Nosocomial or not? A combined epidemiological and genomic investigation to understand hospital-acquired COVID-19 infection on an elderly care ward.

BACKGROUND: COVID-19 has the potential to cause outbreaks in hospitals. Given the comorbid and elderly cohort of patients hospitalized, hospital-acquired COVID-19 infection is often fatal. Pathogen genome sequencing is becoming increasingly important in infection prevention and control (IPC). AIM: To inform the understanding of in-hospital SARS-CoV-2 transmission in order to improve IPC practices and to inform the future development of virological testing for IPC. METHODS: Patients detected COVID-19 positive by polymerase chain reaction on Ward A in April and May 2020 were included with contact tracing to identify other potential cases. Genome sequencing was undertaken for a subgroup of cases. Epidemiological, genomic, and cluster analyses were performed to describe the epidemiology and to identify factors contributing to the outbreak. FINDINGS: Fourteen cases were identified on Ward A. Contact tracing identified 16 further patient cases; in addition, eight healthcare workers (HCWs) were identified as being COVID-19 positive through a round of asymptomatic testing. Genome sequencing of 16 of these cases identified viral genomes differing by two single nucleotide polymorphisms or fewer, with further cluster analysis identifying two groups of infection (a five-person group and a six-person group). CONCLUSION: Despite the temporal relationship of cases, genome sequencing identified that not all cases shared transmission events. However, 11 samples were found to be closely related and these likely represented in-hospital transmission. This included three HCWs, thereby confirming transmission between patients and HCWs.S.R. and A.B. are part-funded from Research England’s Expanding Excellence in England (E3) Fund. The sequencing costs were funded by the COVID-19 Genomics UK (COG-UK) Consortium which is supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute for Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Scaling Up Malaria Control in Zambia: Progress and Impact 2005–2008

Zambia national survey, administrative, health facility, and special study data were used to assess progress and impact in national malaria control between 2000 and 2008. Zambia malaria financial support expanded from US$9 million in 2003 to US$ ~40 million in 2008. High malaria prevention coverage was achieved and extended to poor and rural areas. Increasing coverage was consistent in time and location with reductions in child (age 6–59 months) parasitemia and severe anemia (53% and 68% reductions, respectively, from 2006 to 2008) and with lower post-neonatal infant and 1–4 years of age child mortality (38% and 36% reductions between 2001/2 and 2007 survey estimates). Zambia has dramatically reduced malaria transmission, disease, and child mortality burden through rapid national scale-up of effective interventions. Sustained progress toward malaria elimination will require maintaining high prevention coverage and further reducing transmission by actively searching for and treating infected people who harbor malaria parasites

Value-Chain Wide Food Waste Management: A Systematic Literature Review

© 2019, Springer Nature Switzerland AG. The agriculture value chain, from farm to fork, has received enormous attention because of its key role in achieving United Nations Global Challenges Goals. Food waste occurs in many different forms and at all stages of the food value chain, it has become a worldwide issue that requires urgent actions. However, the management of food waste has been traditionally segmented and in an isolated manner. This paper reviews existing work that has been done on food waste management in literature by taking a holistic approach, in order to identify the causes of food waste, food waste prevention strategies, and elicit recommendations for future work. A five step systematic literature review has been adopted for a thorough examination of the existing research on the topic and new insights have been obtained. The findings suggest that the main sources of food waste include food overproduction and surplus, food waste caused by processing, logistical inconsistencies, and households. Main food waste prevention strategies have been revealed in this paper include policy solutions, packaging solutions, date-labelling solutions, logistics solutions, changing consumers’ behaviours, and reuse and redistribution solutions. Future research directions such as using value chain models to reduce food waste and forecasting food waste have been identified in this paper. This study makes a contribution to the extant literature in the field of food waste management by discovering main causes of food waste in the value chain and eliciting prevention strategies that can be used to reduce/eliminate relevant food waste

Laboratories, laws, and the career of a commodity

Unlike most foods, milk is produced fresh at least twice every day, thus recreating, over 700 times a year, a commodity ‘designed’ by the combination of nature, commerce, and law. The paper is a study of the ontogenesis of this commodity in Britain since 1800, stressing the emergence of two new objectivities: dairy science and the law on adulteration. In the words of Christopher Hamlin, what mattered was the “manufacture of certainty, however flimsy that certainty might later be shown to be.'' This was achieved by the collection of samples, the generation of facts by the deployment of the laboratory technologies of physics and chemistry, and a semimonopoly over the truth-power of dairy science that was gradually built up by the large commercial companies. A foundation of state-sponsored regulation provided an official legitimation of compositional standards that suited the interests of capital but ignored ‘natural’ variations in quality and often pilloried innocent producers. The public eventually became accustomed to the regulated quality of the milk in its ‘pinta’ and assumed it to be natural. Even the standardization of composition since 1993 has caused very little disquiet among the consuming public, although milk is now a fully constructed commodity like any other dairy product. Mechanical modernity has at last triumphed over a century of ‘milk as it came from the cow’

The role of ligand efficiency metrics in drug discovery

The judicious application of ligand or binding efficiencies, which quantify the molecular properties required to gain binding affinity for a drug target, is gaining traction in the selection and optimisation of fragments, hits, and leads. Retrospective analysis of recently marketed oral drugs shows that they frequently have highly optimised ligand efficiency values for their target. Optimising ligand efficiencies based on both molecular size and lipophilicity, when set in the context of the specific target, has the potential to ameliorate the molecular inflation that pervades current practice in medicinal chemistry, and to increase the developability of drug candidates

Contributors to negative biopsychosocial health or performance outcomes in rugby players (CoNBO): a systematic review and Delphi study protocol.

The importance of contributors that can result in negative player outcomes in sport and the feasibility and barriers to modifying these to optimise player health and well-being have yet to be established. Within rugby codes (rugby league, rugby union and rugby sevens), within male and female cohorts across playing levels (full-time senior, part-time senior, age grade), this project aims to develop a consensus on contributors to negative biopsychosocial outcomes in rugby players (known as the CoNBO study) and establish stakeholder perceived importance of the identified contributors and barriers to their management. This project will consist of three parts; part 1: a systematic review, part 2: a three-round expert Delphi study and part 3: stakeholder rating of feasibility and barriers to management. Within part 1, systematic searches of electronic databases (PubMed, Scopus, MEDLINE, SPORTDiscus, CINAHL) will be performed. The systematic review protocol is registered with PROSPERO. Studies will be searched to identify physical, psychological and/or social factors resulting in negative player outcomes in rugby. Part 2 will consist of a three-round expert Delphi consensus study to establish additional physical, psychological and/or social factors that result in negative player outcomes in rugby and their importance. In part 3, stakeholders (eg, coaches, chief executive officers and players) will provide perceptions of the feasibility and barriers to modifying the identified factors within their setting. On completion, several manuscripts will be submitted for publication in peer-reviewed journals. The findings of this project have worldwide relevance for stakeholders in the rugby codes. PROSPERO registration number CRD42022346751

Exploring the relationship between chronic undernutrition and asymptomatic malaria in Ghanaian children

<p>Abstract</p> <p>Background</p> <p>A moderate association has been found between asymptomatic parasitaemia and undernutrition. However, additional investigation using the gold standard for asymptomatic parasitaemia confirmation, polymerase chain reaction (PCR), is needed to validate this association. Anthropometric measurements and blood samples from children less than five years of age in a rural Ghanaian community were used to determine if an association exists between chronic undernutrition and PCR-confirmed cases of asymptomatic malaria.</p> <p>Methods</p> <p>This was a descriptive cross-sectional study of 214 children less than five years of age from a community near Kumasi, Ghana. Blood samples and anthropometric measurements from these children were collected during physical examinations conducted in January 2007 by partners of the Barekuma Collaborative Community Development Programme.</p> <p>Results</p> <p>Findings from the logistic model predicting the odds of asymptomatic malaria indicate that children who experienced mild, moderate or severe stunting were not more likely to have asymptomatic malaria than children who were not stunted. Children experiencing anaemia had an increased likelihood (OR = 4.15; 95% CI: 1.92, 8.98) of asymptomatic malaria. Similarly, increased spleen size, which was measured by ultrasound, was also associated with asymptomatic malaria (OR = 2.17; 95% CI: 1.44, 3.28). Fast breathing, sex of the child, and age of the child were not significantly associated with the asymptomatic malaria.</p> <p>Conclusions</p> <p>No significant association between chronic undernutrition and presence of asymptomatic malaria was found. Children who experience anaemia and children who have splenomegaly are more likely to present asymptomatic malaria. Programmes aimed at addressing malaria should continue to include nutritional components, especially components that address anaemia.</p

Nosocomial or not? A combined epidemiological and genomic investigation to understand hospital-acquired COVID-19 infection on an elderly care ward

Background: COVID-19 has the potential to cause outbreaks in hospitals. Given the comorbid and elderly cohort of patients hospitalized, hospital-acquired COVID-19 infection is often fatal. Pathogen genome sequencing is becoming increasingly important in infection prevention and control (IPC). Aim: To inform the understanding of in-hospital SARS-CoV-2 transmission in order to improve IPC practices and to inform the future development of virological testing for IPC. Methods: Patients detected COVID-19 positive by polymerase chain reaction on Ward A in April and May 2020 were included with contact tracing to identify other potential cases. Genome sequencing was undertaken for a subgroup of cases. Epidemiological, genomic, and cluster analyses were performed to describe the epidemiology and to identify factors contributing to the outbreak. Findings: Fourteen cases were identified on Ward A. Contact tracing identified 16 further patient cases; in addition, eight healthcare workers (HCWs) were identified as being COVID-19 positive through a round of asymptomatic testing. Genome sequencing of 16 of these cases identified viral genomes differing by two single nucleotide polymorphisms or fewer, with further cluster analysis identifying two groups of infection (a five-person group and a six-person group). Conclusion: Despite the temporal relationship of cases, genome sequencing identified that not all cases shared transmission events. However, 11 samples were found to be closely related and these likely represented in-hospital transmission. This included three HCWs, thereby confirming transmission between patients and HCWs

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

There is growing interest in the scientific community, health ministries, and other organizations to control and eventually eliminate neglected tropical diseases (NTDs). Control efforts require reliable maps of NTD distribution estimated from appropriate models and survey data on the number of infected people among those examined at a given location. This kind of data is often available in the literature as part of epidemiological studies. However, an open-access database compiling location-specific survey data does not yet exist. We address this problem through a systematic literature review, along with contacting ministries of health, and research institutions to obtain disease data, including details on diagnostic techniques, demographic characteristics of the surveyed individuals, and geographical coordinates. All data were entered into a database which is freely accessible via the Internet (http://www.gntd.org). In contrast to similar efforts of the Global Atlas of Helminth Infections (GAHI) project, the survey data are not only displayed in form of maps but all information can be browsed, based on different search criteria, and downloaded as Excel files for further analyses. At the beginning of 2011, the database included over 12,000 survey locations for schistosomiasis across Africa, and it is continuously updated to cover other NTDs globally

The costs and consequences of parasitoid attack for the predatory hoverfly, Episyrphus balteatus

Question: What are the life-history costs for a predatory insect of surviving parasitoid attack, and can parasitoid attack alter predator-prey interactions? Hypotheses: Survivorship is influenced by host age. Hosts that suffer parasitoid attack grow more slowly and consume fewer prey. Those that survive attack are smaller as adults and show reduced survivorship. Organisms: The aphidophagous hoverfly Episyrphus balteatus, its endoparasitoid wasp Diplazon laetatorius and its prey, the pea aphid, Acyrthosiphon pisum. Site of experiments: All experiments were conducted in controlled temperature rooms and chambers in the laboratory. Methods: Episyrphus balteatus larvae of each instar were exposed to attack by Diplazon laetatorius, then dissected to measure the encapsulation response (a measure of immunity). Second instar larvae were either attacked or not attacked by D. laetatorius. Their development rates and numbers of prey consumed were noted. The size and survivorship of surviving (immune) and control hoverflies were compared following eclosion. Conclusions: Successful immune response increased with larval age (first instar 0%, second instar 40%, third instar 100% survival). Second instar larvae that successfully resisted parasitoid attack were larger as pupae (but not as adults) and showed reduced adult survivorship. Female adult survivors were more likely than male survivors to have died within 16 days of eclosion, but there was no difference between unattacked male and female control hoverflies. Attacked larvae, irrespective of immune status, consumed fewer aphids than unattacked individuals. Episyrphus balteatus suffers significant costs of resisting parasitoid attack, and parasitoid attack can reduce the top-down effects of an insect predator, irrespective of whether the host mounts an immune response or not