Congenital Toxoplasmosis in Austria: Prenatal Screening for Prevention is Cost-Saving

Background: Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. Methodology/Principal Findings: We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Conclusions/Significance: Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are outstanding. Our results are of relevance for health care providers by supplying economic data based on a unique national dataset including long-term follow-up of affected infants

Incidence of maternal Toxoplasma infections in pregnancy in Upper Austria, 2000-2007

Sagel U, Krämer A, Mikolajczyk RT. Incidence of maternal Toxoplasma infections in pregnancy in Upper Austria, 2000-2007. BMC Infectious Diseases. 2011;11(1): 348.UNLABELLED: ABSTRACT: BACKGROUND: Despite three decades of prenatal screening program for toxoplasmosis in Austria, population-based estimates for the incidence of maternal infections with Toxoplasma gondii during pregnancy are lacking. We studied the incidence of primary maternal infections during pregnancy in the Federal State of Upper Austria. METHODS: Screening tests for 63,416 women and over 90,000 pregnancies (more than 84.5% of pregnancies in the studied region) in the time period between 01.01.2000 and 31.12.2007 were analysed. The incidence of toxoplasmosis was estimated indirectly by binomial and directly by interval censored regression. RESULTS: During the studied period, 66 acute infections (risk of 0.07% per pregnancy) were detected, but only 29.8% of seronegative women were tested at least three times during their pregnancies. The seroprevalence of Toxoplasma antibodies among all tested women was 31%. Indirectly estimated incidence (from differences in prevalence by age) was 0.5% per pregnancy, while directly estimated incidence (interval censored regression) was 0.17% per pregnancy (95% confidence interval: 0.13-0.21%). CONCLUSIONS: Calculating incidence from observed infections results in severe underreporting due to many missed tests and potential diagnostic problems. Using statistical modelling, we estimated primary toxoplasmosis to occur in 0.17% (0.13-0.21%) of all pregnancies in Upper Austria

Predictors of retinochoroiditis in children with congenital toxoplasmosis : European, prospective cohort study

OBJECTIVE. By school age, 20% of children infected with congenital toxoplasmosis will have > 1 retinochoroidal lesion. We determined which children are most at risk and whether prenatal treatment reduces the risk of retinochoroiditis to help clinicians decide about treatment and follow-up. PATIENTS AND METHODS. We prospectively studied a cohort of children with congenital toxoplasmosis identified by prenatal or neonatal screening in 6 European countries. We determined the effects of prenatal treatment and prognostic markers soon after birth on the age at first detection of retinochoroiditis. RESULTS. Of 281 children with congenital toxoplasmosis, 50 developed ocular disease, and 17 had recurrent retinochoroiditis during a median follow-up of 4.1 years. Prenatal treatment had no significant effect on the age at first or subsequent lesions. Delayed start of postnatal treatment did not increase retinochoroiditis, but the analysis lacked power. Older gestational age at maternal seroconversion was weakly associated with a reduced risk of retinochoroiditis. The presence of nonocular clinical manifestations of congenital toxoplasmosis at birth strongly predicted retinochoroiditis. For 92% (230 of 249) of children with no retinochoroiditis detected before 4 months of age, the probability of retinochoroiditis by 4 years was low, whether clinical manifestations were present or not 8.0%. CONCLUSIONS. Prenatal treatment did not significantly reduce the risk of retinochoroiditis in this European cohort. If children have no retinochoroiditis in early infancy, the low risk of subsequent ocular disease may not justify postnatal treatment and repeated ophthalmic assessments during childhood. Controlled trials are needed to address the lack of evidence for the effectiveness of postnatal treatment

Why indigenous water systems are declining and how to revive them: A rough set analysis

For many centuries, rainwater harvesting (RWH) was the main source of water in many ancient countries. However, over the last four decades, its use has been declining steadily. RWH structures fell into disrepair and were abandoned or were only occasionally used. Taking Sana'a Basin in Yemen as a case study, we examined the underlying factors for the decline and explored ways to reverse it. We interviewed 100 farmers and 65 experts and visited 22 RWH systems, both abandoned and still in use. We used rough set analysis to analyze RWH systems data. The overall results showed that the government plays a crucial role in the operational status of the RWH systems. However, the government's rhetoric on the importance of investing in traditional RWH, very few projects were actually implemented or maintained. In contrast, access to groundwater was heavily promoted making it the preferred water source. However, the water table became depleted and there was a dependency on diesel. Other socioeconomic factors including ownership, limited capacity of RWH systems, the availability of imported food, and rural-urban migration were other secondary reasons for abandonment. Without a shift in government support from groundwater to rainwater harvesting, this long-term decline is likely to continue

On the use of Action Units and fuzzy explanatory models for facial expression recognition.

Facial expression recognition is related to the automatic identification of affective states of a subject by computational means. Facial expression recognition is used for many applications, such as security, human-computer interaction, driver safety, and health care. Although many works aim to tackle the problem of facial expression recognition, and the discriminative power may be acceptable, current solutions have limited explicative power, which is insufficient for certain applications, such as facial rehabilitation. Our aim is to alleviate the current limited explicative power by exploiting explainable fuzzy models over sequences of frontal face images. The proposed model uses appearance features to describe facial expressions in terms of facial movements, giving a detailed explanation of what movements are in the face, and why the model is making a decision. The model architecture was selected to keep the semantic meaning of the found facial movements. The proposed model can discriminate between the seven basic facial expressions, obtaining an average accuracy of 90.8±14%, with a maximum value of 92.9±28%

Identification of plasmidic sequences in draft genomes from Streptomyces and Micrococcus

Plasmids are circular or linear extrachromosomal DNA molecules that replicate autonomously. The bacterial genome sequencing has generated a large number of "draft" genomes where the presence of plasmids is not detailed. However, there are several tools that allow predicting plasmid sequences based on raw sequencing data, and can contribute to the identification of new plasmids. This identification would bring new data to understand the diversity and evolution of plasmids, particularly in poorly studied genera.In this work we study genomes of two genera of Actinobacteria of sanitary and environmental importance: Streptomycesand Micrococcus. For each genome, contigs were generated by assembling reads obtained from the SRA-NCBI database. Four independent homology tools were used for the prediction of plasmids: PlasFlow, cBar, Recycler,and plasmidSPAdes. In addition, we face the predictions with the PLSDB online plasmid repository, which includes an extensive set of complete plasmids from the NCBI database, in order to check the presence of novel sequences.The assembled genomes turned out fragmented, in general. Even so, the prediction methods used were able to identify potentially plasmidic sequences. From 46 Streptomycesstrains analyzed, 446 sequences were predicted that would correspond to plasmids or fragments thereof, including 120 that would correspond to circular elements. These sequences on average had a length of 6385 bp and a GC content of 67.5%. On the other hand, 130 plasmidic sequences were identified in 9 strains of Micrococcus, of which 78 could correspond to circular plasmids. In this case, the sequences were on average 2909 bp in length with a GC content of 59.4%.This analysis allowed us to identify potentially plasmid sequences for the two genus of Actinobacteria studied, which sets a precedent with relevant data that can be validated in subsequent studies.Fil: Padilla Franzotti, Carla Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Planta Piloto de Procesos Industriales Microbiológicos; ArgentinaFil: More, Silvia C.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Planta Piloto de Procesos Industriales Microbiológicos; ArgentinaFil: Saracho, Hayde. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Planta Piloto de Procesos Industriales Microbiológicos; ArgentinaFil: Kurth, Daniel German. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Planta Piloto de Procesos Industriales Microbiológicos; Argentina1st Latin American Congress of Women in Bioinformatics and Data SciencesCiudad Autónoma de Buenos AiresArgentinaWomen in Bioinformatics and Data Science Latin Americ

Activation of exchange protein activated by cAMP in the rat basolateral amygdala impairs reconsolidation of a memory associated with self-administered cocaine.

The intracellular mechanisms underlying memory reconsolidation critically involve cAMP signaling. These events were originally attributed to PKA activation by cAMP, but the identification of Exchange Protein Activated by cAMP (Epac), as a distinct mediator of cAMP signaling, suggests that cAMP-regulated processes that subserve memory reconsolidation are more complex. Here we investigated how activation of Epac with 8-pCPT-cAMP (8-CPT) impacts reconsolidation of a memory that had been associated with cocaine self-administration. Rats were trained to lever press for cocaine on an FR-1 schedule, in which each cocaine delivery was paired with a tone+light cue. Lever pressing was then extinguished in the absence of cue presentations and cocaine delivery. Following the last day of extinction, rats were put in a novel context, in which the conditioned cue was presented to reactivate the cocaine-associated memory. Immediate bilateral infusions of 8-CPT into the basolateral amygdala (BLA) following reactivation disrupted subsequent cue-induced reinstatement in a dose-dependent manner, and modestly reduced responding for conditioned reinforcement. When 8-CPT infusions were delayed for 3 hours after the cue reactivation session or were given after a cue extinction session, no effect on cue-induced reinstatement was observed. Co-administration of 8-CPT and the PKA activator 6-Bnz-cAMP (10 nmol/side) rescued memory reconsolidation while 6-Bnz alone had no effect, suggesting an antagonizing interaction between the two cAMP signaling substrates. Taken together, these studies suggest that activation of Epac represents a parallel cAMP-dependent pathway that can inhibit reconsolidation of cocaine-cue memories and reduce the ability of the cue to produce reinstatement of cocaine-seeking behavior

Characterization of Nuclear Pleomorphism and Tubules in Histopathological Images of Breast Cancer

Breast cancer (BC) diagnosis is made by a pathologist who analyzes a portion of the breast tissue under the microscope and performs a histological evaluation. This evaluation aims to determine the grade of cellular differentiation and the aggressiveness of the tumor by the Nottingham Grade Classification System (NGS). Nowadays, digital pathology is an innovative tool for pathologists in diagnosis and acquiring new learning. However, a recurring problem in health services is the excessive workload in all medical services. For this reason, it is required to develop computational tools that assist histological evaluation. This work proposes a methodology for the quantitative analysis of BC tissue that follows NGS. The proposed methodology is based on digital image processing techniques through which the BC tissue can be characterized automatically. Moreover, the proposed nuclei characterization was helpful for grade differentiation in carcinoma images of the BC tissue reaching an 0.84 accuracy. In addition, a metric was proposed to assess the likelihood of a structure in the tissue corresponding to a tubule by considering spatial and geometrical characteristics between lumina and its surrounding nuclei, reaching an accuracy of 0.83. Tests were performed from different databases and under various magnification and staining contrast conditions, showing that the methodology is reliable for histological breast tissue analysis