Generation of neutralizing antibodies and divergence of SIVmac239 in cynomolgus macaques following short-term early antiretroviral therapy.

Neutralizing antibodies (NAb) able to react to heterologous viruses are generated during natural HIV-1 infection in some individuals. Further knowledge is required in order to understand the factors contributing to induction of cross-reactive NAb responses. Here a well-established model of experimental pathogenic infection in cynomolgus macaques, which reproduces long-lasting HIV-1 infection, was used to study the NAb response as well as the viral evolution of the highly neutralization-resistant SIVmac239. Twelve animals were infected intravenously with SIVmac239. Antiretroviral therapy (ART) was initiated ten days post-inoculation and administered daily for four months. Viral load, CD4(+) T-cell counts, total IgG levels, and breadth as well as strength of NAb in plasma were compared simultaneously over 14 months. In addition, envs from plasma samples were sequenced at three time points in all animals in order to assess viral evolution. We report here that seven of the 12 animals controlled viremia to below 10(4) copies/ml of plasma after discontinuation of ART and that this control was associated with a low level of evolutionary divergence. Macaques that controlled viral load developed broader NAb responses early on. Furthermore, escape mutations, such as V67M and R751G, were identified in virus sequenced from all animals with uncontrolled viremia. Bayesian estimation of ancestral population genetic diversity (PGD) showed an increase in this value in non-controlling or transient-controlling animals during the first 5.5 months of infection, in contrast to virus-controlling animals. Similarly, non- or transient controllers displayed more positively-selected amino-acid substitutions. An early increase in PGD, resulting in the generation of positively-selected amino-acid substitutions, greater divergence and relative high viral load after ART withdrawal, may have contributed to the generation of potent NAb in several animals after SIVmac239 infection. However, early broad NAb responses correlated with relatively preserved CD4(+) T-cell numbers, low viral load and limited viral divergence

Environmental impact of recycling nutrients in human excreta to agriculture compared with enhanced wastewater treatment

AbstractHuman excreta are potential sources of plant nutrients, but are today usually considered a waste to be disposed of. The requirements on wastewater treatment plants (WWTPs) to remove nitrogen and phosphorus are increasing and to meet these requirements, more energy and chemicals are needed by WWTPs. Separating the nutrient-rich wastewater fractions at source and recycling them to agriculture as fertiliser is an alternative to removing them at the WWTP. This study used life cycle assessment methodology to compare the environmental impact of different scenarios for recycling the nutrients in the human excreta as fertiliser to arable land or removing them in an advanced WWTP. Three scenarios were assessed. In blackwater scenario, blackwater was source-separated and used as fertiliser. In urine scenario, the urine fraction was source-separated and used as fertiliser and the faecal water treated in an advanced WWTP. In NP scenario, chemical fertiliser was used as fertiliser and the toilet water treated in an advanced WWTP. The emissions from the WWTP were the same for all scenarios. This was fulfilled by the enhanced reduction in the WWTP fully removing the nutrients from the excreta that were not source-separated in the NP and urine scenarios. Recycling source-separated wastewater fractions as fertilisers in agriculture proved efficient for conserving energy and decreasing global warming potential (GWP). However, the blackwater and urine scenarios had a higher impact on potential eutrophication and potential acidification than the WWTP-chemical fertiliser scenario, due to large impacts by the ammonia emitted from storage and after spreading of the fertilisers. The cadmium input to the arable soil was very small with urine fertiliser. Source separation and recycling of excreta fractions as fertiliser thus has potential for saving energy and decreasing GWP emissions associated with wastewater management. However, for improved sustainability, the emissions from storage and after spreading of these fertilisers must decrease

Carbon footprint of urban source separation for nutrient recovery

Source separation systems for the management of domestic wastewater and food waste has been suggested as more sustainable sanitation systems for urban areas. The present study used an attributional life cycle assessment to investigate the carbon footprint and potential for nutrient recovery of two sanitation systems for a hypothetical urban area in Southern Sweden. The systems represented a typical Swedish conventional system and a possible source separation system with increased nutrient recovery. The assessment included the management chain from household collection, transport, treatment and final return of nutrients to agriculture or disposal of the residuals. The results for carbon footprint and nutrient recovery (phosphorus and nitrogen) concluded that the source separation system could increase nutrient recovery (0.30–0.38 kg P capita−1 year−1 and 3.10–3.28 kg N capita−1 year−1), while decreasing the carbon footprint (−24 to −58 kg CO2-eq. capita−1 year−1), compared to the conventional system. The nutrient recovery was increased by the use of struvite precipitation and ammonium stripping at the wastewater treatment plant. The carbon footprint decreased, mainly due to the increased biogas production, increased replacement of mineral fertilizer in agriculture and less emissions of nitrous oxide from wastewater treatment. In conclusion, the study showed that source separation systems could potentially be used to increase nutrient recovery from urban areas, while decreasing the climate impact

The societal costs of problem gambling in Sweden

Background: Problem gambling is a public health issue affecting both the gamblers, their families, their employers, and society as a whole. Recent law changes in Sweden oblige local and regional health authorities to invest more in prevention and treatment of problem gambling. The economic consequences of gambling, and thereby the potential economic consequences of policy changes in the area, are unknown, as the cost of problem gambling to society has remained largely unexplored in Sweden and similar settings. Methods: A prevalence-based cost-of-illness study for Sweden for the year 2018 was conducted. A societal approach was chosen in order to include direct costs (such as health care and legal costs), indirect costs (such as lost productivity due to unemployment), and intangible costs (such as reduced quality of life due to emotional distress). Costs were estimated by combining epidemiological and unit cost data. Results: The societal costs of problem gambling amounted to 1.42 billion euros in 2018, corresponding to 0.30% of the gross domestic product. Direct costs accounted only for 13% of the total costs. Indirect costs accounted for more than half (59%) of the total costs, while intangible costs accounted for 28%. The societal costs were more than twice as high as the tax revenue from gambling in 2018. Direct and indirect costs of problem gambling combined amounted to one third of the equivalent costs of smoking and one sixth of the costs of alcohol consumption in Sweden. Conclusions: Problem gambling is increasingly recognized as a public health issue. The societal costs of it are not negligible, also in relation to major public health issues of an addictive nature such as smoking and alcohol consumption. Direct costs for prevention and treatment are very low. A stronger focus on prevention and treatment might help to reduce many of the very high indirect and intangible costs in the future