Behavioral responses of terrestrial mammals to COVID-19 lockdowns.

COVID-19 lockdowns in early 2020 reduced human mobility, providing an opportunity to disentangle its effects on animals from those of landscape modifications. Using GPS data, we compared movements and road avoidance of 2300 terrestrial mammals (43 species) during the lockdowns to the same period in 2019. Individual responses were variable with no change in average movements or road avoidance behavior, likely due to variable lockdown conditions. However, under strict lockdowns 10-day 95th percentile displacements increased by 73%, suggesting increased landscape permeability. Animals' 1-hour 95th percentile displacements declined by 12% and animals were 36% closer to roads in areas of high human footprint, indicating reduced avoidance during lockdowns. Overall, lockdowns rapidly altered some spatial behaviors, highlighting variable but substantial impacts of human mobility on wildlife worldwide.

Exposure to diverse sarbecoviruses indicates frequent zoonotic spillover in human communities interacting with wildlife.

BACKGROUND: Sarbecoviruses are a subgenus of Coronaviridae that mostly infect bats with known potential to infect humans (SARS-CoV and SARS-CoV-2). Populations in Southeast Asia, where these viruses are most likely to emerge, have been undersurveyed to date. METHODS: We surveyed communities engaged in extractive industries and bat guano harvesting from rural areas in Myanmar. Participants were screened for exposure to sarbecoviruses, and their interactions with wildlife were evaluated to determine the factors associated with exposure to sarbecoviruses. RESULTS: Of 693 people screened between July 2017 and February 2020, 12.1% were seropositive for sarbecoviruses. Individuals were significantly more likely to have been exposed to sarbecoviruses if their main livelihood involved working in extractive industries (logging, hunting, or harvesting of forest products; odds ratio [OR] = 2.71, P = 0.019) or had been hunting/slaughtering bats (OR = 6.09, P = 0.020). Exposure to a range of bat and pangolin sarbecoviruses was identified. CONCLUSION: Exposure to diverse sarbecoviruses among high-risk human communities provides epidemiologic and immunologic evidence that zoonotic spillover is occurring. These findings inform risk mitigation efforts needed to decrease disease transmission at the bat-human interface, as well as future surveillance efforts warranted to monitor isolated populations for viruses with pandemic potential.

Clinician Perspectives on Cannulation for Extracorporeal Cardiopulmonary Resuscitation: A Mixed Methods Analysis.

Out-of-hospital cardiac arrest is a leading cause of mortality with survival rates of less than 10%. In selected patients, survival may be improved via timely application of extracorporeal cardiopulmonary resuscitation (ECPR). However, ECPR is a complex and resource intensive intervention with a high risk of complications that impair widespread clinical adoption. This study employed a mixed approach of qualitative interview analysis embedded with quantitative data collection to uncover the major hurdles faced by clinicians during ECPR initiation. We conducted semi-structured interviews with eight ECPR intensive care specialists with 2-10 years of experience working at a large, tertiary ECPR center in Australia. Clinicians identified dilation as the most time-consuming step, followed by draping, and decision-making during extracorporeal membrane oxygenation patient selection. The most challenging step was the decision-making for patient selection, followed by dilation and imaging. These findings uncovered key barriers to ECPR, and identified priority areas for further research and clinical training. Major logistical hindrances will require well-defined protocols and improved clinical training. Engineering innovations in the identified areas may improve the delivery of ECPR, making it simpler and faster to deliver.

Er:YAG Laser-Activated Irrigation in Comparison with Different Irrigation Systems for Cleaning the Apical Root Canal Area Beyond Ledge.

Objective: To evaluate the effectiveness of erbium:yttrium aluminum garnet (Er:YAG) laser-activated irrigation (LAI) for cleaning the apical root canal area beyond a ledge. Background data: This was the first study that evaluated the efficacy of LAI in debris and smear layer removal from such hard-to-reach canal areas in human teeth. Methods: Eighty-eight human maxillary molars with either a mesiobuccal or distobuccal canal with 25°-35° curvature and mature apices were used. Following instrumentation to a size 25/0.02 taper, a ledge was created at 2.2 ± 0.7 mm short of the apex and checked using microcomputed tomography. Samples were divided into four groups: syringe irrigation (SI), ultrasonic-activated irrigation (UAI), agitation with the XP-endo Finisher (XP), and LAI. Each group was subdivided based on the irrigation regimen: 9 mL of 6% sodium hypochlorite (NaOCl), and 6 mL of 6% NaOCl +3 mL of 14.3% ethylenediaminetetraacetic acid (EDTA) (n = 11). The apical 1-mm region was examined using scanning electron microscopy to evaluate the remaining debris and smear layer. Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test (a = 0.05). Results: Regardless of the irrigants used, LAI showed significantly lower smear layer scores than SI and XP (p < 0.05), with insignificant difference as compared with UAI. LAI showed significantly better debris removal than SI (p < 0.05) when NaOCl alone was used. Conclusions: In the apical area of ledged canals, the cleaning efficacy of Er:YAG LAI with/without EDTA was higher than SI and XP, but was comparable with UAI. Clinical Trial Registration number D2014-33.

Deployable designs to temporarily convert subacute hospital rooms into palliative care rooms.

OBJECTIVE: To explore the design of deployable articles that can turn subacute hospital rooms into palliative care rooms to provide better patient-centred care and to meet the shortage of dedicated palliative care spaces in Australia. METHODS: Clinicians and a design researcher collaborated to review the literature, obtain clinical/practitioner feedback on needs and use design research methods to produce design concepts and prototypes for use in the subacute care hospital setting. RESULTS: A design solution that included: (a) A guest-bed module for improved family togetherness and room personalisation; and (b) A digital connectivity module designed to provide family togetherness virtually. CONCLUSIONS: Informed design solutions for palliative care spaces were derived from clinical feedback and literature evidence. Clinicians expressed great interest and support for further development and implementation in Victorian hospitals. This exploratory concept also provides insights for future research and innovation in the design of palliative care environments.

Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Logging Communities, Myanmar.

Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Asia, infecting many animal hosts, but CCHFV has not been reported in Myanmar. We conducted a seroepidemiologic survey of logging communities in Myanmar and found CCHFV exposure was common (9.8%) and exposure to wild animal blood and body fluids was associated with seropositivity.

New elephant crisis in Asia-Early warning signs from Myanmar.

In the southern Bago Yoma mountain range in Myanmar, Asian elephants are being killed at a disturbing rate. This emerging crisis was identified initially through a telemetry study when 7 of 19 of collared elephants were poached within a year of being fitted with a satellite-GPS collar. Subsequent follow up of ground teams confirmed the human caused death or disappearance of at least 19 elephants, including the seven collared individuals, within a 35 km2 area in less than two years. The carcasses of 40 additional elephants were found in areas located across south-central Myanmar once systematic surveys began by our team and collaborators. In addition to the extreme rate of loss, this study documents the targeting of elephants for their skin instead of the more common ivory, an increasing trend in Myanmar. Intensive research programs focused on other conservation problems identified this issue and are now encouraging local authorities to prioritize anti-poaching efforts and improve conservation policies within the country. Myanmar represents one of the last remaining countries in Asia with substantial wildlands suitable for elephants. Increasing rates of human-elephant conflict and poaching events in this country pose a dire threat to the global population.

Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

BACKGROUND: An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. METHODS: We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. RESULTS: The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. CONCLUSIONS: Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced difficulties in registering with GP practices. Many of those who have registered prefer to forego GP services in favour of self-medication, partly due to long waiting times and language barriers. To ensure that migrants enjoy the health services they need and to which they are entitled, more proactive steps are required, including those that make health services culturally responsive.

Trace metal speciation during dry and wet weather flows in the Tama River, Japan, by using diffusive gradients in thin films (DGT).

The labile species of Ni, Cu, Zn, Cd, and Pb in the Tama River, an urban river in Tokyo, Japan, were measured using diffusive gradients in thin films (DGT) method under dry and wet weather conditions, and the results were compared with total dissolved concentrations in hourly samples collected in parallel. A total of 10 DGT deployments were made and 251 hourly samples were collected during 2 rounds of sampling, conducted between August and October, 2006. Two types of diffusive gradients in thin films (DGT) devices-DGT-RG for labile inorganic and DGT-APA for total (inorganic and organic) labile species-were applied throughout the samplings. The proportions of metals measured by DGT, compared with the dissolved metal concentrations (filtered using a membrane of 0.5 microm pore size), were 38 +/- 5% (RG) and 45 +/- 8% (APA) for Ni and 45 +/- 22% (RG) and 53 +/- 23% (APA) for Zn. No labile Cu was detected throughout the sampling; Cu was assumed to be in stable complexed forms. Labile Pb was detected in 3 out of 10 deployments only; the rest were lower than the detection limit. Dissolved and labile Cd concentrations were below the detection limits. Three rain events encountered during the sampling periods were evaluated. Rains brought considerably higher loads of metals in dissolved form, and DGT measurements indicated that labile metal loads also increased. Selected DGT measurements were compared with the WHAM 6 speciation model and found to be similar to the model-computed results.

Lead isotopic compositions of environmental certified reference materials for an inter-laboratory comparison of lead isotope analysis.

Lead isotope ratios, viz. 207Pb/206Pb and 208Pb/206Pb, of the commercially available certified reference materials (CRMs) issued in Japan are presented with an objective to provide a data set, which will be useful for the quality assurance of analytical procedures, instrumental performance and method validation of the laboratories involved in environmental lead isotope ratio analysis. The analytical method used in the present study was inductively coupled plasma quadrupole mass spectrometry (ICPQMS) preceded by acid digestion and with/without chemical separation of lead from the matrix. The precision of the measurements in terms of the relative standard deviation (RSD) of triplicated analyses was 0.19% and 0.14%, for 207Pb/20Pb and 208Pb/206Pb, respectively. The trueness of lead isotope ratio measurements of the present study was tested with a few CRMs, which have been analyzed by other analytical methods and reported in various literature. The lead isotopic ratios of 18 environmental matrix CRMs (including 6 CRMs analyzed for our method validation) are presented and the distribution of their ratios is briefly discussed.

Exposure assessment of lead among Japanese children.

OBJECTIVE: Lead intake from possible exposure routes among children residing in the Tokyo Metropolitan Area was estimated. METHODS: Lead concentrations in house dust samples collected from the houses of the children and those in 24-h duplicate diet samples of the children were determined. The daily lead intake was estimated by multiplying the lead concentrations in the house dust, diet, soil and ambient air (the latter two were from the literatures) by the corresponding intake and/or inhalation rates, and summing all of the products. Bioaccessibility tests were performed on the house dust, soil and diet samples to determine the lead uptake level. RESULTS: Children residing in the Tokyo Metropolitan Area were estimated to be exposed to 21.5 µg of lead on a daily basis, with a maximum intake of up to 70.4 µg. The average weekly intake per kg body weight for a 5-year-old Japanese child was found to be 8.0 µg/kg bw/wk, which is below the Provisional Tolerable Weekly Intake (PTWI) of 25 µg/kg bw/wk. However, the maximum weekly intake was found to be 26 µg/kg bw/wk. CONCLUSIONS: House dust and soil ingestion can be the predominant routes of exposure to lead among children in Japan, and the source(s) of lead in such media must be specified to reduce the lead intake level of the children.