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Pandemic prevention consortium announces new leadership team

Recognizing the many milestones it has reached in recent months, Strategies to Prevent Spillover, or STOP Spillover, a project funded by the U.S. Agency…

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Recognizing the many milestones it has reached in recent months, Strategies to Prevent Spillover, or STOP Spillover, a project funded by the U.S. Agency for International Development (USAID) and led by Tufts University, has announced that the interim leadership team that was put in place in March 2023 will take on a permanent role for the next two years of the project.

Credit: Alonso Nichols/Tufts University

Recognizing the many milestones it has reached in recent months, Strategies to Prevent Spillover, or STOP Spillover, a project funded by the U.S. Agency for International Development (USAID) and led by Tufts University, has announced that the interim leadership team that was put in place in March 2023 will take on a permanent role for the next two years of the project.

Hellen Amuguni, an associate professor in the Department of Infectious Disease and Global Health at Cummings School of Veterinary Medicine, is the new project director. The co-deputy directors are Felicia Nutter, director of the International Veterinary Medicine Program at Cummings School, and Jonathon Gass, an assistant professor of infectious disease epidemiology at the School of Medicine. (Amuguni and Nutter have secondary appointments at Tufts University School of Medicine, and Gass has a secondary appointment at Cummings School.)

“We are entering the fourth year of STOP Spillover on a high note, and our vision for the project remains clear,” says Amuguni. “Our focus is to build capacity and prepare countries to identify high-risk interfaces, control zoonotic diseases at their source before they become epidemics or pandemics, and develop interventions that reduce risks of exposure in human populations. We are privileged to work closely with amazing country teams and government counterparts as well as our consortium partners who bring expertise in wildlife health, infectious diseases, social and behavior change.”

At least 75 percent of emerging and re-emerging infectious diseases of humans—including Ebola, Nipah virus, and zoonotic avian flu—have an animal origin. Chances are that when the next illness like COVID-19 emerges to threaten global health, it will originate in animals before it passes to humans, a process known as spillover. STOP Spillover aims to keep that tipping point from happening, or at least mitigate the dangerous effects.

“STOP Spillover has achieved so much in its third year thanks to these directors, who have been working with stakeholders in key countries in Africa and Asia to find ways to decrease the risks of harmful viral pathogens that jump—or spill over—from animals to humans,” said Caroline Genco, Tufts’ provost and senior vice president, who is also an immunologist. “Through this important work, our expert researchers and community partners demonstrate our shared commitment to One Health as a way of mitigating the significant global risk represented by zoonotic disease spillover.”

Leading a Global Consortium of Regional Partners

Begun in late 2020, STOP Spillover has so far partnered with colleagues in Bangladesh, Cambodia, Côte d’Ivoire, Liberia, Uganda, Viet Nam, and Sierra Leone to strengthen country capacities to reduce the risks of zoonotic diseases, or those that move between animals and humans. Teams of experts collaborate to develop country- and locality-specific research studies and interventions to reduce risks associated with selected viral zoonotic pathogens and to prevent their spread.

USAID administers the U.S. foreign assistance program providing economic and humanitarian assistance in more than 80 countries worldwide. For this project, Tufts leads a global consortium of partners with cross-disciplinary experience and regional knowledge.

From the outset, this consortium of experts in human, animal, and environmental health has been heavily focused on engagement, working with stakeholders at the national, regional, and local levels to reduce risks of exposure to and mitigate the spread of selected zoonotic viral pathogens, including coronaviruses, filoviruses (Ebola and Marburg viruses), avian influenza, and Lassa virus, among others.

Protecting Health and Providing Financial Stability

On the ground at the local level—in places such as wildlife farms in Dong Nai province, Vietnam, and wild animal meat markets in Kenema, Sierra Leone—community-led workshops have provided important data about the interactions humans have with wild and domestic animals in these settings, as well as the barriers they see to behavior changes that reduce spillover risk.

Gass, who recently visited wildlife farms in Viet Nam with its in-country team, said that STOP Spillover is filling major gaps in understanding the spillover ecosystem, which will improve conditions for both animals and humans.

Gass noted that wildlife farmers, government officials, and other stakeholders are very interested in working together to increase biosafety. “Farming practices are critical for the financial livelihoods of farmers and their families,” he said. “When outbreaks occur on farms and the animals either die or need to be culled, this has serious financial repercussions. STOP Spillover’s interventions will not only protect health but also provide increased financial stability via risk reduction.”

The program has formed local expert working groups to identify places where spillover is most likely to occur and to design risk-reduction interventions. In Liberia, for example, STOP Spillover is conducting research to understand Lassa virus distribution in rodent reservoir hosts both within what is considered the “Lassa belt” and beyond. Working with the Ministry of Health, National Public Health Lab, the Ministry of Agriculture, and local communities, teams are collecting and testing samples from the African soft-furred mouse and other rodents for the presence of Lassa virus RNA (an indication of infection) within and outside of the Lassa belt.

The documentation of the true distribution of Lassa virus in reservoir hosts will allow the country to better understand the risks to humans, develop more effective rodent control strategies, and inform future research, policy, and public health measures.

Technology and Space Redesign for Biosafety

At live bird markets in Dhaka, Bangladesh, where the threat of highly pathogenic avian influenza is a concern, efforts are underway to develop a coordinated and sustainable platform for pathogen surveillance and data sharing. A mobile application has been developed, enabling the public to report sick and dead poultry as well as sudden febrile illness among market vendors. Moreover, the STOP Spillover team is working with public health experts and engineers to redesign market spaces so that biosafety is optimized, and consumer and vendor health protected.

In Côte d’Ivoire, Cambodia, and Liberia, teams have been trained to safely collect samples for surveillance of wastewater and liquid waste effluent, with potential testing for multiple zoonotic viruses. The aim is to create a surveillance system that can act as an “early warning system” for potential spillover events.

The program exemplifies the One Health concept: the interconnection of human, animal, and environmental health. “STOP Spillover continues the longstanding work of Tufts University, mainstreaming One Health approaches to address complex, globally important health problems, including zoonotic diseases,” said Felicia Nutter.

“Humans make choices every day that impact our health, the health of other animals, and the ecosystems and environments that we all share. Our current work empowers people to make more informed choices that safeguard our shared health,” said Nutter.


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Delivering aid during war is tricky − here’s what to know about what Gaza relief operations may face

The politics of delivering aid in war zones are messy, the ethics fraught and the logistics daunting. But getting everything right is essential − and…

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Palestinians on the outskirts of Gaza City walk by buildings destroyed by Israeli bombardment on Oct. 20, 2023. AP Photo/Ali Mahmoud

The 2.2 million people who live in Gaza are facing economic isolation and experiencing incessant bombardment. Their supplies of essential resources, including food and water, are quickly dwindling.

In response, U.S. President Joe Biden has pledged US$100 million in humanitarian assistance for the citizens of Gaza.

As a scholar of peace and conflict economics who served as a World Bank consultant during the 2014 war between Hamas and Israel, I believe that Biden’s promise raises fundamental questions regarding the delivery of humanitarian aid in a war zone. Political constraints, ethical quandaries and the need to protect the security of aid workers and local communities always make it a logistical nightmare.

In this specific predicament, U.S. officials have to choose a strategy to deliver the aid without the perception of benefiting Hamas, a group the U.S. and Israel both classify as a terrorist organization.

Logistics

When aiding people in war zones, you can’t just send money, a development strategy called “cash transfers” that has become increasingly popular due to its efficiency. Sending money can boost the supply of locally produced goods and services and help people on the ground pay for what they need most. But injecting cash into an economy so completely cut off from the world would only stoke inflation.

So the aid must consist of goods that have to be brought into Gaza, and services provided by people working as part of an aid mission. Humanitarian aid can include food and water; health, sanitation and hygiene supplies and services; and tents and other materials for shelter and settlement.

Due to the closure of the border with Israel, aid can arrive in Gaza only via the Rafah crossing on the Egyptian border.

The U.S. Agency for International Development, or USAID, will likely turn to its longtime partner on the ground, the United Nations Relief and Works Agency, or UNRWA, to serve as supply depots and distribute goods. That agency, originally founded in 1949 as a temporary measure until a two-state solution could be found, serves in effect as a parallel yet unelected government for Palestinian refugees.

USAID will likely want to tap into UNRWA’s network of 284 schools – many of which are now transformed into humanitarian shelters housing two-thirds of the estimated 1 million people displaced by Israeli airstrikes – and 22 hospitals to expedite distribution.

Map of Gaza and its neighbors
Gaza is a self-governing Palestinian territory. The narrow piece of land is located on the coast of the Mediterranean Sea, bordered by Israel and Egypt. PeterHermesFurian/iStock via Getty Images Plus

Politics

Prior to the Trump administration, the U.S. was typically the largest single provider of aid to the West Bank and Gaza. USAID administers the lion’s share of it.

Since Biden took office, total yearly U.S. assistance for the Palestinian territories has totaled around $150 million, restored from just $8 million in 2020 under the Trump administration. During the Obama administration, however, the U.S. was providing more aid to the territories than it is now, with $1 billion disbursed in the 2013 fiscal year.

But the White House needs Congress to approve this assistance – a process that requires the House of Representatives to elect a new speaker and then for lawmakers to approve aid to Gaza once that happens.

Ethics

The United Nations Relief and Works Agency is a U.N. organization. It’s not run by Hamas, unlike, for instance, the Gaza Ministry of Health. However, Hamas has frequently undermined UNRWA’s efforts and diverted international aid for military purposes.

Hamas has repeatedly used UNRWA schools as rocket depots. They have repeatedly tunneled beneath UNRWA schools. They have dismantled European Union-funded water pipes to use as rocket fuselages. And even since the most recent violence broke out, the UNRWA has accused Hamas of stealing fuel and food from its Gaza premises.

Humanitarian aid professionals regularly have to contend with these trade-offs when deciding to what extent they can work with governments and local authorities that commit violent acts. They need to do so in exchange for the access required to help civilians under their control.

Similarly, Biden has had to make concessions to Israel while brokering for the freedom to send humanitarian aid to Gaza. For example, he has assured Israel that if any of the aid is diverted by Hamas, the operation will cease.

This promise may have been politically necessary. But if Biden already believes Hamas to be uncaring about civilian welfare, he may not expect the group to refrain from taking what they can.

Security best practices

What can be done to protect the security of humanitarian aid operations that take place in the midst of dangerous conflicts?

Under International Humanitarian Law, local authorities have the primary responsibility for ensuring the delivery of aid – even when they aren’t carrying out that task. To increase the chances that the local authorities will not attack them, aid groups can give “humanitarian notification” and voluntarily alert the local government as to where they will be operating.

Hamas has repeatedly flouted international norms and laws. So the question of if and how the aid convoy will be protected looms large.

Under the current agreement between the U.S., Israel and Egypt, the convoy will raise the U.N. flag. International inspectors will make sure no weapons are on board the vehicles before crossing over from Arish, Egypt, to Rafah, a city located on the Gaza Strip’s border with Egypt.

The aid convoy will likely cross without militarized security. This puts it at some danger of diversion once inside Gaza. But whether the aid convoy is attacked, seized or left alone, the Biden administration will have demonstrated its willingness to attempt a humanitarian relief operation. In this sense, a relatively small first convoy bearing water, medical supplies and food, among other items, serves as a test balloon for a sustained operation to follow soon after.

If the U.S. were to provide the humanitarian convoy a military escort, by contrast, Hamas could see its presence as a provocation. Washington’s support for Israel is so strong that the U.S. could potentially be judged as a party in the conflict between Israel and Hamas.

In that case, the presence of U.S. armed forces might provoke attacks on Gaza-bound aid convoys by Hamas and Islamic jihad fighters that otherwise would not have occurred. Combined with the mobilization of two U.S. Navy carrier groups in the eastern Mediterranean Sea, I’d be concerned that such a move might also stoke regional anger. It would undermine the Biden administration’s attempts to cool the situation.

On U.N.-approved missions, aid delivery may be secured by third-party peacekeepers – meaning, in this case, personnel who are neither Israeli nor Palestinian – with the U.N. Security Council’s blessing. In this case, tragically, it’s unlikely that such a resolution could conceivably pass such a vote, much less quickly enough to make a difference.

Topher L. McDougal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Diagnosis and management of postoperative wound infections in the head and neck region

“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]” Credit: 2023 Barbarewicz…

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“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]”

Credit: 2023 Barbarewicz et al.

“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]”

BUFFALO, NY- October 20, 2023 – A new research perspective was published in Oncoscience (Volume 10) on October 4, 2023, entitled, “Diagnosis and management of postoperative wound infections in the head and neck region.”

In everyday clinical practice at a department for oral and maxillofacial surgery, a large number of surgical procedures in the head and neck region take place under both outpatient and inpatient conditions. The basis of every surgical intervention is the patient’s consent to the respective procedure. Particular attention is drawn to the general and operation-specific risks. 

Particularly in the case of soft tissue procedures in the facial region, bleeding, secondary bleeding, scarring and infection of the surgical area are among the most common complications/risks, depending on the respective procedure. In their new perspective, researchers Filip Barbarewicz, Kai-Olaf Henkel and Florian Dudde from Army Hospital Hamburg in Germany discuss the diagnosis and management of postoperative infections in the head and neck region.

“In order to minimize the wound infections/surgical site infections, aseptic operating conditions with maximum sterility are required.”

Furthermore, depending on the extent of the surgical procedure and the patient‘s previous illnesses, peri- and/or postoperative antibiotics should be considered in order to avoid postoperative surgical site infection. Abscesses, cellulitis, phlegmone and (depending on the location of the procedure) empyema are among the most common postoperative infections in the respective surgical area. The main pathogens of these infections are staphylococci, although mixed (germ) patterns are also possible. 

“Risk factors for the development of a postoperative surgical site infection include, in particular, increased age, smoking, multiple comorbidities and/or systemic diseases (e.g., diabetes mellitus type II) as well as congenital and/ or acquired immune deficiency [10, 11].”

 

Continue reading the paper: DOI: https://doi.org/10.18632/oncoscience.589 

Correspondence to: Florian Dudde

Email: floriandudde@gmx.de 

Keywords: surgical site infection, head and neck surgery

 

About Oncoscience

Oncoscience is a peer-reviewed, open-access, traditional journal covering the rapidly growing field of cancer research, especially emergent topics not currently covered by other journals. This journal has a special mission: Freeing oncology from publication cost. It is free for the readers and the authors.

To learn more about Oncoscience, visit Oncoscience.us and connect with us on social media:

For media inquiries, please contact media@impactjournals.com.

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G77 Nations, China, Push Back On U.S. “Loss And Damage” Climate Fund In Days Leading Up To UN Summit

G77 Nations, China, Push Back On U.S. "Loss And Damage" Climate Fund In Days Leading Up To UN Summit

As was the case in primary school with…

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G77 Nations, China, Push Back On U.S. "Loss And Damage" Climate Fund In Days Leading Up To UN Summit

As was the case in primary school with bringing in presents, make sure you bring enough for the rest of the class, otherwise people get ornery...

This age old rule looks like it could be rearing its head in the days leading up to the UN COP 28 climate summit, set to take place in the United Arab Emirates in about six weeks. 

At the prior UN COP 27, which took place in Egypt last year, the U.S. pushed an idea for a new World Bank "loss and damage" climate slush fund to help poor countries with climate change. But the G77 nations plus China, including many developing countries, are pushing back on the idea, according to a new report from the Financial Times

The goal was to arrange how the fund would operate and where the money would come from for the "particularly vulnerable" nations who would have access to it prior to the upcoming summit in UAE.

But as FT notes, Pedro Luis Pedroso Cuesta, the Cuban chair of the G77 plus China group, has said that talks about these details were instead "deadlocked" over issues of - you guessed it - where the money is going and the governance of the fund.

The U.S.'s proposal for the fund to be governed by the World Bank has been rejected by the G77 after "extensive" discussions, the report says. Cuesta has said that the nations seek to have the fund managed elsewhere, but that the U.S. wasn't open to such arrangements. 

Cuesta said: “We have been confronted with an elephant in the room, and that elephant is the US. We have been faced with a very closed position that it is [the World Bank] or nothing.”

Christina Chan, a senior adviser to US climate envoy John Kerry, responded: “We have been working diligently at every turn to address concerns, problem-solve, and find landing zones.” She said the U.S. has been "clear and consistent" in their messaging on the need for the fund. 

Cuesta contends that the World Bank, known for lending to less affluent nations, lacks a "climate culture" and often delays decision-making, hindering quick responses to climate emergencies like Pakistan's recent severe flooding.

The G77 coalition voiced concerns about the World Bank's legal framework potentially limiting the fund's ability to accept diverse funding sources like philanthropic donations or to access capital markets.

With just days left before the UN COP 28 summit, the World Bank insists that combating climate change is integral to its mission and vows to collaborate on structuring the fund.

Tyler Durden Fri, 10/20/2023 - 15:45

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