Intense human-animal interaction and limited capacity for the surveillance of zoonoses as drivers for Hepatitis E virus infections among animals and humans in Lao PDR

Purpose: In Lao People's Democratic Republic (PDR), overlapping habitats of the population and livestock create a propitious environment for zoonoses. Insufficient hygienic measures in slaughterhouses and in rural settings further increase the risk for zoonotic transmission. Limited laboratory capacity as well as lack of background knowledge prevent timely control of disease oubreaks. Here, we assess the occurrence and transmission of Hepatits E virus (HEV), as well as public awareness of zoonoses. Methods & Materials: In 2015 and 2016, samples were collected from ruminants in rural areas (n=211), as well as from slaughterhouse workers (n=129) and slaughter pigs (n=290) in Lao PDR. Using commercial ELISAs, presence of antibodies (IgG, IgM and IgA) against HEV was assessed. Fecal shedding of HEV by animals was investigated using a generic real-time PCR. Detected viruses were characterized by Sanger sequencing if feasible. Using a standardized questionnaire, data on risk factors for zoonotic pathogen transmission and awareness on zoonoses were captured. Much emphasis was placed on collaborating with local actors and on strengthening laboratory capacities. Results: Anti-HEV antibodies were detected in 13% of ruminants in rural settings and in 46% of slaughter pigs. 7% of the ruminants and 2% of the pigs shed HEV that were thus far not characterizable. While anti-HEV antibody seroprevalence was of 33% in people exposed to pigs, only 15% of the non-exposed control group were seropositive (p= 0.001). Awareness of zoonoses among farmers and slaughterhouse workers was low. Wearing protective equipment was associated with a decrease in anti-HEV antibody detection (p=0.024). Limiting the consumption and use of groundwater and cooking of meat further reduced the risk for HEV infection in a domestic context. Conclusion: We could show that people who are exposed to livestock and pigs are at higher risk for contracting HEV than the general population. Although shedding rates were relatively low, animals may represent an infection source that can be controlled by applying personal protective equipment. Building the capacity for the detection and prevention of infectious diseases and increasing awareness about zoonoses in developing countries is a prerequisite for combating infectious disease outbreaks in future

Livestock diseases threatening smallholder farmers in Lao people's Democratic Republic

Purpose: In Lao People's Democratic Republic, uncontrolled animal trade, lack of animal containment and limited access to veterinary services are a growing-ground for virus spread. Foot-and-Mouth Disease (FMD) and several avian viruses are enzootic and threaten subsistence farmers. We assessed the (sero-)prevalence of several livestock viruses, and evaluated the knowledge, attitude, and practice of smallholder farmers towards FMD. Methods & Materials: In 2018, sera were collected from 394 domestic ruminants and screened using an ELISA that differentiates between infected and vaccinated animals. Questionnaires (n = 101) were statistically explored to identify knowledge gaps and risk factors related to FMD. In addition, oral and cloacal swabs, collected from 619 backyard poultry in 2011, 2014 and 2015, were tested by PCR for Newcastle disease (NDV), Influenza A, Coronavirus (CoV) and Chicken Anemia Virus (CAV). 206 poultry sera were screened by ELISA for the presence of anti-NDV and –Influenza A antibodies. Statistical and phylogenetic analyses revealed the viral infection patterns. Results: Although most farmers had very limited knowledge about FMD, many could correctly enumerate the symptoms and observed outbreaks recently. This was confirmed by our laboratory analysis: overall 37.1% of the animals were seropositive and 72.3% of the farms had at least one seropositive animal. Approx. 90% of the farmers reported that FMD negatively affects livestock trade and health. Moreover, we found high positivity rates of CoV and CAV RNA in cloacal and oral swabs (CoV: 38.3% and 6.2%; CAV: 16.1% and 1.7%). Younger animals were more likely to shed both, CoV and CAV, and similar virus strains co-circulated in chickens and ducks. Despite serological evidence of NDV and influenza A circulation (86.9% and 1.9%), viral RNA was detected in none of the swabs. Conclusion: A large proportion of the Lao population relies on subsistence livestock production which is, as shown here, severely compromised by the circulating viruses. To secure their livelihoods, vaccination programmes should target all susceptible hosts and achieve a high coverage throughout the country. These campaigns should be complemented by community-based sensitization to raise the awareness about prevention strategies, such as quarantine and trade restrictions

Temperature and ac Effects on Charge Transport in Metallic Arrays of Dots

We investigate the effects of finite temperature, dc pulse, and ac drives on the charge transport in metallic arrays using numerical simulations. For finite temperatures there is a finite conduction threshold which decreases linearly with temperature. Additionally we find a quadratic scaling of the current-voltage curves which is independent of temperature for finite thresholds. These results are in excellent agreement with recent experiments on 2D metallic dot arrays. We have also investigated the effects of an ac drive as well as a suddenly applied dc drive. With an ac drive the conduction threshold decreases for fixed frequency and increasing amplitude and saturates for fixed amplitude and increasing frequency. For sudden applied dc drives below threshold we observe a long time power law conduction decay.Comment: 6 pages, 7 postscript figure

A Diagnosis of Irritable Bowel Syndrome Using Rome IV Criteria and Limited Investigations is Durable in Secondary Care

Background & Aims Irritable bowel syndrome (IBS) is a positive diagnosis, made using symptom-based criteria and limited, judicious, investigation. However, this may lead to uncertainty on the part of clinicians regarding potential for a missed diagnosis of organic gastrointestinal disease. Few studies have examined durability of a diagnosis of IBS, and none have used the current gold standard to diagnose IBS, the Rome IV criteria. Methods We collected complete symptom data from 373 well-characterized adults meeting Rome IV criteria for IBS referred to a single UK clinic between September 2016 and March 2020. All patients underwent relatively standardized work-up to exclude relevant organic disease before diagnosis. We followed these individuals up to December 2022, assessing rates of rereferral, reinvestigation, and missed organic gastrointestinal disease. Results During a mean follow-up of 4.2 years per patient (total follow-up in all patients, 1565 years), 62 (16.6%) patients were rereferred. Of these, 35 (56.5%) were rereferred for IBS and 27 (43.5%) for other gastrointestinal symptoms. Among the 35 rereferred with IBS this was caused by a change in symptoms in only 5 (14.3%). Reinvestigation was undertaken in 21 (60.0%) of 35 rereferred with IBS and 22 (81.5%) of 27 rereferred with other symptoms (P = .12). Only 4 (9.3% of those reinvestigated and 1.1% of the entire cohort) new cases of relevant organic disease, which may have been responsible for IBS symptoms at baseline, were identified (1 case of chronic calcific pancreatitis among those rereferred with IBS and 1 case each of inflammatory bowel disease–unclassified, moderate bile acid diarrhea, and small bowel obstruction among those rereferred with other gastrointestinal symptoms). Conclusions Despite rereferral for gastrointestinal symptoms among 1 in 6 patients overall, with almost 10% rereferred with ongoing IBS symptoms, and substantial reinvestigation rates, missed organic gastrointestinal disease occurred in only 1%. A diagnosis of Rome IV IBS after limited investigation is safe and durable

Novel symptom clusters predict disease impact and healthcare utilisation in inflammatory bowel disease: Prospective longitudinal follow-up study

Background Predicting adverse disease outcomes and high-volume users of healthcare amongst patients with inflammatory bowel disease (IBD) is difficult. Aims The aim of this study is to use latent class analysis to create novel clusters of patients and to assess whether these predict outcomes during 6.5 years of longitudinal follow-up. Methods Baseline demographic features, disease activity indices, anxiety, depression, and somatoform symptom-reporting scores were recorded for 692 adults. Faecal calprotectin (FC) was analysed at baseline in 348 (50.3%) patients (<250 mcg/g defined biochemical remission). Using baseline gastrointestinal and psychological symptoms, latent class analysis identified specific patient clusters. Rates of glucocorticosteroid prescription or flare, escalation, hospitalisation, or intestinal resection were compared between clusters using multivariate Cox regression. Results A three-cluster model was the optimum solution; 132 (19.1%) patients had below-average gastrointestinal and psychological symptoms (cluster 1), 352 (50.9%) had average levels of gastrointestinal and psychological symptoms (cluster 2), and 208 (30.1%) had the highest levels of both gastrointestinal and psychological symptoms (cluster 3). Compared with cluster 1, cluster 3 had significantly increased risk of flare or glucocorticosteroid prescription (hazard ratio (HR): 2.13; 95% confidence interval (CI): 1.46–3.10), escalation (HR: 1.92; 95% CI: 1.34–2.76), a composite of escalation, hospitalisation, or intestinal resection (HR: 2.05; 95% CI: 1.45–2.88), or any of the endpoints of interest (HR: 2.06; 95% CI: 1.45–2.93). Healthcare utilisation was highest in cluster 3. Conclusions Novel model-based clusters identify patients with IBD at higher risk of adverse disease outcomes who are high-volume users of healthcare

Progress in Absorber R&D for Muon Cooling

A stored-muon-beam neutrino factory may require transverse ionization cooling of the muon beam. We describe recent progress in research and development on energy absorbers for muon-beam cooling carried out by a collaboration of university and laboratory groups.Comment: 7 pages, 1 figure, presented at the 3rd International Workshop on Neutrino Factory Based on Muon Storage Rings (NuFACT'01), May 24-30, 2001, Tsukuba, Japa

A methodology for measuring the sustainability of car transport systems

Measuring the sustainability of car fleets, an important task in developing transport policy, can be accomplished with an appropriate set of indicators. We applied the Process Analysis Method of sustainability assessment to generate an indicator set in a systematic and transparent way, that is consistent with a declared definition of a sustainable transport system. Our method identifies stakeholder groups, the full range of impacts across the environmental, economic and human/social domains of sustainability, and those who generate and receive those impacts. Car users are shown by the analysis to have dual roles, both as individual makers of decisions and as beneficiaries/sufferers of the impacts resulting from communal choice. Thus car users, through their experience of service quality, are a potential force for system change. Our method addresses many of the well-known flaws in measuring transport sustainability. The indicator set created is independent of national characteristics and will be useful to transport policy practitioners and sustainable mobility researchers globally. © 2013 Elsevier Ltd

Motion integration using competitive priors

Psychophysical experiments show that humans are better at perceiving rotation and expansion than translation [5][9]. These findings are inconsistent with standard models of motion integration which predict best performance for translation. To explain this discrepancy, our theory formulates motion perception at two levels of inference: we first perform model selection between the competing models (e.g. translation, rotation, and expansion) and then estimate the velocity using the selected model. We define novel prior models for smooth rotation and expansion using techniques similar to those in the slow-and-smooth model [23] (e.g. Green functions of differential operators). The theory gives good agreement with the trends observed in four human experiments

Utility of irritable bowel syndrome subtypes and most troublesome symptom in predicting disease impact and burden

Background Little is known about the characteristics of individuals with irritable bowel syndrome (IBS) according to stool subtype or the most troublesome symptom reported by the individual, or whether these are useful in predicting the impact of IBS. Methods We collected demographic, gastrointestinal, and psychological symptoms, healthcare usage and direct healthcare costs, impact on work and activities of daily living, and quality of life data from individuals with Rome IV-defined IBS. Key Results We recruited 752 people with Rome IV IBS. Individuals with IBS-D reported a poorer disease-specific quality of life than those with IBS-C or IBS-M (mean (SD) IBS-QOL 45.3 (23.0) for IBS-D, vs. 52.3 (19.9) for IBS-C, vs. 49.4 (22.0) for IBS-M, p = 0.005). Mean (SD) IBS-QOL scores were also lower amongst those who reported diarrhea (44.8 (22.3)) or urgency (44.6 (22.3)) as their most troublesome symptom, compared with those reporting abdominal pain (52.2 (22.9)), constipation (49.5 (21.8)), or abdominal bloating or distension (50.4 (21.3)). However, there were no differences in mean EQ-5D scores, IBS severity, levels of anxiety, depression, somatoform symptom-reporting, or gastrointestinal symptom-specific anxiety. Direct healthcare costs of IBS were similar across all subtypes and all most troublesome symptom groups, although some differences in work productivity and social leisure activities were detected. Conclusions and Inferences There appears to be limited variation in the characteristics of individuals with Rome IV IBS based on both stool subtypes and most troublesome symptom reported, suggesting that gastrointestinal symptoms alone have limited ability to predict disease impact and burden

Bias in beliefs about the self is associated with depressive but not anxious mood

Background: Biases in beliefs about the self are associated with psychopathology and depressive and anxious mood, but it is not clear if both negative and positive beliefs are associated with depression or anxiety. We examined these relationships in people who present with a wide range of depressive and anxious mood across diagnostic categories. Methods: We probed positive and negative beliefs about the self with a task in which 74 female participants with either Affective Disorder (depression and/or anxiety), Borderline Personality Disorder or no psychiatric history indicated the degree to which 60 self-related words was “like them” or “not like them”. Depressive and anxious mood were assessed with the Beck Depression Inventory–II and the Beck Anxiety Inventory. Results: The participants with no psychiatric history (n=25) reported a positive bias in their beliefs about the self, the participants with Affective Disorder (n=23) reported no bias, and the participants with BPD (n=26) reported a negative bias. Two hierarchical multiple regressions demonstrated that the positive and negative beliefs contributed additively to the ratings of depression (corrected for anxiety), but did not contribute to the ratings of anxiety (corrected for depression). Limitations: Despite the apparent small sample size, the regression analyses indicated adequate sampling. Anxiety is a much more heterogeneous condition than is depression, so it may be difficult to find relevant self-descriptors. Only measures of endorsement were used. Conclusions: Biases in beliefs about the self are associated with depressed, but not anxious mood, across diagnostic categorie