Host Diversification May Split Epidemic Spread into Two Successive Fronts Advancing at Different Speeds.

Host diversification methods such as within-field mixtures (or field mosaics, depending on the spatial scale considered) are promising methods for agroecological plant disease control. We explore disease spread in host mixtures (or field mosaics) composed of two host genotypes (susceptible and resistant). The pathogen population is composed of two genotypes (wild-type and resistance-breaking). We show that for intermediate fractions of resistant hosts, the spatial spread of the disease may be split into two successive fronts. The first front is led by the wild-type pathogen and the disease spreads faster, but at a lower prevalence, than in a resistant pure stand (or landscape). The second front is led by the resistance-breaking type, which spreads slower than in a pure resistant stand (or landscape). The wild-type and the resistance-breaking genotypes coexist behind the invasion fronts, resulting in the same prevalence as in a resistant pure stand. This study shows that host diversification methods may have a twofold effect on pathogen spread compared to a resistant pure stand (or landscape): on the one hand, they accelerate disease spread, and on the other hand they slow down the spread of the resistance-breaking genotype. This work contributes to a better understanding of the multiple effects underlying the performance of host diversification methods in agroecology.

A hybrid gravity and route choice model to assess vector traffic in large-scale road networks.

Human traffic along roads can be a major vector for infectious diseases and invasive species. Though most road traffic is local, a small number of long-distance trips can suffice to move an invasion or disease front forward. Therefore, understanding how many agents travel over long distances and which routes they choose is key to successful management of diseases and invasions. Stochastic gravity models have been used to estimate the distribution of trips between origins and destinations of agents. However, in large-scale systems, it is hard to collect the data required to fit these models, as the number of long-distance travellers is small, and origins and destinations can have multiple access points. Therefore, gravity models often provide only relative measures of the agent flow. Furthermore, gravity models yield no insights into which roads agents use. We resolve these issues by combining a stochastic gravity model with a stochastic route choice model. Our hybrid model can be fitted to survey data collected at roads that are used by many long-distance travellers. This decreases the sampling effort, allows us to obtain absolute predictions of both vector pressure and pathways, and permits rigorous model validation. After introducing our approach in general terms, we demonstrate its benefits by applying it to the potential invasion of zebra and quagga mussels (Dreissena spp.) to the Canadian province British Columbia. The model yields an R 2-value of 0.73 for variance-corrected agent counts at survey locations.

HEREDITARY ENDOCRINE TUMOURS: CURRENT STATE-OF-THE-ART AND RESEARCH OPPORTUNITIES: MEN1-related pancreatic NETs: identification of unmet clinical needs and future directives.

The PanNET Working Group of the 16th International Multiple Endocrine Neoplasia Workshop (MEN2019) convened in Houston, TX, USA, 27-29 March 2019 to discuss key unmet clinical needs related to PanNET in the context of MEN1, with a special focus on non-functioning (nf)-PanNETs. The participants represented a broad range of medical scientists as well as representatives from patient organizations, pharmaceutical industry and research societies. In a case-based approach, participants addressed early detection, surveillance, prognostic factors and management of localized and advanced disease. For each topic, after a review of current evidence, key unmet clinical needs and future research directives to make meaningful progress for MEN1 patients with nf-PanNETs were identified. International multi-institutional collaboration is needed for adequately sized studies and validation of findings in independent datasets. Collaboration between basic, translational and clinical scientists is paramount to establishing a translational science approach. In addition, bringing clinicians, scientists and patients together improves the prioritization of research goals, assures a patient-centered approach and maximizes patient involvement. It was concluded that collaboration, research infrastructure, methodologic and reporting rigor are essential to any translational science effort. The highest priority for nf-PanNETs in MEN1 syndrome are (1) the development of a data and biospecimen collection architecture that is uniform across all MEN1 centers, (2) unified strategies for diagnosis and follow-up of incident and prevalent nf-PanNETs, (3) non-invasive detection of individual nf-PanNETs that have an increased risk of metastasis, (4) chemoprevention clinical trials driven by basic research studies and (5) therapeutic targets for advanced disease based on biologically plausible mechanisms.

A method for screening groundwater vulnerability from subsurface hydrocarbon extraction practices.

This paper describes a new screening method for assessing groundwater vulnerability to pollution from hydrocarbon exploitation in the subsurface. The method can be used for various hydrocarbon energy sources, including conventional oil and gas, shale gas and oil, coal bed methane and underground coal gasification. Intrinsic vulnerability of potential receptors is assessed at any particular location by identifying possible geological pathways for contaminant transport. This is followed by an assessment of specific vulnerability which takes into account the nature of the subsurface hydrocarbon activity and driving heads. A confidence rating is attached to each parameter in the assessment to provide an indication of the confidence in the screening. Risk categories and associated confidence ratings are designed to aid in environmental decision making, regulation and management, highlighting where additional information is required. The method is demonstrated for conventional gas and proposed shale gas operations in northern England but can be adapted for use in any geological or hydrogeological setting and for other subsurface activities.

Modulation of Candida albicans virulence in in vitro biofilms by oral bacteria.

Candida-associated denture stomatitis presents as erythema of the palatal mucosa and is caused by biofilms containing the fungus Candida albicans that co-reside with oral bacteria on the denture-fitting surface. This study aimed to assess the effect of several frequently encountered oral bacteria on the expression of C. albicans virulence factors in in vitro polymicrobial biofilms. Biofilms containing C. albicans and selected bacterial species were grown on denture acrylic, and analysed by microscopy and by qPCR for expression of putative virulence genes. Candida albicans-only biofilms showed limited hyphal production. Hyphal development was significantly (P < 0·001) increased when biofilms also contained four species of oral bacteria (Streptococcus sanguinis, Streptococcus gordonii, Actinomyces odontolyticus and Actinomyces viscosus), as was the expression of virulence genes (P < 0·05). Importantly, inclusion of Porphyromonas gingivalis in the biofilm consortium resulted in significant (P < 0·05) inhibition of virulence gene expression and production of hyphae. The in vitro expression of C. albicans virulence factors was modulated in polymicrobial biofilms. The complexity of this modulation was highlighted by the reversal of effects following introduction of a single bacterial species into a biofilm community. SIGNIFICANCE AND IMPACT OF THE STUDY: The impact of individual bacterial species on Candida albicans virulence highlights both the complexity of predicting infection mediated by polymicrobial communities and the potential for management through pro- or prebiotic therapy. The possibility to selectively modulate microbial virulence by addition of, or treatment with pro- or prebiotics avoids the use of conventional antimicrobial compounds, thus reducing the contribution to potential drug resistance. Understanding which bacterial species modulate virulence, and the mechanisms by which this occurs, particularly in biofilms, provides excellent foundations for further research questions, and the potential for novel clinical interventions.

Mouth cancer: presentation, detection and referral in primary dental care.

Mouth cancer can present as a variety of abnormalities and visible changes affecting the oral mucosa, including ulceration, swelling and areas of erythema. The five-year survival from mouth cancer is poor at approximately 50%. Detection of the cancer while less than 2 cm in diameter with no metastasis greatly improves the outcome for the patient. Although many cancers in the mouth develop from what was previously an apparently normal mucosa, some arise in pre-existing conditions that are therefore regarded as potentially malignant. Regular assessment of the soft tissues within the mouth and the neck for the presence of abnormalities is an essential component of primary dental care. Any persistent and unexplained abnormality requires referral for definitive diagnosis and specialist management.

Global patterns of nitrate storage in the vadose zone.

Global-scale nitrogen budgets developed to quantify anthropogenic impacts on the nitrogen cycle do not explicitly consider nitrate stored in the vadose zone. Here we show that the vadose zone is an important store of nitrate that should be considered in future budgets for effective policymaking. Using estimates of groundwater depth and nitrate leaching for 1900-2000, we quantify the peak global storage of nitrate in the vadose zone as 605-1814 Teragrams (Tg). Estimates of nitrate storage are validated using basin-scale and national-scale estimates and observed groundwater nitrate data. Nitrate storage per unit area is greatest in North America, China and Europe where there are thick vadose zones and extensive historical agriculture. In these areas, long travel times in the vadose zone may delay the impact of changes in agricultural practices on groundwater quality. We argue that in these areas use of conventional nitrogen budget approaches is inappropriate.

Diagnosis and management of oral candidosis.

Candida is a fungus (yeast) that is generally regarded as a normal and harmless member of the oral microbiome in humans. Should host defences against these commensals be compromised in any way then Candida can cause clinical signs and symptoms, which manifest as distinct forms of oral candidosis (candidiasis). Candida albicans is the most frequently isolated candidal species from the oral cavity, although a range of non-C. albicans Candida species are being increasingly encountered. The basic principle of the management of candidosis is to identify and eliminate any underlying host predisposing factor. However, in many cases, antifungal therapy will also be required as part of initial management. This article will provide an overview of the isolation, identification and pathogenicity of Candida species encountered within the mouth and relate these to clinical management of oral candidosis.

Aggregation and a strong Allee effect in a cooperative outbreak insect.

Most species that are negatively impacted when their densities are low aggregate to minimize this effect. Aggregation has the potential to change how Allee effects are expressed at the population level. We studied the interplay between aggregation and Allee effects in the mountain pine beetle (Dendroctonus ponderosae Hopkins), an irruptive bark beetle that aggregates to overcome tree defenses. By cooperating to surpass a critical number of attacks per tree, the mountain pine beetle is able to breach host defenses, oviposit, and reproduce. Mountain pine beetles and Hymenopteran parasitoids share some biological features, the most notable of which is obligatory host death as a consequence of parasitoid attack and development. We developed spatiotemporal models of mountain pine beetle dynamics that were based on the Nicholson-Bailey framework but which featured beetle aggregation and a tree-level attack threshold. By fitting our models to data from a local mountain pine beetle outbreak, we demonstrate that due to aggregation, attack thresholds at the tree level can be overcome by a surprisingly low ratio of beetles per susceptible tree at the stand level. This results confirms the importance of considering aggregation in models of organisms that are subject to strong Allee effects.

Antimicrobial prescribing by dentists in Wales, UK: findings of the first cycle of a clinical audit.

Objective To describe the findings of the first cycle of a clinical audit of antimicrobial use by general dental practitioners (GDPs).Setting General dental practices in Wales, UK.Subjects and methods Between April 2012 and March 2015, 279 GDPs completed the audit. Anonymous information about patients prescribed antimicrobials was recorded. Clinical information about the presentation and management of patients was compared to clinical guidelines published by the Scottish Dental Clinical Effectiveness Programme (SDCEP).Results During the data collection period, 5,782 antimicrobials were prescribed in clinical encounters with 5,460 patients. Of these 95.3% were antibiotic preparations, 2.7% were antifungal agents, and 0.6% were antivirals. Of all patients prescribed antibiotics, only 37.2% had signs of spreading infection or systemic involvement recorded, and 31.2% received no dental treatment. In total, 79.2% of antibiotic, 69.4% of antifungal, and 57.6% of antiviral preparations met audit standards for dose, frequency, and duration. GDPs identified that failure of previous local measures, patient unwillingness or inability to receive treatment, patient demand, time pressures, and patients' medical history may influence their prescribing behaviours.Conclusions The findings of the audit indicate a need for interventions to support GDPs so that they may make sustainable improvements to their antimicrobial prescribing practices.

The changing trend in nitrate concentrations in major aquifers due to historical nitrate loading from agricultural land across England and Wales from 1925 to 2150.

Nitrate is necessary for agricultural productivity, but can cause considerable problems if released into aquatic systems. Agricultural land is the major source of nitrates in UK groundwater. Due to the long time-lag in the groundwater system, it could take decades for leached nitrate from the soil to discharge into freshwaters. However, this nitrate time-lag has rarely been considered in environmental water management. Against this background, this paper presents an approach to modelling groundwater nitrate at the national scale, to simulate the impacts of historical nitrate loading from agricultural land on the evolution of groundwater nitrate concentrations. An additional process-based component was constructed for the saturated zone of significant aquifers in England and Wales. This uses a simple flow model which requires modelled recharge values, together with published aquifer properties and thickness data. A spatially distributed and temporally variable nitrate input function was also introduced. The sensitivity of parameters was analysed using Monte Carlo simulations. The model was calibrated using national nitrate monitoring data. Time series of annual average nitrate concentrations along with annual spatially distributed nitrate concentration maps from 1925 to 2150 were generated for 28 selected aquifer zones. The results show that 16 aquifer zones have an increasing trend in nitrate concentration, while average nitrate concentrations in the remaining 12 are declining. The results are also indicative of the trend in the flux of groundwater nitrate entering rivers through baseflow. The model thus enables the magnitude and timescale of groundwater nitrate response to be factored into source apportionment tools and to be taken into account alongside current planning of land-management options for reducing nitrate losses.

Contaminant profiles for surface water, sediment, flora and fauna associated with the mangrove fringe along middle and lower eastern Tampa Bay.

Contaminant concentrations are reported for surface water, sediment, flora and fauna collected during 2010-2011 from the mangrove fringe along eastern Tampa Bay, Florida. Concentrations of trace metals, chlorinated pesticides, atrazine, total polycyclic aromatic hydrocarbons, and polychlorinated biphenyls were species-, chemical- and location-specific. Contaminants in sediments did not exceed proposed individual sediment quality guidelines. Most sediment quality assessment quotients were less than one indicating the likelihood of no inhibitory effect based on chemical measurements alone. Faunal species typically contained more contaminants than plant species; seagrass usually contained more chemicals than mangroves. Bioconcentration factors for marine angiosperms were usually less than 10 and ranged between 1 and 31. Mercury concentrations (ppm) in blue crabs and fish did not exceed the U.S. Environmental Protection Agency fish tissue criterion of 0.3 and the U.S. Food and Drug Administration action level of 1.0. In contrast, total mercury concentrations in faunal species often exceeded guideline values for wildlife consumers of aquatic biota.

Pitpnm1 is expressed in hair cells during development but is not required for hearing.

Deafness is a genetically complex disorder with many contributing genes still unknown. Here we describe the expression of Pitpnm1 in the inner ear. It is expressed in the inner hair cells of the organ of Corti from late embryonic stages until adulthood, and transiently in the outer hair cells during early postnatal stages. Despite this specific expression, Pitpnm1 null mice showed no hearing defects, possibly due to redundancy with the paralogous genes Pitpnm2 and Pitpnm3.

Continuing dental education: evaluation of the effectiveness of a disinfection and decontamination course.

AIM: To evaluate a disinfection and decontamination dental postgraduate course run by the Wales Dental Postgraduate Deanery between 2008 and 2010. METHODS: Pre- and post-course multiple choice questionnaires were completed by 1177 course attendees. Mean scores before and after participation on the training course were compared and analysed. RESULTS: Mean pre-course score was 45.3%, rising to 87.0% in the post-course assessment, reflecting an improvement of 41.8%. Prior to training, 30.7% achieved a satisfactory score of 13/20 (65%) compared to 98.3% on completion of training. Dental technicians were found to score significantly lower than other occupation groups both before and after course attendance. Decade of graduation had no effect on results. Theoretical microbiology was the question area which showed least improvement. CONCLUSION: Attending the disinfection and decontamination course significantly improved participants' knowledge. Theoretical microbiology, as a topic area, may be targeted for improvements in future courses to improve results further.

Development and psychometric evaluation of the public health surveillance well-being scale.

PURPOSE: To develop and psychometrically evaluate the brief Public Health Surveillance Well-Being Scale (PHS-WB) that captures mental, physical, and social components of well-being. METHODS: Using data from 5,399 HealthStyles survey respondents, we conducted bi-factor, item response theory, and differential item functioning analyses to examine the psychometric properties of a pool of 34 well-being items. Based on the statistical results and content considerations, we developed a brief 10-item well-being scale and assessed its construct validity through comparisons of demographic subgroups and correlations with measures of related constructs. RESULTS: Based on the bi-factor analyses, the items grouped into both an overall factor and individual domain-specific factors. The PHS-WB scale demonstrated good internal consistency (alpha = 0.87) and correlated highly with scores for the entire item pool (r = 0.94). The well-being scale scores differed as expected across demographic groups and correlated with global and domain-specific measures of similar constructs, supporting its construct validity. CONCLUSION: The 10-item PHS-WB scale demonstrates good psychometric properties, and its high correlation with the item pool suggests minimal loss of information with the use of fewer items. The brief PHS-WB allows for well-being assessment on national surveys or in other situations where a longer form may not be feasible.

Microbial contamination of removable prosthodontic appliances from laboratories and impact of clinical storage.

Decontamination of dental instruments has recently been the subject of considerable debate. However, little information is available on the potential bacterial colonisation of dental appliances returning from dental laboratories and their need for decontamination. This study investigated the extent and nature of microbial contamination of removable prosthodontic appliances produced at different dental laboratories and stored in two clinical teaching units (CTU 1 and CTU 2) of a dental hospital and school. Forty consecutive dental prosthodontic appliances that were being stored under varying conditions in the two clinical teaching units were selected for study; the appliances having been produced 'in-house' (hospital laboratory) or 'out-of-house' (external commercial laboratory). Two appliances, that were known to have undergone decontamination before storage, were used as controls. Swabs were taken according to a standard protocol and transferred to the microbiological laboratory with bacterial growth expressed as colony forming units (cfu) per cm(2). Microbial sampling yielded growth from 23 (58%) of the 40 appliances studied (CTU 1, n = 22; CTU 2, n = 18), with 38% of these having a high level of contamination (>42,000 cfu/cm(2)). The predominant bacteria isolated were Bacillus spp. (57%), pseudomonads (22%) and staphylococci (13%). Fungi of the genus Candida were detected in 38% of the samples. There was no significant difference in contamination of the appliances in relation to either their place of production or the CTU (p >0.05). However, the level of contamination was significantly higher (p = 0.035) for those appliances stored in plastic bag with fluid (n = 16) compared to those stored on models (n = 19). No growth was recovered from the two appliances that had undergone decontamination before storage. The research showed that appliances received from laboratories are often contaminated and therefore there is a need for routine disinfection of such items before use and a review of storage conditions required.

Antimicrobial activity of Citrox bioflavonoid preparations against oral microorganisms.

BACKGROUND: Citrox is a formulation of soluble bioflavonoids obtained from citrus fruits. The non-toxic and antimicrobial properties of natural bioflavonoids are well documented, and consequently there has been interest in the therapeutic application of these substances. OBJECTIVE: To determine the antimicrobial activity of two Citrox formulations (BC30 and MDC30) with different bioflavonoid combinations against a range of oral microorganisms. METHODS: The antimicrobial activity of both formulations was tested against 14 bacterial species and six Candida species. The two Citrox formulations (dilution range 0.007-8% v/v) were firstly evaluated by determining the in vitro Minimal Inhibitory Concentration (MIC) against planktonic microorganisms in a broth microdilution assay. Secondly, the ability of the same serial dilutions to inhibit microbial growth was assessed in a modified microtitre biofilm assay. RESULTS: Both Citrox formulations exhibited antimicrobial activity. The BC30 formulation demonstrated greater activity than MDC30 and significantly inhibited growth of all bacterial species and most candidal species tested at a concentration of 1% (v/v) in both the broth and the biofilm assay. CONCLUSION: Bioflavonoid preparations of Citrox have a broad-spectrum of antimicrobial activity against oral microorganisms, and as such have the potential to be used within therapeutic preparations for the control of the oral microflora.