Global and regional source attribution of Shiga toxin-producing Escherichia coli infections using analysis of outbreak surveillance data

Shiga toxin-producing Escherichia coli (STEC) infections pose a substantial health and economic burden worldwide. To target interventions to prevent foodborne infections, it is important to determine the types of foods leading to illness. Our objective was to determine the food sources of STEC globally and for the six World Health Organization regions. We used data from STEC outbreaks that have occurred globally to estimate source attribution fractions. We categorised foods according to their ingredients and applied a probabilistic model that used information on implicated foods for source attribution. Data were received from 27 countries covering the period between 1998 and 2017 and three regions: the Americas (AMR), Europe (EUR) and Western-Pacific (WPR). Results showed that the top foods varied across regions. The most important sources in AMR were beef (40%; 95% Uncertainty Interval 39-41%) and produce (35%; 95% UI 34-36%). In EUR, the ranking was similar though with less marked differences between sources (beef 31%; 95% UI 28-34% and produce 30%; 95% UI 27-33%). In contrast, the most common source of STEC in WPR was produce (43%; 95% UI 36-46%), followed by dairy (27%; 95% UI 27-27%). Possible explanations for regional variability include differences in food consumption and preparation, frequency of STEC contamination, the potential of regionally predominant STEC strains to cause severe illness and differences in outbreak investigation and reporting. Despite data gaps, these results provide important information to inform the development of strategies for lowering the global burden of STEC infections

Hyaluronic acid/poly-L-lysine bilayered silica nanoparticles enhance the osteogenic differentiation of human mesenchymal stem cells

First published online 15 Aug 2014Herein, we evaluate the influence of a PLL–HA bilayer on the surface of silica nanoparticles on their capacity to induce the osteogenic differentiation of human bone marrow stem cells (hBMSCs), as a function of their concentration (50 μg mL−1, 25 μg mL−1 and 12.5 μg mL−1). To this purpose, we synthesized silica nanoparticles (diameter of 250 nm; ζ-potential of −25 mV) that were coated with PLL–HA (diameter of 560 nm; ζ-potential of −35 mV). The cell viability, cell proliferation, protein quantification (i.e. MTS, DNA and ALP, respectively) and gene expression (of osteogenesis-related genes: ALP, osteocalcin, collagen type I, bone sialoprotein, Runx-2, osteopontin and osterix) were monitored, for 21 days. We observed the overexpression of most of the tested osteogenic transcripts in the hBMSCs cultured with SiO2–PLL–HA, at concentrations of 25 μg mL−1 and 12.5 μg mL−1. These results indicate that the proposed nanoparticles temporarily improve the osteogenic differentiation of hBMSCs at low nanoparticle concentrations.We acknowledge funding from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement number REGPOT-CT2012-316331-POLARIS. AM acknowledges QREN (project "RL1-ABMR-NORTE-01-0124-FEDER-000016" co-financed by the North Portugal Regional Operational Programme (ON. 2, "O Novo Norte") under the NSRF through the ERDF) for financing this research work

Toxoplasma gondii and the role of pork

Toxoplasma gondii is an important zoonotic pathogen. Humans can acquire T. gondii infection through foodborne or environmental exposure, and recent estimates suggest that more than 10 million human cases of toxoplasmosis occur globally every year. Infections in humans can be post-natal (i.e. acquired toxoplasmosis) or vertical (i.e. congenital toxoplasmosis). Because congenital toxoplasmosis is considered particu-larly problematic due to the severe health effects it can cause in children since birth and the possibility of fetal death, its public health impact has been more extensively studied than acquired toxoplasmosis, where infection is usually associated with mild flu-like symptoms. However, several newer studies suggest that in some cases ocular disease and severe syndromes such as psychiatric disorders may develop as a result of infection

Using Process Mining to Assess the Fidelity of a Home Visiting Program

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is a federal public health initiative which supports at-risk families through evidence-based programs and promising approaches for pregnant women, and childhood development for children aged 0 to 5. These public health program funding mechanisms commonly include process evaluation mandates. Purpose: The use of process mining was explored as a methodology to assess the fidelity of the MIECHV programs’ actual workflow to that of their intended models. Methods: Research Electronic Data Capture (REDCap) data files that were populated with program process data elements from the local implementing agencies were mined. The focus was on three main variables: participant identification, activity labels, and timestamps. These variables were imported into the Disco process-mining software. Disco was used to develop process maps to track process pathways and compare the actual workflow against the intended model. Results: Using process mining as a diagnostic tool, fidelity to the MIECHV process model was assessed, identifying a total of 262 different process variations. The 15 most frequent variations represent 60.7% of the total pool of process variations, 13 of which were deemed to have fidelity to the intended model. Analysis of the variations indicated that many activities in the intended process were skipped or implemented out of sequence. Implications: Process mining is a useful tool for organizations to visually display, track, understand, compare, and improve their workflow processes. This method should be considered by programs as complex as MIECHV to improve the data reporting and the identification of opportunities to strengthen programs

Visualizing Complex Adaptive Systems: A Case Study of the Missouri Maternal, Infant, and Early Childhood Home Visiting Program

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program was created by the 2010 Patient Protection and Affordable Care Act. MIECHV provides comprehensive services to at-risk families through evidence-based home visiting programs. Purpose: The following question is addressed: Does the Missouri MIECHV system meet the definition of a complex adaptive system (CAS)? Methods: A systematic review was conducted of documents related to MIECHV programs (federal, state, and local levels), and to affiliated programs with a home visiting and early childhood (aged birth to 5 years) scope. The organizations’ fit was identified for the scope of early childhood home visiting programs, and then its relationship extracted to MIECHV and its affiliates. Results: MIECHV meets the definition of a CAS, being dynamic, massively entangled, scale independent, transformative, and emergent. Over 250 organizations were identified; 19 federal and 79 state organizations; 24 nonprofits at the federal level, 31 at the state; over 150 community-level agencies; and 13 home visiting models implemented in Missouri. Implications: A considerable amount of organizational complexity exists within the MIECHV system and among its affiliates with a home visiting and early childhood scope. The complexity of the system challenges its potential for effective and efficient implementation, coordination, sustainability, and evaluation, and increases the potential for redundancy, overlap, and fragmentation. Evaluating a CAS requires acknowledgement of its complexity, beyond traditional approaches to evaluation. Creating visualization tools of federal, state, and local stakeholders and their relationships is a practical approach for aligning, organizing, and communicating the work flow

Climate change impact on the Portuguese exposure to aflatoxins

As alterações climáticas têm sido identificadas como um fator determinante para a segurança dos alimentos consumidos em todo o mundo. As micotoxinas, contaminantes alimentares produzidos por fungos, são habitualmente identificadas como um dos principais perigos neste contexto. As aflatoxinas assumem particular relevo, face à sua toxicidade aguda e crónica. A região do Mediterrâneo, incluindo Portugal, tem sido considerada uma região particularmente vulnerável às consequências das alterações climáticas. O presente estudo pretende estimar o impacto na saúde da exposição a aflatoxinas em Portugal e discutir a potencial influência das alterações climáticas no risco para a saúde associado a esta exposição. Para estimar o número de casos de carcinoma hepatocelular associados à exposição a aflatoxinas, foi determinada a fração atribuível da população. Para estimar o impacto da exposição a aflatoxinas na saúde dos Portugueses, a carga de doença foi determinada aplicando-se o conceito de anos de vida ajustados por incapacidade (DALY). É expectável que no futuro, em consequência das alterações climáticas, o número de DALYs bem como do número de casos de carcinoma hepatocelular aumente. A quantificação do impacto na saúde da exposição a aflatoxinas em cenário de alterações climáticas reveste-se de particular importância, em especial para o desenvolvimento de políticas e medidas preventivas que possam proteger a população.Climate change has been indicated as a driver for food safety issues worldwide, mainly due to the impact on the occurrence of food safety hazards at various stages of food chain. Mycotoxins, natural contaminants produced by fungi, are among the most important of such hazards. Aflatoxins, which have the highest acute and chronic toxicity of all mycotoxins, assume particular importance. Mediterranean region, including Portugal, was considered a climate change hotspot. The present study aims to estimate the health impact of aflatoxins exposure in Portugal and to discuss the potential influence of climate change on the health risk associated to this exposure. A population attributable fraction was determined to estimate the number of extra cases of hepatocellular carcinoma (HCC) associated to the Portuguese aflatoxin exposure, and the Disability Adjusted Life Years (DALYs) were derived to estimate the associated burden of disease. It is expected that in the future the number of DALYs and the associated cases of HCC due to aflatoxins exposure will increase due to climate change. The quantification of the health impact associated with exposure to aflatoxins in climate change scenarios presents particular importance, especially for the development of politics and preventive measures to protect human population.info:eu-repo/semantics/publishedVersio

LONG-REMI : an AI-Based Technological Application to Promote Healthy Mental Longevity Grounded in Reminiscence Therapy

Altres ajuts: Fundación General CSIC (0551_PSL_6_E POCTEP)Reminiscence therapy (RT) consists of thinking about one's own experiences through the presentation of memory-facilitating stimuli, and it has as its fundamental axis the activation of emotions. An innovative way of offering RT involves the use of technology-assisted applications, which must also satisfy the needs of the user. This study aimed to develop an AI-based computer application that recreates RT in a personalized way, meeting the characteristics of RT guided by a therapist or a caregiver. The material guiding RT focuses on intangible cultural heritage. The application incorporates facial expression analysis and reinforcement learning techniques, with the aim of identifying the user's emotions and, with them, guiding the computer system that emulates RT dynamically and in real time. A pilot study was carried out at five senior centers in Barcelona and Portugal. The results obtained are very positive, showing high user satisfaction. Moreover, the results indicate that the high frequency of positive emotions increased in the participants at the end of the intervention, while the low frequencies of negative emotions were maintained at the end of the intervention

The disease burden of congenital toxoplasmosis in Denmark, 2014

Background Congenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available. Methods Using data primarily from two public health surveillance programmes conducted between 1992 and 2007, we estimated the incidence, occurrence of sequelae, mortality and the burden of disease in terms of disability-adjusted life years (DALYs) of CT in Denmark in 2014. Findings We estimated that 14 children were born with CT in 2014, of which six will have developed sequelae by the age of 12. CT resulted in a total disease burden of 123 DALYs (95% uncertainty interval [UI], 100-148), of which 78 (95% UI, 64-94) were due to foetal loss and 2 (95% UI, 1-3) were due to neonatal death; the remaining burden was due to moderate to severe life-long sequelae. A comparison of the estimated incidence of CT with the number of reported CT cases in 2008-2014 indicated that for each reported CT case, at least five other CT cases could be expected to have occurred and gone unreported. Interpretation Early onset, severity, and life-long duration of sequelae have a major effect on the disease burden of CT. Our data suggest that CT is under-diagnosed or under-reported in Denmark. The estimated disease burden and public health impact in Denmark is lower than in other European countries, highlighting the need for country-specific studies.Peer reviewe