Case report: First documented case of cerebral angiostrongyliasis caused by Angiostrongylus costaricensis in a free-ranging opossum.

Angiostrongylus costaricensis is a metastrongyloid nematode that primarily infects the mesenteric arteries of wild rodents. This parasite is endemic in several regions of the American continent, and in humans, causes a disease known as abdominal angiostrongyliasis. Despite the important health implications of this nematode, there are limited studies investigating the involvement of wild animals in its life cycle. In this study, we present the clinical manifestations, pathologic findings, and molecular diagnosis, to the best of our current knowledge, of the first documented onset of cerebral angiostrongyliasis because of A. costaricensis infection in a juvenile free-ranging opossum (Didelphis marsupialis). Histopathological findings stress the presence of eosinophilic meningoencephalitis with nematodes present within the lesions, and PCR was positive for cox1 and ITS1 reactions. The obtained sequences for a 279 bp fragment of ITS1 were 100% identical to A. costaricensis from Costa Rica. This case highlights the substantial difficulties in diagnosing neuroangiostrongyliasis, yet underscores the importance of considering A. costaricensis as a potential culprit behind neurological conditions in wild marsupials. It acts as an urgent call to action to improve surveillance programs tracking infectious and parasitic diseases causing mortality in wildlife populations.

Passive epidemiological surveillance in wildlife in Costa Rica identifies pathogens of zoonotic and conservation importance.

Epidemiological surveillance systems for pathogens in wild species have been proposed as a preventive measure for epidemic events. These systems can minimize the detrimental effects of an outbreak, but most importantly, passive surveillance systems are the best adapted to countries with limited resources. Therefore, this research aimed to evaluate the technical and infrastructural feasibility of establishing this type of scheme in Costa Rica by implementing a pilot program targeting the detection of pathogens of zoonotic and conservation importance in wildlife. Between 2018 and 2020, 85 carcasses of free-ranging vertebrates were admitted for post-mortem and microbiology analysis. However, we encountered obstacles mainly related to the initial identification of cases and limited local logistics capacity. Nevertheless, this epidemiological surveillance scheme allowed us to estimate the general state of health of the country's wildlife by establishing the causes of death according to pathological findings. For instance, 60% (51/85) of the deaths were not directly associated with an infectious agent. Though in 37.6% (32/85) of these cases an infectious agent associated or not with disease was detected. In 27.1% (23/85) of the cases, death was directly related to infectious agents. Furthermore, 12.9% (11/85), the cause of death was not determined. Likewise, this wildlife health monitoring program allowed the detection of relevant pathogens such as Canine Distemper Virus, Klebsiella pneumoniae, Angiostrongylus spp., Baylisascaris spp., among others. Our research demonstrated that this passive surveillance scheme is cost-effective and feasible in countries with limited resources. This passive surveillance can be adapted to the infrastructure dedicated to monitoring diseases in productive animals according to the scope and objectives of monitoring wildlife specific to each region. The information generated from the experience of the initial establishment of a WHMP is critical to meeting the challenges involved in developing this type of scheme in regions with limited resources and established as hotspots for emerging infectious diseases.

Direct-to-Consumer Academic Telemedicine.

Over the past 2 years, telemedicine has skyrocketed as COVID-19 propelled innovation and implementation at unparalleled rates. Within the UC Davis academic health system, a new paradigm for telemedicine emerged: direct-to-consumer telemedicine. The video-based telemedicine program has become the largest of its kind in California and is staffed by 80 providers (MDs, APPs) across five clinical departments/groups (primary care practice group, family and community medicine department, emergency medicine department, the nursing department, and the physical medicine and rehabilitation department). September 2021 marked the 1-year anniversary of a journey that has opened access, improved coordination, and become a workforce engine for our evolving virtual health infrastructure.

Telemedicine Rapid Assessment in the Emergency Department: A Pilot Study.

Background: The objective of this study is to evaluate a rapid assessment telemedicine system in the emergency department for safety, workflow disruption, and satisfaction level by clinicians, staff, and patients. Methods: After consent is obtained, the patient and telemedicine emergency physician are connected on a Health Insurance Portability and Accountability Act-compliant video conference for a rapid assessment, including history of present illness, review of systems, and past medical history. The telemedicine physician initiates orders based on these data. Patient data collected include age, gender, chief complaint, Emergency Severity Index, door to telemedicine physician time, door to in-person physician time, length of stay, left without being seen (LWBS) status, and satisfaction scores. Nurses were assessed for workflow interruptions and communication gaps. In-person physicians were assessed regarding perceived missed information in patient management, perceived workflow interruptions, and satisfaction. Results: Convenience sampling when participating physicians were on-shift resulted in 22 patients enrolled out of 25 approached over 2 months. No patients LWBS, and no in-person physicians perceived missed information in management. Satisfaction was well scored in all evaluated parties, with no score below a 4.77 out of 5 for any of the categories evaluated. Only one case interrupted the workflow of the on-site physician. Discussion: Telemedicine rapid assessment was found to be safe, efficient, and associated with high satisfaction. These results warrant study on a larger scale with a control group to statistically assess differences in outcome metrics such as LWBS rates. If effective, this approach could provide a novel and flexible physician-staffing tool.

Leopardus wiedii Papillomavirus type 1, a novel papillomavirus species in the tree ocelot, suggests Felidae Lambdapapillomavirus polyphyletic origin and host-independent evolution.

The limited knowledge on Papillomavirus diversity (particularly in wild animal species) influences the accuracy of PVs phylogeny and their evolutionary history, and hinders the comprehension of PVs pathogenicity, especially the mechanism of virus - related cancer progression. This study reports the identification of Leopardus wiedii Papillomavirus type 1 (LwiePV1), the first PV type within Lambdapapillomavirus in a Leopardus host. LwiePV1 full genome sequencing allowed the investigation of its taxonomic position and phylogeny. Based on results, LwiePV1 should be assigned to a novel PV species providing evidence for a polyphyletic origin of feline lambda PVs, and representing an exception to codivergence between feline lambda PVs and their hosts. Results improve our knowledge on PV diversity and pave the way to future studies investigating biological and evolutionary features of animal PVs.

The need for cultural adaptations to health interventions for African American women: A qualitative analysis.

OBJECTIVE: Binge eating disorder (BED) is associated with obesity and psychological distress. Although rates in African American (AA) and White women are similar, AA women report more severity of symptoms and higher frequency of binge eating episodes. However, few AA women seek help due to a lack of acknowledgment of sociocultural influences that shape experiences and behaviors related to BED in currently available interventions. Culturally adapted interventions are an important way to acknowledge these sociocultural factors and produce expected outcomes within a specific group. This qualitative study begins the process of culturally adapting evidence-based treatment for AA women to reduce BED. METHOD: Sixteen AA women with BED participated in focus groups to determine the need for adaptations to an evidence-based intervention. Thematic content analysis was used to analyze data from focus groups. RESULTS: The unique experiences of AA women including lack of awareness of BED, cultural deviation from the "thin ideal," influence of family on eating practices, social meanings of food, role of religion, binge eating as coping, skepticism about weight standards, and the importance of motivation to change are highlighted. CONCLUSION: This research adds to the current discourse on the importance of culturally adapting interventions for more targeted use and helps to expand what is known about AA women with BED and associated obesity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The relationship between treatment settings and diagnostic attributions of depression among African Americans.

OBJECTIVE: To explore the relationship between treatment setting characteristics and diagnostic attributions of depression among community-dwelling African Americans. METHODS: Data come from the National Survey of American Life, a nationally representative sample of African Americans and Caribbean Blacks. Major Depression (MD) was assessed using the Composite International Diagnostic Inventory. Participants were categorized into four diagnostic groups: never MD, MD never attributed to physical health problems (i.e., affective depression), MD sometimes attributed to physical health problems (i.e., complicated depression), and MD always attributed to physical health problems (i.e., physical depression). Multinomial regression was used for assessment. RESULTS: Among 441 participants, 66.4% were classified as affective depression, 17.8% as complicated depression and 15.8% as physical depression. Seeking treatment from a mental health professional was associated with increased likelihood of being in the complicated depression group [adjusted odds ratio (AOR): 5.52; 95% confidence interval (CI): 2.28-13.36]. Seeking treatment from a family doctor was associated with physical depression (AOR: 2.93; 95% CI: 1.18-7.26). Seeking care from three or more different health care providers was associated with complicated depression (AOR: 1.99; 95% CI: 1.17-3.40). CONCLUSION: Results suggest that encounters with health care providers influence the diagnostic attribution of depression in a systematic manner.

Colocalization of serotonin and vesicular glutamate transporter 3-like immunoreactivity in the midbrain raphe of Syrian hamsters (Mesocricetus auratus).

Vesicular glutamate transporter 3 (VGLUT3) expression has been specifically localized to brain regions rich in serotonergic cells. It has been suggested that this transporter may contribute to the regulation of extracellular glutamate concentrations via a nonsynaptic mechanism. In this study, we examine the colocalization of vesicular glutamate transporter 3 immunoreactivity with serotonin immunoreactivity in the dorsal and median raphe nuclei of Syrian hamsters. Brain sections from adult hamsters were fluorescently labeled for serotonin-ir and VGLUT3-ir and examined using confocal microscopy. The results indicate that most serotonergic cells of the midbrain raphe also expressed vesicular glutamate transporter 3. In addition, nonserotonergic cells in these brain regions also show immunoreactivity for the transporter. These data confirm previous findings of vesicular glutamate transporter 3 expression in serotonergic and nonserotonergic neurons in rats. These findings suggest that the location of vesicular glutamate transporter 3 may be as much a function of neuroanatomical location as of the neurochemical identity of the expressing neurons.

Factors affecting individuals dissuading sexual partners from using condoms: a comment on McDermott and Noland.

Undergraduate students at an urban, public university were asked if they had ever attempted to dissuade a sexual partner from using condoms. Over 17% of the men and nearly 15% of the women admitted to having done so, and twice as many said that a sexual partner had attempted to dissuade them. Responses to a questionnaire indicated that individuals who had attempted to dissuade use of condoms did not show a greater tendency to engage in nonsexual risk-taking behaviors. Despite their claims that attempts to dissuade partners from using condoms occurred in committed relationships, condom dissuaders did show evidence of engaging in other high-risk sexual behaviors, e.g., greater number of sexual partners, greater number of sexually transmitted diseases.