Tandem Repeat Analysis for Surveillance of Human Salmonella Typhimurium Infections

Multiple-locus variable-number tandem repeats analysis improves surveillance and outbreak investigations

Contexts and Interconnections: A Conjunctural Approach to Territorial Cohesion

This article contributes to current debates around EU policy on territorial cohesion and its place-based approaches. Based on substantial empirical research in seven member countries in an on-going EU Horizon 2020 project, the article develops a conjunctural approach based on Doreen Massey’s conceptualisation of place to provide insight into how local development functions in spatial and temporal dimensions. One of the main objectives of the case studies is to compare policy programmes and practices that seek to alleviate territorial inequality and generate economic growth and territorial cohesion. In such a comparison, the issue of conflating and rescaling administrative territorial units and boundaries demands particular attention. Administrative boundaries do not necessarily reflect the complexity and interconnections between policy actors, businesses, and local communities. Local specificities make it difficult to compare the local political room for manoeuvre due to different administrative principles, unequal degrees of devolution of competences or differences in constitutions, e.g., federal states versus unity states. In this article, we argue that, faced with an analysis of highly diverse cases, a conjunctural analytical approach can help to capture and unpack some of the places’ complexities and regional interconnections and be a useful supplement to more conventional comparisons of more similar places. Through two examples, the article discusses what the application of this conjunctural approach means in practice, how it helped shape our understanding of how differently and how it can be further developed to accommodate place-based approaches to researching territorial cohesion

Identifying possible asthma-COPD overlap syndrome in patients with a new diagnosis of COPD in primary care

The asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) remains poorly characterised. Our aim was to describe an algorithm for identifying possible ACOS in adults with newly diagnosed COPD in primary care. General practitioners (n=241) consecutively recruited subjects ⩾35 years, with tobacco exposure, at least one respiratory symptom and no previous diagnosis of obstructive lung disease. Possible ACOS was defined as chronic airflow obstruction, i.e., post-bronchodilator (BD) forced expiratory volume 1/forced vital capacity (FEV(1)/FVC) ratio<0.70, combined with wheeze (ACOS wheeze) and/or significant BD reversibility (ACOS BD reversibility). Of 3,875 (50% females, mean age 57 years) subjects screened, 700 (18.1%) were diagnosed with COPD, i.e., symptom(s), tobacco exposure and chronic airflow obstruction. Indications for ACOS were found in 264 (38%) of the COPD patients. The prevalence of ACOS wheeze and ACOS BD reversibility was 27% (n=190) and 16% (n=113), respectively (P<0.001), and only 6% (n=39) of the COPD patients fulfilled both criteria for ACOS. Patients with any ACOS were younger (P=0.04), had more dyspnoea (P<0.001), lower FEV(1)%pred (67% vs. 74%; P<0.001) and lower FEV(1)/FVC ratio (P=0.001) compared with COPD-only patients. Comparing subjects fulfilling both criteria for ACOS with those fulfilling criteria for ACOS wheeze only (n=151) and those fulfilling criteria for ACOS BD reversibility only (n=74) revealed no significant differences. Irrespective of the applied ACOS definition, no significant difference in life-time tobacco exposure was found between ACOS- and COPD-only patients. In subjects with a new diagnosis of COPD, the prevalence of ACOS is high. When screening for COPD in general practice among patients with no previous diagnosis of obstructive lung disease, patients with possible ACOS may be identified by self-reported wheeze and/or BD reversibility

Occupation with grain crops is associated with lower type 1 diabetes incidence:Registry-based case-control study

Intranasal administration of gliadin prevents autoimmune diabetes in non-obese diabetic mice. The current study was designed to investigate if bakers are intranasally exposed to gluten during work and whether occupation as baker is inversely associated with type 1 diabetes. Gliadin was measured in nasal swabs from eight bakers and butchers. The odds ratio of type 1 diabetes in selected profession groups was analysed in a registry-based case-control study with data from 1980 to 2010 derived from Statistics Denmark. The cohort included 1,210,017 Danish individuals, thereof 15,451 with type 1 diabetes (1.28%). Average nasal gliadin swab content after full working days was 6.3 μg (confidence interval (CI): 2.8 to 9.7) among bakers, while no nasal gliadin was detected among butchers. The odds ratio of type 1 diabetes was lower among bakers (OR = 0.57; CI: 0.52 to 0.62) and agriculture workers occupied with production of grains (OR = 0.65; CI: 0.56 to 0.75). Bakers had a lower odds ratio of type 1 diabetes, which potentially could be attributed to exposure of nasal mucosal gluten during work, as observed in this study. If other studies confirm the present observations, intranasal gliadin administration could possibly be an easy and safe approach for the prevention of type 1 diabetes in high-risk individuals or prediabetic subjects

Cohesion in the local context:Reconciling the territorial, economic and social dimensions

This brief editorial introduces a set of articles dealing with territorial challenges in Europe. The EU and the member states have put attention to a silent, but growing issue of inequality: The spatial disparities are in several member states considered able to provide wider political tensions and challenges. Consequently, the EU has launched a research theme in its framework programme Horizon 2020 to cope with such matter. Most of the papers in this issue have their origin in the Horizon COHSMO project "Inequality, Urbanization and Territorial Cohesion: Developing the European Social Model of Economic Growth and Democratic Capacity." While social or economic inequalities are recognized as a social problem, spatial disparities are forgotten or ignored. However, territorial inequalities do boost social and economic differences and add to growing tensions and contradictions in many cases. Coping with such challenges is a difficult matter; most European countries have had programmes aiming at rebalancing regional inequalities for many years. Despite major investments in public services, infrastructure, education and culture, as well as targeted support for private investors, businesses raising employment opportunities and so on. However, the success in terms of growing population and employment has been limited. Instead, endogenous structures and relations receive more attention; in particularly local capacity to generate solutions and means to promote economic and social development. This ability strongly links to the concept of collective efficacy, i.e., a joint understanding and capability to organize and execute actions of mutual benefit

DNA microarray analysis of Salmonella serotype Typhimurium strains causing different symptoms of disease

<p>Abstract</p> <p>Background</p> <p><it>Salmonella enterica </it>subsp. <it>enterica </it>is one of the leading food-borne pathogens in the USA and European countries. Outcome of human <it>Salmonella </it>serotype Typhimurium infections ranges from mild self-limiting diarrhoea to severe diarrhoea that requires hospitalization. Increased knowledge of the mechanisms that are responsible for causing infection and especially the severity of infection is of high interest.</p> <p>Results</p> <p>Strains were selected from patients with mild infections (n = 9) and patients with severe infections (n = 9) and clinical data allowed us to correct for known underlying diseases. Additionally, outbreak isolates (n = 3) were selected. Strains were analyzed on a DNA-DNA microarray for presence or absence of 281 genes covering marker groups of genes related to pathogenicity, phages, antimicrobial resistance, fimbriae, mobility, serotype and metabolism. Strains showed highly similar profiles when comparing virulence associated genes, but differences between strains were detected in the prophage marker group. The <it>Salmonella </it>virulence plasmid was present in 72% of the strains, but presence or absence of the virulence plasmid did not correspond to disease symptoms. A dendrogram clustered strains into four groups. Clustering confirmed DT104 as being a clonal phagetype. Clustering of the remaining strains was mainly correlated to presence or absence of the virulence plasmid and mobile elements such as transposons. Each of the four clusters in the tree represented an almost equal amount of strains causing severe or mild symptoms of infection.</p> <p>Conclusions</p> <p>We investigated clinical significance of known virulence factors of <it>Salmonella </it>serotype Typhimurium strains causing different disease symptoms, and conclude that the few detected differences in <it>Salmonella </it>serotype Typhimurium do not affect outcome of human disease.</p