title: Federal air travel restrictions for public health purposes--United States, June 2007-May 2008.

text: Persons with communicable diseases who travel on commercial aircraft can pose a risk for infection to the traveling public. In June 2007, federal agencies developed a public health Do Not Board (DNB) list, enabling domestic and international public health officials to request that persons with communicable diseases who meet specific criteria and pose a serious threat to the public be restricted from boarding commercial aircraft departing from or arriving in the United States. The public health DNB list is managed by CDC and the U.S. Department of Homeland Security (DHS). To describe the experience with the public health DNB list since its inception, CDC analyzed data from June 2007 to May 2008. This report summarizes the results of that analysis, which indicated that CDC received requests for inclusion of 42 persons on the public health DNB list, all with suspected or confirmed pulmonary tuberculosis (TB). From the requests, 33 (79%) persons were included on the list. The public health DNB list enables public health officials to prevent travel on commercial aircraft by persons who pose a risk for infection to other travelers. State and local health departments in the United States and other countries should be aware of this new public health tool.


title: Increased sensitivity of SARS-coronavirus to a combination of human type I and type II interferons.

text: There is currently an urgent need to identify effective antiviral agents that will prevent and treat severe acute respiratory syndrome coronavirus (SARS-CoV) infection. In this study, we have investigated and compared the antiviral effect of different interferons (IFNs) on SARS-CoV replication in the epithelial kidney monkey Vero cell line. The results showed that SARS-CoV grown in Vero cells is moderately sensitive to IFN-beta and only weakly sensitive to IFN-alpha and IFN-gamma, in comparison to other IFN-sensitive viruses, such as those for encephalomyocarditis, vesicular stomatitis and Newcastle disease. Simultaneous incubation of Vero cells with IFN-beta and IFN-gamma indicated that they may act synergistically against SARS-CoV replication. The IFN-induced MxA protein was detected in the IFN-treated Vero cells. The data, however, suggest that the antiviral activity of IFN against SARS-CoV virus is independent of MxA expression.


title: [Analysis of preventable deaths according to postmortem reports in traumatic deaths].

text: BACKGROUND In this study, we aimed to investigate preventable deaths due to trauma among cases in whom autopsy and postmortem examinations were performed in Diyarbakir Council of Forensic Medicine. METHODS In this study, which was planned as retrospectively descriptive, demographic data, type of injury, cause of injury, locations of injuries, cause of death, and scene of death data were withdrawn through the reports of deaths due to trauma in Diyarbakir Council of Forensic Medicine between 1 January 2008 and 31 December 2008. Medical errors in these deaths and preventable deaths were analyzed with this data. The criteria of American College of Surgeons Committee on Trauma was used for definition-classification of errors and compose of preventability criteria. RESULTS It was concluded that of the 747 cases taken into consideration, 4.15% (n=31) were preventable, 16.20% (n=121) were potentially preventable and 79.65% (n=595) were unpreventable. Suboptimal care in 49.34% (n=75), delay in treatment in 41.45% (n=63), missed diagnosis in 10.53% (n=16), clinical judgment error in 10.53% (n=16), missed medical administration in 7.23% (n=11), and other mistakes in 3.95% (n=6) of the cases were determined. CONCLUSION When the results were compared with the studies performed in the areas in which modern trauma care and trauma centers are located, the preventable death ratio was found high. As a result, it has been determined that development of a modern trauma system and trauma centers have significant roles in decreasing preventable death ratios.


title: In vitro and in vivo characterization of three 68Ga- and 111In-labeled peptides for cholecystokinin receptor imaging.

text: Cholecystokinin (CCK) receptors are overexpressed in several human tumor types, such as medullary thyroid carcinomas and small cell lung cancers. Several ligands for the CCK2 receptor (CCK2R) have been developed for radionuclide targeting of these tumors. In this study, we evaluated whether radiolabeled DOTA-sCCK8 and its stabilized derivative, DOTA-sCCK8[Phe(2)(p-CH2SO3H), Nle(3,6)], are suitable for imaging of CCK2R-positive tumors, using DOTA-MG0 as a reference. In vivo targeting of CCK2R-positive tumors with DOTA-sCCK8, DOTA-sCCK8[Phe(2)(p-CH2SO3H), Nle(3,6)], and DOTA-MG0, labeled with (111)In or (68)Ga, was evaluated in BALB/c nude mice with a subcutaneous A431-CCK2R tumor. Biodistribution studies and single-photon emission computed tomography (SPECT) and positron emission tomography (PET) were performed at 1 hour postinjection. All peptides specifically accreted in the CCK2R-expressing tumors. Both (111)In-DOTA-sCCK8 and (111)In-DOTA-sCCK8[Phe(2)(p-CH2SO3H), Nle(3,6)] showed good tumor retention (4.65% ID/g and 5.44% ID/g, respectively, at 4 hours postinjection). On PET/computed tomographic (CT) and SPECT/CT scans, subcutaneous A431-CCK2R tumors were clearly visualized with low uptake of sCCK8 peptides in the intestines. Whereas radiolabeled DOTA-MG0 showed high kidney uptake (70% ID/g), the sCCK8 peptides showed low uptake in the kidneys. Sulfated CCK8 analogues combined high tumor uptake with low retention in the kidney and are therefore promising tracers for imaging of CCK2R-positive tumors.


title: 2-Mercaptoethanol influences the in vitro function of bovine peripheral blood mononuclear cells.

text: The effects of 2-mercaptoethanol (2-ME) on some in vitro functions of bovine peripheral blood mononuclear cells (PBMC) were examined. It was shown that 2-ME enhanced, in a dose-dependent manner, the production of antibodies to bovine coronavirus. In this test the optimal concentration of 2-ME was 50 microM. This molarity of 2-ME was also optimal for the pokeweed mitogen (PWM)-induced proliferation of PBMC obtained from the 7 cattle tested. Similarly, the spontaneous proliferation of PBMC from 4 out of these cattle was enhanced. Thus, 2-ME evoked an increase (up to 2.5 times) or a decrease (at most 10 times) of the quota between the PWM-induced and the spontaneous proliferation (stimulation index). In general, the presence of 50 microM 2-ME enhanced the in vitro production of interferon by bovine PBMC. On the contrary, the highest proliferative response of PBMC to stimulation with bovine virus diarrhoea virus was achieved in cultures without 2-ME or in cultures with 0.5 or 5 microM 2-ME. Since the effects of 2-ME varied, for different tests as well as for cattle tested, attention should be paid to the use of 2-ME in cultures of bovine PBMC.


Editor's Note: Should We have Seen This (COVID-19 Pandemic) Coming? Addendum, President George W. Bush Did in 2005 and Began Planning.


docid: diutdeuu

title: Asbestosis-related years of potential life lost before age 65 years--United States, 1968-2005.

text: Exposure to asbestos fibers can cause asbestosis and other diseases after a latency of 10-40 years from initial exposure to onset of illness. Asbestos still is used in the United States (approximately 2,200 metric tons in 2006) in certain products manufactured domestically. In addition, an undocumented amount of asbestos continues to be imported in products manufactured elsewhere, and a substantial amount of asbestos remains in existing buildings and manufactured products. An estimated 1.3 million construction and general industry workers in the United States potentially are exposed to asbestos each year, mainly from manipulation of asbestos during renovation or demolition activities. Also, although asbestos ore is no longer mined in the United States, some U.S. mine workers might remain at risk for exposure to asbestos contained in other ores. To characterize trends in premature mortality attributed to asbestosis in the United States, CDC analyzed annual underlying cause-of-death data for 1968-2005, the most recent years for which data were available. This report describes the results of that analysis, which indicated that annual years of potential life lost before age 65 years (YPLL) attributed to asbestosis increased 64%, from an average of 146.0 YPLL per year during 1968-1972 to 239.6 per year during 2001-2005 (regression trend for the 5-year moving average, p<0.001), for an overall total of 7,267 YPLL (mean per decedent: 6.2) over the entire period. These results demonstrate that asbestosis-attributable YPLL continue to occur and that efforts to prevent, track, and eliminate asbestosis need to be maintained.


title: Adverse events of lung tissue stapling in thoracic surgery.

text: PURPOSE The use of staplers for thoracic surgery has been regarded as a safe procedure though sometimes adverse events (AEs) of stapling are experienced. The aim of this study is to analyze AEs of lung tissue stapling. METHODS A retrospective multi-institutional review was conducted by 27 institutions of the Central Japan Lung Cancer Surgery Study Group. During the research period, lung tissue stapling was performed 10908 times. RESULTS Total number of AEs related to stapling was 81 (0.74%). Seventy events occurred intraoperatively and 11 events occurred postoperatively. Intraoperative stapling AEs were air leakage (n = 26), laceration of the adjacent lung tissue (n = 23), stapling failure (n = 14), oozing (n = 4), and others (n = 3). The postoperative AEs were prolonged air leakage (n = 9), bleeding from the chest wall (n = 1), and postoperative bleeding (n = 1). Only one case died of acute exacerbation of interstitial pneumonia which was induced after completion lobectomy to cure postoperative bleeding. No relationship was seen between the incidence of AE and cartridge colors or compression types of staplers except the length of cartridges. CONCLUSION Lung tissue stapling in thoracic surgery was safe. The most frequent cause of AEs was stapler-tissue thickness mismatch. The appropriate selection of the cartridge color may decrease the AE incidence of the lung tissue stapling.


title: The spectrum of severe acute respiratory syndrome-associated coronavirus infection.

text: BACKGROUND Whether subclinical or atypical presentations of severe acute respiratory syndrome (SARS) occur and whether clinical judgment is accurate in detecting SARS are unknown. OBJECTIVES To describe the spectrum of SARS coronavirus infection in a large outbreak and to compare diagnoses based on clinical judgment with the SARS coronavirus test. DESIGN Secondary analysis of prospectively collected clinical data and archived serum. SETTING A SARS screening clinic of a university hospital in the New Territories of Hong Kong. PATIENTS 1221 patients attending the clinic between 12 March 2003 and 12 May 2003. MEASUREMENTS SARS coronavirus serology. RESULTS 145 of 553 (26%) patients had serologic evidence of SARS coronavirus infection. Of 910 patients who were managed without hospitalization, only 6 had serologic evidence of SARS. Five of the six patients had normal chest radiographs, and four had symptoms such as myalgia, chills, coughing, and feeling feverish. With the SARS coronavirus serologic test as the gold standard, the clinical diagnosis of probable SARS at hospitalization had a sensitivity of 0.96 (95% CI, 0.91 to 0.98) and a specificity of 0.96 (CI, 0.92 to 0.97). LIMITATIONS Follow-up serologic samples were not obtained from almost half of the patients because they declined further testing. Some people living in the community who were infected but who had minor or no symptoms might not have visited the clinic. CONCLUSIONS There is little evidence of widespread subclinical or mild forms of SARS coronavirus infection. Clinical diagnoses during the outbreak were reasonable and resulted in appropriate triaging.


title: Micro-organisms in outpatient infantile gastroenteritis.

text: This study reports the results of an examination of the stools of 58 infants with gastroenteritis who were seen as outpatients. The stools were examined by routine bacterial culture, and by electron microscopy for virus particles. The stools of a comparable control group of infants who had no gastrointestinal symptoms were also similarly examined. Enteropathogenic Escherichia coli, Salmonella sp., and rotaviruses, as well as other viruses, particularly adenoviruses and coronaviruses, were isolated.


title: SARS precautions.

text: Triage nurses have been urged to ask A&E attenders extra questions to help stop the spread of severe acute respiratory syndrome (SARS).


title: Enhancing the precision of infrared thermodetector for medicine by two-channel measuring technique and mulriple linear interpolation algorithm.

text: The best way to control the spread of Severe Acute Respiratory Syndrome (SARS) is measuring the body temperature precisely, therefore, it is very important to develop a set of high-precision infrared thermodetector for Medicine. The ambient temperature signal and the object temperature signal were collected with two channel AD gates of thermopile infrared sensor unit. The values were calculated by using mulriple linear interpolation algorithm. The precision of the system can reach 0.1°C and the machine can work well in megathermal environment*.


title: Subterfuge and manipulation: type III effector proteins of phytopathogenic bacteria.

text: Diverse gram-negative bacteria deliver effector proteins into the cells of their eukaryotic hosts using the type III secretion system. Collectively, these type III effector proteins function to optimize the host cell environment for bacterial growth. Type III effector proteins are essential for the virulence of Pseudomonas syringae, Xanthomonas spp., Ralstonia solanacearum and Erwinia species. Type III secretion systems are also found in nonpathogenic pseudomonads and in species of symbiotic nitrogen-fixing Rhizobium. We discuss the functions of type III effector proteins of plant-associated bacteria, with an emphasis on pathogens. Plant pathogens tend to carry diverse collections of type III effectors that likely share overlapping functions. Several effectors inhibit host defense responses. The eukaryotic host targets of only a few type III effector proteins are currently known. We also discuss possible mechanisms for diversification of the suite of type III effector proteins carried by a given bacterial strain.


title: Pre-clinical evaluation of a next-generation spray adhesion barrier for multiple site adhesion protection.

text: Intra-abdominal adhesions represent a major cause of postoperative morbidity, including chronic or recurrent pelvic pain and infertility in a significant percent of patients. The SprayShield™ Adhesion Barrier System (Covidien, Waltham, MA) is a next-generation sprayable adhesion barrier to prevent postoperative adhesions. Initially sprayed as a liquid, SprayShield™ solidifies within 2 seconds of contact with tissue through a polyethylene glycol (PEG) ester-Trilysine reaction to form an adherent, internal tissue barrier that protects the underlying tissues for several days after surgery. After tissue begins to heal, the adhesion barrier liquefies via hydrolysis and completely absorbs within 7 days. Safety testing has shown the product to be nongenotoxic, noncytotoxic, nonsensitizing, and nonirritating. SprayShield™ has been shown to adhere well to tissue, with the mechanism of adherence believed to be mainly due to tissue surface mechanical interlocking. In studies that compared SprayShield™ to good surgical technique, virgin hogs were randomized to receive SprayShield™ or good surgical technique (Control). Compared to Controls, SprayShield™ demonstrated a statistically significant reduction in the number of adhesions (46%, p=0.04) and in the area of adhesions (83%, p=0.012) to injured sites. With its ease of application, biocompatibility and adhesion prevention efficacy, SprayShield™ may be an effective next-generation adhesion prevention product for open and laparoscopic abdominopelvic procedures as an adjunct to good surgical technique.


title: Extragenital malignant mixed Mullerian tumor in the incisional hernia - primary carcinosarcoma in the abdominal wall: case report.

text: INTRODUCTION This report presents a primary Mullerian carcinosarcoma localized in the incisional hernia i.e. anterior abdominal wall.There is no data in the literature about this localization of extragenital Mullerian carcinosarcoma. CASE OUTLINE The patient had previous medical history of right-sided ovarian cystadenocarcinoma managed by hysterectomy, bilateral ovariectomy and chemotherapy. An incisional hernia occurred 1 year after the operation and Mullerian carcinosarcoma at the right border of the incisional hernia 16 years later. There was no tumor spreading into the abdominal cavity and pelvis. Full thickness of the abdominal wall resection and coexisting incisional hernia resulted in a large 25x20 cm abdominal wall defect managed by the modified components separation technique and implanting meshes. CONCLUSION Major abdominal wall resection and abdominal wall reconstruction using the modified components separation technique reinforced with meshes could be one of possible solutions in the surgical treatment of primary malignant mixed Mullerian tumor localized in the abdominal wall.


Evolution of a coronavirus during persistent infection in vitro.


title: [Retrospective discriminant analysis of the clinical diagnostic criteria for serious contagious severe acute respiratory syndrome].

text: OBJECTIVE To analyze the clinical diagnostic criteria for serious severe acute respiratory syndrome (SARS) in Guangdong retrospectively discriminant with SARS database, and to screen out the sensitive warning factors in predicting the outcome. METHODS Four hundred and two SARS patients were selected based on the diagnostic criteria for SARS from Ministry of Health, China. Of them, 358 SARS patients were selected as their clinical manifestations conformed to the diagnostic criteria of serious SARS. The study subjects were divided into two groups. One group consisted of the patients with serious SARS (358 patients), and they either underwent invasive or non-invasive mechanical ventilation or died of the disease. The remaining 44 SARS patients constituted the non-serious SARS group. Taking the lowest value of oxygen index (OI) as the main index, the OI was categorized into 3 classes, namely< or =200 mm Hg (1 mm Hg=0.133 kPa) as 1,200-300 mm Hg as 2, and >300 mm Hg as 3. According to this index, the seriousness and the prognosis were analyzed. RESULTS OI less than 300 mm Hg were identified as the unequivocal serious SARS patients, and the mistake judgement rate was 6.800%. Furthermore mortality and complications were compared with Logistic regression, and questionable SARS patients were excluded. The results showed that the patients identified with OI less than 300 mm Hg had worse outcome than the original ones diagnosed with criteria of Ministry of Health. CONCLUSION OI less than 300 mm Hg in patients with ALI meet the diagnostic criteria of serious SARS better, and it can be taken as a prognostic criterion in clinic.


title: High-magnitude, virus-specific CD4 T-cell response in the central nervous system of coronavirus-infected mice.

text: The neurotropic JHM strain of mouse hepatitis virus (MHV) causes acute encephalitis and chronic demyelinating encephalomyelitis in rodents. Previous results indicated that CD8 T cells infiltrating the central nervous system (CNS) were largely antigen specific in both diseases. Herein we show that by 7 days postinoculation, nearly 30% of the CD4 T cells in the acutely infected CNS were MHV specific by using intracellular gamma interferon (IFN-gamma) staining assays. In mice with chronic demyelination, 10 to 15% of the CD4 T cells secreted IFN-gamma in response to MHV-specific peptides. Thus, these results show that infection of the CNS is characterized by a large influx of CD4 T cells specific for MHV and that these cells remain functional, as measured by cytokine secretion, in mice with chronic demyelination.


title: Severe acute respiratory syndrome and the delivery of continuing medical education: case study from Toronto.

text: INTRODUCTION Severe acute respiratory syndrome (SARS) struck Toronto in the spring of 2003, causing many deaths, serious morbidity, forced quarantine of thousands of individuals, and the closure of all provincial hospitals for several weeks. Given the direction by public health authorities to cancel or postpone all continuing medical education (CME) courses, including those sponsored by the University of Toronto Faculty of Medicine, SARS has had a profound effect on the delivery of CME in Toronto and beyond. METHOD Case study design using existing documents and self-report. RESULTS The immediate, specific response of the University of Toronto CME program to SARS is described for the period from March 2003 to September 2003. DISCUSSION During major outbreaks of infectious disease, continuing education providers should maintain regular contact with public health authorities and learners, enact a rational process for postponing or canceling courses, and implement a disaster plan flexible enough to ensure the deliver, of education using technological advances.


title: Atypical extrapulmonary presentations of severe respiratory syncytial virus infection requiring intensive care.

text: The patterns and nature of a four-month epidemic of severe respiratory syncytial virus (RSV)-associated disease were analyzed using presenting, demographic, clinical, and therapeutic data. Of 218 infants with RSV infection admitted to Rainbow Babies and Childrens Hospital, 49 (22.4%), most born prematurely, entered the pediatric intensive care unit (PICU). Fluorescent antibody and/or enzyme-linked immunosorbent assay documented RSV infection. PICU patients underwent airway stabilization; 53.5% were intubated and evaluated for sepsis. Patients with positive bacterial cultures received antibiotics; 18% were given ribavirin. Patterns of infection included hypothermia, septic shock appearance, apnea, pneumonia, and wheezing due to bronchiolitis. The average age difference between patients with hypothermia (23.3 days) and those with pneumonia (11.2 months) was statistically significant. There were no significant differences in average age, gestational age at birth, number intubated, worst pH and PCO2, duration of intensive care, or treatment modalities between infants with bronchopulmonary dysplasia who received ribavirin and those who did not.


title: Differential regulation of Dk and Kk major histocompatibility complex class I proteins on the cell surface after infection of murine cells by pseudorabies virus.

text: After pseudorabies virus (PRV) infection of murine L929 cells, the cell surface expression of major histocompatibility complex (MHC) class I proteins changes such that the total amount of MHC class I molecules remains relatively constant but the levels of the individual alleles Dk and Kk vary. This is an active process involving at least three PRV gene products that act in an allele-specific manner such that cell surface expression of MHC class I Dk is decreased and that of Kk is increased. Our results indicate that an early gene product mediates the overall reduction in Dk protein and a late gene product which is mutant in the attenuated PRV strain Bartha mediates the increase in Kk protein. We provide additional evidence for a third gene product involved in the regulation of the synthesis of both the Dk and Kk proteins. In addition, we show that the early decrease in the Dk protein is not due to a block in synthesis or processing of the complex through the secretory system.


Infectious diseases. Civets back on China's menu.


title: Prospects of RNA interference therapy in respiratory viral diseases: update 2006.

text: Respiratory viruses, such as influenza, parainfluenza and respiratory syncytial virus (RSV), claim millions of lives annually. At present, there is no completely effective vaccine or drug against these highly mutable RNA viruses. Passive antibody therapies for RSV, despite their limited application and staggering cost, enjoy a virtual monopoly in a multibillion-dollar global market. Recently, however, pioneering discoveries have launched RNA interference as a novel, nucleic acid-based therapy against viral pathogens. Specifically, small interfering RNAs (siRNAs) offered protection against respiratory syncytial virus, parainfluenza and influenza. siRNA against RSV has entered Phase I clinical trials in humans, and preliminary reports are promising. If appropriately formulated for improved specificity, delivery and pharmacokinetics, siRNAs may indeed become effective antivirals in the clinics of the future. This paper provides an overview of the prospects and hurdles facing the antiviral siRNA drugs, with special emphasis on RSV.


title: Caspase-mediated cleavage of the feline calicivirus capsid protein.

text: Feline calicivirus (FCV) is responsible for an acute upper respiratory tract disease in cats. The FCV capsid protein is synthesized as a precursor (76 kDa) that is post-translationally processed into the mature 62 kDa capsid protein by removal of the N-terminal 124 amino acids. Our previous studies have also detected a 40 kDa protein, related to the FCV capsid protein, produced during infection. Here we demonstrate that cleavage of the FCV capsid protein, during infection of cells in culture, was prevented by caspase inhibitors. In addition, caspase-2, -3 and -7 were activated during FCV infection, as shown by pro-form processing, an increase in N-acetyl-Asp-Glu-Val-Asp-7-amido-4-trifluoromethylcoumarin cleavage activity and in situ poly(ADP-ribose) polymerase cleavage. Caspase activation coincided with the induction of apoptosis and capsid cleavage to the 40 kDa fragment. An in vitro cleavage assay, using recombinant human caspases and in vitro-derived FCV capsid protein, revealed that caspase-2, and to a lesser extent caspase-6, cleaved the capsid protein to generate a 40 kDa fragment. Taken together, these results suggest that FCV triggers apoptosis within infected cells and that caspase-induced capsid cleavage occurs concomitantly with apoptosis. The possible role of capsid cleavage in the pathogenesis of FCV infection is discussed.


title: A new vision for distance learning and continuing medical education.

text: Increasing demands on continuing medical education (CME) are taking place at a time of significant developments in educational thinking and new learning technologies. Such developments allow today's CME providers to better meet the CRISIS criteria for effective continuing education: convenience, relevance, individualization, self-assessment, independent learning, and a systematic approach. The International Virtual Medical School (IVIMEDS) provides a case study that illustrates how rapid growth of the Internet and e-learning can alter undergraduate education and has the potential to alter the nature of CME. Key components are a bank of reusable learning objects, a virtual practice with virtual patients, a learning-outcomes framework, and self-assessment instruments. Learning is facilitated by a curriculum map, guided-learning resources, "ask-the-expert" opportunities, and collaborative or peer-to-peer learning. The educational philosophy is "just-for-you" learning (learning customized to the content, educational strategy, and distribution needs of the individual physician) and "just-in-time" learning (learning resources available to physicians when they are required). Implications of the new learning technologies are profound. E-learning provides a bridge between the cutting edge of education and training and outdated procedures embedded in institutions and professional organizations. There are important implications, too, for globalization in medical education, for multiprofessional education, and for the continuum of education from undergraduate to postgraduate and continuing education.


title: [The human gastroenteritis virus in the Quebec region (1986-1991). Identification by electronic microscopy].

text: Between 1986 and 1991, 251 fecal samples were examined. Viruses were found in 48% of stools, namely adenoviruses, astroviruses, caliciviruses, coronaviruses, rotaviruses, and particles reassembling the Norwalk agent (74% of positive cases). All morphological types of viruses normally associated with human gastroenteritis are present in Quebec, its vicinity, and in the east of the Province. The interpretation of specimens is complicated by the presence of a wide variety of biological structures including bacteriophages. Electron microscopy is the method of choice for identification of the whole range of gastroenteritis viruses.


title: An Outbreak of Human Coronavirus OC43 Infection and Serological Cross-reactivity with SARS Coronavirus.

text: BACKGROUND In summer 2003, a respiratory outbreak was investigated in British Columbia, during which nucleic acid tests and serology unexpectedly indicated reactivity for severe acute respiratory syndrome coronavirus (SARS-CoV). METHODS Cases at a care facility were epidemiologically characterized and sequentially investigated for conventional agents of respiratory infection, SARS-CoV and other human CoVs. Serological cross-reactivity between SARS-CoV and human CoV-OC43 (HCoV-OC43) was investigated by peptide spot assay. RESULTS Ninety-five of 142 residents (67%) and 53 of 160 staff members (33%) experienced symptoms of respiratory infection. Symptomatic residents experienced cough (66%), fever (21%) and pneumonia (12%). Eight residents died, six with pneumonia. No staff members developed pneumonia. Findings on reverse transcriptase-polymerase chain reaction assays for SARS-CoV at a national reference laboratory were suspected to represent false positives, but this was confounded by concurrent identification of antibody to N protein on serology. Subsequent testing by reverse transcriptase-polymerase chain reaction confirmed HCoV-OC43 infection. Convalescent serology ruled out SARS. Notably, sera demonstrated cross-reactivity against nucleocapsid peptide sequences common to HCoV-OC43 and SARS-CoV. CONCLUSIONS These findings underscore the virulence of human CoV-OC43 in elderly populations and confirm that cross-reactivity to antibody against nucleocapsid proteins from these viruses must be considered when interpreting serological tests for SARS-CoV.


docid: reigunin

title: CVTree: a phylogenetic tree reconstruction tool based on whole genomes.

text: Composition Vector Tree (CVTree) implements a systematic method of inferring evolutionary relatedness of microbial organisms from the oligopeptide content of their complete proteomes (http://cvtree.cbi.pku.edu.cn). Since the first bacterial genomes were sequenced in 1995 there have been several attempts to infer prokaryote phylogeny from complete genomes. Most of them depend on sequence alignment directly or indirectly and, in some cases, need fine-tuning and adjustment. The composition vector method circumvents the ambiguity of choosing the genes for phylogenetic reconstruction and avoids the necessity of aligning sequences of essentially different length and gene content. This new method does not contain 'free' parameter and 'fine-tuning'. A bootstrap test for a phylogenetic tree of 139 organisms has shown the stability of the branchings, which support the small subunit ribosomal RNA (SSU rRNA) tree of life in its overall structure and in many details. It may provide a quick reference in prokaryote phylogenetics whenever the proteome of an organism is available, a situation that will become commonplace in the near future.


10 years later...


Contagious acute gastrointestinal infections.


title: Clarification of Interaction Mechanism of Mouse Hepatitis Virus (MHV) N and nsp3 Protein with Homology Modeling and Protein-Protein Docking Analysis.

text: The coronavirus nucleocapsid (N) plays an important role in the virus structure, the replication, and the transcription of CoV. This protein, which has a helix and flexible structure, and capable of binding on to the viral genomic RNA, is a non-structural protein (nsp3). Many studies suggest that the N protein interaction with nsp3 plays a critical role in the virus replication early in infection. Therefore, it is necessary to know the definition of the interaction mechanism of N and nsp3 protein in terms of the CoV replication transcription mechanism. We report on the homology modeling, molecular dynamics simulation, and docking studies to explain the structure-function relationship and the interaction mechanism. In addition, the prototype MHV is preferred in the wet experiment, so we also based our study on the MHV N and nsp3 proteins that belong to the experimental study. The amino acid sequences of MHV N and nsp3 proteins have similarity between human and severe acute respiratory syndrome coronavirus. Therefore, the 3D structure models of these proteins were built with using the crystal structure of the CoV family members as a template. By following these models, molecular dynamics simulations were applied to attain the most stable conformation. Finally, protein-protein docking was performed to prove accuracy of model structures of the MHV N and to clarify the interaction with nsp3. As a result, Lys 113, Arg 125, Tyr 127, Glu 173, Tyr 190 residues that play an important role in virus replication were determined.


Detection of infectious bursal disease virus in digested formalin-fixed paraffin-embedded tissue sections by polymerase chain reaction.


title: Class orders now possible under Ontario's public health legislation.

text: In April 2003, the Ontario Legislature amended the province's public health legislation as part of a package of amendments related to the recent outbreak of Severe Acute Respiratory Syndrome (SARS). Although the amendments to the Health Protection and Promotion Act (HPPA) were clearly designed to address emergency situations like SARS, they may have unintended and negative consequences for people living with HIV/AIDS.


Scalable high-throughput micro-expression device for recombinant proteins.


title: Restriction of poliovirus RNA replication in persistently infected nerve cells.

text: The aetiology of post-polio syndrome may involve persistence of poliovirus (PV) in the CNS. PV persists in the CNS of infected paralysed mice for over a year after the acute phase of paralytic poliomyelitis. However, infectious PV particles cannot be recovered from homogenates of CNS from paralysed mice after the acute phase of disease, indicating that PV replication is restricted. To identify the molecular mechanism by which PV replication is limited, PV RNA synthesis was analysed by estimating the relative level of genomic (plus-strand) and complementary (minus-strand) PV RNA in the CNS of persistently infected mice. PV RNA replication decreased during the 6 months following onset of paralysis, due mainly to inhibition of plus-strand RNA synthesis. Thus, restriction of PV RNA synthesis may contribute to persistence by limiting virus replication in the mouse CNS. Interestingly, viral RNA replication was similarly inhibited in neuroblastoma IMR-32 cell cultures persistently infected with PV. This in vitro model thus shows that cellular factors play a role in the inhibition of viral RNA synthesis.


title: Measurement equivalence of the center for epidemiological studies depression scale for Latino and Anglo adolescents: a national study.

text: The cross-ethnic measurement equivalence of the Center for Epidemiologic Studies Depression Scale (CES-D; L. S. Radloff, 1977) was examined using a subsample of adolescents (N=10,691) from the National Longitudinal Study of Adolescent Health. Configural and metric invariance, as well as functional and scalar equivalence, were examined for Anglo American, Mexican American, Cuban American, and Puerto Rican American youths age 12-18 years. Confirmatory factor analysis (CFA) in each group provided evidence of configural invariance for European and Mexican American adolescents but not for Cuban and Puerto Rican youths. A 2-group CFA for Anglo and Mexican Americans demonstrated partial metric invariance for these groups. Multigroup structural equation modeling indicated similar relations between CES-D scores and self-esteem for all 4 groups, supporting cross-ethnic functional and scalar equivalence. The results have implications for using the CES-D in cross-ethnic research and, more broadly, for the assessment and treatment of depression in Latinos.


title: The History of Surgical Staplers: A Combination of Hungarian, Russian, and American Innovation.

text: Since their development in 1908, surgical staplers have been used as a method of "mechanical suturing" in efforts to divide hollow viscera and create anastomoses in an efficient and sterile manner. The concept for the surgical stapler was first developed by Humér Hultl, a Hungarian professor and surgeon, and designed by Victor Fischer, a Hungarian businessman and designer of surgical instruments. The design was highly acclaimed; however, it was bulky, cumbersome, and expensive to manufacture. In 1920, Aladár Petz, a student of Hultl, incorporated two innovations to the Fischer-Hultl stapler to create a more lightweight model, which was named the Petz clamp. In 1934, Friedrich of Ulm designed what would be the predecessor to the modern-day linear stapler. In the 1950s, Russian and American staplers began to emerge. Throughout the 1960s, a variety of stapling instruments were developed in the United States, manufactured by the United States Surgical Corporation. In the 1970s, Johnson & Johnson Ethicon brand joined the market. The United States Surgical Corporation was later bought by Tyco Healthcare and became Covidien in 2007. Through the collaboration of Felicien Steichen, Mark Ravitch, and Leon Hirsch, surgical staplers were further modified to incorporate interchangeable cartridges with various designs. With the advent of minimally invasive surgery began production of laparoscopic surgical staplers. Since its inception, the surgical stapler has provided a means to efficiently create safe and effective visceral and vascular anastomoses. The surgical stapler design continues to evolve while still maintaining the basic principles that were implemented in the original design.


Vitamin D, Covid-19 and Children.


title: Kunjin virus replicons: an RNA-based, non-cytopathic viral vector system for protein production, vaccine and gene therapy applications.

text: The application of viral vectors for gene expression and delivery is rapidly evolving, with several entering clinical trials. However, a number of issues, including safety, gene expression levels, cell selectivity and antivector immunity, are driving the search for new vector systems. A number of replicon-based vectors derived from positive-strand RNA viruses have recently been developed, and this paper reviews the current knowledge on the first flavivirus replicon system, which is based on the Australian flavivirus Kunjin (KUN). Like most replicon systems, KUN replicons can be delivered as DNA, RNA or virus-like particles, they replicate their RNA in the cytoplasm and direct prolonged high-level gene expression. However, unlike most alphavirus replicon systems, KUN replicons are non-cytopathic, with transfected cells able to divide, allowing the establishment of cell lines stably expressing replicon RNA and heterologous genes. As vaccine vectors KUN replicons can induce potent, long-lived, protective, immunogen-specific CD8+ T cell immunity, a feature potentially related to extended production of antigen and double-stranded RNA-induced 'danger signals'. The identification of KUN replicon mutants that induce increased levels of IFN-alpha/beta has also spawned investigation of KUN replicons for use in cancer gene therapy. The unique characteristics of KUN replicons may thus make them suitable for specific protein production, vaccine and gene therapy applications.


title: Self-sampling for analysis of respiratory viruses in a large-scale epidemiological study in Sweden.

text: Viral diagnosis of respiratory tract infections has so far required sampling by health professionals,hampering large-scale epidemiological studies of virus-specific disease outcomes. As part of a population-based, prospective study of work-related risk factors for transmission of viral infections (SWEDE-I), we developed a scheme for self-sampling with nasal swabs. Random selection from the gainfully employed population of a medium-sized town in central Sweden resulted in a study cohort of 2,237 men and women aged 25 to 63 years. From September 2011 through May 2012, the cohort reported all instances of respiratory tract infection or gastroenteritis and participants concomitantly sent self-sampled nasal swabs for analysis using regular mail. Diagnosis of 14 viruses was performed. A total of 1,843 samples were received. The week-wise average delay between disease on set and arrival of the specimens at the laboratory varied between four and six days, and the corresponding median delay was between 3.5 and six days. In line with previous community-based studies, picorna- and coronaviruses dominated in specimens obtained from the self-sampling scheme. The results of self-sampling were contrasted to those from contemporaneous routine clinical sampling, on the same age group, in the adjacent Stockholm county. Although higher proportions of positive samples for respiratory syncytial virus and influenza were observed in the clinical sampling scheme, estimations of seasonality for influenza A and picornaviruses derived from both schemes were similar. Our findings show that nasal self-sampling is feasible in large-scale surveillance of respiratory infections and opens new prospects for population based,virologically verified research on virus spread,burden of disease, and effects of environmental factors or interventions.


title: Identification of immunodominant sites on the spike protein of severe acute respiratory syndrome (SARS) coronavirus: implication for developing SARS diagnostics and vaccines.

text: The spike (S) protein of severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) is not only responsible for receptor binding and virus fusion, but also a major Ag among the SARS-CoV proteins that induces protective Ab responses. In this study, we showed that the S protein of SARS-CoV is highly immunogenic during infection and immunizations, and contains five linear immunodominant sites (sites I to V) as determined by Pepscan analysis with a set of synthetic peptides overlapping the entire S protein sequence against the convalescent sera from SARS patients and antisera from small animals immunized with inactivated SARS-CoV. Site IV located in the middle region of the S protein (residues 528-635) is a major immunodominant epitope. The synthetic peptide S(603-634), which overlaps the site IV sequence reacted with all the convalescent sera from 42 SARS patient, but none of the 30 serum samples from healthy blood donors, suggesting its potential application as an Ag for developing SARS diagnostics. This study also provides information useful for designing SARS vaccines and understanding the SARS pathogenesis.


title: Prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty.

text: This clinical practice guideline is based on a systematic review of published studies on the management of adult patients undergoing total hip replacement (THR) or total knee replacement (TKR) aimed specifically at preventing symptomatic pulmonary embolism (PE). The guideline emphasizes the need to assess the patient's risk for both PE and postoperative bleeding. Mechanical prophylaxis and early mobilization are recommended for all patients. Chemoprophylactic agents were evaluated using a systematic literature review. Forty-two studies met eligibility criteria, of which 23 included patients who had TKR and 25 included patients who had THR. The following statements summarize the recommendations for chemoprophylaxis: Patients at standard risk of both PE and major bleeding should be considered for aspirin, low-molecular-weight heparin (LMWH), synthetic pentasaccharides, or warfarin with an international normalized ratio (INR) goal of < or =2.0. Patients at elevated (above standard) risk of PE and at standard risk of major bleeding should be considered for LMWH, synthetic pentasaccharides, or warfarin with an INR goal of < or =2.0. Patients at standard risk of PE and at elevated (above standard) risk of major bleeding should be considered for aspirin, warfarin with an INR goal of < or =2.0, or none. Patients at elevated (above standard) risk of both PE and major bleeding should be considered for aspirin, warfarin with an INR goal of < or =2.0, or none.


title: Risks from emerging animal diseases.

text: Emerging diseases of animals pose great threats to the health of the world and could potentially cripple financial wellbeing, food security or environmental vigour. Recent history has demonstrated that factors inherent in our globalised civilisation will ensure that new diseases will continue to occur in humans, as well as in animals. Focus has been on macroscopic factors underlying disease emergence, including trade, husbandry changes and environmental damage, any of which can facilitate the transfer of a microorganism from one host species to another, with possibly deadly results. However, the events that occur at the microscopic level deserve attention. The author presents the sequence of events that a microbe undertakes as it moves from one species to another and the hurdles faced as it negotiates a new environment to perhaps cause disease.


title: Patterns in Bacterial- and Viral-Induced Immunosuppression and Secondary Infections in the ICU.

text: Immunosuppression renders the host increased susceptible for secondary infections. It is becoming increasingly clear that not only bacterial sepsis, but also respiratory viruses with both severe and mild disease courses such as influenza, respiratory syncytial virus, and the human rhinovirus may induce immunosuppression. In this review, the current knowledge on (mechanisms of) bacterial- and virus-induced immunosuppression and the accompanying susceptibility toward various secondary infections is described. In addition, the frequently encountered secondary pathogens and their preferred localizations are presented. Finally, future perspectives in the context of the development of diagnostic markers and possibilities for personalized therapy to improve the diagnosis and treatment of immunocompromised patients are discussed.


title: [Techniques used for the diagnostic of upper and lower respiratory tract viral infections].

text: Techniques used for the diagnostic of upper and lower respiratory tract viral infections Techniques used for the diagnostic of upper and lower respiratory tract viral infections include conventional procedures and the new molecular tools. Serology has no interest for diagnosis. Antigen detection can be carried out by simple, easy and cheap tools. They are available at hospital and in community practice as well for the detection of influenza virus, RSV, hMPV, parainfluenza virus and adenovirus. To look for viruses which are non detectable by antigen detection assays (rhinovirus, coronavirus, bocavirus, polyomavirus...) or in severe or complicated respiratory lower infections, the use of molecular tools is highly indicated.


title: SJL/J mice are highly susceptible to infection by mouse adenovirus type 1.

text: Mouse adenovirus type 1 (MAV-1) targets endothelial and monocyte/macrophage cells throughout the mouse. Depending on the strain of mouse and dose or strain of virus, infected mice may survive, become persistently infected, or die. We surveyed inbred mouse strains and found that for the majority tested the 50% lethal doses (LD(50)s) were >10(4.4) PFU. However, SJL/J mice were highly susceptible to MAV-1, with a mean LD(50) of 10(-0.32) PFU. Infected C3H/HeJ (resistant) and SJL/J (susceptible) mice showed only modest differences in histopathology. Susceptible mice had significantly higher viral loads in the brain and spleen at 8 days postinfection than resistant mice. Infection of primary macrophages or mouse embryo fibroblasts from SJL/J and C3H/HeJ mice gave equivalent yields of virus, suggesting that a receptor difference between strains is not responsible for the susceptibility difference. When C3H/HeJ mice were subjected to sublethal doses of gamma irradiation, they became susceptible to MAV-1, with an LD(50) like that of SJL/J mice. Antiviral immunoglobulin G (IgG) levels were measured in susceptible and resistant mice infected by an early region 1A null mutant virus that is less virulent that wild-type virus. The antiviral IgG levels were high and similar in the two strains of mice. Taken together, these results suggest that immune response differences may in part account for differences in susceptibility to MAV-1 infection.


title: Will considerations of environmental sustainability revitalise the policy links between the urban environment and health?

text: This paper explores when and how considerations of population health have influenced the creation, planning and management of cities. Cities--now the dominant human habitat--must be planned and managed sustainably in a world that is manifestly experiencing increasing environmental and social strains. Early industrialisation entailed crowding, squalor and industrial environmental blight; the two great associated public health hazards were infectious diseases and air pollution. These hazards have been largely controlled in rich countries. Today's main urban health hazards are obesity (with its life-shortening health consequences) and the huge contribution of cities to climate change with the resultant risks to population health. These and other health issues in urban environments need to be understood and addressed at the community or population level. This is an ecological challenge, crucial to attaining real sustainability.


title: Extent and predictors of microbial hand contamination in a tertiary care ophthalmic outpatient practice.

text: PURPOSE To measure the extent of microbial hand contamination among ophthalmologists during routine clinic practice and examine its association with hand cleansing practices and beliefs, glove use, and patient load. METHODS This was a single-masked analysis of resident and transient flora of ophthalmologists before and after patient examination and after handwashing by agar imprints of the dominant hand. Standardized questionnaires were used to collect information concerning subjects' hand cleansing practices and patient load. RESULTS Of the 108 cultures, 107 (99.1%) were culture positive, yielding 15 separate organisms. Gram-negative bacilli were the most common transient flora, followed by Gram-positive cocci and fungi. Thirty-five (97.2%) ophthalmologists were culture positive for at least one resident and 8 (22.2%) ophthalmologists were culture positive for at least one transient organism, before patient contact. Regression models showed alcohol-based hand rub use, transient and resident floral load before patient contact, and patient load collectively accounted for 58.7% of the variance in resident floral load after patient contact. Use of alcohol-based hand rubs was associated with a mean resident floral reduction of 324.4 CFUs (95% confidence interval [CI] = 185.4 to 463.5; P < 0.01) and 31.6 CFUs (95% CI = 1.2 to 62.0; P < 0.05) after patient contact and handwashing, respectively. Handwashing with chlorhexidine was a significant predictor for transient floral load after handwashing (unstandardized beta = -17.2; 95% CI = -10.2 to -24.2; P < 0.01). CONCLUSIONS The extent of contamination with pathogenic organisms after contact with eye outpatients, who have traditionally been perceived as relatively "clean," was of concern. Previously identified risk factors for hand contamination in inpatient settings, such as patient load, only explained a small proportion of variance in microbial load in the ophthalmic outpatient setting.


title: Assessment of the effectiveness of the 2003-04 influenza vaccine among children and adults--Colorado, 2003.

text: The 2003-04 influenza season was characterized by the early onset of influenza activity, reports of severe illness, particularly in children, and predominant circulation of an influenza A (H3N2) virus strain that was antigenically different from the influenza A (H3N2) vaccine strain. In 2003, a retrospective cohort study among children and a case-control study among adults in Colorado were conducted to provide preliminary data on the effectiveness of the 2003-04 influenza vaccine. This report summarizes the results of those studies, which indicated vaccine effectiveness (VE) among both adults and children, differing from results of a previous study that did not indicate effectiveness among adults.


title: Viruses: overturning RNA turnover.

text: It is becoming clear that viruses interface with the mRNA decay machinery in a variety of ways during an infection. First, RNA viruses in particular must evade the mRNA decay machinery long enough to replicate and establish infection. Second, many viruses usurp or augment cellular mRNA decay pathways to regulate or selectively express their own genes, often inducing massive decay of the host transcripttome. Finally, temporal progression of a viral infection can depend on regulated decay of specific viral transcripts. Therefore, in order to fully understand viral biology, we must take into account the interactions between viruses and the mRNA decay machinery. This approach gives insights into regulatory mechanisms of cellular mRNA decay, as well as reveals novel ways to influence the outcome of viral infections.


A Case of COVID-19 Infection: Chief Symptom, Diarrhea.


[About public health communication strategies and campaigns: what do you know about 2019-nCoV?]


title: [New insight into bacterial zoonotic pathogens posing health hazards to humans].

text: This article presents the problem of evolutionary changes of zoonotic pathogens responsible for human diseases. Everyone is exposed to the risk of zoonotic infection, particularly employees having direct contact with animals, i.e. veterinarians, breeders, butchers and workers of animal products' processing industry. The article focuses on pathogens monitored by the European Centre for Disease Prevention and Control (ECDC), which has been collecting statistical data on zoonoses from all European Union countries for 19 years and publishing collected data in annual epidemiological reports. Currently, the most important 11 pathogens responsible for causing human zoonotic diseases are being monitored, of which seven are bacteria: Salmonella spp., Campylobacter spp., Listeria monocytogenes, Mycobacterium bovis, Brucella spp., Coxiella burnetti and Verotoxin-producing E. coli (VTEC)/Shiga-like toxin producing E. coli (STEC). As particularly important are considered foodborne pathogens. The article also includes new emerging zoonotic bacteria, which are not currently monitored by ECDC but might pose a serious epidemiological problem in a foreseeable future: Streptococcus iniae, S. suis, S. dysgalactiae and staphylococci: Staphylococcus intermedius, S. pseudintermedius. Those species have just crossed the animal-human interspecies barrier. The exact mechanism of this phenomenon remains unknown, it is connected, however, with genetic variability, capability to survive in changing environment. These abilities derive from DNA rearrangement and horizontal gene transfer between bacterial cells. Substantial increase in the number of scientific publications on this subject, observed over the last few years, illustrates the importance of the problem.


title: Infection with porcine respiratory coronavirus does not fully protect pigs against intestinal transmissible gastroenteritis virus.

text: Eight nine-week-old specific-pathogen-free pigs which had been infected with the transmissible gastroenteritis virus (TGEV)-related porcine respiratory coronavirus (PRCV) and four uninfected littermates were challenged with TGEV. The previous PRCV infection failed to protect them against the enteric TGEV infection. Virus excretion in faeces was detected by an ELISA in all the pigs for three to six consecutive days after inoculation. Although little diarrhoea was observed, the infection extended through much of the small intestine of one of the previously infected pigs four days after inoculation. Challenge with TGEV caused a secondary neutralising antibody response. By using a peroxidase conjugate of a monoclonal antibody which recognises a specific antigenic site on TGEV, antibodies against TGEV could be distinguished from antibodies against PRCV in an ELISA blocking test.


title: The United Nations and One Health: the International Health Regulations (2005) and global health security.

text: The One Health approach encompasses multiple themes and can be understood from many different perspectives. This paper expresses the viewpoint of those in charge of responding to public health events of international concern and, in particular, to outbreaks of zoonotic disease. Several international organisations are involved in responding to such outbreaks, including the United Nations (UN) and its technical agencies; principally, the Food and Agriculture Organization of the UN (FAO) and the World Health Organization (WHO); UN funds and programmes, such as the United Nations Development Programme, the World Food Programme, the United Nations Environment Programme, the United Nations Children's Fund; the UN-linked multilateral banking system (the World Bank and regional development banks); and partner organisations, such as the World Organisation for Animal Health (OIE). All of these organisations have benefited from the experiences gained during zoonotic disease outbreaks over the last decade, developing common approaches and mechanisms to foster good governance, promote policies that cut across different sectors, target investment more effectively and strengthen global and national capacities for dealing with emerging crises. Coordination among the various UN agencies and creating partnerships with related organisations have helped to improve disease surveillance in all countries, enabling more efficient detection of disease outbreaks and a faster response, greater transparency and stakeholder engagement and improved public health. The need to build more robust national public human and animal health systems, which are based on good governance and comply with the International Health Regulations (2005) and the international standards set by the OIE, prompted FAO, WHO and the OIE to join forces with the World Bank, to provide practical tools to help countries manage their zoonotic disease risks and develop adequate resources to prevent and control disease outbreaks, particularly at the animal source. All these efforts contribute to the One Health agenda.


Severe acute respiratory syndrome: numbers do not tell whole story.


title: Curcumin combined with glycyrrhetinic acid inhibits the development of hepatocellular carcinoma cells by down-regulating the PTEN/PI3K/AKT signalling pathway.

text: Curcumin is an active component of turmeric, which is derived from the rhizomes of Curcuma longa. Glycyrrhetinic acid (GA) is a natural compound extracted from liquorice. Both curcumin and GA are widely used as anticancer agents for treating many human cancers. In this study, curcumin and GA were used separately and in combination to treat human hepatocellular carcinoma (HCC) HepG2 cells. MTT assays were used to evaluate cell proliferation. Flow cytometry was carried out to measure cell apoptosis and determine cell cycle progression. Western blot analyses were applied to determine the expression levels of B-cell lymphoma-2 (Bcl-2), B-cell associated X protein (Bax), phosphatase and tensin homolog (PTEN), phosphorylated phosphoinositide 3-kinase (PI3K) and AKT serine/threonine kinase 1 (Akt). The results showed that combined treatment with curcumin and GA resulted in a significant reduction in proliferation and an increase in apoptosis and G1 cell cycle arrest in HepG-2 cells. A xenograft tumour model showed that curcumin and GA suppressed HCC development in vivo. Moreover, by knocking down the expression of PTEN, we confirmed that curcumin and GA exert their anticancer effects by inhibiting the PTEN/PI3K/Akt signalling pathway. Collectively, these results indicate that the combination of curcumin and GA could effectively inhibit the development of HepG2 cells by inhibiting PTEN/PI3K/Akt signalling and could be a promising treatment strategy for patients with HCC.


title: Clinical and pathological responses of weaned pigs to atmospheric ammonia and dust.

text: Nine hundred and sixty weaned pigs were exposed for five weeks to controlled concentrations of atmospheric ammonia and dust in a single, multifactorial experiment. The treatments were a mean dust concentration of either 1.2, 2.7, 5.1 or 9.9 mg/m3 (inhalable fraction) and a mean ammonia concentration of either 0.6, 10.0, 18.8 or 37.0 ppm, concentrations representative of commercial conditions. The experiment was carried out over two years and the pigs were used in eight batches, each consisting of five lots of 24 pigs. Each treatment combination was replicated once, and an additional control lot (nominally 0 mg/m3 dust and 0 ppm ammonia) was included in each batch. The dust concentration was the same in the other four lots in each batch in which the four concentrations of ammonia were used; thus, the split-plot design was more sensitive to the effects of ammonia than dust. The groups of pigs were kept separately in five rooms in a purpose-built facility, and the pollutants were injected continuously into the air supply. Ammonia was supplied from a pressurised cylinder, and the endogenous dust in each room was supplemented by an artificial dust manufactured from feed, barley straw and faeces, mixed by weight in the proportions 5:1:4; its ingredients were oven-dried, milled and mixed, and then resuspended in the air supply. The health of the pigs was assessed in terms of general pathology, respiratory tract pathology, and the microbiology of the nasal cavity, trachea and lung. In each batch, postmortem examinations were carried out on 40 pigs after five weeks' exposure to the pollutants and on 30 pigs two weeks later to test for carryover and recovery--a total of 560 pigs. These examinations revealed minimal gross pathology and widespread minor pathological changes of little significance. The pigs' turbinate and lung scores were low and unaffected by exposure to pollutants. All the putative bacterial pathogens, with the exception of toxigenic Pasteurella multocida type D, were isolated from the respiratory tract of the pigs of both ages, but there were no differences between the effects of the different concentrations of pollutants.


title: [Construction and identification of nanobody phage display library targeting Middle East respiratory syndrome coronavirus].

text: Objective To construct a phage display library of specific nano-antibodies against the Middle East respiratory syndrome coronavirus (MERS-CoV) and apply it to the screening of neutralizing nano-antibodies. Methods MERS-CoV receptor-binding domain (RBD) recombinant protein was used to immunize alpaca. After the last immunization, peripheral blood mononuclear cells (PBMCs) were isolated from the whole blood and total RNA was extracted. The VHH gene was amplified by PCR and used to construct recombinant phages. TG1 Escherichia coli was transformed by these recombinant phages. A phage display library of specific nano-antibodies against the MERS-CoV were obtained and used to screen and characterize the nano-antibodies. Results The volume of this library of nano-antibodies was 1.31×108 and its abundance rate was 5.65×1010/mL. The ratio of VHH insertion in the constructed library reached 96%. There was a rich diversity of nano-antibodies in this library. Nano-antibodies with neutralizing activity were identified and expressed from this library. Conclusion We successfully constructed a library of phages which could be effectively applied to the screening of nano-antibodies against MERS-CoV virus.


title: [Isolation and identification of the infective agent of severe acute respiratory syndrome (SARS) from a patient with atypical pneumonia].

text: The virological, morphological, molecular biological and immunochemical study of the infective agent isolated from the patient with the symptoms of atypical pneumonia, hospitalized in the infectious department of the clinical hospital in Blagoveshchensk, was carried out. Thus the fact of the appearance of SARS virus on the territory of Russia was proved. The isolated infective agent, identified as coronavirus strain CoD, was partly characterized and deposited to the virus collection of the Center of Special Laboratory Diagnostics and Treatment of Quarantine and Exotic Infectious Diseases.


title: Detection of turkey enteric coronavirus by enzyme-linked immunosorbent assay and differentiation from other coronaviruses.

text: A double-antibody ELISA for the detection of coronaviruses in intestinal contents from turkey poults with diarrhea was developed. Antibodies were raised in rabbits and guinea pigs against a Minnesota isolate of turkey enteric coronavirus (TCV) propagated in embryonating turkey eggs and were purified by density-gradient centrifugation. The specificity of antisera was confirmed by hemagglutination-inhibition and immunoelectron microscopy. Absorption of anti-TCV hyperimmune sera with egg extracts or egg ovalbumin and the use of different dilution and blocking buffers influenced the sensitivity and specificity of the ELISA. Reciprocal cross-reactivity was detected among turkey, chicken, bovine, and murine coronaviruses. Antisera to the transmissible gastroenteritis virus of swine, the rabbit enteric coronavirus, or the human coronavirus strain 299E failed to react with TCV. The TCV cross-reacted only moderately with the avian infectious bronchitis virus and the hemagglutinating encephalomyelitis virus of swine. Investigations with samples from 47 commercial turkey flocks in Quebec with episodes of transmissible enteritis revealed that the ELISA was more sensitive than was electron microscopy for detection of TCV.


title: [Isolation of a concentrated purified preparation of the transmissible gastroenteritis virus of swine and a study of its antigenic properties].

text: Pretreatment of the transmissible gastroenteritis virus of swine (TGE) (coronavirus) with trypsin increased the yield of the infectious virus approximately 100-fold when propagated in roller cultures of SPEV cells, the time required for the development of marked CPE being twice shorter than without treatment. The method of concentration and purification of TGE virus is described which yields a preparative amount of highly purified virions retaining their structure. Such preparations were used for immunization of guinea pigs. It is concluded that purified preparations of TGE virus possess marked antigenic potency and may be used for generation of highly active and specific hyperimmune sera.


title: The early warning and response system for communicable diseases in the EU: an overview from 1999 to 2005.

text: Under Decision 2119/98/EC of the European Parliament and of the Council, a network for epidemiological surveillance and control of communicable diseases in the Community was set up in 1998. One pillar of Decision 2119/98/EC is the early warning and response system (EWRS). The main objective of the network is to establish permanent communication between European Union (EU) Member States' public health authorities, which are responsible for determining the measures required to control communicable disease-related events. Since 1998, a web based informatics tool has been developed in order to allow information to be shared between the relevant public health authorities. Between 1998 and December 2005, a total of 583 messages were circulated through the EWRS, notifying 396 events. The information shared through the system helped to coordinate public health measures in the EU. However, only few events prompted specific measures at Community level and most of them were controlled with public health measures applied at national level. Major events (such as the Severe Acute Respiratory Syndrome) and the results of simulation exercises prompted the Commission to upgrade the informatics system on the basis of user needs. Since 1 May 2004 the 10 newest Member States have provided information under the current legislation and since April 2005 the European Centre for Disease Prevention and Control (ECDC) is part of the system. Future developments will include a link between the existing EWRS and the communication platform currently developed by the ECDC.


title: Effectiveness of treatment with lincomycin hydrochloride and/or vaccination against Mycoplasma hyopneumoniae for controlling chronic respiratory disease in a herd of pigs.

text: A herd of pigs infected with Mycoplasma hyopneumoniae was used in a double-blind randomised trial to assess the effectiveness of three control strategies against chronic respiratory disease in growing-finishing pigs. One group of 61 pigs received 220 ppm lincomycin hydrochloride in the feed from day 71 to day 91, a second group was vaccinated against M. hyopneumoniae at four and 28 days of age, and a third group received both treatments; a fourth group was left untreated as a control. Throughout the nursery-finishing period (day 29 to slaughter) the average daily weight gain and feed conversion rate of all the treated groups were slightly better than in the controls, but there were no significant differences between them. There were no significant differences between the treated groups in terms of clinical signs, serology, pathology or mortality, which was very low throughout the trial.


title: Immunohistochemical detection of Lawsonia intracellularis in tissue sections from pigs.

text: The aim of the present study was to develop an immunohistochemical method (IHC) for detection of Lawsonia intracellularis (L. intracellularis) in formalin-fixed, paraffin embedded sections of intestines from pigs and to implement this method in differential diagnosis of swine diseases with diarrhea in postweaning pigs. The study was conducted on 165 sections of intestines (ileum, caecum and colon) collected from 76 pigs, representing 42 Polish pig farms. The animals included in the analysis suffered from diarrhea, with bloody or grey to brown feces, and were suspected of porcine proliferative enteropathy (PPE). Sections of intestines were analyzed for the presence of L. intracellularis by polymerase chain reaction (PCR) and IHC. Among 165 intestinal samples from pigs with diarrhea, L. intracellularis DNA was detected by PCR in 33 (20.0%) samples. In this group, 30 samples (18.2% of all the samples tested) were also found positive in IHC, while only 3 (1.8%) were IHC-negative. One hundred thirty-two (80.0%) samples were negative in both tests. The PCR- and IHC-positive samples originated from 11 pigs, 4- to 20-week old, from 8 farms. L. intracellularis antigen was visualized by IHC mostly in intestinal crypts and/or in mononuclear cells of the lamina propria). The positive signal in epithelial cells was observed close to the luminal borders, creating typical specifically stained rims around the crypt lumina. The results of the present study further confirm the usefulness of IHC in the detection of L. intracellularis antigen in the intestinal tissues.


title: Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study.

text: INTRODUCTION AND HYPOTHESIS To compare the effect of laparoscopic and robot-assisted ventral rectopexy for posterior compartment procidentia on the pelvic floor anatomy and function. METHODS A prospective randomised single-centre study was carried out of 29 female patients, who underwent robot-assisted or laparoscopic ventral mesh rectopexy for external or internal rectal prolapse with symptoms of obstructive defecation and/or faecal incontinence. Anatomical changes were measured by Pelvic Organ Prolapse Quantification (POP-Q) and magnetic resonance defecography. Functional changes were evaluated using symptom questionnaires before and 3 months after surgery. RESULTS After rectopexy, changes in POP-Q measurements were statistically significant for points Ap, Bp, C, D and Ba. The descent of the anorectum and cervix/vaginal cuff during straining were significantly reduced with regard to the reference line (mean, -10.4 ± 14.9 mm, p = 0.001) and (-13.3 ± 18.1 mm, p < 0.001) respectively. Pelvic organ mobility (POM) was reduced statistically significantly for the posterior (mean, -16.6 ± 20.8 mm, p < 0.001) and apical compartments (mean, -13.1 ± 14.8, p < 0.001). The PFDI-20, PFIQ-7 and PISQ-12 questionnaires showed statistically significant improvement of symptoms and sexual function. No significant differences were observed between the robot-assisted and laparoscopic techniques in terms of anatomical or functional parameters. CONCLUSION Ventral mesh recto-colpo-sacropexy effectively corrects the anatomy of the posterior compartment, elevates the vaginal apex and reduces pelvic organ mobility of the posterior and middle compartments. The robot-assisted and laparoscopic techniques had similar anatomical and functional outcomes.


title: Updated interim surveillance case definition for severe acute respiratory syndrome (SARS)--United States, April 29, 2003.

text: CDC's interim surveillance case definition for severe acute respiratory syndrome (SARS) has been updated to include laboratory criteria for evidence of infection with the SARS-associated coronavirus (SARS-CoV) (Figure, Box). In addition, clinical criteria have been revised to reflect the possible spectrum of respiratory illness associated with SARS-CoV. Epidemiologic criteria have been retained. The majority of U.S. cases of SARS continue to be associated with travel, with only limited secondary spread to household members or health-care providers.


Seasonal Influenza Vaccination and the Heightened Risk of Coronavirus and Other Pandemic Virus Infections: Fact or Fiction?


title: Laparoscopic repair of hiatal hernia after esophagectomy.

text: BACKGROUND Herniation of abdominal contents via the diaphragmatic hiatus is a potentially life-threatening complication of esophagectomy. Mounting evidence suggests that hiatal hernias are more common following minimally invasive esophagectomy. Therefore, post-esophagectomy hiatal hernia and its treatment bear increasing significance. METHODS We retrospectively reviewed the records of five patients with hiatal hernia following esophagectomy over a 5-year period. RESULTS Successful laparoscopic reduction of a post-esophagectomy hiatal hernia was done without mesh reinforcement in three patients. One patient underwent mesh reinforcement. One patient was found to have carcinomatosis upon laparoscopic inspection, and repair of the hiatal hernia was abandoned. There were no perioperative deaths or complications. One patient developed a recurrent hiatal hernia 14 months after repair of the initial hiatal hernia. Patients were discharged within a mean of 1.75 days after surgical repair. DISCUSSION We have successfully used laparoscopy to treat hiatal hernias after esophagectomy. The benefits conferred by laparoscopy, including better visualization of the right gastroepiploic artery supplying the gastric conduit, minimally invasive evaluation of the field for metastasis, and shorter recovery time, make it our favored approach. Here, we describe our experience with hiatal hernia following esophagectomy and our operative technique.


title: [Management of critical severe acute respiratory syndrome and risk factors for death].

text: OBJECTIVE To investigate the management of critical severe acute respiratory syndrome (SARS) and possible risk factors for death. METHODS Thirty-three patients with SARS referred to Guangzhou Institute of Respiratory Disease (GIRD) between December 2002 and March 2003 were studied retrospectively. Paired t-test using statistical software SPSS 10.0 was employed to compare the respiratory frequency and pulse O(2) saturation (SpO(2)) before and after noninvasive ventilation with continuous positive airway pressure (CPAP) on the 33 patients. Among them, 18 patients who presented with SpO(2) of 90% - 93% at rest under O(2) inhalation 5 L/min were further recorded for their SpO(2) during slight physical movement and CPAP. The possible death-related risk factors including age, underlying diseases, leucocytosis, thrombocytopenia, and lymphopenia were analyzed by the Mantel-Haenszel chi(2) test. RESULTS The respiratory frequencies were significantly decreased and SpO(2) was improved in the 33 patients after one hour of noninvasive ventilation. The SpO(2) in the latter 18 patients fell during slight physical movement and improved one hour after CPAP (p < 0.01). The RRs of the five death predictors concerning thrombocytopenia, age (> 50 yrs, underlying diseases, leucocytosis, and lymphopenia were 25.83, 8.57, 6.40, 1.64, and 1.17, respectively, with the 95% CI of 3.64 - 183.59, 1.94 - 37.83, 1.75 - 23.33, 0.38 - 7.05 and 0.16 - 8.48, respectively. Management with corticosteroids effectively ameliorated and suppressed the development of pulmonary fibrosis. CONCLUSIONS Noninvasive ventilation relieves dyspnea and SpO(2) in patients with critical SARS, and should also be employed in those with SpO(2) of 90% - 93% at rest under O(2) inhalation 5 L/min. Noninvasive as an add-on management may probably cut down on the dosage and duration of corticosteriod therapy. Among 5 possible risk factors, 3 were recognized as death-related, turning out to be thrombocytopenia, age (> 50 yrs) and underlying diseases.


Responding to new severe diseases--the case for routine hospital surveillance and clinical networks in Europe.


title: Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: preliminary data.

text: BACKGROUND The State-Trait Anxiety Inventory form Y is a brief self-rating scale for the assessment of state and trait anxiety. The aim of the current preliminary study was to assess the psychometric properties of its Greek translation. MATERIALS AND METHODS 121 healthy volunteers 27.22 +/- 10.61 years old, and 22 depressed patients 29.48 +/- 9.28 years old entered the study. In 20 of them the instrument was re-applied 1-2 days later. Translation and Back Translation was made. The clinical diagnosis was reached with the SCAN v.2.0 and the IPDE. The Symptoms Rating Scale for Depression and Anxiety (SRSDA) and the EPQ were applied for cross-validation purposes. The Statistical Analysis included the Pearson Correlation Coefficient and the calculation of Cronbach's alpha. RESULTS The State score for healthy subjects was 34.30 +/- 10.79 and the Trait score was 36.07 +/- 10.47. The respected scores for the depressed patients were 56.22 +/- 8.86 and 53.83 +/- 10.87. Both State and Trait scores followed the normal distribution in control subjects. Cronbach's alpha was 0.93 for the State and 0.92 for the Trait subscale. The Pearson Correlation Coefficient between State and Trait subscales was 0.79. Both subscales correlated fairly with the anxiety subscale of the SRSDA. Test-retest reliability was excellent, with Pearson coefficient being between 0.75 and 0.98 for individual items and equal to 0.96 for State and 0.98 for Trait. CONCLUSION The current study provided preliminary evidence concerning the reliability and the validity of the Greek translation of the STAI-form Y. Its properties are generally similar to those reported in the international literature, but further research is necessary.


title: Newer respiratory virus infections: human metapneumovirus, avian influenza virus, and human coronaviruses.

text: PURPOSE OF REVIEW Recently, several previously unrecognized respiratory viral pathogens have been identified and several influenza A virus subtypes, previously known to infect poultry and wild birds, were transmitted to humans. Here we review the recent literature on these respiratory viruses. RECENT FINDINGS Human metapneumovirus has now been detected worldwide, causing severe respiratory tract illnesses primarily in very young, elderly and immunocompromised individuals. Animal models and reverse genetic techniques were designed for human metapneumovirus, and the first vaccine candidates have been developed. Considerable genetic and antigenic diversity was observed for human metapneumovirus, but the implication of this diversity for vaccine development and virus epidemiology requires further study. Two previously unrecognized human coronaviruses were discovered in 2004 in The Netherlands and Hong Kong. Their clinical impact and epidemiology are largely unknown and warrant further investigation. Several influenza A virus subtypes were transmitted from birds to humans, and these viruses continue to constitute a pandemic threat. The clinical symptoms associated with these zoonotic transmissions range from mild respiratory illnesses and conjunctivitis to pneumonia and acute respiratory distress syndrome, sometimes resulting in death. More basic research into virus ecology and evolution and development of effective vaccines and antiviral strategies are required to limit the impact of influenza A virus zoonoses and the threat of an influenza pandemic. SUMMARY Previously unknown and emerging respiratory viruses are an important threat to human health. Development of virus diagnostic tests, antiviral strategies, and vaccines for each of these pathogens is crucial to limit their impact.


Depression in patients with heart failure: prevalence, pathophysiological mechanisms, and treatment.


title: Superfamily 1 helicases .

text: Superfamily 1 helicases are nucleic acid motor proteins that couple ATP hydrolysis to translocation along, and concomitant unwinding of, DNA or RNA. This is central to many aspects of cellular DNA and RNA metabolism and, accordingly, they are implicated in a wide range of nucleic acid processing events including DNA replication, recombination and repair as well as many aspects of RNA metabolism. This review discusses our current understanding of the structure, function and mechanism of Superfamily 1 helicases.


title: Smallpox and bioterrorism.

text: Smallpox was declared to be eradicated on 8 May 1980, during the Thirty-third World Health Assembly. However, concerns about the possible use of the virus as a weapon of bioterrorism have increased in recent years. Governments have responded by initiating selective vaccination programmes and other public health measures. This review uses historical data from 20th century outbreaks to assess the risks to current populations (which have declining immunity) from a deliberate release of virus. The data presented supports the conclusion of a previous reviewer (Mack) that "smallpox cannot be said to live up to its reputation. Far from being a quick-footed menace, it has appeared as a plodding nuisance with more bark than bite." Its R value (the average number of secondary cases infected by a primary case) is lower than that for measles, human parvovirus, chickenpox, mumps, rubella, and poliomyelitis; only the value for severe acute respiratory syndrome (SARS) is lower. Like SARS, close person-to-person contact is required for effective spread of the disease, and exposure to the virus in hospitals has played an important role in transmission for both viruses. In the present paper the dangers of mass vaccination are emphasized, along with the importance of case isolation, contact tracing, and quarantine of close contacts for outbreak control. The need for rapid diagnosis and the continued importance of maintaining a network of electron microscopes for this purpose are also highlighted.


Vitamin E and respiratory tract infections in elderly persons.


title: Contact investigation of a case of human novel coronavirus infection treated in a German hospital, October-November 2012.

text: On 24 October 2012, a patient with acute respiratory distress syndrome of unknown origin and symptom onset on 5 October was transferred from Qatar to a specialist lung clinic in Germany. Late diagnosis on 20 November of an infection with the novel Coronavirus (NCoV) resulted in potential exposure of a considerable number of healthcare workers. Using a questionnaire we asked 123 identified contacts (120 hospital and three out-of-hospital contacts) about exposure to the patient. Eighty-five contacts provided blood for a serological test using a two-stage approach with an initial immunofluorescence assay as screening test, followed by recombinant immunofluorescence assays and a NCoV-specific serum neutralisation test. Of 123 identified contacts nine had performed aerosol-generating procedures within the third or fourth week of illness, using personal protective equipment rarely or never, and two of these developed acute respiratory illness. Serology was negative for all nine. Further 76 hospital contacts also tested negative, including two sera initially reactive in the screening test. The contact investigation ruled out transmission to contacts after illness day 20. Our two-stage approach for serological testing may be used as a template for similar situations.


title: Coronavirus inhibitor in human sera: age distribution and prevalence.

text: We studied the distribution, in human sera, of non antibody serum inhibitor active towards human OC43 and bovine NCDCV coronaviruses. Antibodies to coronaviruses, present with high prevalence in human sera, were filtered by Protein A Sepharose CL 4B column. In the present work we tested sera of newborns, infants, young children and adults. Inhibitory activity was revealed in all sera except these from newborns. This non antibody inhibitor was tested by a plaque-reduction assay.


title: [Left behind populations, COVID-19 and risks of health inequities : a guide of the local social-health network (Vaud, Switzerland)].

text: Since the emergence of the COVID-19 pandemic, the Confederation has referred to « vulnerable populations » over the age of 65 and/or with co-morbidities as potentially at risk. This group should not overshadow other highly vulnerable populations such as forced migrants, people deprived of their liberty, and the homeless. In the context of the current pandemic, there is a risk of increasing inequities in care among these populations. In this practical article, we list the marginalized and disadvantaged left behind populations in the canton of Vaud and the issues of inequities in care in the context of the pandemic; we also present the implementation of procedures sometimes original, always inter-professional and interdisciplinary, specifying who the partners are and what the resources are for front-line caregivers.


title: [Prokaryotic expression of SARS coronavirus spike protein and construction of its DNA vaccine].

text: OBJECTIVE To study the immunological characteristics of the spike (S) protein of SARS coronavirus (SARS-CoV) and analyze the feasibility of using this protein as the component for SARS vaccine development. METHODS The two truncated fragments of S gene were separately cloned into the prokaryotic expression vector pET-15b and expressed in E.coli. The resulting recombinant proteins, rS(a) and rS(b), were purified by affinity chromatography. The full-length S gene was cloned into the eukaryotic expression plasmid pSecTagB to prepare recombinant plasmid pSecS as the DNA vaccine to immunize BALB/c mice for inducing the secretion of anti-SARS-CoV protein. The immunological effect of anti-SARS-CoV antibody was tested with purified rS(a) and rS(b) proteins by enzyme-linked immunosorbent assay (ELISA). RESULTS Both the truncated recombinant proteins were expressed in soluble forms and reacted specifically with the sera from immunized pSecS mice and clinically diagnosed SARS patients. The prokaryotically expressed recombinant truncated S protein had similar antigenicity with SARS-CoV S protein. CONCLUSION The recombinant protein could be used as an antigen for detecting the serum of SARS CoV-infected patients. The SARS-CoV S gene vaccine could induce the production of specific antibody, which offers clues for the research of SARS DNA vaccine.


title: [Recommendations on the identification and transfer of children with critical diabetes during the COVID-19 outbreak].

text: Coronavirus disease 2019 (COVID-19) is the most serious public health problem in China. Children with diabetes are also among the population susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Traffic problems caused by epidemic prevention and control increase the difficulty in the management of children with severe diabetes. In order to control the spread of epidemic, children with mild diabetes are advised to be managed at home and in the community. However, how to treat children with severe diabetes effectively and safely during the outbreak of COVID-19 brings great challenges to primary doctors. The Subspecialty Group of Endocrinology and Metabolism, Society of Pediatrics, Chinese Medical Association and the Subspecialty Group of Endocrinology and Metabolism, Society of Pediatrics, Chinese Medical Doctor Association have developed the recommendations on the identification and transfer of children with critical diabetes during the COVID-19 outbreak, which provide a reference for primary doctors to quickly assess the severity of patient's condition and treat the illness accordingly, thus reducing the risk of referral infection and improving clinical prognosis.


title: Synthetic reconstruction of zoonotic and early human severe acute respiratory syndrome coronavirus isolates that produce fatal disease in aged mice.

text: The severe acute respiratory syndrome (SARS) epidemic was characterized by high mortality rates in the elderly. The molecular mechanisms that govern enhanced susceptibility of elderly populations are not known, and robust animal models are needed that recapitulate the increased pathogenic phenotype noted with increasing age. Using synthetic biology and reverse genetics, we describe the construction of a panel of isogenic SARS coronavirus (SARS-CoV) strains bearing variant spike glycoproteins that are representative of zoonotic strains found in palm civets and raccoon dogs, as well as isolates spanning the early, middle, and late phases of the SARS-CoV epidemic. The recombinant viruses replicated efficiently in cell culture and demonstrated variable sensitivities to neutralization with antibodies. The human but not the zoonotic variants replicated efficiently in human airway epithelial cultures, supporting earlier hypotheses that zoonotic isolates are less pathogenic in humans but can evolve into highly pathogenic strains. All viruses replicated efficiently, but none produced clinical disease or death in young animals. In contrast, severe clinical disease, diffuse alveolar damage, hyaline membrane formation, alveolitis, and death were noted in 12-month-old mice inoculated with the palm civet HC/SZ/61/03 strain or early-human-phase GZ02 variants but not with related middle- and late-phase epidemic or raccoon dog strains. This panel of SARS-CoV recombinants bearing zoonotic and human epidemic spike glycoproteins will provide heterologous challenge models for testing vaccine efficacy against zoonotic reintroductions as well as provide the appropriate model system for elucidating the complex virus-host interactions that contribute to more-severe and fatal SARS-CoV disease and acute respiratory distress in the elderly.


docid: yqywczht

title: World Organisation for Animal Health: strengthening Veterinary Services for effective One Health collaboration.

text: To effectively reduce health risks at the animal-human-ecosystems interface, a One Health strategy is crucially important to create strong national and regional animal health systems that are well coordinated with strong public health systems. Animal diseases, particularly those caused by new and emerging zoonotic pathogens, must be effectively controlled at their source to reduce their potentially devastating impact upon both animal and human health. As the international organisation responsible for developing standards, guidelines and recommendations for animal health, the World Organisation for Animal Health (OIE) plays an important role in minimising animal and public health risks attributable to zoonoses and other animal diseases, which can have severe consequences for global food safety and security. National Veterinary Services, which implement OIE animal health and welfare standards and other measures, are the first line of defence against these diseases, and must have the capacity to meet the core requirements necessary for their diagnosis and control. The OIE works collaboratively with the World Health Organization and Food and Agriculture Organization of the United Nations to improve the ability of national animal and public health systems to respond to current and emerging animal health risks with public health consequences. In addition to improving and aligning national laboratory capacities in high-risk areas, the OIE collaborates on One Health-oriented projects for key diseases, establishing model frameworks which can be applied to manage other existing and emerging priority diseases. This article reviews the role and activities of the OIE in strengthening the national Veterinary Services of its Member Countries for a more effective and sustainable One Health collaboration.


title: Ease of intubation with the Parker Flex-Tip or a standard Mallinckrodt endotracheal tube using a video laryngoscope (GlideScope).

text: Two endotracheal tubes (ETTs) are available for use in operative suites for intubation: the Parker Flex-Tip (PFT, Parker Medical) and the standard Mallinckrodt (Covidien). To the authors' knowledge, no study has compared these 2 ETTs with each other when the anesthesia provider uses the GlideScope video laryngoscope (Verathon) for intubation. The purpose of the study was to determine if there are differences related to ease of intubation reported by anesthesia providers who use the PFT tube compared with the standard tube while using the GlideScope. The study was a randomized block intervention design. The sample consisted of 58 observed intubations in an operating room setting. Data analysis was completed with a 2-factor analysis of covariance using 2 covariates. The PFT tube in suboptimal conditions demonstrated a significantly greater ease of intubation, as measured by decreased time for ETT insertion and greater ease of ETT insertion score. The number of redirections at the glottis to intubate the trachea once the glottis was visualized was not statistically different. Based on the findings from this study, anesthesia providers may want to consider the use of the PFT tube when using the GlideScope to promote ease of intubation.


title: Frequency of detection of picornaviruses and seven other respiratory pathogens in infants.

text: BACKGROUND Previous studies in which molecular-based techniques have been used to identify the causative pathogens of respiratory tract infection have investigated hospitalized children only. We report a prospective study designed to determine the frequency and clinical presentation of community-acquired respiratory illness in infancy associated with 8 common respiratory pathogens. METHODS Eighty-eight infants were monitored through their first winter. With each respiratory illness, infants were examined, and a nasal lavage specimen was collected. Individual reverse transcription-polymerase chain reactions were performed to detect infection with picornaviruses (rhinoviruses and enteroviruses), coronaviruses (serotypes OC43 and 229E), adenoviruses, parainfluenza viruses 1-3, influenza viruses (types A and B), respiratory syncytial virus (RSV), Chlamydia pneumoniae and Mycoplasma pneumoniae. RESULTS Picornaviruses were the most frequently detected pathogen identified in 46% (56 of 123) of episodes, followed by RSV (27%), parainfluenza viruses (13%) and coronaviruses (9%). Dual pathogen infections were identified in 20% of episodes, predominantly caused by picornaviruses together with either RSV or parainfluenza viruses. RSV infection was significantly associated with a diagnosis of bronchiolitis. No other associations were found between pathogen and clinical diagnosis. Dual infection did not predispose infants to a more severe clinical course. CONCLUSIONS Picornaviruses are the predominant cause of community-acquired respiratory tract infection in the first year of life. Large prospective community-based studies will be needed to fully evaluate the contribution of picornaviruses, both in isolation and in combination with other respiratory pathogens, to the various clinical syndromes of respiratory infection observed during infancy.


title: Three outbreaks of salmonellosis associated with baby poultry from three hatcheries--United States, 2006.

text: During 2006, state health departments notified CDC of three outbreaks of Salmonella species infections in persons who had been in contact with chicks and other baby poultry (ducklings, goslings, and baby turkeys) purchased at agricultural feed stores. The feed stores received the poultry from hatcheries, and each of the three outbreaks was traced to a single hatchery. For decades, baby poultry, particularly chicks and ducklings, have been known to be a source of salmonellosis. More recently, the source of birds associated with salmonellosis outbreaks has been traced back to individual hatcheries. Many persons who purchase baby poultry remain unaware that contact with these birds puts them and others who are exposed to the birds, especially children and immunocompromised persons, at risk for salmonellosis. This report describes the three outbreaks and provides recommendations for preventing transmission of Salmonella infection from birds to humans.