Search

Abstract Marburg viral disease (MVD) is a highly infectious disease with a case fatality rate of up to 90%, particularly impacting resource-limited countries where implementing Infection Prevention and Control (IPC) measures is challenging. This paper shares the experience of how Tanzania has improved its capacity to prevent and control highly infectious diseases, and how this capacity was utilized during the outbreak of the MVD disease that occurred for the first time in the country in 2023. In 2016 and the subsequent years, Tanzania conducted self and external assessments that revealed limited IPC capacity in responding to highly infectious diseases. To address these gaps, initiatives were undertaken, including the enhancement of IPC readiness through the development and dissemination of guidelines, assessments of healthcare facilities, supportive supervision and mentorship, procurement of supplies, and the renovation or construction of environments to bolster IPC implementation. The official confirmation and declaration of MVD on March 21, 2023, came after five patients had already died of the disease. MVD primarily spreads through contact and presents with severe symptoms, which make patient care and prevention challenging, especially in resource-limited settings. However, with the use of a trained workforce; IPC rapid needs assessment was conducted, identifying specific gaps. Based on the results; mentorship programs were carried out, specific policies and guidelines were developed, security measures were enhanced, all burial activities in the area were supervised, and both patients and staff were monitored across all facilities. By the end of the outbreak response on June 1, 2023, a total of 212 contacts had been identified, with the addition of only three deaths. Invasive procedures like dialysis and Manual Vacuum Aspiration prevented some deaths in infected patients, procedures previously discouraged. In summary, this experience underscores the critical importance of strict adherence to IPC practices in controlling highly infectious diseases. Recommendations for low-income countries include motivating healthcare providers and improving working conditions to enhance commitment in challenging environments. This report offers valuable insights and practical interventions for preparing for and addressing highly infectious disease outbreaks through implementation of IPC measures.

Abstract Forest soils harbor hyper-diverse microbial communities which fundamentally regulate carbon and nutrient cycling across the globe. Directly testing hypotheses on how microbiome diversity is linked to forest carbon storage has been difficult, due to a lack of paired data on microbiome diversity and in situ observations of forest carbon accumulation and storage. Here, we investigated the relationship between soil microbiomes and forest carbon across 238 forest inventory plots spanning 15 European countries. We show that the composition and diversity of fungal, but not bacterial, species is tightly coupled to both forest biotic conditions and a seven-fold variation in tree growth rates and biomass carbon stocks when controlling for the effects of dominant tree type, climate, and other environmental factors. This linkage is particularly strong for symbiotic endophytic and ectomycorrhizal fungi known to directly facilitate tree growth. Since tree growth rates in this system are closely and positively correlated with belowground soil carbon stocks, we conclude that fungal composition is a strong predictor of overall forest carbon storage across the European continent.

The study presents a daily water balance model with a focus on quantifying drought intensity and duration in different forest stands within the Level II monitoring sites in Saxony. The model requires climatic data input and various site and stand parameters, which mostly have physical meaning and can be measured. We estimated the van Genuchten soil parameters of the model by different pedotransfer functions. Water stress is assumed to occur when the relative extractable soil water (REW) or the ratio of real transpiration and potential transpiration or pressure head drops below a certain threshold. The model was not calibrated to test the robustness of physically based parameters but was validated with available soil moisture measurements at forest climate stations (grass vegetation) and inventory locations in various vegetation and climatic conditions with Kling-Gupta efficiencies > 0.5 at most of the sites. The model captures the dynamics of soil water depletion and recharge in a study period well. Day-to-day estimates of water balance components allow us to calculate the duration and intensity of drought events and derive stress indices. A dendro-ecological application is presented: a retrospective analysis of the effects of drought on radial tree growth. Some limitations and potential of applications of the model are discussed.

IntroductionIn March 2023, a Marburg Virus Disease (MVD) outbreak was declared in Kagera region, Northwestern Tanzania. This was the first MVD outbreak in the country. We describe the epidemiological characteristics of MVD cases and contacts.MethodsThe Ministry of Health activated an outbreak response team. Outbreak investigation methods were applied to cases identified through MVD standard case definitions and confirmed through reverse-transcriptase polymerase chain reaction (RT PCR). All identified case contacts were added into the contact listing form and followed up in-person daily for any signs or symptoms for 21 days. Data collected from various forms was managed and analyzed using Excel and QGIS software for mapping.ResultsA total of nine MVD cases were reported with eight laboratory-confirmed and one probable. Two of the reported cases were frontline healthcare workers and seven were family related members. Cases were children and adults between 1-59 years of age with a median age of 34 years. Six were males. Six cases died equivalent to a case fatality rate (CFR) of 66.7%. A total of 212 individuals were identified as contacts and two (2) became cases. The outbreak was localized in two geo-administrative wards (Maruku and Kanyangereko) of Bukoba District Council.ConclusionTransmission during this outbreak occurred among family members and healthcare workers who provided care to the cases. The delay in detection aggravated the spread and possibly the consequent fatality but once confirmed the swift response stemmed further transmission containing the disease at the epicenter wards. The outbreak lasted for 72 days but as the origin is still unknown, further research is required to explore the source of this outbreak.

På slutten av det 19. og begynnelsen av det 20. århundre var New York City sentrum for en økende politisk radikalisering blant immigranter, i særlig grad i det jødiske samfunnet. Dette viste seg å være et komplekst fenomen med mange faktorer som spilte hver sine roller i en radikaliseringsprosess. USA var «mulighetenes land», og mennesker søkte seg dit for å forbedre sine levevilkår. Men for en stor del av immigrantene ble drømmene knust, og de endte opp med å bli desillusjonerte. Det viste seg å være en solid grobunn for radikalisering av jødiske immigranter. Denne artikkelen utdyper de årsakene som hovedsakelig lå til grunn for at så mange av de jødiske immigrantene ble politisk radikale og engasjerte medlemmer av arbeiderbevegelsen, i tillegg til å problematisere det jødiske aspektet som årsak til økt radikalisering. Casestudien om Isidore Wisotsky gir innsikt i denne radikaliseringsprosessen. Wisotsky var en ung jødisk immigrant som representerer de mange i den samme livssituasjonen, og deres vei mot å bli unge radikale i den amerikanske metropolen tidlig på 1900-tallet. Hans vei mot anarkismen og kamp for arbeidernes rettigheter var et resultat av hans personlige erfaringer som ung immigrant i New York City med både fattigdom og utnyttelse. Denne artikkelen viser at radikaliseringsprosessene blant jødiske immigranter i denne tidsperioden var et komplekst fenomen som fikk stor betydning for arbeiderbevegelsen og klassekampen.

Resource allocation to different plant tissues is likely to be affected by high investment into fruit production during mast years. However, there is a large knowledge gap concerning species-specific differences in resource dynamics. We investigated the influence of mast years on stem growth, leaf production, and leaf carbon (C), nitrogen (N), and phosphorus (P) concentrations and contents in Fagus sylvatica, Quercus petraea, and Q. robur at continental and climate region scales using long-term data from the International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests (ICP Forests) and similar datasets. We discussed the results in the light of opposing resource dynamics hypotheses: (i) resource accumulation before mast years and exhaustion after mast years (resource storage hypothesis), (ii) shifting resources from vegetative to generative compartments (resource switching hypothesis), and (iii) investing resources concurrently in both vegetative and generative compartments (resource matching hypothesis). Linear mixed-effects modelling (LMM) showed that both stem growth and leaf production were negatively influenced by weather conditions which simultaneously lead to high fruit production. Thus, the impact of generative on vegetative growth is intermixed with effects of environmental factors. Superposed epoch analyses and LMM showed that for mast behaviour in F. sylvatica, there are indicators supporting the resource storage and the resource switching hypotheses. Before mast years, resources were accumulated, while during mast years resources switched from vegetative to generative tissues with reduced stem and leaf growth. For the Quercus species, stem growth was reduced after mast years, which supports the resource storage hypothesis. LMM showed that leaf C concentrations did not change with increasing fruit production in neither species. Leaf N and P concentrations increased in F. sylvatica, but not in Quercus species. Leaf N and P contents decreased with increasing fruit production in all species, as did leaf C content in F. sylvatica. Overall, our findings suggest different resource dynamics strategies in F. sylvatica and Quercus species, which might lead to differences in their adaptive capacity to a changing climate.

Since she was one of the most important US anarchists, one might assume that Emma Goldman was in favor of the Bolshevists. However, while she supported the basic idea of the Russian Revolution, she criticized the Bolshevists for establishing a dictatorship based on terror and suppression of those, who criticized them. From her exile in England and France she was writing countless letters to emphasize that the Bolsheviks were not representing the hope for world revolution and the freeing of the international workers, but that they would use and corrupt the revolutionary ideals to establish rule and remain in power. This paper analyzes those writings to show how the hopes related to the events of 1917 were disappointed by the political realities and how the events impacted the life of Emma Goldman directly.

The Amur Society (often falsely translated as Black Dragon Society) was a resource for the Japanese military with regard to the preparation of the Russo-Japanese War, but the real impact, as stated in the later publications by members of the society, might be exaggerated. The present article will outline the influence of this right wing secret society related to the preparation of the Russo-Japanese War at the home front and abroad. It will evaluate the actions by the members of the society and try to answer the question, how important a small right wing society could have been for the course of Japan’s foreign policy.

The Kokuryûkai was founded in 1901 to foster the outbreak of a Russo-Japanese War. For these sake, the members of the society started spying in Korea, Manchuria, China and even Russia and prepared the image of a despotic and weak country, which would not be able to counter Japanese aspirations on the Asian mainland anymore. In 1895 the Triple Intervention under Russian leadership had finished the Japanese dreams of getting the Liaodong peninsula as a compensation for the Sino-Japanese War. And just some years later as a consequence of the Boxer Rebellion Russia seized Manchuria and was not willing to negotiate about its abandonment. Finally, the Japanese nationalists saw no alternative than founding another secret society to prepare the Japanese army and public for war. Due to this, information about the possible opponent needed to be collected and an anti-Russian propaganda campaign was started by the members. This made Russia the enemy number one and many publications like Uchida Ryôhei's Roshiaron started to provide a negative image of the future enemy on the battlefield for Asian hegemony. An article will outline the establishment of this anti-Russian image by analyzing the measures of the Kokuryûkai members from its foundation until the outbreak of the Russo-Japanese War in 1904.

Abstract Introduction Caring with Compassion provides core background information to support clinical care for homeless, underserved, uninsured, and at-risk populations. It was designed by an interdisciplinary team of educators from the fields of medicine, nursing, and social services. The team identified practical knowledge objectives using an iterative, expert consensus approach. Content validity was addressed by incorporating national internal medicine milestones and feedback from national educational leaders. This content is designed for graduate medical learners, advanced medical students, and nurse practitioners. Methods Caring with Compassion is divided into two major content domains: Domain 1 provides an overview of US public health care systems; Domain 2 presents the bio-psychosocial model of health care and special care needs of underserved populations. This submission includes the content for Domain 1: U.S. Public Healthcare Systems. Domain 2 is separately published by MedEdPORTAL. Results Nationally, over 350 learners have registered for the online version of the curriculum, and feedback has been highly positive. Preliminary quantitative outcome data demonstrates highly significant improvement in multiple choice examination scores following exposure to the modules for all assessed content areas [n, pretest, posttest, t test p value]: epidemiology of populations in need (42, 49%, 81%, p < .0001); public health insurance (30, 52%, 80%, p < .0001); health care delivery systems knowledge (19, 53%, 67%, p < .002). Discussion This content has benefited from continual revisions based on learner and faculty feedback, including results of the formal focus groups as detailed above. Expansion of content is ongoing based on requests from faculty users nationally. Further plans include expansion of faculty development tools and continual content revisions based on new research and curricular feedback.

Abstract Introduction The Caring with Compassion series provides core background information to support bio-psychosocial clinical care for homeless, underserved, uninsured, and at-risk populations. At the University of Michigan Medical School, this content serves as a core resource for a fourth-year medical student clinical elective regarding care of the underserved. At the University of Michigan School of Nursing, it is a core resource for advance nurse practitioner clinical rotations in underserved settings. For graduate medical learners, the content is available as an independent learning resource. This resource is the second domain in a two-domain series. The first domain provides an overview of US public health care systems, while this domain presents the bio-psychosocial model of health care and special care needs of underserved populations. Methods In this module, case-based materials are provided to address the topics of biomedical conditions among the homeless, social determinants of health, the biopsychosocial model of health, and interdisciplinary team care. A multiple-choice test and answer key are provided for each topic. Results Nationally, over 300 learners from multiple medical and nursing training programs have registered as learners, and feedback has been highly positive. Through the use of t tests, preliminary quantitative outcome data demonstrated significant improvement in multiple-choice examination scores following exposure to the modules for all assessed content areas: epidemiology of populations in need (n = 42, pretest = 49%, posttest = 81%, p < .0001); health care delivery systems knowledge (n = 19, pretest = 53%, posttest = 67%, p < .002); homelessness and disease (n = 20, pretest = 59%, posttest = 82%, p < .0001); public health insurance (n = 30, pretest = 52%, posttest = 80%, p < .0001); team care (n = 14, pretest = 45%, posttest = 64%, p < .001); social determinants (n = 29, pretest = 51%, posttest = 56%, p = .022). Additionally, comments from users included: “This is incredible and I am going through it slowly — realize how much I need to learn,” “A great tool for everyone not only to raise awareness but hopefully inspire people to take an active role in the care of the underserved.” Discussion Most training programs find it easiest to utilize this resource then encourage application in clinical settings. For programs with residents providing continuity care in federally qualified health care centers, the content may be used for ambulatory case conference discussions.

Abstract Background Kallikrein-related peptidase 7 (KLK7) is a chymotrypsin-like serine protease which is essential for the desquamation of corneocytes and thus plays a pivotal role in maintaining skin homeostasis. In cancer, KLK7 overexpression was suggested to represent a route for metastasis through cleavage of cell junction and extracellular matrix proteins of cancer cells. Methods To comprehensively determine KLK7 protein expression in normal and neoplastic tissues, a tissue microarray containing 13,447 samples from 147 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. Results KLK7 positivity was found in 64 of 147 tumor categories, including 17 tumor categories with at least one strongly positive case. The highest rate of KLK7 positivity was found in squamous cell carcinomas from various sites of origin (positive in 18.1%-63.8%), ovarian and endometrium cancers (4.8%-56.2%), salivary gland tumors (4.8%-13.7%), bilio-pancreatic adenocarcinomas (20.0%-40.4%), and adenocarcinomas of the upper gastrointestinal tract (3.3%-12.5%). KLK7 positivity was linked to nodal metastasis (p = 0.0005), blood vessel infiltration (p = 0.0037), and lymph vessel infiltration (p

ABSTRACT Backround Anterior gradient 2 (AGR2) is a resident endoplasmic reticulum (ER) protein with a vital role in embryonal development, mucus maturation, tissue regeneration, and wound healing. Methods To determine the prevalence and clinical significance of AGR2 expression in cancer, a tissue microarray containing 14,966 tumors from 134 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry (IHC). Results AGR2 positivity was found in 103 of 134 tumor categories, and 83 tumor categories contained at least one strongly positive case. AGR2 expression was most frequently seen in tumors of the female genital tract, particularly adenocarcinomas (up to 100%), various breast cancer subtypes (57.1%–100%), urothelial carcinoma (74.6%–100%), adenocarcinomas of the upper and lower gastrointestinal tract (93.6%–99.6%), and pancreaticobiliary cancers (65.2%–98.2%). AGR2 positivity was slightly less common in squamous cell carcinomas (46.4%–77.3%) and mainly absent in mesenchymal and lymphoid tumors. While AGR2 expression was only weak or absent in the normal thyroid, it was moderate to strong in 46.0% of adenomas, 52.8% of follicular carcinomas, and 81.8% of papillary carcinomas of the thyroid. High AGR2 expression was strongly linked to poor ISUP (p