Upper and Lower Respiratory Tract Viral Infections and Acute Graft Rejection in Lung Transplant Recipients

Background. Lung transplant recipients are frequently exposed to respiratory viruses and are particularly at risk for severe complications. The aim of this study was to assess the association among the presence of a respiratory virus detected by molecular assays in bronchoalveolar lavage (BAL) fluid, respiratory symptoms, and acute rejection in adult lung transplant recipients. Methods. Upper (nasopharyngeal swab) and lower (BAL) respiratory tract specimens from 77 lung transplant recipients enrolled in a cohort study and undergoing bronchoscopy with BAL and transbronchial biopsies were screened using 17 different polymerase chain reaction—based assays. Results. BAL fluid and biopsy specimens from 343 bronchoscopic procedures performed in 77 patients were analyzed. We also compared paired nasopharyngeal and BAL fluid specimens collected in a subgroup of 283 cases. The overall viral positivity rate was 29.3% in the upper respiratory tract specimens and 17.2% in the BAL samples (P < .001). We observed a significant association between the presence of respiratory symptoms and positive viral detection in the lower respiratory tract (P = .012). Conversely, acute rejection was not associated with the presence of viral infection (odds ratio, 0.41; 95% confidence interval, 0.20-0.88). The recovery of lung function was significantly slower when acute rejection and viral infection were both present. Conclusions. A temporal relationship exists between acute respiratory symptoms and positive viral nucleic acid detection in BAL fluid from lung transplant recipients. We provide evidence suggesting that respiratory viruses are not associated with acute graft rejection during the acute phase of infectio

Heart rate variability in association with frequent use of household sprays and scented products in SAPALDIA

Background: Household cleaning products are associated with adverse respiratory health outcomes, but the cardiovascular health effects are largely unknown.Objective: We determined if long-term use of household sprays and scented products at home was associated with reduced heart rate variability (HRV), a marker of autonomic cardiac dysfunction.Methods: We recorded 24-hr electrocardiograms in a cross-sectional survey of 581 Swiss adults, 1, 1-3, or 4-7 days/week, unexposed (reference)] of using cleaning sprays, air freshening sprays, and scented products.Results: Decreases in 24-hr SDNN and TP were observed with frequent use of all product types, but the strongest reductions were associated with air freshening sprays. Compared with unexposed participants, we found that using air freshening sprays 4-7 days/week was associated with 11% [95% confidence interval (CI): -20%, -2%] and 29% (95% CI: -46%, -8%) decreases in 24-hr SDNN and TP, respectively. Inverse associations of 24-SDNN and TP with increased use of cleaning sprays, air freshening sprays, and scented products were observed mainly in participants with obstructive lung disease (p > 0.05 for interactions).Conclusions: In predominantly older adult women, long-term frequent use of household spray and scented products was associated with reduced HRV, which suggests an increased risk of cardiovascular health hazards. People with preexisting pulmonary conditions may be more susceptibl

Thoughts of self-harm in early and late pregnancy in urban South Africa: Investigating prevalence, predictors and screening options

Background. Thoughts of self-harm (TSH) are an important marker of mental health risk, and risk for attempted and completed suicide. While there is increasing attention being paid to mental health problems in pregnancy in South Africa (SA), TSH have received less attention despite some cross-sectional studies suggesting that prevalence may be high (12 - 39%). There is a dearth of longitudinal research to inform prevention and treatment.Objectives. To examine the rates of TSH across pregnancy in a longitudinal SA cohort and to investigate factors associated with the onset and persistence of TSH, as well as the relationship between TSH, depression and/or anxiety.Methods. Women were enrolled in a prospective pregnancy cohort (S1000) in Soweto, SA between 2014 and 2016, and assessed using validated screening measures (Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Index short form) in early and later pregnancy. Data were available for 649 women. TSH were determined using EPDS item 10. Logistic regression and bifactor models were used to determine factors associated with TSH across pregnancy.Results. Of the 649 women, 18% reported TSH at some stage during their pregnancy. Prevalence of TSH was slightly higher in early pregnancy (12.5%) than later in pregnancy (11.6%). TSH were associated with a history of mental illness (adjusted odds ratio (aOR) 4.17; 95% confidence interval (CI) 1.3 - 13.7; p=0.020), concurrent depression (aOR 4.8; 95%CI 2.7 - 8.6; p&lt;0.001); marital stress (aOR 1.74; 95% CI 1.0 - 3.0; p=0.040); and practical support (aOR 0.43; 95% CI 0.2 - 1.0; p=0.040) using a multivariate logistic regression. Bifactor analysis examining depression and anxiety scales showed that TSH contributed the highest variance to a shared depression and anxiety factor in early pregnancy. Logistic regressions showed that early depression was a strong predictor of later reports of TSH.Conclusions. The present study shows that the risk of TSH during pregnancy is relatively common, and starts early during pregnancy. Screening approaches could be simplified to encourage healthcare practitioners working in busy and over-burdened public healthcare settings to engage in identifying at-risk women. Efforts in improving early identification of mental health risk in pregnancy should be matched with strengthening of current treatment and referral options. Since practical support and a good marital relationship reduce the risk of TSH, these may be important avenues of focus for designing interventions

ExTrA: Exoplanets in Transit and their Atmospheres

The ExTrA facility, located at La Silla observatory, will consist of a near-infrared multi-object spectrograph fed by three 60-cm telescopes. ExTrA will add the spectroscopic resolution to the traditional differential photometry method. This shall enable the fine correction of color-dependent systematics that would otherwise hinder ground-based observations. With both this novel method and an infrared-enabled efficiency, ExTrA aims to find transiting telluric planets orbiting in the habitable zone of bright nearby M dwarfs. It shall have the versatility to do so by running its own independent survey and also by concurrently following-up on the space candidates unveiled by K2 and TESS. The exoplanets detected by ExTrA will be amenable to atmospheric characterisation with VLTs, JWST, and ELTs and could give our first peek into an exo-life laboratory.Comment: 15 pages, 11 figures, SPIE 201

Undocumented Migrants in Switzerland: Geographical Origin Versus Legal Status as Risk Factor for Tuberculosis

Undocumented migrants, meaning migrants without a legal residency permit, come to Geneva from countries with high tuberculosis (TB) incidence. We estimate here whether being undocumented is a determinant of TB, independently of origin. Cross-sectional study including undocumented migrants in a TB screening program in 2002; results were compared to 12,904 age and frequency matched participants in a general TB screening program conducted at various workplaces in Geneva, Switzerland from 1992 to 2002. A total of 206 undocumented migrants (36% male, 64% female, mean age 37.8 years (SD 11.8), 82.5% from Latin America) participated in the TB screening program. Compared to legal residents, undocumented migrants had an adjusted OR for TB-related fibrotic signs of 1.7 (95% CI 0.8;3.7). The OR of TB-related fibrotic signs for Latin American (vs. other) origin was 2.7 (95% CI 1.6;4.7) among legal residents and 5.5 (95% CI 2.8;10.8) among undocumented migrants. Chest X-ray screening identified a higher proportion of TB-related fibrotic signs among Latin Americans, independently of their residency statu

Effective Dose and Persistence of Rhodamine-B in Wild Pig Vibrissae

As a result of substantial ecological and economic damage attributed to wild pigs (Sus scrofa), there is international interest in using pharmaceutical baits to control populations. To assess the efficacy and specificity of baiting programs, chemical biomarkers can be used to evaluate uptake of pharmaceutical baits. Rhodamine B (RB) is known to be an effective biomarker in wild pigs. However, significant data gaps exist regarding the minimum effective dosage and persistence of RB in wild pigs. We used a controlled doubleblind study experiment conducted in spring of 2014 on the Savannah River Site, Aiken, South Carolina, USA, wherein we administered a one-time dose of RB at 3 treatment levels (5 mg/kg, 15mg/kg, or 30 mg/kg) to 15 captive pigs, with 5 pigs/treatment group to investigate persistence of RB. Facial vibrissae were collected pre-RB ingestion as a control and every 2 weeks post-RB ingestion for 12 weeks. We examined samples for RB presence and used a generalized linear mixed model (GLMM) to determine the influence of treatment dose on persistence of RB. Additionally, we measured distance moved by the RB mark away from the vibrissae root and used a GLMM to assess movement rates of RB bands along growing vibrissae. We found consistently greater persistence of RB in the 15- and 30-mg/kg treatments across the sampling period. A significant, positive movement trend in RB bands was observed within the 15mg/kg and 30 mg/kg groups. Based on our results, a 15 mg/kg dosage can be considered a minimum effective dose for wild pigs and will reliably produce a detectable RB mark up to and likely beyond 12 weeks after ingestion

Maternal alcohol use and children’s emotional and cognitive outcomes in rural South Africa

Background. Alcohol use in South Africa (SA) is increasing. The World Health Organization (WHO) states that SA is the third-largest drinking population in Africa, with the highest rate of fetal alcohol syndrome in the world. Internationally, parental drinking during childhood is a risk factor for poor child mental health, behavioural problems and weaker educational outcomes in middle childhood. However, parental alcohol use in Africa is under-researched, and much of the literature on maternal alcohol consumption is restricted to clinical and pregnancy samples.Objectives. To investigate alcohol use and hazardous drinking (HD) among mothers/primary caregivers of children aged 7 - 11 years in a rural SA cohort. We explored risk factors for drinking and the association between HD and child behaviour/cognition.Methods. The primary outcome measure was the WHO Alcohol Use Disorder Identification Test (AUDIT) using the standardised cut-off for HD (≥8). Secondary measures were the Patient Health Questionnaire Depression Scale (PHQ-9), Patient Health Questionnaire General Anxiety Disorder Scale (GAD-7), Parenting Stress Index, short form (PSI-36), Child Behaviour Checklist (CBCL, parent reported), Kaufman Developmental Assessment Battery (KABC-II) for child cognition, and Neuropsychological Assessment Battery, 2nd edition, subtests (NEPSY-II) for executive function. We compared characteristics of those drinking/not drinking, using χ2 tests, and modelled outcomes on parenting stress, cognitive outcomes and CBCL scores for children using logistic regression analysis. We grouped mothers/caregivers engaged in HD to examine its effect on parent/child outcomes using t-tests to test for significant differences.Results. Of 1 505 women (1 266 mothers and 239 caregivers) with 1 536 children, 12% reported consuming alcohol and 3% reported HD. Higher maternal/caregiver age (31 - 40 years, adjusted odds ratio (aOR) 0.57 (95% confidence interval (CI) 0.4 - 0.9); &gt;41 years, aOR 0.30 (95% CI 0.2 - 0.5)), education (matriculation, aOR 0.49 (95% CI 0.3 - 0.9); post matriculation, aOR 0.30 (95% CI 0.1 - 0.6)), and a stable relationship with the father (aOR 0.6 (95% CI 0.4 - 1.0)) were associated with no alcohol use. Food insecurity increased the odds of alcohol use (aOR 1.52 (95% CI 1.1 - 2.1)), while parental mental health (parenting stress, anxiety) and child mental health problems were associated with approximately double the odds of consuming alcohol in univariate analysis. Children of HD mothers/caregivers had higher mean scores for psychological problems (CBCL total score: no HD (mean 45.0) v. HD (mean 48.9); p=0.029) and lower cognitive scores (KABC Learning Scale: no HD (mean 14.3) v. HD (mean 12.8); p=0.017).Conclusions. While HD rates were low, maternal/caregiver alcohol use negatively impacted on parenting and children’s behavioural/cognitive outcomes. International evidence suggests that integrated approaches engaging parents and families may be more effective for parent-child outcomes than individual psychiatric or medical care for the parent on their own.

PIONIER: a visitor instrument for the VLTI

PIONIER is a 4-telescope visitor instrument for the VLTI, planned to see its first fringes in 2010. It combines four ATs or four UTs using a pairwise ABCD integrated optics combiner that can also be used in scanning mode. It provides low spectral resolution in H and K band. PIONIER is designed for imaging with a specific emphasis on fast fringe recording to allow closure-phases and visibilities to be precisely measured. In this work we provide the detailed description of the instrument and present its updated status.Comment: Proceedings of SPIE conference Optical and Infrared Interferometry II (Conference 7734) San Diego 201

Shadows cast on the transition disk of HD 135344B. Multiwavelength VLT/SPHERE polarimetric differential imaging

The protoplanetary disk around the F-type star HD 135344B (SAO 206462) is in a transition stage and shows many intriguing structures both in scattered light and thermal (sub-)millimeter emission which are possibly related to planet formation processes. We study the morphology and surface brightness of the disk in scattered light to gain insight into the innermost disk regions, the formation of protoplanets, planet-disk interactions traced in the surface and midplane layers, and the dust grain properties of the disk surface. We have carried out high-contrast polarimetric differential imaging (PDI) observations with VLT/SPHERE and obtained polarized scattered light images with ZIMPOL in R- and I-band and with IRDIS in Y- and J-band. The scattered light images reveal with unprecedented angular resolution and sensitivity the spiral arms as well as the 25 au cavity of the disk. Multiple shadow features are discovered on the outer disk with one shadow only being present during the second observation epoch. A positive surface brightness gradient is observed in the stellar irradiation corrected images in southwest direction possibly due to an azimuthally asymmetric perturbation of the temperature and/or surface density by the passing spiral arms. The disk integrated polarized flux, normalized to the stellar flux, shows a positive trend towards longer wavelengths which we attribute to large aggregate dust grains in the disk surface. Part of the the non-azimuthal polarization signal in the Uphi image of the J-band observation could be the result of multiple scattering in the disk. The detected shadow features and their possible variability have the potential to provide insight into the structure of and processes occurring in the innermost disk regions.Comment: Accepted for publication in A&A, 20 pages, 15 figure