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PubMed1997

Strategies and tools for the control/elimination of lymphatic filariasis.

Lymphatic filariasis infects 120 million people in 73 countries worldwide and continues to be a worsening problem, especially in Africa and the Indian subcontinent. Elephantiasis, lymphoedema, and genital pathology afflict 44 million men, women and children; another 76 million have parasites in their blood and hidden internal damage to their lymphatic and renal systems. In the past, tools and strategies for the control of the condition were inadequate, but over the last 10 years dramatic research advances have led to new understanding about the severity and impact of the disease, new diagnostic and monitoring tools, and, most importantly, new treatment tools and control strategies. The new strategy aims both at transmission control through community-wide (mass) treatment programmes and at disease control through individual patient management. Annual single-dose co-administration of two drugs (ivermectin + diethylcarbamazine (DEC) or albendazole) reduces blood microfilariae by 99% for a full year; even a single dose of one drug (ivermectin or DEC) administered annually can result in 90% reductions; field studies confirm that such reduction of microfilarial loads and prevalence can interrupt transmission. New approaches to disease control, based on preventing bacterial superinfection, can now halt or even reverse the lymphoedema and elephantiasis sequelae of filarial infection. Recognizing these remarkable technical advances, the successes of recent control programmes, and the biological factors favouring elimination of this infection, the Fiftieth World Health Assembly recently called on WHO and its Member States to establish as a priority the global elimination of lymphatic filariasis as a public health problem.

Adult↗

PubMedDate not supplied

The role of databases in drug postmarketing surveillance.

This paper describes the role of databases used for postmarketing surveillance of drugs at the United States Food and Drug Administration (FDA). First we describe the Adverse Event Reporting System (AERS), the largest database of adverse event reports in the world. Next, we explain the methods we have used for assembling these adverse event reports into a case series and analysing them, as well as techniques for employing drug use databases to construct reporting rates in the evaluation of drug safety issues. Finally, we discuss the FDA's use of the databases it accesses through its Cooperative Agreement Program to conduct high priority studies to support regulatory decision-making.

Adverse Drug Reaction Reporting Systems↗

PubMedDate not supplied

Progress in the international protection of human rights.

Great progress has been made in the international protection of human rights since 10 December 1948 (when the United Nations General Assembly adopted the Universal Declaration of Human Rights). Amidst the doom and gloom of the media's reporting of current affairs, it is easy to overlook this progress. This article provides a definition of 'human rights' and examines early human rights campaigns. It then considers the areas of progress: human rights are now part of the international political vocabulary, there is a recognition that respect for human rights can assist a country's economic and social development, there has been a growth of human rights treaties and techniques and non-governmental organizations (NGOs) see protecting human rights as a major activity. State sovereignty has been eroded as national governments are being held accountable to the international community for their human rights policies. A new challenge is to ensure respect for human rights by non-state entities, such as transnational corporations. The growing culture of international protection of human rights is here to stay. This is not a reason for complacency, but it is a sign of hope.

History, 20th Century↗

PubMed1997

The need for comprehensive data on educational affiliations between academic health centers and managed care organizations.

Because of the emerging dominance of managed care, it is important to encourage the development of partnerships and affiliations between academic health centers (AHCs) and managed care organizations (MCOs) to train tomorrow's physicians to operate effectively in the new health care environment. But to what extent do such relationships exist now. In 1996, the authors sought to identify existing databases on the availability and extent of existing education partnerships and affiliations between AHCs and MCOs and the availability of such information to policymakers, the educational community, students, and residents. Despite a thorough search of the literature and interviews with representatives of education and practice organizations and with other experts in the medical education and managed care fields, the authors found no centralized or even partly centralized database on opportunities for training in managed care settings or on AHC-MCO partnerships. However, anecdotal evidence revealed eight such partnerships, each different from the others, that can serve as models for future partnerships; these are described. The authors speculate about why there are not more data describing AHC-MCO partnerships. They conclude by stating that the health care and health education industries have a variety of professional associations that could work together to assemble and make available such data to help build the educational and information infrastructure needed to train future physicians.

Academic Medical Centers↗

PubMed1995

[Promotion of mother-infant health: a comparative study of legislation of pregnancy protection].

OBJECTIVE: To describe the legislative measures aimed at protecting working women during pregnancy, which exist in France, Italy, the United Kingdom and Spain. DESIGN: The aspects studied were employment protection and modifications in work conditions for the pregnant woman. Existing Spanish legislation, the third Programme of Community Action for Equal Opportunities and some relevant scientific articles were reviewed. MEASUREMENTS AND MAIN RESULTS: Regarding protection of pregnant women from dismissal, legislation is more explicit in France and Italy, where protection covers the whole of the pregnancy, extending in France until 4 weeks after the end of the period off-work for the birth and in Italy until the child is one year old. Likewise, both in France and Italy, there is a long list of jobs which a pregnant woman is not allowed to do, with the possibility of a change of post if necessary. In Spain there is a Health at Work draft law, where measures relating to this question have been assembled. CONCLUSION: In general, the legislation referring to the protection of pregnant women at work is not widely known and leaves without protection those women in a more vulnerable work situation. Health professionals could support the equality and health of working women by informing them adequately of their rights.

Adolescent↗

PubMedDate not supplied

Risk and risk assessment in health emergency management.

This article considers the critical roles of risk and risk assessment in the management of health emergencies and disasters. The Task Force on Quality Control of Disaster Management (TFQCDM) has defined risk as the "objective (mathematical) or subjective (inductive) probability that something negative will occur (happen)". Risks with the greatest relevance to health emergency management include: (1) the probability that a health hazard exists or will occur; (2) the probability that the hazard will become an event; (3) the probability that the event will lead to health damage; and (4) the probability that the health damage will lead to a health disaster. The overall risk of a health disaster is the product of these four probabilities. Risk assessments are the tools that help systems at risk-healthcare organizations, communities, regions, states, and countries-transform their visceral reactions to threats into rational strategies for risk reduction. Type I errors in risk assessment occur when situations are predicted that do not occur (risk is overestimated). Type II errors in risk assessment occur when situations are not predicted that do occur (risk is underestimated). Both types of error may have serious, even lethal, consequences. Errors in risk assessment may be reduced through strategies that optimize risk assessment, including the: (1) adoption of the TFQCDM definition of risk and other terms; (2) specification of the system at risk and situations of interest (hazard, event, damage, and health disaster); (3) adoption of a best practice approach to risk assessment methodology; (4) assembly of the requisite range of expert participants and information; (5) adoption of an evidence-based approach to using information; (6) exclusion of biased, irrelevant, and obsolete information; and (7) complete characterizations of any underlying fault and event trees.

Disaster Planning↗

PubMed2026

Divergent avian strains drive an off-season influenza A peak in municipal wastewater.

Wastewater sequencing is an increasingly valuable tool in tracking the spread of infectious disease agents across space and time in areas of dense human settlement. Among pathogens that can be readily detected by this approach is influenza A, which follows predictable patterns of prevalence through the winter months in North America. Here, we leverage routine surveillance of a municipal wastewater treatment plant in Northern California to describe an atypical, off-season spike in influenza A concentrations that rivals that of the winter respiratory virus season. Drawing upon metagenomic data generated through hybrid-capture sequencing, we assemble and subsequently characterize fragments of divergent influenza genomes that appear to derive predominantly from the avian H16 clade. These strains exhibit close evolutionary relationships to influenza isolated from migratory shorebirds, hinting at potential host species and mechanisms of geographic spread. Analysis of read abundances suggests that these avian strains dominate the pool of influenza circulating during the summer months, when typical human-infecting strains are essentially absent. Together, our results expand the value of wastewater sequencing to encompass sensitive tracking of outbreaks within animals in interface regions where human settlement abuts wildlands, increasing overall pandemic preparedness.IMPORTANCEResearchers now commonly search municipal wastewater for viral genetic material, which can indicate trends in the diversity and abundance of strains circulating in communities. Here, we show that under certain conditions, municipal wastewater can also capture the signatures of viruses circulating among animal populations, such as birds. Specifically, we draw on a targeted form of nucleic acid sequencing to discover a strain of influenza that is fairly genetically distinct from known relatives and may be circulating among shorebirds in Northern California. These findings both broaden the possible use cases of wastewater sequencing and provide new insights into avian viruses, some of which can jump host species to make other animals or people sick.

hybrid-capture sequencing↗

PubMed2024

Metagenomic insights and biosynthetic potential of Candidatus Entotheonella symbiont associated with Halichondria marine sponges.

Korea, being surrounded by the sea, provides a rich habitat for marine sponges, which have been a prolific source of bioactive natural products. Although a diverse array of structurally novel natural products has been isolated from Korean marine sponges, their biosynthetic origins remain largely unknown. To explore the biosynthetic potential of Korean marine sponges, we conducted metagenomic analyses of sponges inhabiting the East Sea of Korea. This analysis revealed a symbiotic association of Candidatus Entotheonella bacteria with Halichondria sponges. Here, we report a new chemically rich Entotheonella variant, which we named Ca. Entotheonella halido. Remarkably, this symbiont makes up 69% of the microbial community in the sponge Halichondira dokdoensis. Genome-resolved metagenomics enabled us to obtain a high-quality Ca. E. halido genome, which represents the largest (12 Mb) and highest quality among previously reported Entotheonella genomes. We also identified the biosynthetic gene cluster (BGC) of the known sponge-derived Halicylindramides from the Ca. E. halido genome, enabling us to determine their biosynthetic origin. This new symbiotic association expands the host diversity and biosynthetic potential of metabolically talented bacterial genus Ca. Entotheonella symbionts.IMPORTANCEOur study reports the discovery of a new bacterial symbiont Ca. Entotheonella halido associated with the Korean marine sponge Halichondria dokdoensis. Using genome-resolved metagenomics, we recovered a high-quality Ca. E. halido MAG (Metagenome-Assembled Genome), which represents the largest and most complete Ca. Entotheonella MAG reported to date. Pangenome and BGC network analyses revealed a remarkably high BGC diversity within the Ca. Entotheonella pangenome, with almost no overlapping BGCs between different MAGs. The cryptic and genetically unique BGCs present in the Ca. Entotheonella pangenome represents a promising source of new bioactive natural products.

Animals↗

PubMed1980

[International efforts in the field of drug safety].

The competence of the World Health Organization in the area of safety of pharmaceutical products is based on its constitution and on several resolutions of the World Health Assembly. Evaluation of the safety of pharmaceutical products is one of the major concerns of WHO together with other research activities in the socioeconomic field. The following programmes, amongst others, make up this activity: international drug monitoring, exchange of information on decisions of withdrawal or changes in drug use and on marketing of new products, commented information on problems of international interest, exchange of information on registration systems and control of drug marketing in different countries. Several systems of communication exist between WHO and Member States, but of these the Drug Information Bulletin is the most important. In the future, WHO may provide an independent forum for the discussion of topics relating to drug safety which are of interest to the International community.

Drug Evaluation↗

PubMed2006

AgBase: a functional genomics resource for agriculture.

BACKGROUND: Many agricultural species and their pathogens have sequenced genomes and more are in progress. Agricultural species provide food, fiber, xenotransplant tissues, biopharmaceuticals and biomedical models. Moreover, many agricultural microorganisms are human zoonoses. However, systems biology from functional genomics data is hindered in agricultural species because agricultural genome sequences have relatively poor structural and functional annotation and agricultural research communities are smaller with limited funding compared to many model organism communities. DESCRIPTION: To facilitate systems biology in these traditionally agricultural species we have established "AgBase", a curated, web-accessible, public resource http://www.agbase.msstate.edu for structural and functional annotation of agricultural genomes. The AgBase database includes a suite of computational tools to use GO annotations. We use standardized nomenclature following the Human Genome Organization Gene Nomenclature guidelines and are currently functionally annotating chicken, cow and sheep gene products using the Gene Ontology (GO). The computational tools we have developed accept and batch process data derived from different public databases (with different accession codes), return all existing GO annotations, provide a list of products without GO annotation, identify potential orthologs, model functional genomics data using GO and assist proteomics analysis of ESTs and EST assemblies. Our journal database helps prevent redundant manual GO curation. We encourage and publicly acknowledge GO annotations from researchers and provide a service for researchers interested in GO and analysis of functional genomics data. CONCLUSION: The AgBase database is the first database dedicated to functional genomics and systems biology analysis for agriculturally important species and their pathogens. We use experimental data to improve structural annotation of genomes and to functionally characterize gene products. AgBase is also directly relevant for researchers in fields as diverse as agricultural production, cancer biology, biopharmaceuticals, human health and evolutionary biology. Moreover, the experimental methods and bioinformatics tools we provide are widely applicable to many other species including model organisms.

Agriculture↗

PubMed2006

Biotic habitat complexity controls species diversity and nutrient effects on net biomass production.

Canopy-forming plants and algae commonly contribute to spatial variation in habitat complexity for associated organisms and thereby create a biotic patchiness of communities. In this study, we tested for interaction effects between biotic habitat complexity and resource availability on net biomass production and species diversity of understory macroalgae by factorial field manipulations of light, nutrients, and algal canopy cover in a subtidal rocky-shore community. Presence of algal canopy cover and/or artificial shadings limited net biomass production and facilitated species diversity. Artificial shadings reduced light to levels similar to those under canopy cover, and net biomass production was significantly and positively correlated to light availability. Considering the comparable and dependent experimental effects from shadings and canopy cover, the results strongly suggest that canopy cover controlled net biomass production and species diversity by limiting light and thereby limiting resource availability for community production. Canopy cover also controlled experimental nutrient effects by preventing a significant increase in net biomass production from nutrient enrichment recorded in ambient light (no shading). Changes in species diversity were mediated by changes in species dominance patterns and species evenness, where canopy cover and shadings facilitated slow-growing crust-forming species and suppressed spatial dominance by Fucus vesiculosus, which was the main contributor to net production of algal biomass. The demonstrated impacts of biotic habitat complexity on biomass production and local diversity contribute significantly to understanding the importance of functionally important species and biodiversity for ecosystem processes. In particular, this study demonstrates how loss of a dominant species and decreased habitat complexity change the response of the remaining assembly to resource loading. This is of potential significance for marine conservation since resource loading often promotes low habitat complexity and canopy species are among the first groups lost in degraded aquatic systems.

Analysis of Variance↗

PubMed2026

Experimental insights in taxon-specific functional responses to droughts in glacier-fed stream biofilms.

BACKGROUND: Glacier-fed streams are predicted to face increasingly frequent and intense droughts. However, the impacts of drought events on benthic biofilm, including bacteria, eukaryotes, and viruses, the dominating life form in glacier-fed streams, remain poorly understood. RESULTS: Using streamside flume mesocosms in the Swiss Alps, we grew glacier-fed stream biofilms over 103 days and exposed them to three droughts. Using a multi-omics approach (metagenomics, metatranscriptomics, and metaproteomics), we assessed the effects of a series of droughts on the taxonomy and metabolic activity of bacterial, eukaryotic, and viral metagenome-assembled genomes (MAGs). We found that the first drought (6 h) caused only minor changes, including mild upregulation of heterotrophic metabolism and signs of stress in diatoms. In contrast, the second drought (24 h) significantly altered both the composition and functionality of the microbiome, shifting phototrophic dominance from diatoms to Cyanobacteriota, while maintaining overall phototropic biomass and further upregulating the heterotrophic metabolism. Interestingly, a third 24 h drought had no detectable transcriptomic effect between pre- and post-drought conditions, suggesting a certain level of adaptive responses to droughts, but with the low diatom abundance being maintained. CONCLUSIONS: These findings indicate that glacier-fed biofilm microorganisms initially resisted short-term drought, but a second longer drought caused important shifts in their community structure, activity, and function. Climate-induced increases in drought frequency or duration may therefore have a lasting impact on microbial ecosystem functioning in glacier-fed streams. Video Abstract.

Biofilms↗

PubMed2026

Metagenome-resolved evidence that soluble factors in granular activated carbon-amended reactor effluent reprogram propionate metabolism and methanogenic pathways.

Granular activated carbon (GAC) enhances anaerobic digestion performance, yet the mechanisms underlying reactor-scale improvements remain incompletely understood, particularly how GAC affects biomass not attached to its surface. Here, sludge from a non-GAC up-flow anaerobic sludge blanket reactor was incubated with 0.45-μm-filtered effluents from non-GAC and GAC-amended reactors under repeated propionate loading, followed by genome-resolved metagenomics. GAC-reactor effluent increased methane yield from 64 ± 3% to 76 ± 3% (p < 0.01) in the absence of GAC particles. A non-redundant catalog of 170 quality-filtered metagenome-assembled genomes (MAGs) was recovered, enabling pathway- and gene-set quantification. Genomic potential for both major propionate-oxidation routes increased in the GAC-effluent group relative to the non-GAC group, with a larger increase for the methylmalonyl-CoA (MMC) route than for the dismutation route (1.289- versus 1.221-fold). Accordingly, the MMC-to-dismutation preference ratio was 5.60% higher in the GAC-effluent group, alongside a broader carrier base. Cobamide potential shifted toward remodeling and cobamide-dependent use rather than increased de novo corrin-ring synthesis. Candidate electron-transfer architectures were also rebalanced: PilA-associated carriers became less prominent, whereas maturation-supported multiheme cytochrome carriers increased from 22.96% to 34.90% of community abundance, although H2/formate-module carriers remained prevalent. Quorum-sensing systems underwent pathway- and carrier-specific redistribution, while all eight curated extracellular-polysaccharide modules showed higher mean gene abundance in the GAC-effluent composite. These findings show that a filter-passing effluent fraction can extend GAC-associated effects beyond direct particle contact and link enhanced methanogenesis to a broader, redistributed network of metabolic, redox, and coordination capacities. This expands the mechanistic framework of conductive-material-assisted anaerobic digestion and provides a basis for harnessing GAC-derived functions throughout the reactor.

Extracellular polymeric substances (EPS)↗

PubMed2002

Verification of temporal scheduling constraints in clinical practice guidelines.

The computerization of clinical practice guidelines is a significant scientific challenge for the medical informatics community. One frequently reported factor hindering this objective is the existence of deficiencies within guideline knowledge. In this paper, we focus on the detection of flaws within temporal scheduling constraints. Temporal scheduling constraints are important elements of therapy management, and are frequently incorporated in clinical practice guidelines. We present a suitable verification method that is based on calculating the minimal network of temporal constraints on the execution of guideline activities. Our method serves three purposes: (1) it checks whether temporal scheduling constraints are consistent with scheduling constraints implied by control flow operators and the hierarchical structuring of a guideline; (2) it yields suggestions for an equivalent, yet more explicit representation of non-minimal constraints; (3) it can be used by the guideline interpreter to assemble feasible time intervals for the execution of each guideline activity. We evaluate our approach by applying it to a guideline specified in the Asbru language. For this purpose, we implemented a prototype verifier. Although we concentrate on the guideline representation language Asbru as the demonstration medium of our method within this paper, our approach can be reused to verify several alternative guideline representation formats.

Humans↗

PubMed1995

Assessment of effect levels of chemicals from quantitative structure-activity relationship (QSAR) models. I. Chronic lowest-observed-adverse-effect level (LOAEL).

With the multitude of new chemicals being synthesized and the paucity of long-term test data on chemicals that could be introduced into the environment, innovative approaches must be developed to determine the health and environmental effects of chemicals. Research was conducted to employ quantitative structure-activity relationship (QSAR) techniques to study the feasibility of developing models to estimate the noncarcinogenic toxicity of chemicals that are not addressed in the literature by relevant studies. A database of lowest-observed-adverse effect level (LOAEL) was assembled by extracting toxicity information from 104 U.S. EPA documents, 124 National Cancer Institute/National Toxicology Program (NCI/NTP) reports, and 6 current reports from the literature. A regression model, based on 234 chemicals of diverse structures and chemical classes including both alicyclic and aromatic compounds, was developed to assess the chronic oral LOAELs in rats. The model was incorporated into an automated computer package. Initial testing of this model indicates it has application to a wide range of chemicals. For about 55% of the compounds in the data set, the estimated LOAELs are within a factor of 2 of the observed LOAELs. For over 93%, they are within a factor of 5. Because of the paucity or absence of long-term toxicity data, the public health and risk assessment community could utilize such QSAR models to determine initial estimates of toxicity for the ever-increasing numbers of chemicals that lack complete pertinent data. However, this and other such models should be used only by expert toxicologists who must objectively look at the estimates thus generated in light of the overall weight of evidence of the available toxicologic information of the subject chemical(s).

Algorithms↗

PubMed2006

Advancing the agenda for home healthcare quality: conference proceedings and findings.

On March 31 to April 1, 2005, the Center for Home Care Policy and Research of the Visiting Nurse Service of New York assembled approximately 80 home healthcare stakeholders from across the country to advance the action strategy for measuring, improving, and assuring quality in home healthcare. A specific aim of the conference was to disseminate relevant research on organizational change and evidence-based practices to influence patient safety and quality of care. Attendees worked together to identify high-priority action steps and recommendations at both the organizational and policy levels. This article reports the conference's proceedings and findings.

Community Health Nursing↗

PubMed2006

A TinyOS-enabled MICA2-based wireless neural interface.

Existing approaches used to develop compact low-power multichannel wireless neural recording systems range from creating custom-integrated circuits to assembling commercial-off-the-shelf (COTS) PC-based components. Custom-integrated-circuit designs yield extremely compact and low-power devices at the expense of high development and upgrade costs and turn-around times, while assembling COTS-PC-technology yields high performance at the expense of large system size and increased power consumption. To achieve a balance between implementing an ultra-compact custom-fabricated neural transceiver and assembling COTS-PC-technology, an overlay of a neural interface upon the TinyOS-based MICA2 platform is described. The system amplifies, digitally encodes, and transmits neural signals real-time at a rate of 9.6 kbps, while consuming less than 66 mW of power. The neural signals are received and forwarded to a client PC over a serial connection. This data rate can be divided for recording on up to 6 channels, with a resolution of 8 bits/sample. This work demonstrates the strengths and limitations of the TinyOS-based sensor technology as a foundation for chronic remote biological monitoring applications and, thus, provides an opportunity to create a system that can leverage from the frequent networking and communications advancements being made by the global TinyOS-development community.

Amplifiers, Electronic↗

PubMed2026

Minimizing decompression and warming during deep seawater collection increases abundance and activity of autochthonous bacteria and archaea.

The deep ocean hosts autochthonous pressure-adapted microorganisms that are unique to this environment, as well as allochthonous pressure-sensitive members transported from shallow depths by vertical advection and particle-sinking. However, conventional sampling instruments decompress and warm deep-sea samples during retrieval, potentially altering microbial properties when studied ex situ. Here, we assess this potential sampling bias by comparing seawater microbial communities collected with or without measures aimed at minimizing pressure and temperature effects. When compared to samples collected under pressurized conditions, conventional sampling (using Niskin bottles) was found to affect prokaryotic cells retrieved by reducing their total numbers, diminishing protein synthesis activity (>10%), and also causing overall shifts in the community composition. The most significant compositional change was a >20% decrease in metagenomic archaeal representation (TACK-group/Thaumarchaeota/Nitrososphaerota). Deep-sea bacterial groups had mixed responses to preserving pressure during retrieval, with some groups exhibiting higher representation when samples were maintained pressurized (e.g. members of the family Pelagibacteraceae, unclassified Thiotricales, Thioglobaceae, and Chitinophagaceae), whereas others increased their representation when decompressed (e.g. Burkholderiaceae, Comamonadaceae, and Oxalobacteraceae). This study reveals the existence of bias introduced by the complete decompression of samples retrieved with traditional instrumentation, as well as a decrease in overall bacterial activity when samples are completely decompressed during retrieval. Additionally, incubations lasting for >24 h were shown to transform the original prokaryotic community composition. Precautions addressing these effects are necessary to enhance the reliability of ex situ measurements and improve our understanding of deep-sea microbial ecology and biogeochemistry.

Seawater↗