A review of epidemiological parameters from Ebola outbreaks to inform early public health decision-making.

The unprecedented scale of the Ebola outbreak in West Africa has, as of 29 April 2015, resulted in more than 10,884 deaths among 26,277 cases. Prior to the ongoing outbreak, Ebola virus disease (EVD) caused relatively small outbreaks (maximum outbreak size 425 in Gulu, Uganda) in isolated populations in central Africa. Here, we have compiled a comprehensive database of estimates of epidemiological parameters based on data from past outbreaks, including the incubation period distribution, case fatality rate, basic reproduction number (R 0), effective reproduction number (R t) and delay distributions. We have compared these to parameter estimates from the ongoing outbreak in West Africa. The ongoing outbreak, because of its size, provides a unique opportunity to better understand transmission patterns of EVD. We have not performed a meta-analysis of the data, but rather summarize the estimates by virus from comprehensive investigations of EVD and Marburg outbreaks over the past 40 years. These estimates can be used to parameterize transmission models to improve understanding of initial spread of EVD outbreaks and to inform surveillance and control guidelines

Development of a Global Health Curriculum at Christiana Care Health System: An Independent Academic Health Center and Member of the Delaware Health Sciences Alliance

Work in Progress (16 PowerPoint slides) The Global Health Program at Christiana Care Health System (CCHS) is an innovative, multi-disciplinary educational program seeking to improve the public health knowledge base and skills of interested health professionals through didactic, simulation and clinical experiences. A recent AAMC survey revealed 30% ofU.S.medical students participated in an international elective in 2006 versus 15% in 1997. In a resident survey at CCHS in 2010, 70% of residents responded that it was important to have global health education. These figures indicate an increasing interest in global health during residency training. In order to draw interest from a variety of backgrounds, we developed a multi-disciplinary global health training program. The curriculum is designed to include CCHS staff and our colleagues at other Delaware Health Sciences Alliance (DHSA) institutions, includingNemoursA.I.DuPontHospitalfor Children,ThomasJeffersonUniversityand the University of Delaware. The core curriculum consists of a monthly lecture series, including local and guest speakers. The lectures are recorded and accessible to CCHS affiliates via intranet. In addition, we plan to incorporate a journal club, a skills workshop and develop a global health site to foster an international partnership and resident elective rotations. Since the program began in August 2011, we have had five meetings. Attendance has steadily increased in number and diversity; attendees now include undergraduates, medical students, residents, fellows, attending physicians, nurses, administrators and medical librarians. We initiated a post-meeting survey at our December meeting which demonstrated a mean increase in the level of awareness of the topic by 27%. Global health awareness allowsU.S.based health professionals to be more culturally competent and effective in advocating for the needs of the underserved in their own communities. By inviting all disciplines at multiple institutions we hope to create a community that supports and sustains global health. Learning Objectives: At the end of this session, participants will: 1. Identify the importance of a global health curriculum for training residents that are culturally aware and equipped to work in underserved populations both locally and abroad. 2. Acquire the information to initiate a global health program in a teaching hospital. 3. Learn how to incorporate a multi-disciplinary approach to global health education

Development of a technology adoption and usage prediction tool for assistive technology for people with dementia

This article is available open access through the publisher’s website at the link below. Copyright @ The Authors 2013.In the current work, data gleaned from an assistive technology (reminding technology), which has been evaluated with people with Dementia over a period of several years was retrospectively studied to extract the factors that contributed to successful adoption. The aim was to develop a prediction model with the capability of prospectively assessing whether the assistive technology would be suitable for persons with Dementia (and their carer), based on user characteristics, needs and perceptions. Such a prediction tool has the ability to empower a formal carer to assess, through a very limited amount of questions, whether the technology will be adopted and used.EPSR

Worldwide reduction in MERS cases and deaths since 2016

Since 2012, Middle East respiratory syndrome (MERS) coronavirus has infected 2,442 persons worldwide. Case-based data analysis suggests that since 2016, as many as 1,465 cases and 293–520 deaths might have been averted. Efforts to reduce the global MERS threat are working, but countries must maintain vigilance to prevent further infections

Inkjet printing of transdermal microneedles for the delivery of anticancer agents

A novel inkjet printing technology is introduced as a process to coat metal microneedle arrays with three anticancer agents 5-fluororacil, curcumin and cisplatin for transdermal delivery. The hydrophilic graft copolymer Soluplus® was used as a drug carrier and the coating formulations consisted of drug–polymer solutions at various ratios. A piezoelectric dispenser jetted microdroplets on the microneedle surface to develop uniform, accurate and reproducible coating layers without any material losses. Inkjet printing was found to depend on the nozzle size, the applied voltage (mV) and the duration of the pulse (μs). The drug release rates were determined in vitro using Franz type diffusion cells with dermatomed porcine skin. The drug release rates depended on the drug–polymer ratio, the drug lipophilicity and the skin thickness. All drugs presented increased release profiles (750 μm skin thickness), which were retarded for 900 μm skin thickness. Soluplus assisted the drug release especially for the water insoluble curcumin and cisplatin due to its solubilizing capacity. Inkjet printing was proved an effective technology for coating of metal microneedles which can then be used for further transdermal drug delivery applications

Implementation of Multipronged Approach in Patients with Chest Trauma Reduces VAP and Unplanned Admission to the ICU

Problem The incidence of pulmonary complications in trauma patients with chest trauma has been reported to be as high as 49% (Ruibel L, 2022). However, all trauma patients are at risk for developing pulmonary complications due to a multitude of factors some pre-existing while others injury related sequela. Within our institution, we observed an increase in pulmonary complications through review of our TQIP (Spring 2020) and state registry data.https://jdc.jefferson.edu/surgeryposters/1013/thumbnail.jp

High Cleavage Efficiency of a 2A Peptide Derived from Porcine Teschovirus-1 in Human Cell Lines, Zebrafish and Mice

When expression of more than one gene is required in cells, bicistronic or multicistronic expression vectors have been used. Among various strategies employed to construct bicistronic or multicistronic vectors, an internal ribosomal entry site (IRES) has been widely used. Due to the large size and difference in expression levels between genes before and after IRES, however, a new strategy was required to replace IRES. A self-cleaving 2A peptide could be a good candidate to replace IRES because of its small size and high cleavage efficiency between genes upstream and downstream of the 2A peptide. Despite the advantages of the 2A peptides, its use is not widespread because (i) there are no publicly available cloning vectors harboring a 2A peptide gene and (ii) comprehensive comparison of cleavage efficiency among various 2A peptides reported to date has not been performed in different contexts. Here, we generated four expression plasmids each harboring different 2A peptides derived from the foot-and-mouth disease virus, equine rhinitis A virus, Thosea asigna virus and porcine teschovirus-1, respectively, and evaluated their cleavage efficiency in three commonly used human cell lines, zebrafish embryos and adult mice. Western blotting and confocal microscopic analyses revealed that among the four 2As, the one derived from porcine teschovirus-1 (P2A) has the highest cleavage efficiency in all the contexts examined. We anticipate that the 2A-harboring cloning vectors we generated and the highest efficiency of the P2A peptide we demonstrated would help biomedical researchers easily adopt the 2A technology when bicistronic or multicistronic expression is required

Quality of life among symptomatic compared to PSA-detected prostate cancer survivors - results from a UK wide patient-reported outcomes study

Background: Quality of life among prostate cancer survivors varies by socio-demographic factors and treatment type received; however, less in known about differences in functional outcomes by method of presentation. We investigate differences in reported urinary, bowel, sexual and hormone-related problems between symptomatic and PSA-detected prostate cancer survivors. Methods: A UK wide cross-sectional postal survey of prostate cancer survivors conducted 18-42 months post-diagnosis. Questions were included on presentation method and treatment. Functional outcome was determined using the EPIC-26 questionnaire. Reported outcomes were compared for symptomatic and PSA-detected survivors using ANOVA and multivariable log-linear regression. Results: Thirty-five thousand eight hundred twenty-three men responded (response rate: 60.8%). Of these, 31.3% reported presenting via PSA test and 59.7% symptomatically. In multivariable analysis, symptomatic men reported more difficulty with urinary incontinence (Adjusted mean ratio (AMR): 0.96, 95% CI: 0.96-0.97), urinary irritation (AMR: 0.95, 95% CI: 0.95-0.96), bowel function (AMR: 0.97, 95% CI: 0.97-0.98), sexual function (AMR: 0.90, 95% CI: 0.88-0.92), and vitality/hormonal function (AMR: 0.96, 95% CI: 0.96-0.96) than PSA-detected men. Differences were consistent across respondents of differing age, stage, Gleason score and treatment type. Conclusion: Prostate cancer survivors presenting symptomatically report poorer functional outcomes than PSA-detected survivors. Differences were not explained by socio-demographic or clinical factors. Clinicians should be aware that men presenting with symptoms are more likely to report functional difficulties after prostate cancer treatment and may need additional aftercare if these difficulties persist. Method of presentation should be considered as a covariate in patient-reported outcome studies of prostate cancer

Deletion of parasite immune modulatory sequences combined with immune activating signals enhances vaccine mediated protection against filarial nematodes

<p>Background: Filarial nematodes are tissue-dwelling parasites that can be killed by Th2-driven immune effectors, but that have evolved to withstand immune attack and establish chronic infections by suppressing host immunity. As a consequence, the efficacy of a vaccine against filariasis may depend on its capacity to counter parasite-driven immunomodulation.</p> <p>Methodology and Principal Findings: We immunised mice with DNA plasmids expressing functionally-inactivated forms of two immunomodulatory molecules expressed by the filarial parasite Litomosoides sigmodontis: the abundant larval transcript-1 (LsALT) and cysteine protease inhibitor-2 (LsCPI). The mutant proteins enhanced antibody and cytokine responses to live parasite challenge, and led to more leukocyte recruitment to the site of infection than their native forms. The immune response was further enhanced when the antigens were targeted to dendritic cells using a single chain Fv-αDEC205 antibody and co-administered with plasmids that enhance T helper 2 immunity (IL-4) and antigen-presenting cell recruitment (Flt3L, MIP-1α). Mice immunised simultaneously against the mutated forms of LsALT and LsCPI eliminated adult parasites faster and consistently reduced peripheral microfilaraemia. A multifactorial analysis of the immune response revealed that protection was strongly correlated with the production of parasite-specific IgG1 and with the numbers of leukocytes present at the site of infection.</p> <p>Conclusions: We have developed a successful strategy for DNA vaccination against a nematode infection that specifically targets parasite-driven immunosuppression while simultaneously enhancing Th2 immune responses and parasite antigen presentation by dendritic cells.</p&gt