Pregnant women's and policymakers' preferences for the expansion of noninvasive prenatal screening: A discrete choice experiment approach study.

Background and Aims: Quantitative approaches for eliciting preferences for new interventions are mostly conducted by patients and rarely by policymakers. This study aimed to quantify the preferences of pregnant women and policymakers regarding the addition of a new test to prenatal screening programs for detecting chromosomal abnormalities. Methods: A discrete choice experiment was conducted to measure the respondents' preferences for a new prenatal test. A seven-attribute instrument was built based on interviews with pregnant women and policymakers. The data were analyzed using robust conditional logistic regression and nested logit models. Results: In total, 272 pregnant women and 24 policymakers completed the questionnaire (response rates of 48% and 55%, respectively). Overall, all attributes were statistically significant in the pregnant women group, whereas only three attributes (test performance, degree of test result certainty, and cost) were statistically significant in the policymakers group. Statistically significant differences in test performance and information were observed between the two groups. Conclusion: Policymakers differed from pregnant women in their appraisal of attributes related to their preference for a new prenatal screening intervention. The low response rates observed in both groups suggest that further investigation of the relevance of this approach must be conducted.

Effect of Yttrium-90 transarterial radioembolization in patients with non-surgical hepatocellular carcinoma: A systematic review and meta-analysis.

BACKGROUND: Recently, the use of Yttrium-90 transarterial radioembolization in non-surgical hepatocellular carcinoma was suggested but the evidence supporting its use is unclear. METHODS: We searched Medline, Embase, Web of Science and Cochrane CENTRAL from inception up to April 14, 2020 for randomized controlled trials comparing Y90-TARE to standard of care in non-surgical HCC patients. Our primary outcome was overall survival (OS). Our secondary outcomes were progression-free survival, time to progression, disease control rate, grade ≥3 adverse events and rates of gastro-intestinal ulcers. Hazard ratios (HR) and risk ratios (RR) with random-effects model were used for our analyses. The risk of bias of the included studies was assessed using Cochrane's RoB 2 tool. RESULTS: Of 1,604 citations identified, eight studies (1,439 patients) were included in our analysis. No improvement in overall survival were noted when Yttrium-90 transarterial radioembolization was compared to standard treatments (HR 0.99 [95% CI 0.81-1.21], 6 studies, I2 = 77.6%). However, Yttrium-90 transarterial radioembolization was associated with fewer grade ≥3 adverse events (RR 0.64 [95% CI 0.45-0.92], 7 studies, I2 = 66%). No difference was observed on other secondary outcomes. DISCUSSION: In non-surgical HCC patients, Yttrium-90 transarterial radioembolization was not associated with significant effect on survival, progression-free survival, time to progression, disease control rate and the incidence of gastro-intestinal ulcers but was however associated with significantly lower rates of grade ≥3 adverse events. Further randomized controlled trials are warranted to better delineate optimal treatment.

Latitudinal drivers of oyster mortality: deciphering host, pathogen and environmental risk factors.

Diseases pose an ongoing threat to aquaculture, fisheries and conservation of marine species, and determination of risk factors of disease is crucial for management. Our objective was to decipher the effects of host, pathogen and environmental factors on disease-induced mortality of Pacific oysters (Crassostrea gigas) across a latitudinal gradient. We deployed young and adult oysters at 13 sites in France and we monitored survival, pathogens and environmental parameters. The young oysters came from either the wild collection or the hatchery while the adults were from the wild only. We then used Cox regression models to investigate the effect of latitude, site, environmental factors and origin on mortality risk and to extrapolate this mortality risk to the distribution limits of the species in Europe. We found that seawater temperature, food level, sea level atmospheric pressure, rainfall and wind speed were associated with mortality risk. Their effect on hatchery oysters was generally higher than on wild animals, probably reflecting that hatchery oysters were free of Ostreid herpesvirus 1 (OsHV-1) whereas those from the wild were asymptomatic carriers. The risk factors involved in young and adult oyster mortalities were different, reflecting distinct diseases. Mortality risk increases from 0 to 90% with decreasing latitude for young hatchery oysters, but not for young wild oysters or adults. Mortality risk was higher in wild oysters than in hatchery ones at latitude > 47.6°N while this was the opposite at lower latitude. Therefore, latitudinal gradient alters disease-induced mortality risk but interacts with the initial health status of the host and the pathogen involved. Practically, we suggest that mortality can be mitigated by using hatchery oysters in north and wild collected oysters in the south.

Fine-scale temporal dynamics of herpes virus and vibrios in seawater during a polymicrobial infection in the Pacific oyster Crassostrea gigas.

The Pacific oyster Crassostrea gigas is currently being impacted by a polymicrobial disease that involves early viral infection by ostreid herpesvirus-1 (OsHV-1) followed by a secondary bacterial infection leading to death. A widely used method of inducing infection consists of placing specific pathogen-free oysters ('recipients') in cohabitation in the laboratory with diseased oysters that were naturally infected in the field ('donors'). With this method, we evaluated the temporal dynamics of pathogen release in seawater and the cohabitation time necessary for disease transmission and expression. We showed that OsHV-1 and Vibrio spp. in the seawater peaked concomitantly during the first 48 h and decreased thereafter. We found that 1.5 h of cohabitation with donors was enough time to transmit pathogens to recipients and to induce mortality later, reflecting the highly contagious nature of the disease. Finally, mortality of recipients was associated with increasing cohabitation time with donors until reaching a plateau at 20%. This reflects the cumulative effect of exposure to pathogens. The optimal cohabitation time was 5-6 d, the mortality of recipients occurring 1-2 d earlier.

Determination of risk factors for herpesvirus outbreak in oysters using a broad-scale spatial epidemiology framework.

Marine diseases have major impacts on ecosystems and economic consequences for aquaculture and fisheries. Understanding origin, spread and risk factors of disease is crucial for management, but data in the ocean are limited compared to the terrestrial environment. Here we investigated how the marine environment drives the spread of viral disease outbreak affecting The Pacific oyster worldwide by using a spatial epidemiology framework. We collected environmental and oyster health data at 46 sites spread over an area of 300 km2 along an inshore-offshore gradient during an epizootic event and conducted risk analysis. We found that disease broke out in the intertidal farming area and spread seaward. Mortalities and virus detection were observed in oysters placed 2 km from the farming areas, but oysters of almost all sites were subclinically infected. Increasing food quantity and quality, growth rate and energy reserves of oyster were associated with a lower risk of mortality offshore whereas increasing turbidity, a proxy of the concentration of suspended particulate matter, and terrestrial inputs, inferred from fatty acid composition of oysters, were associated with a higher risk of mortality. Offshore farming and maintenance of good ecological status of coastal waters are options to limit disease risk in oysters.

Intraspecific genetic admixture and the morphological diversification of an estuarine fish population complex.

The North-east American Rainbow smelt (Osmerus mordax) is composed of two glacial races first identified through the spatial distribution of two distinct mtDNA lineages. Contemporary breeding populations of smelt in the St. Lawrence estuary comprise contrasting mixtures of both lineages, suggesting that the two races came into secondary contact in this estuary. The overall objective of this study was to assess the role of intraspecific genetic admixture in the morphological diversification of the estuarine rainbow smelt population complex. The morphology of mixed-ancestry populations varied as a function of the relative contribution of the two races to estuarine populations, supporting the hypothesis of genetic admixture. Populations comprising both ancestral mtDNA races did not exhibit intermediate morphologies relative to pure populations but rather exhibited many traits that exceeded the parental trait values, consistent with the hypothesis of transgressive segregation. Evidence for genetic admixture at the level of the nuclear gene pool, however, provided only partial support for this hypothesis. Variation at nuclear AFLP markers revealed clear evidence of the two corresponding mtDNA glacial races. The admixture of the two races at the nuclear level is only pronounced in mixed-ancestry populations dominated by one of the mtDNA lineages, the same populations showing the greatest degree of morphological diversification and population structure. In contrast, mixed-ancestry populations dominated by the alternate mtDNA lineage showed little evidence of introgression of the nuclear genome, little morphological diversification and little contemporary population genetic structure. These results only partially support the hypothesis of transgressive segregation and may be the result of the differential effects of natural selection acting on admixed genomes from different sources.

Spatial and temporal dynamics of mass mortalities in oysters is influenced by energetic reserves and food quality.

Although spatial studies of diseases on land have a long history, far fewer have been made on aquatic diseases. Here, we present the first large-scale, high-resolution spatial and temporal representation of a mass mortality phenomenon cause by the Ostreid herpesvirus (OsHV-1) that has affected oysters (Crassostrea gigas) every year since 2008, in relation to their energetic reserves and the quality of their food. Disease mortality was investigated in healthy oysters deployed at 106 locations in the Thau Mediterranean lagoon before the start of the epizootic in spring 2011. We found that disease mortality of oysters showed strong spatial dependence clearly reflecting the epizootic process of local transmission. Disease initiated inside oyster farms spread rapidly beyond these areas. Local differences in energetic condition of oysters, partly driven by variation in food quality, played a significant role in the spatial and temporal dynamics of disease mortality. In particular, the relative contribution of diatoms to the diet of oysters was positively correlated with their energetic reserves, which in turn decreased the risk of disease mortality.

Temperature-mediated relationship between western flower thrips (Thysanoptera: Thripidae) and chrysanthemum.

Modeling the effect of temperature on the sustainability of insect-plant interactions requires assessment of both insect and plant performance. We examined the effect of temperature on western flower thrips, Frankliniella occidentalis (Pergande), a generalist herbivore with a high reproductive rate, and chrysanthemum inflorescences, a high quality but relatively fixed, ephemeral resource for thrips population growth. We hypothesized that different thrips versus plant responses to temperature result in significant statistical interaction of temperature with thrips abundance and flower damage attributes over time. Experiments were conducted at five temperatures between 20.7 and 35.3 degrees C, with thrips infestation and time after infestation as main effects. Only minor, uncontrolled variations in relative humidity and light intensity may otherwise have influenced the results. High temperatures lead to an initially rapid increase in density of thrips followed by abrupt declines in abundance. The rate of floral senescence increased with temperature and thrips infestation, as indicated by a reduced fresh biomass and greater leaching of yellow pigments. Multiple regression indicated that indices of plant damage responded more directly to thrips density at low than high temperature, supporting the conclusion that temperature affected the outcome beyond what was predictable simply from differential plant and insect optima. The relative intensity of damage caused by individual thrips decreased with increasing temperature, likely caused by thrips competition and reduced survival, growth, and fecundity on depleted inflorescences. Reduced per capita damage at high temperature may be common in insects exploiting fixed plant resources that exhibit an accelerated rate of deterioration at high temperatures.

Loglinear models for the robust design in mark-recapture experiments.

The robust design is a method for implementing a mark-recapture experiment featuring a nested sampling structure. The first level consists of primary sampling sessions; the population experiences mortality and immigration between primary sessions so that open population models apply at this level. The second level of sampling has a short mark-recapture study within each primary session. Closed population models are used at this stage to estimate the animal abundance at each primary session. This article suggests a loglinear technique to fit the robust design. Loglinear models for the analysis of mark-recapture data from closed and open populations are first reviewed. These two types of models are then combined to analyze the data from a robust design. The proposed loglinear approach to the robust design allows incorporating parameters for a heterogeneity in the capture probabilities of the units within each primary session. Temporary emigration out of the study area can also be accounted for in the loglinear framework. The analysis is relatively simple; it relies on a large Poisson regression with the vector of frequencies of the capture histories as dependent variable. An example concerned with the estimation of abundance and survival of the red-back vole in an area of southeastern Québec is presented.