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ABSTRACTBackgroundUnder the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted mass drug administration (MDA) from 2000-2006. Despite passing Transmission Assessment Surveys (TAS) in 2011/2012 and 2015, American Samoa failed TAS-3 in 2016, with antigen (Ag) prevalence of 0.7% (95%CI 0.3-1.8%) in 6-7 year-olds. A 2016 community survey (Ag prevalence 6.2% (95%CI 4.4-8.5%) in age ≥8 years) confirmed resurgence. Here, we explore the potential of targeted strategies to strengthen post-MDA surveillance.Methodology/Principal FindingsUsing Ag data plus new antibody data (Wb123, Bm14, Bm33) from the 2016 surveys, we identified risk factors for seropositivity using multivariable logistic regression. We compared TAS with strategies that targeted high-risk subpopulations (older ages, householders of Ag-positive TAS children [index children]) and/or known hotspots, and used NNTestav (average number needed to test to identify one positive) to compare sampling efficiency.Antibody prevalence in TAS-3 (n=1143) were 1.6% for Bm14 (95%CI 0.9-2.9%), 7.9% for Wb123 (95%CI 6.4-9.6%), and 20.2% for Bm33 (95%CI 16.7-24.3%); and in the community survey (n=2507), 13.9% for Bm14 (95%CI 11.2-17.2%), 27.9% for Wb123 (95%CI 24.6-31.4%), and 47.3% for Bm33 (95%CI 42.1-52.6%). Ag prevalence was 20.7% (95%CI 9.7-53.5%) in households of index children. Higher Ag prevalence was found in males (adjusted odds ratio [aOR] 3.01), age ≥18 years (aOR 2.18), residents of Fagali’i (aOR 15.81), and outdoor workers (aOR 2.61). Using Ag, NNTestav ranged from 142.5 for TAS, to <5 for households of index children. NNTestav was lower in older ages, and highest for Ag, followed by Bm14, Wb123 and Bm33 antibodies.Conclusions/SignificanceWe propose a multi-stage surveillance strategy, starting with population-representative sampling (e.g. TAS), followed by targeted strategies in subgroups and locations with low NNTestav. This approach could potentially improve the efficiency of identifying remaining infected persons and residual hotspots. The utility of antibodies in surveillance should also be explored.AUTHOR SUMMARYLymphatic filariasis (LF) is a parasitic infection transmitted by mosquito bites. Globally, tens of millions are infected, with many disfigured and disabled by severe damage to their lymphatic systems, such as severe swelling of the legs (elephantiasis) or scrotum (hydrocele). The Global Programme to Eliminate LF (GPELF) aims to interrupt disease transmission through mass drug administration (MDA), and to control illness and suffering in affected persons. The World Health Organization recommends conducting Transmission Assessment Surveys (TAS) in school children aged 6 to 7 years, to determine if infection rates have dropped to levels where disease transmission is no longer sustainable. From 2000-2006, American Samoa conducted MDA and made significant progress towards eliminating LF. However, despite passing TAS in 2011/2012 and 2015, surveys in 2016 showed evidence of resurgence. Our study explored alternative surveillance strategies and compared their efficiency with TAS. Based on our findings, we recommended that in addition to TAS, strategies that target high-risk populations and hotspots would strengthen surveillance and help countries achieve their goals of LF elimination.

La mayor parte de los estudios sobre mujeres toxicómanas indican que se las separa a menudo de sus hijos, ya sea por decisión judicial o por acuerdo familiar. Este artículo aborda la cuestión de las temporalidades del consumo de drogas confrontada a los tiempos sociales de la maternidad y de las instituciones que se ocupan de la colocación de los hijos. Los datos presentados aquí surgen de una investigación sobre la denuncia y la colocación de hijos de madres toxicómanas en Francia. Este trabajo ha puesto en evidencia un hilo conductor en la incomprensión de los diferentes actores de la colocación de hijos de madres toxicómanas, es decir, el desajuste de los tiempos entre los diferentes protagonistas. El trabajo en urgencia, característico hoy de la urgencia social “de hacer algo” con este niño que sale de la maternidad, se superpone a la urgencia de la vida de las madres dependientes, mientras que la maternidad reinscribe el tiempo en su camino. En efecto, el momento del embarazo se describe a menudo como particularmente propicio a un cambio de trayectoria, incluyendo fuera de la droga. La plupart des études sur les femmes toxicomanes montrent -qu’elles sont souvent séparées de leurs enfants, soit par décision judiciaire, soit par accord familial. Cet article aborde la question des temporalités des usages de drogues confrontées aux temps sociaux de la maternité et des institutions mettant en oeuvre le placement des enfants. Les données présentées sont issues d’une recherche sur le signalement et le placement des enfants de mère toxicomane en France. Cette dernière a mis en évidence un fil conducteur dans l’incompréhension des différents protagonistes du placement des enfants de mère toxicomane, soit le décalage des temps entre les différents acteurs. Le travail en urgence, caractéristique aujourd’hui de l’urgence sociale à « faire quelque chose » de cet enfant en sortie de maternité, se superpose à l’urgence de la vie des mères dépendantes, alors que la maternité réinscrit le temps dans leurs trajectoires. De fait, le moment de la grossesse est souvent décrit comme particulièrement propice à un changement de trajectoire, y compris hors de la drogue. Most studies on female drug addicts indicate that they are often separated from their children, either by a court order or by family agreement. This article examines the issue of the temporality of drug use confronted by the social time of maternity and the institutions that place children in foster homes. The data presented comes from a study on reporting and placement of children of drug-addicted mothers in France. It revealed a common thread in the lack of understanding of the various protagonists of placing children of drug-addicted mothers, being the time lag between the various players. Emergency initiatives, characteristic of today’s social urgency to “do something” for this child exiting maternity, are superimposed over the urgency of the life of dependent mothers when maternity re-establishes time in their directional path. Pregnancy is often described as being particularly conducive to a change in direction, including other areas besides drugs.

Although the incidence of breast cancer in the United States is higher in Caucasian women compared with African American women, African-American patients have more aggressive disease as characterized by a higher percentage of triple-negative breast cancers (TNBCs), high-grade tumors, and a higher mortality rate. PKCαis a biomarker associated with endocrine resistance and poor prognosis and ERβis emerging as a protective biomarker. Immunohistochemical analysis of ERβand PKCαexpression was performed on 198 formalin-fixed paraffin-embedded primary infiltrating ductal carcinomas from 105 African-American and 93 Caucasian patients. PKCαis positively correlated with TNBC in patients of both races and with high tumor grade in African-American patients. Patients with TNBC express less nuclear ERβcompared with all other subtypes. We find no difference in frequency or intensity of PKCαor ERβexpression between African-American and Caucasian patients. PKCαand ERβare discussed as potential therapeutic targets for the treatment of patients with TNBC.

>L'infection par le virus Chikungunya est une arbovirose evoluant sur un mode epidemique, dans les continents africain et asiatique, mais aussi dans les iles de l'Ocean Indien, comme le souligne l'epidemie de grande ampleur actuellement en cours a l'ile de la Reunion, apres avoir touche les Comores, Mayotte et l'ile Maurice, depuis le debut de l'annee 2005 [1].

Cet article propose une réflexion sur l’intégration de dimensions de long terme dans une démarche ergonomique, permise par l’articulation entre approche ergonomique, médecine du travail et analyse démographique. Une recherche centrée sur une problématique de troubles musculo-squelettiques en entreprise constitue le fil-guide de cet article.Après avoir présenté des éléments de contexte scientifique et social suggérant d’appréhender des processus à long terme pour étudier les relations entre travail et santé, nous insistons sur les méthodes utilisées et leur complémentarité recherchée, puis nous revenons sur les principaux résultats qui relèvent de trois grands types de processus (« régulation », « usure » et « sélection »).Nous interrogeons, au-delà de cette recherche, les possibilités pour l’ergonomie de développer des moyens d’analyse qui dépassent le cadre temporel de l’observation instantanée, en lui assignant une nouvelle place dans un modèle plus large de compréhension des relations entre santé et travail. Este artículo propone una reflexión sobre la integración de dimensiones de largo plazo en un enfoque ergonómico, permitida por la articulación entre enfoque ergonómico, medicina del trabajo y análisis demográfico. Una investigación centrada en un problemática de trastornos musculoesqueléticos en la empresa constituye el hilo conductor de este artículo. Después de presentar los elementos de contexto científico y social que sugieren procesos a largo plazo para el estudio de las relaciones entre trabajo y salud, insistimos en los métodos utilizados y la complementariedad buscada, para luego volver a los principales resultados que relevan de tres grande tipos de procesos («regulación», «desgaste y «selección»).Más allá de esta investigación, cuestionamos la posibilidad que la ergonomía pueda desarrollar medios analíticos que vayan más allá del marco temporal de la observación instantánea, asignándole un lugar nuevo en un modelo más amplio de comprensión de las relaciones entre salud y trabajo. This article looks at the possibility of integrating long-term dimensions into ergonomics, which could be done by combining the ergonomics approach, occupational medicine, and demographic analysis. Work-related musculoskeletal disorders represent the common thread of this article.After presenting the theoretical framework, which focuses on long-term approaches to studying the relation between health and work, we concentrate on the methods used and how they complement each other to achieve better results. We then take another look at the main results, which belong to three kinds of processes (adjustments, wear and tear, and selection).Above and beyond this study, we question the capacity of ergonomics to create and develop analysis methods that extend beyond the short-term temporal framework. In so doing, we suggest that ergonomics go one step further and take on a new role in a larger model of the relation between health and work.

A meningococcal serogroup A polysaccharide/tetanus toxoid conjugate vaccine (PsA-TT) (MenAfriVac(™) ) is being deployed in countries of the African meningitis belt. Experience with other polysaccharide/protein conjugate vaccines has shown that an important part of their success has been their ability to prevent the acquisition of pharyngeal carriage and hence to stop transmission and induce herd immunity. If PsA-TT is to achieve the goal of preventing epidemics, it must be able to prevent the acquisition of pharyngeal carriage as well as invasive meningococcal disease and whether PsA-TT can prevent pharyngeal carriage needs to be determined. To address this issue, a consortium (the African Meningococcal Carriage (MenAfriCar) consortium) was established in 2009 to investigate the pattern of meningococcal carriage in countries of the African meningitis belt prior to and after the introduction of PsA-TT. This article describes how the consortium was established, its objectives and the standardised field and laboratory methods that were used to achieve these objectives. The experience of the MenAfriCar consortium will help in planning future studies on the epidemiology of meningococcal carriage in countries of the African meningitis belt and elsewhere.

Introduction: Neisseria meningitidis serogroup B is an important infectious agent in developed countries, including Canada. Infants are particularly susceptible to infection with serogroup B because of immature immune systems, pathogen virulence factors and changing serogroup dynamics in the post-vaccination era. Currently, the Ontario provincial government does not include serogroup B in its routine publicly funded meningococcal vaccination program. Case Presentation: A formerly well 14-month-old male presented to a tertiary hospital emergency department with fever, minor respiratory problems, diffuse purpuric rash, distended abdomen, tachycardia, and history of one episode of vomiting and melena each. Meningococcaemia was immediately suspected, and he was treated with ceftriaxone, cefotaxime and vancomycin before transfer to a different acute care facility within 12 h. N. meningitidis serogroup B, sensitive to ceftriaxone and penicillin, was identified in his blood. The patient developed gangrene of the lower legs and underwent bilateral below-knee amputation 8 days post-admission. Conclusion: This instance of meningococcaemia with extensive sequelae is an example of the various serious outcomes of meningococcal infection. It provides persuasive reason for routine publicly funded vaccination against N. meningitidis serogroup B in Ontario.

Autism is one of the twenty-first century’s most contested illnesses. Early controversies around vaccine harm have irrevocably structured the field of autism science. Despite incredible investment in genetic research on autism over the past 30 years, scientists have failed to identify a set of “genes for” autism, and genomic causality has become more complex. Yet, orthodox genetic explanations for autism have retained dominance over a vociferous field of heterodox experts pointing to a series of environmental insults (vaccines, heavy metal exposure, overuse of antibiotics, toxic pollution) as the main causes of autism. To make sense of this puzzling trend, we develop a novel theoretical synthesis combining a Bourdieusian field analysis with a Gramscian conception of hegemony, centered around the concept of “subsumptive orthodoxy.” Analyzing multiple years of archival data from the Interagency Autism Coordinating Committee, we argue that when faced with heterodox challenges, dominant members of the field shore up hegemony by incorporating environmental causal factors into the genome, thus engaging in subsumptive orthodoxy. This move gives rhetorical space to environmental explanations without providing them substantive causal weight, which renders particular environmental causes (like vaccines) impossible. This article traces the strategies dominant members of the field use to retain control over the definition and etiology of autism. We develop the broader implications of the study within autism science and beyond.