Occurrence of Cryptosporidium Oocysts in Leisure Pools in the UK, 2017, and Modelling of Oocyst Contamination Events

Cryptosporidium is a major cause of diarrhoea outbreaks linked to swimming pools, but little is known about the frequency of contamination. The primary aim was to investigate the occurrence and concentration, through sampling and modelling, of Cryptosporidium oocysts in leisure pools. Secondary aims were to compare detections with operational parameters, provide the evidence-base for guidance, and improve sampling capacity and interpretation for public health investigations. Up to 1000 L pool water was sampled during swim sessions once weekly for 10 weeks from 8 August 2017 at six volunteer pools. Oocysts were detected by microscopy in 12/59 (20%) pool water samples, at least once in each pool; 8/12 (66%) detections were in August when bather loads were highest. At three pools, 1 L filter backwash was sampled weekly and oocysts were detected in 2/29 (7%) samples, following detections in pool water. The probabilities of a bather contaminating the pool ranged from 1 in 1000 to over 1 in 10,000. Monte Carlo analysis showed that when high bather numbers caused contamination on over 70% of days, multiple events per day were more likely than single events. In these generally well-managed leisure pools, Cryptosporidium risk related to high bather loads. We conclude that public awareness campaigns for bather hygiene, and reminding pool operators of current guidance for managing faecal accidents, should be ahead of peak swim season

JADES: The production and escape of ionizing photons from faint Lyman-alpha emitters in the epoch of reionization

We present the properties of 17 faint Ly$\alpha$ emitting galaxies (LAEs) at $z>5.8$ from the JWST Advanced Deep Extragalactic Survey (JADES) in the Hubble Ultra Deep Field/GOODS-S. These LAEs span a redshift range $z\approx5.8-8.0$ and a UV magnitude range $M_{UV}\approx-17$ to $-20.6$, with the Ly$\alpha$ equivalent width (EW) in the range $\approx 25-350$ \AA. The detection of other rest-optical emission lines in the spectra of these LAEs enables the determination of accurate systemic redshifts and Ly{\alpha} velocity offsets, as well as the physical and chemical composition of their stars and interstellar media. These faint LAEs are consistent with metal-poor systems with high ionization parameters, similar to the general galaxy population at $z>6$. We measured an average ionizing photon production efficiency, log(\xi_\rm{ion}/erg$^{-1}$ Hz) $\approx25.57$ across our LAEs, which does not evolve strongly with redshift. We report an anti-correlation between the Ly$\alpha$ escape fraction (f_\rm{esc}) and the velocity offset from systemic redshift, consistent with model expectations. We further find that the strength and velocity offset of Ly$\alpha$ are neither correlated with galaxy spectroscopic properties nor with \xi_\rm{ion}. We find a decrease in f_\rm{esc}(Ly$\alpha$) with redshift, indicative of decreasing sizes of ionized bubbles around LAEs at high redshifts. We used a range of galaxy properties to predict Lyman continuum f_\rm{esc} for our LAEs, finding that the ionizing photon output into the intergalactic medium remains roughly constant across the observed Ly$\alpha$ EW, showing a mild increase at fainter M$_{UV}$ and at higher redshifts. We derived correlations between the ionizing photon output from LAEs and $M_{UV}$, Ly$\alpha$ EW and redshifts, which can be used to constrain the ionizing photon contribution of LAEs at $z > 6$ towards cosmic reionization.Comment: Accepted for publication in A&A. 24 pages, 13 figures, spectra presented in the appendix. This updated version includes the addition of one more LAE to the sample, ID 004296 at z=6.71

Inside the bubble: exploring the environments of reionisation-era Lyman-α emitting galaxies with JADES and FRESCO⋆

© 2024 The Author(s). Published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We present a study of the environments of 17 Lyman-α emitting galaxies (LAEs) in the reionisation-era (5.8 5%) observed in our sample of LAEs, suggesting the presence of ionised hydrogen along the line of sight towards at least eight out of 17 LAEs. We find minimum physical 'bubble'sizes of the order of R ion ∼ 0.1- 1pMpc are required in a patchy reionisation scenario where ionised bubbles containing the LAEs are embedded in a fully neutral IGM. Around half of the LAEs in our sample are found to coincide with large-scale galaxy overdensities seen in FRESCO at z ∼ 5.8- 5.9 and z ∼ 7.3, suggesting Lyman-α transmission is strongly enhanced in such overdense regions, and underlining the importance of LAEs as tracers of the first large-scale ionised bubbles. Considering only spectroscopically confirmed galaxies, we find our sample of UV-faint LAEs (M UV ≳ -20mag) and their direct neighbours are generally not able to produce the required ionised regions based on the Lyman-α transmission properties, suggesting lower-luminosity sources likely play an important role in carving out these bubbles. These observations demonstrate the combined power of JWST multi-object and slitless spectroscopy in acquiring a unique view of the early Universe during cosmic reionisation via the most distant LAEs.Peer reviewe

The Star-forming and Ionizing Properties of Dwarf z~6-9 Galaxies in JADES: Insights on Bursty Star Formation and Ionized Bubble Growth

Reionization is thought to be driven by faint star-forming galaxies, but characterizing this population in detail has long remained very challenging. Here we utilize deep nine-band NIRCam imaging from JADES to study the star-forming and ionizing properties of 756 $z\sim6-9$ galaxies, including hundreds of very UV-faint objects ($M_\mathrm{UV}>-18$). The faintest ($m\sim30$) galaxies in our sample typically have stellar masses of $M_\ast\sim(1-3)\times10^7$ $M_\odot$ and young light-weighted ages ($\sim$50 Myr), though some show strong Balmer breaks implying much older ages ($\sim$500 Myr). We find no evidence for extremely massive galaxies ($>3\times10^{10}$ $M_\odot$) in our sample. We infer a strong (factor $>$2) decline in the typical [OIII]$+$H$\beta$ EWs towards very faint $z\sim6-9$ galaxies, yet a weak UV luminosity dependence on the H$\alpha$ EWs at $z\sim6$. We demonstrate that these EW trends can be explained if fainter galaxies have systematically lower metallicities as well as more recently-declining star formation histories relative to the most UV-luminous galaxies in our sample. Our data provide evidence that the brightest galaxies are frequently experiencing a recent strong upturn in SFR. We also discuss how the EW trends may be influenced by a strong correlation between $M_\mathrm{UV}$ and Lyman continuum escape fraction. This alternative explanation has dramatically different implications for the contribution of galaxies along the luminosity function to cosmic reionization, highlighting the need for deep spectroscopic follow-up. Finally, we quantify the photometric overdensities around two $z>7$ strong Ly$\alpha$ emitters in the JADES footprint. One Ly$\alpha$ emitter lies close to a strong photometric overdensity while the other shows no significant nearby overdensity, perhaps implying that not all strong $z>7$ Ly$\alpha$ emitters reside in large ionized bubbles.Comment: 29 pages, 16 figures. Submitted to MNRAS. Comments welcom

The Cosmos in its Infancy: JADES Galaxy Candidates at z > 8 in GOODS-S and GOODS-N

We present a catalog of 717 candidate galaxies at $z > 8$ selected from 125 square arcminutes of NIRCam imaging as part of the JWST Advanced Deep Extragalactic Survey (JADES). We combine the full JADES imaging dataset with data from the JEMS and FRESCO JWST surveys along with extremely deep existing observations from HST/ACS for a final filter set that includes fifteen JWST/NIRCam filters and five HST/ACS filters. The high-redshift galaxy candidates were selected from their estimated photometric redshifts calculated using a template fitting approach, followed by visual inspection from seven independent reviewers. We explore these candidates in detail, highlighting interesting resolved or extended sources, sources with very red long-wavelength slopes, and our highest redshift candidates, which extend to $z_{phot} = 18$. We also investigate potential contamination by stellar objects, and do not find strong evidence from SED fitting that these faint high-redshift galaxy candidates are low-mass stars. Over 93\% of the sources are newly identified from our deep JADES imaging, including 31 new galaxy candidates at $z_{phot} > 12$. Using 42 sources in our sample with measured spectroscopic redshifts from NIRSpec and FRESCO, we find excellent agreement to our photometric redshift estimates, with no catastrophic outliers and an average difference of $\langle \Delta z = z_{phot}- z_{spec} \rangle= 0.26$. These sources comprise one of the most robust samples for probing the early buildup of galaxies within the first few hundred million years of the Universe's history.Comment: v2: 40 pages, 18 figures, submitted to AAS Journals, online data catalog (JADES Deep only) found at https://doi.org/10.5281/zenodo.809252

The Cosmos in its Infancy: JADES Galaxy Candidates at z > 8 in GOODS-S and GOODS-N

© 2024. The Author(s). Published by the American Astronomical Society. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/We present a catalog of 717 candidate galaxies at z > 8 selected from 125 square arcmin of NIRCam imaging as part of the JWST Advanced Deep Extragalactic Survey (JADES). We combine the full JADES imaging data set with data from the JWST Extragalactic Medium Survey and First Reionization Epoch Spectroscopic COmplete Survey (FRESCO) along with extremely deep existing observations from Hubble Space Telescope (HST)/Advanced Camera for Surveys (ACS) for a final filter set that includes 15 JWST/NIRCam filters and five HST/ACS filters. The high-redshift galaxy candidates were selected from their estimated photometric redshifts calculated using a template-fitting approach, followed by visual inspection from seven independent reviewers. We explore these candidates in detail, highlighting interesting resolved or extended sources, sources with very red long-wavelength slopes, and our highest-redshift candidates, which extend to z phot ∼ 18. Over 93% of the sources are newly identified from our deep JADES imaging, including 31 new galaxy candidates at z phot > 12. We also investigate potential contamination by stellar objects, and do not find strong evidence from spectral energy distribution fitting that these faint high-redshift galaxy candidates are low-mass stars. Using 42 sources in our sample with measured spectroscopic redshifts from NIRSpec and FRESCO, we find excellent agreement to our photometric redshift estimates, with no catastrophic outliers and an average difference of 〈Δz = z phot − z spec〉 = 0.26. These sources comprise one of the most robust samples for probing the early buildup of galaxies within the first few hundred million years of the Universe’s history.Peer reviewe

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials

Background Neoadjuvant chemotherapy (NACT) for early breast cancer can make breast-conserving surgery more feasible and might be more likely to eradicate micrometastatic disease than might the same chemotherapy given after surgery. We investigated the long-term benefits and risks of NACT and the influence of tumour characteristics on outcome with a collaborative meta-analysis of individual patient data from relevant randomised trials. Methods We obtained information about prerandomisation tumour characteristics, clinical tumour response, surgery, recurrence, and mortality for 4756 women in ten randomised trials in early breast cancer that began before 2005 and compared NACT with the same chemotherapy given postoperatively. Primary outcomes were tumour response, extent of local therapy, local and distant recurrence, breast cancer death, and overall mortality. Analyses by intention-to-treat used standard regression (for response and frequency of breast-conserving therapy) and log-rank methods (for recurrence and mortality). Findings Patients entered the trials from 1983 to 2002 and median follow-up was 9 years (IQR 5–14), with the last follow-up in 2013. Most chemotherapy was anthracycline based (3838 [81%] of 4756 women). More than two thirds (1349 [69%] of 1947) of women allocated NACT had a complete or partial clinical response. Patients allocated NACT had an increased frequency of breast-conserving therapy (1504 [65%] of 2320 treated with NACT vs 1135 [49%] of 2318 treated with adjuvant chemotherapy). NACT was associated with more frequent local recurrence than was adjuvant chemotherapy: the 15 year local recurrence was 21·4% for NACT versus 15·9% for adjuvant chemotherapy (5·5% increase [95% CI 2·4–8·6]; rate ratio 1·37 [95% CI 1·17–1·61]; p=0·0001). No significant difference between NACT and adjuvant chemotherapy was noted for distant recurrence (15 year risk 38·2% for NACT vs 38·0% for adjuvant chemotherapy; rate ratio 1·02 [95% CI 0·92–1·14]; p=0·66), breast cancer mortality (34·4% vs 33·7%; 1·06 [0·95–1·18]; p=0·31), or death from any cause (40·9% vs 41·2%; 1·04 [0·94–1·15]; p=0·45). Interpretation Tumours downsized by NACT might have higher local recurrence after breast-conserving therapy than might tumours of the same dimensions in women who have not received NACT. Strategies to mitigate the increased local recurrence after breast-conserving therapy in tumours downsized by NACT should be considered—eg, careful tumour localisation, detailed pathological assessment, and appropriate radiotherapy