Improved Decision-Making through a DEMATEL and Fuzzy Cognitive Maps-Based Framework

The decision-making process is highly demanding. There has been an increasing tendency to incorporate human thinking, individual experience about a problem, and pure mathematical approaches. Here, a novel integrated approach is investigated and proposed to develop an advanced hybrid decision-support system based on the decision-making trial and evaluation laboratory (DEMATEL) and fuzzy cognitive maps (FCMs). Indeed, knowledge acquisition and elicitation may present distortions and difficulties finding a consensus and an interpretation. Thus, the proposed combined approach aims to examine in depth the potential to improve FCMs' outcomes by integrating FCM with the DEMATEL approach. The combined methodology achieves at avoiding some of the drawbacks, such as the lack of a standardized FCM theoretical model. Thus, it provides advanced comparative analysis and results in better interpretation of the decision-making process. It is highlighted that the traditional FCM approach does not allow distinguishing the whole number of defined scenarios, in contrast to the hybrid one presented here, which increases the ability of users to make correct decisions. Combining the two approaches provides new capabilities to FCMs in grouping experts' knowledge, while the DEMATEL approach contributes to refining the strength of concepts' connections

West Nile virus in wildlife and nonequine domestic animals, South Africa, 2010–2018

West Nile virus (WNV) lineage 2 is associated with neurologic disease in horses and humans in South Africa. Surveillance in wildlife and nonequine domestic species during 2010–2018 identified WNV in 11 (1.8%) of 608 animals with severe neurologic and fatal infections, highlighting susceptible hosts and risk for WNV epizootics in Africa.The work was funded through the US Centers for Disease Control and Prevention’s Global Disease Detection grant for zoonotic arboviruses under grant 1U19GH000571-01-GDD Non-Research CoAg with the National Health Laboratory Services project 23 and University of Pretoria Zoonotic Arbo and Respiratory Virus Group income-generated funds. J.S. received doctoral scholarships from the National Research Foundation (grant no. 95175), the Meat Industry Trust (grant no. IT8114/98), and the Poliomyelitis Research Foundation (grant no. 15/112) and a partial studentship from the US Centers for Disease Control and Prevention Cooperative Agreement no. 5 NU2GGH001874-02-00 with the University of Pretoria.http://wwwnc.cdc.gov/eidam2020Medical Virolog

Relationships between spatial patterns of colonic pressure and individual movements of content

The aim of this study was to examine the relationship between colonic pressure waves and movement of content. In 11 healthy subjects, pressures were recorded at 10-cm intervals from cecum to rectum for 32 h. In six subjects, transit was simultaneously measured for 8 h after direct cecal instillation of 1.5 mCi of (99m)Tc sulfur colloid. Thirty-two percent of isotope movements were related to nonpropagating activity and twenty-eight percent to propagating sequences. The extent of isotope movement related to propagating sequences (25.1 +/- 2.1 cm) was greater than that due to nonpropagating activity (12.8 +/- 0.7 cm; P = 0.0001). Propagating sequences originated significantly more frequently (P = 0.004) and propagated further (P = 0.0006) in the proximal compared with the distal colon. Only 36% of propagating sequences were propulsive of content, and compared with nonpropulsive sequences, these propagated further (41 +/- 6 vs. 27 +/- 2 cm; P < 0.05) and had a higher probability of originating proximally (P = 0.0003), a higher pressure wave amplitude (50 +/- 5 vs. 34 +/- 4 mmHg; P = 0.0001), and slower velocity (2.2 +/- 0.3 vs. 3.6 +/- 0.47 cm/s; P = 0.02). We conclude that most movements of colonic content are related to pressure waves. There is marked regional variation in the prevalence, velocity, and extent of propagation of propagating pressure wave sequences, which are an important mechanism for transporting content over long distances. The effectiveness of transport by a propagating sequence is influenced by its site of origin, amplitude, and velocity.Ian J. Cook, Yoshiyuki Furukawa, Voula Panagopoulos, Peter J. Collins, and John Den

Monolysocardiolipins accumulate in Barth syndrome but do not lead to enhanced apoptosis

Barth syndrome (BTHS) is an X-linked recessive disorder that is biochemically characterized by low cellular levels of the mitochondrial phospholipid cardiolipin (CL). Previously, we discovered that the yeast disruptant of the TAZ ortholog in Saccharomyces cerevisiae not only displays CL deficiency but also accumulates monolysocardiolipins (MLCLs), which are intermediates in CL remodeling. Therefore, we set out to investigate whether MLCL accumulation also occurs in BTHS. Indeed, we observed MLCL accumulation in heart, muscle, lymphocytes, and cultured lymphoblasts of BTHS patients; however, only very low levels of these lysophospholipids were found in platelets and fibroblasts of these patients. Although the fatty acid composition of the MLCLs was different depending on the tissue source, it did parallel the fatty acid composition of the (remaining) CLs. The possible implications of these findings for the two reported CL remodeling mechanisms, transacylation and deacylation/reacylation, are discussed. Because MLCLs have been proposed to be involved in the initiation of apoptosome-mediated cell death by the sequestration of the proapoptotic protein (t)BH3-interacting domain death agonist (Bid) to the mitochondrial membrane, we used control and BTHS lymphoblasts to investigate whether the accumulation of MLCLs results in higher levels of apoptosis. We found no differences in susceptibility to death receptor-mediated apoptosis or in cellular distribution of Bid, cytochrome c, and other parameters, implying that MLCL accumulation does not lead to enhanced apoptosis in cultured BTHS lymphoblast

The strength of combined cytogenetic and mate-pair sequencing techniques illustrated by a germline chromothripsis rearrangement involving FOXP2

Next-generation mate-pair sequencing (MPS) has revealed that many constitutional complex chromosomal rearrangements (CCRs) are associated with local shattering of chromosomal regions (chromothripsis). Although MPS promises to identify the molecular basis of the abnormal phenotypes associated with many CCRs, none of the reported mate-pair sequenced complex rearrangements have been simultaneously studied with state-of-the art molecular cytogenetic techniques. Here, we studied chromothripsis-associated CCR involving chromosomes 2, 5 and 7, associated with global developmental and psychomotor delay and severe speech disorder. We identified three truncated genes: CDH12, DGKB and FOXP2, confirming the role of FOXP2 in severe speech disorder, and suggestive roles of CDH12 and/or DGKB for the global developmental and psychomotor delay. Our study confirmes the power of MPS for detecting breakpoints and truncated genes at near nucleotide resolution in chromothripsis. However, only by combining MPS data with conventional G-banding and extensive fluorescence in situ hybridizations could we delineate the precise structure of the derivative chromosomes

Shuni virus in wildlife and nonequine domestic animals, South Africa

Shuni virus (SHUV) (Peribunyaviridae: Orthobunyavirus) was isolated in the 1960s from livestock, Culicoides midges, and a febrile child in Nigeria. In South Africa, SHUV was identified as the causative agent of neurologic disease in horses; seropositivity was also demonstrated in 3.0% of veterinarians, suggesting human exposures. SHUV was subsequently identified in aborted livestock and cattle with neurologic disease in Israel, suggesting an extended range beyond Africa. We investigated other potential susceptible species in South Africa.US CDC Global Disease Detection; NHLS; UP Zoonotic Arbo and Respiratory virus program; BBSRC-USDA funding; NRF; Meat Industry Trust; Poliomyelitis Research Foundation.http://wwwnc.cdc.gov/eidpm2020Veterinary Tropical Disease

Is an automated online clinical care pathway for people with genital chlamydia (chlamydia OCCP) within an eSexual health clinic feasible and acceptable?

Introduction UK health strategy supports self- and internet-based care. Within the eSTI2 consortium (www.esti2.org.uk) we developed UK’s first automated Online Clinical Care Pathway for people with genital chlamydia (Chlamydia-OCCP) within an eSexual Health Clinic (eSHC). Chlamydia-OCCP includes: STI results service; clinical consultation; electronic prescription via community pharmacy; partner notification (PN); with integral telephone helpline support. It complies with regulatory, professional, prescribing and surveillance requirements. We report on a study to assess Chlamydia-OCCP feasibility and acceptability as an alternative to routine care.Methods Non-randomised, exploratory study to evaluate Chlamydia-OCCP: 21.07.14 -13.03.15.Participants: 1) chlamydia-positive untreated Genitourinary Medicine (GUM) clinic attenders; 2) people testing chlamydia-positive and negative through six National Chlamydia Screening Programme (NCSP) areas’ online postal self-sampling service. Exclusions: under 16 yrs; co-existing STIs, extra-genital chlamydia. Intervention: eligible people were sent an SMS message with a link to access results from eSHC via a password protected web-app, optimised for smartphone use. Having consented online chlamydia-positive users followed the automated Chlamydia-OCCP. Patients who declined received routine care.Evaluation: treatment rate; time to treatment; PN outcomes; engagement with clinical helpline and health promotion; safety; acceptability, costs.Results GUM: of 197 eligible patients, 161 accessed results online, 112 consented, 110/112 (98%) treated (72 exclusively via Chlamydia-OCCP, median 1 day). NCSP: of 145 eligible patients, 133 accessed results online, 104 consented, 92/104 (88%) treated (59 exclusively via Chlamydia-OCCP, median 1 day).28/515 sexual partners were managed solely online. 1176/1936, (61%) NCSP chlamydia-negative people accessed results online, of whom 407 accessed online health promotion. All patients who didn’t access results online were managed routinely. Patients moved effectively between online, telephone and clinic-based care.Conclusion Chlamydia-OCCP is a feasible, acceptable, safe alternative to routine care for management of people with genital chlamydia. Preliminary evidence indicates comparable treatment outcomes. If linked to home testing, Chlamydia-OCCP offers potential for wholly remote care.Disclosure of interest statement Nothing to declare