Apparent stability masks underlying change in a mule deer herd with unmanaged chronic wasting disease

The contagious prion disease “chronic wasting disease” (CWD) infects mule deer (Odocoileus hemionus) and related species. Unchecked epidemics raise ecological, socioeconomic, and public health concerns. Prion infection shortens a deer’s lifespan, and when prevalence (proportion of adults infected) becomes sufficiently high CWD can affect herd dynamics. Understanding population responses over time is key to forecasting long-term impacts. Here we describe unexpected stability in prevalence and abundance in a mule deer herd where CWD has been left unmanaged. High apparent prevalence (~30%) since at least 2005 likely drove observed changes in the proportion and age distribution of wild-type native prion protein (PRNP) gene homozygotes among deer sampled. Predation by mountain lions (Puma concolor) may be helping keep CWD in check. Despite stable appearances, prion disease nonetheless impairs adult survival and likely resilience in this deer herd, limiting its potential for growth despite refuge from hunter harvest and favorable habitat and winter conditions.

Emergence of Ixodes scapularis (Acari: Ixodidae) in a Small Mammal Population in a Coastal Oak-Pine Forest, Maine, USA

In the United States, surveillance has been key to tracking spatiotemporal emergence of blacklegged ticks [Ixodes scapularis Say (Ixodida:Ixodidae)] and their pathogens such as Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner (Spirochaetales: Spirochaetaceae), the agent of Lyme disease. On the Holt Research Forest in midcoastal Maine, collection of feeding ticks from live-trapped small mammal hosts allowed us to track the emergence and establishment of I. scapularis, 1989–2019. From 1989–1995, we collected only I. angustus Neumann (Ixodida: Ixodidae)(vole tick), Dermacentor variabilis Say (Ixodida: Ixodidae) (American dog tick), and I. marxi Banks (Ixodida: Ixodidae) (squirrel tick) from seven species of small mammals. The most abundant tick host was the white-footed mouse [Peromyscus leucopus Rafinesque (Rodentia:Cricetidae)] followed by the red-backed vole (Myodes gapperi Vigors (Rodentia: Cricetidae)). Emergence of I. scapularis was signaled via the appearance of subadult I. scapularis in 1996. Emergence of B. burgdorferi was signaled through its appearance in I. scapularis feeding on mice in 2005. There was a substantial increase in I. scapularis prevalence (proportion of hosts parasitized) and burdens (ticks/host) on white-footed mice and red-backed voles in 2007. The ~11-yr time-to-establishment for I. scapularis was consistent with that seen in other studies. White-footed mice comprised 65.9% of all captures and hosted 94.1% of the total I. scapularis burden. The white-footed mouse population fluctuated interannually, but did not trend up as did I. scapularis prevalence and burdens. There were concurrent declines in I. angustus and D. variabilis. We discuss these results in the broader context of regional I. scapularis range expansion.

PP259 Invisible Resilience: The Value Of Medical Technology In Reducing Population And Health Systems’ Vulnerability To COVID-19.

IntroductionCOVID-19 has exposed population and health systems’ vulnerability to a highly infectious disease. People with diabetes have a higher risk of COVID-19 hospitalization and death than those without. Medicines that control blood glucose reduce this risk. We quantified COVID-19 hospital admissions and deaths averted by diabetes medicines in the UK during the March-May 2020 wave.MethodsWe estimated COVID-19 hospital and intensive care unit (ICU) admissions averted and COVID-19 hospital deaths avoided by diabetes medicines, considering a counterfactual where those medicines were not available. We used published UK-data sources on diabetes prevalence, proportion of patients achieving diabetes control with medicines, COVID-19 infection risk, probabilities for COVID-19 hospital admission, subsequent ICU admission and hospital death. We calculated the relative risk reduction of controlled vs. uncontrolled diabetes on COVID-19 hospital or ICU admission (71% and 66%, respectively), and hospital death (38%) from the UK Open Safely data.ResultsDiabetes medicines are estimated to have averted 17,417 hospital admissions, 2,752 ICU-admissions and 438 hospital deaths due to COVID-19 compared to a counterfactual where those medicines had not been available in the UK.ConclusionsEffective medicines to control diabetes contribute to population and health systems resilience against COVID-19. Health technology assessment and policy makers should recognize that adoption and usage of health technology reduces societies’ vulnerability to similar shocks.

Trends in the use of oral anticoagulants, antiplatelets and statins in four European countries: a population-based study

Purpose To evaluate time trends in the prevalence of antithrombotic and statin use in four European countries. Methods Using population-based data from the United Kingdom, Denmark, Spain and Italy between 2010 and 2018, we calculated standardized annual prevalence proportions of antithrombotics and statin use, and changes in prevalence proportions (2018 vs. 2010). Results Prevalence proportion of statins increased from 24.8% to 24.6% (UK), 21.0% to 22.3% (Region of Southern Denmark [RSD]), 12.9% to 14.3% (Udine, Italy), and 20.3% to 23.2% (Spain). Prevalence proportions of antithrombotics declined in all four countries: 18.7% to 15.9% (UK; − 2.8% points), 18.9% to 18.1% (RSD; − 0.8% points), 17.7% to 16.6% (Udine; − 1.1% points) and 15.0% to 13.6% (Spain; − 1.4% points). These declines were driven by reductions in low-dose aspirin use: 15.3% to 8.9% (UK; − 6.4% points), 16.3% to 9.5% (RSD; − 6.8% points), 13.5% to 11.6% (Udine; − 1.9% points), and 10.2% to 8.8% (Spain; − 1.4% points). In the UK, low-dose aspirin use declined from 9.1% to 4.3% (− 4.8% points) for primary CVD prevention, and from 49.6% to 36.9% (− 12.7% points) for secondary prevention. Oral anticoagulant use gradually increased but did not fully account for the decrease in low-dose aspirin use. Conclusions Antithrombotic use in the UK, RSD, Udine and Spain declined between 2010 and 2018, driven by a reduction in use of low-dose aspirin that is not completely explained by a gradual increase in OAC use. Use of statins remained constant in the UK, and increased gradually in the RSD, Udine and Spain.

The Prevalence of Exercise Addiction Symptoms in a Sample of National Level Elite Athletes

Exaggerated exercise volumes, lack of control, withdrawal symptoms and conflicts with family and friends are core symptoms of exercise addiction. The condition can lead to health problems and social isolation because exercise is given the highest priority in any situation. The prevalence of the risk of exercise addiction has mostly been assessed in leisure time exercisers such as runners, fitness attendees and cyclists. The prevalence proportion ranges from 3 to 42% depending on the type of sport and the assessment tool. The proportion is greater among elite athletes, and increases with the level of competition. This study's primary aim was to assess the prevalence of exercise addiction among elite athletes competing at national level and its secondary aim was to evaluate the psychometric properties of the Exercise Addition Inventory (EAI) in elite sports. Participants (n = 417) from 15 sports disciplines and with 51% women completed an online survey. Results showed that 7.6% were at risk of exercise addiction. This group was younger, exhibited tendency to exercise despite pain and injury, felt guilty if not exercising enough, and reported substantial eating disorder symptoms. The reliability and validity of the EAI was good suggesting that the scale is appropriate for measuring the risk of exercise addiction in elite athletes.

Lack of Changes in Preterm Delivery and Stillbirths During COVID-19 Lockdown in a European Region

Preliminary data in Europe have suggested a reduction in prematurity rates during the COVID-19 pandemic, implying that contingency measures could have an impact on prematurity rates. We designed a population-based prevalence proportion study to explore the potential link between national lockdown measures and a change in preterm births and stillbirths. Adjusted multivariate analyses did not show any decrease in preterm proportions during the lockdown period with respect to the whole pre-lockdown period or to the pre-lockdown comparison periods (2015-2019): 6.5% (95%CI 5.6-7.4), 6.6% (95%CI 6.5-6.8), and 6.2% (95%CI 5.7-6.7), respectively. Proportions of preterm live births did not change during lockdown when different gestational age categories were analyzed, nor when birthweight categories were considered. No differences in stillbirth rates among the different study periods were found: 0.33% (95%CI 0.04-0.61) during the lockdown period vs 0.34% (95%CI 0.22-0.46) during the pre-lockdown comparison period (2015-2019).ConclusionWe did not find any link between prematurity and lockdown, nor between stillbirths and lockdown. Collaborative efforts are desirable to gather more data and additional evidence on this global health issue.

Meningococcal Disease Burden in India: A Systematic Review and Meta-Analysis

Objective: To perform systematic review and meta-analysis of meningococcal disease burden in India. Methods: We searched publications on meningococcal disease in India between 1996 and 2020 using PubMed and Google Scholar. Prevalence (proportion) of Meningococcal meningitis and Case-fatality ratio (CFR) were pooled using random effects model. Other outcomes were pooled qualitatively. Results: The prevalence of Meningococcal meningitis in epidemic and endemic conditions was 12.1% (95% CI: 5.2-21.4) and 0.76% (95% CI: 0.3-1.4), respectively, with a CFR of 12.8% (95% CI: 6.8-20.4) in epidemic settings; N. meningitis caused 3.2% (95% CI: 1.6-5.3) of Acute Bacterial Meningitis (ABM) cases in endemic settings. The disease appeared in infants, adolescents, and adults with Serogroup A prevalence. Treatment and prophylaxis were limited to antibiotics despite increased resistance. Conclusion: The study reveals epidemic and endemic presence of the disease in India with high fatality and serogroup A prevalence. Further monitoring and immunization are required to prevent outbreaks.

Maternal depression and non-specific health complaints in the offspring: a Danish cohort study

Background: Maternal depression has been linked to adverse outcome in the offspring. Existing literature is mainly based on parental reports, which can be fallible when the parent suffers from depression. Aim: The aim of this study was to explore if maternal depression was associated with daily health complaints and low self-assessed health (SAH) in the offspring. Design and setting: Participants were 45,727 children from the Danish National Birth Cohort. Maternal depression was categorised into: no depression, first-time treatment, continued treatment, post treatment and relapse. Methods: Binomial regression was used to estimate the adjusted prevalence proportion ratio (aPPR) of frequent health complaints and low SAH in children of depressed mothers compared to children of non-depressed mothers. Results: The prevalence of any frequent health complaint was 10.8%, frequent somatic complaints was 3.2%, frequent mental complaints 8.7%, both frequent mental and somatic complaints 1.2%, and low SAH 5.3%. Children of mothers with depression (any category) were more likely to report a frequent health complaint; first-time treatment: aPPR=1.35 (95% CI: 0.96-1.85), continued treatment: aPPR=1.59 (1.37-1.85), post treatment: aPPR=1.30 (1.20-1.41), and relapse: aPPR=1.56 (1.35-1.79). Children of mothers with depression were also more likely to report low SAH; first-time treatment: aPPR=1.58 (0.99-2.54), continued treatment: aPPR=1.86 (1.51-2.28), post treatment: aPPR=1.34 (1.19-1.50), and relapse: aPPR=1.56 (1.26-1.93). Conclusions: Treatment of maternal depression was associated with higher prevalence of frequent health complaints and low SAH in the offspring at age 11 years. The association was strongest for children of mothers with continued depression or relapse.

Prevalence Proportion of Patient with Coronary Heart Disease in Inpatient Room of RSUD Dr. Soetomo Surabaya in 2017

Introduction: Coronary heart disease (CHD) is the most common type of heart disease that causes death. It occurs as a result of hardening of the coronary arteries which supply oxigen-rich blood to the entire heart muscle so that the heart can contract properly. However, many patients neglect the symptoms. Moreover, the risk factor and the comorbides disease worsen the condition. This research aims to study the profile of coronary heart disease patients in the inpatient rooms at Dr. Soetomo General Hospital Surabaya in 2017.Methods: This study was a cross-sectional and retrospective study by assessing patients’ medical record and analyzed descriptively.Results: From total 587, 263 patiens met inclusion criteria, aged between 51-60 years (42.6%) with domination of male (82,13%). %). Risk Factors are into one of the Comorbidities of CHD Patient. There are Risk Factor can be aggravate of CHD Patients. Most of subjects had risk factor hipertension (50,79%), and hypertension with DM (38,7%). Hypertension based on systolic pressure and diastolic pressure obtained that systolic pressure <120 mmhg was 39.6% and diastolic pressure <80 was 37.4%.Conclusion: Most of CHD patients in this study were in age group 51 – 60 years old, male, had risk factor hypertension and DM.