An updated survey of freshwater fishes within Letchworth State Park and surrounding area's of the Genesee River

The goal of this study was to gather information about freshwater fishes in Letchworth State Park (42.615275° N, -77.992825° W), a portion of New York State-owned land located in the Genesee River Watershed that lacks known data about its fish diversity. Fish collection took place between 2017 and 2019 in the Genesse River upstream and downstream of the falls using electrofishing, gill, hoop, and seine netting. This was the first attempt at a comprehensive survey of this portion of the river, which allowed for a baseline to be established regarding fish biodiversity in the region. The updated total number of species found in this portion of the Genesee River was 25, 22 of which were newly identified downstream of the falls in Letchworth State Park. We encourage further collection and continuation of this survey with consistent sampling techniques to raise awareness about the importance of freshwater fish diversity in stream ecosystems across the globe.

Contaminated sediment in the Detroit River provokes acclimated responses in wild brown bullhead (Ameiurus nebulosus) populations

In a previous study, adaptive responses to a single polycyclic aromatic hydrocarbon (PAH), benzo[a]pyrene (BaP), were identified in brown bullhead (Ameiurus nebulosus) captured from contaminated sites across the Great Lakes. The tumor suppressor p53 and phase I toxin metabolizing CYP1A genes showed a elevated and refractory response, respectively, up to the F1 generation (Williams and Hubberstey, 2014). As an extension to the first study, bullhead were exposed to sediment collected from sites along the Detroit River to see if these adaptive responses are attainable when fish from a contaminated site are exposed to a mixture of contaminants, instead of a single compound. p53 and CYP1A proteins were measured again with the addition of phase II glutathione-s-transferase (GST) activity in the present study. Three treatment groups were measured: acute (treated immediately), cleared (depurated for three months and subsequent treatment), and farm raised F1 offspring. All three treatment groups were exposed to clean and contaminated sediment for 24 and 96 h. Acute fish from contaminated sites exposed to contaminated sediment revealed an initial elevated p53 response that did not persist in fish after long-term contaminated sediment exposure. Acute fish from contaminated sites exposed to contaminated sediment revealed refractory CYP1A expression, which disappeared in cleared fish and whose F1 response overlapped with clean site F1 offspring. Decreasing GST activity was evident in both clean and contaminated fish over time, and only clean site fish responded to long-term contaminated sediment deliberately with increasing GST activity. Because p53 and CYP1A gene expression and GST activity responses did not overlap between contaminated fish treatment groups, our study suggests that contaminated fish have acclimated to the contaminants present in their environments and no evidence of adaptation could be detected within these biomarkers.

Determining health-related quality of life and health state utility values of recurrent urinary tract infections in women

INTRODUCTION AND HYPOTHESIS

Health state utility values estimate an individual's valuation of their health-related quality of life. Despite prevalence of recurrent urinary tract infections (rUTIs), the health state utility value of rUTIs is unknown. The primary aim was to determine the utility value of rUTIs using the standard gamble (SG). The secondary aim was to compare the SG utility value with that derived from the EuroQol 5 dimensions (EQ-5D) and visual analog scale (VAS). We hypothesized that a utility value would be successfully derived from the SG and would differ from that derived using the EQ-5D and VAS.

METHODS

Nonpregnant, adult English-speaking female patients with a diagnosis of rUTI were recruited and completed the EQ-5D, VAS, and SG (n = 25). Utility values were evaluated using Wilcoxon signed-rank tests and Spearman's rho correlation.

RESULTS

Health state utility values varied depending on the assessment tool used: EQ-5D 0.76 (IQR 0.52), VAS 0.70 (IQR 0.30), and SG 0.85 (IQR 0.25). There were differences between VAS and the other two assessment methods (p<0.001), as well as between EQ-5D and SG (p=0.013). Spearman correlation demonstrated a moderately positive correlation between EQ-5D and VAS values (r(25) = 0.59, p=0.0019).

CONCLUSIONS

Our data suggest that 0.85 reflects the true health state utility value of rUTIs among nonpregnant adult English-speaking women. The utility value for recurrent UTIs is worse (lower) than that previously published for nonrecurrent UTIs, reflecting the ability of the SG to convey the compounding impact of recurrent disease. In this study, neither the EQ-5D nor the VAS produced results consistent with those found using the SG, which suggests limited validity in this population.

A cryogenic ion trap for single molecule vibrational spectroscopy

We report on an ion trapping system for performing a novel form of cryogenic messenger spectroscopy with single molecule sensitivity. The system features a cryogenic radio-frequency ion trap loaded with single analyte molecules via a quadrupole mass filter. We demonstrate the ability to controllably attach inert gas particles to buffer gas cooled, trapped molecular ions. Sympathetic cooling by co-trapped, laser cooled 88Sr+ further reduces the translational temperature of trapped molecules to the millikelvin regime. We verify the presence of cryogenic "tags" via non-destructive optical mass spectrometry and selectively remove these adducts by resonantly driving vibrational transitions in the tagged molecular ions. This enables us to derive the vibrational spectrum of a single analyte molecule from the frequency dependence of the tag detachment rate. We have demonstrated these capabilities by measuring transitions in the C-H stretching region for single cationic fragments of both indole (C8H7N) and 1,3-benzodioxole (C6H4O2CH2). These capabilities are not reliant on a specific molecular level structure and thus constitute a general, non-destructive method for vibrational spectroscopy of individual molecular ions.

Building capacity to use legal tools to address climate change through a public health lens

Background

EPH Conferences have an increased focus on the health impacts of climate change. However, until 2021 EPHC abstracts did not address opportunities to challenge government inaction in national and international courts. ASPHER’s European List of Core Competences for the Public Health Professional (2018) only mentions NCDs and data protection law. Yet litigation to address environmental degradation and climate change is well-developed in Europe and beyond. International environmental law was presciently framed as part of global health law by Joaquin Cayon in Laaser U. and Beluli F. A Global Public Health Curriculum. South Eastern European Journal of Public Health (2016).

Objectives

1. Clarify the role of litigation in achieving environmental and climate goals

2. Highlight the role of public health practitioners (PHP) in documenting evidence of harms

3. Propose ways to build PHP capacity to use litigation to address related public health challenges

Results

In 2021 EUPHA-LAW, EUPHA-ENV, the Faculty of Public Health (FPH) (UK) and partners co-hosted a multi-stakeholder, interdisciplinary, open-access webinar on public health, climate change and litigation with experts from WHO, Greenpeace, ClientEarth, Lancet Countdown and the Groningen Centre for Health Law (GCHL). A related workshop was held at the 14th EPHC. In March 2022, EUPHA-LAW, FPH, GCHL and the University of Liverpool hosted a webinar on climate action in the European Court of Human Rights. [Patterson et al, Post COP26: legal action now part of public health’s environment and climate change toolbox, EJPH 31/5/2022.] EUPHA-LAW is preparing a toolkit for public health practitioners and a conference on public health litigation in 2023.

Conclusions

There is keen interest in the public health community to better understand how litigation can address public health challenges including climate change and environmental degradation. Capacity building is needed.

Key messages

• Climate litigation supported by interdisciplinary collaboration can strengthen government resolve and accountability for action to address environmental and climate commitments.

• Litigation can advance public health objectives even without a favourable court decision. Its value also includes the publicity and awareness generated and engagement of multiple stakeholders.

Decolonising global health in Africa: research agendas in public health, law, and human rights

Background

In recent years the Groningen Centre for Health Law (‘GCHL’ - formerly the Global Health Law Groningen Research Centre), Netherlands, has held annual summer schools on global health, law, and human rights. Responding to calls to decolonise global health (Fofana, 2021), in February 2022 GCHL convened an online academic colloquium to explore the issues in Africa. Panellists and discussants comprised leading African academics and advocates for public health, law, and human rights.

Objectives

1. Identify priority current and emerging issues in global health, law, and human rights in the African region with, where possible, reference to the climate crisis.

2. Explore opportunities for identifying academic institutions, networks, and researchers working these issues across Africa.

3. Identify opportunities to support collaboration between institutions, networks and researchers and other actors to address the issues identified across the region

Results

Top public health issues identified for further research included: public health law frameworks in Africa; One Health and climate change; inequality in the distribution of the determinants of health and disease; international trade and public health; the right to benefit from scientific progress (e.g. in accessing vaccines for COVID-19); gender-based violence; public health and agri-food systems; noncommunicable diseases; healthy diets; poverty; mental health; social protection; and plastic pollution. The first meeting of the network on health, law and human rights in Africa was held in May 2022. The second academic colloquium was held in July 2022, co-hosted with Moi University and the University of Nairobi, Kenya.

Conclusions

Public health and legal academics in Africa are ready to engage systematically with European partners to address key health-related law and human rights issues of global interest. Research agendas should reflect African priorities, and collaboration should be led by African institutions.

Key messages

• Capacity must be built to understand the links between public health, law and human rights in Africa.

• Collaboration with European institutions to build capacity in public health, law and human rights is welcome, however priorities should be identified by - and responses led by - African academics.

Exposure-response relationship between K. brevis blooms and reporting of upper respiratory and neurotoxin-associated symptoms

In southwest Florida, Karenia brevis (K. brevis) blooms occur frequently, can be very intense and persist over several years. Individuals living in coastal communities around the Gulf of Mexico are particularly vulnerable to brevetoxins released by K. brevis in seawater and carried inland within marine aerosol. Exposure to K. brevis occurs during residential, recreational, and occupational activities and has been associated with upper respiratory tract (URT) symptoms in healthy and medically vulnerable individuals. Additionally, ingestion of brevetoxin-contaminated seafood causes neurotoxic shellfish poisoning (NSP), and severe headaches prompting emergency department visits which occur in excess during K. brevis blooms. The current study examined a dose-response relationship between K. brevis in coastal waters and URT and NSP-like symptoms and headaches among southwest Florida residents. Data on past medical history (PMH) and medical symptoms were collected from the participants (n = 258) in five southwest Florida counties between June 2019 to August 2021. A dose-response relationship was observed between K. brevis blooms and reporting of URT and NSP-like symptoms and headaches. Reporting of NSP-like symptoms was higher among participants with a PMH of migraines, chronic fatigue syndrome (CFS) and mild memory loss, while the association of headaches with K. brevis blooms was accentuated among individuals with a PMH of migraines. These results suggest further investigations into the threshold of aerosolized brevetoxin dose required to elicit URT, headaches and/or NSP-like symptoms. These symptoms ultimately cause significant public health safety concerns, primarily among vulnerable populations with preexisting neurological conditions.

Automated closed-vessel system for in vitro diagnostics based on polymerase chain reaction

An automated system for polymerase chain reaction (PCR) amplification and detection combats false-positive results caused by "PCR product carryover." The system uses a single vessel for both PCR amplification and the subsequent detection of PCR products, eliminating the need to handle PCR products in an open environment and risk product carryover. The sample and PCR reagents are introduced into one compartment within the vessel, and amplification occurs as they are thermally cycled. Other compartments contain the reagents for detection of PCR products. Pressure from a roller provides for sequential delivery of the contents of the compartments to a detection area. The PCR products are biotinylated at their 5' ends during amplification through the use of biotinylated primers. After delivery to the detection area, they are specifically captured by hybridization with immobilized oligonucleotide probes. Subsequent reaction with streptavidin-horseradish peroxidase conjugate forms a complex that catalyzes dye formation from dye precursor. Wash steps minimize nonspecific background. This format is amenable to multiplexing, permitting internal controls, speciation of bacteria, typing of viruses, and panel testing. An HIV assay performed with this system demonstrated 100% sensitivity and 95% specificity for 64 patients' samples relative to a conventional PCR assay based on 32P solution hybridization. Similarly, an automated closed-vessel assay of cytomegalovirus exhibited 97.5% sensitivity and 100% specificity.

Heart rate variability at limiting stationarity: evidence of neuro-cardiac control mechanisms operating at ultra-low frequencies

This study considers the linkage of exogenously stimulated emotional stress with the neurogenic regulation of heart rate operating at very low frequencies. The objectives were three-fold: to consider the present evidence that such a linkage exists as a primary phenomenon; to compare the potential of a frequency-domain method and a time-domain method in revealing this phenomenon by characterizing heart rate variability (HRV) at frequencies of [0.0005...0.4] Hz and to design, implement and report a physiological experiment in which alternating periods of exposure to bland and high valence visual stimuli might reveal this phenomenon. A methodical challenge was to optimize the length of exposure to the stimulus such that subjects did not have time to habituate to stimuli, whilst acquiring sufficient data (heart beats) such that the ultra-low frequency (ULF) components of HRV could be described. With exposure times set to approximately 5 min, during which time the strength of the stimulus and the corresponding evoked response were considered stationary, the lowest HRV frequency component that could be characterized was 0.003 Hz. In trials with parametrically defined test data, the time-domain method based on the Ornstein–Uhlenbeck Gaussian process (OU-GP) was shown to be better than the frequency-domain method in describing the ULF components of the HRV. In an experimental cohort of 16 subjects, analysis using the OU-GP revealed evidence of cardiac regulatory mechanisms influenced by emotional valence operating in the bandwidth (ULF*) [0.002...0.01] Hz.

Assessment of Infant Movement With a Compact Wireless Accelerometer System

There is emerging data that patterns of motor activity early in neonatal life can predict impairments in neuromotor development. However, current techniques to monitor infant movement mainly rely on observer scoring, a technique limited by skill, fatigue, and inter-rater reliability. Consequently, we tested the use of a lightweight, wireless, accelerometer system that measures movement and can be worn by premature babies without interfering with routine care. We hypothesized that this system would be useful in assessing motor activity, in identifying abnormal movement, and in reducing the amount of video that a clinician would need to review for abnormal movements. Ten preterm infants in the NICU were monitored for 1 h using both the accelerometer system and video. A physical therapist trained to recognize cramped-synchronized general movements scored all of the video data by labeling each abnormal movement observed. The parameters of three different computer models were then optimized based on correlating features computed from accelerometer data and the observer’s annotations. The annotations were compared to the model’s prediction on unseen data. The trained observer identified cramped-synchronized general movements in 6 of the 10 infants. The computer models attained between 70% and 90% accuracy when predicting the same observer label for each data point. Our study suggests that mini-accelerometers may prove useful as a clinical tool assessing patterns of movement in preterm infants.

Perspectives of residential contractors on nail gun safety

Perspectives on nail gun safety were sought from residential contractors as part of an injury surveillance and prevention effort (2005-2008). Anonymous surveys inquired about tool use, training, injury risk, and awareness of the 2003 American National Standards Institute (ANSI) standard calling for shipment of pneumatic nail guns used in wood framing with sequential actuation. Despite some awareness of inexperience, lack of training, speed and tool design in injury causation, 55 percent consistently reported injuries resulted from worker carelessness. Contractors reported safety experiences of their employees were considerably better than those of other residential contractors. After five years, only 16 percent reported any awareness of the voluntary standard. These findings raise questions as to what gains can realistically be expected from passage of voluntary standards such as the one described here. Given that the epidemiology of acute injuries from pneumatic nail guns is now well-described, the safer sequential trigger should be required to protect workers.

Analysis of Clinical Record Data for Anticoagulation Management within an EHR System

OBJECTIVES

This paper reports an evaluation of the properties of a generic electronic health record information model that were actually required and used when importing an existing clinical application into a generic EHR repository.

METHOD

A generic EHR repository and system were developed as part of the EU Projects Synapses and SynEx. A Web application to support the management of anticoagulation therapy was developed to interface to the EHR system, and deployed within a north London hospital with five years of cumulative clinical data from the previous existing anticoagulation management application. This offered the opportunity to critique those parts of the generic EHR that were actually needed to represent the legacy data.

RESULTS

The anticoagulation records from 3,226 patients were imported and represented using over 900,000 Record Components (i.e. each patient's record contained on average 289 nodes), of which around two thirds were Element Items (i.e. value-containing leaf nodes), the remainder being container nodes (i.e. headings and sub-headings). Each node is capable of incorporating a rich set of context properties, but in reality it was found that many properties were not used at all, and some infrequently (e.g. only around 0.5% of Record Components had ever been revised).

CONCLUSIONS

The process of developing generic EHR information models, arising from research and embodied within new-generation interoperability standards and specifications, has been strongly driven by requirements. These requirements have been gathered primarily by collecting use cases and examples from clinical communities, and been added to successive generations of these models. A priority setting approach has not to date been pursued - all requirements have been received and almost invariably met. This work has shown how little of the resulting model is actually needed to represent useful and usable clinical data. A wider range of such evaluations, looking at different kinds of existing clinical system, is needed to balance the theoretical requirements gathering processes, in order to result in EHR information models of an ideal level of complexity.

Down syndrome and the genes of human chromosome 21: current knowledge and future potentials. Report on the Expert workshop on the biology of chromosome 21 genes: towards gene-phenotype correlations in Down syndrome. Washington D.C., September 28-October 1, 2007

Down syndrome (DS), trisomy of human chromosome 21, is the most common genetic cause of intellectual disability. With an incidence in some countries as high as one in approximately 700 live births, and a complex, extensive and variably severe phenotype, Down syndrome is a significant medical and social challenge. In recent years, there has been a rapid increase in information on the functions of the genes of human chromosome 21, as well as in techniques and resources for their analysis. A recent workshop brought together experts on the molecular biology of Down syndrome and chromosome 21 with interested researchers in other fields to discuss advances and potentials for generating gene-phenotype correlations. An additional goal of the workshop was to work towards identification of targets for therapeutics that will correct features of DS. A knowledge-based approach to therapeutics also requires the correlation of chromosome 21 gene function with phenotypic features.

New protocol for leg ulcer tissue classification from colour images

Measurement of wound healing status is very important for monitoring progress in individual patients. Tissue classification is a vital step in the development of an automatic measurement system for wound healing assessment. We present a new tissue classification protocol using the RGB (Red, Green and Blue) histogram distributions of pixel values from wound color images. These three histogram distributions (extracted features) were used as three two-dimensional (2D) input signals for classification. This protocol has been carried out using the KNN classifier and results show that the proposed protocol provides an extremely competent practical method for the classification of wound tissues.

Possible compensatory events in adult Down syndrome brain prior to the development of Alzheimer disease neuropathology: targets for nonpharmacological intervention

Adults with Down syndrome (DS) develop Alzheimer disease (AD) pathology progressively with age but clinical signs of dementia are delayed by at least 10 years after the first signs of disease. Some individuals with DS do not develop dementia despite extensive AD neuropathology. Given the discordance between clinical decline and AD neuropathology, compensatory events may be of particular relevance for this group. Imaging studies using PET suggest compensatory increases in metabolic rate in vulnerable brain regions in DS prior to the development of dementia. Neurobiological studies of similarly aged DS autopsy cases provide further evidence of activation of plasticity mechanisms. Genes that are overexpressed in DS (APP, DSCAM, MNB/DYRK1A, and RCAN1) produce proteins critical for neuron and synapse growth, development and maintenance. We present the hypothesis that these genes may lead to developmental cognitive deficits but paradoxically with aging, may participate in molecular cascades supporting neuronal compensation. Enhancing or supporting compensatory mechanisms in aging individuals with DS may be beneficial as suggested by intervention studies in animal models. In combination, adults with DS may be a unique group of individuals well-suited for studies involving the manipulation or upregulation of compensatory responses as an approach to promote successful brain aging in the general population.