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"Liu, Michelle"
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Characterization of an Outbreak of Hand, Foot, and Mouth Disease in Nanchang, China in 2010
Recent outbreaks of human enterovirus 71 (EV71) infection and EV71-associated hand, foot, and mouth disease (HFMD) in China have affected millions and potentially lead to life-threatening complications in newborns. Furthermore, these outbreaks represent a significant global public health issue in the world. Understanding the epidemiology of HFMD and EV71 infection and their transmission patterns in China is essential for controlling outbreaks. However, no studies on the outbreaks of HFMD and EV71 infection in China during 2010 have been reported. In this report, we carried out an epidemiological analysis to study an outbreak of HFMD and EV71 infection in 2010 in the city of Nanchang in the Jiangxi province of People's Republic of China. From April 7 to May 11, 2010, a total of 109 HFMD cases were reported, and in this report the HFMD cases were studied by both epidemiological and laboratory analyses. The epidemiological study indicates that children aged younger than 8 years old represented more than 90% of the reported cases, with the age group of 1-3 years containing the highest number of cases. Laboratory studies detected a high prevalence of EV71 amongst the cases in our study, suggesting EV71 as a common enterovirus found in HFMD cases in Nanchang. Phylogenetic analysis of the sequence of the VP1 region of four EV71 isolates indicated that the Nanchang strains belong to the C4 subgenotype commonly found in China during outbreaks in 2008 but contain distinct variations from these strains. Our study for the first time characterizes the epidemiology of HFMD and EV71 infection in China in 2010 and furthermore, provides the first direct evidence of the genotype of EV71 circulating in Nanchang, China. Our study should facilitate the development of public health measures for the control and prevention of HFMD and EV71 infection in at-risk individuals in China.
Journal Article
Cancer care coordination in rural Hawaii: a focus group study
Background
Rural populations consistently experience a disproportionate burden of cancer, including higher incidence and mortality rates, compared to the urban populations. Factors that are thought to contribute to these disparities include limited or lack of access to care and challenges with care coordination (CC). In Hawaii, many patients residing in rural areas experience unique challenges with CC as they require inter-island travel for their cancer treatment. In this focus group study, we explored the specific challenges and positive experiences that impact the CC in rural Hawaii cancer patients.
Methods
We conducted two semi-structured focus group interviews with cancer patients receiving active treatment for any type of cancer (
n
= 8). The participants were recruited from the rural areas of Hawaii, specifically the Hawaii county and Kauai. Rural was defined using the Rural-Urban Commuting Area Codes (RUCA; rural ≥ 4). The focus group discussions were facilitated using open-ended questions to explore patients’ experiences with CC.
Results
Content analysis revealed that 47% of the discussions were related to CC-related challenges, including access to care (27.3%), insurance (9.1%), inter-island travel (6.1%), and medical literacy (4.5%). Other major themes from the discussions focused on facilitators of CC (30.3%), including the use of electronic patient portal (12.1%), team-based approach (9.1%), family caregiver support (4.5%), and local clinic staff (4.5%).
Conclusion
Our findings indicate that there are notable challenges in rural patients’ experiences regarding their cancer care coordination. Specific factors such as the lack of oncologist and oncology services, fragmented system, and the lack of local general medical providers contribute to problems with access to care. However, there are also positive factors found through the help of facilitators of CC, notability the use of electronic patient portal, team-based approach, family caregiver support, and local clinic staff. These findings highlight potential targets of interventions to improve cancer care delivery for rural patients.
Trial Registration
Not required.
Journal Article
Investigation of Using Hyperspectral Vegetation Indices to Assess Brassica Downy Mildew
Downy mildew caused by Hyaloperonospora brassicae is a severe disease in Brassica oleracea that significantly reduces crop yield and marketability. This study aims to evaluate different vegetation indices to assess different downy mildew infection levels in the Brassica variety Mildis using hyperspectral data. Artificial inoculation using H. brassicae sporangia suspension was conducted to induce different levels of downy mildew disease. Spectral measurements, spanning 350 nm to 1050 nm, were conducted on the leaves using an environmentally controlled setup, and the reflectance data were acquired and processed. The Successive Projections Algorithm (SPA) and signal sensitivity calculation were used to extract the most informative wavelengths that could be used to develop downy mildew indices (DMI). A total of 37 existing vegetation indices and three proposed DMIs were evaluated to indicate downy mildew (DM) infection levels. The results showed that the classification using a support vector machine achieved accuracies of 71.3%, 80.7%, and 85.3% for distinguishing healthy leaves from DM1 (early infection), DM2 (progressed infection), and DM3 (severe infection) leaves using the proposed downy mildew index. The proposed new downy mildew index potentially enables the development of an automated DM monitoring system and resistance profiling in Brassica breeding lines.
Journal Article
Impact of prior flavivirus immunity on Zika virus infection in rhesus macaques
Studies have demonstrated cross-reactivity of anti-dengue virus (DENV) antibodies in human sera against Zika virus (ZIKV), promoting increased ZIKV infection in vitro. However, the correlation between in vitro and in vivo findings is not well characterized. Thus, we evaluated the impact of heterotypic flavivirus immunity on ZIKV titers in biofluids of rhesus macaques. Animals previously infected (≥420 days) with DENV2, DENV4, or yellow fever virus were compared to flavivirus-naïve animals following infection with a Brazilian ZIKV strain. Sera from DENV-immune macaques demonstrated cross-reactivity with ZIKV by antibody-binding and neutralization assays prior to ZIKV infection, and promoted increased ZIKV infection in cell culture assays. Despite these findings, no significant differences between flavivirus-naïve and immune animals were observed in viral titers, neutralizing antibody levels, or immune cell kinetics following ZIKV infection. These results indicate that prior infection with heterologous flaviviruses neither conferred protection nor increased observed ZIKV titers in this non-human primate ZIKV infection model.
Journal Article
The Unbearable Whiteness of John Brown: Theatrical Legacies and Performing Abolition
John Brown is a figure so intensely contested as to embody diametrically opposed meanings according to the varied contexts in which his image has been activated. At times hailed as the man who started the US Civil War, Brown has been variously described as a righteous abolitionist, a religious zealot, a gifted orator, a formidable military strategist, a self-appointed white savior, and a madman. Today, Brown is conjured in the name of all manner of causes, from leftist gun clubs to collegiate sports, while his theatricalized image is activated in wildly disparate ways. The apparent singularity of Brown as a historical figure, together with his ready adoption and deployment across various arenas—from entertainment to revolutionary politics—presents a problem familiar to theatre and performance scholars, namely the space between the image or concept of a person (or a character) and their actual performance, in life or onstage. There is perhaps an obvious tension in the ways that John Brown is remembered and reperformed and for whom he is remembered and reperformed. Or, as Ted A. Smith points out in thinking with Brown: \"An image, however iconic, is not an argument.\"
Journal Article
Expression Divergence in Response to Sex-biased Selection
It remains debated whether greater degrees of sexual dimorphism would evolve if not for intersexual genetic constraints. Here, we used experimental evolution to partially break the intersexual genetic constraint in Drosophila melanogaster to investigate the effects of a shared gene pool on the evolution of sexual dimorphism in gene expression. In six replicate populations of 1,000 flies, a dominant marker (DsRed) was used to force a “Red” pool of genetically variable Chromosome 2 copies through exclusive father-to-son inheritance, while a complimentary pool of “NonRed” chromosomes was inherited primarily from mothers to daughters. After 100 generations, we demonstrated the effect of Red male-limited chromosomes in increasing male mating success. Differentially expressed genes between flies with and without Red chromosomes had on average higher intersexual genetic correlations (rMF), as expected if such correlations represent a constraint to sex-specific adaptation under normal inheritance. If conflict hinders the evolution of further dimorphism, the transcriptomes of male-selected Red chromosomes were predicted to evolve to be “masculinized” relative to female-selected NonRed chromosomes. Consistent with this, splicing patterns in Red males (but not Red females) were masculinized relative to NonRed males. Contrastingly, gene expression levels were largely feminized in Red flies of both sexes compared with NonRed. We discuss alternative forms of intralocus sexual conflict that may explain these patterns.
Journal Article
