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Addressing the global snakebite crisis with geo-spatial analyses – Recent advances and future direction 通过地理空间分析应对全球蛇咬伤危机——最新进展和未来方向。
Q2 TOXICOLOGY Pub Date : 2021-09-01 DOI: 10.1016/j.toxcx.2021.100076
Anna F.V. Pintor , Nicolas Ray , Joshua Longbottom , Carlos A. Bravo-Vega , Masoud Yousefi , Kris A. Murray , Dileepa S. Ediriweera , Peter J. Diggle

Venomous snakebite is a neglected tropical disease that annually leads to hundreds of thousands of deaths or long-term physical and mental ailments across the developing world. Insufficient data on spatial variation in snakebite risk, incidence, human vulnerability, and accessibility of medical treatment contribute substantially to ineffective on-ground management. There is an urgent need to collect data, fill knowledge gaps and address on-ground management problems. The use of novel, and transdisciplinary approaches that take advantage of recent advances in spatio-temporal models, ‘big data’, high performance computing, and fine-scale spatial information can add value to snakebite management by strategically improving our understanding and mitigation capacity of snakebite. We review the background and recent advances on the topic of snakebite related geospatial analyses and suggest avenues for priority research that will have practical on-ground applications for snakebite management and mitigation. These include streamlined, targeted data collection on snake distributions, snakebites, envenomings, venom composition, health infrastructure, and antivenom accessibility along with fine-scale models of spatio-temporal variation in snakebite risk and incidence, intraspecific venom variation, and environmental change modifying human exposure. These measures could improve and ‘future-proof’ antivenom production methods, antivenom distribution and stockpiling systems, and human-wildlife conflict management practices, while simultaneously feeding into research on venom evolution, snake taxonomy, ecology, biogeography, and conservation.

毒蛇咬伤是一种被忽视的热带疾病,每年在发展中国家导致数十万人死亡或长期身心疾病。关于毒蛇咬伤风险、发病率、人类脆弱性和医疗可及性的空间变化数据不足,在很大程度上导致了地面管理的无效。迫切需要收集数据,填补知识空白,解决实地管理问题。利用时空模型、“大数据”、高性能计算和精细空间信息的最新进展,使用新颖的跨学科方法可以从战略上提高我们对蛇咬伤的理解和缓解能力,从而为蛇咬伤管理增加价值。我们回顾了与蛇咬伤相关的地理空间分析的背景和最新进展,并提出了优先研究的途径,这些途径将在蛇咬伤管理和缓解方面具有实际的地面应用。其中包括关于蛇的分布、蛇咬伤、环境、毒液成分、卫生基础设施和抗蛇毒血清可及性的精简、有针对性的数据收集,以及蛇咬伤风险和发病率的时空变化、种内毒液变化和改变人类暴露的环境变化的精细模型。这些措施可以改进和“经得起未来考验”的抗蛇毒血清生产方法、抗蛇毒血清分发和储存系统以及人类与野生动物冲突管理实践,同时为毒液进化、蛇分类学、生态学、生物地理学和保护的研究提供支持。
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引用次数: 11
Integrating lay knowledge and practice into snakebite prevention and care in central Africa, a hotspot for envenomation 将非专业知识和实践融入中部非洲毒蛇咬伤预防和护理,这是一个毒蛇咬伤的热点
Q2 TOXICOLOGY Pub Date : 2021-09-01 DOI: 10.1016/j.toxcx.2021.100077
Romain Duda , Wuelton M. Monteiro , Tamara Giles-Vernick

The WHO has identified the goal of halving deaths and disability from snakebite envenomation (SBE) by 2030 through a four-pillar program that promotes accessible and affordable treatments, strengthens health systems, promotes community and multi-level engagement, and mobilizes partnerships, coordination and resources to advocate for global action. This initiative could accelerate multi-disciplinary research and action in central Africa, a “hotspot” for SBE, but it offers little specific guidance about anthropological research to be conducted. This commentary develops that research agenda. It surveys anthropological, ethnohistorical investigations in the central African forest to elaborate the socio-cultural and historical significance and practices around snakes and snakebites. It draws from south and southeast Asian and Latin American literatures to illustrate anthropological contributions to SBE research. It then outlines a Central African research agenda employing ethnobiological investigation of snake ecologies, participatory evaluations of humans-snake contacts, and interviews and participant-observation of local prevention and treatment practices and knowledge. This research will co-develop policies and practices with forest communities and leaders and regional and national authorities to reduce the burden of SBE.

世卫组织确定了到2030年将蛇咬伤致死和致残减半的目标,通过一项四大支柱规划,促进可获得和负担得起的治疗,加强卫生系统,促进社区和多层次参与,并动员伙伴关系、协调和资源,倡导全球行动。这项计划可以加速中非的多学科研究和行动,中非是SBE的一个“热点”,但是它对将要进行的人类学研究几乎没有提供具体的指导。这篇评论阐述了这一研究议程。它调查了中非森林的人类学和民族历史调查,详细阐述了蛇和蛇咬伤的社会文化和历史意义和实践。它借鉴了南亚、东南亚和拉丁美洲的文献,以说明人类学对SBE研究的贡献。然后,它概述了中非的研究议程,包括对蛇生态的民族生物学调查,对人蛇接触的参与性评估,以及对当地预防和治疗实践和知识的访谈和参与者观察。这项研究将与森林社区和领导人以及区域和国家当局共同制定政策和做法,以减轻森林生态系统的负担。
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引用次数: 6
Delays, fears and training needs: Perspectives of health workers on clinical management of snakebite revealed by a qualitative study in Kitui County, Kenya 延误、恐惧和培训需求:肯尼亚基图伊县的一项定性研究揭示了卫生工作者对蛇咬伤临床管理的看法
Q2 TOXICOLOGY Pub Date : 2021-09-01 DOI: 10.1016/j.toxcx.2021.100078
Kieran Barnes , Cecelia Ngari , Stanley Parkurito , Leo Wood , Denis Otundo , Robert Harrison , George O. Oluoch , Anna Trelfa , Clare Baker

Key aims of the WHO Strategy to halve snakebite morbidity and mortality include health system strengthening and training of health workers. This requires knowledge of local health system needs and capacity, health worker training needs, and factors influencing health worker decision-making in snakebite management. This study explored health worker experiences and perceptions of snakebite management, both individually and in the context of their local health system.

We used a qualitative study design with semi-structured interviews (n = 14) and focus group discussions (n = 4). We employed a combination of sampling strategies aiming to achieve maximum variation among key informants within resource limitations. We recruited health workers (n = 33) of varying roles from purposively selected tier 2, 3 and 4 health facilities (n = 12) and the community (tier 1) in four sub-counties in Kitui County, Kenya. We conducted inductive thematic analysis of all transcripts.

The results identified that health workers recognised snake envenoming as a time-critical emergency in which delay in care seeking, sometimes exacerbated by health system referral delays, was a major barrier to effective management of patients. Clinicians strongly voiced a need for training in snakebite management, diagnosis and antivenom administration. Unexpressed needs for training were demonstrated in traditional remedy ineffectiveness, syndromic management, and critical appraisal of treatment effectiveness. Under-resourcing in antivenom, other medication, equipment, infrastructure and staffing also challenged management. Fear of snakebite and fear of antivenom, both linked to past experiences, influenced clinical decision-making.

Our findings clearly indicate a need in Kitui County for training programmes that equip health workers for clinical decision-making in snakebite management. We further identify community intervention needs to facilitate prompt presentation to healthcare, including practical affordable transport solutions, and systematic health system resourcing needs. In addition, we recommend supportive supervision and further research in response to the emotional stress resulting from managing difficult cases in under-resourced settings.

世卫组织将蛇咬伤发病率和死亡率减半战略的主要目标包括加强卫生系统和培训卫生工作者。这需要了解当地卫生系统的需求和能力、卫生工作者培训需求以及影响卫生工作者在蛇咬伤管理方面决策的因素。本研究探讨了卫生工作者在个人和当地卫生系统背景下对蛇咬伤管理的经验和看法。我们采用了半结构化访谈(n = 14)和焦点小组讨论(n = 4)的定性研究设计。我们采用了抽样策略的组合,旨在在资源有限的情况下实现关键信息提供者之间的最大差异。我们从肯尼亚基图伊县四个县的二级、三级和四级卫生设施(n = 12)和社区(一级)招募了不同角色的卫生工作者(n = 33)。对所有转录本进行归纳性专题分析。结果确定,卫生工作者认识到蛇中毒是一种时间紧迫的紧急情况,在这种情况下,就诊延误(有时因卫生系统转诊延误而加剧)是有效管理患者的主要障碍。临床医生强烈要求对蛇咬伤管理、诊断和抗蛇毒血清管理进行培训。未表达的培训需求在传统疗法无效、综合征管理和治疗效果的关键评估中得到证实。抗蛇毒血清、其他药物、设备、基础设施和人员配备方面的资源不足也给管理带来了挑战。对蛇咬的恐惧和对抗蛇毒血清的恐惧,都与过去的经历有关,影响了临床决策。我们的研究结果清楚地表明,基图伊县需要培训方案,使卫生工作者能够在蛇咬伤管理方面做出临床决策。我们进一步确定社区干预需求,以促进及时向医疗保健机构提供服务,包括切实可行的负担得起的交通解决方案,以及系统的卫生系统资源需求。此外,我们建议支持性监督和进一步研究,以应对在资源不足的情况下管理困难病例所产生的情绪压力。
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引用次数: 11
Clinical management of snakebite envenoming: Future perspectives 蛇咬伤的临床处理:未来展望。
Q2 TOXICOLOGY Pub Date : 2021-09-01 DOI: 10.1016/j.toxcx.2021.100079
Muhammad Hamza , Cecilie Knudsen , Christeine Ariaranee Gnanathasan , Wuelton Monteiro , Matthew R. Lewin , Andreas H. Laustsen , Abdulrazaq G. Habib

Snakebite envenoming is a major cause of morbidity and mortality in rural communities throughout the tropics. Generally, the main clinical features of snakebites are local swelling, tissue necrosis, shock, spontaneous systemic hemorrhage, incoagulable blood, paralysis, rhabdomyolysis, and acute kidney injury. These clinical manifestations result from complex biochemical venom constituents comprising of cytotoxins, hemotoxins, neurotoxins, myotoxins, and other substances. Timely diagnosis of envenoming and identification of the responsible snake species is clinically challenging in many parts of the world and necessitates prompt and thorough clinical assessment, which could be supported by the development of reliable, affordable, widely-accessible, point-of-care tests. Conventional antivenoms based on polyclonal antibodies derived from animals remain the mainstay of therapy along with supportive medical and surgical care. However, while antivenoms save countless lives, they are associated with adverse reactions, limited potency, and are relatively inefficacious against presynaptic neurotoxicity and in preventing necrosis. Nevertheless, major scientific and technological advances are facilitating the development of new molecular and immunologic diagnostic tests, as well as a new generation of antivenoms comprising human monoclonal antibodies with broader and more potent neutralization capacity and less immunogenicity. Repurposed pharmaceuticals based on small molecule inhibitors (e.g., marimastat and varespladib) used alone and in combination against enzymatic toxins, such as metalloproteases and phospholipase A2s, have shown promise in animal studies. These orally bioavailable molecules could serve as early interventions in the out-of-hospital setting if confirmed to be safe and efficacious in clinical studies. Antivenom access can be improved by the usage of drones and ensuring constant antivenom supply in remote endemic rural areas. Overall, the improvement of clinical management of snakebite envenoming requires sustained, coordinated, and multifaceted efforts involving basic and applied sciences, new technology, product development, effective clinical training, implementation of existing guidelines and therapeutic approaches, supported by improved supply of existing antivenoms.

蛇咬伤是整个热带地区农村社区发病率和死亡率的主要原因。一般来说,毒蛇咬伤的主要临床特征是局部肿胀、组织坏死、休克、自发性全身出血、血液不凝、瘫痪、横纹肌溶解症和急性肾损伤。这些临床表现源于复杂的生化毒液成分,包括细胞毒素、血液毒素、神经毒素、肌肉毒素和其他物质。在世界许多地方,及时诊断环境感染和识别责任蛇物种在临床上具有挑战性,需要及时彻底的临床评估,这可以通过开发可靠、负担得起、可广泛获得的护理点测试来支持。基于源自动物的多克隆抗体的常规抗蛇毒血清仍然是治疗以及支持性医疗和外科护理的支柱。然而,尽管抗蛇毒血清挽救了无数人的生命,但它们与不良反应有关,效力有限,对突触前神经毒性和预防坏死相对无效。尽管如此,重大的科学和技术进步正在促进新的分子和免疫诊断测试的发展,以及新一代的抗蛇毒血清,该血清包含具有更广泛、更有效中和能力和更低免疫原性的人类单克隆抗体。基于小分子抑制剂(如marimastat和varespladib)的再利用药物,单独或联合使用对抗酶毒素,如金属蛋白酶和磷脂酶A2,在动物研究中显示出了前景。如果在临床研究中被证实是安全有效的,这些口服生物可利用分子可以作为院外环境的早期干预措施。通过使用无人机和确保偏远流行农村地区持续供应抗蛇毒血清,可以改善抗蛇毒血清的获取。总的来说,改善蛇咬伤环境的临床管理需要持续、协调和多方面的努力,包括基础科学和应用科学、新技术、产品开发、有效的临床培训、现有指南和治疗方法的实施,并辅以现有抗蛇毒药的供应。
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引用次数: 19
Snakebite envenoming in different national contexts: Costa Rica, Sri Lanka, and Nigeria 蛇咬伤发生在不同的国家:哥斯达黎加、斯里兰卡和尼日利亚。
Q2 TOXICOLOGY Pub Date : 2021-07-01 DOI: 10.1016/j.toxcx.2021.100066
José María Gutiérrez , Kalana Maduwage , Garba Iliyasu , Abdulrazaq Habib

Snakebite envenoming is a neglected tropical disease that predominantly affects impoverished rural communities in sub-Saharan Africa, Asia, and Latin America. The global efforts to reduce the impact of this disease must consider the local national contexts and, therefore, comparative studies on envenomings in different countries are necessary to identify strengths, weaknesses and needs. This work presents a comparative analysis of snakebite envenomings in Costa Rica, Sri Lanka, and Nigeria. The comparison included the following aspects: (a) burden of envenomings, (b) historical background of national efforts to confront envenomings, (c) national health systems, (d) antivenom availability and accessibility including local production, (e) training of physicians and nurses in the diagnosis and management of envenomings, (f) prevention campaigns and community-based work, (g) scientific and technological platforms in these topics, and (h) international cooperation programs. Strengths and weaknesses were identified in the three contexts and several urgent tasks to improve the management of this disease in these countries are highlighted. This comparative analysis could be of benefit for similar studies in other national and regional contexts.

蛇咬伤是一种被忽视的热带疾病,主要影响撒哈拉以南非洲、亚洲和拉丁美洲的贫困农村社区。减少这种疾病影响的全球努力必须考虑到当地的国家情况,因此,有必要对不同国家的环境进行比较研究,以确定优势、劣势和需求。这项工作提出了哥斯达黎加,斯里兰卡和尼日利亚蛇咬中毒的比较分析。比较包括以下方面:(a)中毒负担,(b)国家应对中毒的历史背景,(c)国家卫生系统,(d)抗蛇毒血清的可获得性和可及性,包括当地生产,(e)医生和护士在中毒诊断和管理方面的培训,(f)预防运动和社区工作,(g)这些主题的科技平台,以及(h)国际合作计划。确定了这三种情况下的优势和劣势,并强调了在这些国家改善对这一疾病管理的若干紧迫任务。这种比较分析可能有利于在其他国家和区域范围内进行类似的研究。
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引用次数: 15
Implications of global environmental change for the burden of snakebite 全球环境变化对蛇咬伤负担的影响
Q2 TOXICOLOGY Pub Date : 2021-07-01 DOI: 10.1016/j.toxcx.2021.100069
Gerardo Martín , Carlos Yáñez-Arenas , Rodrigo Rangel-Camacho , Kris A. Murray , Eyal Goldstein , Takuya Iwamura , Xavier Chiappa-Carrara

Snakebite envenoming is a set of intoxication diseases that disproportionately affect people of poor socioeconomic backgrounds in tropical countries. As it is highly dependent on the environment its burden is expected to shift spatially with global anthropogenic environmental (climate, land use) and demographic change. The mechanisms underlying the changes to snakebite epidemiology are related to factors of snakes and humans. The distribution and abundance of snakes are expected to change with global warming via their thermal tolerance, while rainfall may affect the timing of key activities like feeding and reproduction. Human population growth is the primary cause of land-use change, which may impact snakes at smaller spatial scales than climate via habitat and biodiversity loss (e.g. prey availability). Human populations, on the other hand, could experience novel patterns and morbidity of snakebite envenoming, both as a result of snake responses to environmental change and due to the development of agricultural adaptations to climate change, socioeconomic and cultural changes, development and availability of better antivenoms, personal protective equipment, and mechanization of agriculture that mediate risk of encounters with snakes and their outcomes. The likely global effects of environmental and demographic change are thus context-dependent and could encompass both increasing and or snakebite burden (incidence, number of cases or morbidity), exposing new populations to snakes in temperate areas due to “tropicalization”, or by land use change-induced snake biodiversity loss, respectively. Tackling global change requires drastic measures to ensure large-scale ecosystem functionality. However, as ecosystems represent the main source of venomous snakes their conservation should be accompanied by comprehensive public health campaigns. The challenges associated with the joint efforts of biodiversity conservation and public health professionals should be considered in the global sustainability agenda in a wider context that applies to neglected tropical and zoonotic and emerging diseases.

蛇咬伤是一组中毒疾病,对热带国家社会经济背景较差的人的影响尤为严重。由于农业高度依赖环境,其负担预计将随着全球人为环境(气候、土地利用)和人口变化而发生空间转移。蛇咬伤流行病学变化的机制与蛇和人的因素有关。蛇的分布和数量预计会随着全球变暖而改变,因为它们的热耐受性会改变,而降雨可能会影响它们进食和繁殖等关键活动的时间。人口增长是土地利用变化的主要原因,这可能会通过栖息地和生物多样性的丧失(例如猎物的可获得性)在比气候更小的空间尺度上影响蛇。另一方面,由于蛇对环境变化的反应,以及农业适应气候变化的发展、社会经济和文化的变化、更好的抗蛇毒血清的开发和可用性、个人防护装备的发展和农业机械化,人类群体可能会经历蛇咬伤的新模式和发病率,这些都可以调节与蛇相遇的风险及其后果。因此,环境和人口变化可能产生的全球影响取决于具体情况,可能分别包括增加和/或蛇咬伤负担(发病率、病例数或发病率)、由于“热带化”而使温带地区的新种群暴露于蛇,或由于土地利用变化导致的蛇生物多样性丧失。应对全球变化需要采取严厉措施,以确保大规模生态系统的功能。然而,由于生态系统是毒蛇的主要来源,对它们的保护应伴随着全面的公共卫生运动。应在适用于被忽视的热带和人畜共患病及新发疾病的更广泛背景下,在全球可持续性议程中考虑与生物多样性保护和公共卫生专业人员共同努力有关的挑战。
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引用次数: 11
Unique venom proteins from Solenopsis invicta x Solenopsis richteri hybrid fire ants 红火蚁与红火蚁杂交火蚁的独特毒液蛋白
Q2 TOXICOLOGY Pub Date : 2021-07-01 DOI: 10.1016/j.toxcx.2021.100065
Steven M. Valles , Jason B. Oliver , Karla M. Addesso , Omaththage P. Perera

The Solenopsis venom protein 2 transcript was amplified, sequenced, probed, and analyzed from Solenopsis invicta x Solenopsis richteri hybrid ant colonies (hybrids) collected from across Tennessee to determine the extent of introgression of each parent allele (Solenopsis invicta venom protein 2 [Soli2] and Solenopsis richteri venom protein 2 [Solr2]). Chemotaxonomic analyses of venom alkaloids and cuticular hydrocarbons were used to categorize hybrid colonies and their relative relatedness to each parent species. Hybrid colonies were chosen randomly from each chemotaxonomic hybridization category, including “very near S. richteri,” “near S. richteri,” “near S. invicta,” and “very near S. invicta.” Lateral flow immunoassays for detection of the Soli2 and Solr2 venom proteins were largely in agreement with the chemotaxonomic analyses for the very near S. richteri (100% Solr2) and very near S. invicta (80% Soli2, 20% Soli2 + Solr2 detected in the sample) groups, while Soli2 and Solr2 were reported in 60% and 40% in the near S. invicta and near S. richteri chemotaxonomic groups. Analysis of transcripts from the hybrid colonies revealed a sequence with 100% identity to Soli2 (GenBank Accession L09560) and three unique sequences, which we identify as Solenopsis hybrid venom protein 2 (Solh2; GenBank Accession MT150127), Solenopsis hybrid truncated venom protein 2 (Solh2Tr97; Genbank Accession MT150129), and Solenopsis richteri venom protein 2, D to A change at position 69 (Solr2A69; GenBank Accession MT150128). The predicted open reading frame for Solh2 and Solh2Tr97 revealed sequences unique to hybrid ants, with Solh2Tr97an alternatively spliced form. A third unique sequence, Solr2A69, is likely the correct sequence for Solr2, which appears to have been published previously with a sequencing error (GenBank Accession P35776).

从田纳西州收集的Solenopsis invicta和Solenopsis richteri杂交蚁群(杂交蚁群)中扩增、测序、探测和分析了Solenopsis venom protein 2转录本,以确定每个亲本等位基因(Solenopsis invicta venom protein 2 [Soli2]和Solenopsis richteri venom protein 2 [Solr2])的基因导入程度。利用毒液生物碱和表皮碳氢化合物的化学分类分析对杂交菌落进行了分类,并对其与各亲本种的相对亲缘关系进行了分析。从每个化学分类杂交类别中随机选择杂交菌落,包括“非常接近S. richteri”,“接近S. richteri”,“接近S. invicta”和“非常接近S. invicta”。检测Soli2和Solr2毒液蛋白的横向流动免疫分析与非常接近李氏弧菌(100% Solr2)和非常接近invicta(样品中检测到80% Solr2, 20% Soli2 + Solr2)组的化学分类分析基本一致,而在接近invicta和接近李氏弧菌的化学分类组中,Soli2和Solr2分别为60%和40%。对杂交菌落的转录本进行分析,发现一个序列与Soli2 (GenBank登录L09560) 100%同源,并有三个独特的序列,我们将其鉴定为Solenopsis hybrid venom protein 2 (Solh2;GenBank Accession MT150127), Solenopsis hybrid truncated venom protein 2 (Solh2Tr97;Genbank加入MT150129),索理梭菌毒液蛋白2,D到A在第69位发生变化(Solr2A69;GenBank Accession MT150128)。预测的Solh2和Solh2Tr97的开放阅读框显示了杂交蚂蚁特有的序列,其中Solh2Tr97是一种选择性拼接形式。第三个独特的序列,Solr2A69,可能是Solr2的正确序列,该序列似乎在之前发表过测序错误(GenBank登录P35776)。
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引用次数: 1
Citizen science and online data: Opportunities and challenges for snake ecology and action against snakebite 公民科学和在线数据:蛇生态学的机遇和挑战以及对抗蛇咬伤的行动
Q2 TOXICOLOGY Pub Date : 2021-07-01 DOI: 10.1016/j.toxcx.2021.100071
Andrew M. Durso , Rafael Ruiz de Castañeda , Camille Montalcini , M. Rosa Mondardini , Jose L. Fernandez-Marques , François Grey , Martin M. Müller , Peter Uetz , Benjamin M. Marshall , Russell J. Gray , Christopher E. Smith , Donald Becker , Michael Pingleton , Jose Louies , Arthur D. Abegg , Jeannot Akuboy , Gabriel Alcoba , Jennifer C. Daltry , Omar M. Entiauspe-Neto , Paul Freed , Isabelle Bolon

The secretive behavior and life history of snakes makes studying their biology, distribution, and the epidemiology of venomous snakebite challenging. One of the most useful, most versatile, and easiest to collect types of biological data are photographs, particularly those that are connected with geographic location and date-time metadata. Photos verify occurrence records, provide data on phenotypes and ecology, and are often used to illustrate new species descriptions, field guides and identification keys, as well as in training humans and computer vision algorithms to identify snakes. We scoured eleven online and two offline sources of snake photos in an attempt to collect as many photos of as many snake species as possible, and attempt to explain some of the inter-species variation in photograph quantity among global regions and taxonomic groups, and with regard to medical importance, human population density, and range size. We collected a total of 725,565 photos—between 1 and 48,696 photos of 3098 of the world's 3879 snake species (79.9%), leaving 781 “most wanted” species with no photos (20.1% of all currently-described species as of the December 2020 release of The Reptile Database). We provide a list of most wanted species sortable by family, continent, authority, and medical importance, and encourage snake photographers worldwide to submit photos and associated metadata, particularly of “missing” species, to the most permanent and useful online archives: The Reptile Database, iNaturalist, and HerpMapper.

蛇的隐秘行为和生活史使得研究它们的生物学、分布和毒蛇咬伤的流行病学具有挑战性。最有用、最通用和最容易收集的生物数据类型之一是照片,特别是那些与地理位置和日期-时间元数据相关的照片。照片验证发生记录,提供表型和生态数据,经常用于说明新物种描述、野外指南和识别密钥,以及训练人类和计算机视觉算法来识别蛇。我们检索了11个在线和2个离线的蛇照片来源,试图收集尽可能多的蛇种类的照片,并试图解释全球区域和分类群体之间照片数量的一些物种间差异,以及关于医学重要性、人口密度和范围大小的差异。我们总共收集了725,565张照片-世界上3879种蛇中的3098种(79.9%)的1至48,696张照片,剩下781种“最想要”的物种没有照片(截至2020年12月发布的爬行动物数据库中所有当前描述的物种的20.1%)。我们提供了一份按科、洲、权威和医学重要性排序的通缉蛇种列表,并鼓励全世界的蛇摄影师将照片和相关元数据,特别是“失踪”物种的照片和元数据提交给最永久和最有用的在线档案:the Reptile Database、iNaturalist和HerpMapper。
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引用次数: 14
Chronic health effects and cost of snakebite 蛇咬伤对慢性健康的影响和成本
Q2 TOXICOLOGY Pub Date : 2021-07-01 DOI: 10.1016/j.toxcx.2021.100074
Anuradhani Kasturiratne , David G. Lalloo , H. Janaka de Silva

The burden of disability among survivors and the socio-economic impact of snakebite have not been adequately researched. We reviewed original research articles, case reports and small case series relating to chronic physical, mental and psycho-social disability and economic burden of snakebite. Both physical and psychological health problems seem common in snakebite survivors and can lead to disability and loss of productivity. Chronic physical health effects, musculoskeletal disability being the commonest, can be largely attributed to limited and delayed access to optimal treatment of acute envenoming. The economic burden is considerable, and includes health system costs, out-of-pocket expenditure and opportunity costs, with regional variations. Health systems should be more responsive to needs and circumstances of bite victims, and a more holistic approach should be developed in the treatment of snakebite which incorporates the management of chronic health effects.

幸存者的残疾负担和蛇咬伤的社会经济影响尚未得到充分研究。我们回顾了有关蛇咬伤的慢性身体、精神和心理社会残疾和经济负担的原始研究文章、病例报告和小病例系列。在蛇咬伤幸存者中,身体和心理健康问题似乎都很常见,并可能导致残疾和丧失生产力。慢性身体健康影响,肌肉骨骼残疾是最常见的,可在很大程度上归因于有限和延迟获得最佳治疗的急性中毒。经济负担相当沉重,包括卫生系统成本、自付支出和机会成本,各地区差异很大。卫生系统应该对咬伤受害者的需要和情况作出更积极的反应,并且应该在治疗蛇咬伤方面制定更全面的办法,其中包括对慢性健康影响的管理。
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引用次数: 25
Mutual enlightenment: A toolbox of concepts and methods for integrating evolutionary and clinical toxinology via snake venomics and the contextual stance 相互启示:通过蛇毒组学和上下文立场整合进化和临床毒理学的概念和方法工具箱。
Q2 TOXICOLOGY Pub Date : 2021-07-01 DOI: 10.1016/j.toxcx.2021.100070
Juan J. Calvete , Bruno Lomonte , Anthony J. Saviola , Fabián Bonilla , Mahmood Sasa , David J. Williams , Eivind A.B. Undheim , Kartik Sunagar , Timothy N.W. Jackson

Snakebite envenoming is a neglected tropical disease that may claim over 100,000 human lives annually worldwide. Snakebite occurs as the result of an interaction between a human and a snake that elicits either a defensive response from the snake or, more rarely, a feeding response as the result of mistaken identity. Snakebite envenoming is therefore a biological and, more specifically, an ecological problem. Snake venom itself is often described as a “cocktail”, as it is a heterogenous mixture of molecules including the toxins (which are typically proteinaceous) responsible for the pathophysiological consequences of envenoming. The primary function of venom in snake ecology is pre-subjugation, with defensive deployment of the secretion typically considered a secondary function. The particular composition of any given venom cocktail is shaped by evolutionary forces that include phylogenetic constraints associated with the snake's lineage and adaptive responses to the snake's ecological context, including the taxa it preys upon and by which it is predated upon. In the present article, we describe how conceptual frameworks from ecology and evolutionary biology can enter into a mutually enlightening relationship with clinical toxinology by enabling the consideration of snakebite envenoming from an “ecological stance”. We detail the insights that may emerge from such a perspective and highlight the ways in which the high-fidelity descriptive knowledge emerging from applications of -omics era technologies – “venomics” and “antivenomics” – can combine with evolutionary explanations to deliver a detailed understanding of this multifactorial health crisis.

蛇咬伤是一种被忽视的热带疾病,每年可能在全球夺走超过10万人的生命。蛇咬伤是人和蛇之间互动的结果,这种互动会引起蛇的防御反应,或者更罕见的是,由于身份错误而引起进食反应。因此,蛇咬伤是一个生物学问题,更具体地说,是一个生态问题。蛇毒本身通常被描述为“鸡尾酒”,因为它是一种分子的异质混合物,包括负责环境致病的病理生理后果的毒素(通常是蛋白质)。毒液在蛇生态学中的主要功能是预先征服,分泌物的防御部署通常被认为是次要功能。任何给定毒液混合物的特定组成都是由进化力决定的,包括与蛇的谱系相关的系统发育约束和对蛇的生态环境的适应性反应,包括它捕食的分类群和它被捕食的分类。在本文中,我们描述了生态学和进化生物学的概念框架如何通过从“生态学角度”考虑蛇咬伤环境,与临床毒理学形成相互启发的关系。我们详细介绍了从这样一个角度可能出现的见解,并强调了从组学时代的技术应用中出现的高保真描述性知识——“静脉组学”和“抗病毒组学”——可以与进化解释相结合,以提供对这场多因素健康危机的详细理解。
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引用次数: 24
期刊
Toxicon: X
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