Patient Perception of Physician Attire Before and After Disclosure of the Risks of Microbial Contamination

Background: The white coat is traditionally considered to be the appropriate attire for physicians but it may also be contaminated with microbes and act as a potential source of infection. We aimed to study patients’ acceptance of physicians’ attire, their underlying reasons, and their reactions to an educational intervention with regards to the risks of contamination. Methods: We conducted a voluntary ques­tionnaire survey at a university teaching hospital in Hong Kong from February to July 2012. 262 patient-responses from adult inpatients and outpatients across various specialties were analysed. Results: White coats were highly favoured (90.8%) when compared with scrubs (22.1%), smart casual (7.6%) and formal (7.3%) wears. ’Professional image’ and ‘ease of identification’ were the main attributes of the white coat. Most patients (92.2%) would prefer doctors washing their white coats every few days, whilst 80.9% believed that doctors were actually doing so. After patients were informed of the potential risk of microbial contamination, white coats remained as the most favoured attire (66.4%), but with scrubs doubling in popularity (45.8%). Smart casual (9.2%) and formal attire (4.6%) remain the least accepted. Conclusion: Despite cross-infections being a significant concern within the healthcare environments, patients’ predominant acceptance and perceived attributes towards the white coat were maintained after an educational intervention on the risks of microbial contamination

Evolutionary and Transmission Dynamics of Reassortant H5N1 Influenza Virus in Indonesia

H5N1 highly pathogenic avian influenza (HPAI) viruses have seriously affected the Asian poultry industry since their recurrence in 2003. The viruses pose a threat of emergence of a global pandemic influenza through point mutation or reassortment leading to a strain that can effectively transmit among humans. In this study, we present phylogenetic evidences for the interlineage reassortment among H5N1 HPAI viruses isolated from humans, cats, and birds in Indonesia, and identify the potential genetic parents of the reassorted genome segments. Parsimony analyses of viral phylogeography suggest that the reassortant viruses may have originated from greater Jakarta and surroundings, and subsequently spread to other regions in the West Java province. In addition, Bayesian methods were used to elucidate the genetic diversity dynamics of the reassortant strain and one of its genetic parents, which revealed a more rapid initial growth of genetic diversity in the reassortant viruses relative to their genetic parent. These results demonstrate that interlineage exchange of genetic information may play a pivotal role in determining viral genetic diversity in a focal population. Moreover, our study also revealed significantly stronger diversifying selection on the M1 and PB2 genes in the lineages preceding and subsequent to the emergence of the reassortant viruses, respectively. We discuss how the corresponding mutations might drive the adaptation and onward transmission of the newly formed reassortant viruses

Data_S1

Accession numbers, isolate name, host of origin, and data on the year and geographical location (country) of collection of the samples that led to the Rabies virus sequences utilized in the work. Values and reference work of all host expected heterozygosity data used in the work

Data from: The impact of host genetic diversity on virus evolution and emergence

Accumulating evidence indicates that biodiversity has an important impact on parasite evolution and emergence. The vast majority of studies in this area have only considered the diversity of species within an environment as an overall measure of biodiversity, overlooking the role of genetic diversity within a particular host species. Although theoretical models propose that host genetic diversity in part shapes that of the infecting parasite population, and hence modulates the risk of parasite emergence, this effect has seldom been tested empirically. Using Rabies virus (RABV) as a model parasite, we provide evidence that greater host genetic diversity increases both parasite genetic diversity and the likelihood of a host being a donor in RABV cross-species transmission events. We conclude that host genetic diversity may be an important determinant of parasite evolution and emergence

Nematode and Acanthocephalan Parasites of Confiscated Sunda pangolins, <i>Manis javanica</i> Desmarest, 1822 (Mammalia: Pholidota: Manidae), with an Updated List of the Parasites of Pangolins

Background: The Sunda pangolin, Manis javanica Desmarest, 1822, is a critically endangered species of pangolin that occurs from Indonesia to southern China. Knowledge of the biology and ecology of M. javanica is limited, however there have been previous reports of parasites, including nematodes, protozoans, ticks, and a cestode. Methods: An illegal shipment of 88 M. javanica carcasses, originally collected from wild populations throughout southeast Asia, were intercepted by Hong Kong border authorities (AFCD) and confiscated in 2018. Results: During necropsy, two different types of parasites were collected from four infected pangolins. The parasites were identified as the nematode Gendrespirura cf. zschokkei (Meyer, 1896) Chabaud 1958, which were embedded in the stomach wall, and the acanthocephalan, Oligacanthorhynchidae sp., collected from the intestine. Morphological descriptions and molecular characterization for each parasite type is provided. Conclusions: In addition, an updated list of parasites from pangolins, incorporating current taxonomic identifications and publications is presented

Rabies_ALL_SPECIES_N.FULL.DATED

Alignment of the Rabies virus N gene sequences used in the study in nexus format

Rabies_ALL_SPECIES_G.FULL.DATED

Alignment of Rabies virus G gene sequences used in the work in nexus forma

Plasma level of adrenomedullin is influenced by a single nucleotide polymorphism in the adiponectin gene.

OBJECTIVE: Adrenomedullin (ADM) and adiponectin are both involved in inflammation and cardiovascular diseases. The plasma levels of these peptides are influenced by single nucleotide polymorphisms (SNPs) in the ADM and ADIPOQ genes respectively. There is some evidence that ADM may regulate adiponectin gene expression, but whether adiponectin can regulate ADM expression is unclear, and was therefore investigated. METHODS: Plasma ADM level was measured in 476 subjects in the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS2). We genotyped them for 2 ADIPOQ SNPs that are known to be associated with plasma adiponectin level. RESULTS: The minor allele frequencies of ADIPOQ SNPs rs182052 and rs12495941 were 40.6% and 42.2% respectively. Plasma ADM level was significantly associated with rs182052 after adjusting for age and sex (β=0.104, P=0.023) but not with rs12495941 (β=0.071, P=0.120). In multivariate analysis, plasma ADM level increased with the number of minor alleles of rs182052 (P=0.013). Compared to subjects with GG genotype, subjects with AA genotype had 17.7% higher plasma ADM level (95% CI: 3.6%-33.7%). Subgroup analysis revealed that the association was significant in diabetic patients (β=0.344, P=0.001) but not in non-diabetic subjects. CONCLUSION: Plasma ADM level is related to SNP rs182052 in the ADIPOQ gene. Our findings provide new evidence of the interplay between these two important peptides in cardiovascular disease and diabetes. Knowing the genotype may help to refine the interpretation of these biomarkers

Effects of syphilis infection among HIV-1-positive individuals on suppressive antiretroviral therapy

Abstract Introduction Incident syphilis leads to changes in plasma HIV-1 RNA and CD4 + T-cell level in people with HIV (PWH) with viraemia. Its effect in PWH on suppressive antiretroviral therapy (ART) is less clear. Methods PWH on suppressive ART (plasma HIV-1 RNA < 50copies/mL) followed at the Queen Elizabeth Hospital, Hong Kong, China were regularly screened for syphilis. Their plasma HIV-1 RNA, CD4 + and CD8 + T-cell, and total lymphocyte levels before syphilis, during syphilis, and after successful treatment were compared. Results Between 2005 and 2020, 288 syphilis episodes from 180 individuals were identified; 287 episodes were related to male, with a median age of 41 at diagnosis; 221 (77%) were syphilis re-infection. The rates of plasma HIV-1 suppression were statistically unchanged across the time-points (97% pre-syphilis, 98% during syphilis, and 99% post-treatment). Total lymphocyte, CD4+ and CD8+ T-cell levels decreased during incident syphilis (p<0.01), and rebounded post-treatment (p<0.01). VDRL titre was associated with declines in CD4+ T-cell (p=0.045), CD8+ T-cell (p=0.004), and total lymphocyte levels (p=0.021). Pre-syphilis CD4/CD8 ratio was associated with increases in CD8+ T-cell (p=0.001) and total lymphocyte levels (p=0.046) during syphilis. Syphilis re-infection was associated with an increase in total lymphocyte level (p=0.037). In the multivariable analysis, only pre-syphilis CD4/CD8 ratio was independently associated with increases in CD8+ T-cell (p=0.014) and total lymphocyte levels (p=0.039) during syphilis. Conclusions Among virally-suppressed PWH, total lymphocyte, CD4+, and CD8+ T-cell levels declined during incident syphilis but rebounded post-treatment. The status of plasma HIV suppression was unaffected by syphilis