Using machine learning to understand microgeographic determinants of the Zika vector, Aedes aegypti.

There are limited data on why the 2016 Zika outbreak in Miami-Dade County, Florida was confined to certain neighborhoods. In this research, Aedes aegypti, the primary vector of Zika virus, are studied to examine neighborhood-level differences in their population dynamics and underlying processes. Weekly mosquito data were acquired from the Miami-Dade County Mosquito Control Division from 2016 to 2020 from 172 traps deployed around Miami-Dade County. Using random forest, a machine learning method, predictive models of spatiotemporal dynamics of Ae. aegypti in response to meteorological conditions and neighborhood-specific socio-demographic and physical characteristics, such as land-use and land-cover type and income level, were created. The study area was divided into two groups: areas affected by local transmission of Zika during the 2016 outbreak and unaffected areas. Ae. aegypti populations in areas affected by Zika were more strongly influenced by 14- and 21-day lagged weather conditions. In the unaffected areas, mosquito populations were more strongly influenced by land-use and day-of-collection weather conditions. There are neighborhood-scale differences in Ae. aegypti population dynamics. These differences in turn influence vector-borne disease diffusion in a region. These results have implications for vector control experts to lead neighborhood-specific vector control strategies and for epidemiologists to guide vector-borne disease risk preparations, especially for containing the spread of vector-borne disease in response to ongoing climate change.

A bellweather for climate change and disability: educational needs of rehabilitation professionals regarding disaster management and spinal cord injuries.

Study design: Cross-sectional survey. Objective: Persons with disabilities are disproportionately impacted by extreme weather disasters and climate change. Individuals with spinal cord injury (SCI) are especially at risk due to inability to control their body temperature and mobility concerns. We surveyed rehabilitation professionals in the field of SCI to determine their experiences, concerns and educational needs regarding natural disasters, climate change and sustainability and the effects on their clientele. Setting: Online survey available to an international cohort. Methods: The survey was developed by the authors and conducted in 2019. It was distributed amongst various international health care organizations whose members care for persons with SCI. Descriptive statistics and chi-square test for association were performed using Microsoft Excel 2016. Results: Of 125 respondents, 50% were from Europe, 18% from North America, and 18% from Asia; 74% were physicians and 13% physical therapists. In total 57.6% believed climate change had impacted their client's health and well-being. Respondents from North America were significantly less likely to report climate change had an impact on their patient's health than those from Asia or Europe (p < 0.01). In total 82.5% of respondents thought professionals should be concerned with sustainability and 85.5% were interested in further education. Conclusions: Most respondents acknowledged a need for more information related to the disasters, climate change, and disability. Results underscore the need for further research, professional, and consumer education.

Assessing the ability of the Sacral Autonomic Standards to document bladder and bowel function based upon the Asia Impairment Scale.

Study design: Retrospective review of data. Objective: To determine if there is a relationship between the Asia Impairment Scale (AIS) and the bladder and bowel components of the International Standards to Document Remaining Autonomic Function after SCI (ISAFSCI). Setting: University-Based Academic Rehabilitation Program. Methods: Retrospective cross-sectional study assessing International Standards for Neurologic Classification After SCI (ISNCSCI) examination along with bladder and bowel components of the ISAFSCI. Results: Subjects with AIS A injuries were statistically less likely to have history of bladder control and bowel control per investigator determination and bladder sensation via self-report versus patients categorized with AIS B injuries. Self-reported history of bowel sensation and control of voiding were more likely in subjects with C, D, or E injuries than with B injuries. Bowel and bladder control as determined by investigator and bladder and bowel sensation and control as self-reported were all statistically less likely in persons with AIS A injuries versus CDE. Conclusions: This retrospective study provides initial data regarding components of the bladder and bowel sections of the sacral ISAFSCI and AIS. Further prospective research is needed to further characterize the relationship between retention of bladder and bowel sensation and function and the AIS. We suggest that incorporation of the sacral components of the ISAFSCI into the ISNCSCI may be beneficial to obtain further information about retention of sacral function with specific patterns of injury.

Effects of climate on dental mesowear of extant koalas and two broadly distributed kangaroos throughout their geographic range.

Dental mesowear analysis can classify the diets of extant herbivores into general categories such as grazers, mixed-feeders, and browsers by using the gross wear patterns found on individual teeth. This wear presumably results from both abrasion (food-on-tooth wear) and attrition (tooth-on-tooth wear) of individual teeth. Mesowear analyses on extinct ungulates have helped generate hypotheses regarding the dietary ecology of mammals across space and time, and recent developments have expanded the use of dental mesowear analysis to herbivorous marsupial taxa including kangaroos, wombats, possums, koalas, and relatives. However, the diet of some of the most ubiquitous kangaroos (e.g., Macropus giganteus) along with numerous other species cannot be successfully classified by dental mesowear analysis. Further, it is not well understood whether climate variables (including precipitation, relative humidity, and temperature) are correlated with dental mesowear variables including various measures of shape and relief. Here, we examine the relationship between dental mesowear variables (including traditional methods scoring the sharpest cusp and a new potential assessment of multiple cusps) and climate variables in the grazers/mixed feeders Macropus giganteus and Macropus fuliginosus, and the obligate browser Phascolarctos cinereus. We find that dental mesowear of mandibular teeth is capable of differentiating the dietary habits of koalas and the kangaroo species. Furthermore, both Macropus giganteus and Phascolarctos cinereus exhibit mesowear correlated with mean minimum temperature, while Macropus fuliginosus dental mesowear is unaffected by temperature, despite significant differences in mean minimum and mean maximum temperature across their distribution (and in the specimens examined here). Contrary to expectations that individuals from drier regions would have blunter and lower relief teeth, dental mesowear is unrelated to proxies of relative aridity-including mean annual precipitation and relative humidity. Collectively, dental mesowear in these marsupials is related to feeding behavior with increased wear in cooler regions (in Macropus giganteus and Phascolarctos cinereus) potentially related to more or different food resources consumed.