The need for One Health systems-thinking approaches to understand multiscale dissemination of antimicrobial resistance.

Although the effects of antimicrobial resistance (AMR) are most obvious at clinical treatment failure, AMR evolution, transmission, and dispersal happen largely in environmental settings, for example within farms, waterways, livestock, and wildlife. We argue that systems-thinking, One Health approaches are crucial for tackling AMR, by understanding and predicting how anthropogenic activities interact within environmental subsystems, to drive AMR emergence and transmission. Innovative computational methods integrating big data streams (eg, from clinical, agricultural, and environmental monitoring) will accelerate our understanding of AMR, supporting decision making. There are challenges to accessing, integrating, synthesising, and interpreting such complex, multidimensional, heterogeneous datasets, including the lack of specific metrics to quantify anthropogenic AMR. Moreover, data confidentiality, geopolitical and cultural variation, surveillance gaps, and science funding cause biases, uncertainty, and gaps in AMR data and metadata. Combining systems-thinking with modelling will allow exploration, scaling-up, and extrapolation of existing data. This combination will provide vital understanding of the dynamic movement and transmission of AMR within and among environmental subsystems, and its effects across the greater system. Consequently, strategies for slowing down AMR dissemination can be modelled and compared for efficacy and cost-effectiveness.

Monitoring of species' genetic diversity in Europe varies greatly and overlooks potential climate change impacts.

Genetic monitoring of populations currently attracts interest in the context of the Convention on Biological Diversity but needs long-term planning and investments. However, genetic diversity has been largely neglected in biodiversity monitoring, and when addressed, it is treated separately, detached from other conservation issues, such as habitat alteration due to climate change. We report an accounting of efforts to monitor population genetic diversity in Europe (genetic monitoring effort, GME), the evaluation of which can help guide future capacity building and collaboration towards areas most in need of expanded monitoring. Overlaying GME with areas where the ranges of selected species of conservation interest approach current and future climate niche limits helps identify whether GME coincides with anticipated climate change effects on biodiversity. Our analysis suggests that country area, financial resources and conservation policy influence GME, high values of which only partially match species' joint patterns of limits to suitable climatic conditions. Populations at trailing climatic niche margins probably hold genetic diversity that is important for adaptation to changing climate. Our results illuminate the need in Europe for expanded investment in genetic monitoring across climate gradients occupied by focal species, a need arguably greatest in southeastern European countries. This need could be met in part by expanding the European Union's Birds and Habitats Directives to fully address the conservation and monitoring of genetic diversity.

Ingestion of anthropogenic debris by migratory barnacle geese Branta leucopsis on a remote north-eastern Atlantic island.

Although seabirds are frequently used as sentinel species for anthropogenic pollution, the extent and impacts of synthetic debris ingestion remains poorly studied for many water bird species. Here, we assess ingestion of synthetic particles (≥0.5 mm) by barnacle geese, Branta leucopsis, wintering on a remote island. Faecal samples were collected over a period of four wintering seasons. In total, 71 individual samples were assessed, with 79% of samples displaying at least one debris particle (maximum lengths 0.5-5 mm) from anthropogenic sources. The recovered synthetic debris were identified as micro-fibres (n = 166) and micro-fragments (n = 165). The number of synthetic particles detected per sample was generally low at 4.7 ± 0.9, 43 (mean ± SE, maximum): micro-fibres 2.3 ± 0.3, 10; micro-fragments 2.3 ± 0.8, 40. Particle numbers detected per gram of faecal sample differed amongst wintering seasons. Our results suggest that non-marine water birds can frequently ingest low quantities of synthetic particles in remote coastal habitats.

Temperature and precipitation at migratory grounds influence demographic trends of an Arctic-breeding bird.

Anthropogenic climate disruption, including temperature and precipitation regime shifts, has been linked to animal population declines since the mid-20th century. However, some species, such as Arctic-breeding geese, have thrived during this period. An increased understanding of how climate disruption might link to demographic rates in thriving species is an important perspective in quantifying the impact of anthropogenic climate disruption on the global state of nature. The Greenland barnacle goose (Branta leucopsis) population has increased tenfold in abundance since the mid-20th century. A concurrent weather regime shift towards warmer, wetter conditions occurred throughout its range in Greenland (breeding), Ireland and Scotland (wintering) and Iceland (spring and autumn staging). The aim of this study was to determine the relationship between weather and demographic rates of Greenland barnacle geese to discern the role of climate shifts in the population trend. We quantified the relationship between temperature and precipitation and Greenland barnacle goose survival and productivity over a 50 year period from 1968 to 2018. We detected significant positive relationships between warmer, wetter conditions on the Icelandic spring staging grounds and survival. We also detected contrasting relationships between warmer, wetter conditions during autumn staging and survival and productivity, with warm, dry conditions being the most favourable for productivity. Survival increased in the latter part of the study period, supporting the possibility that spring weather regime shifts contributed to the increasing population trend. This may be related to improved forage resources, as warming air temperatures have been shown to improve survival rates in several other Arctic and northern terrestrial herbivorous species through indirect bottom-up effects on forage availability.

Medical physics and physics in medicine in Ireland (part 1: 1600-~2000).

Medical physics and other contributions from physics to medicine are relatively well known, if not well documented in Ireland. Less well known are contributions from medicine to the development of physics, which can and do occur. This paper addresses examples of all three. The methods employed include documentary research and interviews with those who share(d) the stage in the area. Documentary evidence for historical aspects of medical physics over the last century are relatively sparse and incomplete. Notwithstanding this, they can and do enable a picture to be built up of how the arrangements in place now have come about, particularly when they are accompanied by mature recollections of the participants. Good critically assessed and accessible sources have been identified covering the seventeenth to nineteenth century material presented. Examples are presented based on the work of significant contributors, each with strong Irish connections, including Robert Boyle, Erwin Schrödinger, Fearghus O'Foghludha, and Edith Stoney the first female medical physicist. Their contributions are striking and continue to be relevant now. The findings provide a rich context and heritage for medical physics in Ireland and in the international community. They will include the contemporary period in a second paper, Part 2 of this study.

Conservation conflict: Managing forestry versus hen harrier species under Europe's Birds Directive.

In this paper we examine an example of a conservation conflict that is encountered in Ireland arising from the designation of Special Protection Areas (SPAs) for the Hen Harrier under the European Birds Directive (Directive, 2009/147/EC) and the consequent restrictions that are placed on forestry activities within these SPAs. We examine the causes of the Hen Harrier-forestry conflict; identify what stakeholders believe are the policy instruments and management strategies that may be useful in managing the conflict and finally identify plausible solutions that may be relevant to similar conflicts around multi-functional forests elsewhere in Europe and globally. Semi-structured interviews were conducted with key actors in this conflict. Drawing on Walker and Daniels' conflict triangle theory, a qualitative analysis of the transcripts of these interviews revealed that the conflict between Hen Harrier conservation and forestry in Ireland has a number of deep-rooted dimensions including those relating to the substance (e.g. restrictions on forest management activity in the SPAs), as well as procedural (e.g. lack of stakeholder engagement) and relationship dimensions (e.g. lack of trust). The polarisation of views in this conflict testifies to how entrenched stakeholders can become through lack of communication and trust. The policy instruments that stakeholders identified as having potential to address the conflict include the introduction of incentives/compensation scheme; changes to restrictions; more data and research on Hen Harrier bird surveys; implementation of landscape management models; and better communication and stakeholder engagement. The study highlights that conservation conflicts persist due to the multi-functional nature of forests and also due to repeated mistakes in terms of the lack of engagement with local stakeholders. Increasing the involvement of local actors has important substantive and instrumental benefits including improving the quality of decisions, as well as creating a greater chance of policies being better socially and politically acceptable. The need for more and better capacity-building across EU Member States for statutory and government agencies to learn from one another in terms of how to avoid repeating the same mistakes from one site to another is highlighted.

Surveillance of Mosquitoes (Diptera, Culicidae) in a Northern Central Region of Spain: Implications for the Medical Community.

Mosquitoes are important to public and animal health due to their capacity to transmit diseases. Since the Zika virus was declared a pandemic by the WHO in 2016, and it has been recorded in different regions of Mediterranean Area (included Spain), the Government of La Rioja (Northern Spain) through the Center of Rickettsiosis and Arthropod-Borne Diseases, implemented an entomological surveillance programme of mosquitoes in La Rioja and in a close area of Navarra. This surveillance extended to some of the pathogens that they can transmit. Here we describe the framework of the initial surveillance programme for the detection of mosquitoes and associated human pathogens. We outline the benefits and the limitation of the programme to date, and explore how greater benefits can be achieved, for example using a One Health approach. Entomological surveillance has been carried out with BG-Sentinel traps, human bait technique and other methods such as collecting adults in resting places or immature stages by dipping in several wetlands. Since Aedes albopictus, vector of arbovirus such as Dengue, Chikungunya, and Zika, has not been detected yet in the region, the entomological programme included the surveillance of this exotic species using ovitraps in the most important cities. Morphological identification was supported using the mitochondrial cytochrome C oxidase subunit I and the internal transcribed spacer 2 genes analysis. In 2016 and 2017, more than 6,000 mosquitoes were collected. The mosquito's community included 21 species associated with six genera: Anopheles (n = 4), Aedes (n = 5), Culex (n = 6), Culiseta (n = 4), Uranotaenia (n = 1) and Coquillettidia (n = 1). Eleven species represent new records for La Rioja and Navarra regions. Several species were collected biting humans and a great proportion of the sampled mosquito population are competent vectors of several pathogens, such as West Nile virus. Sequences closely related to mosquito-only flavivirus have been detected in 0.34% of analysed pools. At the same time, the epidemiological surveillance emphasis is placed in the early detection of mosquito-borne diseases in primary health and emergency services. The surveillance programme represents a relevant and necessary assessment of the risk of pathogen transmission in a region, and it allows for the establishment of the appropriate preventive measures.

Ecosystem change and zoonoses in the Anthropocene.

Changes in land use, animal populations and climate, primarily due to increasing human populations, drive the emergence of zoonoses. Force of infection (FOI), which for these diseases is a measure of the ease with which a pathogen reaches the human population, can change with specific zoonoses and context. Here, we outline three ecosystem categories-domestic, peridomestic and sylvatic, where disease ecology alters the FOI of specific zoonoses. Human intervention is an overriding effect in the emergence of zoonoses; therefore, we need to understand the disease ecology and other influencing factors of pathogens and parasites that are likely to interact differently within ecological and cultural contexts. Planning for One Health and community ecology, such as an ecological impact assessment, is required to prepare and manage the emergence and impact of zoonoses in the Anthropocene.

A scoping review on the prevalence of Shiga-toxigenic Escherichia coli in wild animal species.

Zoonotic pathogens constitute the major source (60.3%) of emerging infectious diseases. Previous studies have investigated the prevalence of Shiga-toxigenic Escherichia coli (STEC) among wild animal species, but comprehensive data are needed to assess the role that these animals have in the transmission of STEC infections to the human population via faecal contamination of the environment, agri-food or water chain. Due to the nature of these microorganisms in which this human-animal-environment interface plays a relevant role on the disease's dynamics, a "One Health" approach is needed to prevent and control the worldwide spread. The aim of this study was to review the published research on the prevalence of STEC in wildlife. The search was performed using several online databases consisting of three blocks of specific search terms covering pathogen, type of study and population. Two reviewers applied the inclusion and exclusion criteria to screening and eligibility phases. Two hundred and twenty-five abstracts were screened for relevance, and 72 were included for data analysis. Most studies (77.8%) investigated the prevalence of STEC in ruminants and urban birds. Their role in transmitting the pathogen to humans, other animals and the agri-food chain is potentiated by the peculiar biological characteristics in ruminants and improved adaptation of urban birds to urban environments. The popularity of convenience and voluntary response sampling may be due to the lack of human-made boundaries on the wild animal species' habitat and having some samples from hunted-harvested animals. To our knowledge, this is the first comprehensive review on STEC prevalence in wild animal species from studies conducted across the globe. We recommend that future research includes and compares samples from varying origins (i.e., human, animal, environment and food) and applies a "One Health" approach to the emerging challenges that STEC poses to public health.

Exploring pyloric dynamics in stenting using a distensibility technique.

BACKGROUND: Perforated duodenal ulcers can be treated with a covered stent. Stent migration is a severe complication, sometimes requiring surgery. Pyloric physiology during stent treatment has not been studied and mechanisms for migration are unknown. The aim of this study was to investigate the pyloric response to distention, mimicking stent treatment, using the EndoFLIP. METHODS: A nonsurvival study in five pigs was carried out, followed by a pilot study in one volunteer. Animals were gastroscoped during anaesthesia and the EndoFLIP was placed straddling the pylorus. Baseline distensibility readings were performed at stepwise balloon distentions to 20, 30, 40, and 50 mL, measuring pyloric cross-sectional area and pressure. Measurements were repeated after administration of a prokinetic drug and after a liquid meal. In the human study, readings were performed in conscious sedation at baseline and after stimulation with metoclopramide. KEY RESULTS: During baseline readings, the pylorus was shown to open more with increasing distention together with higher amplitude motility waves. Reaching maximum distention-volume (50 mL), pyloric pressure increased significantly (P = 0.016), and motility waves disappeared. After prokinetic stimulation, the pressure decreased and the motility waves increased in frequency and amplitude. After food stimulation, the pressure stayed low and the motility showed increase in amplitude. During both tests, the pylorus showed higher pressure and lack of motility waves at maximum probe distention. CONCLUSIONS AND INFERENCES: The pylorus seems to act as a sphincter at low distention but when further dilated starts acting as a pump. Fully distended the pyloric motility disappears and the pressure remains high, suggesting that a stent with high-radial force might show less migration.

Antimicrobial Resistance in Listeria Species.

For nearly a century the use of antibiotics to treat infectious diseases has benefited human and animal health. In recent years there has been an increase in the emergence of antibiotic-resistant bacteria, in part attributed to the overuse of compounds in clinical and farming settings. The genus Listeria currently comprises 17 recognized species found throughout the environment. Listeria monocytogenes is the etiological agent of listeriosis in humans and many vertebrate species, including birds, whereas Listeria ivanovii causes infections mainly in ruminants. L. monocytogenes is the third-most-common cause of death from food poisoning in humans, and infection occurs in at-risk groups, including pregnant women, newborns, the elderly, and immunocompromised individuals.

The esophagiome: integrated anatomical, mechanical, and physiological analysis of the esophago-gastric segment.

Esophageal diseases are highly prevalent and carry significant socioeconomic burden. Despite the apparently simple function of the esophagus, we still struggle to better understand its physiology and pathophysiology. The assessment of large data sets and application of multiscale mathematical organ models have gained attention as part of the Physiome Project. This has long been recognized in cardiology but has only recently gained attention for the gastrointestinal(GI) tract. The term "esophagiome" implies a holistic assessment of esophageal function, from cellular and muscle physiology to the mechanical responses that transport and mix fluid contents. These anatomical, mechanical, and physiological models underlie the development of a "virtual esophagus" modeling framework to characterize and analyze function and disease. Functional models incorporate anatomical details with sensory-motor responses, especially related to biomechanical functions such as bolus transport. Our review builds on previous reviews and focuses on assessment of detailed anatomical and geometric data using advanced imaging technology for evaluation of gastro-esophageal reflux disease (GERD), and on esophageal mechanophysiology assessed using technologies that distend the esophagus. Integration of mechanics- and physiology-based analysis is a useful characteristic of the esophagiome. Experimental data on pressures and geometric characteristics are useful for the validation of mathematical and computer models of the esophagus that may provide predictions of novel endoscopic, surgical, and pharmaceutical treatment options.

Esophageal multimodal stimulation and sensation.

Esophageal mechanosensation describes the relationship between a mechanical stimulation of the esophageal wall, such as bag distension, and the reaction to the stimulation perceived or unperceived. When studying mechanosensation in esophageal disease, it is important to recognize that symptoms might be due to alterations at different levels of the neuromuscular system, such as alterations at the mechanoreceptor level or in the afferent mechanosensory pathways, or irregularities in the homeostatic state. One might ask if it is possible to provoke, record, and describe the multidimensional responses behind a mechanosensory experience? It is a complex system and, at a minimum, a multidisciplinary approach is needed to avoid erroneous conclusions. The multimodal study design, taking the mode, location, and parameters of stimulation into consideration, together with controlled recording of assessment parameters, is an approach that seems rational and valid. Gastrointestinal (GI) physicians of the 21th century need to have knowledge of advances in the evaluation of GI mechanical function and what provokes symptoms. Hereby, it is possible to fully appreciate the slowly emerging awareness of how GI pain symptoms should be explored and explained to patients.

Axial Movements and Length Changes of the Human Lower Esophageal Sphincter During Respiration and Distension-induced Secondary Peristalsis Using Functional Luminal Imaging Probe.

BACKGROUND/AIMS: Efficient transport through the esophago-gastric junction (EGJ) requires synchronized circular and longitudinal muscle contraction of the esophagus including relaxation of the lower esophageal sphincter (LES). However, there is a scarcity of technology for measuring esophagus movements in the longitudinal (axial) direction. The aim of this study is to develop new analytical tools for dynamic evaluation of the length change and axial movement of the human LES based on the functional luminal imaging probe (FLIP) technology and to present normal signatures for the selected parameters. METHODS: Six healthy volunteers without hiatal hernia were included. Data were analyzed from stepwise LES distensions at 20, 30, and 40 mL bag volumes. The bag pressure and the diameter change were used for motion analysis in the LES. The cyclic bag pressure frequency was used to distinguish dynamic changes of the LES induced by respiration and secondary peristalsis. RESULTS: Cyclic fluctuations of the LES were evoked by respiration and isovolumetric distension, with phasic changes of bag pressure, diameter, length, and axial movement of the LES narrow zone. Compared to the respiration-induced LES fluctuations, peristaltic contractions increased the contraction pressure amplitude (P ＜ 0.001), shortening (P ＜ 0.001), axial movement (P ＜ 0.001), and diameter change (P ＜ 0.01) of the narrow zone. The length of the narrow zone shortened as function of the pressure increase. CONCLUSIONS: FLIP can be used for evaluation of dynamic length changes and axial movement of the human LES. The method may shed light on abnormal longitudinal muscle activity in esophageal disorders.

Multi-criteria Decision Analysis to Model Ixodes ricinus Habitat Suitability.

Tick-borne diseases present a major threat to both human and livestock health throughout Europe. The risk of infection is directly related to the presence of its vector. Thereby it is important to know their distribution, which is strongly associated with environmental factors: the presence and availability of a suitable habitat, of a suitable climate and of hosts. The present study models the habitat suitability for Ixodes ricinus in Ireland, where data on tick distribution are scarce. Tick habitat suitability was estimated at a coarse scale (10 km) with a multi-criteria decision analysis (MCDA) method according to four different scenarios (depending on the variables used and on the weights granted to each of them). The western part of Ireland and the Wicklow mountains in the East were estimated to be the most suitable areas for I. ricinus in the island. There was a good level of agreement between results from the MCDA and recorded tick presence. The different scenarios did not affect the spatial outputs substantially. The current study suggests that tick habitat suitability can be mapped accurately at a coarse scale in a data-scarce context using knowledge-based methods. It can serve as a guideline for future countrywide sampling that would help to determine local risk of tick presence and refining knowledge on tick habitat suitability in Ireland.

A Blueprint to Evaluate One Health.

One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the "Network for Evaluation of One Health," an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy.

Don't forget to look down - collaborative approaches to predator conservation.

Finding effective ways of conserving large carnivores is widely recognised as a priority in conservation. However, there is disagreement about the most effective way to do this, with some favouring top-down 'command and control' approaches and others favouring collaboration. Arguments for coercive top-down approaches have been presented elsewhere; here we present arguments for collaboration. In many parts of the developed world, flexibility of approach is built into the legislation, so that conservation objectives are balanced with other legitimate goals. In the developing world, limited resources, poverty and weak governance mean that collaborative approaches are likely to play a particularly important part in carnivore conservation. In general, coercive policies may lead to the deterioration of political legitimacy and potentially to non-compliance issues such as illegal killing, whereas collaborative approaches may lead to psychological ownership, enhanced trust, learning, and better social outcomes. Sustainable hunting/trapping plays a crucial part in the conservation and management of many large carnivores. There are many different models for how to conserve carnivores effectively across the world, research is now required to reduce uncertainty and examine the effectiveness of these approaches in different contexts.