Trends of limb amputation considering type, level, sex and age in Saskatchewan, Canada 2006–2019: an in-depth assessment

Background Most epidemiologic reports focus on lower extremity amputation (LEA) caused specifically by diabetes mellitus. However, narrowing scope disregards the impact of other causes and types of limb amputation (LA) diminishing the true incidence and societal burden. We explored the rates of LEA and upper extremity amputation (UEA) by level of amputation, sex and age over 14 years in Saskatchewan, Canada. Methods We calculated the differential impact of amputation type (LEA or UEA) and level (major or minor) of LA using retrospective linked hospital discharge data and demographic characteristics of all LA performed in Saskatchewan and resident population between 2006 and 2019. Rates were calculated from total yearly cases per yearly Saskatchewan resident population. Joinpoint regression was employed to quantify annual percentage change (APC) and average annual percent change (AAPC). Negative binomial regression was performed to determine if LA rates differed over time based on sex and age. Results Incidence of LEA (31.86 ± 2.85 per 100,000) predominated over UEA (5.84 ± 0.49 per 100,000) over the 14-year study period. The overall LEA rate did not change over the study period (AAPC -0.5 [95% CI − 3.8 to 3.0]) but fluctuations were identified. From 2008 to 2017 LEA rates increased (APC 3.15 [95% CI 1.1 to 5.2]) countered by two statistically insignificant periods of decline (2006–2008 and 2017–2019). From 2006 to 2019 the rate of minor LEA steadily increased (AAPC 3.9 [95% CI 2.4 to 5.4]) while major LEA decreased (AAPC -0.6 [95% CI − 2.1 to 5.4]). Fluctuations in the overall LEA rate nearly corresponded with fluctuations in major LEA with one period of rising rates from 2010 to 2017 (APC 4.2 [95% CI 0.9 to 7.6]) countered by two periods of decline 2006–2010 (APC -11.14 [95% CI − 16.4 to − 5.6]) and 2017–2019 (APC -19.49 [95% CI − 33.5 to − 2.5]). Overall UEA and minor UEA rates remained stable from 2006 to 2019 with too few major UEA performed for in-depth analysis. Males were twice as likely to undergo LA than females (RR = 2.2 [95% CI 1.99–2.51]) with no change in rate over the study period. Persons aged 50–74 years and 75+ years were respectively 5.9 (RR = 5.92 [95% Cl 5.39–6.51]) and 10.6 (RR = 10.58 [95% Cl 9.26–12.08]) times more likely to undergo LA than those aged 0–49 years. LA rate increased with increasing age over the study period. Conclusion The rise in the rate of minor LEA with simultaneous decline in the rate of major LEA concomitant with the rise in age of patients experiencing LA may reflect a paradigm shift in the management of diseases that lead to LEA. Further, this shift may alter demand for orthotic versus prosthetic intervention. A more granular look into the data is warranted to determine if performing minor LA diminishes the need for major LA.

An Integrated Analysis of GWR Models and Spatial Econometric Global Models to Decompose the Driving Forces of the Township Consumption Development in Gansu, China

The investigation of township consumption patterns has become highly significant in order to emphasize the importance of township consumption patterns in economic development and policy formulation. To attain township consumption development in underdeveloped areas is a significant way to meet the general criterion of “rich life” under China’s Rural Revitalization strategy. The primary objective of this study is to evaluate the driving forces that contribute to the development of township consumption in underdeveloped areas such as Gansu Province, China, and then scientifically design and implement a strategy for township consumption development in Gansu, all of which are related to the broader interests of rural revitalization. The study used 1233 township data of Gansu Province, China. The study integrated geographically weighted regression (GWR) and a spatial econometric global (SEG) model for data analysis and interpretation. The integration of these two models can comprehensively capture both spatial heterogeneity and spatial independence concurrently. First, we conducted integrated analyses of GWR and SEG models using consistent settings of spatial weight matrix elements, with GWR focusing on spatial heterogeneity and SEG models on spatial spillover. Second, the permanent resident population, the number of financial institution outlets, the types of townships, and the characteristics of townships had a substantial significant effect on the development of township consumption in Gansu, China. In addition, the ratio of residents with access to basic medical insurance was found to be negatively significant. The revitalization strategy for township consumption in Gansu Province, China should prioritize increasing the permanent resident population of townships, accelerating the development of township urbanization, accelerating the construction of township consumption infrastructures, and strengthening financial support from township financial institutions.

Estimating the impact of interventions against COVID-19: From lockdown to vaccination

Coronavirus disease 2019 (COVID-19) is an infectious disease of humans caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first case was identified in China in December 2019 the disease has spread worldwide, leading to an ongoing pandemic. In this article, we present an agent-based model of COVID-19 in Luxembourg, and use it to estimate the impact, on cases and deaths, of interventions including testing, contact tracing, lockdown, curfew and vaccination. Our model is based on collation, with agents performing activities and moving between locations accordingly. The model is highly heterogeneous, featuring spatial clustering, over 2000 behavioural types and a 10 minute time resolution. The model is validated against COVID-19 clinical monitoring data collected in Luxembourg in 2020. Our model predicts far fewer cases and deaths than the equivalent equation-based SEIR model. In particular, with R0 = 2.45, the SEIR model infects 87% of the resident population while our agent-based model infects only around 23% of the resident population. Our simulations suggest that testing and contract tracing reduce cases substantially, but are less effective at reducing deaths. Lockdowns are very effective although costly, while the impact of an 11pm-6am curfew is relatively small. When vaccinating against a future outbreak, our results suggest that herd immunity can be achieved at relatively low coverage, with substantial levels of protection achieved with only 30% of the population fully immune. When vaccinating in the midst of an outbreak, the challenge is more difficult. In this context, we investigate the impact of vaccine efficacy, capacity, hesitancy and strategy. We conclude that, short of a permanent lockdown, vaccination is by far the most effective way to suppress and ultimately control the spread of COVID-19.

Long term population decline and the impacts of COVID-19 in South Australia’s regions

Background South Australian regions have been given little attention in discussions on population decline. Aims This paper aims to examine the nature and incidence of population decline in South Australia as well as evaluate the potential impacts of COVID-19. Data and methods Estimated Resident Population data from 2001 to 2020, and Census data from 2006 and 2016, were used to investigate demographic and economic change. Measures of population change, age structure, employment and components of population change were used. Results Population decline has been a feature of South Australia’s regions for decades and continues to be so as more of the population concentrates in its capital and regional centres where greater opportunities of employment and greater provisions of amenities are available. COVID-19 has the potential to accelerate this change if South Australia’s vulnerable regions are not able to absorb the economic impacts the pandemic poses. Conclusions A strong driver of population decline in the regions is employment loss in core industries. Strategies that support these industries or otherwise aim to stimulate economic activity in these communities are required to moderate further decline in South Australia’s regions especially as the economy recovers from the impacts of COVID-19.

Lutjanus inermis (Peters, 1869), Golden Snapper, range extension to the Galapagos Islands

The well-cataloged marine fish fauna of the Galapagos Islands includes eight of the 12 species of snappers (Lutjanidae) found in the Tropical Eastern Pacific. A recent recreational scuba dive in the Galapagos produced photographs of an additional snapper species, Lutjanus inermis (Peters, 1869), which was sufficiently common as to likely have a recently established resident population.

COVID-19 Impact in the Italian Reception System for Migrants during the Nationwide Lockdown: A National Observational Study

From the beginning of the COVID-19 pandemic, attention was raised to protect vulnerable populations, including migrants and refugees (M&R), with the claim to leave no one behind in the pandemic response. In particular, concern was expressed in M&R’s reception centres since several COVID-19 outbreaks had been observed in Europe. Our study aimed to evaluate the impact of COVID-19 in the Italian reception system in the first pandemic wave in terms of incidence and health outcomes. A national survey focusing on the lockdown period of early 2020 was performed among reception centre managers. The survey achieved reaching around 70% of reception facilities and hosts. A national cumulative incidence of 400 positive cases per 100,000 and a north–south geographical gradient were observed. Sixty-eight facilities out of the 5038 participating in the survey reported confirmed cases and few COVID-19 clusters were detected especially in accommodations with the highest facility saturation index. Positive migrants were hospitalised in 25.9% of cases and no COVID-19 related deaths were observed. The study highlighted a cumulative incidence of cases and a geographical distribution similar to that of the general resident population, showing a global COVID-19 resilience in the Italian reception system in the period of observation, well beyond the expectations.

Paved Paradise: Belowground Parking Structures Sustain Urban Mosquito Populations in Washington, DC

ABSTRACT After notification of mosquitoes within federal buildings in Washington, DC, we surveyed belowground levels of nearby parking structures for mosquitoes and standing water in the summer months of 2018 and 2019. Aedes aegypti, Ae. albopictus, and members of the Culex pipiens Assemblage were found. Genotyping revealed pipiens, molestus, and quinquefasciatus ancestry among Cx. pipiens Assemblage mosquitoes, and allele frequency comparisons indicated a stable, resident population. Winter and spring aboveground temperatures ranged from −11°C to 35°C, while belowground temperatures never dropped below 5°C or exceeded 30°C, and winter temperatures were significantly higher belowground compared with aboveground. Moderated winter conditions suggest that belowground urban structures could act as refugia for warmer-climate species, like Ae. aegypti and Cx. quinquefasciatus, allowing them to overcome assumed thermal barriers. Surveys of parking structures should be incorporated into integrated vector management programs in urban areas.

Looking for the authentic other: Cosmopolitan ethos and orientalism in French migrants’ experiences in Abu Dhabi

French migrants in Abu Dhabi (United Arab Emirates – UAE) are often portrayed as money-driven and greedy, notably by their compatriots. Common representations of the Gulf area as extraordinarily affluent reinforce these suspicions and prompt migrants to justify their expatriation. This moral effort takes on the form of a cosmopolitan ethos. French residents in Abu Dhabi generally express a strong desire to get out of the ‘expatriate bubble’, to meet the ‘locals’, and to experience ‘difference’ and ‘diversity’. They perform migration as an opportunity for cultural enrichment and continuously search for otherness. Abu Dhabi’s unusual demographics and singular coloniality generate complex tensions around these cosmopolitan desires. French delineations of (valuable) otherness conflate ‘local’ and ‘national’, largely replicating orientalist structures of perception. These perceptive schemes homogenize the UAE and erase its ‘diversity’ within the cosmopolitan rationale. French delineations of localness also draw on national narratives constructing the country as ‘Arab’, while casting the foreign resident population (89% of the total UAE population) as non-local and temporary. Drawing on ethnographic field research, the article analyses expatriate cosmopolitan desires for difference as the encounter of Western orientalism and Emirati national narratives of Arabness.

Dolphin Watching and Compliance to Guidelines Affect Spinner Dolphins’ (Stenella longirostris) Behaviour in Reunion Island

Marine wildlife tourism has rapidly developed in Reunion Island, due to a large demand for interactions with a resident population of spinner dolphins (Stenella longirostris). The presence of dolphin-watching vessels close to dolphin groups can cause short-term impacts on their behaviour; cumulative incidences likely result in deleterious long-term impacts on the population. Using scan sampling, we collected behavioural data on spinner dolphins to evaluate the short-term effects of dolphin watching on their behaviour. The dolphins were less likely to begin socialising or diving while travelling and more likely to stay travelling and milling in the presence of vessels. Additionally, activity budgets for resting and socialising decreased simultaneously with increased travelling and milling. Avoidance responses significantly increased with an increase in the number of vessels and non-compliance with the local dolphin-watching guidelines. These behavioural responses are likely to have energetic costs for the dolphins, which may lead to decreased survival and reproductive success at individual and population levels. More restrictive regulations, increased surveillance and animal-based measures are key tools to adapt the conservation efforts in Reunion Island. Further studies on the island’s resident dolphin populations are necessary to ensure the continuity of dolphin-watching activities in a sustainable manner.