Is that a rodent in your luggage? A mixed method approach to describe bushmeat importation into the United States

Bushmeat, defined as meat derived from wild animals, is a potential source of zoonotic pathogens. Bushmeat from restricted animals is illegal to import into the United States under US federal regulations. We reviewed US Centers for Disease Control and Prevention (CDC) port of entry surveillance records from September 2005 through December 2010 and conducted focus group studies to describe trends in and reasons for bushmeat importation into the United States. In total, 543 confiscated bushmeat items were recorded. Half of the confiscated bushmeat items identified were rodents. Africa was the most frequent continent of origin. Seasonality was evident, with bushmeat confiscations peaking in late spring to early summer. Four times more bushmeat was confiscated during an enhanced surveillance period in June 2010 compared with the same period in previous years, suggesting that routine surveillance underestimated the amount of bushmeat detected at US Ports of Entry. Focus groups held in three major US cities revealed that bushmeat importation is a multifaceted issue. Longstanding cultural practices of hunting and eating bushmeat make it difficult for consumers to acknowledge potential health and ecologic risks. Also, US merchants selling African goods, including bushmeat, in their stores have caused confusion among importers as to whether importation is truly illegal. Enhancing routine surveillance for bushmeat and consistent enforcement of penalties at all ports of entry, along with health education aimed at bushmeat importers, might be useful to deter illegal importation.

Affinity-selected heparan sulfate for bone repair

Bone morphogenetic protein (BMP)-2 is a potent bone healing compound produced at sites of bone trauma. Here we present a therapeutic strategy to harness the activity of endogenously produced BMP-2 by delivery of an affinity-matched heparan sulfate (HS) glycos aminoglycan biomaterial that increases the bioavailability, bioactivity and half-life of this growth factor. We have developed a robust, cost effective, peptide-based affinity platform to isolate a unique BMP-2 binding HS variant from commercially available preparations of HS, so removing the manufacturing bottleneck for their translation into the clinic. This affinity-matched HS enhanced BMP-2-induced osteogenesis through improved BMP-2 kinetics and receptor modulation, prolonged pSMAD signaling and reduced interactions with its antagonist noggin. When co-delivered with a collagen implant, the HS was as potent as exogenous BMP-2 for the healing of critical-sized bone defects in rabbits. This affinity platform can be readily tuned to isolate HS variants targeted ata range of clinically-relevant growth and adhesive factors.

Impacts of introduced European hedgehogs on endemic skinks and weta in tussock grassland

Context Control of introduced pest species is based on the premise that there is a relationship between pest abundance and impact, but this relationship is rarely defined. Aim We investigated the impacts of introduced European hedgehogs (Erinaceus europaeus) on two species of small endemic skink (Oligosoma spp.) and flightless, nocturnal endemic orthopteran ground weta (Hemiandrus spp.), using an enclosure-based experimental manipulation of hedgehog density in tussock grasslands in the South Island of New Zealand. Methods We used capture–mark–recapture methods to estimate the densities of skinks before and after exposure to a range of hedgehog densities over a 3-month period and also compared changes in indices of abundance of skink demographic groups and ground weta. Key results Faecal analysis confirmed that hedgehogs consumed skinks and invertebrates in the enclosures. The proportional change between capture sessions in numbers of captured juvenile McCann’s skinks (O. maccanni) declined with increasing hedgehog density. Similarly, the proportional change in the numbers of ground weta encountered in pitfall traps showed a highly significant negative relationship with increasing hedgehog density. Total species abundances and numbers in other demographic skink groups did not change significantly in relation to hedgehog density. For overall skink abundance estimates, there was an apparent trend suggesting that changes in abundance were more negative with increasing hedgehog density, but this did not reach statistical significance for either skink species. Conclusions Our results confirmed that hedgehogs are important predators of small native fauna, but suggested that highly abundant prey populations may be buffered against significant impacts. Implications Less abundant prey and some demographic groups within populations, however, may be at significant risk from hedgehog predation.

Diet creates metabolic niches in the "immature gut" that shape microbial communities

Although diet composition has been implicated as a major factor in the etiology of various gastrointestinal diseases, conclusive evidence remains elusive. This is particularly true in diseases such as necrotizing enterocolitis where breast milk as opposed to commercial formula appears to confer a "protective effect" to the "immature gut." Yet the mechanism by which this occurs continues to remain speculative. In the present study we hypothesize that the basic chemical composition of diet fundamentally selects for specific intestinal microbiota which may help explain disparate disease outcome and therapeutic direction. Complimentary animal and human studies were conducted on young piglets (21 d.)(n = 8) (IACUC protocols 08070 and 08015) and premature infants (adjusted gestational age 34-36 weeks) (n = 11) (IRB Protocol 15895A). In each study, cecal or stool contents from two groups (Breast milk-fed (BF) vs. Formula-fed (FF)) were analyzed by gas chromatography/mass spectrometry (GC/MS) and comprehensive metabolic profiles generated and compared. Concurrently, bacterial community structure was assayed and respective representative microbiota of the groups determined by 16S rRNA gene amplicon pyrosequencing. Statistical modeling and analysis was done using SIMCA-P+ and R software. GC/MS metabolomics identified clear differences between BF and FF groups in the intestinal environment of piglets and humans. Sugars, amino-sugars, fatty acids, especially unsaturated fatty acids, and sterols were identified as being among the most important metabolites for distinguishing between BF and FF groups. Joint analysis of microbiota and metabolomics pinpointed specific sets of metabolites (p < 0.05) associated with the dominant bacterial taxa. The chemical composition of diet appears to have a significant role in defining the microbiota of the immature gut. Tandem analysis of intestinal microbial and metabolic profiles is potentially a powerful tool leading to better understanding of the role of diet in disease perhaps even leading to specific strategies to alter microbial behavior to improve clinical outcome.

MammoSite partial breast irradiation following breast-conserving surgery for early-stage breast cancer

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Background: Partial breast irradiation (PBI) remains investigational until comparisons to whole-breast external beam radiotherapy (EBRT) confirm noninferiority.

Methods: From 2004 to 2010, 103 patients at York Cancer Center (Pennsylvania) who underwent margin-negative breast-conserving surgery for early-stage invasive or in situ breast carcinoma were enrolled on a prospective MammoSite PBI protocol. NSABP B39 stage and planning criteria were utilized, with unicentric tumors up to 3 cm and pN0-1 axillary staging for invasive carcinomas. PBI was prescribed to 1 cm from the applicator surface in 10 twice-daily fractions to 34 Gy.

Results: With a median follow-up of 27 months, three patients experienced recurrence: one with isolated local in-breast tumor recurrence (local IBTR), one with IBTR remote from the surgical cavity (non-local IBTR) plus regional and distant recurrence, and one with regional and distant recurrence only 3- and 5-year freedom from local IBTR are 100% and 96% (non-local IBTR: 100% and 95%). Physician-reported cosmesis evaluations are available for 25 patients at 2-3 years after treatment, with a median score of “excellent.” 26 additional patients on protocol underwent insertion of the MammoSite applicator but had it removed without treatment, most commonly due to unsatisfactory cavity conformance (24 patients), uncommonly due to infection or seroma (two patients). Their characteristics (invasive vs. in situ disease, T/N stage, negative vs. close margins, age) were not statistically different than the 103 MammoSite-treated patients. All except one received EBRT, and none experienced IBTR, which is not statistically different than the IBTR rates of the 103 MammoSite-treated patients (p=0.84).

Conclusions: MammoSite PBI in well-selected patients was associated with low rates of IBTR and not significantly different than a comparison cohort selected for MammoSite PBI but treated instead with EBRT. Randomized comparisons of PBI vs. EBRT are required to confirm PBI as standard.

Audiovisual Presentations on a Handheld PC are Preferred As an Educational Tool by NICU Parents

BACKGROUND

Health literacy is critical for understanding complex medical problems and necessary for the well being of the patient. Printed educational materials (PM) have limitations in explaining the dynamics of a disease process. Multimedia formats may be useful for enhancing the educational process.

OBJECTIVE

To evaluate whether a printed format or animation with commentary on a handheld personal computer (PC) is preferred as an educational tool by parents of a baby in the NICU.

METHODS

PARENTS EVALUATED TWO FORMATS: A 1-page illustrated document from the American Heart Association explaining patent ductus arteriosus (PDA) and animation with commentary on a handheld PC that explained the physiology of PDA in 1 minute. The reading grade level of the PM was 8.6 versus 18.6 for the audio portion of the animated presentation. Parents viewed each format and completed a four-item questionnaire. Parents rated both formats and indicated their preference as printed, animation, or both.

RESULTS

Forty-six parents participated in the survey. Parents preferred animation over PM (50% vs. 17.4%. p = 0.02); 39.1% expressed that the animation was excellent; whereas 4.3% expressed that the PM was excellent (p<0.001). The order of presentation of formats, sex, age, and educational level of parents did not influence the method preferred (p>0.05).

CONCLUSION

Parents preferred animation on a small screen handheld PC despite a much higher language level. Because handheld PCs are portable and inexpensive, they can be used effectively at the bedside with low-cost animation to enhance understanding of complex disease conditions.

Prevalence and pattern of cognitive impairment in a community cohort of men in South Wales: methodology and findings from the Caerphilly Prospective Study

BACKGROUND/AIMS

The prevalence of dementia and cognitive impairment not dementia was investigated in the Caerphilly Prospective Study cohort (men currently aged 65-84 years).

METHODS

Of 1,633 men eligible for cognitive screening, 1,225 (75%) were seen, with those failing the screening criteria (CAMCOG <83 or decline in CAMCOG >9) being neurologically examined.

RESULTS

For dementia, diagnosed by DSM-IV criteria, the population prevalence was 5.2% rising to 6.1% in the screened population. For cognitive impairment not dementia, the prevalence in the screened population was 15.6% giving an overall prevalence of cognitive impairment of 21.8%. Prevalence rose fivefold between ages of 65 and 84 years to reach over 50%.

CONCLUSION

These figures are likely to underestimate actual prevalence in this population, and developing effective interventions should be a public health priority.