geoFOR: A collaborative forensic taphonomy database for estimating the postmortem interval.

Accurately assessing the postmortem interval (PMI), or the time since death, remains elusive within forensic science research and application. This paper introduces geoFOR, a web-based collaborative application that utilizes ArcGIS and machine learning to deliver improved PMI predictions. The geoFOR application provides a standardized, collaborative forensic taphonomy database that gives practitioners a readily available tool to enter case information that automates the collection of environmental data and delivers a PMI prediction using statistically robust methods. After case submission, the cross-validating machine learning PMI predictive model results in a R² value of 0.82. Contributors receive a predicted PMI with an 80% confidence interval. The geoFOR database currently contains 2529 entries from across the U.S. and includes cases from medicolegal investigations and longitudinal studies from human decomposition facilities. We present the overall findings of the data collected so far and compare results from medicolegal cases and longitudinal studies to highlight previously poorly understood limitations involved in the difficult task of PMI estimation. This novel approach for building a reference dataset of human decomposition is forensically and geographically representative of the realities in which human remains are discovered which allows for continual improvement of PMI estimations as more data is captured. It is our goal that the geoFOR data repository follow the principles of Open Science and be made available to forensic researchers to test, refine, and improve PMI models. Mass collaboration and data sharing can ultimately address enduring issues associated with accurately estimating the PMI within medicolegal death investigations.

Seasonal Abundance of Aedes Sollicitans and Aedes Taeniorhynchus Related to Temperature, Rainfall and Tidal Levels in Northeastern Florida.

The Anastasia Mosquito Control District, which manages mosquitoes in St. Johns County in northeastern Florida, has observed that the maximum numbers of the salt marsh mosquitoes, Aedes taeniorhynchus and Ae. sollicitan appeared to shift or change relative to each other, as evidenced by the Centers for Disease Control and Prevention (CDC) light trap data in the past 17 years. The aim of this study was to analyze environmental data to identify and explore these changes. Data from CDC light traps, temperature, rainfall, and tidal levels were analyzed using ANOVA. Analyses showed the 2 species had maximum abundance at different temperatures, which translated into seasonal differences with peaks of Ae. taeniorhynchus in the summer and, to a lesser extent, later in the year, and Ae. sollicitans with a peak in the autumn. This seasonal pattern was reflected in rainfall (more rain in autumn than in summer) and also, in the general area, in tidal levels (mean highest tide levels at the recording station were in autumn). The research demonstrated that simplifying the mosquito data, initially using only very high trap numbers (Mean ± 2 SD) that are important for control, identified, and made the seasonal pattern very obvious. The pattern was also observed using all the data but, although significant, was not as clear. Having identified tide as a potential driving variable, further research needs to detail spatial tidal patterns to identify areas and timing of flooding and explore the relationship between salinity and mosquito species and abundance. This is important as sea levels rise and climate changes, both potentially changing the mosquito situation and affecting control actions.

Environmental determinants and risk behaviour in the case of indigenous malaria in Muara Enim Regency, Indonesia: A case-control design.

INTRODUCTION: Malaria is a significant public health concern in Indonesia. Muara Enim Regency is one of the districts in South Sumatra with the most important number of indigenous malaria cases in the last three years (2018-2020). Therefore, this study aimed to identify determinants of indigenous malaria in the Muara Enim Regency. METHODS: This study was designed as a case-control study. A stratified random sample in 2018, 2019, and 2020 was used at the Primary Health Centres (PHCs) areas of Tanjung Enim and Tanjung Agung. The sample included 49 cases and 49 controls. Indigenous malaria determinants were discovered using both bivariable and multivariable logistic regression models. RESULT: The multivariable logistic regression model results show that mosquito repellent reduces malaria risk by 71% (AOR = 0.29, 95% CI: 0.11-0.64). Besides, the presence of wire mesh on ventilation reduces the risk of malaria by 76% (AOR = 0.24, 95% CI: 0.10-0.57), and the distance from mosquito breeding sites near hundred meters and fewer increases the risk of malaria by 3.88 fold (AOR = 3.88; 95% CI: 1.67-8.97). CONCLUSIONS: Multivariable analysis revealed distance from mosquito breeding sites as a risk factor for malaria. Besides, the study shows that using insect repellent, wire netting in ventilation, eliminating mosquito breeding sites, mosquito repellent or protective clothing, and improving house conditions were protective factors for indigenous malaria. Therefore, preventive and promotional efforts are essential as the first step toward malaria elimination at the study site, including avoiding direct contact between residents and vectors near mosquito breeding sites.

Diabetes Patient Surveillance in the Emergency Department: Proof of Concept and Opportunities.

INTRODUCTION: The purpose of this study was to characterize the at-risk diabetes and prediabetes patient population visiting emergency department (ED) and urgent care (UC) centers in upstate South Carolina. METHODS: We conducted this retrospective study at the largest non-profit healthcare system in South Carolina, using electronic health record (EHR) data of patients who had an ED or UC visit between February 2, 2016-July 31, 2018. Key variables including International Classification of Diseases, 10th Revision codes, laboratory test results, family history, medication, and demographic characteristics were used to classify the patients as healthy, having prediabetes, having diabetes, being at-risk for prediabetes, or being at-risk for diabetes. Patients who were known to have diabetes were classified further as having controlled diabetes, management challenged, or uncontrolled diabetes. Population analysis was stratified by the patient's annual number of ED/UC visits. RESULTS: The risk stratification revealed 4.58% unique patients with unrecognized diabetes and 10.34% of the known patients with diabetes considered to be suboptimally controlled. Patients identified as diabetes management challenged had more ED/UC visits. Of note, 33.95% of the patients had unrecognized prediabetes/diabetes risk factors identified during their ED/UC with 87.95% having some form of healthcare insurance. CONCLUSION: This study supports the idea that a single ED/UC unscheduled visit can identify individuals with unrecognized diabetes and an at-risk prediabetes population using EHR data. A patient's ED/UC visit, regardless of their primary reason for seeking care, may be an opportunity to provide early identification and diabetes disease management enrollment to augment the medical care of our community.

Disease Risk & Landscape Attributes of Tick-Borne Borrelia Pathogens in the San Francisco Bay Area, California.

Habitat heterogeneity influences pathogen ecology by affecting vector abundance and the reservoir host communities. We investigated spatial patterns of disease risk for two human pathogens in the Borrelia genus-B. burgdorferi and B. miyamotoi-that are transmitted by the western black-legged tick, Ixodes pacificus. We collected ticks (349 nymphs, 273 adults) at 20 sites in the San Francisco Bay Area, California, USA. Tick abundance, pathogen prevalence and density of infected nymphs varied widely across sites and habitat type, though nymphal western black-legged ticks were more frequently found, and were more abundant in coast live oak forest and desert/semi-desert scrub (dominated by California sagebrush) habitats. We observed Borrelia infections in ticks at all sites where we able to collect >10 ticks. The recently recognized human pathogen, B. miyamotoi, was observed at a higher prevalence (13/349 nymphs = 3.7%, 95% CI = 2.0-6.3; 5/273 adults = 1.8%, 95% CI = 0.6-4.2) than recent studies from nearby locations (Alameda County, east of the San Francisco Bay), demonstrating that tick-borne disease risk and ecology can vary substantially at small geographic scales, with consequences for public health and disease diagnosis.

Mass spectrometry identification of age-associated proteins from the malaria mosquitoes Anopheles gambiae s.s. and Anopheles stephensi.

This study investigated proteomic changes occurring in Anopheles gambiae and Anopheles stephensi during adult mosquito aging. These changes were evaluated using two-dimensional difference gel electrophoresis (2D-DIGE) and the identities of aging related proteins were determined using capillary high-pressure liquid chromatography (capHPLC) coupled with a linear ion-trap (LTQ)-Orbitrap XL hybrid mass spectrometry (MS). Here, we have described the techniques used to determine age associated proteomic changes occurring in heads and thoraces across three age groups; 1, 9 and 17 d old A. gambiae and 4 age groups; 1, 9, 17 and 34 d old A. stephensi. We have provided normalised spot volume raw data for all protein spots that were visible on 2D-DIGE images for both species and processed Orbitrap mass spectrometry data. For public access, mass spectrometry raw data are available via ProteomeXchange with identifier PXD002153. A detailed description of this study has been described elsewhere [1].

Proteomic changes occurring in the malaria mosquitoes Anopheles gambiae and Anopheles stephensi during aging.

The age of mosquitoes is a crucial determinant of their ability to transmit pathogens and their resistance to insecticides. We investigated changes to the abundance of proteins found in heads and thoraces of the malaria mosquitoes Anopheles gambiae and Anopheles stephensi as they aged. Protein expression changes were assessed using two-dimensional difference gel electrophoresis and the identity of differentially expressed proteins was determined by using either matrix-assisted laser desorption ionization tandem time-of-flight mass spectrometry or capillary high-pressure liquid chromatography coupled with a linear ion-trap (LTQ)-Orbitrap XL hybrid mass spectrometer. Protein biomarkers were validated by semi quantitative Western blot analysis. Nineteen and nine age dependent protein spots were identified for A. stephensi and A. gambiae, respectively. Among the proteins down-regulated with age were homologs of ADF/Cofilin, cytochome c1, heat shock protein-70 and eukaryotic translation initiation factor 5A (eIF5a). Proteins up-regulated with age included probable methylmalonate-semialdehyde dehydrogenase, voltage-dependent anion-selective channel and fructose bisphosphate aldolase. Semi quantitative Western blot analysis confirmed expression patterns observed by 2-D DIGE for eIF5a and ADF/Cofilin. Further work is recommended to determine whether these biomarkers are robust to infection, blood feeding and insecticide resistance. Robust biomarkers could then be incorporated into rapid diagnostic assays for ecological and epidemiological studies. BIOLOGICAL SIGNIFICANCE: In this study, we have identified several proteins with characteristic changes in abundance in both A. gambiae and A. stephensi during their aging process. These changes may highlight underlying mechanisms beneath the relationship between mosquito age and factors affecting Plasmodium transmission and mosquito control. The similarity of changes in protein abundance between these species and the primary dengue vector Aedes aegypti, has revealed conserved patterns of aging-specific protein regulation.

Everybody matters 2: promoting dignity in acute care through effective communication.

The Dignity in Care Project (DCP) aims to deepen understanding and develop practical interventions to promote dignified care in hospitals. A key feature is that "everybody matters" (a project slogan) and that promoting and sustaining dignity in acute care requires recognition and support for staff as well as for patients and their families. DCP is a nurse led research collaboration with Royal Free Hampstead Trust, Barnet and Chase Farm Hospitals Trust and City University. Practical interventions devised by the project are presented around three keythemes. Part 1 of this series explored the first theme, "maintaining identity: see who I am", and this second part examines the second theme, "creating community: connect with me". This recognises that in the act of caring, nurses receive as well as give. Dignified care has a reciprocity where both carer and patient/family give and receive, rather than simply involving a list of practical tasks done t o someone. The third and final part looks at "shared decision making involve me" (Bridges et al, 2009).

Everybody matters. 1: How getting to know your patients helps to promote dignified care.

The Dignity in Care Project aims to develop practical interventions to promote dignified care in hospitals, embedded in the project slogan: "Everybody matters: sustaining dignity in care." It is a nurse led research collaboration with Royal Free Hampstead and Barnet and Chase Farm Hospitals Trusts and City University. Practical interventions devised by the project are presented around three main themes that emerged from the views of older people and their relatives (Bridges et al, 2010; 2009). The first theme of "maintaining identity--see who I am" focuses on knowing about people, while the second of "creating community--connect with me" recognises that in the act of caring, nurses receive as well as give. The last theme of "shared decision making--involve me" looks at how decisions about care are made. This first article in a three part series summarises the project and focuses on the first theme. It reports on practical initiatives to enhance dignity in hospitals by enabling nurses and patients/carers to know and value each other as people.

Evaluating the risk of potential acid sulfate soils and habitat modification for mosquito control (runneling) in coastal salt marshes: comparing methods and managing the risk.

Coastal environments in Australia are under development pressures. Human settlement encroaches on disease vector salt marsh mosquito breeding areas that are underlain by potential acid sulfate soils (PASS). Altering the hydrology by runneling solves the mosquito problem but may lead to acid sulfate problems. Appropriate analytical tools can assess the risk to the environment. The objective of the research was to compare three methods of assessing PASS. The study area was a low-lying intertidal subtropical salt marsh that was being considered for runneling. The results indicated that using field pH and field peroxide pH (and the relationship between these), and also the peroxide oxidation-combined acidity and sulfate (POCAS) test, appeared to overestimate the potential acidity. This was because the source of acidity in the intertidal salt marsh includes a large organic content, which is not a major environmental concern. The chromium-reducible sulfur test, which is not affected by organic content, was found to provide the most appropriate assessment, and is recommended for use in highly organic salt marshes.