Comparative epidemiology of highly pathogenic avian influenza virus H5N1 and H5N6 in Vietnamese live bird markets: spatio-temporal patterns of distribution and risk factors

Highly pathogenic avian influenza (HPAI) H5N1 virus has been circulating in Vietnam since 2003, whilst outbreaks of HPAI H5N6 virus are more recent, having only been reported since 2014. Although the spatial distribution of H5N1 outbreaks and risk factors for virus occurrence has been extensively studied, there have been no comparative studies for H5N6. Data collected through active surveillance of Vietnamese live bird markets (LBMs) between 2011 and 2015 were used to explore and compare the spatiotemporal distributions of H5N1- and H5N6-positive LBMs. Conditional autoregressive models were developed to quantify spatiotemporal associations between agroecological factors and the two HPAI strains using the same set of predictor variables. Unlike H5N1, which exhibited a strong north–south divide, with repeated occurrence in the extreme south of a cluster of high-risk provinces, H5N6 was homogeneously distributed throughout Vietnam. Similarly, different agroecological factors were associated with each strain. Sample collection in the months of January and February and higher average maximum temperature were associated with higher likelihood of H5N1-positive market-day status. The likelihood of market days being positive for H5N6 increased with decreased river density, and with successive Rounds of data collection. This study highlights marked differences in spatial patterns and risk factors for H5N1 and H5N6 in Vietnam, suggesting the need for tailored surveillance and control approaches

Treatment with exenatide once weekly or twice daily for 30 weeks is associated with changes in several cardiovascular risk markers

Background Dyslipidemia and type 2 diabetes are two of the most significant risk factors for the development of cardiovascular disease. Measurement of lipoprotein subclasses provides important information about derangements in lipid metabolism and helps refine cardiovascular risk assessment. Exenatide, a glucagon-like peptide 1 receptor agonist, improved glycemic control, obesity, hypertension, and dyslipidemia in patients with type 2 diabetes in clinical trials. Methods In the DURATION-1 trial, patients with type 2 diabetes were treated with exenatide once weekly or twice daily for 30 weeks. This post hoc analysis evaluated the impact of exenatide on lipoprotein subclasses in 211 DURATION-1 patients using vertical auto profile methodology and the Statistical Package for the Social Sciences general linear model adjusted for glycosylated hemoglobin (HbA1c) and weight. Results Baseline lipids and high sensitivity C-reactive protein were normal overall based on the standard lipid panel. Once-weekly exenatide reduced apolipoprotein B and the apolipoprotein B to apolipoprotein A1 ratio (P \u3c 0.05), independent of glycemic improvement and weight loss. A significant shift in lipoprotein pattern away from small, dense low-density lipoprotein-4 cholesterol was also observed (P \u3c 0.05). Exenatide once weekly increased high-density lipoprotein-2 cholesterol, even after adjustment for changes in HbA1c and weight (P \u3c 0.05). Triglycerides, very low-density lipoprotein cholesterol, and high sensitivity C-reactive protein were reduced with both the once-weekly and twice-daily exenatide regimens (P \u3c 0.05). Conclusion In this post hoc analysis, exenatide significantly improved a number of cardiovascular risk markers. Continuous exenatide exposure with exenatide once weekly elicited a greater response than did immediate-release exenatide twice daily, generally independent of glycemic improvement and weight loss. Thus, in addition to improving glycemic control, exenatide induced favorable changes in lipid and lipoprotein metabolism and decreased systemic inflammation

Scavenging Ducks and Transmission of Highly Pathogenic Avian Influenza, Java, Indonesia

These ducks may be a source of infection for chickens and humans

Trade patterns facilitating highly pathogenic avian influenza virus dissemination in the free-grazing layer duck system in Vietnam

Highly pathogenic avian influenza (HPAI) viruses continue to threaten smallholder poultry producers in several South‐east Asian countries, including Vietnam. In particular, the free‐grazing duck system has been repeatedly highlighted as a major risk factor for HPAI outbreaks. Free‐grazing ducks, which scavenge on rice paddies after the harvest, account for a large proportion of the duck population in Vietnam and the wider South‐east Asian region. However, the structure and dynamics of the free‐grazing duck production from farm to consumption has not been described for Vietnam. In this study, we used a value chain approach to provide a complete picture of the actors involved in the production and marketing of free‐grazing duck eggs and spent layer ducks, as well as to investigate the governance structure of this food system. Group interviews and key informant interviews were conducted in two provinces located in the Mekong River Delta (MRD) and the Red River Delta (RRD). The results presented here highlight similarities and differences in farming and trade practices between the two provinces. The trade of spent layer ducks involved large volumes of live ducks being sent to China and Cambodia for consumption, generating a substantial risk of transboundary spread of pathogens, including HPAI viruses. We describe the major role of “duck yards”, which act as hubs in the northbound trade of spent layer ducks. These yards should be considered as essential links in the value chain of spent layer ducks when considering HPAI surveillance and control. The veterinary authorities are only marginally involved in the value chain activities, and their influence could be strengthened by increasing surveillance activities for instance in duck yards. Last, we discuss the dynamics of the duck value chain and further implications for future HPAI management policies

Sex, Race, and Primary Language on Opioid Prescribing In Pediatrics

Over-prescription of pain medication has led to an opioid epidemic in the United States. Many factors can contribute to the amount of pain medication prescribed to patients. The amount of pain medication prescribed to patients is affected by many factors and previous research has shown: Men are prescribed more than women Whites more than non-whites English-speaking more than non-English-speaking The goal of the study was to look at whether this held true in a pediatric orthopedic population. We also looked at the trends in opiate prescribing over time

Gas Accretion by Star Clusters and the Formation of Ultraluminous X-ray Sources from Cusps of Compact Remnants

Here we show that the overabundance of ultra-luminous, compact X-ray sources (ULXs) associated with moderately young clusters in interacting galaxies such as the Antennae and Cartwheel can be given an alternative explanation that does not involve the presence of intermediate mass black holes (IMBHs). We argue that gas density within these systems is enhanced by the collective potential of the cluster prior to being accreted onto the individual cluster members and, as a result, the aggregate X-ray luminosity arising from the neutron star cluster members can exceed $>10^{39} {\rm erg s^{-1}}$. Various observational tests to distinguish between IMBHs and accreting neutron star cusps are discussed.Comment: 4 pages, 3 figures, accepted to ApJ

Work stress and cancer researchers : an exploration of the challenges, experiences and training needs of UK cancer researchers.

Work stress is a significant issue for many UK healthcare professionals, in particular those working in the field of oncology. However, there have been very few attempts to explore the challenges, experiences or training needs of researchers working in cancer research. In doing so, we will be better positioned to support and develop these researchers. 18 UK oncology researchers from a variety of backgrounds took part in a semi-structured interview. Interviews were transcribed and analysed using thematic analysis. The analysis identified two overarching themes: logistical research issues (workload, accessing/ recruiting participants, finances) and sensitive research issues (emotional demands, professional boundaries, sensitivity around recruitment). One cross-cutting theme, supportive strategies (support and training, coping mechanisms), was seen to influence both logistical and sensitive research issues. While further research is needed to fully understand the causes and impact of work stress on cancer researchers, three specific issues were highlighted: emotional demands are relevant to quantitative and mixed methods researchers as well as those engaged in qualitative research; the researchers’ background (experience; clinical/non-clinical) was influential and an exploration of effective coping strategies is required; and there is a clear need for adequate support systems and training to be available, particularly for early career researchers.</p

Domestic Ducks and H5N1 Influenza Epidemic, Thailand

Traditional methods of raising ducks in Southeast Asia must be modified

External Mass Accumulation onto Core Potentials: Implications for Star Clusters, Galaxies and Galaxy Clusters

Accretion studies have been focused on the flow around bodies with point mass gravitational potentials, but few general results are available for non-point mass distributions. Here, we study the accretion flow onto non-divergent, core potentials moving through a background medium. We use Plummer and Hernquist potentials as examples to study gas accretion onto star clusters, dwarf and large galaxy halos and galaxy clusters in a variety of astrophysical environments. The general conditions required for a core potential to collectively accrete large quantities of gas from the external medium are derived using both simulations and analytic results. The consequences of large mass accumulation in galaxy nuclei, dwarf galaxies and star clusters are twofold. First, if the gas cools effectively star formation can be triggered, generating new stellar members in the system. Second, if the collective potential of the system is able to alter the ambient gas properties before the gas is accreted onto the individual core members, the augmented mass supply rates could significantly alter the state of the various accreting stellar populations and result in an enhanced central black hole accretion luminosity.Comment: 24 pages, 15 figures, accepted to Ap

Avian Influenza Virus (H5N1) Replication in Feathers of Domestic Waterfowl

We examined feathers of domestic ducks and geese inoculated with 2 different avian influenza virus (H5N1) genotypes. Together with virus isolation from the skin, the detection of viral antigens and ultrastructural observation of the virions in the feather epidermis raise the possibility of feathers as sources of infection