impacts of changing antimalarial drug policy on resistance is critical for resistance management. Plasmodium falciparum isolates were collected from 2003 to 2015 in western Kenya and analyzed for genetic markers associated with resistance to CQ (Pfcrt), sulfadoxine–pyrimethamine (SP) (Pfdhfr/Pfdhps), and artemether–lumefantrine (AL) (PfKelch13/Pfmdr1) antimalarials. In addition, household antimalarial drug use surveys were administered. Pfcrt 76T prevalence decreased from 76% to 6% from 2003 to 2015. Pfdhfr/Pfdhps quintuple mutants decreased from 70% in 2003 to 14% in 2008, but increased to near fixation by 2015. SP “super resistant” alleles Pfdhps 581G and 613S/T were not detected in the 2015 samples that were assessed. The Pfmdr1 N86-184F-D1246 haplotype associated with decreased lumefantrine susceptibility increased significantly from 4% in 2005 to 51% in 2015. No PfKelch13 mutations that have been previously associated with artemisinin resistance were detected in the study populations. The increase in Pfdhfr/Pfdhps quintuple mutants that associates with SP resistance may have resulted from the increased usage of SP for intermittent preventative therapy in pregnancy (IPTp) and for malaria treatment in the community. Prevalent Pfdhfr/Pfdhps mutations call for careful monitoring of SP resistance and effectiveness of the current IPTp program in Kenya. In addition, the commonly occurring Pfmdr1 N86-184F-D1246 haplotype associated with increased lumefantrine tolerance calls for surveillance of AL efficacy in Kenya, as well as consideration for a rotating artemisinin-combination therapy regimen.