17 research outputs found

    Point pattern simulation modelling of extensive and intensive chicken farming in Thailand : accounting for clustering and landscape characteristics

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    In recent decades, intensification of animal production has been occurring rapidly in transition economies to meet the growing demands of increasingly urban populations. This comes with significant environmental, health and social impacts. To assess these impacts, detailed maps of livestock distributions have been developed by downscaling census data at the pixel level (10 km or 1 km), providing estimates of the density of animals in each pixel. However, these data remain at fairly coarse scale and many epidemiological or environmental science applications would make better use of data where the distribution and size of farms are predicted rather than the number of animals per pixel. Based on detailed 2010 census data, we investigated the spatial point pattern distribution of extensive and intensive chicken farms in Thailand. We parameterized point pattern simulation models for extensive and intensive chicken farms and evaluated these models in different parts of Thailand for their capacity to reproduce the correct level of spatial clustering and the most likely locations of the farm clusters. We found that both the level of clustering and location of clusters could be simulated with reasonable accuracy by our farm distribution models. Furthermore, intensive chicken farms tended to be much more clustered than extensive farms, and their locations less easily predicted using simple spatial factors such as human populations. These point-pattern simulation models could be used to downscale coarse administrative level livestock census data into farm locations. This methodology could be of particular value in countries where farm location data are unavailable

    Clade-level Spatial Modelling of HPAI H5N1 Dynamics in the Mekong Region Reveals New Patterns and Associations with Agro-Ecological Factors.

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    The highly pathogenic avian influenza (HPAI) H5N1 virus has been circulating in Asia since 2003 and diversified into several genetic lineages, or clades. Although the spatial distribution of its outbreaks was extensively studied, differences in clades were never previously taken into account. We developed models to quantify associations over time and space between different HPAI H5N1 viruses from clade 1, 2.3.4 and 2.3.2 and agro-ecological factors. We found that the distribution of clades in the Mekong region from 2004 to 2013 was strongly regionalised, defining specific epidemiological zones, or epizones. Clade 1 became entrenched in the Mekong Delta and was not supplanted by newer clades, in association with a relatively higher presence of domestic ducks. In contrast, two new clades were introduced (2.3.4 and 2.3.2) in northern Viet Nam and were associated with higher chicken density and more intensive chicken production systems. We suggest that differences in poultry production systems in these different epizones may explain these associations, along with differences in introduction pressure from neighbouring countries. The different distribution patterns found at the clade level would not be otherwise apparent through analysis treating all outbreaks equally, which requires improved linking of disease outbreak records and genetic sequence data

    Rhodococcus Bacteremia in Cancer Patients Is Mostly Catheter Related and Associated with Biofilm Formation

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    Rhodococcus is an emerging cause of opportunistic infection in immunocompromised patients, most commonly causing cavitary pneumonia. It has rarely been reported as a cause of isolated bacteremia. However, the relationship between bacteremia and central venous catheter is unknown. Between 2002 and 2010, the characteristics and outcomes of seventeen cancer patients with Rhodococcus bacteremia and indwelling central venous catheters were evaluated. Rhodococcus bacteremias were for the most part (94%) central line-associated bloodstream infection (CLABSI). Most of the bacteremia isolates were Rhodococcus equi (82%). Rhodococcus isolates formed heavy microbial biofilm on the surface of polyurethane catheters, which was reduced completely or partially by antimicrobial lock solution. All CLABSI patients had successful response to catheter removal and antimicrobial therapy. Rhodococcus species should be added to the list of biofilm forming organisms in immunocompromised hosts and most of the Rhodococcus bacteremias in cancer patients are central line associated

    Modifiable risk factors associated with bone deficits in childhood cancer survivors

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    <p>Abstract</p> <p>Background</p> <p>To determine the prevalence and severity of bone deficits in a cohort of childhood cancer survivors (CCS) compared to a healthy sibling control group, and the modifiable factors associated with bone deficits in CCS.</p> <p>Methods</p> <p>Cross-sectional study of bone health in 319 CCS and 208 healthy sibling controls. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA). Generalized estimating equations were used to compare measures between CCS and controls. Among CCS, multivariable logistic regression was used to evaluate odds ratios for BMD Z-score ≤ -1.</p> <p>Results</p> <p>All subjects were younger than 18 years of age. Average time since treatment was 10.1 years (range 4.3 - 17.8 years). CCS were 3.3 times more likely to have whole body BMD Z-score ≤ -1 than controls (95% CI: 1.4-7.8; p = 0.007) and 1.7 times more likely to have lumbar spine BMD Z-score ≤ -1 than controls (95% CI: 1.0-2.7; p = 0.03). Among CCS, hypogonadism, lower lean body mass, higher daily television/computer screen time, lower physical activity, and higher inflammatory marker IL-6, increased the odds of having a BMD Z-score ≤ -1.</p> <p>Conclusions</p> <p>CCS, less than 18 years of age, have bone deficits compared to a healthy control group. Sedentary lifestyle and inflammation may play a role in bone deficits in CCS. Counseling CCS and their caretakers on decreasing television/computer screen time and increasing activity may improve bone health.</p

    Characterization of small-scale commercial chicken production in a distant rural area of a lower-middle-income country

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    Poultry production can enhance the livelihoods of rural people. Poultry production in low andmiddle-income countries is dominated by small-scale backyard systems with low inputs and lowoutputs. Poultry production, productivity and generated income can be enhanced through intensi-fication; the provision of inputs such as improved breeds, feed, housing and health-care. In Kenya,poultry production systems encompass free-range, semi-intensive and intensive systems. Despite agrowing intensive sector, mostly located in and around Nairobi and other cities, indigenous chickensstill dominate poultry production. However, their productivity could be improved in semi-intensiveand intensive systems. Intensification is a relatively recent process in low- and middle-income coun-tries compared to high-income countries. The complex reality of smallholders trying to improvetheir production is poorly understood and described. We explored the commercial chicken sector ina rural area distant form major production centres, and developed a fine-scale typology of commer-cial farms in western Kenya. We surveyed 111 chicken commercial farms in 2016. We targeted farmswho sell the majority of their production, with 50 chickens or more, and in which animals wereat least partly confined and were provided feeds. Farms were found mainly to raise dual-purposeindigenous chickens in association with crop production and were not specialised towards any par-ticular product or market. Although the farmers interviewed shared many features of free-rangesystem, they expressed the wish to make a commercial activity of their chicken production, withlarge flocks and management similar to semi-intensive farms. Four types of farms were identifiedbased on two groups of variables, related to intensification and accessibility; (i) remote, small-scaleold farms, with small flocks, using a lot of their own crops as feed, (ii) medium-scale, old farmswith a lar- ger flock and well located (iii) large-scale young farms, with large flocks, (iii-a) welllocated and who buy their chicks and (iii-b) remotely located and who hatch their chicks. Thesegroups sit along a gradient of intensification. Location, which affects access to markets and inputs,determines the opportunities available to farmers and thus gives rise to further diversity in farmmanagement types. We found that commercial chicken farms in western Kenya varied greatly interms of management, opportunities and challenges

    Early intensification of backyard poultry systems in the tropics: A case study

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    Poultry production is an important way of enhancing the livelihoods of rural populations, especially in low- and middle-income countries (LMICs). As poultry production in LMICs remains dominated by backyard systems with low inputs and low outputs, considerable yield gaps exist. Intensification can increase poultry productivity, production and income. This process is relatively recent in LMICs compared to high-income countries. The management practices and the constraints faced by smallholders trying to scale-up their production, in the early stages of intensification, are poorly understood and described. We thus investigated the features of the small-scale commercial chicken sector in a rural area distant from major production centres. We surveyed 111 commercial chicken farms in Kenya in 2016. We targeted farms that sell the majority of their production, owning at least 50 chickens, partly or wholly confined and provided with feeds. We developed a typology of semi-intensive farms. Farms were found mainly to raise dual-purpose chickens of local and improved breeds, in association with crops and were not specialized in any single product or market. We identified four types of semi-intensive farms that were characterized based on two groups of variables related to intensification and accessibility: (i) remote, small-scale old farms, with small flocks, growing a lot of their own feed; (ii) medium-scale, old farms with a larger flock and well located in relation to markets and (iii) large-scale recently established farms, with large flocks, (iii-a) well located and buying chicks from third-party providers and (iii-b) remotely located and hatching their own chicks. The semi-intensive farms we surveyed were highly heterogeneous in terms of size, age, accessibility, management, opportunities and challenges. Farm location affects market access and influences the opportunities available to farmers, resulting in further diversity in farm profiles. The future of these semi-intensive farms could be compromised by several factors, including the competition with large-scale intensive farmers and with importations. Our study suggests that intensification trajectories in rural areas of LMICs are potentially complex, diverse and non-linear. A better understanding of intensification trajectories should, however, be based on longitudinal data. This could, in turn, help designing interventions to support small-scale farmers.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

    North American Neuromodulation Society Educational Curriculum for Intrathecal Drug Delivery Systems Implantation and Management

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    OBJECTIVES: Intrathecal drug delivery systems (IDDSs) are used for the treatment of pain and spasticity. A wide range of educational criteria exist for these devices. The North American Neuromodulation Society (NANS) Education Committee developed a comprehensive IDDS curriculum to function as a standard for physician graduate education and assessment through training and into practice. MATERIAL AND METHODS: A multidisciplinary and diverse task force gathered by the NANS Education Committee met in person and virtually over several sessions and developed an IDDS curriculum modeling their previous work on spinal cord stimulation and following the Accreditation Council for Graduate Medical Education (ACGME) Milestones. There were iterative revisions and adaptations to the curriculum, and the final version was approved by the NANS Board of Directors. RESULTS: The curriculum was developed with distinction between implanting physicians and managing physician and physicians who perform both tasks. There is a lateral temporal progression from early learner to practitioner, with advanced learner in the middle. In addition, there is a modular vertical organization that divides the curriculum into the six educational competencies outlined by the ACGME. CONCLUSION: A comprehensive, modular, graduated, and segmented educational curriculum for IDDSs was developed by NANS. We propose the curriculum to be the standard for guidance and assessment of trainees and physicians pursuing training in implanting or managing IDDSs

    North American Neuromodulation Society Educational Curriculum for Intrathecal Drug Delivery Systems Implantation and Management.

    No full text
    OBJECTIVES: Intrathecal drug delivery systems (IDDSs) are used for the treatment of pain and spasticity. A wide range of educational criteria exist for these devices. The North American Neuromodulation Society (NANS) Education Committee developed a comprehensive IDDS curriculum to function as a standard for physician graduate education and assessment through training and into practice. MATERIAL AND METHODS: A multidisciplinary and diverse task force gathered by the NANS Education Committee met in person and virtually over several sessions and developed an IDDS curriculum modeling their previous work on spinal cord stimulation and following the Accreditation Council for Graduate Medical Education (ACGME) Milestones. There were iterative revisions and adaptations to the curriculum, and the final version was approved by the NANS Board of Directors. RESULTS: The curriculum was developed with distinction between implanting physicians and managing physician and physicians who perform both tasks. There is a lateral temporal progression from early learner to practitioner, with advanced learner in the middle. In addition, there is a modular vertical organization that divides the curriculum into the six educational competencies outlined by the ACGME. CONCLUSION: A comprehensive, modular, graduated, and segmented educational curriculum for IDDSs was developed by NANS. We propose the curriculum to be the standard for guidance and assessment of trainees and physicians pursuing training in implanting or managing IDDSs

    Evidence for a unique expression of CD4 on murine vaginal CD4+ cells

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    Mucosal cell-mediated immunity (CMI) by CD4+ T cells is postulated to be important for host defence against several vaginal pathogens. In addition to the recognized phenotypic distinctions of resident vaginal T lymphocytes, we recently provided evidence by fluorescence-activated cell sorter (FACS) that murine vaginal CD4+ T lymphocytes, are differentially recognized by two epitope-distinct anti-CD4 antibodies, suggesting that the CD4 protein on vaginal CD4+ cells is atypically expressed. In the present study, we confirm this by FACS and immunohistochemistry under non-denaturing conditions using two additional anti-CD4 antibodies. However, positive immunohistochemical staining of vaginal CD4+ cells under denaturing conditions revealed that the CD4 epitope in question is indeed present within the CD4 protein. Using reverse transcription polymerase chain reaction, amplification of CD3, T-cell receptor-β (TCR-β), and TCR-δ mRNA from lymph node and vaginal tissue, and CD4 mRNA from lymph node tissue was demonstrable. In contrast, amplification of CD4 mRNA from vaginal tissue, vaginal enriched lymphoid cells, or a purified (FACS-sorted) population of vaginal-specific CD4+ cells using two distinct primer sets was not demonstrable. Altogether, our results provide evidence that the CD4 protein on vaginal CD4+ T cells is conformationally distinct compared with its systemic counterpart, either as a result of a unique CD4 mRNA sequence or from a stable interaction of soluble CD4 with the surface of vaginal T cells
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