European Economic Integration and the Consequences for U.S. Agriculture

The pace of political-economic change in former East Bloc nations of Europe defies accurate prediction. Some events such as more price-directed markets are predictable enough but integration of former East Bloc countries into the European Community remains a matter of speculation. Analysis indicates that the economics of agriculture favors acceptance by the European Community of members of the European Free Trade Association before former members of the. East Bloc. Analysis also indicates the considerable agricultural production potential of Central and East Europe will be unleased first by market-directed economies and later by integration with the EC -- if the latter occurs. US consumers gain more than producers lose so the economic welfare of Americans is raised modestly.International Relations/Trade,

Models and analyses to understand threats to polio eradication

Abstract To achieve complete polio eradication, the live oral poliovirus vaccine (OPV) currently used must be phased out after the end of wild poliovirus transmission. However, poorly understood threats may arise when OPV use is stopped. To counter these threats, better models than those currently available are needed. Two articles recently published in BMC Medicine address these issues. Mercer et al. (BMC Med 15:180, 2017) developed a statistical model analysis of polio case data and characteristics of cases occurring in several districts in Pakistan to inform resource allocation decisions. Nevertheless, despite having the potential to accelerate the elimination of polio cases, their analyses are unlikely to advance our understanding OPV cessation threats. McCarthy et al. (BMC Med 15:175, 2017) explored one such threat, namely the emergence and transmission of serotype 2 circulating vaccine derived poliovirus (cVDPV2) after OPV2 cessation, and found that the risk of persistent spread of cVDPV2 to new areas increases rapidly 1–5 years after OPV2 cessation. Thus, recently developed models and analysis methods have the potential to guide the required steps to surpass these threats. ‘Big data’ scientists could help with this; however, datasets covering all eradication efforts should be made readily available. Please see related articles: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0937-y and https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0941-2 .https://deepblue.lib.umich.edu/bitstream/2027.42/140392/1/12916_2017_Article_991.pd

Hospital Vozandes del Oriente Wastewater Treatment System Design

Shell is a town located in the Eastern foothills of the Ecuadorian Andes approximately 94 miles Southeast of Quito. Hospital Vozandes del Oriente (HVO) is a hospital located in Shell owned and operated by Hoy Cristo Jesús Bendice (HCJB) Global. HCJB is a non-profit mission organization committed to Biblical values and community development principles. Pure Pastaza, a senior design team from Calvin College, in conjunction with HCJB, has designed a wastewater treatment system for HVO. The design promotes the protection of human and environmental health by providing a sustainable solution to wastewater treatment and sets an example of stewardship to the surrounding community. The existing wastewater treatment system for the hospital property includes a pipe network and collection system leading to an undersized septic tank. As no drainfield or secondary treatment exist, effluent from the septic tank passes directly into the Motolo River south of the hospital without receiving additional treatment. There is also no appropriate method or suitable location established for septage disposal, which has consequently been disposed of directly in the river. The hospital has therefore requested the design of an alternative method of wastewater treatment and disposal of the sludge produced. Various treatment alternatives have been analyzed and compared from a standpoint of stewardship and cultural appropriateness. Pure Pastaza is recommending significant modifications to the existing septic system. The design utilizes an additional septic tank in series with the original, a dosing tank and a drain field. This design has been chosen due to its simplicity and relatively low maintenance. The sludge will be disposed of through on site burial techniques

New Data and Tools for Integrating Discrete and Continuous Population Modeling Strategies

Realistic population models have interactions between individuals. Such interactions cause populations to behave as systems with nonlinear dynamics. Much population data analysis is done using linear models assuming no interactions between individuals. Such analyses miss strong influences on population behavior and can lead to serious errors—especially for infectious diseases. To promote more effective population system analyses, we present a flexible and intuitive modeling framework for infection transmission systems. This framework will help population scientists gain insight into population dynamics, develop theory about population processes, better analyze and interpret population data, design more powerful and informative studies, and better inform policy decisions. Our framework uses a hierarchy of infection transmission system models. Four levels are presented here: deterministic compartmental models using ordinary differential equations (DE); stochastic compartmental (SC) models that relax assumptions about population size and include stochastic effects; individual event history models (IEH) that relax the SC compartmental structure assumptions by allowing each individual to be unique. IEH models also track each individual's history, and thus, allow the simulation of field studies. Finally, dynamic network (DNW) models relax the assumption of the previous models that contacts between individuals are instantaneous events that do not affect subsequent contacts. Eventually it should be possible to transit between these model forms at the click of a mouse. An example is presented dealing with Cryptosporidium . It illustrates how transiting model forms helps assess water contamination effects, evaluate control options, and design studies of infection transmission systems using nucleotide sequences of infectious agents.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75616/1/j.1749-6632.2001.tb02756.x.pd

The dynamics of methicillin-resistant Staphylococcus aureusexposure in a hospital model and the potential for environmental intervention

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections. An important control strategy is hand hygiene; however, non-compliance has been a major problem in healthcare settings. Furthermore, modeling studies have suggested that the law of diminishing return applies to hand hygiene. Other additional control strategies such as environmental cleaning may be warranted, given that MRSA-positive individuals constantly shed contaminated desquamated skin particles to the environment. METHODS: We constructed and analyzed a deterministic environmental compartmental model of MRSA fate, transport, and exposure between two hypothetical hospital rooms: one with a colonized patient, shedding MRSA; another with an uncolonized patient, susceptible to exposure. Healthcare workers (HCWs), acting solely as vectors, spread MRSA from one patient room to the other. RESULTS: Although porous surfaces became highly contaminated, their low transfer efficiency limited the exposure dose to HCWs and the uncolonized patient. Conversely, the high transfer efficiency of nonporous surfaces allows greater MRSA transfer when touched. In the colonized patient’s room, HCW exposure occurred more predominantly through the indirect (patient to surfaces to HCW) mode compared to the direct (patient to HCW) mode. In contrast, in the uncolonized patient’s room, patient exposure was more predominant in the direct (HCW to patient) mode compared to the indirect (HCW to surfaces to patient) mode. Surface wiping decreased MRSA exposure to the uncolonized patient more than daily surface decontamination. This was because wiping allowed higher cleaning frequency and cleaned more total surface area per day. CONCLUSIONS: Environmental cleaning should be considered as an integral component of MRSA infection control in hospitals. Given the previously under-appreciated role of surface contamination in MRSA transmission, this intervention mode can contribute to an effective multiple barrier approach in concert with hand hygiene

Simulations to Evaluate HIV Vaccine Trial Designs

Many HIV vaccine trials have been proposed to evaluate susceptibility of individuals. However, vac cines may also affect an epidemic's course at the population level by altering the infectiousness of vaccinated individuals who become infected. A vac cine trial design that does not estimate both suscep tibility and infectiousness might reject a proposed vaccine that is capable of halting the HIV epidemic. We describe a vaccine trial design called the Retro spective Partner Trial (RPT), which can quantify vaccine effects on both susceptibility and infectious ness. We describe HIVSIM, a simulation environ ment that generates simulated populations and al lows for empirical evaluation of the statistical power of the RPT. HIVSIM explicitly models a number of factors which influence transmission and preva lence, and which have proven difficult to model us ing standard models. These factors include the infec tion stage of infected individuals, partnership selec tion, the duration of partnerships and concurrence, and transmission of HIV. The simulation analysis indicates that the RPT design has substantially greater statistical power for identifying vaccines which, in spite of exhibiting poor protection against infection, are nonetheless capable of halting the HIV epidemic by substantially reducing the infectious ness of vaccinated individuals who become infected.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68501/2/10.1177_003754979807100403.pd

The dynamics of methicillin-resistant Staphylococcus aureus exposure in a hospital model and the potential for environmental intervention

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections. An important control strategy is hand hygiene; however, non-compliance has been a major problem in healthcare settings. Furthermore, modeling studies have suggested that the law of diminishing return applies to hand hygiene. Other additional control strategies such as environmental cleaning may be warranted, given that MRSA-positive individuals constantly shed contaminated desquamated skin particles to the environment. Methods We constructed and analyzed a deterministic environmental compartmental model of MRSA fate, transport, and exposure between two hypothetical hospital rooms: one with a colonized patient, shedding MRSA; another with an uncolonized patient, susceptible to exposure. Healthcare workers (HCWs), acting solely as vectors, spread MRSA from one patient room to the other. Results Although porous surfaces became highly contaminated, their low transfer efficiency limited the exposure dose to HCWs and the uncolonized patient. Conversely, the high transfer efficiency of nonporous surfaces allows greater MRSA transfer when touched. In the colonized patient’s room, HCW exposure occurred more predominantly through the indirect (patient to surfaces to HCW) mode compared to the direct (patient to HCW) mode. In contrast, in the uncolonized patient’s room, patient exposure was more predominant in the direct (HCW to patient) mode compared to the indirect (HCW to surfaces to patient) mode. Surface wiping decreased MRSA exposure to the uncolonized patient more than daily surface decontamination. This was because wiping allowed higher cleaning frequency and cleaned more total surface area per day. Conclusions Environmental cleaning should be considered as an integral component of MRSA infection control in hospitals. Given the previously under-appreciated role of surface contamination in MRSA transmission, this intervention mode can contribute to an effective multiple barrier approach in concert with hand hygiene.http://deepblue.lib.umich.edu/bitstream/2027.42/112924/1/12879_2013_Article_2936.pd

The Effect of Ongoing Exposure Dynamics in Dose Response Relationships

Characterizing infectivity as a function of pathogen dose is integral to microbial risk assessment. Dose-response experiments usually administer doses to subjects at one time. Phenomenological models of the resulting data, such as the exponential and the Beta-Poisson models, ignore dose timing and assume independent risks from each pathogen. Real world exposure to pathogens, however, is a sequence of discrete events where concurrent or prior pathogen arrival affects the capacity of immune effectors to engage and kill newly arriving pathogens. We model immune effector and pathogen interactions during the period before infection becomes established in order to capture the dynamics generating dose timing effects. Model analysis reveals an inverse relationship between the time over which exposures accumulate and the risk of infection. Data from one time dose experiments will thus overestimate per pathogen infection risks of real world exposures. For instance, fitting our model to one time dosing data reveals a risk of 0.66 from 313 Cryptosporidium parvum pathogens. When the temporal exposure window is increased 100-fold using the same parameters fitted by our model to the one time dose data, the risk of infection is reduced to 0.09. Confirmation of this risk prediction requires data from experiments administering doses with different timings. Our model demonstrates that dose timing could markedly alter the risks generated by airborne versus fomite transmitted pathogens

Choosing an appropriate bacterial typing technique for epidemiologic studies

A wide variety of bacterial typing systems are currently in use that vary greatly with respect to the effort required, cost, reliability and ability to discriminate between bacterial strains. No one technique is optimal for all forms of investigation. We discuss the desired level of discrimination and need for a biologic basis for grouping strains of apparently different types when using bacterial typing techniques for different epidemiologic applications: 1) confirming epidemiologic linkage in outbreak investigations, 2) generating hypotheses about epidemiologic relationships between bacterial strains in the absence of epidemiologic information, and 3) describing the distributions of bacterial types and identifying determinants of those distributions. Inferences made from molecular epidemiologic studies of bacteria depend upon both the typing technique selected and the study design used; thus, choice of typing technique is pivotal for increasing our understanding of the pathogenesis and transmission, and eventual disease prevention

Effect of Concurrent Partnerships and Sex-Act Rate on Gonorrhea Prevalence

The disease gonorrhea (GC) is a major public health problem in the United States, and the dynamics of the spread of GC through popula tions are complicated and not well understood. Studies have drawn attention to the effect of concurrent sexual partnerships as an influen tial factor for determining disease prevalence. However, little has been done to date to quantify the combined effects of concurrency and within-partnership sex-act rates on the prevalence of GC. This simulation study examines this issue with a simplified model of GC transmission in closed human populations that include concurrent partnerships. Two models of within-partnership sex-act rate are compared; one is a fixed sex-act rate per partnership, and the other is perhaps more realistic in that the rate depends on the number of concurrent partners. After controlling for total number of sex acts, pseudo-equilibrium prevalence is higher with the fixed sex-act rate than under the concurrency-adjusted rate in all the modeled partnership formation conditions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68414/2/10.1177_003754979807100404.pd