Analysis Of The Gut-Specific Microbiome Of Field-Captured Tsetse Flies, And Its Potential Relevance To Host Trypanosome Vector Competence

The tsetse fly (Glossinasp.) gut is colonized by maternally transmitted and environmentally acquired bacteria. Maternally transmitted symbionts are well characterized, but little is known about the origin and function of environmentally acquired bacteria inhabiting the tsetse midgut. To address this shortcoming, culture dependent and independent methods were used to characterize and quantify bacterial communities that reside within the midgut of tsetse flies collected at five geographically isolated locations in Kenya and Uganda. Bacteria were isolated from 83.33% of flies using culture dependent methods. In total, 38 strains were isolated. To increase the depth of this analysis, Illumina-based deep-sequencing of the V4 hypervariable region of the bacterial 16S ribosomal RNA (rRNA) gene was used to determine the relationship between the type and number of bacteria present in Glossina pallidipes midguts and geographic location. The midgut was dominated by the obligate endosymbiont, Wigglesworthia, but a diversity of other microbiota in individuals that were unique to each location was also observed. This was consistent between trypanosome infected and uninfected samples. The results of this study will increase the understanding of the breadth and depth of tsetse\u27s midgut bacterial communities as they relate to the environmental acquisition of the fly\u27s microbiome and its correlation to trypanosome vectorial capacity. Future studies can then be performed to determine the specific molecular mechanisms that underlie bacteria-mediated trypanocidal immunity in tsetse\u27s gut

Development and usability testing of a data visualisation platform for an African trauma data registry

Introduction Trauma is a significant contribution to the global burden of mortality and disease, especially in sub-Saharan Africa. The methods for tracking, recording, and analysing the incidence and causes of trauma are underdeveloped. To address this, The African Federation for Emergency Medicine (AFEM) developed a trauma form and Trauma Data Registry to collect trauma data in multiple sites in sub-Saharan Africa. We undertook a study to create, and assess the usability and functionality of, a trauma data visualisation platform for use in conjunction with the Trauma Data Registry. Methods We created a web-based trauma data visualisation platform for use with the AFEM Trauma Data Registry. This study involves a usability assessment of the AFEM Trauma Data Visualisation Platform to determine the specific website features and analytical needs of African trauma research facilities. This was done by surveying individuals from healthcare facilities that are currently using the AFEM Trauma Form. Two types of questionnaires were administered: Questionnaire I gathered information on the study population and their expectations for the platform, and Questionnaire II assessed the usability of the platform after it was introduced. Surveys took place in person and online, with the last group of questionnaires being administered on-site at the healthcare facility. Data were captured via Survey Monkey online and paper survey. The results were entered into Excel and analysed using descriptive statistics using Stata Version 14. Results A total of 45 healthcare practitioners from eight countries participated in the background survey. The greatest proportion were trained in Tanzania (14, 31.1%) and Ethiopia (14, 31.1%). The mean age of participants was 32.6 (SD=6.6). The mean number of years reported for working at their current facility is 3.7 (SD=3.5). The greatest number of participants in the survey were physicians (22, 48.9%) and specialists (11, 24.4%). Over half (53.3%, n=24) selected that they had moderate experience with data analysis, and the majority reported that they had less than three publications. A total of 34 HCPs participated in the usability study. The mean scores for the usability questionnaire portion were high, with all of the scores being above 6. Major positive themes of the participant comments included easy to use and time saving, major negative themes included feasibility concerns, and comments specific variable to add were common. Discussion There is a lot of heterogeneity in the data analysis and technology experience of participants. The participants were overall satisfied with the Trauma Data Platform. Participants’ comments and suggestions on elements to add indicate that there is still work to be done to design a Trauma Data Platform that is suitable for this setting. Conclusions Overall satisfaction with the Trauma Data Platform was high, and the user comments and suggestions will be incorporated into future versions of the platform. This research highlights the importance of considering the feasibility of health technology in its introduction

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant