Congenital Cytomegalovirus Reference Material: A Content Analysis of Coverage and Accuracy

Congenital cytomegalovirus (CMV) is the leading cause of birth defects and developmental delays in the United States. However, only 13–22 % of women in the United States have heard of CMV. This research assessed (1) the quantity and accuracy of CMV information included on pregnancy-related websites and reference books, and (2) whether CMV information was included less often than information about other birth defects or infections. A content analysis of 37 pregnancy reference books and seven websites was conducted. The data collection instrument represented categories describing CMV, transmission, and prevention. CMV subject matter experts at the Centers for Disease Control and Prevention reviewed the instrument. Each book and website was coded independently by two different coders. Twenty-one reference books and seven websites included CMV content. CMV was less likely to be included as a topic than other infections or birth defects. There were fewer sentences about CMV than toxoplasmosis, Down syndrome, or HIV. Book length was associated with increased likelihood of including CMV. How to prevent CMV transmission was discussed only half the time. Though limited, nearly all the CMV information was accurate. Pregnancy-related reference books and websites contain limited CMV information. Books are less likely to include CMV as compared to other infections and birth defects. Most of the CMV information is accurate. There is inadequate coverage given to prevention of CMV transmission, which may contribute to CMV remaining a continued leading cause of birth defects in the United States

Environmental Contaminant Concentrations in Canada Goose (\u3ci\u3eBranta canadensis\u3c/i\u3e) Muscle: Probabilistic Risk Assessment for Human Consumers

The issue of food insecurity affects millions of people in the United States every year. Often these people rely on soup kitchens, food banks, and shelters for proper meals, and these organizations often depend on donations to meet needs. One of the most limited food resources is meat. To help alleviate this problem, the U.S. Department of Agriculture Wildlife Services donates more than 60 tons of wild game (deer, moose, feral hogs, goats, geese, and ducks) to a variety of charitable organizations each year. Although commercially produced meat routinely undergoes screening for contaminants, potential exposure to environmental contaminants from eating wild game is not well characterized. In this study, the concentration of 17 contaminants of concern in the breast meat of wild geese was examined. These concentrations were then used in a probabilistic model to estimate potential risk associated with consumption of this meat. Based on model predictions, more than 99% of all adults were below exposure limits for all of the compounds tested. For all consumer age classes modeled, consumption of wild goose meat may expose a small fraction of these populations to levels of lead higher than the recommended exposure limits. Similarly, mercury exposure was predicted to be higher than the recommended limits when the meat was served as steaks. This information about concentrations of contaminants of concern in goose meat and potential exposures associated with meat consumption based on probabilistic models will enable others to make informed decisions about the risks associated with the consumption of wild meat

Environmental Contaminant Concentrations in Canada Goose (\u3ci\u3eBranta canadensis\u3c/i\u3e) Muscle: Probabilistic Risk Assessment for Human Consumers

The issue of food insecurity affects millions of people in the United States every year. Often these people rely on soup kitchens, food banks, and shelters for proper meals, and these organizations often depend on donations to meet needs. One of the most limited food resources is meat. To help alleviate this problem, the U.S. Department of Agriculture Wildlife Services donates more than 60 tons of wild game (deer, moose, feral hogs, goats, geese, and ducks) to a variety of charitable organizations each year. Although commercially produced meat routinely undergoes screening for contaminants, potential exposure to environmental contaminants from eating wild game is not well characterized. In this study, the concentration of 17 contaminants of concern in the breast meat of wild geese was examined. These concentrations were then used in a probabilistic model to estimate potential risk associated with consumption of this meat. Based on model predictions, more than 99% of all adults were below exposure limits for all of the compounds tested. For all consumer age classes modeled, consumption of wild goose meat may expose a small fraction of these populations to levels of lead higher than the recommended exposure limits. Similarly, mercury exposure was predicted to be higher than the recommended limits when the meat was served as steaks. This information about concentrations of contaminants of concern in goose meat and potential exposures associated with meat consumption based on probabilistic models will enable others to make informed decisions about the risks associated with the consumption of wild meat

Variation in host home range size decreases rabies vaccination effectiveness by increasing the spatial spread of rabies virus

Animal movement influences the spatial spread of directly transmitted wildlife disease through host-host contact structure. Wildlife disease hosts vary in home range- associated foraging and social behaviours, which may increase the spread and intensity of disease outbreaks. The consequences of variation in host home range movement and space use on wildlife disease dynamics are poorly understood, but could help to predict disease spread and determine more effective disease management strategies. We developed a spatially explicit individual-based model to examine the effect of spatiotemporal variation in host home range size on the spatial spread rate, persistence and incidence of rabies virus (RABV) in raccoons (Procyon lotor). We tested the hypothesis that variation in home range size increases RABV spread and decreases vaccination effectiveness in host populations following pathogen invasion into a vaccination zone. We simulated raccoon demography and RABV dynamics across a range of magnitudes and variances in weekly home range size for raccoons. We examined how variable home range size influenced the relative effectiveness of three components of oral rabies vaccination (ORV) programmes targeting raccoons—timing and frequency of bait delivery, width of the ORV zone and proportion of hosts immunized. Variability in weekly home range size increased RABV spread rates by 1.2-fold to 5.2-fold compared to simulations that assumed a fixed home range size. More variable host home range sizes decreased relative vaccination effectiveness by 71% compared to less variable host home range sizes under conventional vaccination conditions. We found that vaccination timing was more influential for vaccination effectiveness than vaccination frequency or vaccination zone width. Our results suggest that variation in wildlife home range movement behaviour increases the spatial spread and incidence of RABV. Our vaccination results underscore the importance of prioritizing individual-level space use and movement data collection to understand wildlife disease dynamics and plan their effective control and elimination

Family and Consumer Sciences Focus on the Human Dimension: The Expanded Food and Nutrition Education Program Example

The history of family and consumer sciences (FCS) and the Expanded Food and Nutrition Education Program (EFNEP) is discussed with an emphasis on the critical importance of the human dimension. EFNEP\u27s focus on people, education for change, accountability, strategic partnerships, and public value are highlighted as an example and model for Extension and FCS programs in general. Future FCS success and sustainability depends on ensuring continued attention to the human dimension, while also addressing workforce, societal, and technological developments.https://lib.dr.iastate.edu/extension_pubs/1251/thumbnail.jp

Accounting for animal movement improves vaccination strategies against wildlife disease in heterogeneous landscapes

Oral baiting is used to deliver vaccines to wildlife to prevent, control, and eliminate infectious diseases. A central challenge is how to spatially distribute baits to maximize encounters by target animal populations, particularly in urban and suburban areas where wildlife such as raccoons (Procyon lotor) are abundant and baits are delivered along roads. Methods from movement ecology that quantify movement and habitat selection could help to optimize baiting strategies by more effectively targeting wildlife populations across space. We developed a spatially explicit, individual-based model of raccoon movement and oral rabies vaccine seroconversion to examine whether and when baiting strategies that match raccoon movement patterns perform better than currently used baiting strategies in an oral rabies vaccination zone in greater Burlington, Vermont, USA. Habitat selection patterns estimated from locally radio-collared raccoons were used to parameterize movement simulations. We then used our simulations to estimate raccoon population rabies seroprevalence under currently used baiting strategies (actual baiting) relative to habitat selection-based baiting strategies (habitat baiting). We conducted simulations on the Burlington landscape and artificial landscapes that varied in heterogeneity relative to Burlington in the proportion and patch size of preferred habitats. We found that the benefits of habitat baiting strongly depended on the magnitude and variability of raccoon habitat selection and the degree of landscape heterogeneity within the baiting area. Habitat baiting improved seroprevalence over actual baiting for raccoons characterized as habitat specialists but not for raccoons that displayed weak habitat selection similar to radiocollared individuals, except when baits were delivered off roads where preferred habitat coverage and complexity was more pronounced. In contrast, in artificial landscapes with either more strongly juxtaposed favored habitats and/or higher proportions of favored habitats, habitat baiting performed better than actual baiting, even when raccoons displayed weak habitat preferences and where baiting was constrained to roads. Our results suggest that habitat selection-based baiting could increase raccoon population seroprevalence in urban–suburban areas, where practical, given the heterogeneity and availability of preferred habitat types in those areas. Our novel simulation approach provides a flexible framework to test alternative baiting strategies in multiclass landscapes to optimize bait-distribution strategies

Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022

BACKGROUND: Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant. METHODS: We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses \u3e150 days previously, adjusted for multiple covariates. RESULTS: Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%-90%) during Delta predominance to 65% (58%-70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%-79%) 14-60 days after the booster dose, to 32% (4%-52%) ≥120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants. CONCLUSIONS: A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

BiomeNet: a Bayesian model for inference of metabolic divergence among microbial communities.

Metagenomics yields enormous numbers of microbial sequences that can be assigned a metabolic function. Using such data to infer community-level metabolic divergence is hindered by the lack of a suitable statistical framework. Here, we describe a novel hierarchical Bayesian model, called BiomeNet (Bayesian inference of metabolic networks), for inferring differential prevalence of metabolic subnetworks among microbial communities. To infer the structure of community-level metabolic interactions, BiomeNet applies a mixed-membership modelling framework to enzyme abundance information. The basic idea is that the mixture components of the model (metabolic reactions, subnetworks, and networks) are shared across all groups (microbiome samples), but the mixture proportions vary from group to group. Through this framework, the model can capture nested structures within the data. BiomeNet is unique in modeling each metagenome sample as a mixture of complex metabolic systems (metabosystems). The metabosystems are composed of mixtures of tightly connected metabolic subnetworks. BiomeNet differs from other unsupervised methods by allowing researchers to discriminate groups of samples through the metabolic patterns it discovers in the data, and by providing a framework for interpreting them. We describe a collapsed Gibbs sampler for inference of the mixture weights under BiomeNet, and we use simulation to validate the inference algorithm. Application of BiomeNet to human gut metagenomes revealed a metabosystem with greater prevalence among inflammatory bowel disease (IBD) patients. Based on the discriminatory subnetworks for this metabosystem, we inferred that the community is likely to be closely associated with the human gut epithelium, resistant to dietary interventions, and interfere with human uptake of an antioxidant connected to IBD. Because this metabosystem has a greater capacity to exploit host-associated glycans, we speculate that IBD-associated communities might arise from opportunist growth of bacteria that can circumvent the host's nutrient-based mechanism for bacterial partner selection