North American Cases Research Articles

Older Adults and Gentrification: The Positive Role of Social Policy.

Supportive public policies are suggested as ways to lessen gentrification's impact for older adults. While explicit policies designed to help older adults with gentrification are rare, literature on age-friendly cities is a close proxy. We utilized three North American cases undergoing gentrification: New York City, NY, and Denver, CO, in the United States and Hamilton, in Ontario, Canada, to present existing neighbourhood-based policies as social determinants of health in housing, resource access, healthcare, transportation, and communal places. Age-friendly policy application gap examples and COVID-19's impact were included. Using a qualitative comparative case study method, we found policies were not specifically designed to address older adults' gentrification needs. With the call for age-friendly designations, the role of gentrification in neighbourhoods with older populations must be included. We call for gentrification-specific policies for older adults to provide greater safeguards especially when events such as COVID-19 compete for existing, over-stretched resources.

Epidemiology of infective endocarditis in intravenous drug users

Recently, five North American studies have reported 471 persons who injected drugs intravenously (PWID) (25.34%) out of a total of 1858 patients with infective endocarditis (IE) and three European studies have reported 263 PWID out of 1225 patients with IE (21.46%). Both in North America and Europe the mean age of PWID with IE was 32-38 years and 41-44 years, respectively. Both in North America and in Europe Staphylococcus aureus was the leading cause of IE in PWID (67.30% and 66.15%, respectively). IE involves the tricuspid valve in 90% of cases and mitral and/or aortic valves in less than 15% of cases; the mortality rate is 2.0-2.5%. In North America and in Europe, streptococci caused IE in 10.61% and 10.64% of PWID, respectively, enterococci in 6.58% and 9.50%. Other etiologies accounted for 1-2%. Almost 6% of North American cases and almost 10% of European cases were polymicrobial. New episodes (25-32%) were mostly reinfections (up to 86.4%). PWID's in-hospital mortality was not significantly different from non-PWID's. Ten-year survival of PWID and non-PWID with IE was comparable in an American surgical study (69.5% vs 68.7%) and significantly different in a British study (43.8% vs 83.5%).

34374 Three North American cases of cutaneous pemphigus vulgaris in patients without history of mucosal disease

Pemphigus is a group of autoimmune blistering diseases including pemphigus vulgaris (PV) and pemphigus foliaceus (PF). Lesion morphology has been explained by the desmoglein compensation hypothesis (DCH), which uses the epidermal distribution of desmoglein (Dsg) proteins and autoantibody profile. The DCH theorizes 3 types of lesion morphology: mucosal PV, mucocutaneous PV, and cutaneous PF. While the DCH has been supported in the literature, logical inconsistencies have been identified and published in multiple small-scale studies.

Using crowdsourced imagery to assess cultural ecosystem services in data-scarce urban contexts: The case of the metropolitan area of Cali, Colombia

Sustainable urban and metropolitan planning is increasingly benefiting from differentiated assessments of ecosystem services. Cultural ecosystem services (CES) are particularly relevant for urban residents’ mental and physical health, yet, quantification and mapping of CES are often challenging, especially so in the Global South. The use of social media data (SMD), which has recently gained importance for assessing CES at larger spatial and temporal scales, provides a promising entry point for mitigating this informational gap in land-use planning. However, its application is mainly limited to European and North American cases and rarely applied to data-scarce urban regions in the Global South, with South America as no exception. Addressing this geographical gap, this study assesses CES of urban green spaces in the city of Cali, Colombia, based on 1,686 crowdsourced and geolocated photographs, and compares those results with a metropolitan scale CES potential assessment based on expert opinions performed in a previous study. Despite some important limitations primarily related to Flickr as a data source, we demonstrate the utility of this approach, especially for understanding the fine-scale generation of CES by small green spaces located within the urban fabric that are overlooked in the metropolitan scale expert-based assessment. These green spaces are highly relevant as inner-city pockets for CES production, especially in the form of “existence value” and “aesthetic experiences”, in contrast to green areas highlighted by experts at the metropolitan scale that serve primarily recreational purposes. Our results indicate the large potential of SMD-based CES assessment approaches for informing urban planning processes in the Global South.

Severe skin and soft tissue pythiosis acquired in a hot spring in the southwestern United States, a case report and review of North American cases

BackgroundHuman pythiosis, caused primarily by the aquatic oomycete, Pythium insidiosum, is an emerging but uncommon infection in North America. The infection is frequently life-threatening and is often initially unrecognized due to its rarity and similar presentation to certain fungal infections. MethodsWe report a case of skin and soft tissue pythiosis in a patient without significant underlying comorbidities acquired in a New Mexico hot spring and review its successful treatment. We also review all reported pythiosis cases in North America. ResultsEleven confirmed cases of human pythiosis acquired in North America were identified. The majority of cases occurred in children (64%), ten of eleven cases were acquired in the southern U.S., Mexico, Central America or the Caribbean and four of the eleven individuals succumbed to the infection. ConclusionsWith recognition and aggressive surgical and medical treatment good clinical outcomes can be achieved when treating human pythiosis.

Identifying and understanding determinants of regional differences in light-rail patronage and performance

• Local population density is a dominant factor in LRT performance contrasts. • Bus-LRT connectivity and LRT service level follow as top-tier performance factors. • Regional city planning and urban design traditions influence performance outcomes. • Multifactor heuristics can effectively and fairly rank LRT systems on 14 measures. • Spanish LRT cases markedly outperform North American cases in this study.

Pediatric pineoblastoma: A pooled outcome study of North American and Australian therapeutic data.

BackgroundPineoblastoma is a rare brain tumor usually diagnosed in children. Given its rarity, no pineoblastoma-specific trials have been conducted. Studies have included pineoblastoma accruing for other embryonal tumors over the past 30 years. These included only occasional children with pineoblastoma, making clinical features difficult to interpret and determinants of outcome difficult to ascertain.Patients and MethodsCentrally or independently reviewed series with treatment and survival data from North American and Australian cases were pooled. To investigate associations between variables, Fisher’s exact tests, Wilcoxon-Mann-Whitney tests, and Spearman correlations were used. Kaplan-Meier plots, log-rank tests, and Cox proportional hazards models were used in survival analyses.ResultsWe describe a pooled cohort of 178 pineoblastoma cases from Children’s Oncology Group (n = 82) and institutional series (n = 96) over 30 years. Children <3 years of age have significantly worse survival compared to older children, with 5-year progression-free survival (PFS) and overall survival (OS) estimates of 13.5 ± 5.1% and 16.2 ± 5.3%, respectively, compared with 60.8 ± 5.6% and 67.3 ± 5.0% for ≥3 years old (both P < .0001). Multivariable analysis showed male sex was associated with worse PFS in children <3 years of age (hazard ratio [HR] 3.93, 95% CI 1.80-8.55; P = .0006), suggestive of sex-specific risks needing future validation. For children ≥3 years of age, disseminated disease at diagnosis was significantly associated with an inferior 5-year PFS of 39.2 ± 9.7% (HR 2.88, 95% CI 1.52-5.45; P = .0012) and 5-year OS of 49.8 ± 9.1% (HR 2.87, 95% CI 1.49-5.53; P = .0016).ConclusionGiven the rarity of this tumor, prospective, collaborative international studies will be vital to improving the long-term survival of these patients.

The sense of the right to religious freedom in liberal democracies between accommodation and laicization. A study of the North American and Brazilian cases

This work intends to investigate the different conceptions—accommodation and laicization—that underlie processes of legislative regulation and judicial decision in matters of conflicts involving the right to religious freedom, in the legal systems of North America and Brazil. We will also investigate the potential for harmonization of legal in conflicts with other fundamental rights. The objective here is to build possibilities in order to establish a synthesis meaning for the right of religious freedom, in accordance with the democratic constitutional models of law to begin with, the recent modulations which allowed the fundamental right to religious freedom, especially from the edition of some US federal and state legislation, as well as from a set of decisions taken by Brazilian courts. As a corollary of these modulations, the article intends to assess the consequences that these new laws and judicial decisions caused in the legal system, through social andinstitutional democratic practices related to any fundamental rights. We used the dialectical method, since the idea and the foundation of the right to religious freedom follow a three-stage approach: thesis (religious freedom in its original sense and secularized conception), antithesis (right to religious freedom as a possibility to act in the exercise of belief, by claiming accommodation with other rights), and synthesis (the perspective to elaborate a proper sense to liberal democracies). Initial results indicate that both models based on secularization and accommodation can generate democratic and undemocratic meanings to the right of religious freedom; both models can either harmonize conflicting rights or escalate social antagonisms.

North American Adult T Cell Leukemia Lymphoma (ATLL) Is Characterized By Distinct, Therapeutically Targetable Mutations in Epigenetic Modifiers

Introduction: We described the mutational spectrum of ATLL in North American patients at ASH 2016 and found that these patients have a heterogenous mutational spectrum (abstract #1758). We also noted some significant differences in comparison to Japanese ATLL cases (Kataoka et al. 2015 PMID: 26437031). In this abstract, we determine the mutational landscape of larger cohort of 27 cases and report on the presence of distinct variants in epigenetic and histone modifying genes.Methods: Twenty-seven North American primary ATLL patient samples (44% acute, 41% lymphomatous and 15% chronic/smoldering) and 7 Japanese cell lines were analyzed by targeted sequencing of 173 recurrently mutated genes in cancer (Genoptix) at a mean sequencing depth of 500X coverage.We then carried out proliferation assays with decitabine on 4 Japanese derived cell lines and 5 primary patient samples and belinostat on 1 cell line and 2 primary patient samples. We also did synergy studies with doxorubicin on 3 sensitive samples. R index was calculated for assessing synergy (Romanelli et al. 1998 PMID: 9523734).Results: We found a high number of epigenetic and histone modifying gene mutations (EP300, TET2, EZH2, MED12, PBRM1, DNMT3A, KMT2A, HIST1H1E, SPEN, IDH1 and ASXL1) in our patients, 15/27 patients (55.5%). Amongst these genes EP300 had the highest frequency of mutations and was present in 22% of patients. (Figure 1) In comparison, the Japanese cohort of 370 cases had 5.7% cases with EP300 mutations. (OR: 4.1; 95% CI: 1.5099 to 10.9492; p = 0.0055)The JAK/STAT pathway had significant number of mutations in the Japanese patients (25% had STAT3 mutations and 5% had JAK3 mutations) whereas in our North American cohort there were no STAT3 mutations and 1 patient had a JAK3 mutation (3.7%). The overall percentage of TP53 mutations was similar in both groups 17.8% in the Japanese and 25.9% in the North American patients. The presence of TP53 mutations was associated with a worse overall survival in our patients (p-value: 0.045) and has been described previously (Magalhaes et al. 2015 PMID: 25573202).EP300 is a histone acetyltransferase that acetylates histones and leads to activation of gene transcription. Inactivating mutations in EP300 can lead to aberrant gene silencing and can be associated with increased DNA methylation. A high prevalence of EP300 mutations prompted us to test the sensitivity of ATLL cell lines and primary samples to DNA methyltransferase inhibitor (Decitabine) and histone deacetylase inhibitor (Belinostat). Among the 4 cell lines tested, only the ATL43Tb(-) cell line with EP300 mutation was sensitive to the growth inhibitory effects of decitabine (IC50 < 1 uM) whereas the IC50 was not reached in resistant samples (three Japanese derived cell lines, ED40515(-) and ED41214(-) and Su9T01(-)) (Figure 2A). Since the cell lines were derived from Japanese ATLL, next, we established long term cultures of primary ATLL cells from North American cases and used them for functional studies. For primary samples, we observed that all samples (n=5) were sensitive to decitabine with IC50 < 1 uM. Furthermore, the three samples (EP300 mutant) were also sensitive to HDAC inhibitor Belinostat with an IC50 of upto 0.5 uM in all samples. Next, we tested the efficacy of combining decitabine with chemotherapy. The combination of doxorubicin and decitabine showed synergy with an R index >1 in three EP300 mutant samples tested Pt-5a, Pt-7a and ATL43Tb(-).Conclusions: Mutational analysis of the largest cohort of North American ATLL samples shows a distinct variant landscape with a high prevalence of mutations affecting epigenetic modifiers. EP300 is a histone acetyltransferase that is mutated in 22% of samples and is significantly higher in the North American cohort when compared to the Japanese cases.We also determined that majority of primary ATLL samples and EP300 mutant cell lines tested are sensitive to decitabine. The combination with doxorubicin shows synergy. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

EMBR-03. PINEOBLASTOMA: A POOLED OUTCOME STUDY OF NORTH AMERICAN AND AUSTRALIAN THERAPEUTIC DATA

BackgroundPineoblastoma (PB) is a rare embryonal brain tumour most often diagnosed in young children. To date, no clinical trials have been conducted specific to pediatric PB. Collaborative studies performed over the past 30 years have included PB in studies accruing for other embryonal tumours, primarily medulloblastoma (MB), but also including the entity formerly known as CNS-PNET and atypical teratoid rhabdoid tumors. Each of these studies have included only a small number of children with PB, making clinical features difficult to interpret and determinants of outcome difficult to ascertain. Patients and MethodsPublished centrally reviewed series with sufficient treatment and outcome data from North American and Australian cases were pooled. To investigate associations between variables, Fisher’s exact and Wilcoxon-Mann-Whitney tests, and Spearman correlations were used as appropriate. Kaplan-Meier plots, log-rank tests, and Cox proportional hazards models were used in survival analysis. ResultsWe describe a 30-year review of the reported clinical features of PB and a pooled centrally reviewed, cohort analysis of cases (n=178) from the Children’s Oncology Group (COG) (n=82) groups and several published, centrally reviewed institutional series (n=96). We find young children <3 years of age have a dramatically poorer outlook compared to older children (5-year OS 16.2% +/- 5.3% vs 67.3% +/- 5%) confirming new and novel approaches are needed in future clinical trials for this at risk group. Interestingly, male gender was predictive of worse outcome possibly suggestive of gender specific subgroup risks that needs validation in future studies. Assessment of radiation therapy is not possible as the vast majority of children under age three did not receive any form of radiation therapy. ConclusionGiven the relative scarcity of this tumor and the emerging data on subgroups of pineoblastoma, prospective, collaborative international studies will be vital to improving the long-term survival of these patients.

016 Three North American cases of cutaneous Pemphigus vulgaris with no history of mucosal disease

Pemphigus is a group of autoimmune blistering diseases including Pemphigus vulgaris (PV) and Pemphigus foliaceus (PF). Explanation of lesion morphology has been elegantly proffered by the Desmoglein Compensation Hypothesis (DCH) based on the epidermal distribution of desmoglein (Dsg) proteins and autoantibody profiles. In this theory, PF is characterized by subcorneal lesions in the presence of only anti-Dsg1 antibodies, while PV lesions are suprabasilar and associated with anti-Dsg3 in mucosal PV, or anti-Dsg1 and -Dsg3 in mucocutaneous PV. However, logical inconsistencies in the DHC have emerged and exceptions have been published in multiple small-scale studies. One of these inconsistencies described by our group and others is that some PV patients present with solely cutaneous disease (cPV) without concomitant mucosal lesions, in violation of the tenets of the DHC. To date, cPV patients reported in the literature have been classified as such based on their lesion status at time of presentation. We report here three cases of clinically and histologically confirmed cPV without any history of mucosal lesions (cPVwohm). Of these patients, two do not carry the most common PV associated HLA alleles, DRB1*04:02 or DQB1*05:03. The same two patients also tested negative for the primary PV associated autoantibodies, anti-Dsg 3 and anti-Dsg 1, while in active disease status. We confirm the first documented individual cases of cPVwohm in North America, supporting the existence of PV patients that develop cutaneous disease without a history of mucosal lesions, further challenging the fidelity of the DCH. Two of the 3 patients reported did not type for the common PV-associated HLA genes or display anti-Dsg autoantibodies while in active disease, suggesting some cPV patients may develop Pemphigus via genetic and immune mechanisms that differ from typical mucosal or mucocutaneous PV.

Zoonotic Thelazia californiensis in dogs from New Mexico, USA, and a review of North American cases in animals and humans.

Thelazia californiensis is a spirurid nematode found in the conjunctival sac of domestic and wild animals, including humans, across the western United States of America. Herein, we report two cases of thelaziosis by T. californiensis in dogs from New Mexico, United States, based on integrated morphological and molecular approaches. Nematode specimens collected from the conjunctiva of both dogs were identified as T. californiensis based on morphology. Our study substantially expands the knowledge on morphometry of this nematode species. Therefore, these data will be useful for accurate diagnosis of thelaziosis in domestic animals, wildlife and humans in North America, using classical, microscopy-based methods. We characterized for the first time the mitochondrial cytochrome c-oxidase subunit 1 (COI) and 12S genes of T. californiensis. While these markers support the validity of T. californiensis, they were not very informative for elucidating the phylogenetic relationships among Thelazia species. Nevertheless, the characterization of these diagnostic markers for T. californiensis will be useful for studies on the epidemiology, molecular xenomonitoring of fanniid vectors, and population genetics of this multi-host, zoonotic parasite.

Transoral Thyroidectomy: Safety and Outcomes of 200 Consecutive North American Cases.

North American adoption of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been limited due to concerns regarding the generalizability of published outcomes, as data are predominantly from Asian cohorts with a different body habitus. We describe our experience with TOETVA in a North American population in the context of the conventional transcervical approach thyroidectomy (TCA). Cases of TOETVA and TCA were reviewed from August 2017 to March 2020 at a tertiary care center. Outcomes included operative time, major (permanent recurrent laryngeal nerve (RLN) injury, permanent hypoparathyroidism, hematoma, conversion to open surgery), and minor complications. The TOETVA cohort was stratified into body mass index (BMI) classes of underweight/normal < 25kg/m2, overweight 25-29.9kg/m2, and obese ≥ 30kg/m2 for comparative analysis. Multivariable logistic regression analyses were performed for odds of cumulative complication. Two hundred TOETVA and 333 TCA cases were included. There was no difference in incidence of major complications between the TOETVA and TCA cohorts (1.5% vs. 2.1%, p = 0.75). No difference was found in the rate of temporary RLN injury (4.5% vs. 2.1%, p = 0.124) or temporary hypoparathyroidism (18.2% vs. 12.5%, p = 0.163) for TOETVA and TCA, respectively. Surgical technique (TOETVA vs TCA) did not alter the odds of cumulative complication (OR 0.69 95% CI [0.26-1.85]) on logistic regression analysis. In the TOETVA cohort, higher BMI did not lead to a significantly greater odds of cumulative complication, 0.52 (95% CI [0.17-1.58]) and 1.69 (95% CI [0.74-3.88]) for the overweight and obese groups, respectively. TOETVA can be performed in a North American patient population without a difference in odds of complication compared to TCA. Higher BMI is not associated with greater likelihood of complication with TOETVA.

Kill me a mosquito and I will build a state: political economy and the socio-technicalities of Jewish colonization in Palestine, 1922–1940

Scholars see Israel as a settler state, comparable with North American, South African and Oceanian cases. But how was Jewish settlement-colonization in pre-Israel Palestine even possible? In the North American, Oceanian and South African cases, European settlers did not encounter diseases like malaria that scholars argue impede settlement. Palestine, however, had high malaria morbidity rates. The disease incapacitated and killed settlers and was one of the most serious threats to Jewish settlement and political economic development. I argue that the exigencies caused by malaria are exactly what fostered Jewish settlement-colonization in Palestine because they prompted the formation of socio-technical arrangements in order to combat the disease. These arrangements included, among other things, people, organizations, scientific knowledge, procedures and larvicides as well as considering the agency of mosquitos and other elements in the environment in disrupting settlement. These arrangements were marshalled by medical-national and political institutions that developed to combat malaria. Only then were Jewish settlers able to effectively colonize Palestine, make their colonies economically viable and make Palestine habitable for future Jewish immigrants. I demonstrate this argument by drawing on archival and library materials that describe the work of an important Zionist Malaria Research Unit (MRU) as well as malaria control efforts in Hefer Valley in the 1930s–1940s, after the unit’s disbandment. Then, I discuss the theoretical implications of this paper to settler-colonial and state-building literatures that, for the most part, neglected the socio-technical nature of state-building and settlement.

Creative Destruction and the Social (Re) Construction of Heritage

AbstractIn an era when war, acts of terror, and the potentially catastrophic effects of climate change loom large in the public conscience, the conservation community is grappling with the associated loss of the historic built environment and potential responses. But the built environment—at least some aspects of it—is becoming progressively obsolete due to environmental and social changes. Coastal sea-level rise, inefficient resource and land use, and the role of the built environment in perpetuating social exclusion raise questions about the potential value of destruction and the opportunities it affords for reframing spatial memory and historical narrative in more just and sustainable ways. The heritage field’s preoccupation with the physical, place-based fabric will be challenged in the face of this obsolescence, compelling a reexamination of attitudes toward destruction and reconstruction. This article borrows loosely from Joseph Schumpeter’s economic concept of creative destruction to explore the ways in which both innovation and new lenses on history and memory may be borne of change, loss, and obsolescence. Using the discourse surrounding past and contemporary North American cases, it examines some fundamental ideas regarding capital in the built environment and the economic value of destruction. It also explores the negative social consequences of destruction and the historical influence cum perspective of the heritage enterprise and posits potentially positive values and opportunities engendered through destruction. Finally, it reimagines how approaches to reconstruction by the heritage field may contribute to more socially just and sustainable futures.

The Othering of the Black Community in News Media Reports During the Ebola Epidemic of 2013 to 2016

The purpose of this paper is to identify and analyze the racial undertones found in the news media reports on the West Africa Ebola outbreak of 2013 to 2016, focusing mainly on the portrayal of North American cases on television. As with many political activist issues, the first step to making a change for the better is recognizing exactly where the errors are made. Through the analysis of news reports posted by CityNews and The National, the paper identifies four critical themes: Othering, Them versus Us, and the impact of Visualization. Othering is the process of alienating the Black community from the rest of the population as the leading responsible factor for Ebola. This creates a dilemma of Them (the Black community) versus Us (the general population) that exasperates the already existing racial tensions. All of which is done not only by what is expressed by the reporters, but what is shown on the screen as part of the news story. This is evidence of systemic institutional racism in the media industry. By understanding the key reoccurring themes of racism found in the event of an epidemic, society can be better prepared to confront the situation when it arises again.

Coccidioidomycosis: What a long strange trip it's been.

The recorded history of coccidioidomycosis began in 1892 with the report of the illness of Domingo Escurra by Alejandro Posadas followed by a description of the first North American cases by Rixford and Gilchrist. Originally considered a protozoan, William Ophüls determined that Coccidioides was a fungus and that the lungs were the apparent initial site of infection. During the 1930s, both Gifford and Dickson determined that a self-limited illness, Valley Fever, was caused by the same fungus that caused the often fatal coccidioidal granuloma. Charles Smith, over a period of approximately 2 decades, comprehensively described the clinical and geographic epidemiology of coccidioidomycosis in California. Demosthenes Pappagianis continued this work after Smith's death. In 1957, one year before Marshall Fiese published his masterful monograph on coccidioidomycosis, the use of the first effective agent for the therapy of coccidioidomycosis, amphotericin B, was reported. This was followed by descriptions of its appropriate clinical use by William Winn and by Hans Einstein, among others. The development of the much less toxic azole antifungal agents greatly simplified therapy in many cases, but much of the management of patients with coccidioidomycosis still relies more on art than science. The search for the “Holy Grail” - a vaccine capable of preventing this disease-continues.

The epidemiology of skin ulcers in saltwater reared Atlantic salmon (Salmo salar) in Atlantic Canada

Skin ulcers have been increasing in occurrence on Atlantic salmon (Salmo salar) farms in Atlantic Canada during summer and autumn months when water temperatures are elevated above 10 °C. The clinical presentation in Atlantic Canada resembles lesions associated with winter ulcer disease in Europe caused by Moritella viscosa, but this bacterium is not always identified from skin lesions in North American cases. The objectives of our study were to: 1) describe the onset, duration, magnitude, and temporal and spatial distributions of Atlantic Canadian skin ulcer cases at the cage and farm levels; 2) develop hypotheses regarding potential sources and transmission routes for infection based on the patterns of disease occurrence; and 3) identify potential risk factors associated with total percent mortality during skin ulcer outbreaks. We summarized weekly cage-level data from 29 salmon farms in Atlantic Canada, from April 2014 to January 2016. Cage and farm-level prevalence, onset, duration, and total percent mortality associated with skin ulcer outbreaks were determined. The association of potential risk factors for skin ulcers with total percent mortality during skin ulcer outbreaks was assessed using a mixed-effects linear regression model with random farm effects. The overall farm-level prevalence of skin ulcers on Atlantic Canadian farms included in our study was 41%. The descriptive epidemiology of skin ulcers suggests cages are likely exposed to the causative agent(s) only at certain times of the year and exposure is not uniform across farms based on the patterns of disease occurrence. The onset of skin ulcer outbreaks in our study occurred from late-summer to mid-autumn. The pattern of disease is also suggestive of point source exposures to the causative agent across farms. In our final regression model, year of outbreak onset, and the interaction between the diagnosis of skin ulcers at the cage level and antibiotic treatment during the outbreaks were significantly associated with the log of total percent mortality during the outbreaks (P < .001). Our results did not identify any management factors that could reduce the severity of skin ulcer outbreaks on affected farms.

The political logics of clean energy transitions

AbstractTechnology costs and deployment rates, represented in experience curves, are typically seen as the main factors in the global clean energy transition from fossil fuels towards low-carbon energy sources. We argue that politics is the hidden dimension of technology experience curves, as it affects both costs and deployment. We draw from empirical analyses of diverse North American and European cases to describe patterns of political conflict surrounding clean energy adoption across a variety of technologies. Our analysis highlights that different political logics shape costs and deployment at different stages along the experience curve. The political institutions and conditions that nurture new technologies into economic winners are not always the same conditions that let incumbent technologies become economic losers. Thus, as the scale of technology adoption moves from niches towards systems, new political coalitions are necessary to push complementary system-wide technology. Since the cost curve is integrated globally, different countries can contribute to different steps in the transition as a function of their individual comparative political advantages.

Extended genotypic evaluation and comparison of twenty-two cases of lethal EEHV1 hemorrhagic disease in wild and captive Asian elephants in India.

Thirteen new lethal cases of acute hemorrhagic disease (HD) with typical histopathogical features were identified in young Asian elephants (Elephas maximus indicus) in India between 2013 and 2017. Eight occurred amongst free-ranging wild herds, with three more in camp-raised orphans and two in captive-born calves. All were confirmed to have high levels of Elephant Endotheliotropic Herpesvirus type 1A (EEHV1A) DNA detected within gross pathological lesions from necropsy tissue by multi-locus PCR DNA sequencing. The strains involved were all significantly different from one another and from nine previously described cases from Southern India (which included one example of EEHV1B). Overall, eight selected dispersed PCR loci totaling up to 6.1-kb in size were analyzed for most of the 22 cases, with extensive subtype clustering data being obtained at four hypervariable gene loci. In addition to the previously identified U48(gH-TK) and U51(vGPCR1) gene loci, these included two newly identified E5(vGPCR5) and E54(vOX2-1) loci mapping far outside of the classic EEHV1A versus EEHV1B subtype chimeric domains and towards the novel end segments of the genome that had not been evaluated previously. The high levels of genetic divergence and mosaic scrambling observed between adjacent loci match closely to the overall range of divergence found within 45 analyzed North American and European cases, but include some common relatively unique polymorphic features and preferred subtypes that appear to distinguish most but not all Indian strains from both those in Thailand and those outside range countries. Furthermore, more than half of the Indian cases studied here involved calves living within wild herds, whereas nearly all other cases identified in Asia so far represent rescued camp orphans or captive-born calves.