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Ager EE, Purington EK, Purdy MH, Benenati B, Baker JE, Schellack CJ, Smith GC, Hunt NR, Losman ED. Implementation of an EMS-based naloxone distribution program: A qualitative evaluation. J Am Coll Emerg Physicians Open 2024; 5:e13300. [PMID: 39417009 PMCID: PMC11480357 DOI: 10.1002/emp2.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/30/2024] [Accepted: 07/25/2024] [Indexed: 10/19/2024] Open
Abstract
Objectives We evaluated a novel leave-behind naloxone (LBN) program that allows Emergency Medical Services (EMS) personnel to distribute naloxone after an opioid overdose. Our objective was to explore EMS engagement and experiences with the program, as well as interest in education on addiction and harm reduction. We also assessed the acceptability of LBN programs among people who use drugs (PWUD). Methods We conducted telephone interviews with EMS personnel and residents of substance use recovery housing between February and September 2023. EMS personnel described their direct experiences with the LBN program and perceived facilitating factors and barriers to naloxone distribution. First responder interactions and support for LBN were explored with PWUD. A rapid assessment method was used to analyze the interview data. Results Eighteen of the 23 EMS participants had distributed LBN; most agreed EMS agencies should have an LBN program. Barriers included forgetting, patient acuity, patients declining, and perceived liability. Facilitators included having a clear protocol, accessible kits, and minimal documentation burden. The majority expressed interest in harm reduction education. Eight of the 11 PWUD participants reported recent involvement in an opioid overdose. The majority supported LBN and felt comfortable receiving naloxone training from EMS. Conclusion In this qualitative evaluation, we found broad support for EMS-based naloxone distribution among EMS personnel and PWUD. We identified several modifiable barriers to the success of such programs, which should be the subject of future investigation. EMS and harm reduction communities should support the expansion of LBN programs across the United States.
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Wood AJ, Benton CH, Delahay RJ, Marion G, Palkopoulou E, Pooley CM, Smith GC, Kao RR. The utility of whole-genome sequencing to identify likely transmission pairs for pathogens with slow and variable evolution. Epidemics 2024; 48:100787. [PMID: 39197305 DOI: 10.1016/j.epidem.2024.100787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/03/2024] [Accepted: 08/14/2024] [Indexed: 09/01/2024] Open
Abstract
Pathogen whole-genome sequencing (WGS) has been used to track the transmission of infectious diseases in extraordinary detail, especially for pathogens that undergo fast and steady evolution, as is the case with many RNA viruses. However, for other pathogens evolution is less predictable, making interpretation of these data to inform our understanding of their epidemiology more challenging and the value of densely collected pathogen genome data uncertain. Here, we assess the utility of WGS for one such pathogen, in the "who-infected-whom" identification problem. We study samples from hosts (130 cattle, 111 badgers) with confirmed infection of M. bovis (causing bovine Tuberculosis), which has an estimated clock rate as slow as ∼0.1-1 variations per year. For each potential pathway between hosts, we calculate the relative likelihood that such a transmission event occurred. This is informed by an epidemiological model of transmission, and host life history data. By including WGS data, we shrink the number of plausible pathways significantly, relative to those deemed likely on the basis of life history data alone. Despite our uncertainty relating to the evolution of M. bovis, the WGS data are therefore a valuable adjunct to epidemiological investigations, especially for wildlife species whose life history data are sparse.
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Dowker SR, Downey ML, Majhail NK, Scott IG, Mathisson J, Rizk D, Trumpower B, Yake D, Williams M, Coulter‐Thompson EI, Brent CM, Smith GC, Swor R, Berger DA, Rooney DM, Neumar RW, Friedman CP, Cooke JM, Missel AL. Early intranasal medication administration in out-of-hospital cardiac arrest: Two randomized simulation trials. J Am Coll Emerg Physicians Open 2024; 5:e13100. [PMID: 38260004 PMCID: PMC10800291 DOI: 10.1002/emp2.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Intranasal medications have been proposed as adjuncts to out-of-hospital cardiac arrest (OHCA) care. We sought to quantify the effects of intranasal medication administration (INMA) in OHCA workflows. Methods We conducted separate randomized OHCA simulation trials with lay rescuers (LRs) and first responders (FRs). Participants were randomized to groups performing hands-only cardiopulmonary resuscitation (CPR)/automated external defibrillator with or without INMA during the second analysis phase. Time to compression following the second shock (CPR2) was the primary outcome and compression quality (chest compression rate (CCR) and fraction (CCF)) was the secondary outcome. We fit linear regression models adjusted for CPR training in the LR group and service years in the FR group. Results Among LRs, INMA was associated with a significant increase in CPR2 (mean diff. 44.1 s, 95% CI: 14.9, 73.3), which persisted after adjustment (p = 0.005). We observed a significant decrease in CCR (INMA 95.1 compressions per min (cpm) vs control 104.2 cpm, mean diff. -9.1 cpm, 95% CI -16.6, -1.6) and CCF (INMA 62.4% vs control 69.8%, mean diff. -7.5%, 95% CI -12.0, -2.9). Among FRs, we found no significant CPR2 delays (mean diff. -2.1 s, 95% CI -15.9, 11.7), which persisted after adjustment (p = 0.704), or difference in quality (CCR INMA 115.5 cpm vs control 120.8 cpm, mean diff. -5.3 cpm, 95% CI -12.6, 2.0; CCF INMA 79.6% vs control 81.2% mean diff. -1.6%, 95% CI -7.4, 4.3%). Conclusions INMA in LR resuscitation was associated with diminished resuscitation performance. INMA by FR did not impede key times or quality.
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Salhi RA, Iyengar S, da Silva Bhatia B, Smith GC, Heisler M. How do current police practices impact trauma care in the prehospital setting? A scoping review. J Am Coll Emerg Physicians Open 2023; 4:e12974. [PMID: 37229183 PMCID: PMC10204184 DOI: 10.1002/emp2.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 04/08/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
Objective In the United States, police are often important co-responders to 911 calls with emergency medical services for medical emergencies. To date, there remains a lack of a comprehensive understanding of the mechanisms by which police response modifies time to in-hospital medical care for traumatically injured patients. Further, it remains unclear if differentials exist within or between communities. A scoping review was performed to identify studies evaluating prehospital transport of traumatically injured patients and the role or impact of police involvement. Methods PubMed, SCOPUS, and Criminal Justice Abstracts databases were utilized to identify articles. English-language, US-based, peer-reviewed articles published on or prior to March 30, 2022 were eligible for inclusion. Results Of 19,437 articles initially identified, 70 articles were selected for full review and 17 for final inclusion. Key findings included (1) current law enforcement practices involving scene clearance introduce the potential for delayed patient transport but to date there is little research quantifying delays; (2) police transport protocols may decrease transport times; and (3) there are no studies examining the potential impact of scene clearance practices at the patient or community level. Conclusions Our results highlight that police are often the first on scene when responding to traumatic injuries and have an active role via scene clearance or, in some systems, patient transport. Despite the significant potential for impact on patient well-being, there remains a paucity of data examining and driving current practices.
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Kao RR, Smith GC, Walker M. Infectious disease modelling to inform policy. REV SCI TECH OIE 2023; 42:173-179. [PMID: 37232307 DOI: 10.20506/rst.42.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
With modelling becoming increasingly important in helping to inform decisions about animal diseases, it is essential that the process be optimised to gain the maximum benefit for the decision-maker. Here, the authors set out ten steps that can improve this process for all concerned. Four steps describe initialisation to ensure that the question, answer and timescale are defined; two steps describe the modelling process and quality assurance; and four steps describe the reporting stage. The authors believe that this greater emphasis at the beginning and end of a modelling project will increase the relevance of the work and understanding of the results, and thus contribute towards better decision-making.
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Turer RW, Smith GC, Mehkri Do F, Chou A, Fowler R, Idris AH, Lehmann CU, McDonald SA. Improving Emergency Medical Services Information Exchange: Methods for Automating Entity Resolution. Stud Health Technol Inform 2022; 291:17-26. [PMID: 35593755 DOI: 10.3233/shti220004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 21st century has seen an enormous growth in emergency medical services (EMS) information technology systems, with corresponding accumulation of large volumes of data. Despite this growth, integration efforts between EMS-based systems and electronic health records, and public-sector databases have been limited due to inconsistent data structure, data missingness, and policy and regulatory obstacles. Efforts to integrate EMS systems have benefited from the evolving science of entity resolution and record linkage. In this chapter, we present the history and fundamentals of record linkage techniques, an overview of past uses of this technology in EMS, and a look into the future of record linkage techniques for integrating EMS data systems including the use of machine learning-based techniques.
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Khan AF, Ferrari AGM, Hughes JP, Smith GC, Banks CE, Rowley-Neale SJ. 2D-Hexagonal Boron Nitride Screen-Printed Bulk-Modified Electrochemical Platforms Explored towards Oxygen Reduction Reactions. SENSORS (BASEL, SWITZERLAND) 2022; 22:3330. [PMID: 35591020 PMCID: PMC9105127 DOI: 10.3390/s22093330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022]
Abstract
A low-cost, scalable and reproducible approach for the mass production of screen-printed electrode (SPE) platforms that have varying percentage mass incorporations of 2D hexagonal boron nitride (2D-hBN) (2D-hBN/SPEs) is demonstrated herein. These novel 2D-hBN/SPEs are explored as a potential metal-free electrocatalysts towards oxygen reduction reactions (ORRs) within acidic media where their performance is evaluated. A 5% mass incorporation of 2D-hBN into the SPEs resulted in the most beneficial ORR catalysis, reducing the ORR onset potential by ca. 200 mV in comparison to bare/unmodified SPEs. Furthermore, an increase in the achievable current of 83% is also exhibited upon the utilisation of a 2D-hBN/SPE in comparison to its unmodified equivalent. The screen-printed fabrication approach replaces the less-reproducible and time-consuming drop-casting technique of 2D-hBN and provides an alternative approach for the large-scale manufacture of novel electrode platforms that can be utilised in a variety of applications.
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Rossi G, Crispell J, Brough T, Lycett SJ, White PCL, Allen A, Ellis RJ, Gordon SV, Harwood R, Palkopoulou E, Presho EL, Skuce R, Smith GC, Kao RR. Phylodynamic analysis of an emergent
Mycobacterium bovis
outbreak in an area with no previously known wildlife infections. J Appl Ecol 2021. [DOI: 10.1111/1365-2664.14046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Downs SH, Ashfield S, Arnold M, Roberts T, Prosser A, Robertson A, Frost S, Harris K, Avigad R, Smith GC. Detection of a local Mycobacterium bovis reservoir using cattle surveillance data. Transbound Emerg Dis 2021; 69:e104-e118. [PMID: 34333857 PMCID: PMC9544780 DOI: 10.1111/tbed.14272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Abstract
The incidence of bovine tuberculosis (TB, caused by Mycobacterium bovis) in cattle has been associated with TB in badgers (Meles meles) in parts of England. The aim was to identify badger‐associated M. bovis reservoirs in the Edge Area, between the High‐ and Low‐Risk Areas for cattle TB. Data from badger TB surveys were sparse. Therefore, a definition for a local M. bovis reservoir potentially shared by cattle and badgers was developed using cattle TB surveillance data. The performance of the definition was estimated through Latent Class Analysis using badger TB survey data. Spatial units (25 km2) in the Edge Area were classified as having a reservoir if they had (i) at least one TB incident in at least three of the previous 7 years, (ii) at least one TB incident in a cattle herd confirmed by post‐mortem tests as due to M. bovis infection and not attributable to cattle movements in the previous 2 years and (iii) more confirmed TB incidents than un‐confirmed in the previous 2 years. Approximately 20% of the Edge Area was classified as having a local M. bovis reservoir using the cattle‐based definition. Assuming 15% TB prevalence in Edge Area badgers, sensitivity for the local M. bovis reservoir definition varied from 25.7% [95% credible interval (CrI): 10.7%–85.1%] to 64.8% (95% CrI: 48.1%–88.0%). Specificity was 91.9% (CrI: 83.6%–97.4%). Over 90% of the local reservoir was in stable endemic TB areas identified through previous work and its spatial distribution was largely consistent with local veterinary knowledge. Uncertainty in the reservoir spatial distribution was explored through its recalculation in spatial units shifted in different directions. We recommend that the definition is re‐evaluated as further data on badger infection with M. bovis become available.
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Kim JS, Marlais M, Balasubramanian R, Muorah M, Inward C, Smith GC, Reynolds BC, Yadav P, Morgan H, Shenoy M, Tse Y, Hussain F, Grylls S, Kessaris N, Sinha MD, Marks SD. UK national study of barriers to renal transplantation in children. Arch Dis Child 2021; 106:384-386. [PMID: 32241783 DOI: 10.1136/archdischild-2019-318272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/19/2020] [Indexed: 11/04/2022]
Abstract
AIMS To investigate access to paediatric renal transplantation and examine potential barriers within the process. METHODS Cross-sectional, multicentre, observational study where paediatric nephrology centres in the UK were requested to provide data on transplantation plans for all children (<18 years) with end-stage kidney disease (ESKD). RESULTS 308 children with ESKD were included in this study from 12 out of 13 UK paediatric nephrology centres. 139 (45%) were being prepared for living donor transplantation and 82 (27%) were listed for deceased donor transplantation. The most common cited factors delaying transplantation from occurring in children were disease factors (36%), donor availability (27%) and size of the child (20%). Psychosocial factors were listed as a barrier in 19% of children. CONCLUSIONS In this study we have documented the main barriers to renal transplantation in children. Some identified factors may be modifiable through local or national intervention, including donor availability and patient psychosocial factors.
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Smith GC, Budgey R. Simulating the next steps in badger control for bovine tuberculosis in England. PLoS One 2021; 16:e0248426. [PMID: 33735292 PMCID: PMC7971561 DOI: 10.1371/journal.pone.0248426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/25/2021] [Indexed: 11/18/2022] Open
Abstract
Industry-led culling of badgers has occurred in England to reduce the incidence of bovine tuberculosis in cattle for a number of years. Badger vaccination is also possible, and a move away from culling was "highly desirable" in a recent report to the UK government. Here we used an established simulation model to examine badger control option in a post-cull environment in England. These options included no control, various intermittent culling, badger vaccination and use of a vaccine combined with fertility control. The initial simulated cull led to a dramatic reduction in the number of infected badgers present, which increased slowly if there was no further badger management. All three approaches led to a further reduction in the number of infected badgers, with little to choose between the strategies. We do note that of the management strategies only vaccination on its own leads to a recovery of the badger population, but also an increase in the number of badgers that need to be vaccinated. We conclude that vaccination post-cull, appears to be particularly effective, compared to vaccination when the host population is at carrying capacity.
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Reed BP, Cant DJH, Spencer SJ, Carmona-Carmona AJ, Bushell A, Herrera-Gómez A, Kurokawa A, Thissen A, Thomas AG, Britton AJ, Bernasik A, Fuchs A, Baddorf AP, Bock B, Theilacker B, Cheng B, Castner DG, Morgan DJ, Valley D, Willneff EA, Smith EF, Nolot E, Xie F, Zorn G, Smith GC, Yasufuku H, Fenton JL, Chen J, Counsell JDP, Radnik J, Gaskell KJ, Artyushkova K, Yang L, Zhang L, Eguchi M, Walker M, Hajdyła M, Marzec MM, Linford MR, Kubota N, Cortazar-Martínez O, Dietrich P, Satoh R, Schroeder SLM, Avval TG, Nagatomi T, Fernandez V, Lake W, Azuma Y, Yoshikawa Y, Shard AG. Versailles Project on Advanced Materials and Standards interlaboratory study on intensity calibration for x-ray photoelectron spectroscopy instruments using low-density polyethylene. JOURNAL OF VACUUM SCIENCE & TECHNOLOGY. A, VACUUM, SURFACES, AND FILMS : AN OFFICIAL JOURNAL OF THE AMERICAN VACUUM SOCIETY 2020; 38:063208. [PMID: 33281279 PMCID: PMC7688089 DOI: 10.1116/6.0000577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/30/2020] [Indexed: 06/12/2023]
Abstract
We report the results of a Versailles Project on Advanced Materials and Standards interlaboratory study on the intensity scale calibration of x-ray photoelectron spectrometers using low-density polyethylene (LDPE) as an alternative material to gold, silver, and copper. An improved set of LDPE reference spectra, corrected for different instrument geometries using a quartz-monochromated Al Kα x-ray source, was developed using data provided by participants in this study. Using these new reference spectra, a transmission function was calculated for each dataset that participants provided. When compared to a similar calibration procedure using the NPL reference spectra for gold, the LDPE intensity calibration method achieves an absolute offset of ∼3.0% and a systematic deviation of ±6.5% on average across all participants. For spectra recorded at high pass energies (≥90 eV), values of absolute offset and systematic deviation are ∼5.8% and ±5.7%, respectively, whereas for spectra collected at lower pass energies (<90 eV), values of absolute offset and systematic deviation are ∼4.9% and ±8.8%, respectively; low pass energy spectra perform worse than the global average, in terms of systematic deviations, due to diminished count rates and signal-to-noise ratio. Differences in absolute offset are attributed to the surface roughness of the LDPE induced by sample preparation. We further assess the usability of LDPE as a secondary reference material and comment on its performance in the presence of issues such as variable dark noise, x-ray warm up times, inaccuracy at low count rates, and underlying spectrometer problems. In response to participant feedback and the results of the study, we provide an updated LDPE intensity calibration protocol to address the issues highlighted in the interlaboratory study. We also comment on the lack of implementation of a consistent and traceable intensity calibration method across the community of x-ray photoelectron spectroscopy (XPS) users and, therefore, propose a route to achieving this with the assistance of instrument manufacturers, metrology laboratories, and experts leading to an international standard for XPS intensity scale calibration.
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Hulme PE, Baker R, Freckleton R, Hails RS, Hartley M, Harwood J, Marion G, Smith GC, Williamson M. The Epidemiological Framework for Biological Invasions (EFBI): an interdisciplinary foundation for the assessment of biosecurity threats. NEOBIOTA 2020. [DOI: 10.3897/neobiota.62.52463] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Emerging microparasite (e.g. viruses, bacteria, protozoa and fungi) epidemics and the introduction of non-native pests and weeds are major biosecurity threats worldwide. The likelihood of these threats is often estimated from probabilities of their entry, establishment, spread and ease of prevention. If ecosystems are considered equivalent to hosts, then compartment disease models should provide a useful framework for understanding the processes that underpin non-native species invasions. To enable greater cross-fertilisation between these two disciplines, the Epidemiological Framework for Biological Invasions (EFBI) is developed that classifies ecosystems in relation to their invasion status: Susceptible, Exposed, Infectious and Resistant. These states are linked by transitions relating to transmission, latency and recovery. This viewpoint differs markedly from the species-centric approaches often applied to non-native species. It allows generalisations from epidemiology, such as the force of infection, the basic reproductive ratio R0, super-spreaders, herd immunity, cordon sanitaire and ring vaccination, to be discussed in the novel context of non-native species and helps identify important gaps in the study of biological invasions. The EFBI approach highlights several limitations inherent in current approaches to the study of biological invasions including: (i) the variance in non-native abundance across ecosystems is rarely reported; (ii) field data rarely (if ever) distinguish source from sink ecosystems; (iii) estimates of the susceptibility of ecosystems to invasion seldom account for differences in exposure to non-native species; and (iv) assessments of ecosystem susceptibility often confuse the processes that underpin patterns of spread within -and between- ecosystems. Using the invasion of lakes as a model, the EFBI approach is shown to present a new biosecurity perspective that takes account of ecosystem status and complements demographic models to deliver clearer insights into the dynamics of biological invasions at the landscape scale. It will help to identify whether management of the susceptibility of ecosystems, of the number of vectors, or of the diversity of pathways (for movement between ecosystems) is the best way of limiting or reversing the population growth of a non-native species. The framework can be adapted to incorporate increasing levels of complexity and realism and to provide insights into how to monitor, map and manage biological invasions more effectively.
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Chang X, Smith GC, Quinn J, Carson L, Chan CW, Lee S. Optimization of anti-wear and anti-bacterial properties of beta TiNb alloy via controlling duty cycle in open-air laser nitriding. J Mech Behav Biomed Mater 2020; 110:103913. [PMID: 32957212 DOI: 10.1016/j.jmbbm.2020.103913] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/27/2020] [Accepted: 06/04/2020] [Indexed: 11/17/2022]
Abstract
A multifunctional beta TiNb surface, featuring wear-resistant and antibacterial properties, was successfully created by means of open-air fibre laser nitriding. Beta TiNb alloy was selected in this study as it has low Young's modulus, is highly biocompatible, and thus can be a promising prosthetic joint material. It is, however, necessary to overcome intrinsically weak mechanical properties and poor wear resistance of beta TiNb in order to cover the range of applications to load-bearing and/or shearing parts. To this end, open-air laser nitriding technique was employed. A control of single processing parameter, namely duty cycle (between 5% and 100%), led to substantially different structural and functional properties of the processed beta TiNb surfaces as analyzed by an array of analytical tools. The TiNb samples nitrided at the DC condition of 60% showed a most enhanced performance in terms of improving surface hardness, anti-friction, anti-wear and anti-bacterial properties in comparison with other conditions. These findings are expected to be highly important and useful when TiNb alloys are considered as materials for hip/knee articular joint implants.
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Smith F, Robertson A, Smith GC, Gill P, McDonald RA, Wilson G, Delahay RJ. Estimating wildlife vaccination coverage using genetic methods. Prev Vet Med 2020; 183:105096. [PMID: 32907707 DOI: 10.1016/j.prevetmed.2020.105096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022]
Abstract
Vaccination is a useful approach for the control of disease in wildlife populations. However, its effectiveness is dependent in part on delivery to a sufficient proportion of the target population. Measuring the proportions of wild animal populations that have been vaccinated is challenging and so there is a need to develop robust approaches that can contribute to our understanding of the likely efficacy of wildlife vaccination campaigns. We used a modified capture mark recapture technique to estimate vaccine coverage in a wild population of European badgers (Meles meles) vaccinated by live-trapping and injecting with Bacillus Calmette-Guérin as part of a bovine tuberculosis control initiative in Wales, United Kingdom. Our approach used genetic matching of vaccinated animals to a sample of the wider population to estimate the percentage of badgers that had been vaccinated. Individual-specific genetic profiles were obtained using microsatellite genotyping of hair samples, which were collected directly from trapped and vaccinated badgers and non-invasively from the wider population using hair traps deployed at badger burrows (setts). With two nights of trapping at each sett in an annual campaign, an estimated 50 % (95 % confidence interval 40-60 %) of the badger population received at least one dose of vaccine in a single year. Using a simple population model this suggested that the proportion of the population that would have received at least one dose of vaccine over the course of the four year vaccination campaign was between 67 % and 83 %. This is the first attempt, outside of field trials, to quantify the level of vaccine coverage achieved by trapping and injecting badgers, which is currently the only option for delivering BCG vaccine to this species. The results therefore have specific application to bTB control policy and the novel approach may have wider value in wildlife management and research.
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Kingdom JC, Smith GC. Next steps to prevent stillbirth associated with growth restriction. BJOG 2020; 127:1081. [PMID: 32237039 DOI: 10.1111/1471-0528.16237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 11/27/2022]
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Croft S, Massei G, Smith GC, Fouracre D, Aegerter JN. Modelling Spatial and Temporal Patterns of African Swine Fever in an Isolated Wild Boar Population to Support Decision-Making. Front Vet Sci 2020; 7:154. [PMID: 32322589 PMCID: PMC7156605 DOI: 10.3389/fvets.2020.00154] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/03/2020] [Indexed: 11/13/2022] Open
Abstract
African swine fever (ASF) is a highly contagious disease affecting all suids including wild boar. As the disease can damage commercial pig production and its circulation can threaten international trade, understanding the risks produced by free-living wild boar (as a wildlife reservoir) is important to ensure proportionate policies to exclude the disease, as well as an effective contingency response. The recent spread of the virus into Western Europe has produced concerns in many stakeholders including pig producers and national governments. Unlike in mainland Europe, where wild boar are widespread, in Britain, free-living populations have only recently re-established, and whilst these are still relatively small and isolated, they may provide a sufficient reservoir capable of sustaining disease and may thus present a continual source of infection risk to domestic pigs. This study focuses on one component of the risk produced by wild boar, specifically the distribution and persistence of virus in a landscape produced by the natural circulation of disease within wild boar. We used a spatial individual-based model run across a representation of a real landscape to explore the epidemiological consequences of an introduction of ASF into the Forest of Dean, currently hosting the largest population of wild boar in England. We explore various scenarios including variations in the prophylactic management of boar, as well as variations in reactive management (contingency response) following the detection of disease to evaluate their value in reducing this specific risk (presence of ASF virus of wild boar origin in the landscape). The abundance and distribution of wild boar is predicted to increase across our study extent over the next 20 years. Outbreaks of ASF are not predicted to be self-sustaining, with the median time to disease "burn-out" (no new infections) being 14 weeks. Carcass removal, as a tool in a package of reactive management, was of limited value in reducing the duration of outbreaks in this study. We suggest that useful predictions of some of the risks produced by ASF might be possible using only the distribution of the boar, rather than more difficult abundance or density measures.
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Vicente J, Apollonio M, Blanco-Aguiar JA, Borowik T, Brivio F, Casaer J, Croft S, Ericsson G, Ferroglio E, Gavier-Widen D, Gortázar C, Jansen PA, Keuling O, Kowalczyk R, Petrovic K, Plhal R, Podgórski T, Sange M, Scandura M, Schmidt K, Smith GC, Soriguer R, Thulke HH, Zanet S, Acevedo P. Science-based wildlife disease response. Science 2019; 364:943-944. [PMID: 31171687 DOI: 10.1126/science.aax4310] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Ghonim S, Gatzoulis MA, Smith GC, Heng E, Ernst S, Li W, Keegan J, Diller GP, Dimpoulos K, Moon JC, Pennell DJ, Babu-Narayan SV. 2395LGE CMR predicts sudden death and VT in adults with repaired tetralogy of Fallot - a prospective study with 3500 patient follow up years. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Adults with repaired tetralogy of Fallot (rtoF) are at risk of ventricular arrhythmia and sudden cardiac death (SCD). Cross-sectional data suggest association of late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) with adverse clinical risk factors
Purpose
We sought to determine prognosis related to LGE CMR.
Methods
In this prospective cohort study the primary composite outcome comprised the first of cardiovascular death (SCD or heart failure-related), aborted SCD (successfully resuscitated cardiac arrest or appropriate AICD shock for ventricular fibrillation), and clinical sustained ventricular tachycardia (VT>30 seconds duration).
Results
In 531 rtoF patients (median age 32; 23–42, 296 (56%) male, NYHA≥II 17%) followed up after LGE CMR for median 5 (1.7–8.9) years, there were 39 primary composite outcomes: 10 SCD, 11 heart failure related deaths (2 perioperative RV failure), 2 aborted SCD and 16 clinical sustained VT events. At study end, there were 28 ventricular arrhythmic events in 28 rtoF patients (10 SCD, 16 clinical sustained VT, 2 aborted VF) that were significantly predicted by RV LGE extent (HR 1.45 CI: 1.3–1.6; P<0.001).
Univariable predictors of the primary outcome were RV LGE score; HR: 1.44 (1.31–1.57; p<0.001), (Figure) together with older age; HR: 1.05 (1.02–1.07; P<0.001), late repair; HR: 1.04 (1.02–1.07; p<0.001), lower RV ejection fraction; HR: 0.92 (0.89–0.95; p<0.001), larger RVOT akinetic length; HR: 1.04 (1.02–1.06; p<0.001) larger right atrial area; HR: 1.2 (1.12–1.29; p<0.001); higher BNP levels; HR: 1.01 (1–1.02; p<0.001), lower peak VO2; HR: 0.89 (0.83–0.96; p=0.001), prior atrial arrhythmia; HR: 5.3 (2.8–10.07; p<0.001), and non-sustained VT; HR: 4.1 (2.1–7.7; p<0.001). Inducible VT did not predict the primary outcome; HR: 2.1 (0.57–8; p=0.25)
In multivariable analysis both RV LGE score and indexed right atrial area (RAAi) only, remained predictive of the primary outcome (HR 1.29 CI: 1.12–1.49; p<0.001 and HR 1.1 CI: 1.02–1.12; p=0.01, respectively). Patients could accordingly be stratified such that supramedian RV LGE score (≥5) and RAAi ≥16cm2/m2 had 5-year event free survival 84% vs 94% for supramedian RV LGE score (≥5) and RAAi <16cm2/m2 or 98% for inframedian RV LGE score with RAAI<16cm2/m2. Figure.
Conclusions
For every unit increase in CMR defined RV fibrosis score there is a 44% increased risk of sudden cardiac death and VT. LGE CMR and maximal right atrial area should therefore be incorporated into risk stratification for sudden death in adults with rTOF.
Acknowledgement/Funding
British heart foundation
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Price RJ, Ladislaus PI, Smith GC, Davies TJ. A novel 'bottom-up' synthesis of few- and multi-layer graphene platelets with partial oxidation via cavitation. ULTRASONICS SONOCHEMISTRY 2019; 56:466-473. [PMID: 31101286 DOI: 10.1016/j.ultsonch.2019.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/12/2019] [Accepted: 03/21/2019] [Indexed: 05/14/2023]
Abstract
The transient cavitation of diaromatic components such as 1-methylnaphthalene has been used to produce graphene platelets in a 'bottom-up' synthesis via the high temperature (>5000 K) conditions that are generated inside collapsing bubbles. Acoustic cavitation produced yields of 5.7 × 10-11 kgJ-1 at a production rate of 2.2 × 10-9 kgs-1. This can be improved by generating cavitation hydrodynamically, thus making commercial scale production viable. Hydrodynamic cavitation produced platelets with larger lateral dimensions (≥2 µm) than those formed by acoustic cavitation (10-200 nm). The partially oxidised nature of the platelets enables their covalent chemical functionalisation, which was achieved by combining suitable molecules in the reaction medium to affect a one-pot formation and functionalisation of graphene.
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Croft S, Ward AI, Aegerter JN, Smith GC. Modeling current and potential distributions of mammal species using presence-only data: A case study on British deer. Ecol Evol 2019; 9:8724-8735. [PMID: 31410275 PMCID: PMC6686353 DOI: 10.1002/ece3.5424] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/04/2019] [Accepted: 06/14/2019] [Indexed: 11/07/2022] Open
Abstract
AIM Decisions on wildlife conservation, management, and epidemiological risk are best based on robust evidence. The continual improvement of species distributions, such that they can be relied upon in decision-making, is important. Here we seek to refine aspects of a generic modelling approach and improve the utility of species distribution maps. LOCATION Great Britain (GB). METHODS We applied a modeling framework based on hierarchical Bayesian species distribution models exploiting opportunistic occurrence records from citizen science datasets to predict both current and potential distributions for each of the six deer species known to be present in GB. Using the resulting maps, we performed a simple analysis of the overlap between species to illustrate possible contact, which we interpret as the relative risk of potential disease spread given an introduction. RESULTS Predicted distribution maps showed good agreement with the broader scale occurrence reported by a recent national deer survey with an average True Skill Statistics and AUC of 0.69 and 0.89, respectively. Aggregation of the maps for all species highlighted regions of central and eastern England as well as parts of Scotland where extensive areas of range overlap could result in interspecific contact with consequences for risk assessments for diseases of deer. However, if populations are allowed to expand to their predicted potential, then areas of overlap, and therefore disease interspecific transmission risk, will become extensive and widespread across all of mainland Britain. MAIN CONCLUSIONS The generic modeling approach outlined performed well across all of the deer species tested, offering a robust and reliable tool through which current and potential animal distributions can be estimated and presented. Our application, intended to inform quantitative risk assessments, demonstrates the practical use of such outputs to generate the valuable evidence required to inform policy decisions on issues such as management strategy.
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Halevas E, Mavroidi B, Swanson CH, Smith GC, Moschona A, Hadjispyrou S, Salifoglou A, Pantazaki AA, Pelecanou M, Litsardakis G. Magnetic cationic liposomal nanocarriers for the efficient drug delivery of a curcumin-based vanadium complex with anticancer potential. J Inorg Biochem 2019; 199:110778. [PMID: 31442839 DOI: 10.1016/j.jinorgbio.2019.110778] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/12/2019] [Accepted: 07/14/2019] [Indexed: 01/10/2023]
Abstract
In this work novel magnetic cationic liposomal nanoformulations were synthesized for the encapsulation of a crystallographically defined ternary V(IV)-curcumin-bipyridine (VCur) complex with proven bioactivity, as potential anticancer agents. The liposomal vesicles were produced via the thin film hydration method employing N-[1-(2,3-dioleoyloxy)propyl]-N,N,N-trimethylammonium (DOTAP) and egg phosphatidylcholine lipids and were magnetized through the addition of citric acid surface-modified monodispersed magnetite colloidal magnetic nanoparticles. The obtained nanoformulations were evaluated for their structural and textural properties and shown to have exceptional stability and enhanced solubility in physiological media, demonstrated by the entrapment efficiency and loading capacity results and the in vitro release studies of their cargo. Furthermore, the generated liposomal formulations preserved the superparamagnetic behavior of the employed magnetic core maintaining the physicochemical and morphological requirements for targeted drug delivery applications. The novel nanomaterials were further biologically evaluated for their DNA interaction potential and were found to act as intercalators. The findings suggest that the positively charged magnetic liposomal nanoformulations can generate increased concentration of their cargo at the DNA site, offering a further dimension in the importance of cationic liposomes as nanocarriers of hydrophobic anticancer metal ion complexes for the development of new multifunctional pharmaceutical nanomaterials with enhanced bioavailability and targeted antitumor activity.
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Croft S, Aegerter JN, Massei G, Smith GC. The risk of foot-and-mouth disease becoming endemic in a wildlife host is driven by spatial extent rather than density. PLoS One 2019; 14:e0218898. [PMID: 31242228 PMCID: PMC6594678 DOI: 10.1371/journal.pone.0218898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/11/2019] [Indexed: 11/18/2022] Open
Abstract
In the past 20 years, free living populations of feral wild boar have re-established in several locations across the UK. One of the largest populations is in the Forest of Dean where numbers have been steadily increasing since monitoring began in 2008, with estimates from 2016 reporting a population of more than 1500. Feral wild boar have significant ecological and environmental impacts and may present a serious epidemiological risk to neighbouring livestock as they are a vector for a number of important livestock diseases. This includes foot-and-mouth disease (FMD) which is currently absent from the UK. We developed an individual-based spatially explicit modelling approach to simulate feral wild boar populations in the Forest of Dean (England, UK) and use it to explore whether current or future populations might be sufficient to produce long-lived outbreaks of FMD in this potential wildlife reservoir. Our findings suggest that if you exclude the spread from feral wild boar to other susceptible species, the current population of boar is insufficient to maintain FMD, with 95% of unmanaged simulations indicating disease burn-out within a year (not involving boar management specifically for disease). However, if boar are allowed to spread beyond their current range into the adjacent landscape, they might maintain a self-sustaining reservoir of infection for the disease.
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Ghonim S, Gatehouse PD, Giblin G, Keegan J, Smith GC, Mathews GC, Jenkins S, Alpendurada F, Dimopoulos K, Pennell DJ, Li W, Moon JC, Gatzoulis M, Babu-Narayan S. 277Can RV optimised native T1 mapping and ECV add clinical value in repaired tetralogy of Fallot? Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez121.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kumar D, Stoichkov V, Brousseau E, Smith GC, Kettle J. Correction: High performing AgNW transparent conducting electrodes with a sheet resistance of 2.5 Ω Sq -1 based upon a roll-to-roll compatible post-processing technique. NANOSCALE 2019; 11:5771. [PMID: 30855062 DOI: 10.1039/c9nr90049g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Correction for 'High performing AgNW transparent conducting electrodes with a sheet resistance of 2.5 Ω Sq-1 based upon a roll-to-roll compatible post-processing technique' by D. Kumar et al., Nanoscale, 2019, DOI: 10.1039/c8nr07974a.
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