Publications by authors named "Michael L Wilson"

126 Publications

Research and Conservation in the Greater Gombe Ecosystem: Challenges and Opportunities.

Biol Conserv 2020 Dec 16;252. Epub 2020 Nov 16.

The Jane Goodall Institute, Vienna, VA, 22182 USA.

The study of chimpanzees in Gombe National Park, Tanzania, started by Jane Goodall in 1960, provided pioneering accounts of chimpanzee behavior and ecology. With funding from multiple sources, including the Jane Goodall Institute (JGI) and grants from private foundations and federal programs, the project has continued for sixty years, providing a wealth of information about our evolutionary cousins. These chimpanzees face two main challenges to their survival: infectious disease - including simian immunodeficiency virus (SIVcpz), which can cause Acquired Immune Deficiency Syndrome (AIDS) in chimpanzees - and the deforestation of land outside the park. A health monitoring program has increased understanding of the pathogens affecting chimpanzees and has promoted measures to characterize and reduce disease risk. Deforestation reduces connections between Gombe and other chimpanzee populations, which can cause loss of genetic diversity. To promote habitat restoration, JGI facilitated participatory village land use planning, in which communities voluntarily allocated land to a network of Village Land Forest Reserves. Expected benefits to people include stabilizing watersheds, improving water supplies, and ensuring a supply of forest resources. Surveys and genetic analyses confirm that chimpanzees persist on village lands and remain connected to the Gombe population. Many challenges remain, but the regeneration of natural forest on previously degraded lands provides hope that conservation solutions can be found that benefit both people and wildlife. Conservation work in the Greater Gombe Ecosystem has helped promote broader efforts to plan and work for conservation elsewhere in Tanzania and across Africa.
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http://dx.doi.org/10.1016/j.biocon.2020.108853DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7743041PMC
December 2020

Use of LOINC for interoperability between organisations poses a risk to safety - Authors' reply.

Lancet Digit Health 2020 11 19;2(11):e570. Epub 2020 Oct 19.

Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, UK.

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http://dx.doi.org/10.1016/S2589-7500(20)30247-8DOI Listing
November 2020

Effective coding is key to the development and use of the WHO Essential Diagnostics List.

Lancet Digit Health 2019 12;1(8):e387-e388

Oxford Health System Collaboration, University of Oxford, Oxford OX1 3SY, UK.

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http://dx.doi.org/10.1016/S2589-7500(19)30196-7DOI Listing
December 2019

Hawks, Doves, and mongooses.

Authors:
Michael L Wilson

Proc Natl Acad Sci U S A 2020 12 13;117(48):30012-30013. Epub 2020 Nov 13.

Department of Anthropology, University of Minnesota, Minneapolis, MN 55455;

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http://dx.doi.org/10.1073/pnas.2021188117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720156PMC
December 2020

Unpacking chimpanzee (Pan troglodytes) patch use: Do individuals respond to food patches as predicted by the marginal value theorem?

Am J Primatol 2020 12 28;82(12):e23208. Epub 2020 Oct 28.

Department of Ecology, Evolution and Behavior, University of Minnesota, St. Paul, Minnesota, USA.

The marginal value theorem is an optimal foraging model that predicts how efficient foragers should respond to both their ecological and social environments when foraging in food patches, and it has strongly influenced hypotheses for primate behavior. Nevertheless, experimental tests of the marginal value theorem have been rare in primates and observational studies have provided conflicting support. As a step towards filling this gap, we test whether the foraging decisions of captive chimpanzees (Pan troglodytes) adhere to the assumptions and qualitative predictions of the marginal value theorem. We presented 12 adult chimpanzees with a two-patch foraging environment consisting of both low-quality (i.e., low-food density) and high-quality (i.e., high-food density) patches and examined the effect of patch quality on their search behavior, foraging duration, marginal capture rate, and its proxy measures: giving-up density and giving-up time. Chimpanzees foraged longer in high-quality patches, as predicted. In contrast to predictions, they did not depress high-quality patches as thoroughly as low-quality patches. Furthermore, since chimpanzees searched in a manner that fell between systematic and random, their intake rates did not decline at a steady rate over time, especially in high-quality patches, violating an assumption of the marginal value theorem. Our study provides evidence that chimpanzees are sensitive to their rate of energy intake and that their foraging durations correlate with patch quality, supporting many assumptions underlying primate foraging and social behavior. However, our results question whether the marginal value theorem is a constructive model of chimpanzee foraging behavior, and we suggest a Bayesian foraging framework (i.e., combining past foraging experiences with current patch sampling information) as a potential alternative. More work is needed to build an understanding of the proximate mechanisms underlying primate foraging decisions, especially in more complex socioecological environments.
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http://dx.doi.org/10.1002/ajp.23208DOI Listing
December 2020

Gonorrhea and Chlamydia Rates Among 12- to 24-Year-Old Patients in an Urban Health System.

Sex Transm Dis 2021 Mar;48(3):161-166

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection rates continue to rise. Screening guidelines have largely focused on sexually active female individuals and men who have sex with men populations. Health care system testing and infection rates, particularly among heterosexual male individuals, are poorly understood. Our aim was to evaluate CT and GC testing and prevalence among 12- to 24-year-old patients in an urban federally qualified health center system.

Methods: This retrospective study analyzed electronic health record data from 2017 to 2019 in a large system of federally qualified health centers in Denver, CO. Abstracted data included demographics, sexual activity, sexual orientation, and laboratory results. χ2 Tests were used to evaluate differences between groups.

Results: Of the 44,021 patients included, 37.6% were tested, 15.0% were positive for CT, and 3.4% were positive for GC. Heterosexual male patients had a testing rate of 22.8% and positivity rates of CT and GC at 13.1% and 3.0%, respectively. Among tested patients documented as not sexually active, 7.5% were positive for CT. Multiple or reinfections were detected in 29% of patients.

Conclusions: This study shows low testing rates and high rates of CT and GC infections among all patients, including heterosexual male patients and those documented as not sexually active. Improved screening of these populations in the primary care setting may be key to combating the sexually transmitted disease epidemic.
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http://dx.doi.org/10.1097/OLQ.0000000000001302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867586PMC
March 2021

Urine as a high-quality source of host genomic DNA from wild populations.

Mol Ecol Resour 2021 Jan 17;21(1):170-182. Epub 2020 Oct 17.

Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.

The ability to generate genomic data from wild animal populations has the potential to give unprecedented insight into the population history and dynamics of species in their natural habitats. However, for many species, it is impossible legally, ethically or logistically to obtain tissue samples of quality sufficient for genomic analyses. In this study we evaluate the success of multiple sources of genetic material (faeces, urine, dentin and dental calculus) and several capture methods (shotgun, whole-genome, exome) in generating genome-scale data in wild eastern chimpanzees (Pan troglodytes schweinfurthii) from Gombe National Park, Tanzania. We found that urine harbours significantly more host DNA than other sources, leading to broader and deeper coverage across the genome. Urine also exhibited a lower rate of allelic dropout. We found exome sequencing to be far more successful than both shotgun sequencing and whole-genome capture at generating usable data from low-quality samples such as faeces and dental calculus. These results highlight urine as a promising and untapped source of DNA that can be noninvasively collected from wild populations of many species.
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http://dx.doi.org/10.1111/1755-0998.13260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746602PMC
January 2021

Why chimpanzees carry dead infants: an empirical assessment of existing hypotheses.

R Soc Open Sci 2020 Jul 1;7(7):200931. Epub 2020 Jul 1.

Department of Evolutionary Anthropology, Duke University, Durham, NC, USA.

The study of non-human primate thanatology has expanded dramatically in recent years as scientists seek to understand the evolutionary roots of human death concepts and practices. However, observations of how conspecifics respond to dead individuals are rare and highly variable. Mothers of several species of primate have been reported to carry and continue to interact with dead infants. Such interactions have been proposed to be related to maternal condition, attachment, environmental conditions or reflect a lack of awareness that the infant has died. Here, we tested these hypotheses using a dataset of cases of infant corpse carrying by chimpanzees in Gombe National Park, Tanzania ( = 33), the largest dataset of such cases in chimpanzees. We found that mothers carried infant corpses at high rates, despite behavioural evidence that they recognize that death has occurred. Median duration of carriage was 1.83 days (interquartile range = 1.03-3.59). Using an information theoretic approach, we found no support for any of the leading hypotheses for duration of continued carriage. We interpret these data in the context of recent discussions regarding what non-human primates understand about death.
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http://dx.doi.org/10.1098/rsos.200931DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428235PMC
July 2020

Why chimpanzees carry dead infants: an empirical assessment of existing hypotheses.

R Soc Open Sci 2020 Jul 1;7(7):200931. Epub 2020 Jul 1.

Department of Evolutionary Anthropology, Duke University, Durham, NC, USA.

The study of non-human primate thanatology has expanded dramatically in recent years as scientists seek to understand the evolutionary roots of human death concepts and practices. However, observations of how conspecifics respond to dead individuals are rare and highly variable. Mothers of several species of primate have been reported to carry and continue to interact with dead infants. Such interactions have been proposed to be related to maternal condition, attachment, environmental conditions or reflect a lack of awareness that the infant has died. Here, we tested these hypotheses using a dataset of cases of infant corpse carrying by chimpanzees in Gombe National Park, Tanzania ( = 33), the largest dataset of such cases in chimpanzees. We found that mothers carried infant corpses at high rates, despite behavioural evidence that they recognize that death has occurred. Median duration of carriage was 1.83 days (interquartile range = 1.03-3.59). Using an information theoretic approach, we found no support for any of the leading hypotheses for duration of continued carriage. We interpret these data in the context of recent discussions regarding what non-human primates understand about death.
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http://dx.doi.org/10.1098/rsos.200931DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428235PMC
July 2020

Oral microbiome diversity in chimpanzees from Gombe National Park.

Sci Rep 2019 11 22;9(1):17354. Epub 2019 Nov 22.

Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, USA.

Historic calcified dental plaque (dental calculus) can provide a unique perspective into the health status of past human populations but currently no studies have focused on the oral microbial ecosystem of other primates, including our closest relatives, within the hominids. Here we use ancient DNA extraction methods, shotgun library preparation, and next generation Illumina sequencing to examine oral microbiota from 19 dental calculus samples recovered from wild chimpanzees (Pan troglodytes schweinfurthii) who died in Gombe National Park, Tanzania. The resulting sequences were trimmed for quality, analyzed using MALT, MEGAN, and alignment scripts, and integrated with previously published dental calculus microbiome data. We report significant differences in oral microbiome phyla between chimpanzees and anatomically modern humans (AMH), with chimpanzees possessing a greater abundance of Bacteroidetes and Fusobacteria, and AMH showing higher Firmicutes and Proteobacteria. Our results suggest that by using an enterotype clustering method, results cluster largely based on host species. These clusters are driven by Porphyromonas and Fusobacterium genera in chimpanzees and Haemophilus and Streptococcus in AMH. Additionally, we compare a nearly complete Porphyromonas gingivalis genome to previously published genomes recovered from human gingiva to gain perspective on evolutionary relationships across host species. Finally, using shotgun sequence data we assessed indicators of diet from DNA in calculus and suggest exercising caution when making assertions related to host lifestyle. These results showcase core differences between host species and stress the importance of continued sequencing of nonhuman primate microbiomes in order to fully understand the complexity of their oral ecologies.
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http://dx.doi.org/10.1038/s41598-019-53802-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6874655PMC
November 2019

Corticosteroids for Posttransplant Immune Reconstitution Syndrome in Meningoencephalitis: Case Report and Literature Review.

Open Forum Infect Dis 2019 Nov 23;6(11):ofz460. Epub 2019 Oct 23.

Department of Infectious Diseases, Denver Health Medical Center, Denver, Colorado, USA.

represents an emerging fungal pathogen of immunocompromised and immunocompetent hosts in the United States. To our knowledge, this is the first case of posttransplant immune reconstitution syndrome due to meningoencephalitis successfully treated with corticosteroids. We also report successful maintenance phase treatment with isavuconazole, a novel triazole, following fluconazole-induced prolonged QT syndrome.
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http://dx.doi.org/10.1093/ofid/ofz460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6847472PMC
November 2019

Insights into the evolution of social systems and species from baboon studies.

Elife 2019 11 12;8. Epub 2019 Nov 12.

Cognitive Ethology Laboratory, German Primate Center, Leibniz-Institute for Primate Research, Göttingen, Germany.

Baboons, members of the genus comprise six closely related species distributed throughout sub-Saharan Africa and southwest Arabia. The species exhibit more ecological flexibility and a wider range of social systems than many other primates. This article summarizes our current knowledge of the natural history of baboons and highlights directions for future research. We suggest that baboons can serve as a valuable model for complex evolutionary processes, such as speciation and hybridization. The evolution of baboons has been heavily shaped by climatic changes and population expansion and fragmentation in the African savanna environment, similar to the processes that acted during human evolution. With accumulating long-term data, and new data from previously understudied species, baboons are ideally suited for investigating the links between sociality, health, longevity and reproductive success. To achieve these aims, we propose a closer integration of studies at the proximate level, including functional genomics, with behavioral and ecological studies.
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http://dx.doi.org/10.7554/eLife.50989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6850771PMC
November 2019

New approaches to modeling primate socioecology: Does small female group size BEGET loyal males?

J Hum Evol 2019 12 18;137:102671. Epub 2019 Oct 18.

Department of Anthropology, University of Minnesota, 395 Humphrey Center, 301 19th Ave. S., Minneapolis, MN 55455, USA; Department of Ecology, Evolution and Behavior, University of Minnesota, 1987 Upper Buford Circle, Saint Paul, MN 55108, USA. Electronic address:

Humans are unusual in having stable male-female breeding bonds within multi-level societies. Such societies are not found in other apes, but have evolved independently in other primates, including several African papionins: hamadryas and Guinea baboons and gelada monkeys. Stable breeding bonds have been proposed to evolve either (1) because males can monopolize females when food distribution forces females to forage in small groups or (2) because females exchange exclusive mating for male services, such as protection from infanticide. Comparative studies are needed to test these hypotheses. In the meantime, we used an agent-based computer model to test the plausibility of these hypotheses. We simulated primates living in social groups within a larger population using a model we call BEGET (Behavior, Ecology, Genetics, Evolution, and Tradeoffs), which employed decision vectors, experimental evolution, realistic trade-offs, and phenotypic plasticity. We employed experimental evolution to generate male genotypes that varied in their competitive ability and in their long-term mating strategy. "Rover" males searched for and mated with any sexually receptive females whereas "Loyalist" males formed stable associations with particular groups of females. Much like living primates, the virtual primates exhibited tradeoffs between contest and scramble competition for access to females: Loyalists evolved larger body size than Rovers. We tested the effect of female foraging group size and the presence of infanticide and infant protection on the relative success of these strategies. We found that Loyalists achieved greater reproductive success than Rovers only when females were in groups smaller than four. Both Rovers and Loyalists sometimes evolved infanticidal behavior, but the presence of infanticide benefited Rovers rather than Loyalists, suggesting that the evolution of stable breeding bonds depends on the spatial distribution of females, rather than the risk of infanticide.
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http://dx.doi.org/10.1016/j.jhevol.2019.102671DOI Listing
December 2019

A dream of spring - the Lancet Commission on diagnostics.

Histopathology 2019 12;75(6):797-798

Green Templeton College, Oxford University, Oxford, UK.

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http://dx.doi.org/10.1111/his.13933DOI Listing
December 2019

Risk Factors for Below-the-Knee Amputation in Diabetic Foot Osteomyelitis After Minor Amputation.

J Am Podiatr Med Assoc 2019 Mar;109(2):91-97

Background: Below-the-knee amputation (BKA) can be a detrimental outcome of diabetic foot osteomyelitis (DFO). Ideal treatment of DFO is controversial, but studies suggest minor amputation reduces the risk of BKA. We evaluated risk factors for BKA after minor amputation for DFO.

Methods: This is a retrospective cohort of patients discharged from Denver Health Medical Center from February 1, 2012, through December 31, 2014. Patients who underwent minor amputation for diagnosis of DFO were eligible for inclusion. The outcome evaluated was BKA in the 6 months after minor amputation.

Results: Of 153 episodes with DFO that met the study criteria, 11 (7%) had BKA. Failure to heal surgical incision at 3 months ( < .001) and transmetatarsal amputation ( = .009) were associated with BKA in the 6 months after minor amputation. Peripheral vascular disease was associated with failure to heal but not with BKA ( = .009). Severe infection, bacteremia, hemoglobin A, and positive histopathologic margins of bone and soft tissue were not associated with BKA. The median antibiotic duration was 42 days for positive histopathologic bone resection margin (interquartile range, 32-47 days) and 16 days for negative margin (interquartile range, 8-29 days). Longer duration of antibiotics was not associated with lower risk of BKA.

Conclusions: Patients who fail to heal amputation sites in 3 months or who have transmetatarsal amputation are at increased risk for BKA. Future studies should evaluate the impact of aggressive wound care or whether failure to heal is a marker of another variable.
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http://dx.doi.org/10.7547/16-143DOI Listing
March 2019

The Lancet Commission on diagnostics: advancing equitable access to diagnostics.

Lancet 2019 05;393(10185):2018-2020

Department of Pathology, Aga Khan University Hospital Nairobi, Nairobi, Kenya.

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http://dx.doi.org/10.1016/S0140-6736(19)31052-9DOI Listing
May 2019

The Top 25 Laboratory Tests by Volume and Revenue in Five Different Countries.

Am J Clin Pathol 2019 04;151(5):446-451

Pathology and Laboratory Services, Denver Health Medical Center, Denver, CO.

Objectives: To compare the most common diagnostic/laboratory tests across five different referral hospitals by volume and revenue.

Methods: The authors obtained data on volumes and reimbursement rates for the most common 25 tests at the five hospitals with which they are affiliated and organized them to be as comparable as possible. Simple descriptive statistics were used to make cross-country comparisons.

Results: There are strong similarities across all five hospitals in the top five tests by both volume and revenue. However, the top five by volume differ from the top five by revenue. Reimbursement rates also follow common patterns, being lowest for the most common biochemical test; intermediate for the most common hematology and microbiology tests, respectively; and highest for the most common pathology test.

Conclusions: Most of the most common tests also appear in the new Essential Diagnostics List. This may inform plans for universal health coverage.
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http://dx.doi.org/10.1093/ajcp/aqy165DOI Listing
April 2019

Artificial intelligence can augment global pathology initiatives - Authors' reply.

Lancet 2018 12;392(10162):2352

Centre for Global Health, National Cancer Institute, Rockville, MD, USA; Emeritus Fellow, Green Templeton College, University of Oxford, UK.

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http://dx.doi.org/10.1016/S0140-6736(18)32170-6DOI Listing
December 2018

An Introduction and a New Era.

Authors:
Michael L Wilson

Am J Clin Pathol 2018 Jul;150(3):189

Department of Pathology and Laboratory Services, Denver Health, Denver, CO.

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http://dx.doi.org/10.1093/ajcp/aqy106DOI Listing
July 2018

The Future of Pathology and Laboratory Medicine-Again.

Authors:
Michael L Wilson

Am J Clin Pathol 2018 Jul;150(2):93-95

Department of Pathology and Laboratory Services, Denver Health, Denver, CO.

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http://dx.doi.org/10.1093/ajcp/aqy058DOI Listing
July 2018

Interferon-Gamma Release Assay-Based Screening for Pediatric Latent Tuberculosis Infection in an Urban Primary Care Network.

J Pediatr 2018 09 1;200:202-209. Epub 2018 Jun 1.

Department of Pediatrics, University of Colorado School of Medicine, Aurora CO; Children's Hospital, Dartmouth-Hitchcock, Lebanon, NH; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH.

Objective: To assess outcomes from a QuantiFERON-tuberculosis (TB) Gold (QFT)-based screening for pediatric latent TB infection (LTBI) in the Denver Health Community Health System (CHS), an urban primary-care network in the US.

Study Design: We retrospectively analyzed all QFTs (n = 6685) performed on children aged 2-18 years between January 5, 2011, and August 18, 2014. Risk factors for positive testing in the CHS population were identified by logistic regression, and further assessed using a case-control comparison. Results from CHS were compared with higher-TB-risk populations (refugee and TB clinics) in our health system.

Results: Positive QFT occurred in 79 of 3745 (2.1%) CHS patients. Positive rates increased with age (0.3% in age 2-5 years to 4.9% in age 13-18 years). Indeterminate results were uncommon (0.8%) including in children <5 (1.3%). Risk factors for positive tests in the CHS population included non-Medicaid insured/uninsured and non-English/Spanish preferred language. In the case-control analysis, birth/travel to/residence in a TB-endemic country was the only identified risk factor for positive testing (OR 5.2 [95% CI 1.04-25.5]). Rates of positive testing were lower in the CHS population than the refugee/TB clinic populations, including among children age 2-5.

Discussion: QFT-based LTBI screening was successfully introduced in our pediatric primary-care health system, and supported our programmatic goals of identifying LTBI cases while limiting unnecessary LTBI treatment courses. Increasing positive rates with age, and higher rates in the refugee/TB populations compared with CHS, add indirect evidence of adequate test sensitivity, even among young children, for whom data on interferon-gamma release assay performance are limited.
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http://dx.doi.org/10.1016/j.jpeds.2018.04.034DOI Listing
September 2018

Access to pathology and laboratory medicine services: a crucial gap.

Lancet 2018 05 15;391(10133):1927-1938. Epub 2018 Mar 15.

Department of Pathology and Laboratory Medicine, Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin, China.

As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. In this first in a Series of three papers on PALM in LMICs, we describe the crucial and central roles of PALM services in the accurate diagnosis and detection of disease, informing prognosis and guiding treatment, contributing to disease screening, public health surveillance and disease registries, and supporting medical-legal systems. We also describe how, even though data are sparse, these services are of both insufficient scope and inadequate quality to play their key role in health-care systems in LMICs. Lastly, we identify four key barriers to the provision of optimal PALM services in resource-limited settings: insufficient human resources or workforce capacity, inadequate education and training, inadequate infrastructure, and insufficient quality, standards, and accreditation.
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http://dx.doi.org/10.1016/S0140-6736(18)30458-6DOI Listing
May 2018

Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions.

Lancet 2018 05 15;391(10133):1939-1952. Epub 2018 Mar 15.

Center for Global Health, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; Green Templeton College, University of Oxford, Oxford, UK.

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan.
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http://dx.doi.org/10.1016/S0140-6736(18)30459-8DOI Listing
May 2018

Improving Anatomic Pathology in Sub-Saharan Africa to Support Cancer Care.

Am J Clin Pathol 2018 Mar;149(4):310-315

African Strategies for Advancing Pathology, Denver, CO.

Objectives: Cancer care requires both accurate pathologic diagnosis as well as pathologic cancer staging. We evaluated three approaches to training pathologists in sub-Saharan Africa to perform pathologic cancer staging of breast, cervix, prostate, and colorectal cancers.

Methods: One of three training methods was used at each workshop: didactic, case-based testing (CBT), or a blended approach. The project involved 52 participants from 16 pathology departments in 11 countries in East, Central, and Southern Africa. Evaluation of each method included pre- and postworkshop knowledge assessments, online pre- and postworkshop surveys of practice changes at the individual and institutional levels, and selected site visits.

Results: While CBT resulted in the highest overall average postassessment individual scores, both CBT and blended approaches resulted in 19% increases in average scores from pre- to postworkshop assessments. Institutions that participated in the blended workshop had increased changes in practice as indicated by the institutional survey.

Conclusions: Both CBT and a blended approach are effective methods for training pathologists in pathologic cancer staging. Both are superior to traditional lectures alone.
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http://dx.doi.org/10.1093/ajcp/aqx158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144773PMC
March 2018

Practice Guidelines for Clinical Microbiology Laboratories: Mycobacteria.

Clin Microbiol Rev 2018 04 31;31(2). Epub 2018 Jan 31.

Denver Health, Denver, Colorado, USA.

Mycobacteria are the causative organisms for diseases such as tuberculosis (TB), leprosy, Buruli ulcer, and pulmonary nontuberculous mycobacterial disease, to name the most important ones. In 2015, globally, almost 10 million people developed TB, and almost half a million patients suffered from its multidrug-resistant form. In 2016, a total of 9,287 new TB cases were reported in the United States. In 2015, there were 174,608 new case of leprosy worldwide. India, Brazil, and Indonesia reported the most leprosy cases. In 2015, the World Health Organization reported 2,037 new cases of Buruli ulcer, with most cases being reported in Africa. Pulmonary nontuberculous mycobacterial disease is an emerging public health challenge. The U.S. National Institutes of Health reported an increase from 20 to 47 cases/100,000 persons (or 8.2% per year) of pulmonary nontuberculous mycobacterial disease among adults aged 65 years or older throughout the United States, with 181,037 national annual cases estimated in 2014. This review describes contemporary methods for the laboratory diagnosis of mycobacterial diseases. Furthermore, the review considers the ever-changing health care delivery system and stresses the laboratory's need to adjust and embrace molecular technologies to provide shorter turnaround times and a higher quality of care for the patients who we serve.
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http://dx.doi.org/10.1128/CMR.00038-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5967691PMC
April 2018

Infanticide in chimpanzees: Taphonomic case studies from Gombe.

Am J Phys Anthropol 2018 01 26;165(1):108-122. Epub 2017 Oct 26.

Gombe Stream Research Center, the Jane Goodall Institute, Kigoma, Tanzania.

Objectives: We present a study of skeletal damage to four chimpanzee (Pan troglodytes) infanticide victims from Gombe National Park, Tanzania. Skeletal analysis may provide insight into the adaptive significance of infanticide by examining whether nutritional benefits sufficiently explain infanticidal behavior. The nutritional hypothesis would be supported if bone survivorship rates and skeletal damage patterns are comparable to those of monkey prey. If not, other explanations, such as the resource competition hypothesis, should be considered.

Methods: Taphonomic assessment of two chimpanzee infants included description of breakage and surface modification, data on MNE, %MNE, and bone survivorship. Two additional infants were assessed qualitatively. The data were compared to published information on monkey prey. We also undertook a review of published infanticide cases.

Results: The cases were intercommunity infanticides (one male and three female infants) committed by males. Attackers partially consumed two of the victims. Damage to all four infants included puncture marks and compression fractures to the cranium, crenulated breaks to long bones, and incipient fractures on ribs. Compared to monkey prey, the chimpanzee infants had an abundance of vertebrae and hand/foot bones.

Conclusions: The cases described here suggest that chimpanzees may not always completely consume infanticide victims, while reports on chimpanzee predation indicated that complete consumption of monkey prey usually occurred. Infanticidal chimpanzees undoubtedly gain nutritional benefits when they consume dead infants, but this benefit may not sufficiently explain infanticide in this species. Continued study of infanticidal and hunting behavior, including skeletal analysis, is likely to be of interest.
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http://dx.doi.org/10.1002/ajpa.23335DOI Listing
January 2018

Personality in the chimpanzees of Gombe National Park.

Sci Data 2017 10 24;4:170146. Epub 2017 Oct 24.

Evolutionary Anthropology, Duke University, Durham, NC 27708, USA.

Researchers increasingly view animal personality traits as products of natural selection. We present data that describe the personalities of 128 eastern chimpanzees (Pan troglodytes schweinfurthii) currently living in or who lived their lives in the Kasekela and Mitumba communities of Gombe National Park, Tanzania. We obtained ratings on 24 items from an established, reliable, well-validated questionnaire used to study personality in captive chimpanzee populations. Ratings were made by former and present Tanzanian field assistants who followed individual chimpanzees for years and collected detailed behavioral observations. Interrater reliabilities across items ranged from acceptable to good, but the personality dimensions they formed were not as interpretable as those from captive samples. However, the personality dimensions corresponded to ratings of 24 Kasekela chimpanzees on a different questionnaire in 1973 that assessed some similar traits. These correlations established the repeatability and construct validity of the present ratings, indicating that the present data can facilitate historical and prospective studies that will lead to better understanding of the evolution of personality in chimpanzees and other primates.
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http://dx.doi.org/10.1038/sdata.2017.146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654364PMC
October 2017

Improving Global Access to Diagnostic Testing.

Am J Clin Pathol 2017 01;147(1):6-7

Center for Global Health,, National Cancer Institute, Washington, DC

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http://dx.doi.org/10.1093/ajcp/aqw219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248438PMC
January 2017

Distinct GATA1 Point Mutations in Monozygotic Twins With Down Syndrome and Transient Abnormal Myelopoiesis From a Triplet Pregnancy: A Case Report and Review of Literature.

Am J Clin Pathol 2016 Dec 27;146(6):753-759. Epub 2016 Dec 27.

From the Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora

Objectives: Down syndrome (DS)-associated transient abnormal myelopoiesis (TAM) or acute megakaryoblastic leukemia (AMKL) in monozygotic twins is exceedingly rare and has not been well characterized.

Methods: We describe a unique case of monozygotic twins with simultaneous TAM from a triplet pregnancy at 34 weeks' gestation. Previously reported cases of TAM and DS-AMKL in monozygotic twins have been reviewed to compare with our cases. The current concept of a sequential multistep process in leukemogenesis and disease evolution of TAM into DS-AMKL through the collaboration among trisomy 21, GATA1, and other gene mutations is also reviewed.

Results: Distinct GATA1 mutations are identified in our neonate twins with TAM from a triplet pregnancy, whereas precisely identical GATA1 mutations have been detected in all three monozygotic DS twins reported in the literature.

Conclusions: Identical GATA1 mutations in cases of monozygotic twins are likely derived from twin-twin transmission. Distinct GATA1 mutations identified in our neonate twins with TAM provide unequivocal evidence of independent intra-utero GATA1 mutations, a completely different mechanism of development of TAM in monozygotic twins from previously reported cases. Interaction of trisomy 21 and GATA1 mutation produces TAM, but additional gene mutations are required for TAM to transform into DS-AMKL.
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http://dx.doi.org/10.1093/ajcp/aqw190DOI Listing
December 2016