Patterns Of Disease Spread Research Articles

Relationship between smoking, prognostic factors, and outcomes in patient (pts) with metastatic castration-resistant prostate cancer (mCRPC) receiving sipuleucel-T (sip-T): Preliminary analysis of the PROCEED registry.

216 Background: Smoking is associated with poor treatment outcomes after definitive therapy for PC (Steinberger 2015 BJU Int; Joshu 2011 JNCI). However, there is a paucity of data on the effects of active smoking on pts with mCRPC. The PROCEED registry provides an opportunity to evaluate differences in disease characteristics and outcomes by smoking status in men receiving sip-T, an FDA-approved, autologous cellular immunotherapy for asymptomatic or minimally symptomatic mCRPC. Methods: Enrolled pts with mCRPC who never smoked (NS) or were current smokers (CS) were evaluated.Pt characteristics, time to first anticancer intervention (tACI; measured from last sip-T infusion to first ACI; agents: abiraterone, enzalutamide, docetaxel, cabazitaxel, radium-223), PC-specific survival, and OS were assessed. Results: Of 1956 enrolled pts with known smoking status, 904 were NS, 179 were CS; 873 were former smokers and not included in this analysis. Compared with NS, CS were younger, had lower BMI (p < 0.001), higher hemoglobin (Hgb; p < 0.001), lower lactate dehydrogenase (LDH; p = 0.05), and shorter time between PC diagnosis and first sip-T infusion (p = 0.01). Fewer CS pts had Gleason score < 8 (p = 0.2) and prior radical prostatectomy (p = 0.07). CS and NS did not differ in pattern or extent of metastatic disease spread. CS was associated with shorter OS, PC-specific survival, and tACI (Table). Conclusions: CS were younger at enrollment and had shorter OS, PC-specific survival, and tACI. Higher Hgb in CS likely reflects reduced plasma volume and/or increased red cell production. A multivariate analysis of prognostic factors for survival outcomes including smoking status in mCRPC is planned. However, active smoking represents a possible modifiable risk factor in the mCRPC setting. Clinical trial information: NCT01306890. [Table: see text]

Head and neck sarcomas: A single institute series

BackgroundSarcomas are tumours of mesenchymal origin, accounting for 1% of all malignancies. MethodsThis is a retrospective analysis of 107 head and neck sarcoma cases, treated over a period of thirteen years. ResultsFifty-four patients had with craniofacial bone sarcomas (BSs) (male: 33; female: 21) with high grade osteosarcoma being the most predominant type. The soft tissue sarcomas (STS) (53 patients; male: 28, female: 25) were histologically diverse with rhabdomyosarcomas and myxofibrosarcomas being the predominant types. The majority of BSs were managed with neoadjuvant chemotherapy followed by surgery, whereas in STSs treatment included predominantly surgery followed by radiotherapy. Overall survival estimates were 79% at 2years and 64% at 5years (mean follow-up period was 48months). ConclusionsThe mesenchymal origin of sarcomas, the pattern of disease spread and the different extent of cancellous bone infiltration in contrast to epithelial tumours, dictate distinct principles for surgical clearance.

The impact of staging laparoscopy on treatment strategy in advanced ovarian cancer

Introduction: Complete primary cytoreductive surgery (PCS) is the most important prognostic factor for progression free survival (PFS) and overall survival (OS) in patients with advanced (FIGO stage III) ovarian cancer (AOC). In patients with poor general conditions or with heavy disease burden, complete PCS is difficult to achieve. Various patterns of abdominal disease spread represent biological aggressiveness affect prognosis and demands visual evaluation before planning treatment strategy. Beside imaging methods, laparoscopic pretreatment evaluation of resectability was proposed to more accurately identify those patients that can not be completely resected. In such cases neoadjuvant chemotherapy (NACT), followed with interval debulking surgery (IDS) is proposed. We present the preliminary results of treatment with NACT and IDS in patients selected according to laparoscopic evaluation of resectability. Methods: 2 years retrospective analysis (2011–2013) of 41 patients with clinical signs of AOC, where according to gyn-oncology consultative team, laparoscopy was proposed as a diagnostic and staging procedure. After evaluation of respectability, PCS by laparotomy was performed. Metastatic process of intestinal mesenterium and/or serosa was considered unresectable and NACT was started followed by IDS. Evaluation of laparoscopic procedures and impact on treatment strategy is presented through PFS analysis between the subgroup that had PCS and those started with NACT, followed with IDS. Results: Ascites together with elevated tumor markers, with or without pelvic mass were the most common clinical sign in population studied. 32 patients presented in Stage IIIC and 9 in stage IV. Laparoscopic staging included evaluation of omental infiltration, peritoneal and diaphragmatic carcinosis, intestinal mesenteric or serosal involvement, bowel infiltration, and liver superficial metastasis as well as amount of pelvic disease. In all stage IV patients only laparoscopy was performed. According to laparoscopic staging in stage III patients, conversion to laparotomy for PCS and adjuvant chemotherapy was performed in 21 patients; while in 12 neodjuvant chemotherapy was started. Laparoscopic procedures were: unilateral or bilateral adnexectomy (N = 18); omental biopsy (N = 21), peritoneal biopsy (N = 21); and cytology specimen (N = 15). Average start of chemotherapy was 10 days (7–14) after surgery No major intraoperative complications were registered. In 2 patients laparotomy was performed because of obstructive ileum on day 3 and 5 after laparoscopy. During the mean follow up of 21 (8–33) months 3/21 patients died in PCS subgroup and 5/12 in NACT subgroup; all in the first 8 months after surgery. PFS were 27.80 (19.41–36.19) months for complete PCS; 13.62 (8.54–18.7) months for suboptimal PCS and 15.80 (8.6–22.99) months for NACT with IDS. Estimated OS were 35.6 (30.09–41.26) months for complete PCS, 31.85 (26.35–37.35) months for suboptimal PCS and 31.33 (25.48–37.18) months for NACT with IDS. Conclusions: According to our results, laparoscopy as a staging procedure have a certain impact on treatment strategy in AOC by selecting patients where tumor biology disables complete PCS and making them candidates for NACT. Our preliminary analysis of PFS and estimated OS in this selected group demonstrates that this strategy is not inferior towards suboptimal PCS and adjuvant chemotherapy, but more cases should be analyzed for more definitive conclusions.

ANALISIS POLA PENYEBARAN PENYAKIT DIARE DI KABUPATEN BOGOR

Diarrheal disease is an endemic disease in Indonesia, meaning it occurs continuously in all regions both in the city and in the village, especially in poor areas. In poor areas are generally diarrhea diseases are considered not as a dangerous disease, so the way healing is not through medical treatment. In fact, diarrhea can cause system disturbances or complications that are very harmful for the sufferer. Some of them are fluid and electrolyte disturbances, hypovolemia shock, various body disorders, and if not handled properly can cause death. Thus it becomes important for the nurse to know more about diarrhea, the negative impact it has, and the handling and prevention of its complications.
 The objective of this study was to determine the pattern of diarrheal disease spread in Bogor Regency. The method according to the purpose of this research is Ordinary Kriging. To know the distribution of diarrhea disease in Bogor Regency by looking at the result of countour plot. Based on the countour plot, the area that has the highest number of diarrhea sufferers around Barekah and Bojonggenteng villages is marked with White contour color with the range of diarrhea sufferer is 40 - 42 people. Areas with the highest number of diarrheal diseases indicate that the area has a relationship with the number of diarrheal diseases in the surrounding area. Therefore, the area needs to be prioritized in improving water sanitation, counseling to the community and improving health services.

Investigating the spatial distribution of growth anomalies affecting Montipora capitata corals in a 3-dimensional framework

Diseases have caused significant reductions in coral populations throughout the global ocean. Despite a substantial effort to thoroughly characterize the epizootiology and etiology of coral diseases, little is known about the distribution and spatial clustering of disease lesions on affected coral colonies. This study investigated spatial clustering of the coral disease, growth anomaly (GA), which exhibits high levels of prevalence and severity in Montipora capitata and other corals at Wai’ōpae, southeast Hawai’i Island. Like many other coral diseases, the patterns of disease spread and transmissibility of GA remains unknown. We utilized cutting-edge 3D reconstruction techniques to map the precise spatial distribution of GAs on affected coral colonies. Three statistical measures, Ripley’s K, Moran’s I, and the Kolmogorov-Smirnov test were used to determine if the GA lesions were distributed in a non-random pattern. Each measure showed the GA lesions exhibited distinct spatial clustering on all ten affected colonies analyzed in this study. Our study is not only the first 3D analysis of intra-colony disease clustering, but also provides a novel approach for investigating and quantifying levels of disease clustering in order to improve our understanding of coral disease epizootiology, transmission, and etiology.

Southward autumn migration of waterfowl facilitates cross-continental transmission of the highly pathogenic avian influenza H5N1 virus.

The highly pathogenic avian influenza subtype H5N1 (HPAI H5N1) is a worldwide zoonotic infectious disease, threatening humans, poultry and wild birds. The role of wild birds in the spread of HPAI H5N1 has previously been investigated by comparing disease spread patterns with bird migration routes. However, the different roles that the southward autumn and northward spring migration might play in virus transmission have hardly been explored. Using direction analysis, we analyze HPAI H5N1 transmission directions and angular concentration of currently circulating viral clades, and compare these with waterfowl seasonal migration directions along major waterfowl flyways. Out of 22 HPAI H5N1 transmission directions, 18 had both a southward direction and a relatively high concentration. Differences between disease transmission and waterfowl migration directions were significantly smaller for autumn than for spring migration. The four northward transmission directions were found along Asian flyways, where the initial epicenter of the virus was located. We suggest waterfowl first picked up the virus from East Asia, then brought it to the north via spring migration, and then spread it to other parts of world mainly by autumn migration. We emphasize waterfowl autumn migration plays a relatively important role in HPAI H5N1 transmission compared to spring migration.

Reconstructing a spatially heterogeneous epidemic: Characterising the geographic spread of 2009 A/H1N1pdm infection in England

Understanding how the geographic distribution of and movements within a population influence the spatial spread of infections is crucial for the design of interventions to curb transmission. Existing knowledge is typically based on results from simulation studies whereas analyses of real data remain sparse. The main difficulty in quantifying the spatial pattern of disease spread is the paucity of available data together with the challenge of incorporating optimally the limited information into models of disease transmission. To address this challenge the role of routine migration on the spatial pattern of infection during the epidemic of 2009 pandemic influenza in England is investigated here through two modelling approaches: parallel-region models, where epidemics in different regions are assumed to occur in isolation with shared characteristics; and meta-region models where inter-region transmission is expressed as a function of the commuter flux between regions. Results highlight that the significantly less computationally demanding parallel-region approach is sufficiently flexible to capture the underlying dynamics. This suggests that inter-region movement is either inaccurately characterized by the available commuting data or insignificant once its initial impact on transmission has subsided.

A small plot study of Chalara infestation in a recently established natural stand of ash, UK

A small plot study of Chalara infestation was carried out in a recently established stand of natural secondary woodland on an abandoned field in Suffolk. The aim was to determine the pattern of disease spread in relation to the structure of young ash stands. Wind-dispersed colonisation by ash was typically patchy but clustered along the eastern edge of mature ancient semi-natural woodland. All the trees were small with an average diameter of 1.25 ± .614 cm and average height of 1.63 ± 1.54 metres. Symptoms of dieback were recorded in 51% of the 220 quadrats surveyed but was most prevalent in areas where tree density was highest. Of the 1,343 trees sampled 33% were infected and showing advanced stages of dieback in areas where the disease was most concentrated. The observed positive correlation between tree height and the prevalence of dieback may be due to chance effects emerging from larger patterns of wind-born dispersal in both host and pathogen. The results of the study point to indiscriminate modes of infection operating at local levels and determined by the presence of high numbers of host trees. High levels of infection in early stages of growth suggests ash has little chance to establish itself before it is culled by the disease. The findings also highlight the vulnerability of homogenous stands to wind-borne pathogens.

Inferring social structure and its drivers from refuge use in the desert tortoise, a relatively solitary species

For several species, refuges (such as burrows, dens, roosts, nests) are an essential resource for protection from predators and extreme environmental conditions. Refuges also serve as focal sites for social interactions, including mating, courtship, and aggression. Knowledge of refuge use patterns can therefore provide information about social structure, mating, and foraging success, as well as the robustness and health of wildlife populations, especially for species considered to be relatively solitary. In this study, we construct networks of burrow use to infer social associations in a threatened wildlife species typically considered solitary—the desert tortoise. We show that tortoise social networks are significantly different than null networks of random associations, and have moderate spatial constraints. We next use statistical models to identify major mechanisms behind individual-level variation in tortoise burrow use, popularity of burrows in desert tortoise habitat, and test for stressor-driven changes in refuge use patterns. We show that seasonal variation has a strong impact on tortoise burrow switching behavior. On the other hand, burrow age and topographical condition influence the number of tortoises visiting a burrow in desert tortoise habitat. Of three major population stressors affecting this species (translocation, drought, disease), translocation alters tortoise burrow switching behavior, with translocated animals visiting fewer unique burrows than residents. In a species that is not social, our study highlights the importance of leveraging refuge use behavior to study the presence of and mechanisms behind non-random social structure and individual-level variation. Our analysis of the impact of stressors on refuge-based social structure further emphasizes the potential of this method to detect environmental or anthropogenic disturbances. Adaptive and social behavior that affects fitness is now being increasingly incorporated in the conservation and management of wildlife species. However, direct observations of social interactions in species considered to be solitary are difficult, and therefore integration of behavior in conservation and management decisions in such species has been infrequent. For such species, we propose quantifying refuge use behavior as it can provide insights towards their (hidden) social structure, establish relevant contact patterns of infectious disease spread, and provide early warning signals of population stressors. Our study highlights this approach in a long-lived and threatened species, the desert tortoise. We provide evidence toward the presence of and identify mechanisms behind the social structure in desert tortoises formed by their burrow use preferences. We also show how individuals burrow use behavior responds to the presence of population stressors.

ID-Viewer: a visual analytics architecture for infectious diseases surveillance and response management in Pakistan

ObjectivesGlobally, disease surveillance systems are playing a significant role in outbreak detection and response management of Infectious Diseases (IDs). However, in developing countries like Pakistan, epidemic outbreaks are difficult to detect due to scarcity of public health data and absence of automated surveillance systems. Our research is intended to formulate an integrated service-oriented visual analytics architecture for ID surveillance, identify key constituents and set up a baseline for easy reproducibility of such systems in the future. Study designThis research focuses on development of ID-Viewer, which is a visual analytics decision support system for ID surveillance. It is a blend of intelligent approaches to make use of real-time streaming data from Emergency Departments (EDs) for early outbreak detection, health care resource allocation and epidemic response management. MethodsWe have developed a robust service-oriented visual analytics architecture for ID surveillance, which provides automated mechanisms for ID data acquisition, outbreak detection and epidemic response management. Classification of chief-complaints is accomplished using dynamic classification module, which employs neural networks and fuzzy-logic to categorize syndromes. Standard routines by Center for Disease Control (CDC), i.e. c1-c3 (c1-mild, c2-medium and c3-ultra), and spatial scan statistics are employed for detection of temporal and spatio-temporal disease outbreaks respectively. Prediction of imminent disease threats is accomplished using support vector regression for early warnings and response planning. Geographical visual analytics displays are developed that allow interactive visualization of syndromic clusters, monitoring disease spread patterns, and identification of spatio-temporal risk zones. ResultsWe analysed performance of surveillance framework using ID data for year 2011–2015. Dynamic syndromic classifier is able to classify chief-complaints to appropriate syndromes with high classification accuracy. Outbreak detection methods are able to detect the ID outbreaks in start of epidemic time zones. Prediction model is able to forecast dengue trend for 20 weeks ahead with nominal normalized root mean square error of 0.29. Interactive geo-spatiotemporal displays, i.e. heat-maps, and choropleth are shown in respective sections. ConclusionThe proposed framework will set a standard and provide necessary details for future implementation of such a system for resource-constrained regions. It will improve early outbreak detection attributable to natural and man-made biological threats, monitor spatio-temporal epidemic trends and provide assurance that an outbreak has, or has not occurred. Advanced analytics features will be beneficial in timely organization/formulation of health management policies, disease control activities and efficient health care resource allocation.

Epidemiology-based Task Assignment Algorithm for Distributed Systems

ObjectiveDesign task assignment algorithms based on the patterns of disease spread among the population. ScopeEpidemiology studies spatiotemporal patterns of illness in populations and the factors affecting it. An epidemic emerges out of the population activities and environment. Task assignment is a common activity in many realms where sub-tasks are created, delegated, and collectively carried out to achieve the original task. Due to its complexity and context, task assignment can be a challenging activity that can result in limited outcomes. This research studies task assignment as an epidemic assigned to a distributed system. We have developed computational models to understand the outbreak of aerosol-borne diseases by using the agent-based modelling approach. Experiments are carried out to observe the patterns of emergence during the spread of disease among the individuals and get insights of their mechanisms. These mechanisms are used to design algorithms for task assignment on distributed systems. ResultsUnderstanding the emergent behaviour of diseases can provide the platform for the development of distributed algorithms that can be helpful in overcoming some of the challenges of task assignment in a distributed system.

A study of correlation between molecular subtypes of breast cancer and site of metastasis

Context: Studies have correlated the presence or absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2/neu) with metastatic spread and ultimate clinical outcomes in breast cancer. However, the influence of molecular subtype on the pattern of disease spread is not well known. Aims: The aim of this study is to evaluate the role of various molecular subtypes as a predictor of metastatic distribution in breast carcinoma. Settings and Design: This was a prospective observational study. Subjects and Methods: One-hundred and ten patients of infiltrating ductal carcinoma of breast with distant metastasis were included in the study. Evaluation for metastasis was done using radiodiagnostics. Pathological data were obtained from previous mastectomy specimens. Tumor marker status (ER, PR, and Her2/neu) was assessed, and patients were classified into Luminal A, Luminal B, Her2 enriched, and triple negative. Chi-square test was used to check the relationship between metastasis and different molecular subtypes ( P Statistical Analysis Used: Chi-square test was performed. Results: About 44.6% cases were Luminal A, followed by Luminal B (26.4%), triple negative (18.2%), and Her2 enriched (10.9%). Metastasis was seen in bones (62.7%), lungs (38.2%), liver (27.3%), and brain (10.9%). Luminal A breast cancers metastasized most commonly to bones (71.4%), lungs (36.7%), liver (18.4%), and brain (8.2%) ( P = 0.0001). Luminal B type spread to bones in 62.1% cases, followed by liver (37.9%), lungs (34.5%), and brain (10.3%) ( P = 0.001). Triple negative type cancers involved bones (60%), lungs (50%), liver (20%), and brain (10%) ( P = 0.002). Her2-enriched cancers spread to liver (50%), followed by bones and lungs (33.3% each) and brain (25%) ( P = 0.630). Conclusions: The major molecular subtypes in breast cancer are evidently different with regard to their ability to metastasize to different organs.

Where Does Diffuse Large B-Cell Lymphoma Relapse?

This study aimed to investigate the anatomic pattern of disease spread at first disease relapse compared with baseline in diffuse large B-cell lymphoma (DLBCL). All patients who were newly diagnosed as having DLBCL between January 2004 and June 2014 who initially achieved complete remission but who eventually developed relapsed disease during follow-up were retrospectively identified. Available histological and imaging data were used to determine which nodal regions and extranodal locations were involved at relapse. A total of 21 patients with relapsed DLBCL were included, of whom 8 (38.1%) presented with disease relapse at previously involved sites only, 7 (33.3%) presented with disease relapse at both previously involved and new sites, and 6 (28.6%) presented with disease relapse at new sites only. A total of 57 nodal stations and 34 extranodal locations were involved in all 21 relapsed DLBCL patients. Of these 57 involved nodal regions, 47 (82.5%) were also involved at baseline, whereas 10 (17.5%) were not involved at baseline. Of the 34 involved extranodal locations, 17 (50.0%) were also involved at baseline, whereas 17 (50.0%) were not involved at baseline. Relapsed DLBCL generally tends to affect previously involved sites, although close to one third of patients seem to have disease recurrence exclusively in previously uninvolved sites. The great majority of involved nodal stations at relapse are also involved at baseline, whereas only one half of involved extranodal locations at relapse are involved at baseline.

Simulation Study on Effects of Order and Step Size of Runge-Kutta Methods that Solve Contagious Disease and Tumor Models.

Biological processes such as contagious disease spread patterns and tumor growth dynamics are modelled using a set of coupled differential equations. Experimental data is usually used to calibrate models so they can be used to make future predictions. In this study, numerical methods were implemented to approximate solutions to mathematical models that were not solvable analytically, such as a SARS model. More complex models such as a tumor growth model involve high-dimensional parameter spaces; efficient numerical simulation techniques were used to search for optimal or close-to-optimal parameter values in the equations. Runge-Kutta methods are a group of explicit and implicit numerical methods that effectively solve the ordinary differential equations in these models. Effects of the order and the step size of Runge-Kutta methods were studied in order to maximize the search accuracy and efficiency in parameter spaces of the models. Numerical simulation results showed that an order of four gave the best balance between truncation errors and the simulation speed for SIR, SARS, and tumormodels studied in the project. The optimal step size for differential equation solvers was found to be model-dependent.

Occult Dermal Lymphatic Involvement Is Frequent in Primary Cutaneous Anaplastic Large Cell Lymphoma.

Primary cutaneous anaplastic large cell lymphoma (pcALCL) is an indolent T-cell lymphoproliferative disorder managed with low-dose radiation therapy, surgery, and/or mild chemotherapy; patients with extensive limb disease (ELD) have a more aggressive clinical course. We have previously demonstrated that histologically apparent vascular involvement in pcALCL is lymphatic. We hypothesized that histologically occult lymphatic involvement may be associated with particular patterns of disease spread that could involve lymphangitic spread including locoregional spread of disease in the form of ELD and extracutaneous spread of disease. We have therefore set out to quantitate the incidence of occult lymphovascular involvement in pcALCL and to assess for an association between lymphovascular involvement and these patterns of disease. We performed immunohistochemistry for the lymphovascular marker D2-40 on skin biopsies from 29 patients with pcALCL followed in the Stanford Cutaneous Lymphoma Clinic. Immunohistochemically evident dermal lymphovascular involvement was found in nearly half of cases examined (48%; 95% confidence interval, 29%-67%). There was a nonsignificant trend toward a higher prevalence of ELD among patients with pcALCL involving dermal lymphatics (7% vs. 29%; p = 0.12). In this small cohort, there was no indication of a significantly more aggressive disease course in patients with lymphatic involvement either in the form of disease-related mortality (one each in the lymphatic and nonlymphatic groups) or in time to extracutaneous involvement.

Epidemiological study ofCucumber green mottle mosaic virusin greenhouses enables reduction of disease damage in cucurbit production

Since 2007, the tobamovirus Cucumber green mottle mosaic virus (CGMMV) has become widespread in Israel, causing severe damage to trellised cucumber and melon in greenhouses and watermelon grown in open fields. To reduce disease damage below the economic threshold, this study focused on four objectives: (a) monitoring the patterns of virus distribution within commercial cucumber greenhouses; (b) studying the potential transmission of CGMMV by agrotechnical activities; (c) virus localization in plant tissues; and (d) searching for techniques that might be adapted for mitigating the disease in trellised cucurbit growth. The results of our surveys demonstrated the role of contaminated seeds and soil as primary inoculum sources, and secondary spread caused by agrotechnical activities. The patterns of secondary disease spread were demonstrated in a series of inoculation experiments involving contaminated knives, shears or hands on wet and dry plants, conducted under research-greenhouse conditions. In parallel experiments using CGMMV-specific antibody and secondary antibody conjugated to Alexa fluor 488, the viral coat protein was visualized in several plant tissues: phloem, xylem, trichomes and grasping tendrils. In addition, commercial-greenhouse experiments were aimed at reducing the number of inoculum sources by identifying and removing infected plants from the plots (early monitoring) prior to agrotechnical activities and/or by adding intermediate medium (IM), such as virus-free compost, to the planting pits at the planting stage. It is suggested that the use of IM combined with early monitoring, awareness of worker mobility (from contaminated structures to young planting areas) and proper sanitation (e.g. disinfection of agrotechnical tools) may reduce the yield losses caused by CGMMV below the economic threshold.

Different Patterns of Disease Spread between Advanced-Stage Type I and II Epithelial Ovarian Cancer

Background and Aims: Two types of epithelial ovarian carcinoma (EOC) have been recently distinguished. Type I comprises low-grade serous, endometrioid and clear-cell tumors. High-grade endometrioid and serous tumors belong to type II. The aim of this study was to compare patterns of disease spread in advanced-stage type I and II EOCs at primary surgery. Methods: Surgical and pathological data of 233 patients with advanced-stage EOCs were collected, 42 with type I and 191 with type II. The two groups were compared for tumor localization at primary surgery. Intraoperative mapping of ovarian cancer (IMO) was used to assess tumor dissemination. Results: Tumor involvement was significantly higher in the type II group for the following: peritoneum (68.1 vs. 40.5%, p < 0.001), pouch of Douglas (60.2 vs. 40.5%, p = 0.06), vesicouterine ligament (40.8 vs. 19%, p = 0.027), diaphragm (45.0 vs. 11.9%, p < 0.001), serosa of liver (17.2 vs. 4.8%, p = 0.05), omentum (81.1 vs. 59.5%, p = 0.007), mesentery (42.9 vs. 16.7%, p = 0.005), pleural effusions (19.4 vs. 4.6%, p = 0.01) and ascites (60.7 vs. 21.4%, p < 0.001). IMO levels were different between the two groups (p = 0.001). Conclusions: This study provides clinical evidence in favor of the dualistic model of carcinogenesis, since types I and II are characterized by different findings at primary surgery.

An ex-ante economic appraisal of Bluetongue virus incursions and control strategies

SUMMARYThe incursion of Bluetongue disease into the UK and elsewhere in Northern Europe in 2008 raised concerns about maintaining an appropriate level of preparedness for the encroachment of exotic diseases as circumstances and risks change. Consequently the Scottish government commissioned the present study to inform policy on the specific threat of Bluetongue virus 8 (BTV8) incursion into Scotland. An interdisciplinary expert panel, including BTV and midge experts, agreed a range of feasible BTV incursion scenarios, patterns of disease spread and specific control strategies. The study was primarily desk-based, applying quantitative methodologies with existing models, where possible, and utilizing data already held by different members of the project team. The most likely distribution of the disease was explored given Scotland's agricultural systems, unique landscape and climate. Epidemiological and economic models are integrated in an ex-ante cost-benefit appraisal of successful prevention of hypothetical BTV8 incursion into Scotland under various feasible incursion scenarios identified by the interdisciplinary panel. The costs of current public and private surveillance efforts are compared to the benefits of the avoided losses of potential disease outbreaks. These avoided losses included the direct costs of alternative vaccination, protection zone (PZ) strategies and their influence on other costs arising from an outbreak as predicted by the epidemiological model. Benefit-cost ratios were ranked within each incursion scenario to evaluate alternative strategies. In all incursion scenarios, the ranking indicated that a strategy, including 100% vaccination within a PZ set at Scottish counties along the England–Scotland border yielded the least benefit in terms of the extent of avoided outbreak losses (per unit cost). The economically optimal vaccination strategy was the scenario that employed 50% vaccination and all Scotland as a PZ. The results provide an indicator of how resources can best be targeted for an efficient ex-ante control strategy.

Spatial Pattern of Natural Spread of Rice False Smut (&lt;i&gt;Ustilaginoidea virens&lt;/i&gt;) Disease in Fields

Pattern of disease spread provides improved knowledge on how the pathogen introduces itself and interacts with environment in fields and expresses as a disease. It is especially significant when epidemiology of a disease, such as Rice False Smut (RFSm), is unclearly understood. Not reported before, this study attempted an analysis of spatial pattern of natural spread of RFSm in nine fields in an intensive rice ecosystem in Bangladesh. Both conventional and specialized statistical methods were applied in the analysis. Results show that the spread of the disease was not similar between and within the fields and even some fields were almost disease free. RFSm recorded aggregation in spaces in most of the fields, but the location of this aggregation differed between the fields. Symptom recorded on panicles in regenerated tillers from harvested main crop (otherwise known as ratoons). The disease tended to be prominent towards proximity of drainage channels. The probability of occurring one diseased tiller per hill was calculated as 73% and cumulative probability of four or less smut balls per diseased panicle as little over 60%. This study establishes soil as the absolute dominant source of initiation of the epidemic. The analysis did not find evidence of any long- or short-distance primary and/or secondary sources of infection. It is concluded that the disease management be directed specific to the fields at risk. It suggests development of a soil testing tool for quantifying inoculum potential in a field to ascertain the risk. With the discovery of symptom on ratoons, this study highlights the need for fresh thinking on identifying the pathway of entry of the pathogen into the plant.

Ecology of Basal Stem Rot Disease of Oil Palm (&amp;lt;i&amp;gt;Elaeis guineensis&amp;lt;/i&amp;gt; Jacq.) in Cameroon

Basal stem rot (BSR) disease caused by species of <i>Ganoderma { XE "Ganoderma"}</i>is of immense importance in oil palm production. Although much is known on the occurrence of this devastating disease, fundamental studies on the ecology in oil palm in plantations are rather limited. This study sought to determine the incidence, severity, distribution and spread pattern of BSR disease in oil palm plantations and relate disease parameters to climatic and edaphic factors. Surveys were carried out for two years on two–hectare plots in each of five oil palm estates of the Cameroon Development Corporation. Data for disease incidence and severity in each estate were recorded. Disease spread patterns were generated from Arc GIS version 9.3 using GIS coordinates of diseased plants. A correlation between disease parameters and soil physicochemical properties and multivariate analyses were done. Typical BSR disease symptoms were observed including unopened spear leaves, skirt–like appearance of leaves, basidiocarp formation, bole creation and death of the palm. The disease incidence ranged from 5.4% in 16-year old palms at Bota to 39.0% in palms of the same age in Mungo were about 50% of infected plants had extreme severe symptoms. Although principal component analysis showed that six soil properties account for variation in BSR disease incidence and severity, only fine sand content was positively correlated (P≤0.05) with disease incidence and severity, while C/N ratio was negatively correlated. This study has established the occurrence and spread of basal stem rot disease in five oil palm plantations in South Western Cameroon.