Since mid-2018, the New Zealand (NZ) Ministry for Primary Industries (MPI) has been operating an eradication program for an incursion of Mycoplasma bovis. Although NZ is still delimiting the outbreak, consideration is being given to how freedom from M. bovis will be demonstrated. Rapid demonstration of freedom will minimise the length of the program, significantly reducing its financial burden. This collaborative research was undertaken to help inform planning of surveillance to demonstrate freedom after M. bovis is believed eradicated. Scenario tree modelling (STM) involves assimilating multiple surveillance system components to determine whether disease is absent. STM has infrequently been used to plan appropriate surveillance but this was the approach used here. A stochastic simulation model was implemented in R. The model represented the NZ commercial dairy and non-dairy cattle industries and the current surveillance components that are also planned to be used to gather evidence of absence of M. bovis once it is eradicated. Different surveillance intensities and risk based versus random surveillance were simulated and compared for probability of freedom, financial cost of sampling and testing and the time to demonstrate freedom. The results indicate that the current surveillance components will enable demonstration of freedom. Surveillance components included bulk tank milk testing, herd testing and testing at meat processing plants, predominantly using an imperfect ELISA. Several combinations of surveillance components appeared most efficient achieving >95 % confidence of freedom over 2-4 years, whilst sampling 4-7 % of the non-dairy herds and less than 25 % of dairy herds annually. The results indicate that surveillance intensity can be lower than is currently occurring to support the delimiting phase, thereby saving significant resources in the post eradication phase (proof of freedom phases). Further consideration is required to enable the assumption of 100 % herd specificity made in the model to be achieved. The ELISA used is very specific, but will yield some false positives that must be resolved to their true status. This may occur for example through modified diagnostic test interpretation (e.g. cut point optimisation at individual and herd level) or resolution of putative false positive herds with epidemiological investigation. In conclusion this research demonstrates the utility of STM for planning surveillance programs, and in this instance has highlighted efficient and effective surveillance components for demonstrating freedom from M. bovis in NZ. It also highlights the need to achieve 100 % specificity for M. bovis in herds tested during the proof of freedom phases.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.prevetmed.2021.105523 | DOI Listing |
Mol Cancer
January 2025
Foshan Maternity and Child Healthcare Hospital; School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 515150, China.
Background: Intratumor-resident bacteria represent an integral component of the tumor microenvironment (TME). Microbial dysbiosis, which refers to an imbalance in the bacterial composition and bacterial metabolic activities, plays an important role in regulating breast cancer development and progression. However, the impact of specific intratumor-resident bacteria on tumor progression and their underlying mechanisms remain elusive.
View Article and Find Full Text PDFBMC Endocr Disord
January 2025
Social Determinants of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Background: Considering, the changes in lifestyle during the last decade the main aim of this study was to investigate the pooled prevalence of metabolic syndrome (MetS) and its components in Iran.
Methods: For implementing a comprehensive search strategy related to the objectives of the present meta-analysis, all international databases like PubMed (Medline), Scopus, Embase, Web of Sciences (Elsevier), and CINHAL were searched up to January 2024. The quality of the final selected studies was evaluated according to the Joanna Briggs Institute Critical Appraisal (JBI) tool for analytical cross-sectional studies.
Nat Med
January 2025
State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, Beijing, China.
The delivery of accurate diagnoses is crucial in healthcare and represents the gateway to appropriate and timely treatment. Although recent large language models (LLMs) have demonstrated impressive capabilities in few-shot or zero-shot learning, their effectiveness in clinical diagnosis remains unproven. Here we present MedFound, a generalist medical language model with 176 billion parameters, pre-trained on a large-scale corpus derived from diverse medical text and real-world clinical records.
View Article and Find Full Text PDFBMJ Open
January 2025
Amsterdam Public Health research institute, Amsterdam, The Netherlands.
Objectives: Knowledge about the long-term course and prognosis of persistent somatic symptoms (PSS) is important to improve clinical decision-making and guidance for patients with PSS. Therefore, we aimed to: (1) identify distinct 5-year trajectories of symptom severity, physical and mental functioning in adult patients with PSS and (2) explore patient characteristics associated with these trajectories.
Design: We used longitudinal data (seven measurements over a 5-year period) of the PROSPECTS study: a prospective cohort of adult patients with PSS.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!