bluuebunny/crossref_metadata_2025 huggingface dataset:
Natural Hazards Governance Practices and Key Natural Hazards in Latin America and the Caribbean
Authors: García Ivis
Published: December 2019

Along with sub-Saharan Africa and South Asia, Latin America and the Caribbean is among the geographic regions most exposed and vulnerable to the occurrence of disasters. The vulnerability is explained by geography and climate, but also by prevailing poverty and inequality. Year after year, multiple disasters such as landslides, hurricanes, floods, rains, droughts, storms, earthquakes, volcanic eruptions, and tsunamis, among others, threaten the region. Natural disasters reveal the deficiencies of infrastructure and essential services. In particular, they highlight the lack of an institutional framework for effective governance with clearly defined goals of how to prevent, respond to, and reconstruct after a natural catastrophe.

One of the priorities of governments in the region is to achieve resilience—that is, to strengthen the capacity to resist, adapt, and recover from the effects of natural disasters. To be able to accomplish this, governments need to prepare before a natural disaster strikes. Therefore, disaster risk management is critical. A fundamental element in the strategy of increasing resilience is good planning in general—that is, to reduce inequality, manage urbanization, and invest in necessary infrastructure such as energy, sewage, and water management. Because climate change increases the risk of disasters, it is generally understood that good governance practices can prevent further global warming. Governments might achieve this, for example, by investing in renewable energy and financing other environmentally friendly initiatives.

Unfortunately, most current governance models in Latin America and the Caribbean are characterized by bureaucratic structures that are fragmented into different sectors and whose actors do not have much interaction between them. With technical assistance from organizations, such as the World Bank and the United Nations, stakeholders in Latin America and the Caribbean are learning how to develop plans that encourage the collaboration of multiple sectors (e.g., transportation, housing) and improve the working relationships between various institutions (e.g. local associations, NGOs, private and public organizations). To be adequately prepared for a disaster, it is necessary to establish a network of actors that can engage quickly in decision-making and coordinate effectively between local, regional, and national levels.
Climate Change Adaptation in New Zealand
Authors: Schneider Paul , Glavovic Bruce
Published: December 2019

Coastal hazard risk is compounded by climate change. The promise and prospects of adaptation to escalating coastal hazard risk is fraught, even in a country like New Zealand that has laudable provisions for local authorities to be proactive in adapting to climate change. Continuing property development in some low-lying coastal areas is resulting in contestation and maladaptation. The resistance of some local authorities to do the inevitable and make long-term planning decisions in the face of amplifying risk can be linked to adaptation barriers. What can be done to overcome barriers and facilitate adaptation? Is transformation of the current mismatch between short-term planning and development aspirations, long-term societal goals, dynamic coastal processes and well-intended legislation and policy goals even possible? What can we learn from adaptation failures? In the face of compelling evidence and an enabling institutional framework, why is it that some coastal communities fail to prepare for the future? We shed light on such questions based on a long-term study of experience in New Zealand’s Coromandel Peninsula. We focus on the overarching question: Why is adaptation so challenging; and why are some coastal communities locked- into maladaptive pathways? We focus on the influence of a short-term decision-making focus of the problem of a low level of understanding and, following from this, the prioritization of protective works to combat erosion. Further, we draw attention to a major storm impact and the failure to turn this window of opportunity to a shift away from business as usual. Through the exploration of key stakeholder insights, the findings from the literature are reinforced and put into local context thus making the otherwise abstract barriers locally relevant. Matching and aligning adaptation theory with local reality can assist in advancing inquiry and policy practice to govern complex adaptation challenges.
Managed Retreat in Practice: Mechanisms and Challenges for Implementation
Authors: Hanna Christina , White Iain , Glavovic Bruce
Published: December 2019

Managed retreat is a deliberate strategy to remedy unsustainable land use patterns that expose people, ecosystems, and assets to significant natural (and socio-natural) hazard and climate induced risks. The term is all-encompassing, broadly capturing planned relocation in the fields of disaster risk reduction and climate change adaptation, as well as managed retreat or realignment in coastal management and environmental planning practice. Managed retreat helps to ensure that people and the resources they value are no longer exposed to extreme events and to the adverse impacts of slow-onset environmental change.

Distinct from migration and displacement, managed retreat is the strategically planned withdrawal from development in risky spaces. It can be applied at a range of spatial scales, in an anticipatory, staged, or reactive manner. Unlike traditional risk management alternatives, managed retreat affords space to natural processes and minimizes long-term maintenance and emergency management costs. While it has great promise as a sustainable disaster risk reduction and climate change adaptation strategy, there are a number of socio-political-cultural, environmental, economic, and institutional barriers affecting its implementation, particularly in contexts with extensive existing development. There may also be significant challenges in integrating relocated and receiving communities. In practice, people are deeply connected to, and reliant upon, the security, networks and cultural values of their lands, homes, communities, and livelihoods. To realize the long-term benefits, managed retreat needs to be considered as an integrated approach that uses information, regulation, and various financial levers in a strategic manner, and recognizes the need to work alongside communities in a fair, transparent, and inclusive way.
Adding Biodiversity to Agricultural Landscapes Through Ecology and Biotechnology
Authors: Still David
Published: December 2019

Agriculture is practiced on 38% of the landmass on Earth, and having replaced natural ecosystems, it is the largest terrestrial biome on Earth. Agricultural biomes are typically focused on annual crops that are produced as a succession of genetically uniform monocultures. Compared to the ecosystems they replaced, agroecosystems provide fewer ecosystem functions and contain much less biodiversity. The large-scale conversion from natural lands to agriculture occurred centuries ago in the Old World (Africa, China, Europe, and India), but in many areas during the latter 20th and early 21st centuries, especially tropical areas with rich biodiversity, agriculture is an emerging industry. Here, displacement of natural ecosystems is also a late 20th-century occurrence, and much of it is ongoing. Regardless of where or when agriculture was established, biodiversity declined and ecosystem services were eroded.

Agricultural practices are the second largest contributor to biodiversity loss, due to the loss of habitat, competition for resources, and pesticide use. Most (~96%) of the land used to produce crops is farmed using conventional methods, while smaller percentages are under organic production (~2%) or are producing biotech crops (~4%). Regardless of how agriculture is practiced, it exacts a toll on biodiversity and ecosystem services. While organic agriculture embraces many ecological principals in producing food, it fails to recognize the value of biotechnology as a tool to reduce the environmental impact of agriculture. Herbicide- and/or insect-resistant crops are the most widely planted biotech crops worldwide. Biotech crops in general, but especially insect-resistant crops, reduce pesticide use and increase biodiversity. The widespread adoption of glyphosate-resistant crops increased the use of this herbicide, and resistance evolved in weeds. On the other hand, glyphosate has less environmental impacts than other herbicides. Because of the limited scale of biotech production, it will not have large impacts on mitigating the effects of agriculture on biodiversity and ecosystem services. To have any hope of reducing the environmental impact of agriculture, agro-ecology principals and biotechnology will need to be incorporated. Monetizing biodiversity and ecosystem services through incorporation into commodity prices will incentivize producers to be part of the biodiversity solution. A multi-level biodiversity certification is proposed that is a composite score of the biodiversity and ecosystem services of an individual farm and the growing region were the food is produced. Such a system would add value to the products from farms and ranches proportionate to the level by which their farm and region provides biodiversity and ecosystem services as the natural ecosystem it replaced.
Industrial Fertilizers in Agriculture
Authors: Willoughby Gregory L.
Published: December 2019

Agriculture has been said to be the key to civilization development. The longevity of the production of the soils which sustained the population development influenced, in fact caused, the rise and often the collapse of those ancient cultures. Furthermore, the fertilization of those soils, if by new sediment or by other means, enabled some civilizations to survive longer than others. It was only with the development of more consistent fertilization and newer, higher-analysis materials that crop production entered an era where it could reliably feed beyond the family unit but feed the city, and then the whole country. This modern industrial fertilization required fewer people to be devoted to food production so that their efforts could be directed to more secondary and tertiary careers. The growth of the use of fertilizer by over 200% in 40 years has led to an increased scrutiny of its environmental aspect in the early 21st century, and this has led to a revaluation of application procedures and to an increase in research and development of new forms of fertilizer and into ways to change modern fertilizers’ environmental footprints to better steward food production and remedy systems that are off target environmentally. These technologies are sometimes very basic, such as including combinations of elements which help stabilize each other (e.g. sulfur and nitrogen or phosphorus and sulfur). Other technologies include polymer-coating (e.g. slow-release coatings) and impregnatable coatings (e.g. nitrapyrin, NBPT). In other cases, new materials have been developed (e.g. methylated urea) and in yet others progress has come from a mixing of other compounds with the fertilizer (e.g. gypsum to phosphorus fertilizer, or humic acids to nitrogen formulations). Lastly, there has been a rise in the importance of micronutrients as production has increased (e.g. zinc, manganese, and boron) especially as yield levels have increased.
Challenges to Environmental Valuation of Water in Light of Global Change
Authors: Adamowicz Vic , Dupont Diane
Published: December 2019

A number of challenges are faced by practitioners seeking to elicit values associated with water in a world of global change. These values are needed to assist in decision-making around the use of water as a country’s key asset. Five different pathways show the complexity of the relationship between global change and environmental valuation of water: a climate change pathway, ecosystem infrastructure pathway, population/demographics pathway, income pathway, and technological change/innovation pathway. The challenges are most acute for water when it is related to ecosystem services since values need to be elicited through the use of non-market survey-based valuation techniques. In addition, environmental valuation will be important to inform the determination of water quality standards associated with different uses of water (drinking, recreation, etc.) and the allocation of resources to provide these different services. Several case studies illustrate issues and solutions. The article concludes with an appreciation of future challenges and opportunities.
The Mirage of Supply-side Development: The Hydraulic Mission and the Politics of Agriculture and Water in the Nile Basin
Authors: Verhoueven Harry
Published: December 2019

In an era of calamitous climate change, entrenched malnutrition, and the chronic exclusion of hundreds of millions of people from access to affordable energy, food, and water, evaluating the policy options of African states to address these challenges matters more than ever. In the Nile Basin especially, a region notorious for its poverty, violent instability and lack of industrialisation, states have invested their scarce resources and political capital in a “hydraulic mission” in the belief that they can engineer their way out of international marginalization. Incumbents have bet on large-scale hydro-infrastructure and capital-intensive agriculture to boost food production, strengthen energy security, and deal with water scarcity, despite the woeful track-record of such a supply-side approach to development.

While ruling elites in the Nile Basin have portrayed the hydraulic mission as the natural way of developing the region’s resources—supposedly validated by the historical achievements of Pharaonic civilization and its mastery over its tough environment—this is a modern fiction, spun to justify politically expedient projects and the exclusion of broad layers of the population. In the last two hundred years, the hydraulic mission has made three major political contributions that underline its strategic usefulness to centralizing elites: it has enabled the building of modern states and a growing bureaucratic apparatus around a riverain political economy; it has generated new national narratives that have allowed unpopular regimes to rebrand themselves as protectors of the nation; and it has facilitated the forging of external alliances, linking the resources and elites of Egypt, Ethiopia, and Sudan to global markets and centers of influence. Mega-dams, huge canals and irrigation for export are fundamentally about power and the powerful—and the privileging of some interests and social formations over others. The one-sided focus on increasing supply—based on the false premise that this will allow ordinary people to access more food and water—transfers control over livelihoods from one (broad) group of people to (a much narrower) other one by legitimizing top-down interventionism and dislocation. What presents itself as a strategy of water resources and agricultural development is really about (re)constructing hierarchies between people. The mirage of supply-side development continues to seduce elites at the helm of the state because it keeps them in power and others out of it.
Bisphenol compounds regulate decidualized stromal cells in modulating trophoblastic spheroid outgrowth and invasion in vitro†
Authors: Fan Hongjie , Jiang Luhan , Lee Yin-Lau , Wong Chris K C , Ng Ernest H Y , Yeung William S B , Lee Kai-Fai
Published: December 2019

Bisphenol A (BPA) is commonly found in epoxy resins used in the manufacture of plastic coatings in food packaging and beverage cans. There is a growing concern about BPA as a weak estrogenic compound that can affect human endocrine function. Chemicals structurally similar to BPA, such as bisphenol F (BPF) and bisphenol S (BPS), have been developed as substitutes in the manufacturing industry. Whether these bisphenol substitutes have adverse effects on human endocrine and reproductive systems remains largely unknown. This study investigated the effects of BPA, BPF, and BPS on regulating the function of decidualized human primary endometrial stromal cells on trophoblast outgrowth and invasion by indirect and direct co-culture models. All three bisphenols did not affect the stromal cell decidualization process. However, BPA- and BPF-treated decidualized stromal cells stimulated trophoblastic spheroid invasion in the indirect coculture model. The BPA-treated decidualized stromal cells had upregulated expressions of several invasion-related molecules including leukemia inhibitory factor (LIF), whereas both BPA- and BPF-treated decidualized stromal cells had downregulated expressions of anti-invasion molecules including plasminogen activator inhibitor type 1 (PAI-1) and tumor necrosis factor (TNFα) . Taken together, BPA and BPF altered the expression of invasive and anti-invasive molecules in decidualized stromal cells modulating its function on trophoblast outgrowth and invasion, which could affect the implantation process and subsequent pregnancy outcome.
Reproductive success of the threatened San Clemente Bell’s Sparrow (Artemisiospiza belli clementeae) in recovering habitats is similar to success in historical habitat
Authors: Meiman Susan T , DeLeon Emma E , Bridges Andrew S
Published: December 2019

The San Clemente Bell’s Sparrow (Artemisiospiza belli clementeae) is a federally threatened subspecies endemic to San Clemente Island, California. Previous research suggested dependence on boxthorn (Lycium californicum) as breeding habitat and nesting substrate; however, this conclusion was based on data collected when introduced feral ungulates had severely degraded the soil and vegetation cover. Since removal of the ungulates, native vegetation has gradually increased and the San Clemente Bell’s Sparrows have expanded into areas where habitat had been unsuitable. To explore how Bell’s Sparrows use these areas, we examined reproductive metrics associated with habitat covariates gathered at 214 nest sites used by Bell’s Sparrows from 2014 to 2016. We found that nest success in boxthorn habitat, previously considered an essential habitat for Bell’s Sparrow nesting, was similar to success in alternative habitat types. Our findings contradict previous conclusions that Bell’s Sparrows were boxthorn-dependent. We believe this previously documented relationship was likely due to the lack of available alternative nesting habitat following years of feral ungulate degradation, and Bell’s Sparrows now reproduce in multiple habitat types and throughout most of San Clemente Island. Furthermore, our findings illustrate the importance of long-term monitoring and corresponding adaptive management when monitoring species in changing and recovering landscapes.
P191 MINIMALLY-INVASIVE ESOPHAGECTOMY IN TREATMENT FOR ESOPHAGEAL DISEASES
Authors: Oleksandr Usenko , Andriy Sydiuk , Olena Sydiuk , Georgiy Savenko , Andriy Klimas
Published: December 2019

Aim

to study the benefits of the mini-invasive approach.

Background & Methods

115 esophagectomies were performed for the period from 2015 to 2018. Gastric conduit in 84 patients, colon - 2 and small intestine - 29. The study included 65 patients after I.Lewis, McKeown or transhiatal esophagectomy, who was performed esophageal replacement with gastric conduit. The first group consisted of 44 patients after open esophagectomy; second group - 21 patients after MIE (minimally invasive esophagectomy): included 8 patients - thoraco-laparoscopic McKeown surgery, 1 patient - laparoscopic transhiatal esophagectomy with anastomosis on the neck, 9 patients – hybrid minimally invasive I.Lewis surgery (laparoscopy+thoracotomy), and 3 patients – minimally invasive thoraco-laparoscopic I.Lewis surgery. The average age of patients was 53 years (13-64). 55 patients (84.6%) with esophageal cancer and 10 patients (15.4%) with benign strictures of the esophagus. There were anastomosis on the neck in 28 patients (43%) and intrathoracic anastomosis in 37 patients (57%).

Results

In the first group the average operative time was 286 minutes (240-370 min.), the average volume of blood loss was 345 ml (100-600 ml), the length of in-hospital stay was 15 days (9-29), complications: anastomosis leakage - 1 patient on the 5th postoperative day - EndoVAC system was used with a defect closure after 18 days; 1 patient - adhesive intestinal obstruction (relaparotomy, separation of adhesions). In the second group the average operative time was 400 min (370-480 min.), blood loss - 100 ml (50-200 ml), the length of in-hospital stay - 10 days (8-16), complications in 1 patient - acute strangulation with intestinal obstruction. There was no mortality in both groups.

Conclusions

The application of MIE helps to reduce the severity of postoperative pain, the length of in-hospital stay and intraoperative blood loss. This procedure should be performed in specialized hospitals with experience in miniinvasive surgery and esophageal surgery.
Natural Enemy Community Composition and Impact on Brown Marmorated Stink Bug (Hemiptera: Pentatomidae) Eggs in Minnesota Apple Orchards
Authors: Shanovich Hailey N , Aukema Brian H , Koch Robert L
Published: December 2019

Halyomorpha halys is an invasive, polyphagous insect that feeds on many major crops, including apple. Statewide monitoring in Minnesota has shown continued increase of H. halys populations and occurrence of this pest in apple orchards. Potential arthropod natural enemies of H. halys and other pests have not been studied in Minnesota apple orchards. The purpose of this study was to characterize the composition of natural enemy communities; compare their abundances, richness and diversities between apple cultivars using different sampling methods; and assess the impact of natural enemies on sentinel eggs of H. halys in Minnesota apple orchards. Sampling occurred during the summers of 2017 and 2018 on Zestar! and Honeycrisp cultivars in four different apple orchards. In vacuum samples, arachnids, neuropterans, and coccinellids had the highest relative abundances. On yellow sticky traps, anthocorids were the most abundant. The total predator abundance differed between the cultivars sampled across years, with more predators found on Zestar! compared with Honeycrisp. No differences were observed in richness or diversity between cultivars with the exception of yellow sticky traps in 2017, which showed a greater diversity of predators in Zestar!. Despite the abundance of natural enemies sampled, sentinel egg masses deployed in the orchards each summer suffered on average <2% predation and no parasitism across years. Knowledge of differences in predator abundance between cultivars could inform management decisions; however, with current management practices, the potential for biological control of H. halys in conventional apple orchards appears low.
2019 environment, epigenetics and reproduction
Authors: Skinner Michael K
Published: December 2019

A conference summary of the fourth 2018 biannual Kenya Africa Conference ‘Environment, Epigenetics and Reproduction’ is provided. A special Environmental Epigenetics issue containing a number of papers in Volume 5, Issue 3 and 4 are discussed.
Drug therapy in elderly heart failure patients
Authors: Jankowska Ewa A , Vitale Cristiana , Uchmanowicz Izabella , Tkaczyszyn Michał , Drozd Marcin , Ponikowski Piotr
Published: December 2019

Although heart failure (HF) is considered as a cardiogeriatric syndrome, elderly and very elderly patients are under-represented in the vast majority of clinical trials investigating novel drugs and therapies in this population. The homoeostatic systems of elderly subjects are very fragile, and the management of HF accompanied by numerous comorbidities requires a holistic approach towards the patient, with special emphasis not only on psychosomatic problems but also on the individual (including social) needs of each particular patient, along with the support for the family and/or caregivers. In this article, we summarize current evidence regarding pharmacotherapy of elderly patients with HF and summarize the clinical problems occurring in this population.
Workshop: Real-world data: are we ready to take up the challenge?
Authors:   Organised by: EUPHA (HTA), EUPHA (EPI) Chair persons: Chiara de Waure - EUPHA (HTA), Stefania Boccia - Italy
Published: December 2019

Evidence provided by traditional clinical research often fails to answer patients’, physicians’ and healthcare decision-makers’ questions about real-world practice and outcomes; in fact, real-world effectiveness may considerably differ from efficacy assessed in clinical trial settings. The rise of interest in real-world data (RWD) - data routinely collected outside a controlled research environment - is driven by the increasing need for evidence in specific populations, such as comorbid or multi-treated people. RWD can also allow investigation of unanticipated, uncommon or long-term outcomes. In addition, RWD may represent the only source of information in some fields of special interest, e.g. rare diseases. Furthermore, current conditional reimbursement systems of drugs require dynamic evaluations of cost-effectiveness that have necessarily to take RWD into account. Indeed, RWD play a relevant role also in Health Technology Assessment (HTA) projects that should release the most up-to-date evidence and should be updated once new data are available. Nonetheless, common concerns about evidence derived from RWD include uncertainty about data quality, high possibility of bias, difficulties in managing a vast amount of data coming from different sources as well as legal and privacy requirements, in particular in the light of the new General Data Protection Regulation. However, HTA cannot exempt using RWD as it is entrusted to assess short- and long-term consequences of the application of health technologies, in terms of both health outcomes and costs. This workshop is an opportunity to discuss current and future challenges in the use of RWD in HTA and concerns preventing researchers from exploiting RWD full potential.

Key messages

Real-world evidence and randomized control trial data are considered mutually complementary in generating evidence and supporting decision-making. Real-world data have proved to be crucial as instrument to gather data in HTA and to support decision-making.
Near-Random Distribution of Chromosome-Derived Circular DNA in the Condensed Genome of Pigeons and the Larger, More Repeat-Rich Human Genome
Authors: Møller Henrik Devitt , Ramos-Madrigal Jazmín , Prada-Luengo Iñigo , Gilbert M Thomas P , Regenberg Birgitte
Published: December 2019

Extrachromosomal circular DNA (eccDNA) elements of chromosomal origin are known to be common in a number of eukaryotic species. However, it remains to be addressed whether genomic features such as genome size, the load of repetitive elements within a genome, and/or animal physiology affect the number of eccDNAs. Here, we investigate the distribution and numbers of eccDNAs in a condensed and less repeat-rich genome compared with the human genome, using Columba livia domestica (domestic rock pigeon) as a model organism. By sequencing eccDNA in blood and breast muscle from three pigeon breeds at various ages and with different flight behavior, we characterize 30,000 unique eccDNAs. We identify genomic regions that are likely hotspots for DNA circularization in breast muscle, including genes involved in muscle development. We find that although eccDNA counts do not correlate with the biological age in pigeons, the number of unique eccDNAs in a nonflying breed (king pigeons) is significantly higher (9-fold) than homing pigeons. Furthermore, a comparison between eccDNA from skeletal muscle in pigeons and humans reveals ∼9-10 times more unique eccDNAs per human nucleus. The fraction of eccDNA sequences, derived from repetitive elements, exist in proportions to genome content, that is, human 72.4% (expected 52.5%) and pigeon 8.7% (expected 5.5%).

Overall, our results support that eccDNAs are common in pigeons, that the amount of unique eccDNA types per nucleus can differ between species as well as subspecies, and suggest that eccDNAs from repeats are found in proportions relative to the content of repetitive elements in a genome.
Mapping the Memory of Luther: Place and Confessional Identity in the Later Reformation*
Authors: Hill Kat
Published: December 2019

In 1571 mapmakers Johannes Mellinger and Tilemann Stella produced a map of the county of Mansfeld, Luther’s birthplace. This article considers this map as a complex printed material object: it is far more than a straightforward representation of place as it is covered with historical details, quotations, writing and references to Luther’s life, the Reformation and Mansfeld’s history. It created a notion of Lutheran space and used this space as a form of memory-making and memorialization at a critical time in Lutheran history. The decades following the death of Luther, in 1546, were a time of crisis, when Lutheranism grieved the loss of the Wittenberg reformer while also inscribing its presence on the confessional map of sixteenth-century Europe. Mellinger and Stella’s map of Mansfeld reveals how second-generation Lutherans reconceptualized the landscape to provide an alternative way of writing Luther’s life, and how Lutherans could integrate pasts and places which were not specifically Lutheran into a providential narrative. The map addressed the tensions of tradition and novelty with its composite, hybrid form that combined space, events and person, and it historicized and reimagined space. This map demands that we think about how space functioned within a culture which wanted to remember Luther’s life and write histories in a way that could validate Lutheranism and its future, and in particular it focuses our attention on how memory-making at this specific point of existential concern shaped the Lutheran Church.
TEACHING MOTIVATIONAL INTERVIEWING OF OLDER ADULTS IN AN INTERPROFESSIONAL EDUCATION SETTING: A PILOT STUDY
Authors: Tamashunas Nina L , Smilovich-Fine Elizabeth
Published: December 2019

Motivational interviewing (MI), a person-centered method of strengthening personal motivation for change, improves health behaviors (i.e. blood pressure control) in older adults. However, literature lacks exploration of teaching MI in interprofessional and geriatric settings. We sought to pilot and assess the utility of an MI curriculum for an interprofessional group of second-year graduate students (medical, physician assistant, nursing, and speech pathology) working with older adults. The 5-week curriculum included a 2-hour interactive workshop, a geriatric standardized patient (SP), and small group meetings with a geriatric community member. We employed a pretest/posttest design to assess perceived importance and confidence using a 5-point Likert scale and knowledge acquisition using a modified version of the Motivational Interviewing Knowledge and Attitudes Test. Feedback from students on curricular design was obtained via a post-curriculum survey. Of the 17 students enrolled, 100% (17/17) completed the pretest and posttest and 94% (16/17) completed the post-curriculum survey. Previous MI training ranged from 0 to 12 hours. Students felt more confident in their MI skills (p<0.05) after the curriculum. Aggregate knowledge scores did not achieve statistical significance. Feedback indicated that students enjoyed practicing with SPs and processing feedback and would have preferred more student diversity and a more advanced curriculum. While limited by sample size, this pilot demonstrated that a brief geriatric-specific curriculum was well received and improved student confidence in MI skills. Larger studies should explore tailoring teaching methods of MI knowledge and skills in a diverse learner population working with older adults to promote health behavior change.
CHOICE MODERATES RELATIONSHIPS BETWEEN LEVEL AND DURATION OF CARE AND THE HEALTH IMPACT OF CARING FOR AN OLDER PARENT
Authors: Tarter Robin , Hassouneh Dena , Lindauer Allison , Dieckmann Nathan
Published: December 2019

The perception of choice in the caregiving role has emerged as a key theme in qualitative gerontological caregiving research but few studies have examined choice quantitatively. The aim of our study was to test whether perceived choice moderated the relation between level and duration of care and the health impact of caring for a parent over the age of 65. We tested these questions in a series of structural equation models using existing data from the National Alliance for Caregiving, Caregiving in the U.S. 2015 Survey. We found that for adult-child caregivers of parents who reported a lack of choice in taking on the caregiving role, greater responsibilities for assistance with activities of daily living (ADLs) (p<0.01) and instrumental ADLS (p<0.01), and greater time providing care (p<0.05) predicted the negative impact of caregiving on caregiver health. The number of ADLs performed also predicted the emotional stress of caregiving for parents (p<0.01). Conversely, for caregivers who reported that they did have a choice in taking on the caregiving role, level and duration of care were not significantly related to the impact of caregiving on caregiver health, or the emotional stress of caregiving. Women were significantly more likely to report a lack of choice than men (p<0.05). Additional research is needed to explore the meaning of choice, and the ways in which choice may be especially constrained for daughters who care for older adults, in order to develop interventions to ameliorate the potentially deleterious health effects of caregiving on adult-children.
Dynamic, Helminth-Induced Immune Modulation Influences the Outcome of Acute and Chronic Hepatitis B Virus Infection
Authors: Loffredo-Verde Eva , Bhattacharjee Sonakshi , Malo Antje , Festag Julia , Kosinska Anna D , Ringelhan Marc , Rim Sarkar Sabrina , Steiger Katja , Heikenwaelder Mathias , Protzer Ulrike , Prazeres da Costa Clarissa U
Published: December 2019

Background

Chronic hepatitis B develops more frequently in countries with high prevalence of helminth infections. The crosstalk between these 2 major liver-residing pathogens, Schistosoma mansoni and hepatitis B virus (HBV), is barely understood.

Methods

We used state-of-the-art models for both acute and chronic HBV infection to study the pathogen-crosstalk during the different immune phases of schistosome infection.

Results

Although liver pathology caused by schistosome infection was not affected by either acute or chronic HBV infection, S mansoni infection influenced HBV infection outcomes in a phase-dependent manner. Interferon (IFN)-γ secreting, HBV- and schistosome-specific CD8 T cells acted in synergy to reduce HBV-induced pathology during the TH1 phase and chronic phase of schistosomiasis. Consequently, HBV was completely rescued in IFN-γ-deficient or in TH2 phase coinfected mice demonstrating the key role of this cytokine. It is interesting to note that secondary helminth infection on the basis of persistent (chronic) HBV infection increased HBV-specific T-cell frequency and resulted in suppression of virus replication but failed to fully restore T-cell function and eliminate HBV.

Conclusions

Thus, schistosome-induced IFN-γ had a prominent antiviral effect that outcompeted immunosuppressive effects of TH2 cytokines, whereas HBV coinfection did not alter schistosome pathogenicity.
Epidemiology and Clinical Outcomes of Hospitalizations for Acute Respiratory or Febrile Illness and Laboratory-Confirmed Influenza Among Pregnant Women During Six Influenza Seasons, 2010–2016
Authors: Dawood Fatimah S , Garg Shikha , Fink Rebecca V , Russell Margaret L , Regan Annette K , Katz Mark A , Booth Stephanie , Chung Hannah , Klein Nicola P , Kwong Jeffrey C , Levy Avram , Naleway Allison , Riesel Dan , Thompson Mark G , Wyant Brandy E , Fell Deshayne B
Published: December 2019

Background

Pregnant women are at increased risk of seasonal influenza hospitalizations, but data about the epidemiology of severe influenza among pregnant women remain largely limited to pandemics.

Methods

To describe the epidemiology of hospitalizations for acute respiratory infection or febrile illness (ARFI) and influenza-associated ARFI among pregnant women, administrative and electronic health record data were analyzed from retrospective cohorts of pregnant women hospitalized with ARFI who had testing for influenza viruses by reverse-transcription polymerase chain reaction (RT-PCR) in Australia, Canada, Israel, and the United States during 2010–2016.

Results

Of 18 048 ARFI-coded hospitalizations, 1064 (6%) included RT-PCR testing for influenza viruses, 614 (58%) of which were influenza positive. Of 614 influenza-positive ARFI hospitalizations, 35% were in women with low socioeconomic status, 20% with underlying conditions, and 67% in their third trimesters. The median length of influenza-positive hospitalizations was 2 days (interquartile range, 1–4), 18% (95% confidence interval [CI], 15%–21%) resulted in delivery, 10% (95% CI, 8%–12%) included a pneumonia diagnosis, 5% (95% CI, 3%–6%) required intensive care, 2% (95% CI, 1%–3%) included a sepsis diagnosis, and <1% (95% CI, 0%–1%) resulted in respiratory failure.

Conclusions

Our findings characterize seasonal influenza hospitalizations among pregnant women and can inform assessments of the public health and economic impact of seasonal influenza on pregnant women.
Plasmodium falciparum Gametocyte Density and Infectivity in Peripheral Blood and Skin Tissue of Naturally Infected Parasite Carriers in Burkina Faso
Authors: Meibalan Elamaran , Barry Aissata , Gibbins Matthew P , Awandu Shehu , Meerstein-Kessel Lisette , Achcar Fiona , Bopp Selina , Moxon Christopher , Diarra Amidou , Debe Siaka , Ouédraogo Nicolas , Barry-Some Ines , Badoum Emilie S , Fagnima Traoré , Lanke Kjerstin , Gonçalves Bronner P , Bradley John , Wirth Dyann , Drakeley Chris , Guelbeogo Wamdaogo Moussa , Tiono Alfred B , Marti Matthias , Bousema Teun
Published: December 2019

Background

Plasmodium falciparum transmission depends on mature gametocytes that can be ingested by mosquitoes taking a blood meal on human skin. Although gametocyte skin sequestration has long been hypothesized as important contributor to efficient malaria transmission, this has never been formally tested.

Methods

In naturally infected gametocyte carriers from Burkina Faso, we assessed infectivity to mosquitoes by direct skin feeding and membrane feeding. We directly quantified male and female gametocytes and asexual parasites in finger-prick and venous blood samples, skin biopsy samples, and in of mosquitoes that fed on venous blood or directly on skin. Gametocytes were visualized in skin tissue with confocal microscopy.

Results

Although more mosquitoes became infected when feeding directly on skin then when feeding on venous blood (odds ratio, 2.01; 95% confidence interval, 1.21–3.33; P = .007), concentrations of gametocytes were not higher in the subdermal skin vasculature than in other blood compartments; only sparse gametocytes were observed in skin tissue.

Discussion

Our data strongly suggest that there is no significant skin sequestration of P. falciparum gametocytes. Gametocyte densities in peripheral blood are thus informative for predicting onward transmission potential to mosquitoes and can be used to target and monitor malaria elimination initiatives.
Correlates of Nonrandom Patterns of Serotype Switching in Pneumococcus
Authors: Joshi Shreyas S , Al-Mamun Mohammad A , Weinberger Daniel M
Published: December 2019

Background

Pneumococcus is a diverse pathogen, with >90 serotypes, each of which has a distinct polysaccharide capsule. Pneumococci can switch capsules, evading vaccine pressure. Certain serotype pairs are more likely to occur on the same genetic background as a results of serotype switching, but the drivers of these patterns are not well understood.

Methods

We used the PubMLST and Global Pneumococcal Sequencing Project databases to quantify the number of genetic lineages on which different serotype pairs occur together. We also quantified the genetic diversity of each serotype. Regression model were used to evaluate the relationship between shared polysaccharide components and the frequency of serotype co-occurrence and diversity.

Results

A number of serotype pairs occurred together on the same genetic lineage more commonly than expected. Co-occurrence of between-serogroup pairs was more common when both serotypes had glucose as a component of the capsule (and, potentially, glucuronic acid, any-N-acetylated sugar, or ribitol). Diversity also varied markedly by serotype and was associated with the presence of specific sugars in the capsule.

Conclusions

Certain pairs of serotypes are more likely to co-occur on the same genetic background. These patterns were correlated with shared polysaccharide components. This might reflect adaptation of strains to produce capsules with specific characteristics.
Chronic Disseminated Candidiasis During Hematological Malignancies: An Immune Reconstitution Inflammatory Syndrome With Expansion of Pathogen-Specific T Helper Type 1 Cells
Authors: Candon Sophie , Rammaert Blandine , Foray Anne Perrine , Moreira Baptiste , Gallego Hernanz Maria Pilar , Chatenoud Lucienne , Lortholary Olivier
Published: December 2019

Background

Chronic disseminated candidiasis (CDC) is a rare disease that mostly occurs after chemotherapy-induced prolonged neutropenia in patients with hematological malignancies. It is believed to ensue from Candida colonization, breach of the intestinal epithelial barrier, and venous translocation to organs. Fungal blood or liver biopsy cultures are generally negative, suggesting the absence of an ongoing invasive fungal disease.

Methods

To unravel the contribution of the immune system to CDC pathogenesis, we undertook a prospective multicentric exploratory study in 44 CDC patients at diagnosis and 44 matched controls.

Results

Analysis of Candida-specific T-cell responses using enzyme-linked immunospot assays revealed higher numbers of interferon (IFN)γ-producing T cells reactive to mp65 or candidin in 27 CDC cases compared with 33 controls. Increased plasma levels of soluble CD25, interleukin (IL)-6, IL-1β, tumor necrosis factor-α, and IL-10 and lower levels of IL-2 were observed in CDC patients versus controls. Neutrophilia and higher levels of CD4 and CD8 T-cell activation were found in CDC patients as well as increased proportions of CXCR3-expressing TCRγδ +Vδ2+ cells.

Conclusions

The expansion of Candida-specific IFNγ-producing T cells together with features of T-cell activation and systemic inflammation identified here support the view that CDC belongs to the broad spectrum of fungal-associated immune reconstitution inflammatory syndromes.
10 Occurrence of mycotoxins in wheat middlings
Authors: Gott Paige N , Hendel Erika G , Curry Shelby M , Hofstetter Ursula , Murugesan G Raj
Published: December 2019

Mycotoxins are harmful secondary fungal metabolites which can contaminate a variety of feedstuffs worldwide. Various negative effects in vivo are associated with these toxins and severity is dependent on the level, type, and duration of exposure and age, species, and health status of animals. Wheat middlings or “midds” are a by-product of flour milling and are used in a wide range of livestock rations including frequent inclusion in pelleted feeds. The objectives of the current study were to determine the occurrence of mycotoxins in wheat midds samples and to evaluate the potential risk posed to livestock. Since November 2015, 97 samples submitted from 21 states and provinces have been screened via LC-MS/MS technique for the presence of six major mycotoxin groups: aflatoxins, type A trichothecenes, type B trichothecenes (B-Trich), fumonisins, zearalenone, and ochratoxin A (OTA) at Romer Labs (Union, MO, USA) or Activation Laboratories (Ancaster, Ontario, Canada). A subset of samples were also screened for the presence of six ergot alkaloids. Parameters of the main mycotoxins detected are presented in Table 1. On average, 1.7 mycotoxin groups were detected per sample with 91.8% of samples testing positive for at least one mycotoxin. The B-Trich deoxynivalenol was detected in 89.7% of samples (mean 1871.5 ± 157.5 ppb). OTA was also frequently detected (30.9% positive), but at low risk levels (4.2 ± 0.5 ppb). Out of 33 samples screened for ergot alkaloids, 72.7% were positive (493.3 ppb ± 68.3 ppb). Wheat midds are a commonly used feed ingredient for various livestock species. The types and concentrations of mycotoxins detected may pose challenges to livestock health, performance, and reproduction. Special consideration for young animals which are especially susceptible to mycotoxin challenges, such as calves consuming starter feeds, is warranted.
335 Genomic predictions with a multi-breed genomic relationship matrix
Authors: Steyn Yvette , Lourenco Daniela , Misztal Ignacy
Published: December 2019

Multi-breed evaluations have the advantage of increasing the size of the reference population for genomic evaluations and are quite simple; however, combining breeds usually have a negative impact on prediction accuracy. The aim of this study was to evaluate the use of a multi-breed genomic relationship matrix (G), where SNP for each breed are non-shared. The multi-breed G is set assuming known genotypes for one breed and missing genotypes for the remaining breeds. This setup may avoid spurious IBS relationships between breeds and considers breed-specific allele frequencies. This scenario was contrasted to multi-breed evaluations where all SNP are shared, i.e., the same SNP, and to single-breed evaluations. Different SNP densities, namely 9k and 45k, and different effective population sizes (Ne) were tested. Five breeds mimicking recent beef cattle populations that diverged from the same historical population were simulated using different selection criteria. It was assumed that QTL effects were the same over all breeds. For the recent population, generations 1 to 9 had approximately half of the animals genotyped, whereas all 1200 animals were genotyped in generation 10. Genotyped animals in generation 10 were set as validation; therefore, each breed had a validation set. Analysis were performed using single-step GBLUP (ssGBLUP). Prediction accuracy was calculated as correlation between true (T) and genomic estimated (GE) BV. Accuracies of GEBV were lower for the larger Ne and low SNP density. All three scenarios using 45K resulted in similar accuracies, suggesting that the marker density is high enough to account for relationships and linkage disequilibrium with QTL. A shared multi-breed evaluation using 9K resulted in a decrease of accuracy of 0.08 for a smaller Ne and 0.11 for a larger Ne. This loss was mostly avoided when markers were treated as non-shared within the same genomic relationship matrix.