Transmission dynamics of rabies virus in Thailand: Implications for disease control

BACKGROUND: In Thailand, rabies remains a neglected disease with authorities continuing to rely on human death statistics while ignoring the financial burden resulting from an enormous increase in post-exposure prophylaxis. Past attempts to conduct a mass dog vaccination and sterilization program have been limited to Bangkok city and have not been successful. We have used molecular epidemiology to define geographic localization of rabies virus phylogroups and their pattern of spread in Thailand. METHODS: We analyzed 239 nucleoprotein gene sequences from animal and human brain samples collected from all over Thailand between 1998 and 2002. We then reconstructed a phylogenetic tree correlating these data with geographical information. RESULTS: All sequences formed a monophyletic tree of 2 distinct phylogroups, TH1 and TH2. Three subgroups were identified in the TH1 subgroup and were distributed in the middle region of the country. Eight subgroups of TH2 viruses were identified widely distributed throughout the country overlapping the TH1 territory. There was a correlation between human-dependent transportation routes and the distribution of virus. CONCLUSION: Inter-regional migration paths of the viruses might be correlated with translocation of dogs associated with humans. Interconnecting factors between human socioeconomic and population density might determine the transmission dynamics of virus in a rural-to-urban polarity. The presence of 2 or more rabies virus groups in a location might be indicative of a gene flow, reflecting a translocation of dogs within such region and adjacent areas. Different approaches may be required for rabies control based on the homo- or heterogeneity of the virus. Areas containing homogeneous virus populations should be targeted first. Control of dog movement associated with humans is essential

Liquid Biopsy in Breast Cancer

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3D Airway changes using CBCT in patients following mandibular setback surgery ± maxillary advancement

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149310/1/ocr12291_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149310/2/ocr12291.pd

Qualidade de alface crespa cultivada em sistema orgânico, convencional e hidropônico.

O objetivo deste trabalho foi avaliar a qualidade da alface do grupo crespa, cv. Vera, em sistemas de cultivo orgânico, convencional e hidropônico em Rio Branco-AC. O experimento foi conduzido em julho de 2009. As amostras dos sistemas, convencional e hidropônico (3 marcas comerciais), foram escolhidas aleatoriamente nos supermercados do município de Rio Branco, no mesmo dia de coleta da alface produzida em sistema orgânico. A alface orgânica, produzida na área experimental do Setor de Agricultura Ecológica da Universidade Federal do Acre (UFAC), em Rio Branco, foi cultivada em estufa, sob plantio direto utilizando folhas de bambu como cobertura do solo, e adubada com composto orgânico (17 t ha-1 em base seca). O delineamento utilizado foi o inteiramente casualizado, com cinco tratamentos e quatro repetições compostas por três plantas. As amostras foram lavadas, cortadas e processadas com folha e caule, para obter o suco. Logo após foram determinados os teores de sólidos solúveis e a concentração de nitrato e ácido ascórbico. As três marcas de alface hidropônica apresentaram maior teor de nitrato e menor concentração de sólidos solúveis e ácidos ascórbico, enquanto a alface orgânica apresentou qualidade superior, com baixa concentração de nitrato e maior teor de ácido ascórbico

Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis

Background Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy. Methods We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance. Results We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography. Conclusion Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data