Modelling the spatial risk of malaria through probability distribution of Anopheles maculipennis s.l. and imported cases

Malaria remains one of the most important infectious diseases globally due to its high incidence and mortality rates. The influx of infected cases from endemic to non-endemic malaria regions like Europe has resulted in a public health concern over sporadic local outbreaks. This is facilitated by the continued presence of competent Anopheles vectors in non-endemic countries.We modelled the potential distribution of the main malaria vector across Spain using the ensemble of eight modelling techniques based on environmental parameters and the Anopheles maculipennis s.l. presence/absence data collected from 2000 to 2020. We then combined this map with the number of imported malaria cases in each municipality to detect the geographic hot spots with a higher risk of local malaria transmission.The malaria vector occurred preferentially in irrigated lands characterized by warm climate conditions and moderate annual precipitation. Some areas surrounding irrigated lands in northern Spain (e.g. Zaragoza, Logroño), mainland areas (e.g. Madrid, Toledo) and in the South (e.g. Huelva), presented a significant likelihood of A. maculipennis s.l. occurrence, with a large overlap with the presence of imported cases of malaria.While the risk of malaria re-emergence in Spain is low, it is not evenly distributed throughout the country. The four recorded local cases of mosquito-borne transmission occurred in areas with a high overlap of imported cases and mosquito presence. Integrating mosquito distribution with human incidence cases provides an effective tool for the quantification of large-scale geographic variation in transmission risk and pinpointing priority areas for targeted surveillance and prevention.

Surveillance and screening of Stomoxyinae flies from Mallorca Island (Spain) reveal the absence of selected pathogens but confirm the presence of the endosymbiotic bacterium Wolbachia pipientis

Adult brachycera biting flies can significantly impact livestock through both direct effects (reduction of food intake, disturbance, painful bites, and blood loss) and indirect effects (pathogen transmission), leading to substantial economic losses and production damage. This study aimed to assess the presence of blood-sucking flies in six mixed-animal farm environments on the island of Mallorca (Balearic Islands, Spain) by employing multiple trapping methods. Additionally, distribution maps of brachycera biting fly species recorded in Spain were created, based on data extracted thorough review of scientific literature and citizen digital databases. Investigation of several pathogens, including equine infectious anemia virus (EIAV), Anaplasmataceae bacteria, and piroplasm protozoa, was carried out using different PCR targets (18S rRNA, 16S rRNA, groESL, and tat genes). Citizen science databases and literature review corroborated the consistent distribution trend for two Stomoxyinae species, underscoring the importance of citizen collaboration as a complement to traditional entomological surveillance. Our study confirmed the presence of two biting Stomoxyinae species: the prevalent stable fly Stomoxys calcitrans across all sampled farms, and the horn fly Haematobia irritans, which turned out to be less abundant. DNA barcoding techniques validated the identification of the two species. Neither EIAV nor bacterial/protozoan pathogens were detected using the selected PCR targets in either fly species. However, Wolbachia pipientis (clustered in the supergroup A together with the only sequence of W. pipientis from the USA) was identified through PCR targeting 16S rRNA, groESL and wsp genes in all pools of H. irritans (n = 13) collected from two of the examined farms. This study represents the first attempt to investigate pathogens in Stomoxyinae biting flies in Spain. The discovery of the endosymbiotic Wolbachia organism in H. irritans represents the first record in Spain and the second from Europe. This finding holds significant implications for future research on the applications of this bacterium in biocontrol programs.

First report of Culicoides caucoliberensis in Spain: Exploring molecular phylogeny, host-feeding behaviour and avian haemosporidian parasites

Culicoides biting midges (Diptera: Ceratopogonidae) are vectors of pathogens that affect wildlife and livestock. Understanding the composition and distribution of vector species is crucial for implementing control strategies and preventing the spread of infectious diseases. This study provides a morphological and molecular characterisation of Culicoides caucoliberensis, which represents the first record for Spain, increasing the number of Culicoides species in the country to 85. A total of 213 specimens were collected using Onderstepoort-ultraviolet down-draught light traps on a rocky coastline in the Balearic Islands during two sampling periods in 2022. Phylogenetic analysis showed that C. caucoliberensis forms a monophyletic cluster within the Maritimus group. Host preferences were determined for the first time and showed propensity to feed on the European shag (Phalacrocorax aristotelis). The vector role of C. caucoliberensis for haemosporidian transmission remains unclear since molecular detection of Haemosporidians (Haemoproteus and Plasmodium) was negative for all the pools of parous and engorged females analysed. This study emphasises the importance of conducting entomofauna studies in lesser-known Mediterranean islet landscapes and highlights the need for research on vectors within the One Health framework.

The use of path analysis to determine effects of environmental factors on the adult seasonality of Culicoides (Diptera: Ceratopogonidae) vector species in Spain

Culicoides biting midges (Diptera: Ceratopogonidae) are the main vectors of livestock diseases such as bluetongue (BT) which mainly affect sheep and cattle. In Spain, bluetongue virus (BTV) is transmitted by several Culicoides taxa, including Culicoides imicola, Obsoletus complex, Culicoides newsteadi and Culicoides pulicaris that vary in seasonality and distribution, affecting the distribution and dynamics of BT outbreaks. Path analysis is useful for separating direct and indirect, biotic and abiotic determinants of species' population performance and is ideal for understanding the sensitivity of adult Culicoides dynamics to multiple environmental drivers. Start, end of season and length of overwintering of adult Culicoides were analysed across 329 sites in Spain sampled from 2005 to 2010 during the National Entomosurveillance Program for BTV with path analysis, to determine the direct and indirect effects of land use, climate and host factor variables. Culicoides taxa had species-specific responses to environmental variables. While the seasonality of adult C. imicola was strongly affected by topography, temperature, cover of agro-forestry and sclerophyllous vegetation, rainfall, livestock density, photoperiod in autumn and the abundance of Culicoides females, Obsoletus complex species seasonality was affected by land-use variables such as cover of natural grassland and broad-leaved forest. Culicoides female abundance was the most explanatory variable for the seasonality of C. newsteadi, while C. pulicaris showed that temperature during winter and the photoperiod in November had a strong effect on the start of the season and the length of overwinter period of this species. These results indicate that the seasonal vector-free period (SVFP) in Spain will vary between competent vector taxa and geographic locations, dependent on the different responses of each taxa to environmental conditions.

Publishing data to support the fight against human vector-borne diseases

Vector-borne diseases are responsible for more than 17% of human cases of infectious diseases. In most situations, effective control of debilitating and deadly vector-bone diseases (VBDs), such as malaria, dengue, chikungunya, yellow fever, Zika and Chagas requires up-to-date, robust and comprehensive information on the presence, diversity, ecology, bionomics and geographic spread of the organisms that carry and transmit the infectious agents. Huge gaps exist in the information related to these vectors, creating an essential need for campaigns to mobilise and share data. The publication of data papers is an effective tool for overcoming this challenge. These peer-reviewed articles provide scholarly credit for researchers whose vital work of assembling and publishing well-described, properly-formatted datasets often fails to receive appropriate recognition. To address this, GigaScience's sister journal GigaByte partnered with the Global Biodiversity Information Facility (GBIF) to publish a series of data papers, with support from the Special Programme for Research and Training in Tropical Diseases (TDR), hosted by the World Health Organisation (WHO). Here we outline the initial results of this targeted approach to sharing data and describe its importance for controlling VBDs and improving public health.

Semiclassical relativistic stars

We present strong evidence that semiclassical gravity can give place to self-consistent ultracompact stars beyond the Buchdahl limit. We integrate the semiclassical equations of (spherically symmetric) stellar equilibrium for a constant-density classical fluid. The semiclassical contribution is modelled by a quantum massless scalar field in the only static vacuum state compatible with asymptotic flatness (Boulware vacuum). The Renormalized Stress-Energy Tensor (RSET) is firstly approximated by the analytic Polyakov approximation. This already reveals a crucial difference with respect to purely classical solutions: stars with compactness close to that of a black hole exhibit bounded pressures and curvatures up to a very small central core compared with the star radius. This suggests that a more refined approximation to the RSET at the core may give rise to strictly regular configurations. Following this suggestion, we prove that a minimal deformation of the Polyakov approximation inside the central core is sufficient to produce regular ultracompact stellar configurations.

AIMSurv: First pan-European harmonized surveillance of Aedes invasive mosquito species of relevance for human vector-borne diseases

Human and animal vector-borne diseases, particularly mosquito-borne diseases, are emerging or re-emerging worldwide. Six Aedes invasive mosquito (AIM) species were introduced to Europe since the 1970s: Aedes aegypti, Ae. albopictus, Ae. japonicus, Ae. koreicus, Ae. atropalpus and Ae. triseriatus. Here, we report the results of AIMSurv2020, the first pan-European surveillance effort for AIMs. Implemented by 42 volunteer teams from 24 countries. And presented in the form of a dataset named "AIMSurv Aedes Invasive Mosquito species harmonized surveillance in Europe. AIM-COST Action. Project ID: CA17108". AIMSurv2020 harmonizes field surveillance methodologies for sampling different AIMs life stages, frequency and minimum length of sampling period, and data reporting. Data include minimum requirements for sample types and recommended requirements for those teams with more resources. Data are published as a Darwin Core archive in the Global Biodiversity Information Facility- Spain, comprising a core file with 19,130 records (EventID) and an occurrences file with 19,743 records (OccurrenceID). AIM species recorded in AIMSurv2020 were Ae. albopictus, Ae. japonicus and Ae. koreicus, as well as native mosquito species.

Larvae ecology and adult activity of Aedes mariae (Diptera: Culicidae) in a touristic rock-pool area of the Balearic Islands (Western Mediterranean)

Mosquitoes are vectors of several diseases of medical concern such as malaria or dengue and can also negatively affect tourism and the life-quality of the neighbourhood. The species Aedes mariae (Sergent and Sergent, 1903) is a poorly studied mosquito that breeds in rock-pools of the Mediterranean coast. General Linear Mixed Models (GLMM) were used to determine drivers affecting the presence and abundance of this species. Abiotic and biotic factors were recorded in rock-pools with the presence of Ae. mariae sub-adults across a supralittoral area of Majorca Island (Balearic Islands, Spain) from July 2018 to June 2019. We tested how abiotic factors affected the presence of larvae, while the biotic factors were used to check their effect on larvae abundance. human landing collection was also conducted to assess the adult activity of this species. Valuable data were recorded to improve our knowledge about the bioecology of Ae. mariae in a touristic area of the island of Majorca. Salinity and pH were the most explanatory variables for the presence of Ae. mariae larvae. The presence of Posidonia oceanica (L.) Delile 1813 leaves negatively affected the abundance of Ae. mariae larvae while the presence of other fauna enhanced it. Adult females of Ae. mariae were active for 26 min after sunset in June and its host-seeking activity decreased during autumn months. Control methods against this species should be focussed on rock-pools and planning treatments according to tides, waves and precipitation.

At the tip of an iceberg: citizen science and active surveillance collaborating to broaden the known distribution of Aedes japonicus in Spain

BACKGROUND

Active surveillance aimed at the early detection of invasive mosquito species is usually focused on seaports and airports as points of entry, and along road networks as dispersion paths. In a number of cases, however, the first detections of colonizing populations are made by citizens, either because the species has already moved beyond the implemented active surveillance sites or because there is no surveillance in place. This was the case of the first detection in 2018 of the Asian bush mosquito, Aedes japonicus, in Asturias (northern Spain) by the citizen science platform Mosquito Alert.

METHODS

The collaboration between Mosquito Alert, the Ministry of Health, local authorities and academic researchers resulted in a multi-source surveillance combining active field sampling with broader temporal and spatial citizen-sourced data, resulting in a more flexible and efficient surveillance strategy.

RESULTS

Between 2018 and 2020, the joint efforts of administrative bodies, academic teams and citizen-sourced data led to the discovery of this species in northern regions of Spain such as Cantabria and the Basque Country. This raised the estimated area of occurrence of Ae. japonicus from < 900 km2 in 2018 to > 7000 km2 in 2020.

CONCLUSIONS

This population cluster is geographically isolated from any other population in Europe, which raises questions about its origin, path of introduction and dispersal means, while also highlighting the need to enhance surveillance systems by closely combining crowd-sourced surveillance with public health and mosquito control agencies' efforts, from local to continental scales. This multi-actor approach for surveillance (either passive and active) shows high potential efficiency in the surveillance of other invasive mosquito species, and specifically the major vector Aedes aegypti which is already present in some parts of Europe.

Evidence of Wing Shape Sexual Dimorphism in Aedes (Stegomyia) albopictus in Mallorca, Spain

The Asian tiger mosquito Aedes albopictus (Skuse, 1894) is a highly invasive species widely distributed on the Spanish Mediterranean coast and the Balearic archipelago. Most studies involving this species in Spain have been focused on surveillance and control methods. However, micro-evolutionary studies for Ae. albopictus in Spain have been traditionally neglected. Morphological diversity could be the result of long-term evolutionary diversification in responses to selective pressures such as temperature, precipitation, food availability, predation, or competition that may influence flight activity, host-seeking, and blood-feeding behavior. Wing geometric morphometric have been used not only to study micro- and macro-evolution in mosquitoes but also in studies of population structuring and sexual dimorphism. Therefore, the main goal of this study was to investigate the wing shape patterns of Ae. albopictus populations to unveil sexual dimorphism that could provide information about their ecology and behavior. Mosquito eggs were collected using oviposition traps at the main campus of the University of the Balearic Islands (Palma de Mallorca, Spain) and reared under laboratory conditions. In order to study wing shape variation patterns in Ae. albopictus males and females, the left wing of each adult mosquito was removed and analyzed based on 18 landmarks. Our results indicated strong levels of sexual dimorphism between Ae. albopictus males and females. Furthermore, according to the cross-validated reclassification test, males were correctly distinguished from females with an accuracy of 84% and females from males 75%. We observed a significant sexual dimorphism in the wing shape patterns of Ae. albopictus when considering different seasonal patterns (spring vs. autumn). Our results suggested that selective pressures may affect males differently to females. Host-seeking, blood-feeding, and oviposition behavior of females may act as a major driver for wing shape sexual dimorphism. These results should be considered for the development of more effective and targeted mosquito control strategies.

Development and lifespan of Culicoides obsoletus s.s. (Meigen) and other livestock-associated species reared at different temperatures under laboratory conditions

Culicoides Latreille (Diptera: Ceratopogonidae) transmit arboviruses affecting wild and domestic ruminants such as bluetongue (BTV) and Schmallenberg virus (SBV). The sub-adult development and lifespan of Culicoides obsoletus s.s. (Meigen), Culicoides circumscriptus Kieffer and Culicoides paolae Boorman were examined at three different temperatures under laboratory conditions. Insects were collected from field between spring and autumn 2015 in two livestock farms located in Majorca (Spain). Gravid females were held individually at 18, 25 or 30 °C. Low temperatures increased the adult lifespan, time to oviposit and rate of development, whereas high temperatures increased the number of eggs, successful pupation and adult emergence as well as the larvae growth rate. The results showed that C. obsoletus s.s. have optimum development at 18 °C, whereas the optimal rearing temperature for C. circumscriptus and C. paolae was under warmer conditions of 25-30 °C. Variations in temperature/humidity and assays with different materials and substrates for oviposition should be considered in future studies. Understanding the requirements of the different species of Culicoides optimizing the results should be of special interest for predicting environmental change effects on these species, in addition to determining the rearing conditions for candidate Culicoides vectors.

Molecular Characterization of Mosquito Diversity in the Balearic Islands

Several outbreaks of mosquito-borne diseases have taken place in Europe in recent years. In Spain, both active and passive surveillance have demonstrated that dengue and West Nile viruses are currently circulating, and seven autochthonous dengue cases have been reported in the last 2 yr. The effectiveness of vector control programs largely depends on the accuracy of the taxonomic identification of the species. However, in Spain, identification almost completely relies on the use of morphological keys to characterize the mosquito fauna. This study investigates the congruence between molecular and morphological species boundaries in 13 Spanish mosquito taxa. The Cytochrome c oxidase subunit I (COI) gene region was sequenced from 60 adult specimens collected in Mallorca, plus several representatives from other Spanish regions for comparative purposes. Phylogenetic relationships were established using Bayesian and maximum-likelihood approaches. Using three species delimitation algorithms (ABGD, mPTP, and GMYC), we found strong evidence for cryptic speciation within Anopheles algeriensis Theobald, a widespread mosquito in the Mediterranean basin. We also delimited the Mallorcan rock pool mosquito Aedes mariae (Sergent & Sergent), from mainland European populations. Finally, we found difficulties in the use of wing characters in species keys to distinguish Culiseta annulata (Schrk) from Culiseta subochrea (Edwards). Given that these species are vectors of pathogens of medical relevance and have veterinary importance, their accurate taxonomic identification is essential in European vector surveillance programs.

Environmental Drivers of Adult Seasonality and Abundance of Biting Midges Culicoides (Diptera: Ceratopogonidae), Bluetongue Vector Species in Spain

Bluetongue is a viral disease affecting wild and domestic ruminants transmitted by several species of biting midges Culicoides Latreille. The phenology of these insects were analyzed in relation to potential environmental drivers. Data from 329 sites in Spain were analyzed using Bayesian Generalized Linear Mixed Model (GLMM) approaches. The effects of environmental factors on adult female seasonality were contrasted. Obsoletus complex species (Diptera: Ceratopogonidae) were the most prevalent across sites, followed by Culicoides newsteadi Austen (Diptera: Ceratopogonidae). Activity of female Obsoletus complex species was longest in sites at low elevation, with warmer spring average temperatures and precipitation, as well as in sites with high abundance of cattle. The length of the Culicoides imicola Kieffer (Diptera: Ceratopogonidae) female adult season was also longest in sites at low elevation with higher coverage of broad-leaved vegetation. Long adult seasons of C. newsteadi were found in sites with warmer autumns and higher precipitation, high abundance of sheep. Culicoides pulicaris (Linnaeus) (Diptera: Ceratopogonidae) had longer adult periods in sites with a greater number of accumulated degree days over 10°C during winter. These results demonstrate the eco-climatic and seasonal differences among these four taxa in Spain, which may contribute to determining sites with suitable environmental circumstances for each particular species to inform assessments of the risk of Bluetongue virus outbreaks in this region.

Determinants of the current and future distribution of the West Nile virus mosquito vector Culex pipiens in Spain

Changes in environmental conditions, whether related or not to human activities, are continuously modifying the geographic distribution of vectors, which in turn affects the dynamics and distribution of vector-borne infectious diseases. Determining the main ecological drivers of vector distribution and how predicted changes in these drivers may alter their future distributions is therefore of major importance. However, the drivers of vector populations are largely specific to each vector species and region. Here, we identify the most important human-activity-related and bioclimatic predictors affecting the current distribution and habitat suitability of the mosquito Culex pipiens and potential future changes in its distribution in Spain. We determined the niche of occurrence (NOO) of the species, which considers only those areas lying within the range of suitable environmental conditions using presence data. Although almost ubiquitous, the distribution of Cx. pipiens is mostly explained by elevation and the degree of urbanization but also, to a lesser extent, by mean temperatures during the wettest season and temperature seasonality. The combination of these predictors highlights the existence of a heterogeneous pattern of habitat suitability, with most suitable areas located in the southern and northeastern coastal areas of Spain, and unsuitable areas located at higher altitude and in colder regions. Future climatic predictions indicate a net decrease in distribution of up to 29.55%, probably due to warming and greater temperature oscillations. Despite these predicted changes in vector distribution, their effects on the incidence of infectious diseases are, however, difficult to forecast since different processes such as local adaptation to temperature, vector-pathogen interactions, and human-derived changes in landscape may play important roles in shaping the future dynamics of pathogen transmission.

Modelling the monthly abundance of Culicoides biting midges in nine European countries using Random Forests machine learning

BACKGROUND

Culicoides biting midges transmit viruses resulting in disease in ruminants and equids such as bluetongue, Schmallenberg disease and African horse sickness. In the past decades, these diseases have led to important economic losses for farmers in Europe. Vector abundance is a key factor in determining the risk of vector-borne disease spread and it is, therefore, important to predict the abundance of Culicoides species involved in the transmission of these pathogens. The objectives of this study were to model and map the monthly abundances of Culicoides in Europe.

METHODS

We obtained entomological data from 904 farms in nine European countries (Spain, France, Germany, Switzerland, Austria, Poland, Denmark, Sweden and Norway) from 2007 to 2013. Using environmental and climatic predictors from satellite imagery and the machine learning technique Random Forests, we predicted the monthly average abundance at a 1 km2 resolution. We used independent test sets for validation and to assess model performance.

RESULTS

The predictive power of the resulting models varied according to month and the Culicoides species/ensembles predicted. Model performance was lower for winter months. Performance was higher for the Obsoletus ensemble, followed by the Pulicaris ensemble, while the model for Culicoides imicola showed a poor performance. Distribution and abundance patterns corresponded well with the known distributions in Europe. The Random Forests model approach was able to distinguish differences in abundance between countries but was not able to predict vector abundance at individual farm level.

CONCLUSIONS

The models and maps presented here represent an initial attempt to capture large scale geographical and temporal variations in Culicoides abundance. The models are a first step towards producing abundance inputs for R0 modelling of Culicoides-borne infections at a continental scale.

A Mondrian matrix of seasonal patterns of Culicoides nulliparous and parous females at different latitudes in Spain

Insects from genus Culicoides (Diptera; Ceratopogonidae) transmit arboviruses such as Bluetongue virus (BTV); affecting wild and domestic ruminants. These insects are age graded for monitoring purposes in surveillance programs. Parous females (PF) are the only fraction of the entire population that could effectively transmit viruses in a subsequent blood meal. Data of the Spanish Entomosurveillance National Program from 2008 to 2010 were used to analyse the seasonal pattern of the nulliparous females (NF) and PF of the vector species Obsoletus complex, C. imicola, C. newsteadi and C. pulicaris. Latitude variation on the seasonal abundance patterns of PF was also analysed in trap sites spanning a North-South axis in mainland Spain. The weekly abundance of PF was always highest in summer. The peak of abundance mainly occurred between April and July except for C. imicola that was from September to November. The analysis of the latitudinal seasonal variation of PF in Spain showed that Northern provinces have absence of C. imicola while the Obsoletus species were more present in Northern areas. There were periods of the year were no individuals of any vector species were collected, which should be considered in order to calculate the Seasonally Vector-Free Period (SVFP). Culicoides newsteadi and C. pulicaris exhibited the highest population in Toledo, probably related to their inland preferences. These findings would be of interest for a better understanding of the periods of low and high risk of transmission of BTV in Spain.

Water associated with residential areas and tourist resorts is the key predictor of Asian tiger mosquito presence on a Mediterranean island

The Asian tiger mosquito, Aedes albopictus (Diptera: Culicidae), is a highly invasive species and a vector of several viruses of serious concern to public health. Investigating the habitat selection of this species at small to medium scales is essential to the planning of effective prevention and control campaigns. The present group considered detailed data for this species' presence/absence collected at 228 sites on Mallorca Island (Spain) in autumn 2015, 3 years after the first detection of the species on the island. Site occupancy models accounting for false negative detections and imperfect monitoring were used to evaluate the relationships between mosquito presence and habitat variables. In the study area, mosquito presence was negatively associated with altitude, probably as a result of greater human presence at low altitudes near the coast. Moreover, the presence of Ae. albopictus was positively associated with swimming pools as a result of associated gardens, plants and sources of fresh water. These two variables were combined to predict the presence of the species across the entire island.

Monthly variation in the probability of presence of adult Culicoides populations in nine European countries and the implications for targeted surveillance

BACKGROUND

Biting midges of the genus Culicoides (Diptera: Ceratopogonidae) are small hematophagous insects responsible for the transmission of bluetongue virus, Schmallenberg virus and African horse sickness virus to wild and domestic ruminants and equids. Outbreaks of these viruses have caused economic damage within the European Union. The spatio-temporal distribution of biting midges is a key factor in identifying areas with the potential for disease spread. The aim of this study was to identify and map areas of neglectable adult activity for each month in an average year. Average monthly risk maps can be used as a tool when allocating resources for surveillance and control programs within Europe.

METHODS

We modelled the occurrence of C. imicola and the Obsoletus and Pulicaris ensembles using existing entomological surveillance data from Spain, France, Germany, Switzerland, Austria, Denmark, Sweden, Norway and Poland. The monthly probability of each vector species and ensembles being present in Europe based on climatic and environmental input variables was estimated with the machine learning technique Random Forest. Subsequently, the monthly probability was classified into three classes: Absence, Presence and Uncertain status. These three classes are useful for mapping areas of no risk, areas of high-risk targeted for animal movement restrictions, and areas with an uncertain status that need active entomological surveillance to determine whether or not vectors are present.

RESULTS

The distribution of Culicoides species ensembles were in agreement with their previously reported distribution in Europe. The Random Forest models were very accurate in predicting the probability of presence for C. imicola (mean AUC = 0.95), less accurate for the Obsoletus ensemble (mean AUC = 0.84), while the lowest accuracy was found for the Pulicaris ensemble (mean AUC = 0.71). The most important environmental variables in the models were related to temperature and precipitation for all three groups.

CONCLUSIONS

The duration periods with low or null adult activity can be derived from the associated monthly distribution maps, and it was also possible to identify and map areas with uncertain predictions. In the absence of ongoing vector surveillance, these maps can be used by veterinary authorities to classify areas as likely vector-free or as likely risk areas from southern Spain to northern Sweden with acceptable precision. The maps can also focus costly entomological surveillance to seasons and areas where the predictions and vector-free status remain uncertain.

Bionomics of livestock-associated Culicoides (biting midge) bluetongue virus vectors under laboratory conditions

This research contributes to knowledge of the basic bionomic parameters of vector and non-vector Culicoides species. Field-collected gravid C. imicola and Obsoletus complex showed the longest lifespans in laboratory conditions. Culicoides paolae and C. circumscriptus seemed to be the most suitable species for laboratory rearing in view of their high oviposition rates, short lifecycles, long adult lifespans and female-biased sex ratios.

Addition of N-terminal pro-B natriuretic peptide to soluble fms-like tyrosine kinase-1/placental growth factor ratio > 38 improves prediction of pre-eclampsia requiring delivery within 1 week: a longitudinal cohort study

OBJECTIVE

Short-term prediction of pre-eclampsia (PE) using the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio is characterized by frequent false-positive results. As such, no treatment can be recommended to test-positive patients and multiple measurements are often required. The aim of this study was to evaluate the effectiveness of N-terminal pro-B natriuretic peptide (NT-proBNP), uric acid and the sFlt-1/PlGF ratio for prediction of delivery with PE within 1 week in singleton pregnancies with suspected PE and sFlt-1/PlGF ratio > 38.

METHODS

This was a longitudinal prospective cohort study of singleton pregnancies presenting at 24 + 0 to 36 + 6 weeks of gestation with clinically suspected PE and sFlt-1/PlGF ratio > 38, enrolled between January 2015 and June 2017. Multiple samples per patient were allowed but were restricted to one sample per gestational week. From 495 enrolled patients, 270 blood samples from 134 patients were ultimately analyzed. By using generalized estimating equations (GEE), the best-fit model was selected for prediction of delivery with PE within 1 week. The predictive value of this model was then assessed using area under the paired-ROC curve (AUC) analysis.

RESULTS

The best-fit model included the sFlt-1/PlGF ratio, NT-proBNP and the gestational week at the time of the measurement. This combined model was compared with the GEE model based on the sFlt-1/PlGF ratio and the gestational week at the time of the measurement (reduced model). The AUC for the combined model was 0.845 (95% CI, 0.787-0.896), which was significantly greater (P = 0.011) than that of the reduced model (0.786 (95% CI, 0.722-0.844)).

CONCLUSION

The addition of NT-proBNP assessment improves the short-term prediction of delivery as a result of PE compared with sFlt-1/PlGF ratio alone, when the sFlt-1/PlGF ratio is > 38. This finding should be considered in future research on the assessment of short-term risk of delivery as a result of PE. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Spatial and temporal variation in the abundance of Culicoides biting midges (Diptera: Ceratopogonidae) in nine European countries

BACKGROUND

Biting midges of the genus Culicoides (Diptera: Ceratopogonidae) are vectors of bluetongue virus (BTV), African horse sickness virus and Schmallenberg virus (SBV). Outbreaks of both BTV and SBV have affected large parts of Europe. The spread of these diseases depends largely on vector distribution and abundance. The aim of this analysis was to identify and quantify major spatial patterns and temporal trends in the distribution and seasonal variation of observed Culicoides abundance in nine countries in Europe.

METHODS

We gathered existing Culicoides data from Spain, France, Germany, Switzerland, Austria, Denmark, Sweden, Norway and Poland. In total, 31,429 Culicoides trap collections were available from 904 ruminant farms across these countries between 2007 and 2013.

RESULTS

The Obsoletus ensemble was distributed widely in Europe and accounted for 83% of all 8,842,998 Culicoides specimens in the dataset, with the highest mean monthly abundance recorded in France, Germany and southern Norway. The Pulicaris ensemble accounted for only 12% of the specimens and had a relatively southerly and easterly spatial distribution compared to the Obsoletus ensemble. Culicoides imicola Kieffer was only found in Spain and the southernmost part of France. There was a clear spatial trend in the accumulated annual abundance from southern to northern Europe, with the Obsoletus ensemble steadily increasing from 4000 per year in southern Europe to 500,000 in Scandinavia. The Pulicaris ensemble showed a very different pattern, with an increase in the accumulated annual abundance from 1600 in Spain, peaking at 41,000 in northern Germany and then decreasing again toward northern latitudes. For the two species ensembles and C. imicola, the season began between January and April, with later start dates and increasingly shorter vector seasons at more northerly latitudes.

CONCLUSION

We present the first maps of seasonal Culicoides abundance in large parts of Europe covering a gradient from southern Spain to northern Scandinavia. The identified temporal trends and spatial patterns are useful for planning the allocation of resources for international prevention and surveillance programmes in the European Union.

Modelling the range expansion of the Tiger mosquito in a Mediterranean Island accounting for imperfect detection

BACKGROUNDS

Aedes albopictus (Diptera; Culicidae) is a highly invasive mosquito species and a competent vector of several arboviral diseases that have spread rapidly throughout the world. Prevalence and patterns of dispersal of the mosquito are of central importance for an effective control of the species. We used site-occupancy models accounting for false negative detections to estimate the prevalence, the turnover, the movement pattern and the growth rate in the number of sites occupied by the mosquito in 17 localities throughout Mallorca Island.

RESULTS

Site-occupancy probability increased from 0.35 in the 2012, year of first reported observation of the species, to 0.89 in 2015. Despite a steady increase in mosquito presence, the extinction probability was generally high indicating a high turnover in the occupied sites. We considered two site-dependent covariates, namely the distance from the point of first observation and the estimated yearly occupancy rate in the neighborhood, as predicted by diffusion models. Results suggested that mosquito distribution during the first year was consistent with what predicted by simple diffusion models, but was not consistent with the diffusion model in subsequent years when it was similar to those expected from leapfrog dispersal events.

CONCLUSIONS

Assuming a single initial colonization event, the spread of Ae. albopictus in Mallorca followed two distinct phases, an early one consistent with diffusion movements and a second consistent with long distance, 'leapfrog', movements. The colonization of the island was fast, with ~90% of the sites estimated to be occupied 3 years after the colonization. The fast spread was likely to have occurred through vectors related to human mobility such as cars or other vehicles. Surveillance and management actions near the introduction point would only be effective during the early steps of the colonization.

Immunohistochemical analysis of T-type calcium channels in acquired melanocytic naevi and melanoma

BACKGROUND

Cutaneous malignant melanoma arises from transformed melanocytes de novo or from congenital or acquired melanocytic naevi. We have recently reported that T-type Ca²⁺ channels (TT-Cs) are upregulated in human melanoma and play an important role in cell proliferation.

OBJECTIVES

To describe for the first time in formalin-fixed paraffin-embedded tissue the immunoexpression of TT-Cs in biopsies of normal skin, acquired melanocytic naevi and melanoma, in order to evaluate their role in melanomagenesis and/or tumour progression, their utility as prognostic markers and their possible use in targeted therapies.

METHODS

Tissue samples from normal skin, melanocytic naevi and melanoma were subjected to immunohistochemistry for two TT-Cs (Cav3.1, Cav3.2); markers of proliferation (Ki67), the cell cycle (cyclin D1), hypoxia (Glut1), vascularization (CD31) and autophagy (LC3); BRAF V600E mutation (VE1) and phosphatase and tensin homologue (PTEN). Immunostaining was evaluated by histoscore. In silico analysis was used to assess the prognostic value of TT-C overexpression.

RESULTS

TT-C immunoexpression increased gradually from normal skin to common naevi, dysplastic naevi and melanoma samples, but with differences in the distribution of both isoforms. Particularly, Cav3.2 expression was significantly higher in metastatic melanoma than in primary melanoma. Statistical correlation showed a linear interaction between PTEN loss/BRAF V600E/Cav3.1/LC3/ Ki67/cyclin D1/Cav3.2/Glut1. Disease-free survival (DFS) and overall survival correlated inversely with overexpression of Cav3.2. DFS also correlated inversely with overexpression of Cav3.1.

CONCLUSIONS

TT-C immunoexpression on melanocytic neoplasms is consistent with our previous in vitro studies and appears to be related to tumour progression. TT-C upregulation can be considered as a prognostic marker using The Cancer Genome Atlas database. The high expression of Cav3.2 in metastatic melanoma encourages the investigation of the use of TT-C blockers in targeted therapies.

[Selection of candidates for prostate biopsy using multiparametric magnetic resonance imaging in patients with persistently raising PSA]

The current diagnosis of prostate cancer is based on randomized prostate biopsies to obtain histological material for study, without introducing any imaging technique in the diagnostic algorithm.

OBJECTIVES

To conduct a literature review of the role of multiparametric MRI ( mMRI ) in the diagnosis of prostate cancer, and present preliminary data from our series of 233 patients undergoing mRMN and transrectal ultrasound (TRUS) prostate biopsy.

MATERIAL AND METHODS

We performed a PubMed search for those articles that refer to the usefulness of mMRI in the follow-up and monitoring of patients with persistently elevated PSA without previous biopsies, and those with a previous negative biopsy, and assess the power of mRMN for detecting PCa in both the peripheral and the central gland. We present the preliminary results of our series, consisting of 233 patients selected between 2008 and 2011 undergoing mMRI and TRUS-guided prostatic biopsy because of elevated PSA levels or suspicious digital rectal examination.

RESULTS

We discuss several articles published from 2003 to 2014. We compare our results with those from the literature.

DISCUSSION

The diagnostic algorithm of prostate cancer to date does not include any imaging technique in the decision-making process. The mMRI is a functional imaging technique that provides increasing evidence in deciding which patients should be biopsied and which patients may avoid it despite persisting high levels of PSA. The advantage of this technique lies not only in its high detection rate in intermediate and high risk lesions, but also in its high specificity. It allows us to avoid diagnosing clinically insignificant tumors and thus, avoids overtreatment.

CONCLUSION

The mRMN is a useful technique not yet incorporated in algorithms of prostate cancer diagnosis in urological societies. Its safety, effectiveness and efficiency are forcing to include its progressive use and with high probability will be soon incorporated into the decision-making charts.

Susceptibility of Culicoides species biting midges to deltamethrin-treated nets as determined under laboratory and field conditions in the Balearic Islands, Spain

Culicoides Latreille (Diptera: Ceratopogonidae) are vectors of several arboviruses, including bluetongue virus (BTV) and African horse sickness virus (AHSV), which cause diseases in, respectively, sheep and cattle, and horses, and have economic repercussions mainly as a result of trade restrictions. Insecticides can be used to reduce vector populations and hence the spread of disease. Despite the economic importance of these diseases, relatively few studies have evaluated the efficacy of commercially available insecticides and the effectiveness of treated nets against Culicoides species. The aim of the present study was to evaluate the insecticidal effect of commercially available polyethylene nets (ZeroVector(®) ) treated with deltamethrin (4.4 g/kg ± 15%) on Culicoides species. Laboratory and field trials were conducted in Culicoides populations collected in Majorca in the Balearic Islands, Spain. The present study shows that deltamethrin-treated nets provoke high and rapid mortality (90-100%) in Culicoides midges under laboratory conditions and increase mortality by 13% when deployed in the field.

[Treatment of loculated parapneumonic empyema. Video assisted thoracoscopy or fibrinolytics?]

OBJECTIVE

There is no consensus regarding the ideal treatment of loculated parapneumonic empyema (PPE). The aim of this study is to compare the effectiveness of drainage plus urokinase (DF) with video-assisted thoracoscopy (VATS).

MATERIAL AND METHODS

Retrospective review. Patients admitted with a PPE between January 2001 and July 2008. Loculated empyema was diagnosed by chest ultrasound and patients were treated with DF or VATS depending on the attending surgeon. Compared variables were: post-operative stay, total hospital stay, days of tube thoracostomy, post-operative fever and treatment failure.

RESULTS

One hundred and twenty one patients were admitted with the diagnosis of PPE. Seventeen patients were excluded from analysis because of simple parapneumonic effusions. Of the 104 patients included in the study, 47 were treated with urokinase and 57 with videothoracoscopy. No statistically significant differences (P>.05) were found between the median values in the DF and VATS groups for hospital stay (median 12 vs 12 days) or post-operative stay (median 9 vs 9 days). There were differences in duration of tube thoracostomy (median DF group 5 days, VATS, 4 days, P<.05) and in the post-operative fever (median 3 vs 2 days, p<0,05).Twenty two per cent of children needed a second procedure (14 patients of DF and 9 of VATS group, P=.09).

CONCLUSIONS

According to our experience, the results of DF and VATS for the treatment of loculated parapneumonic empyema are similar. Although there are no statistical differences, there seems to be a higher rate of failure, with the need of more procedures in the DF group. This difference does not affect the average total hospital stay.

Analogue Gravity

Analogue gravity is a research programme which investigates analogues of general relativistic gravitational fields within other physical systems, typically but not exclusively condensed matter systems, with the aim of gaining new insights into their corresponding problems. Analogue models of (and for) gravity have a long and distinguished history dating back to the earliest years of general relativity. In this review article we will discuss the history, aims, results, and future prospects for the various analogue models. We start the discussion by presenting a particularly simple example of an analogue model, before exploring the rich history and complex tapestry of models discussed in the literature. The last decade in particular has seen a remarkable and sustained development of analogue gravity ideas, leading to some hundreds of published articles, a workshop, two books, and this review article. Future prospects for the analogue gravity programme also look promising, both on the experimental front (where technology is rapidly advancing) and on the theoretical front (where variants of analogue models can be used as a springboard for radical attacks on the problem of quantum gravity).

[Endobronchial chondromesenchymal hamartoma]

Primary lung tumours are uncommon in childhood. Among these tumours, endobronchial masses are even less common and, among benign tumours, inflammatory pseudotumours and hamartomas have the highest incidence in children. We present the case of a 2.5-year-old girl with a left endobronchial chondromesenchymal hamartoma with obstruction of 90% of the bronchial lumen. Complete resection of the endobronchial mass was performed by rigid bronchoscopy and application of topical mitomycin C. After tumour resection and a 12-month follow-up, the patient has shown a favourable outcome with immediate disappearance of respiratory symptoms. Successive fibreoptic bronchoscopies have shown no residual tumour.

[Current treatment of pediatric penetrating traumas]

INTRODUCTION

The traditional management of pediatric penetrating trauma has been wide surgical examination. However, the selective nonoperative management is increasing thanks to the precise diagnosis obtained from radiologic studies as CT scan. The purpose of this study is reviewing our experience in the last eight years with a less invasive management.

PATIENTS AND METHODS

We retrospectively reviewed (2000-2007) the patients with penetrating injuries of different parts of the body (excluding cranioencephalic traumatism) treated in our center and registered by the Clinical Documentation Unit. The variables collected and evaluated included age, mechanism of injury, kind of injury, diagnostic and therapeutic modalities and outcome.

RESULTS

There were 17 patients (median 9.5 years, range 4-17) with penetrating trauma. According the localization of injury the patients were divided into 4 groups: abdominal (17.6%), thoracic (23.5%), cervical (17.6%) and extremities (41.2%). The most frequent kind of injuries were: skin and muscle (with or without penetrating peritoneal or chest cavity, 52.9%) vascular or neurological structures (29.4%). We would like to highlight one case of cardiac perforation and taponade, one traqueal lesion and one case of external iliac vein injury. The injuries caused by glass (35.3%) and sharp arms (29,4%) were the most frequent mechanism. Simple suture and observation was treatment enough in 47.1%. Three patients required neural and vascular micro suture. One patient followed a thoracotomy procedure and other one, a sternotomy. It wasn't necessary any laparotomy. No patient died and 88% of the patients have no sequelae.

CONCLUSIONS

Most of the penetrating child traumas have good prognosis and are associated with few sequelae. Low energy thoracic and abdominal penetrating traumas can be managed conservatively when the patient is hemodiynamically stable and CT scan shows no organ injury, avoiding unnecessary surgical examinations.

Hawking-like radiation does not require a trapped region

We discuss the issue of quasiparticle production by "analogue black holes" with particular attention paid to the possibility of reproducing Hawking radiation in a laboratory. By constructing simple geometric acoustic models, we obtain a somewhat unexpected result: We show that, in order to obtain a stationary and Planckian emission of quasiparticles, it is not necessary to create a trapped region in the acoustic spacetime (corresponding to a supersonic regime in the fluid flow). It is sufficient to set up a dynamically changing flow asymptotically approaching a sonic regime with sufficient rapidity in laboratory time. This result is generic to curved-space quantum field theory, the "analogue spacetimes" we consider providing a guide to physical intuition, and a possible route to laboratory experiments.

Analogue Gravity

Analogue models of (and for) gravity have a long and distinguished history dating back to the earliest years of general relativity. In this review article we will discuss the history, aims, results, and future prospects for the various analogue models. We start the discussion by presenting a particularly simple example of an analogue model, before exploring the rich history and complex tapestry of models discussed in the literature. The last decade in particular has seen a remarkable and sustained development of analogue gravity ideas, leading to some hundreds of published articles, a workshop, two books, and this review article. Future prospects for the analogue gravity programme also look promising, both on the experimental front (where technology is rapidly advancing) and on the theoretical front (where variants of analogue models can be used as a springboard for radical attacks on the problem of quantum gravity).

[Good results with Passerini's technique in severely masculinised female pseudohermaphroditism]

In female pseudohermaphroditism due to congenital adrenal hyperplasia (CAH), some cases develope a very important masculinization degree with a high outlet of the vagina above the outern urethral sphincter. There are several surgical techniques to solve this problem. Our group uses Passerini's thecnique since 1990. 9 Girls with CAH with extreme masculitation (IV and V Prader degree) have been operated with this technique. The age at intervention varies between 9 months and 3 years, with a follow-up between 1 and 12 years. All these patients had hormonal studies, demostrating a deficiency of 21-hydroxilase in 8 cases and a deficiency of 11-B-hydroxilase in one case. To determine the vaginal outlet a genitography was performed in all cases, vaginoscopy in 7 cases and MNR in 2 cases. Passerini's technique consists of two phases: the first step has the objective of forming the distal 2/3 of the vagina using the skin and the urethral mucosa of the phallus. At the second time transtrigonal way is performed to access the vagina which is desinserted from its urethral outlet and anastomosed with the distal neovagina. There were no significative complications in immediate time. The esthetic result is acceptable in all cases, although one case had to be surgically repaired because of a prominent vulvar flap. We use vaginoscopy to prove vaginal permeability in all cases although one of them developed adherences around the anastomosis. This severe genital malformation, very uncommon, has a difficult surgical solution. Passerini's technique allows, with less complications, to create an acceptable outer genitals at early age and only in one surgical time.

What the Cuban context provides health researchers: the feasibility of a longitudinal multi-method study of the impact of housing improvements on health in Havana, Cuba

BACKGROUND

From extensive participatory research in inner city communities in Central Havana, Cuba, we found housing to be the largest perceived source of health risk. The objective of this study, therefore, was to ascertain the feasibility of conducting a multi-method longitudinal evaluation of the impact of housing improvements on health.

METHODS

Meetings with community and governmental stakeholders were held; housing policy documents were reviewed; key informants were interviewed; decisions were made by a collaborative interdisciplinary team regarding measurement instruments for health as well as housing quality; training was conducted for use of new measurement tools; and a 3 month multi-method trial with repeated measures was conducted on individuals in good housing and poor housing in the inner city of Central Havana. Questionnaires were administered at monthly intervals for 3 months to 25 adults living in good housing and 25 in poor housing.

RESULTS

Cuba's housing policies made it easy to identify a suitable cohort and control group for possible longitudinal study. Consent to participate was enthusiastically obtained, and no difficulties were encountered in collecting or analysing the data. Housing quality measurements were conducted using validated instruments with minimal difficulties. There was strong community involvement and support for a comprehensive longitudinal study.

CONCLUSION

Cuba, although a poor country, has the necessary infrastructural support and capacity to make it an excellent site for health and housing intervention studies.

The value of endorectal MR imaging to predict positive biopsies in clinically intermediate-risk prostate cancer patients

The aim of this study was to assess the effectiveness of endorectal MR imaging in predicting the positive biopsy results in patients with clinically intermediate risk for prostate cancer. We performed a prospective endorectal MR imaging study with 81 patients at intermediate risk to detect prostate cancer between January 1997 and December 1998. Intermediate risk was defined as: prostatic specific antigen (PSA) levels between 4 and 10 ng/ml or PSA levels in the range of 10-20 ng/ml but negative digital rectal examination (DRE) or PSA levels progressively higher (0.75 ng/ml year(-1)). A transrectal sextant biopsy was performed after the endorectal MR exam, and also of the area of suspicion detected by MR imaging. The accuracies were measured, both singly for MR imaging and combined for PSA level and DRE, by calculating the area index of the receiver operating characteristics (ROC) curve. Cancer was detected in 23 patients (28%). Overall sensitivity and specificity of endorectal MRI was 70 and 76%, respectively. Accuracy was 71% estimated from the area under the ROC curve for the total patient group and 84% for the group of patients with PSA level between 10-20 ng/ml. Positive biopsy rate (PBR) was 63% for the group with PSA 10-20 ng/ml and a positive MR imaging, and 15% with a negative MR exam. The PBR was 43% for the group with PSA 4-10 ng/ml and a positive MR study, and 13% with a negative MR imaging examination. We would have avoided 63% of negative biopsies, while missing 30% of cancers for the total group of patients. Endorectal MR imaging was not a sufficient predictor of positive biopsies for patients clinically at intermediate risk for prostate cancer. Although we should not avoid performing systematic biopsies in patients with endorectal MR imaging negative results, as it will miss a significant number of cancers, selected patients with a PSA levels between 10-20 ng/ml or clinical-biopsy disagreement might benefit from endorectal MR imaging.

Fine-needle aspiration cytology of columnar-cell carcinoma of the thyroid: report of two cases with cytohistologic correlation

The columnar-cell variant of papillary carcinoma is a rare tumor of the thyroid, associated with aggressive behavior, early visceral metastasis, and a rapidly fatal course. In this report we present the fine-needle aspiration cytologic findings of two examples of this variant of papillary carcinoma with cytohistologic correlation. In the smears, clusters, monolayered sheets, and scattered papillary fronds of tumor cells were present. The tumor cells were columnar and exhibited overlapping and stratification of the nuclei. In the first case the tumoral cells showed round nuclei with finely granular chromatin pattern, small nucleoli and vacuolated-appearing cytoplasm. The malignant cells in the second case presented oval to elongated nuclei with stippled chromatin, inconspicuous nucleoli and indistinct cytoplasmic borders. It is important to distinguish this tumor from the common thyroid papillary carcinoma because of its much more aggressive behavior.

Massive crystal-storing histiocytosis associated with low-grade malignant B-cell lymphoma of MALT-type of the parotid gland

Massive crystal deposition is unusual in lymphoproliferative disorders. In this report, a mucosa-associated lymphoid tissue (MALT) low-grade B-cell lymphoma of the parotid gland containing large numbers of crystal-storing histiocytes is described. The patient, an 81-yr-old female, presented with a history of long-standing left parotid gland enlargement. FNA cytology of the tumor showed a lymphoplasmacytic infiltrate and sheets of large benign histiocytes with abundant eosinophilic intracytoplasmic inclusions. Paraffinsection immunohistochemistry performed on the cell block demonstrated that the histiocytic cells were immunoreactive for the KP-1 (CD-68) antibody and monotypic for cytoplasmic IGM and L-light chain. The cytological diagnosis was consistent with a low-grade B-cell lymphoma with plasmacytic differentiation associated with crystal-storing histiosis. A periparotid lymph node was biopsied and showed involvement by a monocytoid B-cell lymphoma with plasmacytic differentiation and crystal-storing histiocytosis in the pericapsular region.