Cross‐species transmission and evolutionary dynamics of canine distemper virus during a spillover in African lions of Serengeti National Park

The outcome of pathogen spillover from a reservoir to a novel host population can range from a “dead‐end” when there is no onward transmission in the recipient population, to epidemic spread and even establishment in new hosts. Understanding the evolutionary epidemiology of spillover events leading to discrete outcomes in novel hosts is key to predicting risk and can lead to a better understanding of mechanisms of emergence. Here we use a Bayesian phylodynamic approach to examine cross‐species transmission and evolutionary dynamics during a canine distemper virus spillover event causing clinical disease and population decline in an African lion population (Panthera leo) in the Serengeti Ecological Region between 1993 and 1994. Using 21 near‐complete viral genomes from four species we found that this large‐scale outbreak was likely ignited by a single cross‐species spillover event from a canid reservoir to non‐canid hosts less than one year before disease detection and explosive spread of CDV in lions. Cross‐species transmission from other non‐canid species likely fueled the high prevalence of CDV across spatially structured lion prides. Multiple lines of evidence suggest that spotted hyenas (Crocuta crocuta) could have acted as the proximate source of CDV exposure in lions. We report thirteen nucleotide substitutions segregating CDV strains found in canids and non‐canids. Our results are consistent with the hypothesis that virus evolution played a role in CDV emergence in non‐canid hosts following spillover during the outbreak, and suggests that host barriers to clinical infection can limit outcomes of CDV spillover in novel host species

Modern Jobs for Modern Women: Female Military Service in Britain, 1945-1962

“Modern Jobs for Modern Women: Female Military Service in Britain, 1945-1962” examines the first generation of British servicewomen to serve in peacetime under regular, full-time engagements. The Women’s Royal Air Force, the Women’s Royal Army Corps, and the Women’s Royal Naval Service were created out of the successful women’s auxiliaries that had employed hundreds of thousands of women during the Second World War. Through the 1950s and 1960s, these permanent services employed British women in clerical and domestic, as well as technical, positions all over Britain and the world. Although this period is generally considered a low ebb of feminism, Britain’s armed forces were at the same time declaring their commitment to recruiting women as an “integral part” of their services. Based on an extensive reading of official files alongside materials produced by servicewomen themselves, I examine how women fit into the military in peacetime, both in terms of discipline and employment as well as identity and lifestyle. Although the women’s services were initially formed in anticipation that the next war would be a total war on the same lines as the Second World War, their place in overall personnel policy evolved to meet the new nuclear strategy. Women were intended to help rebalance the distribution of tasks in the armed forces, so that men could be employed almost exclusively on technical and combat-oriented tasks. Postwar servicewomen continued the process started by wartime auxiliaries of claiming military symbols and culture for themselves. Their organizations were models of a conservative kind of feminism, giving women authority in their own sphere and promoting the pursuit of career goals alongside domesticity. The dissertation thus contributes to literature that expands military history beyond the realm of active campaigning and technological development, as well as literature on gender and war and the history of women’s work

Enhanced skin blood flow and sensitivity to noxious heat stimuli in papulopustular rosacea

Although patients with rosacea often complain of increased skin sensitivity, there has been no quantitative sensory testing of this phenomenon. Furthermore, cutaneous blood flow in these patients has not been assessed using state-of-the-art laser Doppler imaging (LDI). To assess heat pain thresholds and skin blood flow using quantitative thermal sensory testing and LDI in patients with untreated rosacea. Of the total 24 subjects enrolled, 8 had papulopustular rosacea (PPR), 8 had erythematotelangiectatic rosacea (ETR) and 8 were control subjects. Subjective burning perception, heat pain threshold, skin blood flow, and skin temperature was assessed in all subjects. In the ETR and PPR groups, two areas were compared: affected and nonaffected. Heat pain thresholds of areas affected by rosacea were lower than those of nonaffected areas. In addition, subjective burning perception was increased in rosacea patients when compared with control subjects. Although PPR-affected skin had elevated skin blood flow when compared with nonaffected skin, this was not significant for ETR-affected skin. The small number of subjects enrolled was the main limitation. This study showed enhanced sensitivity to noxious heat stimuli in rosacea-affected skin, which was more prominent in the PPR group

A pramoxine-based anti-itch lotion is more effective than a control lotion for the treatment of uremic pruritus in adult hemodialysis patients

Objective: The objective of this study was to evaluate the efficacy of a commercially available anti-itch lotion containing 1% pramoxine hydrochloride versus control lotion in the treatment of uremic pruritus in adult hemodialysis patients. Methods: This was a randomized, double-blind, controlled comparative trial set in a community hemodialysis center. The study population comprised 28 individuals (mean age 53.5) with moderate to severe uremic pruritus who had been receiving hemodialysis for at least 3 months. All participants were recruited from one community hemodialysis center. Topical anti-itch lotion containing 1% pramoxine was applied twice daily to all affected areas of pruritus for 4 weeks. The main outcome measure was a reduction in itch intensity. Secondary outcomes included increases in the investigator's global assessment and improvement in skin hydration. Results: There was a 61% decrease in itch intensity in the treatment group, whereas a 12% reduction in itch intensity was observed in the control group. The rate of decline in itching was also greater in the treatment arm versus the control arm. No significant differences were displayed in other studied disease-related variables. Conclusion: Our study shows that individuals using pramoxine 1% lotion experienced a reduction in pruritus to a greater degree than those using the control lotion. This safe, convenient and effective topical lotion may potentially benefit the large number of patients affected by pruritus associated with end-stage renal disease

Evaluation of nationwide referral pathways, investigation and treatment of suspected cauda equina syndrome in the United Kingdom

Purpose: Cauda equina syndrome (CES) is a spinal emergency with clinical symptoms and signs that have low diagnostic accuracy. National guidelines in the United Kingdom (UK) state that all patients should undergo an MRI prior to referral to specialist spinal units and surgery should be performed at the earliest opportunity. We aimed to evaluate the current practice of investigating and treating suspected CES in the UK. Materials and Methods: A retrospective, multicentre observational study of the investigation and management of patients with suspected CES was conducted across the UK, including all patients referred to a spinal unit over 6 months between 1st October 2016 and 31st March 2017. Results: A total of 28 UK spinal units submitted data on 4441 referrals. Over half of referrals were made without any previous imaging (n = 2572, 57.9%). Of all referrals, 695 underwent surgical decompression (15.6%). The majority of referrals were made out-of-hours (n = 2229/3517, 63.4%). Patient location and pre-referral imaging were not associated with time intervals from symptom onset or presentation to decompression. Patients investigated outside of the spinal unit experienced longer time intervals from referral to undergoing the MRI scan. Conclusions: This is the largest known study of the investigation and management of suspected CES. We found that the majority of referrals were made without adequate investigations. Most patients were referred out-of-hours and many were transferred for an MRI without subsequently requiring surgery. Adherence to guidelines would reduce the number of referrals to spinal services by 72% and reduce the number of patient transfers by 79%