Environment, vector, or host? Using machine learning to untangle the mechanisms driving arbovirus outbreaks

Climatic, landscape, and host features are critical components in shaping out-breaks of vector-borne diseases. However, the relationship between the outbreaks of vector-borne pathogens and their environmental drivers is typically complicated, nonlinear, and mayvary by taxonomic units below the species level (e.g., strain or serotype). Here, we aim tountangle how these complex forces shape the risk of outbreaks of Bluetongue virus (BTV); avector-borne pathogen that is continuously emerging and re-emerging across Europe, with sev-ere economic implications. We tested if the ecological predictors of BTV outbreak risk wereserotype-specific by examining the most prevalent serotypes recorded in Europe (1, 4, and 8).We used a robust machine learning (ML) pipeline and 23 relevant environmental features to fitpredictive models to 24,245 outbreaks reported in 25 European countries between 2000 and2019. Our ML models demonstrated high predictive performance for all BTV serotypes (accu-racies>0.87) and revealed strong nonlinear relationships between BTV outbreak risk andenvironmental and host features. Serotype-specific analysis suggests, however, that each of themajor serotypes (1, 4, and 8) had a unique outbreak risk profile. For example, temperature andmidge abundance were as the most important characteristics shaping serotype 1, whereas forserotype 4 goat density and temperature were more important. We were also able to identifystrong interactive effects between environmental and host characteristics that were also sero-type specific. Our ML pipeline was able to reveal more in-depth insights into the complex epi-demiology of BTVs and can guide policymakers in intervention strategies to help reduce theeconomic implications and social cost of this important pathogen

Evaluating hospital websites in Kuwait to improve consumer engagement and access to health information:a cross-sectional analytical study

Abstract Background Current advances in information and communication technology have made accessing and obtaining health-related information easier than ever before. Today, many hospital websites use a patient-centric approach to promote engagement and encourage learning for better health-related decision making. However, little is known about the current state of hospital websites in the State of Kuwait. This study aims to evaluate hospital websites in Kuwait and offer recommendations to improve patient engagement and access to health information. Methods This study employs a cross-sectional analytical approach to evaluate hospital websites in Kuwait in 2017. The websites of hospitals that provide in-patient services were identified through a structured search. Only active websites that were available in either English or Arabic were considered. The evaluation of the websites involved a combination of automated and expert- based evaluation methods and was performed across four dimensions: Accessibility, Usability, Presence, and Content. Results Nine hospitals met the inclusion criteria. Most of the websites fell short in all four dimensions. None of the websites passed the accessibility guidelines. The usability of websites varied between hospitals. Overall, the majority of hospitals in Kuwait have rudimentary online presence and their websites require careful reassessment with respect to design, content, and user experience. The websites focus primarily on promoting services provided by the hospital rather than engaging and communicating with patients or providing evidence-based information. Conclusions Healthcare organization and website developers should follow best-practices to improve their websites taking into consideration the quality, readability, objectivity, coverage and currency of the information as well as the design of their websites. Hospitals should leverage social media to gain outreach and better engagement with consumers. The websites should be offered in additional languages commonly spoken by people living in Kuwait. Efforts should be made to ensure that health information on hospital websites are evidence-based and checked by healthcare professionals

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review.

Background: Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors. Methods: We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis. Results: 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. Conclusions: Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups

The Association Between Skeletal Facial Types and Third Molars Impaction in a Saudi Arabian Subpopulation: A CBCT Study

Muslat A Bin Rubaia’an,1 Aymen Neyaz,1 Faisal Talic,1 Ali Alkhamis,1 Abdulmalek Alghabban,1 Ahmad Assari2 1College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia; 2Oral and Maxillofacial Surgery and Diagnostic Sciences Department, Riyadh Elm University, Riyadh, Kingdom of Saudi ArabiaCorrespondence: Muslat A Bin Rubaia’an, Tel +966 557020222, Email [email protected]: To assess the state of mandibular and maxillary third molars in relation to different facial types in a Saudi population using cone-beam computed tomography (CBCT) records.Patients and Methods: A retrospective study was performed on CBCTs. Statistical analysis determined the relationship between impacted maxillary and mandibular third molars and different skeletal facial types. The degree of third molar impaction was evaluated.Results: A total of 198 CBCTs from subjects were evaluated, with a mean age of 34.2 years. Archer II classification was found to be significantly associated with all skeletal profiles. The incidence of mesioangular impactions in lower third molar showed a notable increase in the brachyfacial group, which was statistically significant.Conclusion: In conclusion, this study demonstrates that different facial types are associated with the angulation of third molar impactions.Keywords: impacted, wisdom tooth, brachyfacial, dolichofacial, mesiofacial, retrospectiv