Persistence and clearance of Ebola virus RNA from seminal fluid of Ebola virus disease survivors: a longitudinal analysis and modelling study

Background By January, 2016, all known transmission chains of the Ebola virus disease (EVD) outbreak in west Africa had been stopped. However, there is concern about persistence of Ebola virus in the reproductive tract of men who have survived EVD. We aimed to use biostatistical modelling to describe the dynamics of Ebola virus RNA load in seminal fl uid, including clearance parameters. Methods In this longitudinal study, we recruited men who had been discharged from three Ebola treatment units in Guinea between January and July, 2015. Participants provided samples of seminal fl uid at follow-up every 3–6 weeks, which we tested for Ebola virus RNA using quantitative real-time RT-PCR. Representative specimens from eight participants were then inoculated into immunodefi cient mice to test for infectivity. We used a linear mixed-eff ect model to analyse the dynamics of virus persistence in seminal fl uid over time. Findings We enrolled 26 participants and tested 130 seminal fl uid specimens; median follow up was 197 days (IQR 187–209 days) after enrolment, which corresponded to 255 days (228–287) after disease onset. Ebola virus RNA was detected in 86 semen specimens from 19 (73%) participants. Median duration of Ebola virus RNA detection was 158 days after onset (73–181; maximum 407 days at end of follow-up). Mathematical modelling of the quantitative time-series data showed a mean clearance rate of Ebola virus RNA from seminal fl uid of –0·58 log units per month, although the clearance kinetic varied greatly between participants. Using our biostatistical model, we predict that 50% and 90% of male survivors clear Ebola virus RNA from seminal fl uid at 115 days (90% prediction interval 72–160) and 294 days (212–399) after disease onset, respectively. We also predicted that the number of men positive for Ebola virus RNA in aff ected countries would decrease from about 50 in January 2016, to fewer than 1 person by July, 2016. Infectious virus was detected in 15 of 26 (58%) specimens tested in mice. Interpretation Time to clearance of Ebola virus RNA from seminal fl uid varies greatly between individuals and could be more than 13 months. Our predictions will assist in decision-making about surveillance and preventive measures in EVD outbreaks

Persistence and clearance of Ebola virus RNA from seminal fluid of Ebola virus disease survivors: a longitudinal analysis and modelling study.

BACKGROUND: By January, 2016, all known transmission chains of the Ebola virus disease (EVD) outbreak in west Africa had been stopped. However, there is concern about persistence of Ebola virus in the reproductive tract of men who have survived EVD. We aimed to use biostatistical modelling to describe the dynamics of Ebola virus RNA load in seminal fluid, including clearance parameters. METHODS: In this longitudinal study, we recruited men who had been discharged from three Ebola treatment units in Guinea between January and July, 2015. Participants provided samples of seminal fluid at follow-up every 3-6 weeks, which we tested for Ebola virus RNA using quantitative real-time RT-PCR. Representative specimens from eight participants were then inoculated into immunodeficient mice to test for infectivity. We used a linear mixed-effect model to analyse the dynamics of virus persistence in seminal fluid over time. FINDINGS: We enrolled 26 participants and tested 130 seminal fluid specimens; median follow up was 197 days (IQR 187-209 days) after enrolment, which corresponded to 255 days (228-287) after disease onset. Ebola virus RNA was detected in 86 semen specimens from 19 (73%) participants. Median duration of Ebola virus RNA detection was 158 days after onset (73-181; maximum 407 days at end of follow-up). Mathematical modelling of the quantitative time-series data showed a mean clearance rate of Ebola virus RNA from seminal fluid of -0·58 log units per month, although the clearance kinetic varied greatly between participants. Using our biostatistical model, we predict that 50% and 90% of male survivors clear Ebola virus RNA from seminal fluid at 115 days (90% prediction interval 72-160) and 294 days (212-399) after disease onset, respectively. We also predicted that the number of men positive for Ebola virus RNA in affected countries would decrease from about 50 in January 2016, to fewer than 1 person by July, 2016. Infectious virus was detected in 15 of 26 (58%) specimens tested in mice. INTERPRETATION: Time to clearance of Ebola virus RNA from seminal fluid varies greatly between individuals and could be more than 13 months. Our predictions will assist in decision-making about surveillance and preventive measures in EVD outbreaks. FUNDING: This study was funded by European Union's Horizon 2020 research and innovation programme, Directorate-General for International Cooperation and Development of the European Commission, Institut national de la santé et de la recherche médicale (INSERM), German Research Foundation (DFG), and Innovative Medicines Initiative 2 Joint Undertaking

Temporal and spatial analysis of the 2014-2015 Ebola virus outbreak in West Africa

West Africa is currently witnessing the most extensive Ebola virus (EBOV) outbreak so far recorded. Until now, there have been 27,013 reported cases and 11,134 deaths. The origin of the virus is thought to have been a zoonotic transmission from a bat to a two-year-old boy in December 2013 (ref. 2). From this index case the virus was spread by human-to-human contact throughout Guinea, Sierra Leone and Liberia. However, the origin of the particular virus in each country and time of transmission is not known and currently relies on epidemiological analysis, which may be unreliable owing to the difficulties of obtaining patient information. Here we trace the genetic evolution of EBOV in the current outbreak that has resulted in multiple lineages. Deep sequencing of 179 patient samples processed by the European Mobile Laboratory, the first diagnostics unit to be deployed to the epicentre of the outbreak in Guinea, reveals an epidemiological and evolutionary history of the epidemic from March 2014 to January 2015. Analysis of EBOV genome evolution has also benefited from a similar sequencing effort of patient samples from Sierra Leone. Our results confirm that the EBOV from Guinea moved into Sierra Leone, most likely in April or early May. The viruses of the Guinea/Sierra Leone lineage mixed around June/July 2014. Viral sequences covering August, September and October 2014 indicate that this lineage evolved independently within Guinea. These data can be used in conjunction with epidemiological information to test retrospectively the effectiveness of control measures, and provides an unprecedented window into the evolution of an ongoing viral haemorrhagic fever outbreak.status: publishe

Kulttuurilähtöisten ohjauspalveluiden kehittäminen yritystoiminnaksi

Tämän opinnäytetyön tavoitteena oli taide- ja kulttuurilähtöisten ohjauspalveluiden kehittäminen yritystoiminnaksi. Taustatiedoksi selvitettiin, minkälaisia kulttuurilähtöisiä ohjauspalveluita ihmiset olisivat kiinnostuneita tilaamaan. Tutkimus keskittyi työhyvinvointia lisäävään tyky-toimintaan sekä erilaisiin aikuisten ja lastenjuhliin. Opinnäytetyön tekijät toimivat itse opinnäytetyön toimeksiantajana ja toteuttivat tutkimuksen oman yritystoimintansa kehittämiseksi. Ohjaustoiminnan artenomiksi (AMK) valmistumisen jälkeen tekijöiden suunnitelmissa on perustaa kulttuurilähtöisiä ohjauspalveluja tarjoava yritys. Opinnäytetyön tietoperustana hyödynnettiin asiakaslähtöisyyttä, palvelumuotoilua, luovuutta ja kulttuurilähtöistä toimintaa koskevaa kirjallisuutta ja verkkolähteitä, sekä Lapin elämysteollisuuden osaamiskeskuksessa kehitettyä elämyskolmiomallia. Opinnäytetyön tutkimusaineisto kerättiin kyselyiden avulla. Kaikkiaan toteutettiin neljä erillistä määrällistä kyselyä, joista kaksi oli suunnattu työpaikoille; toinen työkykyä ylläpitävästä tyky-toiminnasta vastaaville henkilöille ja toinen muulle työyhteisölle. Toiset kaksi kyselyä koskivat kulttuurilähtöistä juhlatoimintaa osana aikuisten tai lastenjuhlia. Kyselyt toteutettiin sähköisesti Webropol-ohjelmalla, ja niitä jaettiin sähköpostin ja sosiaalisen median avulla. Opinnäytetyön tuloksena syntyi asiakastarpeiden ja toiveiden mukaan toteutettu ohjauspalveluvalikoima. Tutkimuksesta saatujen vastausten perusteella tämän kaltaiselle yritystoiminnalle voisi olla kiinnostusta ja markkinoita. Etenkin tyky-toiminnan puolella kulttuurilähtöistä tarjontaa on tällä hetkellä vielä vähän.The aim of this Bachelor’s thesis was to develop culture and arts -related instruction services into entrepreneurship. This aim was approached by finding out what sort of culture and arts -oriented activities people would be interested in ordering. The survey focuses on two main subjects: workplace health promotion which aims to increase occupational health, and on different kinds of party activities for adults’ and children’s parties. The starting point for the thesis was a personal interest in entrepreneurship and the survey was carried out in order to develop a business idea for the future. The theoretical background of the thesis was based on literature and web pages including information about customer-oriented approach, service design, creativity and culture-oriented activities. The Experience Pyramid that has been developed in the Lapland Centre of Expertise for the Experience Industry was also examined. The research material of the thesis was collected through inquiries. Four different quantitative inquiries were carried out, two of which were directed to workplaces: one for persons responsible for workplace health promotion and another one for the rest of the staff. The other two inquiries concerned culture and arts -related party activity for adults or children. The inquiries were carried out as online Webropol surveys spread out by e-mail and social media. As a result of the Bachelor’s thesis, a selection of instruction services was created according to the customers’ needs and wishes. The results of the survey imply that there could be a need and demand for this kind of entrepreneurship. Especially in the area of workplace health promotion there are not many cultural activities available at the moment

Taidetta lähelle toimijoita : museolta lainattavien taideaineistojen soveltuvuus kehitysvammaisten taideryhmässä

Tässä toiminnallisessa opinnäytetyössä tutkittiin, miten Hämeenlinnan taidemuseolta lainatut taideaineistot soveltuivat kehitysvammaisten taideryhmään. Hämeenlinnan taidemuseo lainaa taidesalkkuja, jotka sisältävät paikallisten taiteilijoiden teoksia. Teokset on toteutettu niin, että niitä saa tutkia läheltä ja koskettamalla. Tutkimus toteutettiin eteläsuomalaisessa kunnassa sijaitsevassa päivätoiminnassa. Opinnäytetyön tavoitteena oli tehdä taiteen kokeminen saavutettavaksi tuomalla sitä päivätoimintaan. Tutkimuksessa oli mukana neljä päivätoiminnan toimijaa. Taidetuokioita oli neljä kertaa, jossa jokaisessa aluksi tutkittiin teoksia ja keskusteltiin niistä ja sen jälkeen tehtiin itse taidetta aineistojen teemaan sopivilla aiheilla ja tekniikoilla. Osallistuvan havainnoinnin ja ryhmähaastattelun avulla tutkittiin taideaineistojen toimivuutta ja ryhmän vuorovaikutusta. Opinnäytetyössä tutkittiin myös keinoja, joilla osallisuutta voi edistää taidelähtöisessä toiminnassa. Johtopäätöksenä voidaan todeta, että taideaineistot toivat iloa ja elämyksiä sekä toimivat hyvinä inspiraation lähteinä toimijoiden omaan taidetyöskentelyyn. Ne synnyttivät muistelua omasta elämästä, vahvistivat minäkuvaa ja loivat yhteisöllisyyttä. Toimijat eli taidetuokioon osallistuneet henkilöt kokivat taidetuokioiden sisällön mukavana vaihteluna normaaliin päivätoiminnan arkeen. Tuokioiden jälkeen valmiista teoksista toteutettiin talon väelle taidenäyttely, jonka toimijat suunnittelivat

Jäte- ja sivuvirtabiomassapotentiaalin arviointi

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Assessing regional potentials of waste and energy crop biomass of agrifood systems - Towards an adequate method

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Spatially explicit assessment of agrifood biomass resources - towards a method for small-scale assessments

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Potential of agrifood wastes in mitigation of climate change and eutrophication - Two case regions

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