Low Incident Levels Research Articles

Gene pyramiding for achieving enhanced disease and insect multiple resistance in Coffea arabica

AbstractDeveloping a new coffee cultivar can take up to 25 years using traditional approaches. The implementation of molecular tools into the coffee breeding pipeline can speed up the development of high‐yielding varieties with multiple resistance to pests and diseases. This study aimed to verify the presence of gene pyramiding for resistance to coffee berry disease (CBD) and coffee leaf rust and access the breeding potential of a breeding population of coffee (Coffea arabica L.) that presents partial phenotypic resistance to coffee leaf miner. A progeny of 128 individuals was evaluated in 2019 during the coffee maturation stage for 11 agronomic traits. The individuals were genotyped for four loci related to rust and CBD resistance. Gene pyramiding was verified based on the presence of markers linked with the resistance alleles. Genetic parameters were estimated, and a selection index was used to rank the individuals based on the phenotypic evaluation. Gene pyramiding for rust and CBD was detected in ∼82% of the individuals. Moreover, the phenotypic evaluation of rust indicated high levels of resistance, confirmed by the presence of the resistance alleles. Ninety‐five percent of the 38 top‐ranked individuals presented resistance alleles and could be used in an interpopulation recurrent selection scheme with marker‐assisted selection. The studied coffee population has the potential to be used in coffee breeding programs since it presents vigorous individuals with low levels of coffee leaf miner incidence (CLMI) and gene pyramiding for CBD and rust resistance, the main pest and diseases of this crop.

Millimeter-Wave Band Electro-Optical Imaging System Using Polarization CMOS Image Sensor and Amplified Optical Local Oscillator Source.

In this study, we developed and demonstrated a millimeter-wave electric field imaging system using an electro-optic crystal and a highly sensitive polarization measurement technique using a polarization image sensor, which was fabricated using a 0.35-µm standard CMOS process. The polarization image sensor was equipped with differential amplifiers that amplified the difference between the 0° and 90° pixels. With the amplifier, the signal-to-noise ratio at low incident light levels was improved. Also, an optical modulator and a semiconductor optical amplifier were used to generate an optical local oscillator (LO) signal with a high modulation accuracy and sufficient optical intensity. By combining the amplified LO signal and a highly sensitive polarization imaging system, we successfully performed millimeter-wave electric field imaging with a spatial resolution of 30×60 µm at a rate of 1 FPS, corresponding to 2400 pixels/s.

Spatial-temporal distribution of visceral leishmaniasis in Rio de Janeiro, Brazil, 2001-2020: expansion and challenges.

Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas. Twenty years (2001-2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters). Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0-4 y (28.7%) and 20-39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001-2010), cases were concentrated in the Metropolitan region, and in the second decade (2011-2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases. Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion.

IBC-Oxford University2023_BJSOral_5Comparative Effectiveness of Bupivacaine-Dexamethasone and Liposomal Bupivacaine for Autonomic Neural Blockade in Laparoscopic Sleeve Gastrectomy: A Study on Pain, Postoperative Nausea and Vomiting and Analgesic Consumption

Abstract Background Pain is increasingly recognised as a syndrome not merely a symptom, emphasizing the importance of pain management. Visceral pain impacts up to 75% of bariatric patients during recovery. Concurrently, postoperative nausea and vomiting (PONV) persist as challenges after laparoscopic sleeve gastrectomy (LSG). An earlier RCT demonstrated the safety and effectiveness of para-gastric autonomic neural blockade (ANB) as a novel strategy to manage these issues in the first 24 hours after a laparoscopic sleeve gastrectomy. A limitation of using bupivacaine for ANB is its half-life, with clinical effects limited to 14 to 18 hours. This study compares the effectiveness of ANB using a combination of bupivacaine and Dexamethasone with that of liposomal bupivacaine. Methods This research represents a secondary analysis of an earlier RCT titled "Impact on Anaesthetic Agents Consumption Following Autonomic Neural Blockade as Part of a Combined Anaesthesia Protocol," currently under review. This secondary analysis focuses on two patient groups; one where ANB was performed with a mix of 5% bupivacaine and Dexamethasone (47 patients), and another with liposomal bupivacaine (25 patients). Data on pain, PONV, and analgesic requirements at 1, 8, and 24 hour post-surgery were recorded and analysed. Results Both treatment groups demonstrated low levels of pain, PONV incidence, and analgesic usage. No significant differences in pain scores or analgesic use were found between the groups at the selected postoperative time points. However, the liposomal bupivacaine group exhibited a reduced incidence of PONV, statistically significant only for vomiting. Discussion Visceral pain and PONV significantly affects patients' quality of life, recovery time, nursing time allocation, the risk of opioid abuse and readmission rates. Various strategies have been explored to manage visceral pain and associated symptoms. ANB has proven safe and effective in reducing pain, PONV, and analgesic consumption post-LSG. This study confirms that application of either 5 % bupivacaine plus Dexamethasone or liposomal bupivacaine during ANB results in very low levels of pain, PONV incidence, and analgesic use, outperforming the results of the original RCT using only 5% bupivacaine. These results may be attributed to the local anaesthetic used or the improved proficiency in performing the ANB. The similar low pain level and analgesic needs in both groups may render any statistical difference undetected due to the sample size. However, liposomal bupivacaine demonstrated a clinical advantage in reducing PONV after LSG. Conclusion ANB utilizing 5% bupivacaine plus Dexamethasone or liposomal bupivacaine effectively mitigates pain, PONV, and analgesic use following LSG. Liposomal bupivacaine appears more effective in managing nausea and vomiting.

128 Reviewing the Definition of Mortality in Broiler Chickens

Abstract Mortality has been a trait of importance in livestock species, especially for poultry, as birds continue to become more efficient and grow larger, and mortality rates have shown an increase at the phenotypic level. Mortality at different stages may be due to different genetic, environmental, and biological factors; however, in most cases, selection can be based on overall mortality. This study aimed to investigate alternative models and trait definitions of mortality by exploring the classification of mortality into different life stages and including a maternal effect in the model. Data provided by Cobb-Vantress, Inc. included mortality records from three separate lines of chicken making up about three generations worth of data. The datasets included records for mortality (0-1) and weekly mortality (0-10) recorded on individuals during their first ten weeks of life. Due to low incidence levels of weeks seven through ten for weekly mortality, those birds were combined with those that survived the first six weeks. Three models with different trait definitions were considered in this study. They were compared against a benchmark model with overall survival as trait definition (M0). Each line was evaluated separately for each model investigated, and the traits under different definitions were treated as binary traits. Thus, threshold models were used to estimate variance components under a Bayesian approach via the Gibbs sampling algorithm implemented in Gibbsf90+ software. The first model and trait definition (M1) investigated was a single trait model with weekly mortality classified into a binary response to whether the bird died within the first six weeks of life (BMORT). The second model and trait definition (M2) investigated was a bivariate model that classified weekly mortality into early (EMORT; weeks 1 to 3) and late (LMORT; weeks 4 to 6) mortality. The heritabilities ranged from 0.11 to 0.19 for M1, 0.10 to 0.21 for EMORT, and 0.15 to 0.17 for LMORT. For both models investigated, heritabilities were greater than that of M0, ranging from 0.03 to 0.09. The second model was additionally run with the maternal effect (M3) composed of the additive maternal and maternal permanent environmental (mpe) effects to investigate any potential effect on the estimated variance components. The maternal heritability and the percentage of phenotypic variance explained by mpe ranged from 0.02 to 0.03 and 0.01 to 0.04, respectively. Including the maternal effect considerably decreased direct heritability for EMORT but not for LMORT, indicating the maternal effect plays an important role in early mortality. The genetic correlations between EMORT and LMORT were low, ranging from 0.23 to 0.44; therefore, it may be necessary to include both traits in the selection index to make better-informed decisions. Selecting against early and late mortality may help improve overall livability in broiler chickens.

Economic Evaluation of Wastewater Surveillance Combined with Clinical COVID-19 Screening Tests, Japan.

The COVID-19 pandemic has imposed substantial burdens on the global society. To find an optimal combination of wastewater surveillance and clinical testing for tracking COVID-19, we evaluated the economic efficiency of hypothetical screening options at a single facility in Japan. To conduct cost-benefit analyses, we developed standard decision models in which we assumed model parameters from literature and primary data, such as screening policies used at the Tokyo Olympic and Paralympic Village in 2021. We compared hypothetical 2-step screening options that used clinical PCR to diagnose COVID-19 after a positive result from primary screening using antigen tests (option 1) or wastewater surveillance (option 2). Our simulation results indicated that option 2 likely would be economically more justifiable than option 1, particularly at lower incidence levels. Our findings could help justify and promote the use of wastewater surveillance as a primary screening at a facility level for COVID-19 and other infectious diseases.

Wheat Stem Rust Detection and Race Characterization in Tunisia.

Climate changes over the past 25 years have led to conducive conditions for invasive and transboundary fungal disease occurrence, including the re-emergence of wheat stem rust disease, caused by Puccinia graminis f.sp. tritici (Pgt) in East Africa, Europe, and the Mediterranean basin. Since 2018, sporadic infections have been observed in Tunisia. In this study, we investigated Pgt occurrence at major Tunisian wheat growing areas. Pgt monitoring, assessment, and sampling from planted trap nurseries at five different locations over two years (2021 and 2022) revealed the predominance of three races, namely TTRTF (Clade III-B), TKKTF (Clade IV-F), and TKTTF (Clade IV-B). Clade III-B was the most prevalent in 2021 as it was detected at all locations, while in 2022 Pgt was only reported at Beja and Jendouba, with the prevalence of Clade IV-B. The low levels of disease incidence during these two years and Pgt population diversity suggest that this fungus most likely originated from exotic incursions and that climate factors could have caused disease establishment in Tunisia. Further evaluation under the artificial disease pressure of Tunisian wheat varieties and weather-based modeling for early disease detection in the Mediterranean area could be helpful in monitoring and predicting wheat stem rust emergence and epidemics.

When schools were open for in-person teaching during the COVID-19 pandemic - the nordic experience on control measures and transmission in schools during the delta wave

BackgroundExtensive measures to control spread of SARS-CoV-2 have led to limited access to education for millions of children and adolescents during the COVID-19 pandemic. Education and access to schools is vital for children and adolescents’ learning, health, and wellbeing. Based on high vaccine uptake and low incidence levels, the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) decided to start the academic year 2021/22 with schools open for in-person teaching and moderate mitigation measures. We describe trends in SARS-CoV-2 infections and vaccination coverage among students during the first 12 weeks of the fall semester.MethodsIn this multinational, retrospective, observational study, we have used surveillance and registry data from each of the Nordic countries to describe vaccine uptake (≥12 years), infection incidence (whole population) and transmission of SARS-CoV-2 among students. The study period, week 30 to 41 (Jul 26th – Oct 17th), represents the autumn semester from immediately before school started until fall break. In addition, we collected information on mitigation measures applied by the respective countries.ResultsThere were slight variations between the countries regarding existing infection prevention and control (IPC) measures, testing strategies and vaccination start-up among adolescents. All countries had high vaccine uptake in the adult population, while uptake varied more in the younger age groups. Incidence in the school-aged population differed between countries and seemed to be influenced by both vaccine uptake and test activity. Infection clusters among school-aged children were described for Denmark and Norway, and the number of clusters per week reflected the incidence trend of the country. Most events consisted of only 1–2 cases. Larger clusters appeared more frequently in the higher grades in Norway and in lower grades in Denmark.ConclusionData from the Nordic countries indicate that vaccination of adults and adolescents, in addition to mitigation measures, enabled full in-person learning. As SARS-CoV-2 infection does not represent a severe medical risk for most children as previously thought, measures targeting this group should be carefully adjusted and kept at a minimum. Our data add to the evidence on incidence and transmission of SARS-CoV-2 among students in schools open for in-person teaching, and may be valuable for decision makers worldwide.

Analyse exploratoire spatiale des effets sanitaires et économiques de la COVID-19 à partir de données mondiales

L'objectif : L'objectif de cet article est d'analyser les effets sanitaires et économiques de la pandémie de COVID-19. Conception/méthodologie/approche : L'échantillon est composé de 132 pays et la méthodologie se fonde sur l ' analyse exploratoire des données spatiales. Le calcul de l'output gap par la méthode de Hodrick-Prescott a permis de ressortir les conséquences économiques de la crise sanitaire, à travers les écarts de production pour l'année 2020. La variable sanitaire, quant à elle, est mesurée par le taux d'incidence de la COVID-19 et la mortalité. Résultats: Les résultats des estimations ont permis de valider l'hypothèse d'autocorrélation spatiale aussi bien pour la variable sanitaire que pour la variable économique. L'examen du diagramme de Moran confirme le schéma d'association spatiale local positif, c'est-à-dire l'existence à la fois de similitudes entre pays voisins dans la manifestation de la pandémie et d'hétérogénéité spatiale entre les groupes de pays. De manière plus précise, les résultats montrent l'existence de clusters avec de faibles niveaux d'incidence de la COVID-19 en Afrique et en Asie, comparativement à l'Europe et à l'Amérique du Nord. De plus, si les pays à revenu élevé ont généralement été davantage touchés sur le plan sanitaire, ils ont toutefois développé une plus grande résilience économique. Originalité/valeur : Ces résultats montrent que la prise en compte de l'espace pourrait permettre de mieux comprendre la dynamique des chocs sanitaires et économiques.

Genetic Resistance of Switchgrass to Rust Evaluated in a Composite Upland × Lowland Population in Lab and Field Settings

Maintaining low levels of rust incidence (caused by Puccinia novopanici) in switchgrass (Panicum virgatum L.) breeding populations is a priority for the USDA-ARS program engaged in improving cultivars for high biomass yield and quality. Essential to this goal is the unbiased and accurate estimation of genetic parameters to predict the merits of parents and progeny. Spores of the fungus were inoculated in greenhouse-grown seedling progeny of 31 half-sib families in generation 2 (Gen 2) of a composite Summer × Kanlow population for evaluation of rust incidence on the leaves with a 0–9 rating scale. Two parents were later chosen to cross and develop a linkage mapping population as Gen 3. The Gen 2, 3, and Kanlow seedlings were transplanted into the field located near Mead, NE, in early June 2020 and laid out as a replicated row–column design with six blocks of single-row plots of five plants each. The field trial was rated in September 2021 and 2022 with a 0–4 scale. Lab and field data were subjected to univariate linear mixed models via the restricted maximum likelihood to extract the variance components needed to predict the breeding values. The additive genetic variation was substantial (p < 0.01), enough to result in high heritability estimates ranging from 0.42 ± 14 to 0.73 ± 0.09 at the individual and family mean levels. This result implies that rust resistance is under strong genetic control to use mass selection for obtaining satisfactory gains. A possible rust incidence x year interaction was detected with a Spearman correlation of breeding values of −0.38, caused by significant rank changes of the Gen 3 genotypes in 2022 (a high heat and drought year). Genetic gains were predicted to reduce rust incidence scores by at least two points on the rating scale when selecting backwards, and by one point when selecting individual candidates as parents of the next generation. Faster gains (31 and 59%) were realized relative to the second generation by respectively selecting the top 10% of the families in Gen 3 or the top 10% of genotypes within this group. Based on these results, strategies for controlling the incidence of rust will be developed to optimize gains in the other traits of economic importance.

Evaluation of porcine GM-CSF during PRRSV infection in vitro and in vivo indicating a protective role of GM-CSF related with M1 biased activation in alveolar macrophage during PRRSV infection.

Granulocyte-macrophage colony stimulating factor (GM-CSF), participates in diverse biological processes associated with innate and adaptive immunity, has unknown effects during PRRSV infection. Here, a double-antibody sandwich ELISA for pGM-CSF was developed in-house for evaluation of pGM-CSF level during PRRSV infection both in vitro and in vivo. In in vitro assay, it was notable that PRRSV-infected porcine alveolar macrophages (PAMs) yielded inconsistent pGM-CSF protein- and mRNA-level, suggesting a post-transcriptional inhibition of pGM-CSF mRNA was employed by PRRSV. Meanwhile, concurrent analysis of pGM-CSF levels in serum samples from PRRSV-infected piglets suggested that effect of PRRSV infection demonstrated minimum effect on pGM-CSF levels regardless of PRRSV virulence phenotypes. Moreover, in vitro treatment of PAMs with pGM-CSF prior PRRSV inoculation did not inhibit PRRSV replication in PAMs although genes downstream of pGM-CSF in PAMs could be upregulated by pGM-CSF treatment. Meanwhile, knockdown of pGM-CSF using siRNA did not enhance PRRSV replication as well. Intriguingly, therapeutic antibody treatment of HP-PRRSV-infected piglets led to significantly increased serum pGM-CSF levels, thus aligning with low pneumonia incidence and low intracellular PRRSV-RNA levels in PAMs of therapeutic antibody treated piglets. Furthermore, transcriptome analysis of PAMs from infected piglets revealed increased serum pGM-CSF levels correlated with activation of downstream signal of pGM-CSF in PAMs as evidenced by a M1-like phenotypes of gene expression pattern, implying a potential host-protective role played by pGM-CSF for PRRSV infection in vivo. In conclusion, our results demonstrated developments of a highly sensitive and specific ELISA for pGM-CSF and revealed a potential protective role conferred by pGM-CSF during PRRSV infection.

Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States.

Current routine immunizations for children aged ≤10 years in the United States in 2019 cover 14 vaccine-preventable diseases. We characterize the public-health impact of vaccination by providing updated estimates of disease incidence with and without universally recommended pediatric vaccines. Prevaccine disease incidence was obtained from published data or calculated using annual case estimates from the prevaccine period and United States population estimates during the same period. Vaccine-era incidence was calculated as the average incidence over the most recent 5 years of available surveillance data or obtained from published estimates (if surveillance data were not available). We adjusted for underreporting and calculated the percent reduction in overall and age-specific incidence for each disease. We multiplied prevaccine and vaccine-era incidence rates by 2019 United States population estimates to calculate annual number of cases averted by vaccination. Routine immunization reduced the incidence of all targeted diseases, leading to reductions in incidence ranging from 17% (influenza) to 100% (diphtheria, Haemophilus influenzae type b, measles, mumps, polio, and rubella). For the 2019 United States population of 328 million people, these reductions equate to >24 million cases of vaccine-preventable disease averted. Vaccine-era disease incidence estimates remained highest for influenza (13 412 per 100 000) and Streptococcus pneumoniae-related acute otitis media (2756 per 100 000). Routine childhood immunization in the United States continues to yield considerable sustained reductions in incidence across all targeted diseases. Efforts to maintain and improve vaccination coverage are necessary to continue experiencing low incidence levels of vaccine-preventable diseases.

Is there a dose-response relationship? Investigating the functional form between COVID-19 incidence rates and life satisfaction in a multilevel framework

While there is plenty of research linking the effects of the global COVID-19 pandemic to a drastic reduction of life satisfaction in the population, there is little information on the functional form of this relationship. Until now, one could suspect that this association is linear and a higher number of COVID-19 infections in a region leads to a continuous decline of satisfaction. However, there are reasons to assume that this interrelation is indeed more complex and deserves further attention. To resolve this question, high-quality panel data of the first wave of COVID-19 from Germany are analysed in a fixed-effect multilevel framework. With information from more than 6,000 respondents (after imputation) nested in 339 federal districts, we estimate linear models with higher-order terms up to the fifth degree of median COVID-19 incidence rates and random intercepts for districts to describe the functional form. The results indicate that even regions with very low incidences are affected and a linear decline of satisfaction is only apparent for rather low incidence levels, quickly reaching a plateau, which is then quite constant, even for higher incidence levels. These findings indicate that at least in rich and industrialized countries like Germany, assuming a strictly linear relation between incidences and change of satisfaction is not appropriate.

The Gut Microbiota: Master of Puppets Connecting the Epidemiology of Infectious, Autoimmune, and Metabolic Disease.

Infectious, autoimmune, and metabolic diseases put an enormous pressure on both quality of life and the economy. For all three disease types, it is known that the quality of the gut microbiota composition is correlated to both onset and progression of disease. Hence, maintaining eubiosis and preventing gradual irreversible loss of beneficial microbes within the gut microbial ecosystem is of utmost importance. As such, the epidemiological trends of these disease types may serve as proxies for the integrity of the human gut microbiota. Here, we present incidence data covering the last decades for prototypical infectious diseases (tuberculosis and measles), autoimmune disorders (type-1 diabetes and multiple sclerosis), and the prevalence of metabolic syndrome. Our findings reveal that vaccination efforts correlate with relatively low levels of archetypal infectious disease incidence. However, autoimmune and metabolic disorders are, together with the usage of antibiotics, steeply on the rise. These findings suggest that the status of the gut microbiota is persistently deteriorating, as reflected by the proxies. As such, the epidemiological trends shown here may serve as a starting point for a mechanistic understanding of the interplay between these different disease types that can be used for future prevention and mitigation strategies like targeted stimulation and suppletion of microorganisms by means of, e.g., fermented foods, prebiotics and probiotics.

Determination of tetracycline residues in dairy milk powder and fresh dairy milk by HPLC method

Tetracycline residues are group of antibiotics found in animal products such as dairy milk. In this study, the occurrence of tetracycline residues in 45 dairy milk powder and 24 fresh dairy milk samples have been investigated. Tetracycline residue were extracted from milk samples using McIlvine buffer and purified with a solid phase extraction (SPE) C18 column. Residues were detected through HPLC-PDA at wavelengths of 355 and 368 nm. Three forms of tetracyclines were discovered in the 45 milk powder samples, namely; oxytetracycline (31.75 ng/g), tetracycline (28.02 ng/g) and chlortetracycline (10.55 ng/g). The results of 24 fresh dairy milk samples, on the other hand, revealed that only one form of tetracycline (i.e., oxytetracycline) was detected with concentrations ranging from 6.67 to 10.19 ng/g. Although the low incidence and concentration levels of tetracycline contamination in all samples analysed were not alarming, regular monitoring is recommended to avoid any negative public health consequences.

High-Performance Energy Selective Surface Based on the Double-Resonance Concept

In this article, a high-performance energy selective surface (ESS) is proposed based on a double-resonance concept, which has a nonlinear transmission response for high-power electromagnetic protection. With well-designed grid and cross patterns as well as properly chosen p-i-n diodes, bandpass and band-stop resonances are excited by the ESS at the same frequency under low and high incident power levels, respectively, resulting in low insertion loss (IL) and high shielding effectiveness (SE) of the ESS. Two samples of single-layer and double-layer ESSs operating at 3 GHz are designed to demonstrate the double-resonance concept. By utilizing a double-layer structure, a second-order band-stop resonance is produced to achieve a broader bandwidth with high SE in comparison with the single-layer ESS. Equivalent circuit models are employed to explain how the double resonances are produced and a wide bandwidth of high SE is obtained. Field circuit cosimulation is conducted to estimate the nonlinear performance of the ESS designs. Moreover, the ESS designs are measured in a rectangular waveguide setup. Good agreement is observed between the simulation and measurement. Simulated and measured results demonstrate that low IL less than 1 dB and high SE larger than 24 dB can be obtained under low and high incident power levels, respectively.

Has Continued Exposure to Banana Xanthomonas Wilt Worsened Farmers’ Welfare Over Time? Evidence From Banana-Producing Households in Uganda

The livelihoods of millions of banana-farming households have been affected by Banana Xanthomonas Wilt (BXW) in Uganda for nearly two decades. The disease has no known cure, all banana cultivars grown are susceptible to it and it is endemic in all banana-producing regions in the country. This study analysed the long-term impact of the disease on the livelihoods of banana-producing households. Using a balanced panel dataset of 1,056 households, which were visited in 2015 and revisited in 2018, provides the opportunity to empirically measure the long-term consequences of the disease on farmers’ economic wellbeing in the four major banana growing regions in Uganda. We find striking results pertinent to disease incidence, success in disease management, household income and poverty when deploying BXW control practices. Although the disease has remained present in farmers’ fields, there is a significant reduction in household poverty levels. Results show that some farmers expanded the production of beans and coffee without encroaching on their banana plantations. Increase in bean production was largely through intercropping. Investment in coffee was constrained by land ownership, hence only a viable venture for the wealthy farmers who own bigger pieces of land. Land-poor farmers continued to rely on bananas for their livelihoods. Consistent participation in disease management training significantly influenced adoption of the cultural control practices. Consequently, farming households that systematically adopted these practices were able to maintain low levels of disease incidence, improve productivity by 438 kg/ha/year and increased their daily and annual household income by US$1.75 and UGX 2.383 million (US$648), respectively. The findings suggest that banana is an important crop to smallholder farmers and expansion into other cash crops requires bigger resource outlays, and that despite continued exposure to BXW, farmers’ income increased over time. Farmers should continuously and systematically use the recommended control practices to avoid BXW resurgence and, consequently, a reduction in their income.

Recommendations for a More Organized and Effective Approach to the Early Detection of Pancreatic Cancer From the PRECEDE (Pancreatic Cancer Early Detection) Consortium

Recommendations for a More Organized and Effective Approach to the Early Detection of Pancreatic Cancer From the PRECEDE (Pancreatic Cancer Early Detection) Consortium

An update on the epidemiology of hepatitis A in Italy 2015-2019. Data from the surveillance of acute viral hepatitis SEIEVA

hepatitis A is an infective disease whose global diffusion appears to be variable and strictly related to socioeconomic status, hygiene conditions, and access to potable water. During last twenty years, Italy registered a constant decrease of new cases with recurrent epidemic outbreaks. to outline the hepatitis A epidemiological situation in Italy in the five-year period 2015-2019. descriptive study based on cases reported to the National Surveillance System for Acute Viral Hepatitis (SEIEVA). hepatitis A cases reported to SEIEVA from 2015 to 2019. hepatitis A incidence, percentages of cases exposed to known risk factors, distribution of cases by vaccination status. during the whole observational period, SEIEVA registered 4,929 type A hepatitis cases. The epidemic curve initially showed a trend with a low incidence level interrupted in August 2016 with the onset of a large epidemic, in the period between August 2016 and December 2017, involving 3,428 cases mostly adult men exposed to homosexual intercourses (MSM). Since January 2018, the trend of the cases has been decreasing even though its level is still higher than the pre-epidemic period. Based on the analysis of the epidemic curve, three periods characterized by different trends in the monthly number of notified cases were identified: January 2015-July 2016 (pre-epidemic period), August 2016-December 2017 (epidemic period), January 2018-December 2019 (post-epidemic period). In the last observation period, cases show different characteristics compared to the previous periods. They are mainly males under 18 years (p=0.026), subjects travelling to Morocco (8.9% vs 15.9%; p< 0.001) or being in contact with an infected person (p< 0.001). The multivariate analysis confirmed a significantly higher probability for cases notified in the post-epidemic period, compared to the pre-epidemic, to be secondary cases or to have traveled to Morocco. Compared to the pre-epidemic period and the epidemic period, there was a higher percentage of subjects who received a single dose of anti-hepatitis A vaccine (p=0.001). Taking into account only secondary cases reported in the third period, the percentage of cases with incomplete vaccination rises to 31%; in this group, a single dose of the vaccine was administered at a median of 11.5 days before the onset of symptoms. vaccination is of paramount importance for the prevention of hepatitis A in all risk groups, including adult males exposed to same-sex sexual intercourse and travelers to areas at high-medium endemic level, especially children, as the timeliness in the vaccination of contacts is fundamental and crucial for interrupting the chains of infection. The observed increase in secondary cases and the delay in the administration of doses lead to a reflection on the need for greater promotion of vaccination, but also highlight the critical issues in the organization of vaccination services, mainly in the areas that have reported the greatest number of cases.

Estimating the cumulative incidence of SARS-CoV-2 with imperfect serological tests: Exploiting cutoff-free approaches.

Large-scale serological testing in the population is essential to determine the true extent of the current SARS-CoV-2 pandemic. Serological tests measure antibody responses against pathogens and use predefined cutoff levels that dichotomize the quantitative test measures into sero-positives and negatives and use this as a proxy for past infection. With the imperfect assays that are currently available to test for past SARS-CoV-2 infection, the fraction of seropositive individuals in serosurveys is a biased estimator of the cumulative incidence and is usually corrected to account for the sensitivity and specificity. Here we use an inference method-referred to as mixture-model approach-for the estimation of the cumulative incidence that does not require to define cutoffs by integrating the quantitative test measures directly into the statistical inference procedure. We confirm that the mixture model outperforms the methods based on cutoffs, leading to less bias and error in estimates of the cumulative incidence. We illustrate how the mixture model can be used to optimize the design of serosurveys with imperfect serological tests. We also provide guidance on the number of control and case sera that are required to quantify the test's ambiguity sufficiently to enable the reliable estimation of the cumulative incidence. Lastly, we show how this approach can be used to estimate the cumulative incidence of classes of infections with an unknown distribution of quantitative test measures. This is a very promising application of the mixture-model approach that could identify the elusive fraction of asymptomatic SARS-CoV-2 infections. An R-package implementing the inference methods used in this paper is provided. Our study advocates using serological tests without cutoffs, especially if they are used to determine parameters characterizing populations rather than individuals. This approach circumvents some of the shortcomings of cutoff-based methods at exactly the low cumulative incidence levels and test accuracies that we are currently facing in SARS-CoV-2 serosurveys.