Isoprognostic functional CT map for open partial horizontal laryngectomy

PURPOSE

To identify a radiological map of laryngeal subsites whose involvement by the tumor could predict patients' functional outcomes after open partial horizontal laryngectomy (OPHL).

METHODS

The present retrospective analysis concerned 96 patients with glottic squamous cell carcinoma, who were radiologically staged with contrast-enhanced neck CT scans before undergoing supracricoid or supratracheal laryngectomy. A radiological map of patients' functional risk was developed by considering the distribution of functional outcomes in relation to the laryngeal subsites involved. The functional outcomes considered were: (i) decannulation at discharge; (ii) time to removal of the nasogastric feeding tube (NFT); (iii) postoperative complication rate; and (iv) length of hospital stay.

RESULTS

Involvement of the anterior supraglottis was related to a longer need for NFT, and a longer hospital stay (p = 0.003, and p = 0.003, respectively). Involvement of the posterior glottis negatively affected the time to decannulation, and the likelihood of postoperative complications (p = 0.000, and p = 0.002, respectively).

CONCLUSIONS

Anterior glottic small tumors (without significant subglottic and/or supraglottic extension) are related to the best functional outcomes after OPHL, since the suprahyoid epiglottis and both the arytenoids are likely to be spared.

Positive cases of bovine genital campylobacteriosis and bovine trichomonosis in the eradication program of La Pampa, Argentina: 2008-2021

Bovine genital campylobacteriosis, caused by the gram-negative bacteria Campylobacter fetus venerealis, and bovine trichomonosis, caused by the parasite protozoan Tritrichomonas foetus, are venereal diseases that occur with long intercalving periods and abortion. The control of both diseases relies on microbiological testing and culling infected bulls. Vaccination and antibiotic treatment may help in controlling campylobacteriosis but are not recommended for trichomonosis control. Several regions of the world have active control programs for trichomonosis, not campylobacteriosis. In Argentina, the state of La Pampa aims to eradicate trichomonosis and campylobacteriosis by imposing annual diagnostic testing of every bull and slaughtering positive animals. Prior studies indicated a declining trend in the prevalence of campylobacteriosis and trichomonosis in La Pampa. It was also proposed that the prevalence of one disease could be estimated from the prevalence of the other. The purpose of this retrospective analysis of data gathered from 2008 to 2021 was to determine the La Pampa program's efficacy. Descriptive statistics were employed to determine the reason behind the correlation between tricomonosis and campylobacteriosis diagnostic results. The outcomes refute the notion that this program of venereal eradication was a success. Furthermore, an excess of false positives in both diagnoses may have contributed to the correlation between the prevalences of campylobactriosis and trichomonosis. The practice of killing animals without verifying positive results hinders the determination of disease prevalence and results in the death of numerous healthy animals.

Enteropathogenic E. coli infection co-elicits lysosomal exocytosis and lytic host cell death

IMPORTANCE

Enteropathogenic Escherichia coli (EPEC) infection is a significant cause of gastroenteritis, mainly in children. Therefore, studying the mechanisms of EPEC infection is an important research theme. EPEC modulates its host cell life by injecting via a type III secretion machinery cell death modulating effector proteins. For instance, while EspF and Map promote mitochondrial cell death, EspZ antagonizes cell death. We show that these effectors also control lysosomal exocytosis, i.e., the trafficking of lysosomes to the host cell plasma membrane. Interestingly, the capacity of these effectors to induce or protect against cell death correlates completely with their ability to induce LE, suggesting that the two processes are interconnected. Modulating host cell death is critical for establishing bacterial attachment to the host and subsequent dissemination. Therefore, exploring the modes of LE involvement in host cell death is crucial for elucidating the mechanisms underlying EPEC infection and disease.

Fracture line and comminution zone characteristics, and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humeral fractures: complex proximal humerus fracture map

PURPOSE

To identify fracture characteristics and zones of comminution as well as the relationship with anatomic landmarks and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humerus fractures.

METHODS

Computed tomography images of 201 OTA/AO 11C3 fractures were included. Fracture lines were superimposed to a 3D proximal humerus template, created from a healthy right humerus, after fracture fragment reduction on 3D reconstruction images. Rotator cuff tendon footprints were marked on the template. Lateral, anterior, posterior, medial, and superior views were captured for the interpretation of fracture line and comminution zone distribution as well as to define the relationship with anatomic landmarks and rotator cuff tendon footprints.

RESULTS

A total of 106 females and 95 males (mean age = 57.5 ± 17.7 [range 18-101] years) with 103 C3.1-, 45 C3.2-, and 53 C3.3-type fractures were included. On the lateral, medial, and superior humeral surfaces, fracture lines and comminution zones were distributed differently in 3 groups. Tuberculum minus and medial calcar region were significantly less severely affected in C3.1 and C3.2 fractures than C3.3 fractures. The supraspinatus footprint was the most severely affected rotator cuff footprint area.

CONCLUSIONS

Specifically defining the certain differences for repeatable fracture patterns and comminution zones in OTA/AO 11C3-type fractures and the relationship between the rotator cuff footprint and the joint capsule may contribute to the decision-making process of surgeons.

Early-stage findings in an experimental calf model infected with Argentinean isolates of Mycobacterium avium subsp. paratuberculosis

Mycobacterium avium subsp. paratuberculosis (MAP) is an important pathogen that causes granulomatous enteritis known as Johne's disease or paratuberculosis (PTB). In this study an experimental model of calves infected with Argentinean isolates of MAP for 180 days was used to provide more data of the early PTB stages. Calves were challenged by oral route with MAP strain _IS900-RFLPA (MA; n = 3), MAP strain _IS900-RFLPC (MC; n = 2) or mock infected (MI; n = 2), and response to infection was evaluated through peripheral cytokine expression, MAP tissue distribution and histopathological early-stage findings. Specific and varied levels of IFN-γ were only detected at 80 days post-infection in infected calves. These data indicate that specific IFN-γ is not a useful indicator for early detection of MAP infection in our calf model. At 110 days post-infection, TNF-α expression was higher than IL-10 in 4 of the 5 infected animals and a significant decrease of TNF-α expression was detected in infected vs. non-infected calves. All calves challenged were identified as infected by mesenteric lymph node tissue culture and real time IS900 PCR. In addition, for lymph nodes samples, the agreement between these techniques was almost perfect (κ = 0.86). Colonization of tissues and levels of tissue infection varied between individuals. Evidence of early MAP dissemination to extraintestinal tissues such as the liver was detected by culture in one animal (MAP strain _IS900-RFLPA). In both groups microgranulomatous lesions were observed predominantly in the lymph nodes, with giant cells present only in the MA group. In summary, the findings described herein may indicate that local MAP strains induced specific immune responses with particularities that could suggest differences in their biological behavior. Further studies should be carried out in order to obtain an in-depth understanding of the influence of MAP strains in host-pathogen interactions and the outcome of disease.

Understanding the burden of chronic back pain: a spatial microsimulation of chronic back pain at small area level across England

PURPOSE

Chronic back pain (CBP) carries a significant burden. Understanding how and why CBP prevalence varies spatially, as well as the potential impact of policies to decrease CBP would prove valuable for public health planning. This study aims to simulate and map the prevalence of CBP at ward-level across England, identify associations which may explain spatial variation, and explore 'what-if' scenarios for the impact of policies to increase physical activity (PA) on CBP.

METHODS

A two-stage static spatial microsimulation approach was used to simulate CBP prevalence in England, combining national-level CBP and PA data from the Health Survey for England with spatially disaggregated demographic data from the 2011 Census. The output was validated, mapped, and spatially analysed using geographically weighted regression. 'What-if' analysis assumed changes to individuals' moderate-to-vigorous physical activity (MVPA) levels.

RESULTS

Large significant clusters of high CBP prevalence were found predominantly in coastal areas and low prevalence in cities. Univariate analysis found a strong positive correlation between physical inactivity and CBP prevalence at ward-level (R² = 0.735; Coefficient = 0.857). The local model showed the relationship to be stronger in/around cities (R² = 0.815; Coefficient: Mean = 0.833, SD = 0.234, Range = 0.073-2.623). Multivariate modelling showed this relationship was largely explained by confounders (R² = 0.924; Coefficient: Mean = 0.070, SD = 0.001, Range = 0.069-0.072). 'What-if' analysis showed a detectable reduction in CBP prevalence for increases in MVPA of 30 and 60 min (- 2.71%; 1, 164, 056 cases).

CONCLUSION

CBP prevalence varies at ward-level across England. At ward-level, physical inactivity is strongly positively correlated with CBP. This relationship is largely explained by geographic variation in confounders (the proportion of residents that are: over 60, in low-skilled jobs, female, pregnant, obese, smokers, white or black, disabled). Policies to increase PA by 30 min weekly MVPA will likely result in a significant reduction in CBP prevalence. To maximise their impact, policies could be tailored to areas of high prevalence, which are identified by this study.

Understanding school food systems to support the development and implementation of food based policies and interventions

BACKGROUND

Schools provide opportunities to improve the quality of children's diet, whilst reducing inequalities in childhood diet and health. Evidence supports whole school approaches, including consistency in food quality, eating culture and food education. However, such approaches are often poorly implemented due to the highly complex environments in which schools operate. We aimed to develop a school food systems map using a systems thinking approach to help identify the key factors influencing primary school children's dietary choice.

METHODS

Eight workshops were conducted with 80 children (from schools from varying locations (region of England/UK; urban/rural), deprivation levels and prioritisation of school food policies)) and 11 workshops were held with 82 adult stakeholders across the UK (principals, teachers, caterers, school governors, parents, and local and voluntary sector organisations) to identify factors that influence food choice in children across a school day and their inter-relationships. Initial exploratory workshops started with a 'blank canvas' using a group model building approach. Later workshops consolidated findings and supported a wider discussion of factors, relationships and influences within the systems map. Strengths of the relationship between factors/nodes were agreed by stakeholders and individually depicted on the map. We facilitated an additional eight interactive, in-person workshops with children to map their activities across a whole school day to enable the production of a journey map which was shared with stakeholders in workshops to facilitate discussion.

RESULTS

The final 'CONNECTS-Food' systems map included 202 factors that were grouped into 27 nodes. Thematic analysis identified four key themes: leadership and curriculum; child food preference; home environment; and school food environment. Network analysis highlighted key factors that influence child diet across a school day, which were largely in keeping with the thematic analysis; including: 'available funds/resources', 'awareness of initiatives and resources', 'child food preference and intake', 'eligibility of free school meals', 'family circumstances and eating behaviours', 'peer/social norms', 'priorities of head teachers and senior leaders'.

CONCLUSIONS

Our systems map demonstrates the need to consider factors external to schools and their food environments. The map supports the identification of potential actions, interventions and policies to facilitate a systems-wide positive impact on children's diets.

Household access to basic drinking water, sanitation and hygiene facilities: secondary analysis of data from the demographic and health survey V, 2017-2018

BACKGROUND

In Benin, access to water, sanitation and hygiene (WASH) remains an issue. This study aims to provide an overview of household access to basic WASH services based on nationally representative data.

METHOD

Secondary analyses were run using the 'HOUSEHOLD' dataset of the fifth Demographic and Health Survey 2017-2018. The dependent variables were household access to individual and combined basic WASH services. The characteristics of the household head and those related to the composition, wealth and environment of the household were independent variables. After a descriptive analysis of all study variables, multivariate logistic regression was performed to identify predictors of outcome variables.

RESULTS

The study included 14,156 households. Of these, 63.98% (95% CI = 61.63-66.26), 13.28% (95% CI = 12.10-14.57) and 10.11% (95% CI = 9.19-11.11) had access to individual basic water, sanitation and hygiene facilities, respectively. Also, 3% (95% CI = 2.53-3.56) of households had access to combined basic WASH services. Overall, the richest households and few, and those headed by people aged 30 and over, female and with higher levels of education, were the most likely to have access to individual and combined basic WASH services. In addition, disparities based on the department of residence were observed.

CONCLUSION

The authors suggest a multifactorial approach that addresses the identified determinants.

Exploring Acupuncture Actions in the Body and Brain

Acupuncture's actions have been explained by biomedical research. However, the meridian system used in acupuncture needs further clarification. This review describes how acupuncture affects the body and brain. From the perspective of traditional East Asian medicine, the meridian system is closely connected with acupuncture's treatment effects. In the body, the indications of acupoints, primarily established based on the meridian system, have spatial symptom patterns. Spatial patterns of acupoint indications are distant from the stimulated sites and strongly associated with the corresponding meridian's route. Understanding how acupuncture works based on the original meridian system is important. From a neuroscience perspective, an acupuncture-induced sensation originates from the bottom-up action of simple needling in the peripheral receptor and the reciprocal interaction with top-down brain modulation. In the brain, enhanced bodily attention triggered by acupuncture stimulation can activate the salience network and deactivate the default mode network regardless of the actual stimulation. The application of data science technology to acupuncture research may provide new tools to uncover the principles of acupoint selection and enhance the clinical efficacy of acupuncture treatment in various diseases.

An atlas to support the progressive control of tsetse-transmitted animal trypanosomosis in Burkina Faso

Background

African animal trypanosomosis (AAT), transmitted by tsetse flies, is arguably the main disease constraint to integrated crop-livestock agriculture in sub-Saharan Africa, and African heads of state and governments adopted a resolution to rid the continent of this scourge. In order to sustainably reduce or eliminate the burden of AAT, a progressive and evidence-based approach is needed, which must hinge on harmonized, spatially explicit information on the occurrence of AAT and its vectors.

Methods

A digital repository was assembled, containing tsetse and AAT data collected in Burkina Faso between 1990 and 2019. Data were collected either in the framework of control activities or for research purposes. Data were systematically verified, harmonized, georeferenced and integrated into a database (PostgreSQL). Entomological data on tsetse were mapped at the level of individual monitoring traps. When this was not possible, mapping was done at the level of site or location. Epidemiological data on AAT were mapped at the level of location or village.

Results

Entomological data showed the presence of four tsetse species in Burkina Faso. Glossina tachinoides, present from the eastern to the western part of the country, was the most widespread and abundant species (56.35% of the catches). Glossina palpalis gambiensis was the second most abundant species (35.56%), and it was mainly found in the west. Glossina morsitans submorsitans was found at lower densities (6.51%), with a patchy distribution in the southern parts of the country. A single cluster of G. medicorum was detected (less than 0.25%), located in the south-west. Unidentified tsetse flies accounted for 1.33%. For the AAT component, data for 54,948 animal blood samples were assembled from 218 geographic locations. The samples were tested with a variety of diagnostic methods. AAT was found in all surveyed departments, including the tsetse-free areas in the north. Trypanosoma vivax and T. congolense infections were the dominant ones, with a prevalence of 5.19 ± 18.97% and 6.11 ± 21.56%, respectively. Trypanosoma brucei infections were detected at a much lower rate (0.00 ± 0.10%).

Conclusions

The atlas provides a synoptic view of the available information on tsetse and AAT distribution in Burkina Faso. Data are very scanty for most of the tsetse-free areas in the northern part of the country. Despite this limitation, this study generated a robust tool for targeting future surveillance and control activities. The development of the atlas also strengthened the collaboration between the different institutions involved in tsetse and AAT research and control in Burkina Faso, which will be crucial for future updates and the sustainability of the initiative.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-05131-4.

Getting in Touch With Tactile Map Automated Production: Evaluating impact and areas for improvement

This study evaluated the impact the Tactile Maps Automated Production (TMAP) system has had on its blind and visually impaired (BVI) and Orientation and Mobility (O&M) users and obtained suggestions for improvement. A semi-structured interview was performed with six BVI and seven O&M TMAP users who had printed or ordered two or more TMAPs in the last year. The number of maps downloaded from the online TMAP generation platform was also reviewed for each participant. The most significant finding is that having access to TMAPs increased map usage for BVIs from less than 1 map a year to getting at least two maps from the order system, with those who had easy access to an embosser generating on average 18.33 TMAPs from the online system and saying they embossed 42 maps on average at home or work. O&Ms appreciated the quick, high-quality, and scaled map they could create and send home with their students, and they frequently used TMAPs with their braille reading students. To improve TMAPs, users requested that the following features be added: interactivity, greater customizability of TMAPs, viewing of transit stops, lower cost of the ordered TMAP, and nonvisual viewing of the digital TMAP on the online platform.

Magnetoreception and magnetic navigation in fishes: a half century of discovery

As the largest and most diverse vertebrate group on the planet, fishes have evolved an impressive array of sensory abilities to overcome the challenges associated with navigating the aquatic realm. Among these, the ability to detect Earth's magnetic field, or magnetoreception, is phylogenetically widespread and used by fish to guide movements over a wide range of spatial scales ranging from local movements to transoceanic migrations. A proliferation of recent studies, particularly in salmonids, has revealed that fish can exploit Earth's magnetic field not only as a source of directional information for maintaining consistent headings, but also as a kind of map for determining location at sea and for returning to natal areas. Despite significant advances, much about magnetoreception in fishes remains enigmatic. How fish detect magnetic fields remains unknown and our understanding of the evolutionary origins of vertebrate magnetoreception would benefit greatly from studies that include a wider array of fish taxa. The rich diversity of life-history characteristics that fishes exhibit, the wide variety of environments they inhabit, and their suitability for manipulative studies, make fishes promising subjects for magnetoreception studies.

Large-scale citizen science protocol provides high-resolution nitrogen dioxide values while enhancing community knowledge and collective action

We present an already tested protocol from a large-scale air quality citizen science campaign (xAire, 725 measurements, see Ref. [1]). A broad partnership with 1,650 people from communities including 18 primary schools in Barcelona (Spain) provided the capacity to obtain unprecedented high-resolution NO₂ levels. Communities followed the protocol to select measurement points and obtain NO₂ levels from outdoor locations n=671, playgrounds n=31, and inside school buildings (primarily classrooms) n=23. Data was calibrated and annualized with concentration levels from the city´s automatic air quality monitoring reference stations [2].

Data set from large-scale citizen science provides high-resolution nitrogen dioxide values for enhancing community knowledge and collective action to related health issues

Dataset from a large-scale air quality citizen science campaign is presented (xAire, 725 measurements, see Ref. [1]). A broad partnership with 1650 citizens from communities around 18 primary schools across Barcelona (Spain) provided the capacity to obtain unprecedented high-resolution NO₂ levels which had in turn the capacity to provide an updated asthma Health Impact Assessment. Nitrogen dioxide levels being obtained in a 4-week period during February and March 2018 with Palmes' diffusion samplers are herein provided. Dataset includes NO₂ levels from outdoor locations n=671, playgrounds n=31, and inside school buildings (mostly classrooms) n=23. Data was calibrated and annualized with concentration levels from automatic reference stations. It is shown that NO₂ levels vary considerably with at some cases very high levels. Strong differences might also however be explained by the fact that ambient air pollution is reduced exponentially with distance from an emission source like traffic meaning that two samplers located about 100 m away can measure a tenfold difference concentration level.

Early response of monocyte-derived macrophages from vaccinated and non-vaccinated goats against in vitro infection with Mycobacterium avium subsp. paratuberculosis

Paratuberculosis is a disease of ruminants caused by Mycobacterium avium subsp. paratuberculosis (Map). Vaccination is the most cost-effective control method. However, despite the fact that macrophages are the main target cells for this pathogen, the precise mechanisms behind the response of the macrophage to Map infection and how it is modified by vaccination are yet poorly understood. The aim of this study was to investigate the effect of Silirum^® vaccination in the early immune response of caprine monocyte-derived macrophages (CaMØs). Peripheral blood mononuclear cells (PBMCs) were obtained from vaccinated and non-vaccinated goats, cultured in vitro until differentiation to macrophages and infected with Map. After a 24 h incubation, Map viability and DNA were assessed in culture by viable colony count and real time quantitative polymerase chain reaction (qPCR). In addition, Map phagocytosis and expression of IL-10, IL-12, IFN-γ, TNF-α, IL-17A, IL-1β, iNOS, IL-6 and MIP-1β were also evaluated through immunofluorescence labelling and reverse transcriptase qPCR (RT-qPCR), respectively. A significant reduction of Map viability was observed in both supernatants (P < 0.05) and CaMØs (P < 0.001) from the vaccinated group. Similarly, the percentage of infected CaMØs and the number of internalized Map by CaMØs (P < 0.0001) was higher in the vaccinated group. Finally, iNOS (P < 0.01) and IL-10 were significantly up-regulated in CaMØs from vaccinated goats, whereas only MIP-1β was up-regulated in non-vaccinated animals (P < 0.05). These results show that vaccination modifies the immune response of CaMØs, suggesting that the phagocytosis and microbiocidal activity of macrophages against Map is enhanced after vaccination.

European countries in the race to attract successful biopharma investment: Winners and laggers

The post-coronavirus era will open myriad opportunities for the biopharma industry. However, the extent to which each country will take advantage of this promising new scenario will largely depend on its position in a few key areas. Here, we offer an overview of the European countries that are winning and those that are lagging behind in the race to attract the greatest investment in this industry and to attain the highest rate of successful new ventures. Our results highlight the vital importance of a sound, active funding base, especially in terms of venture capital. Our findings also suggests that general scientific foundations are not enough to secure an advantage in new venture formation.

The Netherlands Sports Cardiology Map: a step towards sports cardiology network medicine for patient and athlete care

Sports cardiology is a rapidly evolving subspecialty of cardiology, with a growing demand for expertise. To improve patient care, clinicians, patients, and athletes (recreational to elite) should be able to easily identify specialised care pathways, expertise centres and clinicians with sports cardiology expertise. To this purpose, several international societies and organisations recommend establishing a local and national sports cardiology infrastructure. We therefore aimed to establish The Netherlands Sports Cardiology Map. We conducted a web-based survey, which was published on the Netherlands Society of Cardiology home page (2019–2020) and in which each cardiology department or clinic was asked to provide information on sports cardiology expertise and the current infrastructure. Of the 46 respondent centres, 28 (61%) reported that they had expertise in sports cardiology, of which 22 (79%) had specific expertise in one or more specific types of sports. Integrated multidisciplinary meetings were reported by 43% of the centres (n = 12/28). Only two centres reported ongoing research projects that had been approved by an institutional review board. The Netherlands Sports Cardiology Map is an important step towards improving the existing infrastructure and developing network medicine for sports cardiology.

A digital mapping application for quantifying and displaying air temperatures at high spatiotemporal resolutions in near real-time across Australia

Surface air temperature (T_a) required for real-time environmental modelling applications should be spatially quantified to capture the nuances of local-scale climates. This study created near real-time air temperature maps at a high spatial resolution across Australia. This mapping is achieved using the thin plate spline interpolation in concert with a digital elevation model and ‘live’ recordings garnered from 534 telemetered Australian Bureau of Meteorology automatic weather station (AWS) sites. The interpolation was assessed using cross-validation analysis in a 1-year period using 30-min interval observation. This was then applied to a fully automated mapping system—based in the R programming language—to produce near real-time maps at sub-hourly intervals. The cross-validation analysis revealed broad similarities across the seasons with mean-absolute error ranging from 1.2 °C (autumn and summer) to 1.3 °C (winter and spring), and corresponding root-mean-square error in the range 1.6 °C to 1.7 °C. The R² and concordance correlation coefficient (P_c ) values were also above 0.8 in each season indicating predictions were strongly correlated to the validation data. On an hourly basis, errors tended to be highest during the late afternoons in spring and summer from 3 pm to 6 pm, particularly for the coastal areas of Western Australia. The mapping system was trialled over a 21-day period from 1 June 2020 to 21 June 2020 with majority of maps completed within 28-min of AWS site observations being recorded. All outputs were displayed in a web mapping application to exemplify a real-time application of the outputs. This study found that the methods employed would be highly suited for similar applications requiring real-time processing and delivery of climate data at high spatiotemporal resolutions across a considerably large land mass.

Effective data convergence, mapping, and pollution categorization of ghats at Ganga River Front in Varanasi

Rivers support life of Indian population but water pollution threatens human health. There is no consensus data for water quality (WQ) of rivers in India including River Ganga. For robust stakeholder participation and community involvement and governance, a consolidation of WQ parameters for River Ganga from different data sources is essentially needed. The priority to combat environmental, economic, and social dislocations due to river pollution also necessitates WQ data convergence, its availability in public domain for policy makers, citizens, researchers, etc, and mapping with respect to the flowing river. Lack of real-time data limits civic involvement in river management. This paper is a novel attempt to consolidate the WQ data available in literature for River Ganga at Varanasi during 1992-2016. Results indicate water of River Ganga to have high coliform and BOD levels due to direct discharge of sewage waste from Varuna and that from Varanasi city. Categorization of ghats based on WQ parameters reveal pollution status of ghats to vary from low to highly polluted (coliform data excluded as it changes the category of all the ghats to highly polluted). More urban population with lack of readiness of authorities to follow the law appear to be major contributors towards failure of river management strategies. The consolidated information mapped with demographic data can be used as data management tools for sustenance of River Ganga. A need for change in policy framework and publicizing the real-time data seem key solutions for improving water quality of River Ganga at Varanasi.

Does the multiple sclerosis (MS) map need to change again? An update of MS prevalence in Mazandaran province of Iran in 2018

BACKGROUND

Information of Previous studies on the prevalence of MS, including our study conducted 12 years ago, used to shape global prevalence map of MS. According to those results, Iran placed in medium-prevalence MS region in the world Atlas of MS 2013.This study aimed to investigate the prevalence of MS in Mazandaran province after 12 years and the need for possible changes in the global map of the prevalence of MS.

METHODS

We included all MS patients living in Mazandaran province in 2018 in this descriptive cross-sectional study. We updated our pre-existing registration questionnaires which included demographic information and medical data of MS patients by interview. We obtained the demographic profile of Mazandaran province from the most recent census in 2016 and the National Civil Registry of the Mazandaran province for calculating prevalence of MS.

RESULTS

The total number of MS patients in Mazandaran was 2418 (25.8% male and 74.2% female) with a female to male ratio of 2.9. Based on the local population of 3,332,556, (50.4% male and 49.6% female), this study showed a prevalence of 72.5 per 100,000 for MS in this region. The prevalence of this disease by gender was 37.1 per 100,000 for men and 108.5 per 100,000 for women. The mean (SD) age of the patients at the time of the study was 38.5 (10.1) years with a minimum of 15 and a maximum of 75 years. The most common type of MS was Relapsing-Remitting MS with 86%.

CONCLUSIONS

All recent studies showed significant upward trend in the prevalence of MS around the world. Based on the results of our study and many other studies in Iran, the Atlas of MS prevalence map needs to be update. Iran's status should be changed to the high-prevalence of MS in the new Atlas. Due to the increasing prevalence of MS, we suggest an adjustment in the Global MS Prevalence Scale.

Rapid Assessment of Opioid Exposure and Treatment in Cities Through Robotic Collection and Chemical Analysis of Wastewater

INTRODUCTION

Accurate data regarding opioid use, overdose, and treatment is important in guiding community efforts at combating the opioid epidemic. Wastewater-based epidemiology (WBE) is a potential method to quantify community-level trends of opioid exposure beyond overdose data, which is the basis of most existing response efforts. However, most WBE efforts collect parent opioid compounds (e.g., morphine) at wastewater treatment facilities, measuring opioid concentrations across large catchment zones which typically represent an entire municipality. We sought to deploy a robotic sampling device at targeted manholes within a city to semi-quantitatively detect opioid metabolites (e.g., morphine glucuronide) at a sub-city community resolution.

METHODS

We deployed a robotic wastewater sampling platform at ten residential manholes in an urban municipality in North Carolina, accounting for 44.5% of the total municipal population. Sampling devices comprised a robotic sampling arm with in situ solid phase extraction, and collected hourly samples over 24-hour periods. We used targeted mass spectrometry to detect the presence of a custom panel of opioids, naloxone, and buprenorphine.

RESULTS

Ten sampling sites were selected to be a representative survey of the entire municipality by integrating sewer network and demographic GIS data. All eleven metabolites targeted were detected during the program. The average morphine milligram equivalent (MME) across the nine illicit and prescription opioids, as excreted and detected in wastewater, was 49.1 (standard deviation of 31.9) MME/day/1000-people. Codeine was detected most frequently (detection rate of 100%), and buprenorphine was detected least frequently (12%). The presence of naloxone correlated with city data of known overdoses reversed by emergency medical services in the prehospital setting.

CONCLUSION

Wastewater-based epidemiology with smart sewer selection and robotic wastewater collection is feasible to detect the presence of specific opioids, naloxone, methadone, and buprenorphine within a city. These results suggest that wastewater epidemiology could be used to detect patterns of opioid exposure and may ultimately provide information for opioid use disorder (OUD) treatment and harm reduction programs.

Comparison of in-sight and handheld navigation devices toward supporting industry 4.0 supply chains: First and last mile deliveries at the human level

Last (and First) mile deliveries are an increasingly important and costly component of supply chains especially those that require transport within city centres. With reduction in anticipated manufacturing and delivery timescales, logistics personnel are expected to identify the correct location (accurately) and supply the goods in appropriate condition (safe delivery). Moving towards more environmentally sustainable supply chains, the last/first mile of deliveries may be completed by a cyclist courier which could result in significant reductions in congestion and emissions in cities. In addition, the last metres of an increasing number of deliveries are completed on foot i.e. as a pedestrian. Although research into new technologies to support enhanced navigation capabilities is ongoing, the focus to date has been on technical implementations with limited studies addressing how information is perceived and actioned by a human courier. In the research reported in this paper a comparison study has been conducted with 24 participants evaluating two examples of state-of-the-art navigation aids to support accurate (right time and place) and safe (right condition) navigation. Participants completed 4 navigation tasks, 2 whilst cycling and 2 whilst walking. The navigation devices under investigation were a handheld display presenting a map and instructions and an in-sight monocular display presenting text and arrow instructions. Navigation was conducted in a real-world environment in which eye movements and device interaction were recorded using Tobii-Pro 2 eye tracking glasses. The results indicate that the handheld device provided better support for accurate navigation (right time and place), with longer but less frequent gaze interactions and higher perceived usability. The in-sight display supported improved situation awareness with a greater number of hazards acknowledged. The benefits and drawbacks of each device and use of visual navigation support tools are discussed.

[Management of cancer patients with oral therapy at home in Brittany and Pays de la Loire areas: Survey (end of 2016) and cartography]

INTRODUCTION

The Cancer Observatory, from the OMEDITs (Observatory for Medicines and Medical Devices and Treatment Innovations) of Bretagne and Pays de la Loire areas has conducted a survey aiming to know and map the current practices of management of patients by Oral Anti-cancer Drug (OAD) in inter-region.

METHODS

Forty eight cancer centers received by e-mail in July and October 2016 a questionnaire concerning the management of OADs : from prescription by the specialist of oncology, to the intervention of the pharmacist (analysis and pharmaceutical consulting), to follow-up by nurse, as well as the financing of this activity and the feelings of the actors about this organizational set up.

RESULTS

Fifty-seven professionals from 31 centers, including the most important ones, responded to the survey. As a result, half of the establishments carry out a pharmaceutical analysis for some or all of the OAD prescriptions and only 30% carry out a pharmaceutical consulting. The nurse consultation is, on the other hand, more largely implanted (74% of the centers) as well as the telephone follow-up (6%). More than 90% of professionals believe that the organizational set up could be improved and more secure by, at least, the stronger involvement of pharmacists, the development of tools for nurse (for monitoring, therapeutic education…) and by improving the city-hospital link.

CONCLUSION

This survey shows the variability in the management of patients under OAD because of the lack of resources to ensure the fairness and sustainability of the organizational set up. The hospital/city link could still be optimized to secure patient care.

The FIRST large-scale mapping of radon concentration in soil gas and water in Romania

In the framework of the last Council Directive 2013/59 (Euratom, 2014) laying down basic safety standards for protection against the dangers arising from exposure to ionizing radiation, the problem of radon was assumed in Romania at national level by responsible authorities through the design and development of a National Radon Action Plan and an adequate legislation (HG nr. 526/2018). In order to identify radon risk areas, however, it is necessary to perform systematic radon measurements in different environmental media (soil gas, water, indoor air) and to map the results. This paper presents an atlas of up-to-date radon in soil and water levels for central and western part of Romania. The radon in soil map includes data from 2564 measurements carried out on-site, using Luk3C radon detector. The Luk-VR system was used to measure radon activity concentration from 2452 samples of drinking water. The average radon activity concentration was 29.3 kBq m^-3 for soil gas, respectively 9.8 Bq l^-1 for water dissolved air. Mapping of radon can be a useful tool to implement radon policies at both the national and local levels, defining priority areas for further study when land-use decisions must be made.

Effects of orientation change during environmental learning on age-related difference in spatial memory

It has been suggested that older adults suffer a greater degree of decline in environmental learning when navigating in an environment than when reading a map of the environment. However, the two types of spatial learning differ not only in perspectives (i.e., navigation is done with a ground-level perspective; a map is read from an aerial perspective) but also in orientations (i.e., orientations vary during navigation; spatial information is drawn from a single orientation in a map), making it unclear which factor critically affects older adults' spatial learning. The present study addressed this issue by having younger and older participants learn the layout of a large-scale environment through an aerial movie that contained changes in orientations from which the environment was depicted. Results showed that older participants' memories for the environmental layout were as distorted as those created through a ground-level movie (which involved the same orientation changes), whereas they formed more accurate memories through another aerial movie in which an orientation was fixed. By contrast, younger participants learned the environment equally well from the three movies. Taken together, these findings suggest that there is age-related alteration specifically in the ability to process multiple orientations of an environment while encoding its layout in memory. It is inferred that this alteration stems from functional deterioration of the medial temporal lobe, and possibly that of posterior cingulate areas as well (e.g., the retrosplenial cortex), in late adulthood.

Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso

BACKGROUND

In malaria endemic countries, asymptomatic cases constitute an important reservoir of infections sustaining transmission. Estimating the burden of the asymptomatic population and identifying areas with elevated risk is important for malaria control in Burkina Faso. This study analysed the spatial distribution of asymptomatic malaria infection among children under 5 in 24 health districts in Burkina Faso and identified the determinants of this distribution.

METHODS

The data used in this study were collected in a baseline survey on "evaluation of the impact of pay for performance on the quality of care" conducted in 24 health districts in Burkina Faso, between October 2013 and March 2014. This survey involved 7844 households and 1387 community health workers. A Bayesian hierarchical logistic model that included spatial dependence and covariates was implemented to identify the determinants of asymptomatic malaria infection. The posterior probability distribution of a parameter from the model was summarized using odds ratio (OR) and 95% credible interval (95% CI).

RESULTS

The overall prevalence of asymptomatic malaria infection in children under 5 years of age was estimated at 38.2%. However, significant variation was observed between districts ranging from 11.1% in the district of Barsalgho to 77.8% in the district of Gaoua. Older children (48-59 vs < 6 months: OR: 6.79 [5.62, 8.22]), children from very poor households (Richest vs poorest: OR: 0.85 [0.74-0.96]), households located more than 5 km from a health facility (< 5 km vs  ≥ 5 km: OR: 1.14 [1.04-1.25]), in localities with inadequate number of nurses (< 3 vs  ≥ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67 [1.39-2.01]) and those surveyed in high transmission period of asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk for asymptomatic malaria infection. In addition, the spatial analysis identified the following nine districts that reported significantly higher risks: Batié, Boromo, Dano, Diébougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The district of Zabré reported the lowest risk.

CONCLUSION

The analysis of spatial distribution of infectious reservoir allowed the identification of risk areas as well as the identification of individual and contextual factors. Such national spatial analysis should help to prioritize areas for increased malaria control activities.

Climate change vulnerability in a tropical region based on environmental and socio-economic factors

The understanding of the regional and local dimensions of vulnerability due to climate change is essential to develop appropriate and targeted adaptation efforts. We assessed the local dimensions of vulnerability in the tropical state of Kerala, India, using a purposely developed vulnerability index, which accounts for both environmental and socio-economic factors. The large extents of coastal wetlands and lagoons and high concentration of mangrove forests make the state environmentally vulnerable. Low human development index, large population of socially deprived groups, which are dependent on the primary sector, and high population density make the state vulnerable from a socio-economic point of view. The present study investigates climate change vulnerability at the district level in the State of Kerala relying on a purposely developed composite vulnerability index that encompasses both socio-economic and environmental factors. The Kerala coast contains the socio-economically and ecologically most vulnerable regions, as demonstrated by a composite vulnerability index.

Towards universal health coverage: a mixed-method study mapping the development of the faith-based non-profit sector in the Ghanaian health system

BACKGROUND

Faith-based non-profit (FBNP) providers have had a long-standing role as non-state, non-profit providers in the Ghanaian health system. They have historically been considered to be important in addressing the inequitable geographical distribution of health services and towards the achievement of universal health coverage (UHC), but in changing contexts, this contribution is being questioned. However, any assessment of contribution is hampered by the lack of basic information about their comparative presence and coverage in the Ghanaian health system. In response, since the 1950s, there have been repeated calls for the 'mapping' of faith-based health assets.

METHODS

A historically-focused mixed-methods study was conducted, collecting qualitative and quantitative data and combining geospatial mapping with varied documentary resources (secondary and primary, current and archival). Geospatial maps were developed, providing a visual representation of changes in the spatial footprint of the Ghanaian FBNP health sector.

RESULTS

The geospatial maps show that FBNPs were originally located in rural remote areas of the country but that this service footprint has evolved over time, in line with changing social, political and economic contexts.

CONCLUSION

FBNPs have had a long-standing role in the provision of health services and remain a valuable asset within national health systems in Ghana and sub-Saharan Africa more broadly. Collaboration between the public sector and such non-state providers, drawing on the comparative strengths and resources of FBNPs and focusing on whole system strengthening, is essential for the achievement of UHC.

Spatio-temporal mapping of Madagascar's Malaria Indicator Survey results to assess Plasmodium falciparum endemicity trends between 2011 and 2016

BACKGROUND

Reliable measures of disease burden over time are necessary to evaluate the impact of interventions and assess sub-national trends in the distribution of infection. Three Malaria Indicator Surveys (MISs) have been conducted in Madagascar since 2011. They provide a valuable resource to assess changes in burden that is complementary to the country's routine case reporting system.

METHODS

A Bayesian geostatistical spatio-temporal model was developed in an integrated nested Laplace approximation framework to map the prevalence of Plasmodium falciparum malaria infection among children from 6 to 59 months in age across Madagascar for 2011, 2013 and 2016 based on the MIS datasets. The model was informed by a suite of environmental and socio-demographic covariates known to influence infection prevalence. Spatio-temporal trends were quantified across the country.

RESULTS

Despite a relatively small decrease between 2013 and 2016, the prevalence of malaria infection has increased substantially in all areas of Madagascar since 2011. In 2011, almost half (42.3%) of the country's population lived in areas of very low malaria risk (<1% parasite prevalence), but by 2016, this had dropped to only 26.7% of the population. Meanwhile, the population in high transmission areas (prevalence >20%) increased from only 2.2% in 2011 to 9.2% in 2016. A comparison of the model-based estimates with the raw MIS results indicates there was an underestimation of the situation in 2016, since the raw figures likely associated with survey timings were delayed until after the peak transmission season.

CONCLUSIONS

Malaria remains an important health problem in Madagascar. The monthly and annual prevalence maps developed here provide a way to evaluate the magnitude of change over time, taking into account variability in survey input data. These methods can contribute to monitoring sub-national trends of malaria prevalence in Madagascar as the country aims for geographically progressive elimination.

Pollen and spore monitoring in the world

Background

Ambient air quality monitoring is a governmental duty that is widely carried out in order to detect non-biological ("chemical") components in ambient air, such as particles of < 10 µm (PM₁₀, PM_2.5), ozone, sulphur dioxide, and nitrogen oxides. These monitoring networks are publicly funded and air quality data are open to the public. The situation for biological particles that have detrimental effects on health, as is the case of pollen and fungal spores, is however very different. Most pollen and spore monitoring networks are not publicly funded and data are not freely available. The information regarding which biological particle is being monitored, where and by whom, is consequently often not known, even by aerobiologists themselves. This is a considerable problem, as local pollen data are an important tool for the prevention of allergic symptoms.

Objective

The aim of this study was to review pollen monitoring stations throughout the world and to create an interactive visualization of their distribution.

Methods

The method employed to collect information was based on: (a) a review of the recent and historical bibliography related to pollen and fungal spore monitoring, and (b) personal surveys of the managers of national and regional monitoring networks. The interactive application was developed using the R programming language.

Results

We have created an inventory of the active pollen and spore monitoring stations in the world. There are at least 879 active pollen monitoring stations in the world, most of which are in Europe (> 500). The prevalent monitoring method is based on the Hirst principle (> 600 stations). The inventory is visualised as an interactive and on-line map. It can be searched, its appearance can be adjusted to the users' needs and it is updated regularly, as new stations or changes to those that already exist can be submitted online.

Conclusions

The map shows the current situation of pollen and spore monitoring and facilitates collaboration among those individuals who are interested in pollen and spore counts. It might also help to improve the monitoring of biological particles up to the current level employed for non-biological components.

Map of biomedical research in Cameroon; a documentary review of approved protocols from 1997 to 2012

Background

Over the last decade, there has been a rapid increase in biomedical research in Cameroon. However, the question of whether these research projects target major health priorities, vulnerable populations and geographic locations at risk remains to be answered. The aim of this paper is to describe the state of biomedical research in Cameroon which is a key determinant that would guide future health care policies and promote equitable access to healthcare.

Methods

A documentary review of all approved protocols (proposals) of biomedical research projects, from 1997 through 2012, at the Cameroon National Ethics Committee. Protocols were reviewed systematically by independent reviewers and data were extracted on a grid. Data were analyzed by calculating proportions at 95% confidence interval, chi-square test (chi2) and p-values.

Results

Two thousand one hundred seventy two protocols were reviewed for data extraction. One thousand three hundred ninety-five (64.7%) were student projects, 369 (17.0%) projects had international sponsors, and 1528 (72.4%) were hospital-based studies. The most targeted domain was the fight against diseases 1323 (61.3%); mostly HIV 342 (25.8%) and Malaria 136 (10.3%). Over half of the studies were concentrated in the Centre region 1242 (57.2%), with the least projects conducted in the Northern region 15 (0.7%). There was strong evidence that international and local sponsors would influence the research site (p-value = 0.01) and population targets (p-value = 0.00).

Conclusion

Although biomedical research targets some important diseases that pose a great burden to Cameroonians, the most vulnerable populations are excluded from research. Biomedical research scarcely addresses other components of the health system and emerging diseases of vital public health importance. We recommend that the government should play a central role, between researchers from academic institutions, sponsors, NGOs and research institutions, to ensure that biomedical research addresses the health priorities of Cameroonians. It should include vulnerable populations, and address other components of the health system for a balance. These recommendations are critical to ensuring that future research informed health policies reflect the health needs of the populations and promote equity in healthcare access.

Electronic supplementary material

The online version of this article (10.1186/s12992-017-0312-y) contains supplementary material, which is available to authorized users.

Modeling a novel hypothetical use of postal collection boxes as automated external defibrillator access points

INTRODUCTION

Optimizing placement of Automated External Defibrillators (AED) can increase survival after an out-of-hospital cardiac arrest (OHCA). Using postal collection boxes (PCB) as locations for AEDs could potentially enhance accessibility and streamline maintenance. In this study, we modeled the hypothetical effects of deploying AEDs at PCB locations.

HYPOTHESIS

We hypothesized that PCB-AEDs would increase AED coverage overall and in residential areas, and reduce the distance from OHCA to an AED.

METHODS

AEDs in Pittsburgh, PA were identified by the University of Pittsburgh Resuscitation Logistics and Informatics Venture (n=747). PCB locations were obtained from the United States Postal Service (n=479). OHCA locations from 2009 to 2014 were obtained from the Pittsburgh site of the Resuscitation Outcomes Consortium. AED coverage assuming a ¼ mile radius around each AED was estimated for known AEDs, PCB-AEDs (hypothetical AED locations), and known AEDs augmented by PCB-AEDs, both overall and for residential and non-residential zones. Linear distance from each OHCA to the nearest AED was calculated and compared between the sets.

RESULTS

The set of known AEDs augmented with PCB-AEDs covered more of the city overall (55% vs 30%), as well as greater proportions of residential (62% vs 27%) and non-residential areas (45% vs 30%). The median distance from OHCA to AED was significantly shorter when known AEDs were augmented with PCB-AEDs (0.12mi vs 0.32mi; p=0.001).

CONCLUSION

Augmenting existing publicly accessible AEDs with AEDs deployed at PCBs can increase AED spatial coverage in both residential and non-residential areas, and reduce the distance from AED to OHCA.

Mapping patent classifications: portfolio and statistical analysis, and the comparison of strengths and weaknesses

The Cooperative Patent Classifications (CPC) recently developed cooperatively by the European and US Patent Offices provide a new basis for mapping patents and portfolio analysis. CPC replaces International Patent Classifications (IPC) of the World Intellectual Property Organization. In this study, we update our routines previously based on IPC for CPC and use the occasion for rethinking various parameter choices. The new maps are significantly different from the previous ones, although this may not always be obvious on visual inspection. We provide nested maps online and a routine for generating portfolio overlays on the maps; a new tool is provided for “difference maps” between patent portfolios of organizations or firms. This is illustrated by comparing the portfolios of patents granted to two competing firms—Novartis and MSD—in 2016. Furthermore, the data is organized for the purpose of statistical analysis.

Developing global maps of insecticide resistance risk to improve vector control

Background

Significant reductions in malaria transmission have been achieved over the last 15 years with elimination occurring in a small number of countries, however, increasing drug and insecticide resistance threatens these gains. Insecticide resistance has decreased the observed mortality to the most commonly used insecticide class, the pyrethroids, and the number of alternative classes approved for use in public health is limited. Disease prevention and elimination relies on operational control of Anopheles malaria vectors, which requires the deployment of effective insecticides. Resistance is a rapidly evolving phenomena and the resources and human capacity to continuously monitor vast numbers of mosquito populations in numerous locations simultaneously are not available.

Methods

Resistance data are obtained from published articles, by contacting authors and custodians of unpublished data sets. Where possible data is disaggregated to single sites and collection periods to give a fine spatial resolution.

Results

Currently the data set includes data from 1955 to October 2016 from 71 malaria endemic countries and 74 anopheline species. This includes data for all four classes of insecticides and associated resistance mechanisms.

Conclusions

Resistance is a rapidly evolving phenomena and the resources and human capacity to continuously monitor vast numbers of mosquito populations in numerous locations simultaneously are not available. The Malaria Atlas Project-Insecticide Resistance (MAP-IR) venture has been established to develop tools that will use available data to provide best estimates of the spatial distribution of insecticide resistance and help guide control programmes on this serious issue.

Electronic supplementary material

The online version of this article (doi:10.1186/s12936-017-1733-z) contains supplementary material, which is available to authorized users.

Quercus as case study

Mapping pollen concentrations is of great interest to study the health impact and ecological implications or for forestry or agronomical purposes. A deep knowledge about factors affecting airborne pollen is essential for predicting and understanding its dynamics. The present work sought to predict annual Quercus pollen over the Castilla and León region (Central and Northern Spain). Also to understand the relationship between airborne pollen and landscape. Records of Quercus and Quercus pyrenaica pollen types were collected at 13 monitoring sites over a period of 8years. They were analyzed together with land use data applying the Concentric Ring Method (CRM), a technique that we developed to study the relationship between airborne particle concentrations and emission sources in the region. The maximum correlation between the Quercus pollen and forms of vegetation was determined by shrubland and "dehesa" areas. For the specific Qi pyrenaica model (Q. pyrenaica pollen and Q. pyrenaica forest distribution), the maximum influence of emission sources on airborne pollen was observed at 14km from the pollen trap location with some positive correlations up to a distance of 43km. Apart from meteorological behavior, the local features of the region can explain pollen dispersion patterns. The method that we develop here proved to be a powerful tool for multi-source pollen mapping based on land use.

Expression and purification of a gene encoding a 9.7 kDa PE protein of Mycobacterium avium subsp. paratuberculosis

Mycobacterium avium subsp. paratuberculosis (Map) contains PE family antigens which are Proline and glutamic acid rich and may play important role as T-cell antigens. In the present study, the Map 1507 ORF encoding 9.7 kDa PE protein was amplified by polymerase chain reaction and cloned into E. coli vector pQE30 UA. The recombinant plasmid designated as pQ PE was transformed into E. coli M15 cells and induced with IPTG revealed the high level expression of 11.9 kDa His-fusion protein as estimated by migration in 15 % sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Recombinant PE protein was purified by Ni-NTA agarose chromatography. Polyclonal antibodies raised against purified recombinant PE protein reacted with expressed PE protein as well as with Map sonicate. The recombinant PE protein was also recognized by serum from goat with clinical paratuberculosis. The protein elicited significant delayed type hypersensitivity (DTH) skin reaction in mice sensitized with Map. The results indicated that the recombinant PE protein of Map was associated with T-cell response.

Construction of an integrative regulatory element and variation map of the murine Tst locus

BACKGROUND

Given the abundance of new genomic projects and gene annotations, researchers trying to pinpoint causal genetic variants are faced with a challenging task of how to efficiently integrate all current genomic information. The objective of the study was to develop an approach to integrate various genomic annotations for a recently positionally-cloned Tst gene (Thiosulfate Sulfur Transferase, synonym Rhodanese) responsible for the Fob3b2 QTL effect on leanness and improved metabolic parameters. The second aim was to identify and prioritize Tst genetic variants that may be causal for the phenotypic effects.

RESULTS

A bioinformatics approach was developed to integrate existing knowledge of regulatory elements of the Tst gene. The entire Tst locus along with flanking segments was sequenced between our unique polygenic mouse Fat and Lean strains that were generated by divergent selection on adiposity for over 60 generations. The bioinformatics-generated regulatory element map of the Tst locus was then combined with genetic variants between the Fat and Lean mice and with comparative analyses of polymorphisms across 17 mouse strains in order to prioritise likely causal polymorphisms. Two candidate regulatory variants were identified, one overlapping an evolutionary constrained Tst intronic element and the other residing in the seed region of a predicted 3'UTR miRNA binding site.

CONCLUSIONS

This study developed a map of regulatory elements for the Tst locus in mice and identified candidate genetic variants with increased causal likelihood. This map provides a basis for experimental validation and functional analyses of this novel candidate leanness and antidiabetic gene. Our methodological approach is of general utility for analyzing regulation of loci that have limited annotations and experimental evidence and for identifying candidate causal regulatory genetic variants in post-GWAS or post-QTL- cloning studies.

Surveillance of Drug Overdoses Using Google Fusion Tables

Introduction

Drug use is a constantly evolving public health challenge. We present the use of Google Fusion Tables and Google Maps for the surveillance of drug-related deaths and discuss its potential large-scale use.

Methods

Demographic and geographic data for deaths related to cocaine and heroin use occurring from 2012-2014 was queried from the Jefferson County Coroner/Medical Examiner's Office. Fusion Tables was then used to plot each address onto a map.

Results

We developed a method to automatically import data into Fusion Tables. Individualized icons were then used to denote specific demographics and locations on a Google Map where filters could be applied to visualize findings such as only 18-25 year old white males. These features provided an easy means to visualize the relative high frequency of heroin-related deaths in white males. Furthermore, the date filters highlighted heroin-related deaths more than doubled in 2014 compared to previous years.

Conclusions

Mapping of health-related data has a long-standing history in public health, though its use in the forensic pathology community is limited. Fusion Tables provides users with the ability to visualize and analyze patterns and share data. Many geocoding solutions exist; however, we found this software to be user friendly and flexible. Our office now includes these visualizations into the annual summary that is provided to local law enforcement, public health officials, and the general public.

Geography and social distribution of malaria in Indonesian Papua: a cross-sectional study

Background

Despite being one of the world’s most affected regions, only little is known about the social and spatial distributions of malaria in Indonesian Papua. Existing studies tend to be descriptive in nature; their inferences are prone to confounding and selection biases. At the same time, there remains limited malaria-cartographic activity in the region. Analysing a subset (N = 22,643) of the National Basic Health Research 2007 dataset (N = 987,205), this paper aims to quantify the district-specific risk of malaria in Papua and to understand how socio-demographic/economic factors measured at individual and district levels are associated with individual’s probability of contracting the disease.

Methods

We adopt a Bayesian hierarchical logistic regression model that accommodates not only the nesting of individuals within the island’s 27 administrative units but also the spatial autocorrelation among these locations. Both individual and contextual characteristics are included as predictors in the model; a normal conditional autoregressive prior and an exchangeable one are assigned to the random effects. Robustness is then assessed through sensitivity analyses using alternative hyperpriors.

Results

We find that rural Papuans as well as those who live in poor, densely forested, lowland districts are at a higher risk of infection than their counterparts. We also find age and gender differentials in malaria prevalence, if only to a small degree. Nine districts are estimated to have higher-than-expected malaria risks; the extent of spatial variation on the island remains notable even after accounting for socio-demographic/economic risk factors.

Conclusions

Although we show that malaria is geography-dependent in Indonesian Papua, it is also a disease of poverty. This means that malaria eradication requires not only biological (proximal) interventions but also social (distal) ones.

A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts

Introduction

Maps are powerful tools for visualization of differences in health indicators by geographical region, but multi-country maps of HIV indicators do not exist, perhaps due to lack of consistent data across countries. Our objective was to create maps of four HIV indicators in North, Central, and South American countries.

Methods

Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet), we mapped median CD4 at presentation for HIV clinical care, proportion retained in HIV primary care, proportion prescribed antiretroviral therapy (ART), and the proportion with suppressed plasma HIV viral load (VL) from 2010 to 2012 for North, Central, and South America. The 15 Canadian and US clinical cohorts and 7 clinical cohorts in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru represented approximately 2–7% of persons known to be living with HIV in these countries.

Results

Study populations were selected for each indicator: median CD4 at presentation for care was estimated among 14,811 adults; retention was estimated among 87,979 adults; ART use was estimated among 84,757 adults; and suppressed VL was estimated among 51,118 adults. Only three US states and the District of Columbia had a median CD4 at presentation >350 cells/mm³. Haiti, Mexico, and several states had >85% retention in care; lower (50–74%) retention in care was observed in the US West, South, and Mid-Atlantic, and in Argentina, Brazil, and Peru. ART use was highest (90%) in Mexico. The percentages of patients with suppressed VL in the US South and Northeast were lower than in most of Central and South America.

Conclusions

These maps provide visualization of gaps in the quality of HIV care and allow for comparison between and within countries as well as monitoring policy and programme goals within geographical boundaries.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

Introduction:

management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard.

Methods:

the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified.

Results:

the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers.

Conclusion:

the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

Methodology to design a municipal solid waste generation and composition map: a case study

The municipal solid waste (MSW) management is an important task that local governments as well as private companies must take into account to protect human health, the environment and to preserve natural resources. To design an adequate MSW management plan the first step consists in defining the waste generation and composition patterns of the town. As these patterns depend on several socio-economic factors it is advisable to organize them previously. Moreover, the waste generation and composition patterns may vary around the town and over the time. Generally, the data are not homogeneous around the city as the number of inhabitants is not constant nor it is the economic activity. Therefore, if all the information is showed in thematic maps, the final waste management decisions can be made more efficiently. The main aim of this paper is to present a structured methodology that allows local authorities or private companies who deal with MSW to design its own MSW management plan depending on the available data. According to these data, this paper proposes two ways of action: a direct way when detailed data are available and an indirect way when there is a lack of data and it is necessary to take into account bibliographic data. In any case, the amount of information needed is considerable. This paper combines the planning methodology with the Geographic Information Systems to present the final results in thematic maps that make easier to interpret them. The proposed methodology is a previous useful tool to organize the MSW collection routes including the selective collection. To verify the methodology it has been successfully applied to a Spanish town.

Methodology to design a municipal solid waste generation and composition map: a case study

The municipal solid waste (MSW) management is an important task that local governments as well as private companies must take into account to protect human health, the environment and to preserve natural resources. To design an adequate MSW management plan the first step consist in defining the waste generation and composition patterns of the town. As these patterns depend on several socio-economic factors it is advisable to organize them previously. Moreover, the waste generation and composition patterns may vary around the town and over the time. Generally, the data are not homogeneous around the city as the number of inhabitants is not constant nor it is the economic activity. Therefore, if all the information is showed in thematic maps, the final waste management decisions can be made more efficiently. The main aim of this paper is to present a structured methodology that allows local authorities or private companies who deal with MSW to design its own MSW management plan depending on the available data. According to these data, this paper proposes two ways of action: a direct way when detailed data are available and an indirect way when there is a lack of data and it is necessary to take into account bibliographic data. In any case, the amount of information needed is considerable. This paper combines the planning methodology with the Geographic Information Systems to present the final results in thematic maps that make easier to interpret them. The proposed methodology is a previous useful tool to organize the MSW collection routes including the selective collection. To verify the methodology it has been successfully applied to a Spanish town.

Non-tuberculous mycobacterial infections of veterinary relevance

Mycobacteria play an important role in human and animal health fields. We here examine the place of non tuberculous mycobacteria (NTM) infections in the veterinary context. Relevant aspects of a reference laboratory experience and a literature review are presented in this article. Importance is given both to productivity and to economic losses due to misdiagnosis with bovine tuberculosis and paratuberculosis. The impact NTM may have is relative to geographical location, ecology, husbandry, extent of surveillance programs and bovine tuberculosis and paratuberculosis prevalence. The role of the most relevant NTM in animal disease is summarized with a special focus on Mycobacterium avium subsp. paratuberculosis, given its role as causative agent of paratuberculosis, a disease with huge economic consequences for ruminant livestock.

Mapping tissue sodium concentration in the human brain: a comparison of MR sequences at 9.4Tesla

Sodium is the second most abundant MR-active nucleus in the human body and is of fundamental importance for the function of cells. Previous studies have shown that many pathophysiological conditions induce an increase of the average tissue sodium concentration. To date, several MR sequences have been used to measure sodium. The aim of this study was to evaluate the performance and suitability of five different MR sequences for quantitative sodium imaging on a whole-body 9.4Tesla MR scanner. Numerical simulations, phantom experiments and in vivo imaging on healthy subjects were carried out. The results demonstrate that, of these five sequences, the Twisted Projection Imaging sequence is optimal for quantitative sodium imaging, as it combines a number of features which are particularly relevant in order to obtain high quality quantitative images of sodium. These include: ultra-short echo times, efficient k-space sampling, and robustness against off-resonance effects. Mapping of sodium in the human brain is a technique not yet fully explored in neuroscience. Ultra-high field sodium MRI may provide new insights into the pathogenesis of neurological disorders, and may help to develop new and disease-specific biomarkers for the early diagnosis and therapeutic intervention before irreversible brain damage has taken place.

A novel low-cost method for Mycobacterium avium subsp. paratuberculosis DNA extraction from an automated broth culture system for real-time PCR analysis

PCR is a highly accurate technique for confirming the presence of Mycobacterium avium subsp. paratuberculosis (Map) in broth culture. In this study, a simple, efficient, and low-cost method of harvesting DNA from Map cultured in liquid medium was developed. The proposed protocol (Universidad Austral de Chile [UACH]) was evaluated by comparing its performance to that of two traditional techniques (a QIAamp DNA Stool Mini Kit and cethyltrimethylammonium bromide [CTAB] method). The results were statistically assessed by agreement analysis for which differences in the number of cycles to positive (CP) were compared by Student's t-test for paired samples and regression analysis. Twelve out of 104 fecal pools cultured were positive. The final PCR results for 11 samples analyzed with the QIAamp and UACH methods or ones examined with the QIAamp and CTAB methods were in agreement. Complete (100%) agreement was observed between data from the CTAB and UACH methods. CP values for the UACH and CTAB techniques were not significantly different, while the UACH method yielded significantly lower CP values compared to the QIAamp kit. The proposed extraction method combines reliability and efficiency with simplicity and lower cost.