High Incidence Area Research Articles

Geo-epidemiology of animal tuberculosis and Mycobacterium bovis genotypes in livestock in a small, high-incidence area in Sicily, Italy.

The persistence of animal tuberculosis (TB) in livestock is a major concern in Sicily, Italy. The objective of this study was to elucidate the transmission dynamics of M. bovis infection in a highly circumscribed, and at the same time geographically diverse, high-risk area of the island through an in-depth geo-epidemiological investigation of TB in cattle and black pigs raised in small-scale extensive farms across the district of Caronia. We used genotype analysis coupled with geographic information system (GIS) technology and phylogenetic inference to characterize the spatial distribution of TB and M. bovis genotypes in livestock and the genetic relationships between M. bovis isolates. A total of 589 M. bovis isolates collected from slaughtered cattle (n = 527) and Sicilian black pigs (n = 62) over a 5-year period (2014-2018) were included in the study. TB was widespread throughout the district and was most frequent in the north-central area of the district, especially along one of the district's streams. We identified a total of 62 M. bovis genotypes. Identical genetic profiles were isolated from both neighboring and non-neighburing herds. The 10 most frequent genotypes, accounting for 82% of M. bovis isolates, showed geographic specificities in that they tended to cluster in specific spatial niches. The landscape structure of these niches-i.e. steep slopes, rocky ridges, meadows and streams-is likely to have had a significant influence on the distribution of TB among livestock in Caronia. Higher concentrations of TB were observed along streams and in open meadows, while rocky ridges and slopes appeared to have hampered the spread of TB. The geographical distribution of TB cases among livestock in Caronia is consistent with several epidemiological scenarios (e.g., high density of infected herds along the streams or in hilly plateau where livestock share pastures). Landscape structure is likely to play an important role in the transmission and persistence of M. bovis infection across the district. Additional potential risk factors, such as livestock trading and extensive breeding methods, are also discussed. Our results will contribute to the improvement of surveillance, control and eradication activities of TB in Sicily by the implementation of ad hoc TB control measures, especially in farms located along streams, sharing common pastures or with mixed animal species.

Congenital Syphilis: a Review of Global Epidemiology.

In 2007, the World Health Organization (WHO) launched a global health initiative for the elimination of mother-to-child transmission (MTCT) of syphilis. This condition is highly preventable through antenatal identification of syphilis infection and treatment with penicillin during pregnancy. This review summarizes the global status of MTCT of syphilis and concludes that this condition remains a significant issue worldwide. There are large variations in case rates by region, with the highest numbers of cases in the African and Eastern Mediterranean regions, where there are also the least data available. There are also pockets of high-incidence areas within the other regions. Although the general trend is of decreasing rates over time, there are concerning indications of consistently increasing congenital syphilis cases in some areas, particularly in areas which have previously had very low case numbers. A concerted effort will be required to achieve the 2007 WHO goal of worldwide elimination of MTCT of syphilis in the near future.

Epidemiological landscape of esophageal cancer in Asia: Results from GLOBOCAN 2020.

Esophageal cancer (EC) is a global health problem. Asia represents a huge burden of EC globally, and incidence and mortality vary considerably across different Asian regions. Data on incidence, mortality, and preference were extracted from GLOBOCAN 2020. Age-standardized incidence and mortality rates were calculated overall by sex, age, country, region, and continent. The predicted burden of incidence and mortality in 2040 was calculated based on global demographic projections. It was estimated there were 481 552 new cases of and 434 363 deaths from EC in Asia in 2020, accounting for 79.7% and 79.8% of world EC cases and deaths, respectively. EC incidence and mortality in Asia ranked the highest among all continents. Eastern Asia represents the highest age-standardized world incidence rate (ASWIR) of 12.3 per 100 000 for all Asian regions. Western Asia represents the lowest ASWIR of 1.7 per 100 000, accounting for 0.7% of the globe. There exist obvious differences in epidemiological features in Asian countries, including incidence, mortality, prevalence, and mortality incidence ratio. There is forecast to be up to 781 000 new cases of EC in Asia by 2040, with increasing rates of 63% for incidence and 72% for mortality from 2020. Asia has an increasing number of EC cases and deaths. Strategies for targeting in high-incidence areas, the elderly, and survival should be prioritized to reduce the global EC burden, especially in low- and middle-income countries in Asia.

De-Escalation Training for Managing Patient Aggression in High-Incidence Care Areas.

Health care personnel who have close, face-to-face patient contact experience more workplace violence (WPV) than employees in other fields. Certain health care departments (i.e., high-incidence care areas) have elevated rates of WPV that can have adverse emotional, physical, and financial consequences for patients, employees, and institutions. Health care workers need de-escalation training to efficiently manage patient aggression while also safeguarding patients' dignity and patient-provider trust. The current Plan, Do, Study, Act quality improvement project used insights from an in-depth literature review to create a 1-hour, evidence-based, in-service de-escalation training for personnel from high-incidence care areas. A pre/post design was used to evaluate participants' responses to the Confidence Coping with Patient Aggression Instrument. Post-training, participants reported significantly increased feelings of safety regarding potential patient aggression (p = 0.001) and more efficacy regarding their aggression management techniques (p = 0.039). Based on the training's results, recommendations were made for future institutional de-escalation initiatives. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 17-24.].

COVID-19 Lockdown and Decline in Road Accidents in Bangkok, Thailand

This study presents the distribution of road accidents in Bangkok, Thailand, during the COVID-19 outbreak (162 days) using spatial statistics. The findings show that the number of road accidents fell by 28.53% during the lockdown period (March 26 to June 14, 2020) compared to before the lockdown period (January 5 to March 25, 2020). There was also a considerable decrease in road accidents by approximately 4.96% compared to the same period in 2019 (January 4 to June 14, 2019). High accident incidence areas were located in central and southwestern Bangkok, and this pattern was also observed before and during the lockdown as well as in 2019. The findings revealed the numbers and patterns of road accidents that occurred during the COVID-19 outbreak. This information can be useful in minimizing and limiting the impact and damage caused by road accidents in Bangkok.

Cultural Habitus, Poverty Traps and High Incidence of Esophageal CancerBased on A Field Observation in Linzhou, China

In the paper, the human behavior risk factors of esophageal cancer will be summarized and sorted out, Linzhou, a high-incidence area of esophageal cancer in northern China, is regarded as the field observation object for the study, and it is hoped that the reasons for many risk factors continuously existing in high-risk areas are explained by Bourdieus habitus theory, meanwhile, the existence and prevention of esophageal cancer in Linzhou was described correspondingly, and the economic and cultural background behind it was tried to explore. As an epitome of major prevention and control of diseases in rural areas of China, the study can be an effective supplement to anthropology and epidemiology in the field.

Analysis of living habit risk factors for esophageal cancer in central China: A bi-center case-control study.

Esophageal cancer remains a public health problem in many countries, especially developing countries. The early lifestyle preventive measures mentioned in the treatment guidelines for esophageal cancer are very limited. We aimed to evaluate the risk factors for esophageal cancer in a high-incidence area in China and to provide evidence for clinical intervention in esophageal cancer prevention. Symptom and lifestyle/habit questionnaires including 19 items were designed. The correlation between the occurrence of esophageal cancer and living habits was analyzed retrospectively through questionnaire survey. A total of 708 subjects (365 esophageal cancer, 343 non-esophageal cancer) enrolled from two hospitals in central China (Linzhou Esophageal Cancer Hospital and The Third Xiangya Hospital of Central South University) completed symptom and lifestyle/habit questionnaires. We used conditional logistic regression to estimate the odds ratio (OR) with consideration of 95% confidence interval (CI). The composition ratio analysis showed that the top five lifestyle factors related to esophageal cancer were eating too fast, drinking, hot drinks, smoking and overeating. Univariate analysis showed that 15 factors, including male sex, smoking, drinking, eating too fast, overeating, hot drinks, greasy food, acidic food, hard food, strong tea, coffee, bedtime immediately after meals, eating food before bedtime, difficult defecation, and an overtight belt, were associated with esophageal cancer (all P <0.05). Logistic multivariate regression analysis showed, drinking (OR 3.609, 95%CI 2.223-5.859; P=0.000); hot drinks (OR 2.672, 95%CI 1.786-3.997; P=0.000); overeating (OR 2.110, 95%CI 1.411-3.154; P=0.000); eating too fast (OR 1.879, 95%CI 1.274-2.772; P=0.001); strong tea (OR 1.882, 95%CI 1.171~3.023; P=0.009); hard food (OR 1.723, 95%CI 1.113-2.667; P=0.015); smoking (OR 1.686, 95%CI 1.045-2.720; P=0.032), which were significantly associated with the development of esophageal cancer. The unhealthy lifestyles of patients in high-incidence areas of esophageal cancer in central China are significantly associated with the incidence of esophageal cancer. Lifestyle changes that address these factors, especially overeating and eating too fast, which are rarely studied or discussed despite being common, may improve esophageal cancer management and treatment outcomes. The present results may be used as a reference for preventive education and treatment.

A Global Perspective on Gastric Cancer Screening: Which Concepts Are Feasible, and When?

Gastric cancer (GC) remains the fifth most common cancer and the third most common cause of cancer-related death globally. In 2022, GC fell into the scope of the updated EU recommendations for targeted cancer screening. Given the growing awareness of the GC burden, we aimed to review the existing screening strategies for GC in high-risk regions and discuss potentially applicable modalities in countries with low-to-intermediate incidence. The references for this Review article were identified through searches of PubMed with the search terms "gastric cancer", "stomach cancer", "Helicobacter pylori", and "screening" over the period from 1995 until August 2022. As Helicobacter pylori (H. pylori)-induced gastritis is the primary step in the development of GC, the focus on GC prevention may be directed toward testing for and treating this infection. Such a strategy may be appealing in countries with low- and intermediate- GC incidence. Other biomarker-based approaches to identify at-risk individuals in such regions are being evaluated. Within high-incidence areas, both primary endoscopic screening and population-based H. pylori "test-and-treat" strategies represent cost-effective models. Given the significant variations in GC incidence and healthcare resources around the globe, screening strategies for GC should be adjusted to the actual conditions in each region. While several proven tools exist for accurate GC diagnosis, a universal modality for the screening of GC populations remains elusive.

Epidemiological Characteristics and Factors Associated with Cure of Leprosy in Chongqing, China, from 1949 to 2019.

Chongqing is one of the focuses of leprosy control in China. Although leprosy control in Chongqing has achieved remarkable results over the years, there are also some problems, such as recurrent epidemics and insufficient early detection in some areas. The aim of this study was to analyze the epidemiological characteristics of leprosy in Chongqing, from 1949 to 2019 and explore the potential factors sociated with cure of leprosy to provide a basis for improving leprosy prevention and treatment strategies in Chongqing. Epidemiological indicators such as incidence and prevalence rates were used to evaluate the prevalence of leprosy. The epidemiological characteristics and control situation of leprosy in patients were analyzed using demographic characteristics, diagnosis, and treatment. Survival analysis was conducted to explore factors associated with the cure of leprosy. From 1949 to 2019, 3,703 cases of leprosy were registered in Chongqing. The incidence of leprosy in the city peaked at 0.853/105 in 1960 and remained below 0.100/105 after 2003. The number of high incidence areas decreased significantly, but they were mainly concentrated in the northeast and southeast regions. The early detection rate increased yearly from 1949 to 2019, and the rate of grade 2 disability ranged from 38.2% to 21.7%, with a fluctuating downward trend after 1960. Male, young age, employment as a farmer, delayed diagnosis, and multibacillary leprosy were risk factors for leprosy cure. Chongqing should continue to strengthen leprosy monitoring to improve the early detection of leprosy and focus on sociated risk factors to carry out multiple strategies.

Abstract B048: Cancer care in people living with HIV in Nevada

Abstract Background: Prior national registry and hospital data have demonstrated that people with HIV and cancer are less likely to receive cancer treatment compared with HIV-uninfected patients with the same cancer types. We sought to characterize demographic, clinical, and treatment patterns among people living with HIV and newly diagnosed with cancer in Nevada, an area of high HIV incidence and limited cancer treatment infrastructure. As Nevada data is not included in national registries, previously published national registry studies may overestimate rates of cancer care in PLWHIV and minimize disparities Methods: We obtained data through a linkage from the Nevada Cancer Registry and the Nevada HIV registry in the years 1985 to 2017. Cases were matched using unique identifiers, including medical record number and date of birth, then a de-identified dataset was shared with investigators and used for analysis[GS1] [CC2] . Descriptive statistics were used to examine the cohort of patients living with HIV and newly diagnosed with cancer. Multivariate logistic regression was used to identify predictors of receipt of cancer treatment. The model covariates were age at HIV diagnosis, year of HIV diagnosis, sex, race, insurance status, year of cancer diagnosis, primary cancer site, and tumor stage. Results: The cohort included a total of 984 patients, of whom 847 (86.1%) patients identified as male, 135 (13.7%) as female, and 2 (0.2%) as transgender. For race/ethnicity, 583 (54.9%) reported non-Hispanic White race, 203 (20.6%) non-Hispanic Black race, 151 (15.3%) Hispanic ethnicity, and 47 (4.8%) other races/ethnicities. Among all patients in the cohort, 445 (45.2%) patients received no cancer-directed therapy. Of those receiving treatment, 333 (37.9%) underwent surgery, 118 (15.1%) had radiotherapy, and 232 (42.8%) received chemotherapy. Overall rates of any cancer treatment varied year to year, but increased over time from 40% to 60% during the study period. On multivariate analysis, Black patients (adjusted odds ratio [aOR], 0.44; 95% confidence interval [95% CI], 0.20-0.96; reference group White patients), patients with lung cancer (aOR 0.17, 95% 0.049-0.61; reference group head and neck cancer) and patients with stage IV cancers (aOR 0.27, 95% 0.12-0.64; reference group stage I cancers) were significantly less likely to receive any cancer treatment. Conclusion: Cancer treatment rates among people living with HIV in Nevada is lower than expected based on previously published national data. The data suggest a unique opportunity for collaboration to improve cancer care delivery to people living with HIV in Nevada. Several initiatives are underway to improve access to cancer treatment for people living with HIV in the Mountain West. Citation Format: Valencia T. Henry, Ryan Hutten, Chad Cross, David W. Wetter, Angie Fagerlin, Gita Suneja. Cancer care in people living with HIV in Nevada [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B048.

Comparative Analysis of Machine Learning Methods and a Physical Model for Shallow Landslide Risk Modeling

Shallow landslides restrict local sustainable socioeconomic development and threaten human lives and property in loess tableland. Therefore, the appropriate creation of risk maps is critical for mitigating shallow landslide disasters. The first task to be done was to evaluate the vulnerability of shallow landslides based on a machine learning model (random forest (RF), a support vector machine (SVM) and logistic regression (Log)), and a physical model (SINMAP) in the loess tableland area. By comparing the differences, the best method for evaluating the vulnerability of shallow landslide was selected. The nonlinear response relationship between shallow landslides and environmental factors was quantified based on the frequency ratio. Multicollinearity analysis was used to identify 10 factors that were applied on ML to construct the spatial distribution model. The SINMAP model used a DEM and soil physical parameters to determine the stability coefficient of the study area. The results showed that (1) shallow landslides in Dongzhiyuan mainly occurred on shady slopes with an elevation of 1068–1249 m, a slope gradient of 36°–60° and a concave shape. The stream power and stream transport indexes increased with increasing rainfall erosion, making shallow landslides likely. The susceptibility of shallow landslides changed parabolically with the change in the NDVI and mainly occurred in grassland and shrubland. (2) The four methods performed similarly in predicting the sensitivity of shallow landslides. The high-incidence areas were on both sides of eroded gully slopes. The tableland and gully bottom areas were not prone to shallow landslides. (3) The highest area under the curve (AUC) values were generated from the RF training and validation datasets of 0.92 and 0.93, respectively, followed by SVM AUC values of 0.91 and 0.92, respectively; Log AUC values of 0.91 and 0.89, respectively, and the SINMAP model AUC values of 0.69 and 0.74, respectively. In conclusion, the RF model best predicted the susceptibility of shallow landslides in the study area. The results provide a scientific basis for disaster mitigation on the Loess Plateau.

When case reporting becomes untenable: Can sewer networks tell us where COVID-19 transmission occurs?

Monitoring SARS-CoV-2 in wastewater is a valuable approach to track COVID-19 transmission. Designing wastewater surveillance (WWS) with representative sampling sites and quantifiable results requires knowledge of the sewerage system and virus fate and transport. We developed a multi-level WWS system to track COVID-19 in Atlanta using an adaptive nested sampling strategy. From March 2021 to April 2022, 868 wastewater samples were collected from influent lines to wastewater treatment facilities and upstream community manholes. Variations in SARS-CoV-2 concentrations in influent line samples preceded similar variations in numbers of reported COVID-19 cases in the corresponding catchment areas. Community sites under nested sampling represented mutually-exclusive catchment areas. Community sites with high SARS-CoV-2 detection rates in wastewater covered high COVID-19 incidence areas, and adaptive sampling enabled identification and tracing of COVID-19 hotspots. This study demonstrates how a well-designed WWS provides actionable information including early warning of surges in cases and identification of disease hotspots.

2218. Spatial Epidemiology of Gonorrhea Incidence Among Women in Chicago

Abstract Background Neisseria gonorrhea is the second most prevalent sexually transmitted infection (STI) in the US with increasing incidence. Untreated, it leads to devastating sequelae for nonpregnant women, pregnant women, and their neonates. Geographic clustering of gonorrhea coincides with clustering of other risk factors and may help guide interventions. We utilize Geographic Information Systems (GIS) software to map gonorrhea incidence among women in Chicago, and examine factors associated with the spatial distribution of infection. Methods Chicago Department of Public Health data sets and shape files were available through the Chicago Data Portal. ArcGIS was utilized for map illustrating and data analysis. Ordinary Least Squares (OLS) Regression was utilized using the dependent variable of Gonorrhea incidence in women per Chicago Community Area (CCA), with various explanatory variables. Within the OLS, the Koenker Statistic (KS) was reported and from this a Geographically Weighted Regression (GWR) tool was run for combinations with statistically significant KS. Results The highest incidence is shown in the southern and western CCA’s, with hospitals clustered in the northern and southeastern CCA’s &amp; clinics with gaps primarily noted in the southern and northwestern CCA’s. (Figure 1.) Teen pregnancy incidence (TP), infant mortality (IM), and first trimester prenatal care, had statistical significance of the robust probability for all of their explanatory variables, and VIF’s less than 2 for all explanatory variables, JBS were not statistically significant, and AICc were approximately 1170 demonstrating stable OLS. (Figure 2&amp;3) TP &amp; IM did have a statistically significant KS and GWR was run demonstrating random spatial pattern. This confirms TP &amp; IM as predictors for gonorrheal incidence had variable predictability throughout the CCA’s and GWR improves the model outcome. Both combinations spatially explain gonorrhea incidence. Map of Gonorrhea Incidence among Females in 2006-2010 Figure 1:The data of the incidence of gonorrhea in females was mapped with 5 separate classifications created and displayed in the form of a map. Also included on the map were hospitals in the city, and Chicago Department of Public Health clinic locations where free STI management could take place. illustrates gonorrhea incidence rates (per 100,000) within the 77 Chicago Community Areas (CCA) of the city. The darker shades of green correspond with higher incidence. The highest incidence is shown to be greatest in the southern and western CCA’s. Also illustrated are the locations of the hospitals within the city in addition to CDPH clinics that are Federally Qualified Health Clinics (FQHC) that offer services for treatment at a reduced or free cost depending on health insurance status. The majority of the hospitals are shown to clustered in the northern and southeastern CCA’s. The clinics are more evenly spaced out with gaps primarily noted in the southern and northwestern CCA’s. The Ordinary Least Squares (OLS) regression results are illustrated in Table 1 above. The results are shown for six separate regressions: chlamydia incidence, Natality (teen pregnancy incidence [TP], percent of live births that were preterm [Preterm], fetal low birth percentage [LBW], prenatal care in the 1st trimester rate [PNC 1T], infant mortality rate [IM]), poverty (total # below poverty line per 100,000), poverty &amp; chlamydia, TP &amp; IM, TP &amp; IM &amp; PNC 1T, and all coefficients (natality incidence, poverty incidence, chlamydia incidence, fertility rate). Utilizing ArcGIS software, OLS Regression was mapped with the 77 Chicago Community Areas (CCA) with Gonorrhea Infection Incidence per CCA as the dependent variable and Teen Pregnancy (TP), Infant Mortality (IM) and 1st trimester prenatal care (1TM) incidence per CCA as the explanatory variables. Regression reported with standard deviation (SD) and color coded based off quantity of SD. Map shapefile is of the 77 CCA’s. Overlying are Hospitals and Chicago Department of Public Health (CDPH) clinic locations as made available through CDPH public domain website. Conclusion Teen pregnancy rates, infant mortality rates, and prenatal care in the first trimester explain some of the spatial patterns of gonorrhea incidence of females in Chicago. Identification of these factors identified should prompt providers to ensure enhanced testing of gonorrhea and other STI’s to reduce burden in areas of high incidence. Disclosures All Authors: No reported disclosures.

Genome Editing and Protein Energy Malnutrition.

Protein-energy malnutrition is a state of disordered catabolism resulting from metabolic derangements or starvation. It is associated with chronic disease, hypoglycemia, hypothermia, serious infections, and even an increased prevalence of morbidity and mortality in countries with poor socioeconomic or environmental factors. Adequate food administration is essential to satisfy the main caloric and nutritional demands of humans. The most significant factors seen in the development of protein-energy malnutrition in areas of high incidence, such as underdeveloped countries, are inadequate food and nutrient supplies. It has been well established that one of the strategies to alleviate undernourishment is the biofortification of staple crops. This is because vegetables and plants are significant sources of crucial nutrients for human growth and development. To enhance plant nutrition, recent tactics aim to formulated balanced and diverse diets with acceptable levels ofvitamins and minerals that benefit human health. New advances in plant biotechnology and animal productivity could control key enzymes in several metabolic pathways, enriching important nutrients such as iron and vitamins and decreasing the content of disadvantageous compounds such as acrylamide-forming amino acids and phytic acids. Numerous biofortified crops such as rice, maize, and wheat have been created to resolve the problem of nutrition deficiencies. Some examples of these methodologies are genome editing engineered nucleases, transcriptional activator-like effector nucleases, zinc finger nucleases, and clustered regularly interspaced short palindromic repeats and associated Cas9 endonuclease which have been created and widely studied for their application, efficiency, and specificity.

Genetic variant in miR-17-92 cluster binding sites is associated with esophageal squamous cell carcinoma risk in Chinese population

BackgroundSingle nucleotide polymorphisms (SNPs) located in microRNA (miRNA) binding sites can affect the interactions between miRNAs and target genes, which is related to cancer susceptibility and tumorigenesis. However, the association between SNPs located in miR-17-92 cluster binding sites and ESCC risk remains unclear. Therefore, we aimed to explore the relationship between polymorphisms in miR-17-92 cluster binding sites and ESCC susceptibility.MethodsSix SNPs in the binding sites of miR-17-92 cluster were selected using bioinformatics databases, and their association with ESCC risk was investigated in a case-control study (including 488 cases and 512 controls) based on the population from high incidence areas of ESCC in China. We evaluated the SNP-SNP and SNP-smoking interactions using generalized multifactor dimensionality reduction (GMDR). Moreover, the expression of the miR-17-92 cluster and its target genes was determined in ESCC and adjacent normal tissues by quantitative real-time polymerase chain reaction (qRT-PCR). The dual-luciferase reporter assay was conducted to verify the effect of SNPs on the binding affinity between miRNAs and target genes.ResultsWe found that the SNP rs1804506 C > T had a significant association with the decreased ESCC risk. The SNP rs1804506 T allele was associated with a significantly decreased risk of ESCC in the additive model (OR = 0.817, 95% CI = 0.681–0.981, P = 0.030). The rs1804506 T allele had more striking effects on reducing ESCC risk in older individuals, female or non-smoker subgroups. We also found a significant interaction effect between rs1366600 and smoking by GMDR methods (P = 0.011). Additionally, the expression levels of miR-19a-3p and TGFBR3 were significantly downregulated in ESCC tissues compared with normal tissues, and the carriers of rs1804506 TT genotype had lower expression level of TGFBR3 than those of rs1804506 CC/CT genotype. Following dual-luciferase reporter assay showed that the rs1804506 T allele reduced the binding of miR-19a-3p and TGFBR3 3′-UTR.ConclusionsOur findings suggest that the rs1804506 polymorphism in miR-17-92 cluster binding sites contributes to the susceptibility of ESCC, which might provide new clues and scientific evidence for the etiology and biomarkers for the prevention and treatment of ESCC.

Use of multimodal dataset in AI for detecting glaucoma based on fundus photographs assessed with OCT: focus group study on high prevalence of myopia

BackgroundGlaucoma is one of the major causes of blindness; it is estimated that over 110 million people will be affected by glaucoma worldwide by 2040. Research on glaucoma detection using deep learning technology has been increasing, but the diagnosis of glaucoma in a large population with high incidence of myopia remains a challenge. This study aimed to provide a decision support system for the automatic detection of glaucoma using fundus images, which can be applied for general screening, especially in areas of high incidence of myopia.MethodsA total of 1,155 fundus images were acquired from 667 individuals with a mean axial length of 25.60 ± 2.0 mm at the National Taiwan University Hospital, Hsinchu Br. These images were graded based on the findings of complete ophthalmology examinations, visual field test, and optical coherence tomography into three groups: normal (N, n = 596), pre-perimetric glaucoma (PPG, n = 66), and glaucoma (G, n = 493), and divided into a training-validation (N: 476, PPG: 55, G: 373) and test (N: 120, PPG: 11, G: 120) sets. A multimodal model with the Xception model as image feature extraction and machine learning algorithms [random forest (RF), support vector machine (SVM), dense neural network (DNN), and others] was applied.ResultsThe Xception model classified the N, PPG, and G groups with 93.9% of the micro-average area under the receiver operating characteristic curve (AUROC) with tenfold cross-validation. Although normal and glaucoma sensitivity can reach 93.51% and 86.13% respectively, the PPG sensitivity was only 30.27%. The AUROC increased to 96.4% in the N + PPG and G groups. The multimodal model with the N + PPG and G groups showed that the AUROCs of RF, SVM, and DNN were 99.56%, 99.59%, and 99.10%, respectively; The N and PPG + G groups had less than 1% difference. The test set showed an overall 3%–5% less AUROC than the validation results.ConclusionThe multimodal model had good AUROC while detecting glaucoma in a population with high incidence of myopia. The model shows the potential for general automatic screening and telemedicine, especially in Asia.Trial registration: The study was approved by the Institutional Review Board of the National Taiwan University Hospital, Hsinchu Branch (no. NTUHHCB 108-025-E).

Mosquitoes and Mosquito-Borne Diseases in Vietnam.

Mosquito-borne diseases pose a significant threat to humans in almost every part of the world. Key factors such as global warming, climatic conditions, rapid urbanisation, frequent human relocation, and widespread deforestation significantly increase the number of mosquitoes and mosquito-borne diseases in Vietnam, and elsewhere around the world. In southeast Asia, and notably in Vietnam, national mosquito control programmes contribute to reducing the risk of mosquito-borne disease transmission, however, malaria and dengue remain a threat to public health. The aim of our review is to provide a complete checklist of all Vietnamese mosquitoes that have been recognised, as well as an overview of mosquito-borne diseases in Vietnam. A total of 281 mosquito species of 42 subgenera and 22 genera exist in Vietnam. Of those, Anopheles, Aedes, and Culex are found to be potential vectors for mosquito-borne diseases. Major mosquito-borne diseases in high-incidence areas of Vietnam include malaria, dengue, and Japanese encephalitis. This review may be useful to entomological researchers for future surveys of Vietnamese mosquitoes and to decision-makers responsible for vector control tactics.

Voluntary Medical Male Circumcision for HIV Prevention: a Global Overview.

With the promise of HIV prevention, there has been a scale-up of voluntary medical male circumcision (VMMC) in high HIV incidence/low circumcision prevalence nations worldwide. Nonetheless, debates over the implementation and the effectiveness and safety of the VMMC in real-world settings persist. We revisit the role of VMMC in HIV prevention to inform health professionals, policymakers, and advocates or opponents in this new era. There has been substantial progress on VMMC scale-up to date, but this has varied considerably by region. The evidence of solid and direct protection of VMMC is available for heterosexual men and older adolescent boys in sub-Saharan Africa. The protective effect in men who have sex with men is suggested by systematic reviews but is not confirmed by clinical trials. Sexual partners, including women, likely benefit indirectly from the increased VMMC coverage through a decreased risk of exposure to infected male partners. Fortunately, the preponderance of studies does not suggest higher sexual risk behaviors among circumcised men, so-called risk compensation. VMMC requires health systems strengthening and continued promulgation of other evidence-based HIV prevention strategies to be successful. Health authorities in high HIV incidence areas that have low circumcision coverage should implement VMMC within a context of complementary biomedical and behavioral prevention strategies.

Research on Resilience Evaluation and Enhancement of Deep Foundation Pit Construction Safety System

Deep foundation pit (DFP) projects have been a high incidence area of safety accidents because of their own high danger and complexity. Therefore, it is necessary to study the resilience of their construction safety system. This paper systematically identifies the key factors affecting the resilience of deep foundation pit construction based on the analysis of the composition of the deep foundation pit construction safety system (DFPCTSS), the synergistic relationship of its subsystems in the face of the interference and impact of internal and external disaster-causing factors, and the causal mechanism of typical accidents in DFP accidents and the emergent process of system resilience. A resilience evaluation indicator system based on four capacity dimensions of prevention absorption, resistance, recovery, and learning adaptation was constructed by using the fuzzy Delphi method, which is characterized by the resilience emergence process. Then the correlation and weight of evaluation indexes were analyzed based on the DEMATEL–ANP method, the boundary cloud parameters of the resilience evaluation grade were set according to the normal extension cloud model, and the membership degree of the resilience evaluation level was calculated to complete the evaluation of the resilience level. Finally, taking a DFP project of a metro station as an example, the above model was used to evaluate the resilience level of its construction safety system, and suggestions for resilience enhancement were put forward. The results show that the evaluation results are consistent with the actual situation of the project, and the evaluation model is conducive to providing a systematic analysis method and improvement countermeasures for deep foundation pit construction safety management from the perspective of resilience.

Spatial and temporal genetic stock composition of river herring bycatch in southern New England Atlantic herring and mackerel fisheries

Anadromous river herring (alewife and blueback herring) persist at historically low abundances and are caught as bycatch in commercial fisheries, potentially preventing recovery despite conservation efforts. We used newly established single-nucleotide polymorphism genetic baselines for alewife and blueback herring to define fine-scale reporting groups for each species. We then determined the occurrence of fish from these reporting groups in bycatch samples from a Northwest Atlantic fishery over four years. Within sampled bycatch events, the highest proportions of alewife were from the Block Island (34%) and Long Island Sound (22%) reporting groups, while for blueback herring the highest proportions were from the Mid-Atlantic (47%) and Northern New England (24%) reporting groups. We then quantified stock-specific mortality in a focal geographic area (∼3500 km2, including Block Island Sound) of high bycatch incidence and sampling effort, where the most accurate estimates of mortality could be made. During this period, we estimate that bycatch took about 4.6 million alewife and 1.2 million blueback herring, highlighting the need to reduce bycatch mortality for the most depleted river herring stocks.