The Economic Impact of High Consequence Zoonotic Pathogens: Why Preparing for these is a Wicked Problem

Abstract: This paper reviews literature on the economic impacts of outbreaks and control strategies for high consequence zoonotic priority diseases, ie. zoonotic diseases that are generally FADs, zoonotic diseases that occur rarely, or zoonotic diseases that have bioterrorist potential sufficient to be important for the United States. Such diseases are referred to here as zoonotic priority diseases (ZPDs). These ZPDs are categorized into three levels of economic impact: high, moderate, and low with the recognition that there are aspects of each of these diseases that could make the categorization presented here inaccurate. Arguments are made for why determination of optimal ZPD and more generally FAD preparedness and response strategies are wicked problems. The paper concludes with the implications for further development of appropriate ZPD policy and some needs for further analyses

Democracy in action: A case study of InternetforEveryone.org

In this research, I investigated the process by which a media reform organization involves the public in informing media policy. Through a case study I examined the InternetforEveryone.org initiative of the media reform organization Free Press, and the democratic development of media policy, specifically the framework for a national broadband plan. I performed my research within the larger framework of the United States democracy. For that reason, I investigate the democratic values and practices of the initiative. To inform my research, I engaged in multiple forms of ethnographic methods, including participant observations, open-ended in-depth interviews, and examination of internal and external documents. I analyzed my findings according to the initiative’s goals, strategies, and tactics and framed them within resource mobilization theory (RMT). My findings reveal the initiative’s operations support the basic tenets of RMT. I also found that the initiative was operating in a democratic manner on three levels. Their primary goal and the manner in which they engaged the public and their coalition members were all democratically significant. In addition, I call attention to the role of public sociology in civil society. As an intern at Free Press, I had the opportunity to engage in public sociology with policy implications. I reflect on this experience and the tension between being a public sociologist and working in the field. Lastly, I recommend further research into the successful adoption rates of policy recommendations developed through deliberative town hall models such as InternetforEveryone.org’s. I also recommend further research into the effect the Internet in general, and the use of social networking sites specifically, is having on modern organizing

Performance Assessment of Bi-Directional Knotless Tissue-Closure Device in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters, 2010 - Final Report

In 2010, researchers at Pacific Northwest National Laboratory (PNNL) and the University of Washington (UW) conducted a compliance monitoring study—the Lower Columbia River Acoustic Transmitter Investigations of Dam Passage Survival and Associated Metrics 2010 (Carlson et al. in preparation)—for the U.S. Army Corps of Engineers (USACE), Portland District. The purpose of the compliance study was to evaluate juvenile Chinook salmon (Oncorhynchus tshawytscha) and steelhead (O. mykiss) passage routes and survival through the lower three Columbia River hydroelectric facilities as stipulated by the 2008 Federal Columbia River Power System (FCRPS) Biological Opinion (BiOp; NOAA Fisheries 2008) and the Columbia Basin Fish Accords (Fish Accords; 3 Treaty Tribes and Action Agencies 2008)

The systematic development of a novel integrated spiral undergraduate course in general practice

In 2007 Keele University School of Medicine rolled out its novel curriculum to which general practice makes a major contribution. In this paper we describe the systematic approach we took to developing the GP curriculum; from the underlying educational principles which guided its development, the subsequent decisions we made to the curriculum itself. This consists of 23 weeks of clinical placements in general practice; four weeks in year 3, four weeks in year 4 and 15 weeks in year 5. We describe the steps which were necessary to prepare for the implementation of the GP curriculum. We consider that the successful implementation of our general practice contribution is a result of our systematic identification of these principles, the clearly articulated design decisions and the systematic preparation for implementation involving the academic GP team and all our potential teaching practices

Surgically Implanted JSATS Micro-Acoustic Transmitters Effects on Juvenile Chinook Salmon and Steelhead Tag Expulsion and Survival, 2010

The purpose of this study was to evaluate survival model assumptions associated with a concurrent study - Acoustic Telemetry Evaluation of Dam Passage Survival and Associated Metrics at John Day, The Dalles, and Bonneville Dams, 2010 by Thomas Carlson and others in 2010 - in which the Juvenile Salmonid Acoustic Telemetry System (JSATS) was used to estimate the survival of yearling and subyearling Chinook salmon (Oncorhynchus tshawytscha) and steelhead (O. mykiss) migrating through the Federal Columbia River Power System (FCRPS). The micro-acoustic transmitter used in these studies is the smallest acoustic transmitter model to date (12 mm long x 5 mm wide x 4 mm high, and weighing 0.43 g in air). This study and the 2010 study by Carlson and others were conducted by researchers from the Pacific Northwest National Laboratory and the University of Washington for the U.S. Army Corps of Engineers, Portland District, to meet requirements set forth by the 2008 FCRPS Biological Opinion. In 2010, we compared survival, tag burden, and tag expulsion in five spring groups of yearling Chinook salmon (YCH) and steelhead (STH) and five summer groups of subyearling Chinook salmon (SYC) to evaluate survival model assumptions described in the concurrent study. Each tagging group consisted of approximately 120 fish/species, which were collected and implanted on a weekly basis, yielding approximately 600 fish total/species. YCH and STH were collected and implanted from late April to late May (5 weeks) and SYC were collected and implanted from mid-June to mid-July (5 weeks) at the John Day Dam Smolt Monitoring Facility. The fish were collected once a week, separated by species, and assigned to one of three treatment groups: (1) Control (no surgical treatment), (2) Sham (surgical implantation of only a passive integrated transponder [PIT] tag), and (3) Tagged (surgical implantation of JSATS micro-acoustic transmitter [AT] and PIT tags). The test fish were held for 30 days in indoor circular tanks at the Bonneville Dam Juvenile Monitoring Facility. Overall mortality ranged weekly from 45 to 72% for YCH, 55 to 83% for STH, and 56 to 84% for SYC. The high background mortality in all groups and species made it difficult to discern tag effects. However, for YCH, STH, and SYC, the Tagged treatment groups had the highest overall mean mortality - 62%, 79%, and 76%, respectively. Fungal infections were found on 35% of all fish. Mean tag burden for the Tagged treatment group was relatively low for YCH (1.7%) and moderate for SYC (4.2%), while STH had a very low mean tag burden (0.7%). Tag burden was significantly higher in the Tagged treatment group for all species when compared to the Sham treatment group because of the presence of two tags. Surgeon performance did not contribute to the difference in mortality between the Sham and Tagged treatment groups. Tag expulsion from fish that survived to the end of the 30-day experiment was low but occurred in all species, with only two PIT tags and one AT lost, one tag per species. The high background mortality in this experiment was not limited to a treatment, temperature, or month. The decreased number of surviving fish influenced our experimental results and thus analyses. For future research, we recommend that a more natural exposure to monitor tag effects and other factors, such as swimming ability and predator avoidance, be considered to determine the effects of AT- and PIT- implantation on fishes

International Spread of Multidrug-resistant Salmonella Schwarzengrund in Food Products

This serovar was isolated from persons, food, and food animals in Thailand, Denmark, and the United States

The systematic development of a novel integrated spiral undergraduate course in general practice

In 2007 Keele University School of Medicine rolled out its novel curriculum to which generalpractice makes a major contribution. In this paper we describe the systematic approach wetook to developing the GP curriculum; from the underlying educational principles whichguided its development, the subsequent decisions we made to the curriculum itself. Thisconsists of 23 weeks of clinical placements in general practice; four weeks in year 3, fourweeks in year 4 and 15 weeks in year 5. We describe the steps which were necessary toprepare for the implementation of the GP curriculum.We consider that the successful implementation of our general practice contribution is aresult of our systematic identification of these principles, the clearly articulated designdecisions and the systematic preparation for implementation involving the academic GPteam and all our potential teaching practices

Minimal residual disease in Myeloma: Application for clinical care and new drug registration

The development of novel agents has transformed the treatment paradigm for multiple myeloma, with minimal residual disease (MRD) negativity now achievable across the entire disease spectrum. Bone marrow–based technologies to assess MRD, including approaches using next-generation flow and next-generation sequencing, have provided real-time clinical tools for the sensitive detection and monitoring of MRD in patients with multiple myeloma. Complementary liquid biopsy–based assays are now quickly progressing with some, such as mass spectrometry methods, being very close to clinical use, while others utilizing nucleic acid–based technologies are still developing and will prove important to further our understanding of the biology of MRD. On the regulatory front, multiple retrospective individual patient and clinical trial level meta-analyses have already shown and will continue to assess the potential of MRD as a surrogate for patient outcome. Given all this progress, it is not surprising that a number of clinicians are now considering using MRD to inform real-world clinical care of patients across the spectrum from smoldering myeloma to relapsed refractory multiple myeloma, with each disease setting presenting key challenges and questions that will need to be addressed through clinical trials. The pace of advances in targeted and immune therapies in multiple myeloma is unprecedented, and novel MRD-driven biomarker strategies are essential to accelerate innovative clinical trials leading to regulatory approval of novel treatments and continued improvement in patient outcomes

Age-Dependent Maturation of Toll-Like Receptor-Mediated Cytokine Responses in Gambian Infants

The global burden of neonatal and infant mortality due to infection is staggering, particularly in resource-poor settings. Early childhood vaccination is one of the major interventions that can reduce this burden, but there are specific limitations to inducing effective immunity in early life, including impaired neonatal leukocyte production of Th1-polarizing cytokines to many stimuli. Characterizing the ontogeny of Toll-like receptor (TLR)-mediated innate immune responses in infants may shed light on susceptibility to infection in this vulnerable age group, and provide insights into TLR agonists as candidate adjuvants for improved neonatal vaccines. As little is known about the leukocyte responses of infants in resource-poor settings, we characterized production of Th1-, Th2-, and anti-inflammatory- cytokines in response to agonists of TLRs 1-9 in whole blood from 120 Gambian infants ranging from newborns (cord blood) to 12 months of age. Most of the TLR agonists induced TNFα, IL-1β, IL-6, and IL-10 in cord blood. The greatest TNFα responses were observed for TLR4, -5, and -8 agonists, the highest being the thiazoloquinoline CLO75 (TLR7/8) that also uniquely induced cord blood IFNγ production. For most agonists, TLR-mediated TNFα and IFNγ responses increased from birth to 1 month of age. TLR8 agonists also induced the greatest production of the Th1-polarizing cytokines TNFα and IFNγ throughout the first year of life, although the relative responses to the single TLR8 agonist and the combined TLR7/8 agonist changed with age. In contrast, IL-1β, IL-6, and IL-10 responses to most agonists were robust at birth and remained stable through 12 months of age. These observations provide fresh insights into the ontogeny of innate immunity in African children, and may inform development of age-specific adjuvanted vaccine formulations important for global health