Background Snakebite envenoming is a major global health problem that kills or disables half a million people in the world's poorest countries. Biting snake identification is key to understanding snakebite eco-epidemiology and optimizing its clinical management. The role of snakebite victims and healthcare providers in biting snake identification has not been studied globally. Objective This scoping review aims to identify and characterize the practices in biting snake identification across the globe. Methods Epidemiological studies of snakebite in humans that provide information on biting snake identification were systematically searched in Web of Science and Pubmed from inception to 2 nd February 2019. This search was further extended by snowball search, hand searching literature reviews, and using Google Scholar. Two independent reviewers screened publications and charted the data. Results We analysed 150 publications reporting 33,827 snakebite cases across 35 countries. On average 70% of victims/bystanders spotted the snake responsible for the bite and 38% captured/killed it and brought it to the healthcare facility. This practice occurred in 30 countries with both fast-moving, active-foraging as well as more secretive snake species. Methods for identifying biting snakes included snake body examination, victim/bystander biting snake description, interpretation of clinical features, and laboratory tests. In nine publications, a

Neglected tropical diseases (NTDs) are a diverse group of diseases that continue to affect >1 billion people, with these diseases disproportionately impacting vulnerable populations and territories. Climate change is having an increasing impact on public health in tropical and subtropical areas and across the world and can affect disease distribution and transmission in potentially diverse ways. Improving our understanding of how climate change influences NTDs can help identify populations at risk to include in future public health interventions. Articles were identified by searching electronic databases for reports of climate change and NTDs between 1 January 2010 and 1 March 2020. Climate change may influence the emergence and re-emergence of multiple NTDs, particularly those that involve a vector or intermediate host for transmission. Although specific predictions are conflicting depending on the geographic area, the type of NTD and associated vectors and hosts, it is anticipated that multiple NTDs will have changes in their transmission period and geographic range and will likely encroach on regions and populations that have been previously unaffected. There is a need for improved surveillance and monitoring to identify areas of NTD incursion and emergence and include these in future public health interventions.

Previous studies have found strong relationships between calcium availability and eggshell pigmentation in the Great Tit (Parus major). According to the ''structural function hypothesis'', protoporphyrins, the pigments responsible for reddish spots on speckled eggs, are deposited in those areas of the shell where calcium deposition is less intense. In the study reported here, which was carried out in three Blue Tit (Cyanistes caeruleus) populations in central Spain, we provide partial experimental support for the association between protoporphyrin eggshell pigmentation and shell thinning. Contrary to our expectations, we did not observe a decrease in the size and intensity of pigment spots for those eggs from calciumsupplemented nests. However, we did find that the provision of calcium-rich material during the egg-laying period led to a more wide distribution of pigment spots and reduced the proportion of eggs with defective shells (deviant pigmentation, dull and rough surface). When only the supplemented nests were considered in the analysis, within the same clutch we also detected differences in the spotting distribution between those eggs laid by female Blue Tits observed to have consumed calcium consumption on the day prior to laying and those observed not to have consumed calcium on the day prior to laying. Clutch size was not affected by the calcium supplementation. Female Blue Tits experimentally supplied with calcium-rich material had a shorter incubation period than control females, and they laid eggs with thicker shells. Eggshell thickness markedly affects the probability of hatching and could explain the lower proportion of unhatched late eggs found in supplemented nests in comparison with control ones. This study highlights the role of calcium in eggshell maculation and its effects on breeding performance of small passerines. We found the spotting distribution to be a good predictor of calcium deficiency. However, our results provide only mixed support for the ''structural function hypothesis'': in our study populations, the thickness of the eggshell was intimately associated with calcium availability, but the relationship between calcium and protoporphyrin deposition remains far from clear.

Background: The objectives of this paper are to (i) provide an overview of the educational and clinical experiences of the Réseau en Afrique Francophone pour la Télémédecine (RAFT) network, (ii) analyze key challenges and lessons learnt throughout a decade of activity, and (iii) draw a vision and perspectives of its sustainability.Methods: The study was carried out following three main stages: (i) a literature review, (ii) the analysis of key documents, and (iii) discussions with key collaborators of the RAFT.Results: Réseau en Afrique Francophone pour la Télémédecine has been offering an important quantity of educational, clinical, and public health activities during the last decade. The educational activities include the weekly delivery of video-lectures for continuing and post-graduate medical education, the use of virtual patients for training in clinical decision making, research training activities using ICTs and other e-learning activities. The clinical and public health activities include tele-expertise to support health professionals in the management of difficult clinical cases, the implementation of clinical information systems in African hospitals, the deployment of mHealth projects, etc. Since 2010, the RAFT has been extended to the Altiplano in Bolivia and Nepal (in progress).Lessons Learnt and Perspectives: Important lessons have been learnt from the accumulated experiences throughout these years. These lessons concern: social and organization, human resources, technologies and data security, policy and legislation, and economy and financing. Also, given the increase of the activities and the integration of eHealth and telemedicine in the health system of most of the countries, the RAFT network faces many other challenges and perspectives such as learning throughout life, recognition, and valorization of teaching or learning activities, the impact evaluation of interventions, and the scaling up and transferability out of Africa of RAFT activities. Based on the RAFT experience, effective integration and optimum use of eHealth and telemedicine in low- and middle-income countries (LMICs) health systems should take into account the context (resources, infrastructure, and funding), the needs of key stakeholders, and the results derived from theoretical and practical experience. The relevant items highlighted to illustrate the sustainability of the RAFT network and the analyses performed in this study, should serve as discussion basis for the development of eHealth and telemedicine in LMICs.