Biosecurity indemnification and attitudes of United States swine producers towards the prevention of an african swine fever outbreak.

Animal disease outbreaks, such as the recent outbreak of African Swine Fever in 2018, are a major concern for stakeholders across the food supply chain due to their potential to disrupt global food security, cause economic losses, and threaten animal welfare. As a result of their transboundary nature, discussions have shifted to preventive measures aimed at protecting livestock while ensuring food security and safety. Emergency assistance has been a critical response option during pandemics. However, this may not be sustainable in the long run because the expectation of government bailout may encourage risk taking behaviours. Our hypothesis is that an indemnity policy that is conditioned on showing biosecurity practices would increase compliance and reduce government expenditure during disease outbreaks. We developed and launched a survey from March to July 2022 targeted at swine producers across the US. From the survey, we examined livestock farmers' attitudes and intentions regarding biosecurity investment and assessed their attitudes towards the purchase of livestock insurance and reporting suspected infected livestock on their farm. We used a partial proportion odds model analysis to examine the model. Our analysis revealed that intention to call a veterinarian, trust in government agencies and risk perception of farmers were instrumental in the willingness to self-invest in biosecurity, purchase livestock insurance, and promptly report infected livestock on their farms. This provides evidence that biosecurity compliance would increase if indemnification was tied to a demonstration of effort to adopt biosecurity practices. We also show that individuals who have been in the industry for a longer period may become complacent and less likely to report outbreaks. Farmers with a higher share of income from their production operations bear a greater risk from their operational income and are more willing to report any suspected infections on their farms. The data suggest that motivating the willingness of farmers to invest in biosecurity while overcoming cost concerns is achievable.

Serologic Survey of Selected Arthropod-Borne Pathogens in Free-Ranging Snowshoe Hares (Lepus americanus) Captured in Northern Michigan, USA.

Snowshoe hares (Lepus americanus) in the Upper Peninsula (UP) of Michigan, USA, occupy the southern periphery of the species' range and are vulnerable to climate change. In the eastern UP, hares are isolated by the Great Lakes, potentially exacerbating exposure to climate-change-induced habitat alterations. Climate change is also measurably affecting distribution and prevalence of vector-borne pathogens in North America, and increases in disease occurrence and prevalence can be one signal of climate-stressed wildlife populations. We conducted a serosurvey for vector-borne pathogens in snowshoe hares that were captured in the Hiawatha National Forest in the eastern UP of Michigan, USA, 2016-2017. The most commonly detected antibody response was to the mosquito-borne California serogroup snowshoe hare virus (SSHV). Overall, 24 (51%) hares screened positive for SSHV antibodies and of these, 23 (96%) were confirmed positive by plaque reduction neutralization test. We found a positive association between seroprevalence of SSHV and live weight of snowshoe hares. Additionally, we detected a significant effect of ecological land type group on seroprevalence of SSHV, with strong positive support for a group representing areas that tend to support high numbers of hares (i.e., acidic mineral containing soils with cedar, mixed swamp conifers, tamarack and balsam fir as common overstory vegetation). We also detected and confirmed antibodies for Jamestown Canyon virus and Silverwater virus in a single hare each. We did not detect antibodies to other zoonotic vector-borne pathogens, including Lacrosse encephalitis virus, West Nile virus, Borrelia burgdorferi, Powassan virus, and Francisella tularensis. These results provide a baseline for future serological studies of vector-transmitted diseases that may increase climate vulnerability of snowshoe hares in the UP of Michigan, as well as pose a climate-related zoonotic risk.

Hashtags in Plastic Surgery: A Sentiment Analysis of over 1 Million Tweets.

BACKGROUND: Current literature has sparse recommendations that guide social networking practices in plastic surgery. To address this, we used natural language processing and sentiment analysis to investigate the differences in plastic surgery-related terms and hashtags on Twitter. METHODS: Over 1 million tweets containing keywords #plasticsurgery, #cosmeticsurgery, and their non-hashtagged versions plastic surgery and cosmetic surgery were collected from the Twitter Gardenhose feed spanning from 2012 to 2016. We extracted the average happiness/positivity (h-avg) using hedonometrics and created word-shift graphs to determine influential words. RESULTS: The most popular keywords were plastic and cosmetic surgery, comprising more than 90% of the sample. The positivity scores for plastic surgery, cosmetic surgery, #plasticsurgery, and #cosmeticsurgery were 5.72, 6.00, 6.17, and 6.18, respectively. Compared to plastic surgery, the term cosmetic surgery was more positive because it lacked antagonistic words, such as "fake," "ugly," "bad," "fails," and "wrong." For similar reasons, #plasticsurgery and #cosmeticsurgery were more positively associated than their non-hashtagged counterparts. CONCLUSION: Plastic surgery-related hashtags are more positively associated than their non-hashtagged versions. The language associated with such hashtags suggests a different user profile than the public and, given their underutilization, remain viable channels for professionals to achieve their diverse social media goals. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effects of message delivery on cross-cultural biosecurity compliance: Insights from experimental simulations.

Background: Effective biosecurity communication of transmission risks and associated protective behaviors can reduce the impacts of infectious diseases in US animal agriculture. Yet, more than 1/5 of animal production workers speak a language other than English at home, and more than 40 percent are less than fluent in English. Communicating with these workers often involves translating into their primary languages. However, communication strategies targeting different cultural groups are not well-understood. Aims: To identify cross-linguistic risk communication strategies to facilitate compliance, we hypothesized that uncertainty avoidance cultures associated with the languages might affect biosecurity compliance contingent upon two additional covariates: (1) the risk of acquiring an infection and (2) the delivery method of the infection risk. Methods: We designed an experimental game simulating a line of separation (LOS) biosecurity tactic in a swine production facility, where participants were tasked with completing tasks inside and outside of the facility. Data were collected using games in the two most spoken languages in the US: English (EN) and Spanish (SP). Participants made binary decisions about whether to use the LOS biosecurity tactic based on the risk information provided. Mixed-effect logistic models were used to test the effects of covariates on using the LOS tactic by different language groups. Results: We found that biosecurity compliance rates of participants who took the experiments in the language associated with high and low uncertainty cultures showed no significant differences. However, there are substantial differences in how risk information is perceived between the two language groups under different infection risks. Specifically, and counterintuitively, SP participants were more risk-averse in gain scenarios but more risk-taking in loss scenarios. These differences are most pronounced in numeric risk messaging, indicating that numbers may not be the best way to communicate risk information regarding biosecurity cross-culturally. Conclusions: When confronted with situational biosecurity decisions, risk perception and preferences vary by language group. Effective biosecurity communication needs to account for these differences and not assume that direct translation of risk messages will result in comparable compliance.

Assessing strategic, tactical, and operational decision-making and risk in a livestock production chain through experimental simulation platforms.

This paper provides a research summary of a series of serious games and simulations that form the basis of an experimental platform for the study of human decision-making and behavior associated with biosecurity across complex livestock production chains. This platform is the first of its kind to address the challenges associated with scaling micro-behavior of biosecurity decision-making to macro-patterns of disease spread across strategic, tactical and operational levels, capturing the roles that facility managers and front-line workers play in making biosecurity decisions under risk and uncertainty. Informational and incentive treatments are tested within each game and simulation. Behavioral theories are used to explain these findings. Results from serious games in the form of behavioral probability distributions are then used to simulate disease incidence and spread across a complex production chain, demonstrating how micro-level behaviors contribute to larger macro-level patterns. In the case of this study, the propensity to adopt micro-level biosecurity practices are applied to a network percolation disease spread model. By presenting the suite of companion models of behavior and disease spread we are able to capture scaling dynamics of complex systems, and in the process, better understand how individual behaviors impact whole systems.

Comparing behavioral risk assessment strategies for quantifying biosecurity compliance to mitigate animal disease spread.

Understanding the impact of human behavior on the spread of disease is critical in mitigating outbreak severity. We designed an experimental game that emulated worker decision-making in a swine facility during an outbreak. In order to combat contamination, the simulation features a line-of-separation biosecurity protocol. Participants are provided disease severity information and can choose whether or not to comply with a shower protocol. Each simulated decision carried the potential for either an economic cost or an opportunity cost, both of which affected their potential real-world earnings. Participants must weigh the risk infection vs. an opportunity cost associated with compliance. Participants then completed a multiple price list (MPL) risk assessment survey. The survey uses a context-free, paired-lottery approach in which one of two options may be selected, with varying probabilities of a high and low risk payouts. We compared game response data to MPL risk assessment. Game risk was calculated using the normalized frequency of biosecurity compliance. Three predominant strategies were identified: risk averse participants who had the highest rate of compliance; risk tolerant participants who had the lowest compliance rate; and opportunists who adapted their strategy depending on disease risk. These findings were compared to the proportion of risk averse choices observed within the MPL and were classified into 3 categories: risk averse, risk tolerant and neutral. We found weak positive correlation between risk measured in our experimental game compared to the MPL. However, risk averse classified participants in the MPL tended to comply with the biosecurity protocol more often than those classified as risk tolerant. We also found that the behavioral risk clusters and categorization via the MPL were significantly, yet weakly associated. Overall, behavioral distributions were skewed toward more risk averse choices in both the MPL and game. However, the MPL risk assessment wasn't a strong predictor for observed game behavior. This may indicate that MPL risk aversion metrics might not be sufficient to capture these simulated, situational risk aversion behaviors. Experimental games have a large potential for expanding upon traditional survey instruments by immersing participants in a complex decision mechanism, and capturing dynamic and evolving behavioral signals.

Flow impacts of hot/cold zone infection control procedures during the COVID-19 pandemic in the emergency department.

BACKGROUND: The COVID-19 pandemic forced emergency departments (EDs) to change operations to minimize nosocomial infection risk. Many EDs cohort patients using provincial screening tools at triage. Despite cohorting, staff exposures occurred in the 'cold zone' due to lack of personal protective equipment (PPE) use with patients deemed low risk, resulting in staff quarantines. The cohorting strategy was perceived to lengthen time to physician initial assessment and ED length of stay times in our ED without protecting staff well enough due to varying PPE use. The objective of this study was to assess the impact of hot/cold zones for patient cohorting during a viral pandemic on ED length of stay. METHODS: We conducted an interrupted time series analysis 3 weeks before and after the removal of hot/cold zone care space cohorting in our ED. In the before period, staff did not routinely wear full PPE to see cold zone patients. After removal, staff wore full PPE to see almost all patients. We collected data on ED length of stay, physician initial assessment times, arrival-to-room times, patient volumes, Canadian Triage Acuity Score (CTAS), admissions, staff hours of coverage, as well as proportions of patients on droplet/contact precautions and COVD-19 positive patients. The primary outcome was median ED length of stay. RESULTS: After the removal of the hot/cold divisions, there was a decrease in the adjusted median ED length of stay by 24 min (95% CI 14; 33). PPE use increased in the after arm of the study. The interrupted time series analysis suggested a decrease in median ED length of stay after removal, although the change in slope and difference did not reach statistical significance. CONCLUSION: Cohorted waiting areas may provide a safety benefit without operational compromise, but cohorting staff and care spaces is likely to compromise efficiency and create delays.

RéSUMé: CONTEXTE: La pandémie de COVID-19 a contraint les services d'urgence (SU) à modifier leur fonctionnement afin de minimiser le risque d'infection nosocomiale. De nombreux SU regroupaient des patients à l'aide d'outils de dépistage provinciaux au triage. Malgré la constitution de cohortes, les expositions du personnel se sont produites dans la "zone froide" en raison du manque d'utilisation d'équipements de protection individuelle (EPI) avec des patients jugés à faible risque, ce qui a entraîné la mise en quarantaine du personnel. Dans notre service d'urgence, la stratégie de cohorte a été perçue comme prolongeant l'évaluation initiale des médecins et la durée du séjour dans le service sans pour autant protéger suffisamment le personnel en raison de l'utilisation variable des EPI. L'objectif de cette étude était d'évaluer l'impact des zones chaudes/froides pour le regroupement de patients lors d'une pandémie virale sur la durée du séjour à l'urgence. MéTHODES: Nous avons réalisé une analyse de séries chronologiques interrompues trois semaines avant et après la suppression de la cohorte d'espace de soins en zone chaude/froide dans nos urgences. Au cours de la période précédente, le personnel ne portait pas systématiquement un EPI complet pour voir les patients des zones froides. Après le retrait, le personnel a porté un EPI complet pour voir presque tous les patients. Nous avons recueilli des données sur la durée du séjour aux urgences, les délais d'évaluation initiale par les médecins, les délais d'arrivée en salle, le volume de patients, L'échelle canadienne de triage et de gravité (ÉTG), les admissions, les heures de couverture du personnel, ainsi que les proportions de patients ayant reçu des précautions contre les gouttelettes et les contacts et de patients positifs au COVD-19. Le critère de jugement principal était la durée médiane du séjour aux urgences. RéSULTATS: Après la suppression des divisions chaudes/froides, la durée médiane ajustée du séjour aux urgences a diminué de 24 minutes (IC à 95 % : 14 ; 33). L'utilisation des EPI a augmenté dans le groupe suivant de l'étude. L'analyse des séries chronologiques interrompues suggère une diminution de la durée médiane de séjour aux urgences après le retrait, bien que le changement de la pente et de la différence n'ait pas atteint la signification statistique. CONCLUSION: Les zones d'attente en cohorte peuvent offrir un avantage en matière de sécurité sans compromis sur le plan opérationnel, mais le regroupement du personnel et des espaces de soins est susceptible de compromettre l'efficacité et de créer des retards.

The Adverse Event Unit (AEU): A novel metric to measure the burden of treatment adverse events.

OBJECTIVE: To design a physician and patient derived tool, the Adverse Event Unit (AEU), akin to currency (e.g. U.S. Dollar), to improve AE burden measurement independent of any particular disease or medication class. PATIENTS/METHODS: A Research Electronic Data Capture (REDCap) online survey was administered to United States physicians with board certification or board eligibility in general neurology, subspecialty neurology, primary care internal medicine or family medicine, subspecialty internal medicine, general pediatrics, and subspecialty pediatrics. Physicians assigned value to 73 AE categories chosen from the Common Terminology Criteria of Adverse Events (CTCAE) relevant to neurologic disorder treatments. An online forced choice survey was administered to non-physician, potential patients, through Amazon Mechanical Turk (MTurK) to weight the severity of the same AE categories. Physician and non-physician data was combined to assign value to the AEU. Surveys completed between 1/2017 and 3/2019. RESULTS: 363 physicians rated the 73 AE categories derived from CTCAE. 660 non-physicians completed forced choice experiments comparing AEs. The AEU provides 0-10, weighted values for the AE categories studied that differ from the ordinal 1-4 CTCAE scale. For example, CTCAE severe diabetes (category 4) is assigned an AEU score of 9. Although non-physician input changed physician assigned AEU values, there was general agreement among physicians and non-physicians about severity of AEs. CONCLUSION: The AEU has promise to be a useful, practical tool to add precision to AE burden measurement in the clinic and in comparative efficacy research with neurology patients. AEU utility will be assessed in planned comparative efficacy clinical trials.

Implementation of the Abbott ID Now COVID-19 assay at a tertiary care center: a prospective pragmatic implementation study during the third wave of SARS-CoV-2 in Ontario.

The Abbott ID Now COVID-19 assay is a point-of-care molecular diagnostic tool for the detection of SARS-CoV-2. We prospectively monitored implementation of the assay in a tertiary care hospital emergency department (ED) for the diagnosis of early symptomatic patients. A total of 269 paired nasopharyngeal swabs were tested in parallel with the ID Now and laboratory-based molecular methodologies, 191 of which met selection criteria for testing based on symptoms description and duration. Forty-six and 48 samples were positive for SARS-CoV-2 with the ID Now and reference molecular assays respectively. Percent positive and negative agreement were high (93.8% and 99.6% respectively), as were the sensitivity and specificity (93.8% and 99.5%). ID Now results were available 17.47 hours earlier than qRT-PCR. In symptomatic patients seen in ED within 7 to 10 days of symptoms onset, the ID Now COVID-19 assay allows for rapid and accurate detection of infection.

Connecting livestock disease dynamics to human learning and biosecurity decisions.

The acceleration of animal disease spread worldwide due to increased animal, feed, and human movement has driven a growing body of epidemiological research as well as a deeper interest in human behavioral studies aimed at understanding their interconnectedness. Biosecurity measures can reduce the risk of infection, but human risk tolerance can hinder biosecurity investments and compliance. Humans may learn from hardship and become more risk averse, but sometimes they instead become more risk tolerant because they forget negative experiences happened in the past or because they come to believe they are immune. We represent the complexity of the hog production system with disease threats, human decision making, and human risk attitude using an agent-based model. Our objective is to explore the role of risk tolerant behaviors and the consequences of delayed biosecurity investments. We set up experiment with Monte Carlo simulations of scenarios designed with different risk tolerance amongst the swine producers and we derive distributions and trends of biosecurity and porcine epidemic diarrhea virus (PEDv) incidence emerging in the system. The output data allowed us to examine interactions between modes of risk tolerance and timings of biosecurity response discussing consequences for disease protection in the production system. The results show that hasty and delayed biosecurity responses or slow shifts toward a biosecure culture do not guarantee control of contamination when the disease has already spread in the system. In an effort to support effective disease prevention, our model results can inform policy making to move toward more resilient and healthy production systems. The modeled dynamics of risk attitude have also the potential to improve communication strategies for nudging and establishing risk averse behaviors thereby equipping the production system in case of foreign disease incursions.

A Multi-Site Analysis of the Prevalence of Food Insecurity in the United States, before and during the COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support and identify long-term impacts and needs. OBJECTIVE: The National Food Access and COVID research Team (NFACT) was formed to assess food security over different US study sites throughout the pandemic, using common instruments and measurements. This study presents results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. METHODS: A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA 6-item module. Food security prevalence was analyzed using ANOVA by sampling method to assess statistically significant differences. RESULTS: Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, compared with before the pandemic. In nearly all study sites, there is a higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but a statistically higher prevalence of food insecurity among high-risk compared with convenience surveys. CONCLUSIONS: This comprehensive study demonstrates a higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to the survey implementation method.

Nuclear dynamics and stress responses in Alzheimer's disease.

In response to extracellular and intracellular stressors, the nucleus and nuclear compartments undergo distinct molecular changes to maintain cell homeostasis. In the context of Alzheimer's disease, misfolded proteins and various cellular stressors lead to profound structural and molecular changes at the nucleus. This review summarizes recent research on nuclear alterations in AD development, from the nuclear envelope changes to chromatin and epigenetic regulation and then to common nuclear stress responses. Finally, we provide our thoughts on the importance of understanding cell-type-specific changes and identifying upstream causal events in AD pathogenesis and highlight novel sequencing and gene perturbation technologies to address those challenges.

Message Delivery Strategy Influences Willingness to Comply With Biosecurity.

As the Covid-19 pandemic continues worldwide, it has become increasingly clear that effective communication of disease transmission risks associated with protective behaviors is essential, and that communication tactics are not ubiquitously and homogenously understood. Analogous to Covid-19, communicable diseases in the hog industry result in millions of animal deaths and in the United States costs hundreds of millions of dollars annually. Protective behaviors such as preventative biosecurity practices are implemented to reduce these costs. Yet even with the knowledge of the importance of biosecurity, these practices are not employed consistently. The efficacy of biosecurity practices relies on consistent implementation and is influenced by a variety of behavioral factors under the umbrella of human decision-making. Using an experimental game, we collected data to quantify how different messages that described the likelihood of a disease incursion would influence willingness to follow biosecurity practices. Here we show that graphical messages combined with linguistic phrases demarking infection risk levels are more effective for ensuring compliance with biosecurity practices, as contrasted with either simple linguistic phrases or graphical messages with numeric demarcation of risk levels. All three of these delivery methods appear to be more effective than using a simple numeric value to describe probability of infection. Situationally, we saw greater than a 3-fold increase in compliance by shifting message strategy without changing the infection risk, highlighting the importance of situational awareness and context when designing messages.

Using fractal self-similarity to increase precision of shrub biomass estimates.

We show that aerial tips are self-similar fractals of whole shrubs and present a field method that applies this fact to improves accuracy and precision of biomass estimates of tall-shrubs, defined here as those with diameter at root collar (DRC) ≥ 2.5 cm. Power function allometry of biomass to stem diameter generates a disproportionate prediction error that increases rapidly with diameter. Thus, biomass should be modeled as a single measure of stem diameter only if stem diameter is less than a threshold Dmax . When stem diameter exceeds Dmax , then the stem internode should be treated as a conic frustrum requiring two additional measures: a second, node-adjacent diameter and a length. If the second diameter is less than Dmax , then the power function allometry can be applied to the aerial tip; otherwise an additional internode is measured. This "two-component" allometry-internodes as frustra and aerial tips as shrubs-can reduce estimated biomass error propagated to the plot-level by as much as 50% or more where very large shrubs are present Dmax is any diameter such that the ratio of single-component to two-component uncertainty exceeds the ratio of two-component to single-component measurement time. Guidelines for estimating Dmax based on pilot field data are provided. Tall shrubs are increasing in abundance and distribution across Arctic, alpine, boreal, and dryland ecosystems. Estimating their biomass is important for both ecological studies and carbon accounting. Reducing field-sample prediction error increases precision in multi-stage modeling because additional measures efficiently improve plot-level biomass precision, reducing uncertainty for shrub biomass estimates.

Complementary and divergent functions of zebrafish Tango1 and Ctage5 in tissue development and homeostasis.

Coat protein complex II (COPII) factors mediate cargo export from the endoplasmic reticulum (ER), but bulky collagens and lipoproteins are too large for traditional COPII vesicles. Mammalian CTAGE5 and TANGO1 have been well characterized individually as specialized cargo receptors at the ER that function with COPII coats to facilitate trafficking of bulky cargoes. Here, we present a genetic interaction study in zebrafish of deletions in ctage5, tango1, or both to investigate their distinct and complementary potential functions. We found that Ctage5 and Tango1 have different roles related to organogenesis, collagen versus lipoprotein trafficking, stress-pathway activation, and survival. While disruption of both ctage5 and tango1 compounded phenotype severity, mutation of either factor alone revealed novel tissue-specific defects in the building of heart, muscle, lens, and intestine, in addition to previously described roles in the development of neural and cartilage tissues. Together, our results demonstrate that Ctage5 and Tango1 have overlapping functions, but also suggest divergent roles in tissue development and homeostasis.

Effects of Social Cues on Biosecurity Compliance in Livestock Facilities: Evidence From Experimental Simulations.

Disease outbreaks in U.S. animal livestock industries have economic impacts measured in hundreds of millions of dollars per year. Biosecurity, or procedures intended to protect animals against disease, is known to be effective at reducing infection risk at facilities. Yet, to the detriment of animal health, humans do not always follow biosecurity protocols. Human behavioral factors have been shown to influence willingness to follow biosecurity protocols. Here we show how social cues may affect cooperation with a biosecurity practice. Participants were immersed in a simulated swine production facility through a graphical user interface and prompted to make a decision that addressed their willingness to comply with a biosecurity practice. We tested the effect of varying three experimental variables: (1) the risk of acquiring an infection, (2) the delivery method of the infection risk information (numerical vs. graphical), and (3) the behavior of an automated coworker in the facility. We provide evidence that participants changed their behavior when they observed a simulated worker making a choice to follow or not follow a biosecurity protocol, even though the simulated worker had no economic effect on the participants' payouts. These results advance the understanding of human behavioral effects on biosecurity protocol decisions, demonstrating that social cues need to be considered by livestock facility managers when developing policies to make agricultural systems more disease resilient.

Using experimental gaming simulations to elicit risk mitigation behavioral strategies for agricultural disease management.

Failing to mitigate propagation of disease spread can result in dire economic consequences for agricultural networks. Pathogens like Porcine Epidemic Diarrhea virus, can quickly spread among producers. Biosecurity is designed to prevent infection transmission. When considering biosecurity investments, management must balance the cost of protection versus the consequences of contracting an infection. Thus, an examination of the decision making processes associated with investment in biosecurity is important for enhancing system wide biosecurity. Data gathered from experimental gaming simulations can provide insights into behavioral strategies and inform the development of decision support systems. We created an online digital experiment to simulate outbreak scenarios among swine production supply chains, where participants were tasked with making biosecurity investment decisions. In Experiment One, we quantified the risk associated with each participant's decisions and delineated three dominant categories of risk attitudes: risk averse, risk tolerant, and opportunistic. Each risk class exhibited unique approaches in reaction to risk and disease information. We also tested how information uncertainty affects risk aversion, by varying the amount of visibility of the infection as well as the amount of biosecurity implemented across the system. We found evidence that more visibility in the number of infected sites increases risk averse behaviors, while more visibility in the amount of neighboring biosecurity increased risk taking behaviors. In Experiment Two, we were surprised to find no evidence for differences in behavior of livestock specialists compared to Amazon Mechanical Turk participants. Our findings provide support for using experimental gaming simulations to study how risk communication affects behavior, which can provide insights towards more effective messaging strategies.

Emulating Agricultural Disease Management: Comparing Risk Preferences Between Industry Professionals and Online Participants Using Experimental Gaming Simulations and Paired Lottery Choice Surveys.

Mitigating the spread of disease is crucial for the well-being of agricultural production systems. Implementing biosecurity disease prevention measures can be expensive, so producers must balance the costs of biosecurity investments with the expected benefits of reducing the risk of infections. To investigate the risk associated with this decision making process, we developed an online experimental game that simulates biosecurity investment allocation of a pork production facility during an outbreak. Participants are presented with several scenarios that vary the visibility of the disease status and biosecurity protection implemented at neighboring facilities. Certain rounds allowed participants to spend resources to reduce uncertainty and reveal neighboring biosecurity and/or disease status. We then test how this uncertainty affects the decisions to spend simulation dollars to increase biosecurity and reduce risk. We recruited 50 attendees from the 2018 World Pork Expo to participate in our simulation. We compared their performance to an opportunity sample of 50 online participants from the survey crowdsourcing tool, Amazon Mechanical Turk (MTurk). With respect to biosecurity investment, we did not find a significant difference between the risk behaviors of industry professionals and those of MTurk participants for each set of experimental scenarios. Notably, we found that our sample of industry professionals opted to pay to reveal disease and biosecurity information more often than MTurk participants. However, the biosecurity investment decisions were not significantly different during rounds in which additional information could be purchased. To further validate these findings, we compared the risk associated with each group's responses using a well-established risk assessment survey implementing paired lottery choices. Interestingly, we did not find a correlation in risk quantified with simulated biosecurity investment in comparison to the paired lottery choice survey. This may be evidence that general economic risk preferences may not always translate into simulated behavioral risk, perhaps due to the contextual immersion provided by experimental gaming simulations. Online recruitment tools can provide cost effective research quality data that can be rapidly assembled in comparison to industry professionals, who may be more challenging to sample at scale. Using a convenience sample of industry professionals for validation can also provide additional insights into the decision making process. These findings lend support to using online experimental simulations for interpreting risk associated with a complex decision mechanism.

Alcohol Medical Intervention Clinic: A Rapid Access Addiction Medicine Model Reduces Emergency Department Visits.

OBJECTIVES: Problematic alcohol use accounts for a large proportion of Emergency Department (ED) visits and revisits. We developed the Alcohol Medical Intervention Clinic (AMIC), a Rapid Access Addiction Medicine (RAAM) service, to reduce alcohol-related ED re-utilization and improve care for individuals with alcohol problems. This article describes the AMIC model and reports on an evaluation of its impact on patients and the ED system. METHODS: Individuals presenting to The Ottawa Hospital Emergency Departments (TOH-ED) for an alcohol-related issue were referred to AMIC. Using data collected via medical chart review, and also self-report questionnaires, we assessed ED visits, revisits, and changes in alcohol use and mental health symptoms in patients before and after receiving services in AMIC. The incidence of alcohol-related ED visits and re-visits from 12-month periods before and after the introduction of AMIC were compared using data from TOH Data Warehouse. Connections made to additional services and patient satisfaction was also assessed. RESULTS: For patients served by AMIC, from May 26, 2016 to June 30, 2017 (n = 194), there was an 82% reduction in 30-day visits and re-visits (P < 0.001). An 8.1% reduction in total alcohol-related 30-day TOH-ED revisit rates and a 10% reduction in total alcohol-related TOH-ED visits were found. After receiving AMIC services, clients reported reductions in alcohol use, depression, and anxiety (P < 0.001). CONCLUSIONS: AMIC demonstrated positive impacts on patients and the healthcare system. AMIC reduced ED utilization, connected people with community services, and built system capacity to serve people with alcohol problems.

Establishment and validation of an endoplasmic reticulum stress reporter to monitor zebrafish ATF6 activity in development and disease.

Induction of endoplasmic reticulum (ER) stress is associated with diverse developmental and degenerative diseases. Modified ER homeostasis causes activation of conserved stress pathways at the ER called the unfolded protein response (UPR). ATF6 is a transcription factor activated during ER stress as part of a coordinated UPR. ATF6 resides at the ER and, upon activation, is transported to the Golgi apparatus, where it is cleaved by proteases to create an amino-terminal cytoplasmic fragment (ATF6f). ATF6f translocates to the nucleus to activate transcriptional targets. Here, we describe the establishment and validation of zebrafish reporter lines for ATF6 activity. These transgenic lines are based on a defined and multimerized ATF6 consensus site, which drives either eGFP or destabilized eGFP, enabling dynamic study of ATF6 activity during development and disease. The results show that the reporter is specific for the ATF6 pathway, active during development and induced in disease models known to engage UPR. Specifically, during development, ATF6 activity is highest in the lens, skeletal muscle, fins and gills. The reporter is also activated by common chemical inducers of ER stress, including tunicamycin, thapsigargin and brefeldin A, as well as by heat shock. In models for amyotrophic lateral sclerosis and cone dystrophy, ATF6 reporter expression is induced in spinal cord interneurons or photoreceptors, respectively, suggesting a role for ATF6 response in multiple neurodegenerative diseases. Collectively our results show that these ATF6 reporters can be used to monitor ATF6 activity changes throughout development and in zebrafish models of disease.This article has an associated First Person interview with the first author of the paper.