Excreta disposal in emergencies: the use of bag systems in challenging urban contexts

While anecdotes of approaches to sanitation in complex urban humanitarian response exist, there is a need for research and development to mainstream emerging technologies to meet the challenges. In response to the wide-spread devastation and mass internal displacement caused by the January 12, 2010 earthquake in Port-au-Prince, Haiti, Oxfam GB trialled standard bag and Peepoo excreta disposal systems in two IDP settlements. Trial results demonstrated that both bag types are viable excreta disposal options. Based on these positive results, bag excreta disposal methodologies were further studied in additional IDP settlements in Port-au-Prince to create key programmatic recommendations including a six-step methodology for contingency planning for disaster-prone areas. Further research is still needed into the cost effectiveness and phase-out points for bag excreta disposal systems

The Fungal and Bacterial Microbiome in Cystic Fibrosis (FABB CF): Changes in the Cystic Fibrosis Airway Mycobiome Over Time and its Link with Bacterial Species Rarefication

Background: The significance of airway colonisation with Aspergillus fumigatus in CF lung disease remains uncertain. Bacterial diversity decreases with age in CF, whilst fungal airway colonisation increases. The cause and effect of these findings are not well understood in the pre-modulated CF airway microbiome.Aims: To longitudinally study the dynamic changes in sputum fungal composition, airway microbiome rarefication, airway inflammatory markers and disease progression in CF.Methods A prospective, single-centre longitudinal study over a six-year period, including paediatric and adult CF patients. Sputum and/or BAL samples processed for fungal culture (FC), bacterial and fungal quantitative PCR, high-throughput sequencing and airway inflammatory biomarkers. Age-matched paediatric disease-control participants were also recruited.Results Seventy patients provided 235 respiratory samples. Median age at recruitment was 17 years (range 0.5–59 years) with a median percent predicted FEV1 of 88% (range 26–135%). 60% of participants were FC positive, of which 3% were persistently colonised. 68% of the FC naïve group were aged Conclusion Chronic Aspergillus fumigatus airway colonisation is associated with a change in bacterial and fungal community structure and diversity in CF. Further comparative studies are needed to understand the impact of fungal airway colonisation on the modulated CF airway microbiome.</p

Comparative Analysis of Clinical Parameters and Sputum Biomarkers in Establishing the Relevance of Filamentous Fungi in Cystic Fibrosis.

BackgroundThe relationship between fungal culture (FC) positivity and airway inflammation in CF is largely unknown. Identifying the clinical significance of filamentous fungi in CF using both clinical parameters and biomarkers may change our antimicrobial therapeutic strategies.ObjectivesTo investigate the clinical characteristics and airway biomarker profile in relation to the detection of filamentous fungi in respiratory samples obtained from CF patients.MethodsA prospective cohort study over 24 months, including children and adults with CF. Participants provided sputum and/or bronchoalveolar lavage samples, which underwent processing for bacterial and fungal culture, leukocyte differential cell count and biomarker analysis for neutrophil elastase (NE), interleukin-8 (IL-8), galactomannan and tumor necrosis factor receptor type 2 (TNF-R2). We performed FC using neat sputum plugs, an approach shown to be more sensitive compared to routine laboratory testing.ResultsSixty-one patients provided 76 respiratory samples (72 sputum and 4 BAL). Median age was 17 years (range 6 months-59 years). FC positivity was noted in 49% of the cohort. FC positivity was greater during pulmonary exacerbation compared to the stable state (67 versus 50%). Participants aged 5-30 years had a lower FEV1 within the FC positive group. A significant association between FC positivity and non-tuberculosis mycobacterial (NTM) culture was observed on non-parametric testing (p = 0.022) and regression analysis (p = 0.007). Exposure to indoor mold was a predictor for FC positivity (p = 0.047). There was a trend towards increased lung clearance index (LCI), bronchiectasis and intravenous antibiotic use in the FC positive group. There was no significant difference in biomarkers between FC positive and negative patients.ConclusionAspergillus. fumigatus is the commonest filamentous fungi cultured from CF airways. We found no difference in the airway biomarker profile between FC positive and negative patients. The role of galactomannan and TNFR2 as fungal specific biomarkers in CF remains uncertain. FC positivity is associated with a lower FEV1 in younger patients, a lower LCI, NTM positivity, bronchiectasis, and intravenous antibiotic exposure. Larger trials are needed to determine the role of galactomannan and TNF-R2 as potential fungal biomarkers in CF

Oxidative addition to a monomeric stannylene to give four-coordinate tin compounds containing the bulky bidentate ligand C(SiMe3)2SiMe2CH2CH2Me2Si(Me3Si)2C. Crystal structures of CH2Me2Si(Me3Si)2CSnC(SiMe3)2SiMe2CH2, CH2Me2Si(Me3Si)2CSnMe(OCOCF3)C(SiMe3)2SiMe2CH2, and (CF3COO)2MeSnC(SiMe3)2SiMe2CH2CH2Me2Si- (Me3Si)2CSnMe(OCOCF3)2

Reaction of (THF)2KRRK(THF)2 (RR = C(SiMe3)2SiMe2CH2CH2Me2Si(Me3Si)2C) with SnCl2 in Et2O gave a mixture of the cyclic and linear SnII compounds RSnR 4, and ClSnRRSnCl, 9. This mixture was treated with MeI to give the corresponding SnIV compounds 5, and IClMeSnRRSnMeClI, 10. Treatment of RSnMeIR 5 and 10 with AgO2CCF3 gave the corresponding trifluoroacetates 6 and 11, which were structurally characterized

GAG-specific ELISPOT analysis post boost.

<p>Splenocytes were isolated from individual animals and GAG specific gamma interferon ELISPOT assays were performed to determine the number of antigen-specific cytokine-secreting T cells. Error bars represent 1 standard error.</p

VEE GP coat mouse immunogenicity study design

a<p>Genome equivalent (GE) titer determined by quantitative reverse transcription PCR.</p>b<p>Infectious unit (IU) titer determined on Vero cells.</p

Comparison of genome equivalents

a<p>Infectious unit (IU) titer determined on Vero cells. IU/ml titer represented.</p>b<p>Genome equivalent (GE) titer determined by quantitative reverse transcription PCR. GE/ml titer represented.</p

GAG-specific ELISPOT analysis post prime.

<p>Splenocytes were isolated from individual animals and GAG specific gamma interferon ELISPOT assays were performed to determine the number of antigen-specific cytokine-secreting T cells. Error bars represent 1 standard error.</p

Structural protein coding region and location of glycoprotein mutations in different VEE viruses

<p>Structural protein coding region and location of glycoprotein mutations in different VEE viruses</p

GAG-specific ELISA analysis post boost.

<p>Sera was collected from individual animals 1 week after the booster vaccination and GAG-specific ELISA analysis was performed. Error bars represent 1 standard error.</p