The effect of treatment on pathogen virulence.

The optimal virulence of a pathogen is determined by a trade-off between maximizing the rate of transmission and maximizing the duration of infectivity. Treatment measures such as curative therapy and case isolation exert selective pressure by reducing the duration of infectivity, reducing the value of duration-increasing strategies to the pathogen and favoring pathogen strategies that maximize the rate of transmission. We extend the trade-off models of previous authors, and represents the reproduction number of the pathogen as a function of the transmissibility, host contact rate, disease-induced mortality, recovery rate, and treatment rate, each of which may be influenced by the virulence. We find that when virulence is subject to a transmissibility-mortality trade-off, treatment can lead to an increase in optimal virulence, but that in other scenarios (such as the activity-recovery trade-off) treatment decreases the optimal virulence. Paradoxically, when levels of treatment rise with pathogen virulence, increasing control efforts may raise predicted levels of optimal virulence. Thus we show that conflict can arise between the epidemiological benefits of treatment and the evolutionary risks of heightened virulence

Potential for rabies control through dog vaccination in wildlife-abundant communities of Tanzania

Canine vaccination has been successful in controlling rabies in diverse settings worldwide. However, concerns remain that coverage levels which have previously been sufficient might be insufficient in systems where transmission occurs both between and within populations of domestic dogs and other carnivores. To evaluate the effectiveness of vaccination targeted at domestic dogs when wildlife also contributes to transmission, we applied a next-generation matrix model based on contract tracing data from the Ngorongoro and Serengeti Districts in northwest Tanzania. We calculated corresponding values of R0, and determined, for policy purposes, the probabilities that various annual vaccination targets would control the disease, taking into account the empirical uncertainty in our field data. We found that transition rate estimates and corresponding probabilities of vaccination-based control indicate that rabies transmission in this region is driven by transmission within domestic dogs. Different patterns of rabies transmission between the two districts exist, with wildlife playing a more important part in Ngorongoro and leading to higher recommended coverage levels in that district. Nonetheless, our findings indicate that an annual dog vaccination campaign achieving the WHO-recommended target of 70% will control rabies in both districts with a high level of certainty. Our results support the feasibility of controlling rabies in Tanzania through dog vaccination

Influence of energy cost and physical fitness on the preferred walking speed and gait variability in elderly women

Typically gait speed decreases and gait variability increases in elderly. The aim of this study was to define the influence of energy cost of walking on gait speed and of health-related physical fitness on gait variability. Thirty healthy young and older women were recruited in the study. Energy cost of walking (NetCW) was analyzed with indirect calorimetry while a kinematic analysis was performed with an optoelectronic system to calculate gait variability (GV) during treadmill walking at different speeds. Gait speed was defined as the preferred walking speed (PWS) of the subject and health related physical fitness (HRPF) comprised body fat, strength, flexibility, and cardiorespiratory fitness. In healthy elderly women, the coefficient of variation of step width was found to be a better indicator of GV than stride time, stride length and double support coefficients of variation. GV was not affected by age allowing a high PWS. Furthermore, significant associations, adjusted for age, body mass index and number of falls, were identified neither between NetCW and the PWS, nor between HRPF and GV; only a significant association was found between hand-grip strength and gait stability. Findings highlighted the importance to evaluate hand-grip strength as an indicator of gait efficiency

Uniformidade de maturação dos frutos no cacho de macaúbas nativas do pantanal e cerrado.

o presente trabalho teve como objetivo avaliar a uniformidade de maturação dos frutos no cacho em macaúbas de ocorrência natural nos biomas Pantanal e Cerrado

Twitching motility among pathogenic Xylella fastidiosa isolates and the influence of bovine serum albumin on twitching-dependent colony fringe morphology

Fourteen Xylella fastidiosa isolates from grapevines exhibiting Pierce's disease symptoms in California, Texas, and South Carolina were examined for type IV pilus-mediated twitching motility, a phenotype previously observed in a Temecula isolate from California. All isolates except one from South Carolina (SC 19A97) exhibited colonies with a peripheral fringe on PW agar, a feature indicative of twitching motility; however, when individual cells of SC 19A97 were examined at higher magnifications twitching motility was observed. The presence and width of colony peripheral fringes were related to the amount of bovine serum albumin (BSA) present in the medium; no or low levels of BSA (0-1.8 g L−1) permitted development of the widest fringe, whereas higher levels (3.5-6.0 g L−1) severely limited, and in many instances prevented, peripheral fringe development. The growth rate of the wild-type Temecula isolate in PW broth with different concentrations of BSA was similar for all tested concentrations of BSA; however, growth was significantly reduced in medium without BS

Spatial heterogeneity in projected leprosy trends in India

Background: Leprosy is caused by infection with Mycobacterium leprae and is characterized by peripheral nerve damage and skin lesions. The disease is classified into paucibacillary (PB) and multibacillary (MB) leprosy. The 2012 London Declaration formulated the following targets for leprosy control: (1) global interruption of transmission or elimination by 2020, and (2) reduction of grade-2 disabilities in newly detected cases to below 1 per million population at a global level by 2020. Leprosy is treatable, but diagnosis, access to treatment and treatment adherence (all necessary to curtail transmission) represent major challenges. Globally, new case detection rates for leprosy have remained fairly stable in the past decade, with India responsible for more than half of cases reported annually. Methods: We analyzed publicly available data from the Indian Ministry of Health and Family Welfare, and fit linear mixed-effects regression models to leprosy case detection trends reported at the district level. We assessed correlation of the new district-level case detection rate for leprosy with several state-level regressors: TB incidence, BCG coverage, fraction of cases exhibiting grade 2 disability at diagnosis, fraction of cases in children, and fraction multibacillary. Results: Our analyses suggest an endemic disease in very slow decline, with substantial spatial heterogeneity at both district and state levels. Enhanced active case finding was associated with a higher case detection rate. Conclusions: Trend analysis of reported new detection rates from India does not support a thesis of rapid progress in leprosy control

Substance Use and Disabilities: Experiences of Adults’ Social Care Professionals and the Implications for Education and Training

This paper draws on data from a national survey of social workers and social care practitioners in England undertaken in 2010–2011. It focuses on practitioners working in services for adults with either learning or physical disabilities and, in particular, their experiences of responding to alcohol and other drug use among their service users. Based on secondary analysis of survey and focus group data from the earlier study, the paper outlines the extent to which workers in these areas of practice encounter alcohol and drug problems and discusses the key challenges this poses for them. The findings show that between 4% and 10% of adults' practitioners' service users have alcohol and drug problems depending on the nature of the disability. Regardless of the type of disability, practitioners reported difficulties in talking about substance use with their service users as well as identifying tensions around life-style choice and risk management. They also reported the need for education and training in a number of areas. Social work education and subsequent training in working with substance use problems needs to be available to adults' practitioners and it needs to address the specific issues and needs in different areas of social work practice

Kinematic evaluation of physical impairments of an elite Paralympic karateka

Karate is a Japanese martial art that counts millions of practitioners worldwide and that is spreading also in Paralympic competitions, requiring accurate categories definition for disabled athletes. The aim of the study is to present kinematic data of an elite Paralympic karateka, in comparison with able-bodied athletes. The authors also aim to promote a better classification within the discipline, based on objective biomechanical evaluations of physical impairments. A male black belt Paralympic karateka (age: 36 y; body weight: 75.5 kg; height: 173 cm) with lower limbs impairments was evaluated. The athlete had been performing high level karate for 20 years before the disability took place. After the post-operative rehabilitation, he attended 3/4 sessions of para- karate training per week. He performed a standardized sequence of movements, involving a sequence of offensive and defensive techniques, (kata) from traditional Shotokan karate. Joints and body Center of Mass (CoM) kinematics were collected with an optoelectronic motion capture system and compared with those obtained in two groups of able-bodied (elite and amateurs) athletes from a previous study1. Knee angular range of motion (RoM) and peak angular velocity were obtained. Coordinates of CoM were estimated, using the Segmental Centroid Method2, along with CoM average velocity and acceleration. To assess differences between Paralympic karateka and able-bodied groups, the one-sample t-test was performed. The sequence performed by the karateka lasted more than in both able-bodied groups. CoM average velocity and acceleration decreased in comparison with elite karateka. Knees range of movement and peak angular velocity were similar to amateur but lower than elite athletes. Results show that the physical impairments negatively affected the function of lower limbs in the Paralympic athlete. Fundamental skills in karate elite performance (dynamic balance control and joint RoM and angular velocity) were reduced