Metastatic Squamous Cell Carcinoma in a Northern Brown Bandicoot (<i>Isoodon macrourus</i>)

Aside from a handful of notable exceptions, neoplasia is not reported as a major cause of mortality in wild animal populations and often goes undetected. For northern brown bandicoots specifically, there are few reported tumors in the literature and on file in the Australian Registry of Wildlife Health. This report describes a case of squamous cell carcinoma in a northern brown bandicoot (Isoodon macrourus), with metastases to the draining lymph nodes and lung. This neoplasm consisted predominantly of well-differentiated squamous cells and multifocal keratin pearls, with areas possibly consistent with epithelial to mesenchymal transition, as identified by positive immunohistochemical staining by both pancytokeratin (AE1/AE3) and vimentin. Additional investigations were negative for bandicoot papillomatosis carcinomatosis viruses

Drosophila DNA polymerase theta utilizes both helicase-like and polymerase domains during microhomology-mediated end joining and interstrand crosslink repair

Double strand breaks (DSBs) and interstrand crosslinks (ICLs) are toxic DNA lesions that can be repaired through multiple pathways, some of which involve shared proteins. One of these proteins, DNA Polymerase theta (Pol theta), coordinates a mutagenic DSB repair pathway named microhomology-mediated end joining (MMEJ) and is also a critical component for bypass or repair of ICLs in several organisms. Pol theta contains both polymerase and helicase-like domains that are tethered by an unstructured central region. While the role of the polymerase domain in promoting MMEJ has been studied extensively both in vitro and in vivo, a function for the helicase-like domain, which possesses DNA-dependent ATPase activity, remains unclear. Here, we utilize genetic and biochemical analyses to examine the roles of the helicase-like and polymerase domains of Drosophila Pol theta. We demonstrate an absolute requirement for both polymerase and ATPase activities during ICL repair in vivo. However, similar to mammalian systems, polymerase activity, but not ATPase activity, is required for ionizing radiation-induced DSB repair. Using a site-specific break repair assay, we show that overall end-joining efficiency is not affected in ATPase-dead mutants, but there is a significant decrease in templated insertion events. In vitro, Pol theta can efficiently bypass a model unhooked nitrogen mustard crosslink and promote DNA synthesis following microhomology annealing, although ATPase activity is not required for these functions. Together, our data illustrate the functional importance of the helicase-like domain of Pol theta and suggest that its tethering to the polymerase domain is important for its multiple functions in DNA repair and damage tolerance

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Conservation and health of Lumholtz's tree-kangaroo (Dendrolagus lumholtzi)

Lumholtz's tree-kangaroo (Dendrolagus lumholtzi) is an iconic species in far north Queensland yet little is known about its health or population status. Studies on this species have been conducted in a limited number of locations and focused primarily on ecology, habitat use and home-range size. The species is relatively common in the Atherton Tablelands but habitat loss, predation by domestic, feral and wild dogs, vehicle strike, low fecundity, and disease have been identified as threats to the population. We review knowledge of population ecology and threats for this species, and include a novel collation of disease reports on all tree-kangaroos with particular reference to Lumholtz’s tree-kangaroo. Health of Lumholtz's tree-kangaroo appears to be impacted by the increase in humans and domestic animals in their range. There have been reports of melioidosis, toxoplasmosis, tick paralysis and blindness in wild tree-kangaroos. We identify where increased information on health and population viability will improve conservation and management of the species

Ocular anatomy and pathology in Lumholtz's tree-kangaroo (Dendrolagus lumhotzi)

Lumholtz's tree-kangaroo (Dendrolagus lumhobzi) is one of two species of tree-kangaroos found in Queensland, Australia. There is little information about ocular anatomy and pathology in any species of tree-kangaroo, and there are claims of blindness from unknown causes in free-ranging Lumholtz's tree-kangaroos. This study investigated ocular anatomy and pathology in 80 individuals, using examination of 31 live animals and histopathologic examination of eyes from 49 carcasses. Tree-kangaroos were found to have a typical vertebrate eye with immuno-histochemical evidence for dichromatic color vision. Only 5.4% of animals had evidence of pathology from traumatic injury, infection, or a variety of nonspecific lesions. Toxoplasmosis was implicated in ocular lesions in three animals. This study did not find evidence of widespread blindness in free-ranging animals nor evidence of toxic optic neuropathy. Examinations of live animals highlighted the need to establish normal ocular examination parameters and vision testing protocols suitable for use in tree-kangaroos and the need for more comprehensive examination and testing of animals thought to have vision loss of unknown origin

Factors affecting the mortality of Lumholtz's tree-kangaroo (Dendrolagus lumholtzi) by vehicle strike

Context. Vehicle strike is a major issue where wildlife habitat is intersected by busy roads. Near Threatened Lumholtz's tree-kangaroo (Dendrolagus lumholtzi) is a large (5-10 kg) semi-arboreal mammal found in populated rural and forested areas of north-eastern Australia. Warning signs, rope bridges and underpasses have not prevented similar to 20 animals being killed on the road each year.Aims. To identify factors influencing Lumholtz's tree-kangaroo vehicle strike to help inform mitigation options.Methods. Citizen sightings (1998-2000) and 90 road-kills collected over 4.5 years on the Atherton Tablelands, Australia, were examined to determine the causes of vehicle strike in Lumholtz's tree-kangaroo. The spatial distributions of sightings and road-kills were characterised using nearest-neighbour analysis, and the relationship between them was determined using a Bayesian approach that accounted for spatial autocorrelation. Gender, age, weight, season, rainfall, road and verge characteristics, traffic volumes, speed limits and mitigation measures were recorded to assess their influence on road-kill risk. Adequacy of speed limits to prevent collisions along road sections with more than four road-kills per 8 km (hazard zones) was assessed from visibility and stopping distances.Key results. Vehicle strikes mainly affected male tree-kangaroos (2-5 years, 5.5-8 kg), occurred where live animals were most frequently sighted and were most likely on roads with narrow verges, low visibility and medium traffic volumes. Speed limits at hazard zones were inadequate to prevent collisions. Few warning signs corresponded with these zones, and road mortalities persisted where they did.Conclusions. Unpredictable dispersal of young males and vehicle speeds unsuited to road conditions drive road mortalities in Lumholtz's tree-kangaroo. Because tree-kangaroos do not appear to respond to existing mitigation measures, reducing traffic speeds, and increasing visibility, appear to be the most effective mitigation strategies for reducing tree-kangaroo road mortality

Herpesvirus infection in Lumholtz’s tree-kangaroo (Dendrolagus lumholtzi)

Herpesvirus infections associated with a range of clinical findings are widespread in freeranging and captive Australian marsupials. We report on herpesviruses identified by virus neutralization and PCR in free-ranging and captive Lumholtz’s tree-kangaroos (Dendrolagus lumholtzi). Herpesvirus has not been confirmed previously by DNA testing in tree kangaroos. Virus neutralization testing for alphaherpesviruses MaHV1 and MaHV2 was positive on 4/10 captive and 0/35 free-ranging tree-kangaroo samples tested. A novel gammaherpesvirus was found on PCR in 17/20 apparently healthy individuals (11/ 12 free-ranging, 5/6 wild-caught, captive, and 1/2 captive-bred). One captive-bred animal that died following an acute illness was positive on PCR only for MaHV4, an alphaherpesvirus previously identified from an eastern grey kangaroo (Macropus giganteus). The detection of MaHV4, associated with morbidity and mortality in captive treekangaroos, raises biosecurity concerns about introducing a non-endemic alphaherpesvirus into naive wild populations through release of captive animals. We propose that: 1) further work on herpesviruses in marsupials be carried out to determine whether herpesviruses from captive individuals represent a potential threat to wild populations, particularly for endangered species in which there are captive breeding and crossfostering programs; and 2) that captive tree kangaroos be kept in such a way that prevents cross-species transmission of herpesviruses, in particular eliminating close direct or indirect contact with other species of macropods

A guide for ecologists: Detecting the role of disease in faunal declines and managing population recovery

Biodiversity is declining at an alarming rate, especially among vertebrates. Disease is commonly ignored or dismissed in investigations of wildlife declines, partly because there is often little or no obvious clinical evidence of illness. We argue that disease has the potential to cause many species declines and extinctions and that there is mounting evidence that this is a more important cause of declines than has been appreciated. We summarise case studies of diseases that have affected wildlife to the point of extinction and bring together the experiences of wildlife managers, veterinarians, epidemiologists, infectious disease specialists, zoologists and ecologists to provide an investigation framework to help ecologists and wildlife managers address disease as a factor in wildlife declines. Catastrophic declines of wildlife may be the result of single or multiple synergistic causes, and disease should always be one factor under consideration, unless proven otherwise. In a rapidly changing world where emerging infectious diseases have become increasingly common, the need to consider diseases has never been more important