Application of knowledge-driven spatial modelling approaches and uncertainty management to a study of Rift Valley fever in Africa

BACKGROUND: There are few studies that have investigated uncertainties surrounding the scientific community's knowledge of the geographical distribution of major animal diseases. This is particularly relevant to Rift Valley fever (RVF), a zoonotic disease causing destructive outbreaks in livestock and man, as the geographical range of the disease is widening to involve previously unaffected regions. In the current study we investigate the application of methods developed in the decision sciences: multiple criteria decision making using weighted linear combination and ordered weighted averages, and Dempster-Shafer theory, implemented within the geographical information system IDRISI, to obtain a greater understanding of uncertainty related to the geographical distribution of RVF. The focus is on presenting alternate methods where extensive field data are not available and traditional, model-based approaches to disease mapping are impossible to conduct. RESULTS: Using a compensatory multiple criteria decision making model based on weighted linear combination, most of sub-Saharan Africa was suitable for endemic circulation of RVF. In contrast, areas where rivers and lakes traversed semi-arid regions, such as those bordering the Sahara, were highly suitable for RVF epidemics and wet, tropical areas of central Africa had low suitability. Using a moderately non-compensatory model based on ordered weighted averages, the areas considered suitable for endemic and epidemic RVF were more restricted. Varying the relative weights of the different factors in the models did not affect suitability estimates to a large degree, but variations in model structure had a large impact on our suitability estimates. Our Dempster-Shafer analysis supported the belief that a range of semi-arid areas were suitable for RVF epidemics and the plausibility that many other areas of the continent were suitable. Areas where high levels of uncertainty were highlighted included the Ethiopian Highlands, southwest Kenya and parts of West Africa. CONCLUSION: We have demonstrated the potential of methods developed in the decision sciences to improve our understanding of uncertainties surrounding the geographical distribution of animal diseases, particularly where information is sparse, and encourage wider application of the decision science methodology in the field of animal health

Patterns of management of patients with dual disorder (psychosis) in Italy: a survey of psychiatrists and other physicians focusing on clinical practice

© 2018 Clerici, de Bartolomeis, De Filippis, Ducci, Maremmani, Martinotti and Schifano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).Patients with severe psychotic disorders such as schizophrenia, schizoaffective and bipolar disorders frequently suffer from concomitant substance use disorders (SUDs) – Dual Disorder (DD) patients. In order to better understand current practices for management of patients with psychotic episodes and concomitant SUD in Italy, we carried out a survey of psychiatrists on current routine practice among prescribers. These aspects can help to identify at-risk patients, improve current prescribing practices, and favor early intervention. An ad hoc survey of 17 questions was administered to psychiatrists via electronic polling and on-line distribution; 448 completed questionnaires were collected. Comorbid substance abuse was most frequently diagnosed within the context of anxiety disorder (46%), followed by bipolar disorder (25%), and schizophrenia/schizoaffective disorder (12%). The vast majority of respondents felt that patient management was becoming more complex due to substance abuse. The areas reported to be most affected in patients with SUD were functioning, interpersonal relations, and impulsivity, while sensory perception disorders, ideation, agitation, and impulsivity were the most frequently reported symptoms. In the acute setting, haloperidol was used as the first-line agent of choice followed by aripiprazole and olanzapine. In the maintenance phase, aripiprazole was the dominantly used first-line agent, followed by olanzapine. Almost half of respondents used long-acting agents, while about one-third did not. Among those prescribing long-acting agents, efficacy, control of impulsivity, and control of specific symptoms were cited as motivators, while in the maintenance phase, better adherence and tolerability were mainly cited. From the responses to the present survey, it is clear that the respondents are aware of the problem of SUD in psychotic patients. While treatment be optimized in terms of the choice and formulation of antipsychotics, greater emphasis should be placed on efficacy, tolerability and the negative metabolic consequences of some antipsychotics. When considering the ideal antipsychotic, long-acting agents were considered to be superior in reducing relapse, even if current treatment guidelines often give preference to oral formulations.Peer reviewe

In Vivo Analysis of Trypanosoma cruzi Persistence Foci at Single-Cell Resolution.

Infections with Trypanosoma cruzi are usually lifelong despite generating a strong adaptive immune response. Identifying the sites of parasite persistence is therefore crucial to understanding how T. cruzi avoids immune-mediated destruction. However, this is a major technical challenge, because the parasite burden during chronic infections is extremely low. Here, we describe an integrated approach involving comprehensive tissue processing, ex vivo imaging, and confocal microscopy, which allowed us to visualize infected host cells in murine tissue with exquisite sensitivity. Using bioluminescence-guided tissue sampling, with a detection level of 200 parasites, which we term mega-nests. In contrast, during the acute stage, when the total parasite burden is considerably higher and many cells are infected, nests containing >50 parasites are rarely found. In C3H/HeN mice, but not BALB/c mice, we identified skeletal muscle as a major site of persistence during the chronic stage, with most parasites being found in large mega-nests within the muscle fibers. Finally, we report that parasites are also frequently found in the skin during chronic murine infections, often in multiple infection foci. In addition to being a site of parasite persistence, this anatomical reservoir could play an important role in insect-mediated transmission and have implications for drug development.IMPORTANCE Trypanosoma cruzi causes Chagas disease, the most important parasitic infection in Latin America. Major pathologies include severe damage to the heart and digestive tract, although symptoms do not usually appear until decades after infection. Research has been hampered by the complex nature of the disease and technical difficulties in locating the extremely low number of parasites. Here, using highly sensitive imaging technology, we reveal the sites of parasite persistence during chronic-stage infections of experimental mice at single-cell resolution. We show that parasites are frequently located in smooth muscle cells in the circular muscle layer of the colon and that skeletal muscle cells and the skin can also be important reservoirs. This information provides a framework for investigating how the parasite is able to survive as a lifelong infection, despite a vigorous immune response. It also informs drug development strategies by identifying tissue sites that must be accessed to achieve a curative outcome

Emissions of carbon tetrachloride from Europe

Carbon tetrachloride (CCl4) is a long-lived radiatively active compound with the ability to destroy stratospheric ozone. Due to its inclusion in the Montreal Protocol on Substances that Deplete the Ozone Layer (MP), the last two decades have seen a sharp decrease in its large-scale emissive use with a consequent decline in its atmospheric mole fractions. However, the MP restrictions do not apply to the use of carbon tetrachloride as feedstock for the production of other chemicals, implying the risk of fugitive emissions from the industry sector. The occurrence of such unintended emissions is suggested by a significant discrepancy between global emissions as derived from reported production and feedstock usage (bottom-up emissions), and those based on atmospheric observations (top-down emissions). In order to better constrain the atmospheric budget of carbon tetrachloride, several studies based on a combination of atmospheric observations and inverse modelling have been conducted in recent years in various regions of the world. This study is focused on the European scale and based on long-term high-frequency observations at three European sites, combined with a Bayesian inversion methodology. We estimated that average European emissions for 2006–2014 were 2.2 (± 0.8) Gg yr−1, with an average decreasing trend of 6.9 % per year. Our analysis identified France as the main source of emissions over the whole study period, with an average contribution to total European emissions of approximately 26 %. The inversion was also able to allow the localisation of emission "hot spots" in the domain, with major source areas in southern France, central England (UK) and Benelux (Belgium, the Netherlands, Luxembourg), where most industrial-scale production of basic organic chemicals is located. According to our results, European emissions correspond, on average, to 4.0 % of global emissions for 2006–2012. Together with other regional studies, our results allow a better constraint of the global budget of carbon tetrachloride and a better quantification of the gap between top-down and bottom-up estimates

Current and Emergent Economic Impacts of Covid-19 and Brexit on UK Fresh Produce and Horticultural Businesses

This paper describes a study designed to investigate the current and emergent impacts of Covid-19 and Brexit on UK horticultural businesses. Various characteristics of UK horticultural production, notably labour reliance and import dependence, make it an important sector for policymakers concerned to understand the effects of these disruptive events as we move from 2020 into 2021. The study design prioritised timeliness, using a rapid survey to gather information from a relatively small (n = 19) but indicative group of producers. The main novelty of the results is to suggest that a very substantial majority of producers either plan to scale back production in 2021 (47%) or have been unable to make plans for 2021 because of uncertainty (37%). The results also add to broader evidence that the sector has experienced profound labour supply challenges, with implications for labour cost and quality. The study discusses the implications of these insights from producers in terms of productivity and automation, as well as in terms of broader economic implications. Although automation is generally recognised as the long-term future for the industry (89%), it appeared in the study as the second most referred short-term option (32%) only after changes to labour schemes and policies (58%). Currently, automation plays a limited role in contributing to the UK's horticultural workforce shortage due to economic and socio-political uncertainties. The conclusion highlights policy recommendations and future investigative intentions, as well as suggesting methodological and other discussion points for the research community