The Risk of Reported Cryptosporidiosis in Children Aged < 5 Years in Australia is Highest in Very Remote Regions

The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2-1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2-2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3-6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9-9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years

Session C7: Tricky Little Lampreys! Efficacy of an Unmodified and Modified Super-Active Baffle Fish Pass for European River Lamprey (Lampetra Fluviatilis)

Abstract: Achieving good upstream passage of lampreys, a threatened group of serpentine fishes, remains a problem. The ability of European river lamprey (Lampetra fluviatilis) to pass a Crump weir using a 15% gradient Larinier superactive baffle fish pass during their upstream spawning migration was tested. This type of fish pass has become widespread in Europe in the last two decades, but its efficiency for river lamprey is unknown. River lamprey were PIT tagged (n=350) PIT, a subsample were acoustic tagged (n=31), and all were released downstream in batches in Oct-Dec 2013. Telemetry arrays were installed in the pass (PIT) and river (acoustic) and ran throughout the migration period. Attraction efficiency into the fishway (estimated at 90.1%) was good and half of lampreys entered within 24 h of release, but only one lamprey successfully ascended the pass (0.3% passage efficiency), despite many entering repeatedly. Out of 29 acoustic tagged lamprey that visited the weir, four (13.8%) passed the weir directly. The fishway was unsuitable for river lamprey over a wide range of flows. The pass was modified by addition of vertically mounted peg-and-slot tiles, interrogated at the entrance and exit by PIT telemetry and retested in winter 2014- 15. There was an increase in passage success. Preliminarily, out of 197 river lamprey PIT tagged Oct-Dec 2014, 184 (93.4%) were logged at the fishway entrance. 74 (40.2%) entered the tiles at the downstream end, of which 14 (18.9%) swam up through the tiles successfully. Twelve lamprey (6.5% passage efficiency) were logged at the upstream exit of the pass. Reduced flow velocity in combination with increased availability of resting habitat within the tiles may increase the passage efficiency of this type of fish pass for river lamprey. Although increased, passage efficiency, after placement of the tiles, is still considered far from optimal

Bacterial spore based hygromorphs: A novel active material with potential for architectural applications

This paper introduces a new active material which responds to changes in environmental humidity. There has been a growing interest in active materials which are able to respond to their environment creating dynamic architectural systems without the need for energy input or complex systems of sensors and actuators. A subset of these materials are hygromorphs which respond to changes in relative humidity (RH) and wetting through shape change. Here we introduce a novel hygromorphic material in the context of architectural design, composed of multiple monolayers of microbial spores of Bacillus subtilis and latex sheets. Methods of fabrication and testing for this new material are described, showing that small actuators made from this material demonstrate rapid, reversible and repeatable deflection in response to changes in RH. It was demonstrated that the hygromorphic actuators are able to lift at least 150% of their own mass. Investigations were also extended to understanding this new biomaterial in terms of meaningful work

Waterparks are high risk for cryptosporidiosis: A case-control study in Victoria, 2015

BACKGROUND: An increase in notifications of cryptosporidiosis was observed in Victoria between March and April 2015. Cases mostly resided in one metropolitan region and hypothesis-generating interviews identified common exposures to aquatic facilities. We conducted a case-control study to determine exposure source(s) and facilitate control measures. METHODS: Laboratory-confirmed cases of cryptosporidiosis from the region of interest notified between 1 March and 23 April 2015 were included. Controls residing in the same region were recruited from participants in a population health survey and frequency matched (2 per case) by age group. Details of exposure to potential risk factors were collected using a standardised telephone questionnaire for the 14-days prior to illness for cases, and an analogous exposure period for controls. Univariable and multivariable logistic regression were used to determine risk factors associated with illness using STATA SE 13.1. RESULTS: Thirty cases and 66 controls were included in the study. Half the cases were less than 12 years of age and 62% were female. Illness was most strongly associated with recreational water exposure at any waterpark (adjusted odds ratio (aOR)=73.5; 95% confidence interval (CI):6.74-802), and specifically at Victorian waterparks (aOR=45.6; 95% CI:5.20-399). Cases were linked with attendance at either a waterpark in the region or an adjacent region. As a result of this investigation, hyperchlorination was completed at identified facilities and swim hygiene information distributed. CONCLUSION: This study reinforces the potential for recreational water facilities, particularly waterparks, to act as a transmission source of Cryptosporidium infections. Continued communication to patrons is required to ensure healthy swimming practice in Victorian aquatic facilities

Identification and analysis of low-molecular-weight dissolved organic carbon in subglacial basal ice ecosystems by ion chromatography

Determining the concentration and composition of dissolved organic carbon (DOC) in glacial ecosystems is important for assessments of in situ microbial activity and contributions to wider biogeochemical cycles. Nonetheless, there is limited knowledge of the abundance and character of DOC in basal ice and the subglacial environment and a lack of quantitative data on low-molecular-weight (LMW) DOC components, which are believed to be highly bioavailable to microorganisms. We investigated the abundance and composition of DOC in basal ice via a molecular-level DOC analysis. Spectrofluorometry and a novel ion chromatographic method, which has been little utilized in glacial science for LMW-DOC determinations, were employed to identify and quantify the major LMW fractions (free amino acids, carbohydrates, and carboxylic acids) in basal ice from four glaciers, each with a different type of overridden material (i.e. the pre-entrainment sedimentary type such as lacustrine material or palaeosols). Basal ice from Joyce Glacier (Antarctica) was unique in that 98% of the LMW-DOC was derived from the extremely diverse free amino acid (FAA) pool, comprising 14 FAAs. LMW-DOC concentrations in basal ice were dependent on the bioavailability of the overridden organic carbon (OC), which in turn was influenced by the type of overridden material. Mean LMW-DOC concentrations in basal ice from Russell Glacier (Greenland), Finsterwalderbreen (Svalbard), and Engabreen (Norway) were low (0–417nMC), attributed to the relatively refractory nature of the OC in the overridden palaeosols and bedrock. In contrast, mean LMW-DOC concentrations were an order of magnitude higher (4430nMC) in basal ice from Joyce Glacier, a reflection of the high bioavailability of the overridden lacustrine material (> 17% of the sediment OC comprised extractable carbohydrates, a proxy for bioavailable OC). We find that the overridden material may act as a direct (via abiotic leaching) and indirect (via microbial cycling) source of DOC to the subglacial environment and provides a range of LMW-DOC compounds that may stimulate microbial activity in wet subglacial sediments

Greenland Ice Sheet exports labile organic carbon to the Arctic oceans

Runoff from small glacier systems contains dissolved organic carbon (DOC) rich in protein-like, low molecular weight (LMW) compounds, designating glaciers as an important source of bioavailable carbon for downstream heterotrophic activity. Fluxes of DOC and particulate organic carbon (POC) exported from large Greenland catchments, however, remain unquantified, despite the Greenland Ice Sheet (GrIS) being the largest source of global glacial runoff (ca. 400 km3 yr−1). We report high and episodic fluxes of POC and DOC from a large (> 600 km2) GrIS catchment during contrasting melt seasons. POC dominates organic carbon (OC) export (70–89% on average), is sourced from the ice sheet bed, and contains a significant bioreactive component (9% carbohydrates). A major source of the “bioavailable” (free carbohydrate) LMW–DOC fraction is microbial activity on the ice sheet surface, with some further addition of LMW–DOC to meltwaters by biogeochemical processes at the ice sheet bed. The bioavailability of the exported DOC (26–53%) to downstream marine microorganisms is similar to that reported from other glacial watersheds. Annual fluxes of DOC and free carbohydrates during two melt seasons were similar, despite the approximately two-fold difference in runoff fluxes, suggesting production-limited DOC sources. POC fluxes were also insensitive to an increase in seasonal runoff volumes, indicating a supply limitation in suspended sediment in runoff. Scaled to the GrIS, the combined DOC (0.13–0.17 TgC yr−1 (±13 %)) and POC fluxes (mean = 0.36–1.52 TgC yr−1 (±14 %)) are of a similar order of magnitude to a large Arctic river system, and hence may represent an important OC source to the near-coastal North Atlantic, Greenland and Labrador seas

Functional network topology in drug resistant and well-controlled idiopathic generalized epilepsy:a resting state functional MRI study

Despite an increasing number of drug treatment options for people with idiopathic generalized epilepsy (IGE), drug resistance remains a significant issue and the mechanisms underlying it remain poorly understood. Previous studies have largely focused on potential cellular or genetic explanations for drug resistance. However, epilepsy is understood to be a network disorder and there is a growing body of literature suggesting altered topology of large-scale resting networks in people with epilepsy compared with controls. We hypothesize that network alterations may also play a role in seizure control. The aim of this study was to compare resting state functional network structure between well-controlled IGE (WC-IGE), drug resistant IGE (DR-IGE) and healthy controls. Thirty-three participants with IGE (10 with WC-IGE and 23 with DR-IGE) and 34 controls were included. Resting state functional MRI networks were constructed using the Functional Connectivity Toolbox (CONN). Global graph theoretic network measures of average node strength (an equivalent measure to mean degree in a network that is fully connected), node strength distribution variance, characteristic path length, average clustering coefficient, small-world index and average betweenness centrality were computed. Graphs were constructed separately for positively weighted connections and for absolute values. Individual nodal values of strength and betweenness centrality were also measured and 'hub nodes' were compared between groups. Outcome measures were assessed across the three groups and between both groups with IGE and controls. The IGE group as a whole had a higher average node strength, characteristic path length and average betweenness centrality. There were no clear differences between groups according to seizure control. Outcome metrics were sensitive to whether negatively correlated connections were included in network construction. There were no clear differences in the location of 'hub nodes' between groups. The results suggest that, irrespective of seizure control, IGE interictal network topology is more regular and has a higher global connectivity compared to controls, with no alteration in hub node locations. These alterations may produce a resting state network that is more vulnerable to transitioning to the seizure state. It is possible that the lack of apparent influence of seizure control on network topology is limited by challenges in classifying drug response. It is also demonstrated that network topological features are influenced by the sign of connectivity weights and therefore future methodological work is warranted to account for anticorrelations in graph theoretic studies

The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda

Hepatitis B virus (HBV) infection represents a significant global health threat, accounting for 300 million chronic infections and up to 1 million deaths each year. HBV disproportionately affects people who are under-served by health systems due to social exclusion, and can further amplify inequities through its impact on physical and mental health, relationship with stigma and discrimination, and economic costs. The 'inclusion health' agenda focuses on excluded and vulnerable populations, who often experience barriers to accessing healthcare, and are under-represented by research, resources, interventions, advocacy, and policy. In this article, we assimilate evidence to establish HBV on the inclusion health agenda, and consider how this view can inform provision of better approaches to diagnosis, treatment, and prevention. We suggest approaches to redress the unmet need for HBV interventions among excluded populations as an imperative to progress the global goal for the elimination of viral hepatitis as a public health threat

Understanding the Patient Experience with Carcinoid Syndrome: Exit Interviews from a Randomized, Placebo-Controlled Study of Telotristat Ethyl

Purpose: Telotristat ethyl, an oral tryptophan hydroxylase inhibitor, is intended to treat carcinoid syndrome by reducing serotonin production. Telotristat ethyl was evaluated in TELESTAR, a Phase III study for patients who had carcinoid syndrome with at least 4 bowel movements (BMs) per day and who were receiving somatostatin analogue therapy. This interview substudy was conducted to provide insight into the patient experience in TELESTAR and to help understand whether reductions in BM frequency (the primary end point) and other symptoms were clinically meaningful. Methods: Participating sites were asked to invite (before randomization) all eligible patients to telephone interviews scheduled at the end of the double-blind treatment period. Patients and interviewers were blinded to treatment. Findings: All 35 interviewed participants reported diarrhea and/or excessive BMs at baseline. Patients reported that these symptoms negatively affected emotional, social, physical, and occupational well-being. Prespecified criteria for treatment response (achieving ≥ 30% reduction in BM frequency for at least 50% of the days) were met by 8 of 26 patients taking telotristat ethyl and 1 of 9 patients taking placebo. All 8 patients taking telotristat ethyl described clinically meaningful reductions in BM frequency and were very satisfied with the ability of the study drug to control their carcinoid syndrome symptoms. Overall, reports of being very satisfied were observed in 12 patients taking telotristat ethyl and 0 taking placebo. Implications: Patient interviews revealed that TELESTAR patients, at baseline, were significantly affected by their high BM frequency. Patient reports of their clinical trial experience supported the significance of the primary end point and clinical responder analysis in TELESTAR, helping identify and understand clinically meaningful change produced by telotristat ethyl