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ABSTRACTComparing a parasitic lineage to its free-living relatives is a powerful way to understand how the evolutionary transition to parasitism occurred.Giardia intestinalis(Fornicata) is a leading cause of gastrointestinal disease world-wide and is famous for its unusual complement of cellular compartments, such as having peripheral vacuoles instead of typical endosomal compartments. Endocytosis plays an important role inGiardia’s pathogenesis. Endosomal sorting complexes required for transport (ESCRT) are membrane-deforming proteins associated with the late endosome/multivesicular body (MVB). MVBs are ill-defined inG. intestinalisand roles for identified ESCRT-related proteins are not fully understood in the context of its unique endocytic system. Furthermore, components thought to be required for full ESCRT functionality have not yet been documented in this species.We used genomic and transcriptomic data from several Fornicata species to clarify the evolutionary genome streamlining observed inGiardia, as well as to detect any divergent orthologs of the Fornicata ESCRT subunits. We observed differences in the ESCRT machinery complement betweenGiardiastrains. Microscopy-based investigations of key components of ESCRT machinery such asGiVPS36andGiVPS25 link them to peripheral vacuoles, highlighting these organelles as simplified MVB equivalents. Unexpectedly, we show ESCRT components associated with the Endoplasmic Reticulum, and for the first time, mitosomes. Finally, we identified the rare ESCRT component CHMP7 in several fornicate representatives, includingGiardia, and show that contrary to current understanding, CHMP7 evolved from a gene fusion of VPS25 and SNF7 domains, prior to the last eukaryotic common ancestor, over 1.5 billion years ago. Our findings show that ESCRT machinery inG. intestinalisis far more varied and complete than previously thought, and associating to multiple cellular locations and presenting changes in ESCRT complement which pre-date adoption of a parasitic lifestyle.

Early exposure to stress and teratogenic substances have an impact on brain structures involved in cognition and mental health. While moderate-to-high levels of prenatal alcohol exposure (PAE) have repeatedly been associated with long-term neurodevelopmental deficits, no consensus has yet been reached on the detrimental effects of low-to-moderate PAE on the children's functioning, including the limbic-hypothalamic-pituitary-adrenal axis.The study aims to examine the association between low PAE and cortisol response to unfamiliar situations in 19-month-old children and to determine whether this association was moderated by sex and testosterone levels.Information regarding PAE, cortisol response to unfamiliar situations, and testosterone activity was available in a total of 130 children participating to the Québec Newborn Twin Study (Montréal, QC, Canada). Mother alcohol consumption during pregnancy was assessed via a semistructured interview conducted when the children were 6 months of age. The contribution of prenatal and postnatal confounds were examined.Disrupted patterns of cortisol activity were observed only in PAE males. Testosterone tended to be negatively associated with the cortisol response, but not for PAE males, suggesting an altered sensitivity to the inhibitory effects of testosterone in these participants.Low levels of PAE were associated with disrupted cortisol activity, and males may be at higher risk. These findings challenge the existence of a "safe level" of alcohol consumption during pregnancy and have public health implications.

Biodiversity and ecosystem conservation in the Amazon play a critical role in climate-change mitigation. However, institutional responses have had conflicted and complex relations with Indigenous peoples. There is a growing need for meaningful engagement with—and recognition of—the centrality of Indigenous peoples’ perceptions and understanding of the changes they are experiencing to inform successful and effective place-based adaptation strategies. To fill this gap, this study focuses on the value-based perspectives and pragmatic decision-making of Shawi Indigenous men in the Peruvian Amazon. We are specifically interested in their perceptions of how their food system is changing, why it is changing, its consequences, and how/whether they are coping with and responding to this change. Our results highlight that Shawi men’s agency and conscious envisioning of their future food system intersect with the effects of government policy. Shawi men perceive that the main driver of their food-system changes, i.e., less forest food, is self-driven population growth, leading to emotions of guilt and shame. During our study, they articulated a conscious belief that future generations must transition from forest-based to agricultural foods, emphasising education as central to this transition. Additionally, results suggest that the Peruvian government is indirectly promoting Shawi population growth through policies linking population size to improved service delivery, particularly education. Despite intentional Shawi moves to transition to agriculture, this results in a loss of men’s cultural identity and has mental-health implications, creating new vulnerabilities due to increasing climatic extremes, such as flooding and higher temperatures.

Background: Season and weather are associated with many health outcomes, which can influence hospital admission rates. We examined associations between hospital admissions (all diagnoses) and local meteorological parameters in Southwestern Uganda, with the aim of supporting hospital planning and preparedness in the context of climate change. Methods: Hospital admissions data and meteorological data were collected from Bwindi Community Hospital and a satellite database of weather conditions, respectively (2011 to 2014). Descriptive statistics were used to describe admission patterns. A mixed-effects Poisson regression model was fitted to investigate associations between hospital admissions and season, precipitation, and temperature. Results: Admission counts were highest for acute respiratory infections, malaria, and acute gastrointestinal illness, which are climate-sensitive diseases. Hospital admissions were 1.16 (95% CI: 1.04, 1.31; p = 0.008) times higher during extreme high temperatures (i.e., >95th percentile) on the day of admission. Hospital admissions association with season depended on year; admissions were higher in the dry season than the rainy season every year, except for 2014. Discussion: Effective adaptation strategy characteristics include being low-cost and quick and practical to implement at local scales. Herein, we illustrate how analyzing hospital data alongside meteorological parameters may inform climate-health planning in low-resource contexts.

Local public health authorities often lack the capacity to adapt to climate change, despite being on the 'front lines' of climate impacts. Upper-level governments are well positioned to create an enabling environment for adaptation and build local public health authorities' capacity, yet adaptation literature has not specified how upper-level governments can build local-level adaptive capacity. In this paper we examine how federal and regional governments can contribute to enabling and supporting public health adaptation to climate change at the local level in federal systems. We outline the local level's self-assessed adaptive capacity for public health adaptation in Canadian and German comparative case studies, in terms of funding, knowledge and skills, organizations, and prioritization, drawing upon 30 semi-structured interviews. Based on interviewees' recommendations and complemented by scientific literature, we develop a set of practical measures that could enable or support local-level public health adaptation. We find that adaptive capacity varies widely between local public health authorities, but most report having insufficient funding and staff for adaptation activities. We propose 10 specific measures upper-level governments can take to build local public health authorities' capacity for adaptation, under the interrelated target areas of: building financial capital; developing and disseminating usable knowledge; collaborating and coordinating for shared knowledge; and claiming leadership. Federal and regional governments have an important role to play in enabling local-level public health adaptation, and have many instruments available to them to fulfill that role. Selecting and implementing measures to enable local public health authorities' adaptive capacity will require tailoring to, and consideration, of the local context and needs.

The effect of climate change and its effects on vegetation growth, and consequently on rhinitis, are uncertain.To examine between- and within-country associations of climate measures and the normalized difference vegetation index with intermittent and persistent rhinitis symptoms in a global context.Questionnaire data from 6- to 7-year-olds and 13- to 14-year-olds were collected in phase 3 of the International Study of Asthma and Allergies in Childhood. Associations of intermittent (>1 symptom report but not for 2 consecutive months) and persistent (symptoms for ≥2 consecutive months) rhinitis symptom prevalences with temperature, precipitation, vapor pressure, and the normalized difference vegetation index were assessed in linear mixed-effects regression models adjusted for gross national income and population density. The mean difference in prevalence per 100 children (with 95% confidence intervals [CIs]) per interquartile range increase of exposure is reported.The country-level intermittent symptom prevalence was associated with several country-level climatic measures, including the country-level mean monthly temperature (6.09 °C; 95% CI, 2.06-10.11°C per 10.4 °C), precipitation (3.10 mm; 95% CI, 0.46-5.73 mm; per 67.0 mm), and vapor pressure (6.21 hPa; 95% CI, 2.17-10.24 hPa; per 10.4 hPa) among 13- to 14-year-olds (222 center in 94 countries). The center-level persistent symptom prevalence was positively associated with several center-level climatic measures. Associations with climate were also found for the 6- to 7-year-olds (132 center in 57 countries).Several between- and within-country spatial associations between climatic factors and intermittent and persistent rhinitis symptom prevalences were observed. These results provide suggestive evidence that climate (and future changes in climate) may influence rhinitis symptom prevalence.

AbstractThe urban environment influences human health, safety and wellbeing. Cities in Africa are growing faster than other regions but have limited data to guide urban planning and policies. Our aim was to use smart sensing and analytics to characterise the spatial patterns and temporal dynamics of features of the urban environment relevant for health, liveability, safety and sustainability. We collected a novel dataset of 2.1 million time-lapsed day and night images at 145 representative locations throughout the Metropolis of Accra, Ghana. We manually labelled a subset of 1,250 images for 20 contextually relevant objects and used transfer learning with data augmentation to retrain a convolutional neural network to detect them in the remaining images. We identified 23.5 million instances of these objects including 9.66 million instances of persons (41% of all objects), followed by cars (4.19 million, 18%), umbrellas (3.00 million, 13%), and informally operated minibuses known as tro tros (2.94 million, 13%). People, large vehicles and market-related objects were most common in the commercial core and densely populated informal neighbourhoods, while refuse and animals were most observed in the peripheries. The daily variability of objects was smallest in densely populated settlements and largest in the commercial centre. Our novel data and methodology shows that smart sensing and analytics can inform planning and policy decisions for making cities more liveable, equitable, sustainable and healthy.