The public health importance of scabies in community domiciliary care settings: an exploratory cross-sectional survey of health protection teams in England

Scabies is a contagious skin infection commonly occurring in institutions such as care homes. However, a large proportion of vulnerable people in England receive domiciliary care in the community and their experience of scabies has not been described. We undertook a pragmatic cross-sectional survey of Health Protection Teams (HPTs) in England to determine the burden of scabies related to domiciliary care. Fifteen cases or outbreaks were notified to HPTs between January 2013 and December 2017. Although a relatively uncommon event for individual HPTs, they were complex to manage and required the co-ordination of multiple stakeholders. Diagnosis was often delayed and required several clinical consultations. A lack of guidance led to difficulties establishing stakeholder roles and responsibilities and sources of funding for treatment. The stigmatisation of scabies sometimes affected the quality of care provided to patients, such as use of excessive personal protective equipment. Our study demonstrates that scabies is an issue of public health importance for domiciliary care service providers and users, and research is required to better understand the impacts of the disease and to develop evidence-based guidance. More generally, there is a need for simpler treatment regimens and methods of diagnosing scabies

Selective reduction of coliforms in constructed wetlands

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The impact of direct-acting antivirals on hepatitis C viraemia among people who inject drugs in England; real-world data 2011–2018

Direct‐acting antiviral (DAA) therapy for anybody with viraemic HCV infection has been scaled‐up in England since 2017. To assess early impacts, we investigated trends in, and factors associated with, HCV viraemia among people who inject drugs (PWID). We also examined trends in self‐reported treatment access. Bio‐behavioural data from an annual, national surveillance survey of PWID (2011–2018) estimated trends in viraemic prevalence among HCV antibody‐positive PWID. Multivariable logistic regression identified characteristics independently associated with viraemia. Trends in treatment access were examined for PWID with known infection. Between 2011 and 2016, viraemic prevalence among antibody‐positive PWID remained stable (2011, 57.7%; 2016, 55.8%) but decreased in 2017 (49.4%) and 2018 (50.4%) (both p < 0.001). After adjustment for demographic and behavioural characteristics, there remained significant reduction in viraemia in 2017 (adjusted odds ratio [aOR] 0.79, 95% CI 0.65–0.94) and 2018 (aOR 0.79, 95% CI 0.66–0.93) compared to 2016. Other factors associated with viraemia were male gender (aOR 1.68, 95% CI 1.53–1.86), geographical region, injecting in past year (aOR 1.26, 95% CI 1.13–1.41), imprisonment (aOR 1.14, 95% CI 1.04–1.31) and homelessness (aOR 1.17, 95% CI 1.04–1.31). Among non‐viraemic PWID with known infection, the proportion reporting ever receiving treatment increased in 2017 (28.7%, p < 0.001) and 2018 (38.9%, p < 0.001) compared to 2016 (14.5%). In conclusion, there has been a small reduction in HCV viraemia among antibody‐positive PWID in England since 2016, alongside DAA scale‐up, and some indication that treatment access has improved in the same period. Population‐level monitoring and focus on harm reduction is critical for achieving and evaluating elimination

Upper crustal structure and axial topography at intermediate spreading ridges : seismic constraints from the southern Juan de Fuca Ridge

Author Posting. © American Geophysical Union, 2005. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 110 (2005): B12104, doi:10.1029/2005JB003630.We use multichannel seismic reflection data to image the upper crustal structure of 0-620 ka crust along the southern Juan de Fuca Ridge (JdFR). The study area comprises two segments spreading at intermediate rate with an axial high morphology with narrow (Cleft) and wide (Vance) axial summit grabens (ASG). Along most of the axis of both segments we image the top of an axial magma chamber (AMC). The AMC along Cleft deepens from south to north, from 2.0 km beneath the RIDGE Cleft Observatory and hydrothermal vents near the southern end of the segment, to 2.3 km at the northern end near the site of the 1980’s eruptive event. Along the Vance segment, the AMC also deepens from south to north, from 2.4 km to 2.7 km. Seismic layer 2A, interpreted as the basaltic extrusive layer, is 250-300 m thick at the ridge axis along the Cleft segment, and 300-350 m thick along the axis of the Vance segment. However off-axis layer 2A is similar in both segments (500-600 m), indicating ~90% and ~60% off-axis thickening at the Cleft and Vance segments, respectively. Half of the thickening occurs sharply at the walls of the ASG, with the remaining thickening occurring within 3-4 km of the ASG. Along the full length of both segments, layer 2A is thinner within the ASG, compared to the ridge flanks. Previous studies argued that the ASG is a cyclic feature formed by alternating periods of magmatism and tectonic extension. Our observations agree with the evolving nature of the ASG. However, we suggest that its evolution is related to large changes in axial morphology produced by small fluctuations in magma supply. Thus the ASG, rather than being formed by excess volcanism, is a rifted flexural axial high. The changes in axial morphology affect the distribution of lava flows along the ridge flanks, as indicated by the pattern of layer 2A thickness. The fluctuations in magma supply may occur at all spreading rates, but its effects on crustal structure and axial morphology are most pronounced along intermediate spreading rate ridges.This study was supported by the National Science Foundation grants OCE-0002551 to Woods Hole Oceanographic Institution, OCE-0002488 to Lamont-Doherty Earth Observatory, and OCE-0002600 to Scripps Institution of Oceanography

Proceedings of the third international molecular pathological epidemiology (MPE) meeting

Molecular pathological epidemiology (MPE) is a transdisciplinary and relatively new scientific discipline that integrates theory, methods and resources from epidemiology, pathology, biostatistics, bioinformatics and computational biology. The underlying objective of MPE research is to better understand the etiology and progression of complex and heterogeneous human diseases with the goal of informing prevention and treatment efforts in population health and clinical medicine. Although MPE research has been commonly applied to investigating breast, lung, and colorectal cancers, its methodology can be used to study most diseases. Recent successes in MPE studies include: 1) the development of new statistical methods to address etiologic heterogeneity; 2) the enhancement of causal inference; 3) the identification of previously unknown exposure-subtype disease associations; and 4) better understanding of the role of lifestyle/behavioral factors on modifying prognosis according to disease subtype. Central challenges to MPE include the relative lack of transdisciplinary experts, educational programs, and forums to discuss issues related to the advancement of the field. To address these challenges, highlight recent successes in the field, and identify new opportunities, a series of MPE meetings have been held at the Dana-Farber Cancer Institute in Boston, MA. Herein, we share the proceedings of the Third International MPE Meeting, held in May 2016 and attended by 150 scientists from 17 countries. Special topics included integration of MPE with immunology and health disparity research. This meeting series will continue to provide an impetus to foster further transdisciplinary integration of divergent scientific fields

Time variation in igneous volume flux of the Hawaii-Emperor hot spot seamount chain

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 109 (2004): B11401, doi:10.1029/2003JB002949.Satellite gravity, ship track bathymetry, sediment thickness, and crustal magnetic age data were combined to calculate the residual bathymetry and residual mantle Bouguer gravity anomaly (RMBA) for the northwest Pacific Ocean. The Hawaii-Emperor hot spot track appears on the RMBA map as a chain of negative anomalies, implying thickened crust or less dense mantle. The hot spot swell is clearly visible in a broad band of half-width ∼500 km for about 2000 km downstream from the current hot spot location, corresponding to hot spot ages of 0–25 Ma. A much narrower expression of the hot spot is visible for the rest of the chain at hot spot ages of 25–80 Ma. Comparison of the observed RMBA with various compensation models reveals that the relatively narrow features of the Hawaii-Emperor seamounts are best explained as being supported by plate flexure, while the Shatsky Rise, Hess Rise, and Mid-Pacific Mountains oceanic plateaus are best fit by Airy isostasy with a thickened crustal root. Amplitude comparisons between the RMBA predictions of various compensation models and the observed RMBA for the Hawaiian swell are ambiguous. However, on the basis of the shape of the predicted anomalies, we favor a model of flexure in response to a buried load at 120 km depth. We further calculate igneous (i.e., crustal) volume flux along the axis of the Hawaii-Emperor hot spot by integrating cross-sectional areas of gravity-derived excess crustal thickness and seafloor elevation, respectively, with respect to the normal oceanic crust. The highest values of the calculated igneous volume flux along the Hawaiian and Emperor ridges (∼8 m3/s) occur at present and at about 20 Ma. The flux was reduced to only 50% of this maximum (∼4 m3/s) at 10 Ma. The calculated igneous volume flux is systematically smaller (maximum values of ∼4 m3/s) along the Emperor ridge. Overall, the Hawaiian and Emperor ridges appear to have experienced quasi-periodic variations in fluxes on timescales of 6–30 Ma. Furthermore, during the low-flux periods at 25–48, 57, and 75 Ma the height and size of individual hot spot seamounts appear to be noticeably less than those of the high-flux periods. We hypothesize that the variations in the fluxes of the Hawaiian ridge might be controlled by the thickness of the overlying lithosphere at the time of hot spot emplacement, while the variations along the Emperor ridge may be influenced by the dynamics of the slow absolute motion of the hot spot at the time.E. Van Ark was supported by a National Science Foundation Graduate Research Fellowship, and J. Lin was supported by NSF grant OCE-0129741 and the Andrew W. Mellon Foundation Endowed Fund for Innovative Research at WHOI

H I - MaNGA : H I follow-up for the MaNGA survey

We present the H I-MaNGA programme of H I follow-up for the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey. MaNGA, which is part of the Fourth phase of the Sloan Digital Sky Surveys, is in the process of obtaining integral field unit spectroscopy for a sample of ∼10 000 nearby galaxies. We give an overview of the H I 21cm radio follow-up observing plans and progress and present data for the first 331 galaxies observed in the 2016 observing season at the Robert C. Bryd Green Bank Telescope. We also provide a cross-match of the current MaNGA(DR15) sample with publicly available H I data from the Arecibo Legacy Fast Arecibo L-band Feed Array survey. The addition of H I data to the MaNGA data set will strengthen the survey's ability to address several of its key science goals that relate to the gas content of galaxies, while also increasing the legacy of this survey for all extragalactic science.Publisher PDFPeer reviewe