Modernising epidemic science: enabling patient-centred research during epidemics

Background: Emerging and epidemic infectious disease outbreaks are a significant public health problem and global health security threat. As an outbreak begins, epidemiological investigations and traditional public health responses are generally mounted very quickly. However, patient-centred research is usually not prioritised when planning and enacting the response. Instead, the clinical research response occurs subsequent to and separate from the public health response, and is inadequate for evidence-based decision-making at the bedside or in the offices of public health policymakers.Discussion: The deficiencies of the clinical research response to severe acute respiratory syndrome, pandemic influenza, Middle East respiratory syndrome coronavirus and Ebola virus demonstrate that current research models do not adequately inform and improve the quality of clinical care or public health response. Three suggestions for improvements are made. First, integrate the data and sample collection needs for clinical and public health decision-making within a unified framework, combined with a risk-based, rather than a discipline-based, approach to ethical review and consent. Second, develop clinical study methods and tools that are specifically designed to meet the epidemiological and contextual challenges of emerging and epidemic infectious diseases. Third, invest in investigator-led clinical research networks that are primed and incentivised to respond to outbreak infections, and which can call on the support and resources of a central centre of excellence.Conclusions: It is crucial that the field of epidemic science matures to place patients at the heart of the response. This can only be achieved when patient-centred research is integrated in the outbreak response from day one and practical steps are taken to reduce the barriers to the generation of reliable and useful evidence

Computations in the social brain

This thesis consists of three empirical chapters that investigate elements of human social behavior, adherence to and violations of social norms, and the computational and neurological underpinnings thereof. I focus on three behavioral paradigms in particular – the attacker-defender contest, the trust game, and the ultimatum game – which model asymmetrical conflicts, generosity and reciprocity, and norms of fairness, respectively. Ultimately, each chapter acts as a building block contributing a different perspective to the study of human sociality. Using economic games, computational models based on the principle of utility, and model-based neuroimaging, my research contributes to the scientific endeavor working to crack the “elaborate and secret code that is written nowhere, known by none, and understood by all” (Sapir, 1927, p.137)Social decision makin

Whose Lives Do We Flatten Along With “The Curve?”

Ganesh, A., Rato, J. M., Chennupati, V. M., Rojek, A., & Viswanathan, A. (2020). Public Health Responses to COVID-19: Whose Lives Do We Flatten Along With “The Curve?”. Frontiers in public health, 8, [564111]. https://doi.org/10.3389/fpubh.2020.564111The Coronavirus 2019 (COVID-19) pandemic has received varying and evolving public health responses worldwide (1). Sweden remained largely open with health measures aimed most substantively at vulnerable groups, while South Korea implemented a large testing program, combined with extensive efforts to isolate infected people and trace/quarantine contacts. The United Kingdom (UK) considered various approaches before deciding on measures to isolate, quarantine, and promote social-distancing that were eased in mid-July (1); lockdown is now being re-implemented with a surging second wave (2). In contrast to early social-distancing measures in Canada to “flatten the curve,” American states adopted varying approaches, with many states having now relaxed their measures to differing extents (3). China adopted an aggressive approach of quarantining the affected Hubei province and isolating infected populations (4). India was under an ambitious 40-day lockdown, which was then extended until May-31 with districts designated as red/orange/green based on cumulative cases and doubling rate; red zones continued under full lockdown whereas orange/green zones had more relaxed measures (5). Gradual easing of restrictions (“unlock” 1.0 through 5.0) ensued, with lockdown measures nevertheless continuing in designated containment zones (6). Millions of people around the world still face public health measures of one form or another, raising the question: how stringent should government responses be in such pandemics (7), and how long can (or should) such measures continue?publishersversionpublishe

Sex and Gender in Medical Education, and proceedings from the 2015 Sex and Gender Education Summit

The Sex and Gender Medical Education Summit: a roadmap for curricular innovation was a collaborative initiative of the American Medical Women\u27s Association, Laura W. Bush Institute for Women’s Health, Mayo Clinic, and Society for Women\u27s Health Research (www.sgbmeducationsummit.com). It was held on October 18–19, 2015 to provide a unique venue for collaboration among nationally and internationally renowned experts in developing a roadmap for the incorporation of sex and gender based concepts into medical education curricula. The Summit engaged 148 in-person attendees for the 1 1/2-day program. Pre- and post-Summit surveys assessed the impact of the Summit, and workshop discussions provided a framework for informal consensus building. Sixty-one percent of attendees indicated that the Summit had increased their awareness of the importance of sex and gender specific medicine. Other comments indicate that the Summit had a significant impact for motivating a call to action among attendees and provided resources to initiate change in curricula within their home institutions. These educational efforts will help to ensure a sex and gender basis for delivery of health care in the future

Interaction of Salivary alpha-Amylase and Amylase-Binding-Protein A (AbpA) of Streptococcus gordonii with Glucosyltransferase of S. gordonii and Streptococcus mutans

<p>Abstract</p> <p>Background</p> <p>Glucosyltransferases (Gtfs), enzymes that produce extracellular glucans from dietary sucrose, contribute to dental plaque formation by <it>Streptococcus gordonii </it>and <it>Streptococcus mutans</it>. The alpha-amylase-binding protein A (AbpA) of <it>S. gordonii</it>, an early colonizing bacterium in dental plaque, interacts with salivary amylase and may influence dental plaque formation by this organism. We examined the interaction of amylase and recombinant AbpA (rAbpA), together with Gtfs of <it>S. gordonii </it>and <it>S. mutans</it>.</p> <p>Results</p> <p>The addition of salivary alpha-amylase to culture supernatants of <it>S. gordonii </it>precipitated a protein complex containing amylase, AbpA, amylase-binding protein B (AbpB), and the glucosyltransferase produced by <it>S. gordonii </it>(Gtf-G). rAbpA was expressed from an inducible plasmid, purified from <it>Escherichia coli </it>and characterized. Purified rAbpA, along with purified amylase, interacted with and precipitated Gtfs from culture supernatants of both <it>S. gordonii </it>and <it>S. mutans</it>. The presence of amylase and/or rAbpA increased both the sucrase and transferase component activities of <it>S. mutans </it>Gtf-B. Enzyme-linked immunosorbent assay (ELISA) using anti-Gtf-B antibody verified the interaction of rAbpA and amylase with Gtf-B. A <it>S. gordonii abp</it>A-deficient mutant showed greater biofilm growth under static conditions than wild-type in the presence of sucrose. Interestingly, biofilm formation by every strain was inhibited in the presence of saliva.</p> <p>Conclusion</p> <p>The results suggest that an extracellular protein network of AbpA-amylase-Gtf may influence the ecology of oral biofilms, likely during initial phases of colonization.</p

The Indian family on UK reality television: Convivial culture in salient contexts

This is the author's accepted manuscript. The final published article is available from the link below, copyright 2012 @ the author.This article demonstrates how The Family (2009), a fly-on-the wall UK reality series about a British Indian family, facilitates both current public service broadcasting requirements and mass audience appeal. From a critical cultural studies perspective, the author examines the journalistic and viewer responses to the series where authenticity, universality, and comedy emerge as major themes. Textual analysis of the racialized screen representations also helps locate the series within the contexts of contested multiculturalism, genre developments in reality television and public service broadcasting. Paul Gilroy’s concept of convivial culture is used as a frame in understanding how meanings of the series are produced within a South Asian popular representational space. The author suggests that the social comedy taxonomy is a prerequisite for the making of this particular observational documentary. Further, the popular (comedic) mode of conviviality on which the series depends is both expedient and necessary within the various sociopolitical contexts outlined

The Use of Social Media by Alleged Members of Mexican Cartels and Affiliated Drug Trafficking Organizations

Focusing on Mexican cartels and affiliated drug trafficking organizations, this article examines how self-proclaimed cartel members use social media to further the criminal activities of their organizations. Employing an opensource, intelligence-driven methodology, the authors identified, followed, and mapped the connections between and among 75 alleged cartel members over a period of 4 months. Results indicated that cartel members actively use Facebook to plan, organize, and communicate in real-time. These findings provide tentative validation to the utility of using open-source social media platforms to study the social structure and operations of Mexican drug cartels. Implications for law enforcement, homeland security, and the intelligence enterprise are discussed

Neurocognitive Underpinnings of Aggressive Predation in Economic Contests

Competitions are part and parcel of daily life and require people to invest time and energy to gain advantage over others and to avoid (the risk of) falling behind. Whereas the behavioral mechanisms underlying competition are well documented, its neurocognitive underpinnings remain poorly understood. We addressed this using neuroimaging and computational modeling of individual investment decisions aimed at exploiting one's counterpart (“attack”) or at protecting against exploitation by one's counterpart (“defense”). Analyses revealed that during attack relative to defense (i) individuals invest less and are less successful; (ii) computations of expected reward are strategically more sophisticated (reasoning level k = 4 vs. k = 3 during defense); (iii) ventral striatum activity tracks reward prediction errors; (iv) risk prediction errors were not correlated with neural activity in either ROI or whole-brain analyses; and (v) successful exploitation correlated with neural activity in the bilateral ventral striatum, left OFC, left anterior insula, left TPJ, and lateral occipital cortex. We conclude that, in economic contests, coming out ahead (vs. not falling behind) involves sophisticated strategic reasoning that engages both reward and value computation areas and areas associated with theory of mind

Speech therapy — a non-pharmacological method to manage difficult-to-treat chronic cough

  Cough is the most common symptom of respiratory diseases. The results of management of chronic cough in adults are still unsatisfactory. Unexplained and difficult-to-treat chronic cough causes significant impairment in patients‘ quality of life. The results of recent studies suggest that speech therapy (speech language intervention) is one of the few methods which are usefull in management of persistent chronic cough. We present a case of a patient with chronic cough due to chronic nonallergic rhinitis and gastroesophageal reflux disease, who had been unsuccessfully treated for 18 years. In the patient speech therapy resulted in a significant decrease of cough severity and improvement of quality of life.