Norovirus outbreak in a natural playground: A One Health approach.

Norovirus constitutes the most frequently identified infectious cause of disease outbreaks associated with untreated recreational water. When investigating outbreaks related to surface water, a One Health approach is insightful. Historically, there has been a focus on potential contamination of recreational water by bird droppings and a recent publication demonstrating human noroviruses in bird faeces suggested this should be investigated in future water-related norovirus outbreaks. Here, we describe a One Health approach investigating a norovirus outbreak in a natural playground. On social media, a large amount of waterfowl were reported to defecate near these playground premises leading to speculations about their potential involvement. Surface water, as well as human and bird faecal specimens, was tested for human noroviruses. Norovirus was found to be the most likely cause of the outbreak but there was no evidence for transmission via waterfowl. Cases had become known on social media prior to notification to the public health service underscoring the potential of online media as an early warning system. In view of known risk factors, advice was given for future outbreak investigations and natural playground design

Affinity Inequality among Serum Antibodies That Originate in Lymphoid Germinal Centers

Upon natural infection with pathogens or vaccination, antibodies are produced by a process called affinity maturation. As affinity maturation ensues, average affinity values between an antibody and ligand increase with time. Purified antibodies isolated from serum are invariably heterogeneous with respect to their affinity for the ligands they bind, whether macromolecular antigens or haptens (low molecular weight approximations of epitopes on antigens). However, less is known about how the extent of this heterogeneity evolves with time during affinity maturation. To shed light on this issue, we have taken advantage of previously published data from Eisen and Siskind (1964). Using the ratio of the strongest to the weakest binding subsets as a metric of heterogeneity (or affinity inequality), we analyzed antibodies isolated from individual serum samples. The ratios were initially as high as 50-fold, and decreased over a few weeks after a single injection of small antigen doses to around unity. This decrease in the effective heterogeneity of antibody affinities with time is consistent with Darwinian evolution in the strong selection limit. By contrast, neither the average affinity nor the heterogeneity evolves much with time for high doses of antigen, as competition between clones of the same affinity is minimal.Ragon Institute of MGH, MIT and HarvardSamsung Scholarship FoundationNational Science Foundation (U.S.). Graduate Research Fellowship (Grant 1122374

Semiautomated surveillance of deep surgical site infections after primary total hip or knee arthroplasty

Manual surveillance of surgical site infections (SSIs) after total hip or knee arthroplasty is time-consuming and prone to error. Semiautomated surveillance based on routine care data extracted from electronic health records can retrospectively identify deep SSIs and substantially reduce workload while maintaining 100% sensitivity

Fc receptor-mediated phagocytosis in tissues as a potent mechanism for preventive and therapeutic HIV vaccine strategies

Although the development of a fully protective HIV vaccine is the ultimate goal of HIV research, to date only one HIV vaccine trial, the RV144, has successfully induced a weakly protective response. The 31% protection from infection achieved in the RV144 trial was linked to the induction of nonneutralizing antibodies, able to mediate antibody-dependent cell-mediated cytotoxicity (ADCC), suggestive of an important role of Fc-mediated functions in protection. Similarly, Fc-mediated antiviral activity was recently shown to play a critical role in actively suppressing the viral reservoir, but the Fc effector mechanisms within tissues that provide protection from or after infection are largely unknown. Here we aimed to define the landscape of effector cells and Fc receptors present within vulnerable tissues. We found negligible Fc receptor-expressing natural killer cells in the female reproductive and gastrointestinal mucosa. Conversely, Fc receptor-expressing macrophages were highly enriched in most tissues, but neutrophils mediated superior antibody-mediated phagocytosis. Modifications in Fc domain of VRC01 antibody increased phagocytic responses in both phagocytes. These data suggest that non-ADCC-mediated mechanisms, such as phagocytosis and neutrophil activation, are more likely to play a role in preventative vaccine or reservoir-eliminating therapeutic approaches

Assessment of bioaccessibility and exposure risk of arsenic and lead in urban soils of Guangzhou City, China

Soil ingestion is an important human exposure pathway of heavy metals in urban environments with heavy metal contaminated soils.This study aims to assess potential health risks of heavy metals in soils sampled from an urban environment where high frequency of human exposure may be present. A bioaccessibility test is used, which is an in vitro gastrointestinal (IVG) test of soluble metals under simulated physiological conditions of the human digestion system. Soil samples for assessing the oral bioaccessibility of arsenic (As) and lead (Pb) were collected from a diverse range of different land uses, including urban parks, roadsides, industrial sites and residential areas in Guangzhou City, China. The soil samples contained a wide range of total As (10.2 to 61.0 mg kg) and Pb (38.4 to 348 mg kg) concentrations. The bioaccessibility of As and Pb in the soil samples were 11.3 and 39.1% in the stomach phase, and 1.9 and 6.9% in the intestinal phase, respectively. The As and Pb bioaccessibility in the small intestinal phase was significantly lower than those in the gastric phase. Arsenic bioaccessibility was closely influenced by soil pH and organic matter content (r = 0.451, p residential area/road side. Although the risk of heavy metal exposure from direct ingestion of urban soils is relatively low, the risk of inhalation of fine soil particulates in the air remains to be evaluated

Progress toward fully noninductive, high beta conditions in DIII-D

The DIII-D Advanced Tokamak (AT) program in the DIII-D tokamak [J. L. Luxon, Plasma Physics and Controlled Fusion Research, 1986, Vol. I (International Atomic Energy Agency, Vienna, 1987), p. 159] is aimed at developing a scientific basis for steady-state, high-performance operation in future devices. This requires simultaneously achieving 100% noninductive operation with high self-driven bootstrap current fraction and toroidal beta. Recent progress in this area includes demonstration of 100% noninductive conditions with toroidal beta, ΒT =3.6%, normalized beta, ΒN =3.5, and confinement factor, H89 =2.4 with the plasma current driven completely by bootstrap, neutral beam current drive, and electron cyclotron current drive (ECCD). The equilibrium reconstructions indicate that the noninductive current profile is well aligned, with little inductively driven current remaining anywhere in the plasma. The current balance calculation improved with beam ion redistribution that was supported by recent fast ion diagnostic measurements. The duration of this state is limited by pressure profile evolution, leading to magnetohydrodynamic (MHD) instabilities after about 1 s or half of a current relaxation time (τCR). Stationary conditions are maintained in similar discharges (∼90% noninductive), limited only by the 2 s duration (1 τCR) of the present ECCD systems. By discussing parametric scans in a global parameter and profile databases, the need for low density and high beta are identified to achieve full noninductive operation and good current drive alignment. These experiments achieve the necessary fusion performance and bootstrap fraction to extrapolate to the fusion gain, Q=5 steady-state scenario in the International Thermonuclear Experimental Reactor (ITER) [R. Aymar, Fusion Energy Conference on Controlled Fusion and Plasma Physics, Sorrento, Italy (International Atomic Energy Agency, Vienna, 1987), paper IAEA-CN-77/OV-1]. The modeling tools that have been successfully employed to both plan and interpret the experiment are used to plan future DIII-D experiments with higher power and longer pulse ECCD and fast wave and co- and counterneutral beam injection in a pumped double-null configuration. The models predict our ability to control the current and pressure profiles to reach full noninductivity with increased beta, bootstrap fraction, and duration. The same modeling tools are applied to ITER, predicting favorable prospects for the success of the ITER steady-state scenario. © 2006 American Institute of Physics