Coliform as an indicator of waterborne microbial pathogens : identification using DNA sequencing

Coliforms are a group of bacteria that since the end of the 1900s’ have been used as an indicator for fecal contamination of water. With advances in microbiology in the 1900’s it became clear that the coliform group is large and varied group of bacteria and not ideal to use as indicator of waterborne pathogens. However, in lack of better indicator organisms for fecal pollution of water, it is still used. The aims of this study are to give an overview of water quality in the view of global goals, to identify coliform bacteria from water samples and to discuss the results in the light of new achievements in ongoing development of new identification methods. In this study coliforms from collected water samples have been identified and their presumed identity based on growth on chromogenic differential agar have been compared with 16S rDNA-sequencing. Out of 14 samples, 12 where confirmed to be coliforms by the 16S rDNA-sequencing. In addition to identify bacteria from water samples the different detection methods of coliforms are discussed. In relationship to the global goals, which aims to achieve universal access to safe and affordable drinking water by 2030, it is concluded that new, faster and cheaper methods are required to achieve universal basic WASH services by 2030. A suggestion on such a method is Loop-Mediated Isothermal Amplification (LAMP)

Non-pharmaceutical prevention of hip fractures – a cost-effectiveness analysis of a community-based elderly safety promotion program in Sweden

<p>Abstract</p> <p>Background</p> <p>Elderly injuries are a recognized public health concern and are due to two factors; osteoporosis and accidental falls. Several osteoporosis pharmaceuticals are considered cost-effective, but intervention programs aiming at preventing falls should also be subjected to economic evaluations. This study presents a cost-effectiveness analysis of a community-based elderly safety promotion program.</p> <p>Methods</p> <p>A five-year elderly safety promotion program combining environmental structural changes with individually based measures was implemented in a community in the metropolitan area of Stockholm, Sweden. The community had around 5,500 inhabitants aged 65+ years and a first hip fracture incidence of 10.7 per 1,000 in pre-intervention years 1990–1995. The intervention outcome was measured as avoided hip fractures, obtained from a register-based quasi-experimental longitudinal analysis with several control areas. The long-term consequences in societal costs and health effects due to the avoided hip fractures, conservatively assumed to be avoided for one year, were estimated with a Markov model based on Swedish data. The analysis holds the societal perspective and conforms to recommendations for pharmaceutical cost-effectiveness analyses.</p> <p>Results</p> <p>Total societal intervention costs amounted to 6.45 million SEK (in Swedish krona 2004; 1 Euro = 9.13 SEK). The number of avoided hip fractures during the six-year post-intervention period was estimated to 14 (0.44 per 1,000 person-years). The Markov model estimated a difference in societal costs between an individual that experiences a first year hip fracture and an individual that avoids a first year hip fracture ranging from 280,000 to 550,000 SEK, and between 1.1 and 3.2 QALYs (quality-adjusted life-years, discounted 3%), for males and females aged 65–79 years and 80+ years. The cost-effectiveness analysis resulted in zero net costs and a gain of 35 QALYs, and the do-nothing alternative was thus dominated.</p> <p>Conclusion</p> <p>The community-based elderly safety promotion program aiming at preventing accidental falls seems as cost-effective as osteoporosis pharmaceuticals.</p

Cereals as ‘leftover biomass’

In a time with climate change and a growing population it is important to use the arable land as effectively as possible to ensure food security and minimize environmental impacts. Currently, livestock production uses 70% of all agricultural land which highlights the competition between the usage of land for crops for feed rather than for human consumption. The overarching aim of this thesis is to analyse Swedish cereal production from the perspective of feed-food competition. The objective is to understand to what extent cereals produced in Sweden can be considered a left-over biomass, that is, unsuitable for human consumption and the reasons for that. The present work looked at current use of Swedish cereals as well as the quality criteria for food and feed cereals. This study shows that most of the cereals produced in Sweden are used for feed and that a great extent of the cereals used for feed reaches food quality. However, this is not to say that all cropland that is currently used to grow cereals for feed could instead be used to grow cereals that will reach the current quality criteria. This study has shown the current quality criteria used for cereals could be lowered in some aspects for cereals that are going to be used for example food-grains and groats. The conclusion of this study is that the amount of cereals that can be considered truly a leftover biomass, from growing cereals for human consumption, is small in Sweden.För att säkra tillgången till mat för jordens befolkning är det viktigt att använda jordbruksmarken så effektivt som möjligt. Särskilt med tanke på rådande klimatförändringar och att befolkningsmängden ökar. Idag använder animalieproduktion 70% av all jordbruksmark. Detta belyser konceptet ‘feed-food competition’ som beskriver användandet av jordbruksmark till att odla foder istället för att odla grödor till humanföda. Det övergripande syftet för denna masteruppsats är att analysera svensk spannmålsproduktion utifrån ett ‘feed-food competition’ perspektiv. Målet är att förstå i vilken utsträckning svenskt spannmål är olämpligt för humankonsumtion och orsakerna till detta. För att besvara de grundläggande frågeställningarna undersöktes användningen av svenskt spannmål samt kvalitetskriterierna för spannmål för mat och foder. Resultatet av denna studie visar att den största andelen spannmål som produceras i Sverige används till foder och att en stor del av foderspannmålet uppnår kvalitén för att användas till livsmedel. Dock är det, troligtvis, inte möjligt att odla spannmål av livsmedelskvalitet, med nuvarande kvalitetskrav, på all svensk åkermark. Den här studien visar att nuvarande kvalitetskriterier för livsmedelsspannmål kan sänkas i vissa aspekter för spannmål som kommer användas till produkter som till exempel gryn. Slutsatsen av denna studie är att endast en liten del av spannmålen som odlas i Sverige, i livsmedelssyfte, kan anses ej tjänligt som människoföda

Hur tar kommuner hänsyn till miljökvalitetsmålet begränsad klimatpåverkan vid gatu- och trafikplanering? - En studie om Lunds och Malmös kommun

Swedish environmental politics is held together by an environmental objectives system consisting of one generational goal, 16 environmental quality objectives and 24 milestone targets. In order to achieve these objectives municipalities are considered to play an important role. The purpose of this study is to examine how municipalities can take reduced climate impact into account when they deal with road planning. Furthermore, the purpose is to describe what role municipalities play in the Swedish environmental objectives system. This study focuses on Lund and Malmö. The issues examined are: What is the role of municipalities in the work of reaching the environmental quality objective reduces climate impact, when they are dealing with road planning? How can municipalities take reduced climate impact into account when they deal with road planning? To answer these questions both literature reviews and interviews have been made. Legislation related to city planning and road planning have been studied to sort out how far the decision making competence of municipalities goes. Strategic document and plans from Lund and Malmö were observed in order to see how they chosen to coordinate reduced climate impact with their work concerning road planning. Interviews have also been made with officials from the traffic department of both Lund and Malmö to clarify in what way they are involved with the environmental objectives. This study shows that municipalities are important players in the effort of reducing greenhouse gas emissions from the traffic. In order to do this successfully Lund and Malmö mainly has three instruments available: physical planning, traffic regulation and an active work with behavioral change. However, municipalities are free to choose to what extent they want to contribute to the environmental objectives and it is therefore up to each municipality to set up their own objectives. In the current situation, problems arise when municipalities that have different ambitions needs to cooperate concerning these questions.Sveriges miljöpolitik kretsar kring ett gemensamt miljömålssystem med sexton miljökvalitetsmål, tjugofyra etappmål och ett övergripande mål om att kunna ”lämna över ett samhälle där de stora miljöproblemen i Sverige är lösta”. För att uppnå målen krävs det ett engagemang från en mängd olika samhällsaktörer inom olika samhällssektorer. Samtidigt är det oklart vem som ansvarar för att detta verkligen ska ske. Endast två av de sexton uppsatta miljökvalitetsmålen bedöms kunna uppnås med ”idag beslutade styrmedel och med genomförda åtgärder före år 2020”. Detta kan ses som både oroväckande och ett dåligt betyg på svensk miljöpolitik. Kommunerna anses som viktiga aktörer för att uppnå miljömålen men saknar samtidigt formellt ansvar för att arbeta aktivt med målen. Detta kan utgöra ett problem för huruvida målen uppfylls eller ej och risken finns att ett glapp uppstår mellan Sveriges miljömålsarbete och kommuners fysiska planering. Därför är det viktigt att undersöka vilken betydelse miljömålen har då planering av hur kommuner ska byggas sker. Denna studie belyser kommuners roll i det svenska miljömålsarbetet vid planering av gator och trafik, och undersöker hur miljökvalitetsmålet begränsad klimatpåverkan vägs in i Lunds och Malmös gatu- och trafikplanering. Resultaten visar att kommuners arbete med gatu- och trafikfrågor har stor betydelse för huruvida begränsad klimatpåverkan är möjligt att uppnå. Sveriges kommuner har en viktig och unik roll i arbetet med att uppnå begränsad klimatpåverkan, vilket till stor del beror på att de sitter på det kommunala plan monopolet. De arbetsområden inom gatu- och trafikplanering där kommuner har goda möjligheter att ta hänsyn till begränsad klimatpåverkan är: fysisk planering, trafikreglering och att jobba med beteendeförändringar. För att på ett framgångsrikt sätt kunna jobba med detta krävs det att enskilda kommuner på mer eller mindre eget intiativ väljer att ta sitt ansvar och vågar göra nödvändiga prioriteringar mellan olika samhällsintressen. Vidare bygger det på att kommuner lyckas samarbeta och samordna sina målsättningar med andra kommuner och myndigheter. I vilken mån Sveriges kommuner väljer att försöka göra detta återstår att se. En tydligare ansvarsfördelning inom det svenska miljömålssystemet hade kunnat underlätta för att skapa dessa förutsättningar

Novel Small Leucine-Rich Protein Chondroadherin-like (CHADL) is Expressed in Cartilage and Modulates Chondrocyte Differentiation.

The constitution and biophysical properties of extracellular matrices can dramatically influence cellular phenotype during development, homeostasis, or pathogenesis. These effects can be signaled through a differentially regulated assembly of collagen fibrils, orchestrated by a family of collagen-associated Small Leucine-Rich Proteins, SLRPs. In this report, we describe the tissue-specific expression and function of a previously uncharacterized SLRP Chondroadherin-like (CHADL). We have developed antibodies against CHADL and, by immunohistochemistry, detected CHADL expression mainly in skeletal tissues, particularly in fetal cartilage and in pericellular space of adult chondrocytes. In situ hybridizations and immunoblots on tissue lysates confirmed this tissue-specific expression pattern. Recombinant CHADL bound collagen in cell culture, and inhibited in vitro collagen fibrillogenesis. After Chadl shRNA knockdown chondrogenic ATDC5 cells increased their proliferation and differentiation, indicated by increased transcript levels of Sox9, Ihh, Col2a1, and Col10a1. The knockdown increased collagen II and aggrecan deposition in the cell layers. Microarray analysis of the knockdown samples suggested collagen receptor-related changes, although other upstream effects could not be excluded. Together, our data indicate that the novel SLRP CHADL is expressed in cartilaginous tissues, influences collagen fibrillogenesis, and modulates chondrocyte proliferation and differentiation. CHADL appears to have a negative regulatory role, possibly ensuring the formation of a stable extracellular matrix

Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden – a randomized trial

<p>Abstract</p> <p>Background</p> <p>Tobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to oral problems and diseases. Dentistry may be a potential setting for several aspects of clinical public health interventions and there is a growing interest in several countries to develop tobacco cessation support in dentistry setting. The aim of the present study was to assess the relative effectiveness of a high intensity intervention compared with a low intensity intervention for smoking cessation support in a dental clinic setting.</p> <p>Methods</p> <p>300 smokers attending dental or general health care were randomly assigned to two arms and referred to the local dental clinic for smoking cessation support. One arm received support with low intensity treatment (LIT), whereas the other group was assigned to high intensity treatment (HIT) support. The main outcome measures included self-reported point prevalence and continuous abstinence (≥ 183 days) at the 12-month follow-up.</p> <p>Results</p> <p>Follow-up questionnaires were returned from 86% of the participants. People in the HIT-arm were twice as likely to report continuous abstinence compared with the LIT-arm (18% vs. 9%, p = 0.02). There was a difference (not significant) between the arms in point prevalence abstinence in favour of the HIT-protocol (23% vs. 16%). However, point prevalence cessation rates in the LIT-arm reporting additional support were relatively high (23%) compared with available data assessing abstinence in smokers trying to quit without professional support.</p> <p>Conclusion</p> <p>Screening for willingness to quit smoking within the health care system and offering smoking cessation support within dentistry may be an effective model for smoking cessation support in Sweden. The LIT approach is less expensive and time consuming and may be appropriate as a first treatment option, but should be integrated with other forms of available support in the community. The more extensive and expensive HIT-protocol should be offered to those who are unable to quit with the LIT approach in combination with other support.</p> <p>Trial Registration</p> <p>Trial registration number: NCT00670514</p

Imiquimod shows anti-viral actions in human bronchial epithelium - implications for COVID-19 treatment

Introduction: Combining anti-viral and anti-inflammatory effects in a single drug may be beneficial in treating COVID-19. We hypothesized that the TLR7 agonist imiquimod (imq) may exert these actions in human bronchial epithelial cells (HBECs), which are targets in SARS-CoV-2 mediated lung injury. Methods: Using primary HBECs from asthmatic donors (N=18), we explored actions of imq related to airway viral resistance and tolerance. HBECs were treated with imq alone or in combination with the viral mimic poly (I:C) or the SARS-CoV-2 spike protein 1 (SP1). Anti-viral and pro-inflammatory mediators were analyzed by Luminex, RT-qPCR and mRNA gene pathway analysis. Results: imq treatment alone induced IFN-ß and CCL5 (p<0.05) mRNA and reduced transcription of IL-1ß (p<0.01) at 24h. In SP1 or poly (I:C) stimulated HBECs, treatment with imq augmented IFN-ß mRNA expression by a 2-fold, respectively (p<0.05). Imq in combination with poly (I:C) decreased protein release of IL-8, CCL5, IL-1ß and IL-6 (p<0.05). Furthermore, gene pathway analysis revealed that imq enriched poly(I:C)-induced IFN signaling, IL-20 family signaling (epithelial repair), antigen presentation and cytokine signaling. Enriched cytokine signaling genes included negative regulators such as IKBKG and SIGIRR. Conclusion: imq exerts distinct anti-viral resistance effects in HBECs by increasing anti-viral signaling and improves viral infection tolerance by diminishing epithelial cytokines potentially involved in severe COVID-19. Our findings highlight a possibility of developing dual action drugs suitable for anti-SARS-CoV-2 treatment

C57Bl/6N mice have an attenuated lung inflammatory response to dsRNA compared to C57Bl/6J and BALB/c mice

Background Lower respiratory infections caused by ssRNA viruses are a major health burden globally. Translational mouse models are a valuable tool for medical research, including research on respiratory viral infections. In in vivo mouse models, synthetic dsRNA can be used as a surrogate for ssRNA virus replication. However, studies investigating how genetic background of mice impacts the murine lung inflammatory response to dsRNA is lacking. Hence, we have compared lung immunological responses of BALB/c, C57Bl/6N and C57Bl/6J mice to synthetic dsRNA. Methods dsRNA was administered intranasally to BALB/c, C57Bl/6N and C57Bl/6J mice once/day for three consecutive days. Lactate dehydrogenase (LDH) activity, inflammatory cells, and total protein concentration were analyzed in bronchoalveolar lavage fluid (BALF). Pattern recognition receptors levels (TLR3, MDA5 and RIG-I) were measured in lung homogenates using RT-qPCR and western blot. Gene expression of IFN-β, TNF-α, IL-1β and CXCL1 was assessed in lung homogenates by RT-qPCR. ELISA was used to analyze protein concentrations of CXCL1 and IL-1β in BALF and lung homogenates. Results BALB/c and C57Bl/6J mice showed infiltration of neutrophils to the lung, and an increase in total protein concentration and LDH activity in response to dsRNA administration. Only modest increases in these parameters were observed for C57Bl/6N mice. Similarly, dsRNA administration evoked an upregulation of MDA5 and RIG-I gene and protein expression in BALB/c and C57Bl/6J, but not C57Bl/6N, mice. Further, dsRNA provoked an increase in gene expression of TNF-α in BALB/c and C57Bl/6J mice, IL-1β only in C57Bl/6N mice and CXCL1 exclusively in BALB/c mice. BALF levels of CXCL1 and IL-1β were increased in BALB/c and C57Bl/6J mice in response to dsRNA, whereas the response of C57Bl/6N was blunt. Overall, inter-strain comparisons of the lung reactivity to dsRNA revealed that BALB/c, followed by C57Bl/6J, had the most pronounced respiratory inflammatory responses, while the responses of C57Bl/6N mice were attenuated. Conclusions We report clear differences of the lung innate inflammatory response to dsRNA between BALB/c, C57Bl/6J and C57Bl/6N mice. Of particular note, the highlighted differences in the inflammatory response of C57Bl/6J and C57Bl/6N substrains underscore the value of strain selection in mouse models of respiratory viral infections

Structural validity of the Finnish Manchester-Oxford Foot Questionnaire (MOXFQ) using the Rasch model

Background: The 16-item patient-reported Manchester-Oxford Foot Questionnaire (MOXFQ) with subscales of pain, social interactions, and walking/standing has been claimed for strongest scientific evidence in measuring foot and ankle complaints. This study tests the validity of the Finnish MOXFQ for orthopaedic foot and ankle population using the Rasch analysis. Methods: We translated the MOXFQ into Finnish and used that translation in our study. MOXFQ scores were obtained from 183 patients. Response category distribution, item fit, coverage, targeting, item dependency, ability to measure latent trait (unidimensionality), internal consistency (Cronbach's alpha), and person separation index (PSI) were analyzed. Results: Fifteen of the items had ordered response categories and/or sufficient fit statistics. The subscales provided coverage and targeting. Some residual correlation was noted. Removing one item in the pain subscale led to a unidimensional structure. Alphas and PSIs ranged between 0.68-0.90 and 0.67-0.92, respectively. Conclusions: Despite some infractions of the Rasch model, the instrument functioned well. The subscales of the MOXFQ are meaningful for assessing patient-reported complaints and outcomes in orthopaedic foot and ankle population. (C) 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Mortality in GOLD stages of COPD and its dependence on symptoms of chronic bronchitis

BACKGROUND: The GOLD classification of COPD severity introduces a stage 0 (at risk) comprising individuals with productive cough and normal lung function. The aims of this study were to investigate total mortality risks in GOLD stages 0–4 with special focus on stage 0, and furthermore to assess the influence of symptoms of chronic bronchitis on mortality risks in GOLD stages 1–4. METHOD: Between 1974 and 1992, a total of 22 044 middle-aged individuals participated in a health screening, which included a spirometry as well as recording of respiratory symptoms and smoking habits. Individuals with comorbidity at baseline (diabetes, stroke, cancer, angina pectoris, or heart infarction) were excluded from the analyses. Hazard ratios (HR 95% CI) of total mortality were analyzed in GOLD stages 0–4 with individuals with normal lung function and without symptoms of chronic bronchitis as a reference group. HR:s in smoking individuals with symptoms of chronic bronchitis within the stages 1–4 were calculated with individuals with the same GOLD stage but without symptoms of chronic bronchitis as reference. RESULTS: The number of deaths was 3674 for men and 832 for women based on 352 324 and 150 050 person-years respectively. The proportion of smokers among men was 50% and among women 40%. Self reported comorbidity was present in 4.6% of the men and 6.6% of the women. Among smoking men, Stage 0 was associated with an increased mortality risk, HR; 1.65 (1.32–2.08), of similar magnitude as in stage 2, HR; 1.41 (1.31–1.70). The hazard ratio in stage 0 was significantly higher than in stage 1 HR; 1.13 (0.98–1.29). Among male smokers with stage 1; HR: 2.04 (1.34–3.11), and among female smokers with stage 2 disease; HR: 3.16 (1.38–7.23), increased HR:s were found in individuals with symptoms of chronic bronchitis as compared to those without symptoms of chronic bronchitis. CONCLUSION: Symptoms fulfilling the definition of chronic bronchitis were associated with an increased mortality risk among male smokers with normal pulmonary function (stage 0) and also with an increased risk of death among smoking individuals with mild to moderate COPD (stage 1 and 2)