Intersystem Collaboration: A Statewide Initiative to Support Families

The study described in this paper utilized a qualitative case study method to assess the processes involved in inter-system collaboration in the context of one state\u27s system change initiative. The collaborative experience is described from the perspective of participating service system professionals and family members. The major themes of collaboration that emerged from the study included changes in communication across systems, changes in inter-system relationships, changes in attitudes, changes in interactions with families, and changes in the ways services are delivered. Lessons learned and practice implications of each theme are discussed

Low Pathogenic Avian Influenza Isolates from Wild Birds Replicate and Transmit via Contact in Ferrets without Prior Adaptation

Direct transmission of avian influenza viruses to mammals has become an increasingly investigated topic during the past decade; however, isolates that have been primarily investigated are typically ones originating from human or poultry outbreaks. Currently there is minimal comparative information on the behavior of the innumerable viruses that exist in the natural wild bird host. We have previously demonstrated the capacity of numerous North American avian influenza viruses isolated from wild birds to infect and induce lesions in the respiratory tract of mice. In this study, two isolates from shorebirds that were previously examined in mice (H1N9 and H6N1 subtypes) are further examined through experimental inoculations in the ferret with analysis of viral shedding, histopathology, and antigen localization via immunohistochemistry to elucidate pathogenicity and transmission of these viruses. Using sequence analysis and glycan binding analysis, we show that these avian viruses have the typical avian influenza binding pattern, with affinity for cell glycoproteins/glycolipids having terminal sialic acid (SA) residues with α 2,3 linkage [Neu5Ac(α2,3)Gal]. Despite the lack of α2,6 linked SA binding, these AIVs productively infected both the upper and lower respiratory tract of ferrets, resulting in nasal viral shedding and pulmonary lesions with minimal morbidity. Moreover, we show that one of the viruses is able to transmit to ferrets via direct contact, despite its binding affinity for α 2,3 linked SA residues. These results demonstrate that avian influenza viruses, which are endemic in aquatic birds, can potentially infect humans and other mammals without adaptation. Finally this work highlights the need for additional study of the wild bird subset of influenza viruses in regard to surveillance, transmission, and potential for reassortment, as they have zoonotic potential

Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation

Purpose of Review: Atrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management of AF patients. Recent Findings: Novel echocardiographic biomarkers and their clinical application related to the management of AF have been taken into consideration. Both standard parameters such as atrial size and volume but also novels like atrial strain and tissue Doppler techniques have been analyzed. Summary: A number of novel echocardiographic parameters have been proven to enable early detection of left atrial dysfunction along with increased diagnosis accuracy. This concerns particularly experienced echocardiographers. Hence, these techniques might improve the prediction of stroke and thromboembolic events among AF patients and need to be further developed and disseminated. Nonetheless, even the standard imaging parameters could be of significant value and should not be discontinued in everyday clinical practice. © 2019, The Author(s)

Human malarial disease: a consequence of inflammatory cytokine release

Malaria causes an acute systemic human disease that bears many similarities, both clinically and mechanistically, to those caused by bacteria, rickettsia, and viruses. Over the past few decades, a literature has emerged that argues for most of the pathology seen in all of these infectious diseases being explained by activation of the inflammatory system, with the balance between the pro and anti-inflammatory cytokines being tipped towards the onset of systemic inflammation. Although not often expressed in energy terms, there is, when reduced to biochemical essentials, wide agreement that infection with falciparum malaria is often fatal because mitochondria are unable to generate enough ATP to maintain normal cellular function. Most, however, would contend that this largely occurs because sequestered parasitized red cells prevent sufficient oxygen getting to where it is needed. This review considers the evidence that an equally or more important way ATP deficency arises in malaria, as well as these other infectious diseases, is an inability of mitochondria, through the effects of inflammatory cytokines on their function, to utilise available oxygen. This activity of these cytokines, plus their capacity to control the pathways through which oxygen supply to mitochondria are restricted (particularly through directing sequestration and driving anaemia), combine to make falciparum malaria primarily an inflammatory cytokine-driven disease

Emergence of a novel drug resistant H7N9 influenza virus: evidence based clinical potential of a natural IFN-α for infection control and treatment

The novel avian H7N9 influenza virus has caused more than 130 human infections with 43 deaths in China. Because of the lack of existing immunity against H7 subtype influenza viruses in the human population and the absence of a licensed commercial vaccine, antiviral drugs are critical tools for the treatment of infection with this novel H7N9. Both M2-ion channel blockers and neuraminidase inhibitors are used as antiviral drugs for influenza infections of humans. The emerging H7N9 viruses are resistant to the M2-ion channel blockers because of a S31N mutation in the M2 protein; additionally, some H7N9 isolates have gained neuraminidase R292K substitution resulting in broad resistance to neuraminidase inhibitors. In this study we report that Alferon N can inhibit wild type and 292K H7N9 viruses replication in vitro. Since Alferon N is approved for clinical use, this would allow a rapid regulatory approval process for this drug under pandemic threat

Conocimiento académico sobre los pueblos indígenas en el continente americano: un abordaje comparativo sobre las condiciones de su circulación internacional

Studies concerning indigenous peoples in the Americas have grown notably in recent decades, though with diverse rhythms and featuring-specific conditions in different countries and regions. Within the framework of studies of the history of science that address the conditions of production and circulation of knowledge, in this paper, some characteristics of international links between researchers in this field are analyzed. I suggest that features such as overseas training, the use of foreign languages, publications in a second language, frequency and quality of contacts with foreign countries and international collaboration, are indicators that can provide insights into the extent of internationalization of this field. It is my hypothesis that there is not an internationalized field of indigenous studies as such, but rather regionally segmented circuits mostly defined by linguistic areas. The study covers, in a comparative manner, academics from countries such as Canada, the United States of America, Mexico, Argentina, Brazil, Colombia, Chile and Peru.Estudos sobre os povos indígenas nas Américas cresceram significativamente nas últimas décadas, embora com diferentes ritmos e condições específicas em diferentes países e regiões. Como parte dos estudos de história da ciência que lidar com as condições de produção e circulação do conhecimento, este artigo discute algumas das características de ligações internacionais entre os pesquisadores da área. Sugiro que características como a formação no estrangeiro, o uso de uma segunda língua, publicações em língua estrangeira, a frequência ea qualidade dos contactos com países estrangeiros e colaboração internacional são indicadores que possam fornecer informações sobre o grau de internacionalização neste campo. Minha hipótese é a de que não existe um campo internacionalizada de estudos indígenas como tal, mas circuitos regionais segmentado principalmente definido por regiões linguísticas. As tampas de estudo, comparativamente, académicos de países como o Canadá, EUA, México, Argentina, Brasil, Colômbia, Chile e Peru.Los estudios sobre los pueblos indígenas en el continente americano han crecido notablemente en las últimas décadas, aunque con ritmos diversos y con condiciones específicas en diferentes países y regiones. En el marco de los estudios de historia de la ciencia que abordan las condiciones de producción y circulación del conocimiento, en este artículo se analizan algunas de las características de los vínculos internacionales entre los investigadores en este campo. Sugiero que las características como la formación en el extranjero, el uso de una segunda lengua, las publicaciones en otro/s idioma/s, la frecuencia y la calidad de los contactos con países extranjeros y la colaboración internacional son indicadores que pueden proporcionar información sobre el grado de internacionalización de este campo. Mi hipótesis es que no existe un campo internacionalizado de estudios indígenas como tal, sino circuitos regionalmente segmentados, definidos en su mayoría por áreas lingüísticas. El estudio abarca, de manera comparativa, a académicos de países como Canadá, Estados Unidos de América, México, Argentina, Brasil, Colombia, Chile y Perú.Fil: Salomon Tarquini, Celia Claudia. Universidad Nacional de la Pampa. Facultad de Ciencias Humanas. Instituto de Estudios Históricos y Sociales de La Pampa. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Confluencia. Instituto de Estudios Históricos y Sociales de La Pampa; Argentin

Immunogenicity of NVX-CoV2373 heterologous boost against SARS-CoV-2 variants

Abstract As part of a multicenter study evaluating homologous and heterologous COVID-19 booster vaccines, we assessed the magnitude, breadth, and short-term durability of binding and pseudovirus-neutralizing antibody (PsVNA) responses following a single booster dose of NVX-CoV2373 in adults primed with either Ad26.COV2.S, mRNA-1273, or BNT162b2 vaccines. NVX-CoV2373 as a heterologous booster was immunogenic and associated with no safety concerns through Day 91. Fold-rises in PsVNA titers from baseline (Day 1) to Day 29 were highest for prototypic D614G variant and lowest for more recent Omicron sub-lineages BQ.1.1 and XBB.1. Peak humoral responses against all SARS-CoV-2 variants were lower in those primed with Ad26.COV2.S than with mRNA vaccines. Prior SARS CoV-2 infection was associated with substantially higher baseline PsVNA titers, which remained elevated relative to previously uninfected participants through Day 91. These data support the use of heterologous protein-based booster vaccines as an acceptable alternative to mRNA or adenoviral-based COVID-19 booster vaccines. This trial was conducted under ClinicalTrials.gov: NCT04889209