Association between Giardia and arthritis or joint pain in a large health insurance cohort: could it be reactive arthritis?
Painter JE , Collier SA , Gargano JW . Epidemiol Infect 2016 145 (3) 1-7 This study aimed to assess the association between giardiasis and subsequent development of arthritis or joint pain using a retrospective cohort of individuals from a large administrative claims database in the United States. Using 2006-2010 data from MarketScan Commercial Claims and Encounters, we conducted a retrospective cohort study in people with an ICD-9-CM code for giardiasis (n = 3301) and persons without giardiasis (n = 14 612) individually matched on age, sex, and enrolment length. We used conditional logistic regression to model the association between giardiasis and arthritis or joint pain documented in the 6 months following initial giardiasis diagnosis or index date for matched controls. After adjusting for healthcare utilization rate, giardiasis was associated with a 51% increase in claims for arthritis or joint pain (odds ratio 1.51, 95% confidence interval 1.26-1.80). In age- and sex-stratified adjusted analyses, the association remained significant across all subgroups (age 0-19 years, age 20-64 years, males, and females). Findings from this study lend epidemiological support for the association between giardiasis and subsequent development of arthritis. Reactive arthritis might occur more frequently than has been reported in the literature. Further research is necessary to determine the mechanisms by which giardiasis could lead to arthritis. |
Characteristics and practices of adults who use tanning beds in private residences
Nahar VK , Rosenthal M , Lemon SC , Holman DM , Watson M , Hillhouse JJ , Pagoto SL . JAMA Dermatol 2016 152 (12) 1383-1385 Recent research shows that 7.7% of individuals who use indoor tanning beds do so in private homes,1 but little is known about this group. This study evaluated the tanning practices, reasons for tanning, and association with tanning addiction of adults who use tanning beds in private residences. |
Community-wide interventions to prevent skin cancer: Two Community Guide systematic reviews
Sandhu PK , Elder R , Patel M , Saraiya M , Holman DM , Perna F , Smith RA , Buller D , Sinclair C , Reeder A , Makin J , McNoe B , Glanz K . Am J Prev Med 2016 51 (4) 531-9 CONTEXT: Skin cancer is a preventable and commonly diagnosed cancer in the U.S. Excessive ultraviolet radiation exposure is a known cause of skin cancer. This article presents updated results of two types of interventions evaluated in a previously published Community Guide systematic review: multicomponent community-wide interventions and mass media interventions when used alone. EVIDENCE ACQUISITION: Studies assessing multicomponent community-wide and mass media interventions to prevent skin cancer by reducing ultraviolet radiation exposure were evaluated using Community Guide systematic review methods. Relevant studies published between 1966 and 2013 were included and analyzed for this review. EVIDENCE SYNTHESIS: Seven studies evaluating the effectiveness of multicomponent community-wide interventions showed a median increase in sunscreen use of 10.8 (interquartile interval=7.3, 23.2) percentage points, a small decrease in ultraviolet radiation exposure, a decrease in indoor tanning device use of 4.0 (95% CI=2.5, 5.5) percentage points, and mixed results for other protective behaviors. Four studies evaluating the effectiveness of mass media interventions found that they generally led to improved ultraviolet protection behaviors among children and adults. CONCLUSIONS: The available evidence showed that multicomponent community-wide interventions are effective in reducing the deleterious effects of ultraviolet radiation exposure by increasing sunscreen use. There was, however, insufficient evidence to determine the effectiveness of mass media interventions alone in reducing ultraviolet radiation exposure and increasing ultraviolet protection behaviors, indicating a continuing need for more research in this field to improve assessment of effectiveness. |
Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa.
Wong VK , Holt KE , Okoro C , Baker S , Pickard DJ , Marks F , Page AJ , Olanipekun G , Munir H , Alter R , Fey PD , Feasey NA , Weill FX , Le Hello S , Hart PJ , Kariuki S , Breiman RF , Gordon MA , Heyderman RS , Jacobs J , Lunguya O , Msefula C , MacLennan CA , Keddy KH , Smith AM , Onsare RS , De Pinna E , Nair S , Amos B , Dougan G , Obaro S . PLoS Negl Trop Dis 2016 10 (9) e0004781 BACKGROUND: The burden of typhoid in sub-Saharan African (SSA) countries has been difficult to estimate, in part, due to suboptimal laboratory diagnostics. However, surveillance blood cultures at two sites in Nigeria have identified typhoid associated with Salmonella enterica serovar Typhi (S. Typhi) as an important cause of bacteremia in children. METHODS: A total of 128 S. Typhi isolates from these studies in Nigeria were whole-genome sequenced, and the resulting data was used to place these Nigerian isolates into a worldwide context based on their phylogeny and carriage of molecular determinants of antibiotic resistance. RESULTS: Several distinct S. Typhi genotypes were identified in Nigeria that were related to other clusters of S. Typhi isolates from north, west and central regions of Africa. The rapidly expanding S. Typhi clade 4.3.1 (H58) previously associated with multiple antimicrobial resistances in Asia and in east, central and southern Africa, was not detected in this study. However, antimicrobial resistance was common amongst the Nigerian isolates and was associated with several plasmids, including the IncHI1 plasmid commonly associated with S. Typhi. CONCLUSIONS: These data indicate that typhoid in Nigeria was established through multiple independent introductions into the country, with evidence of regional spread. MDR typhoid appears to be evolving independently of the haplotype H58 found in other typhoid endemic countries. This study highlights an urgent need for routine surveillance to monitor the epidemiology of typhoid and evolution of antimicrobial resistance within the bacterial population as a means to facilitate public health interventions to reduce the substantial morbidity and mortality of typhoid. |
Progression and Transmission of HIV/AIDS (PATH 2.0).
Gopalappa C , Farnham PG , Chen YH , Sansom SL . Med Decis Making 2016 37 (2) 224-233 BACKGROUND: HIV transmission is the result of complex dynamics in the risk behaviors, partnership choices, disease stage and position along the HIV care continuum-individual characteristics that themselves can change over time. Capturing these dynamics and simulating transmissions to understand the chief sources of transmission remain important for prevention. METHODS: The Progression and Transmission of HIV/AIDS (PATH 2.0) is an agent-based model of a sample of 10,000 people living with HIV (PLWH), who represent all men who have sex with men (MSM) and heterosexuals living with HIV in the U.S.A. Persons uninfected were modeled as populations, stratified by risk and gender. The model included detailed individual-level data from several large national surveillance databases. The outcomes focused on average annual transmission rates from 2008 through 2011 by disease stage, HIV care continuum, and sexual risk group. RESULTS: The relative risk of transmission of those in the acute phase was nine-times [5th and 95th percentile simulation interval (SI): 7, 12] that of those in the non-acute phase, although, on average, those with acute infections comprised 1% of all PLWH. The relative risk of transmission was 24- to 50-times as high for those in the non-acute phase who had not achieved viral load suppression as compared with those who had. The relative risk of transmission among MSM was 3.2-times [SI: 2.7, 4.0] that of heterosexuals. Men who have sex with men and women generated 46% of sexually acquired transmissions among heterosexuals. CONCLUSIONS: The model results support a continued focus on early diagnosis, treatment and adherence to ART, with an emphasis on prevention efforts for MSM, a subgroup of whom appear to play a role in transmission to heterosexuals. |
Under-reporting of sputum smear-positive tuberculosis cases in Kenya
Tollefson D , Ngari F , Mwakala M , Gethi D , Kipruto H , Cain K , Bloss E . Int J Tuberc Lung Dis 2016 20 (10) 1334-1341 BACKGROUND: Although an estimated three million tuberculosis (TB) cases worldwide are missed by national TB programs annually, the level of under-reporting of diagnosed cases in high TB burden settings is largely unknown. OBJECTIVE: To quantify and describe under-reporting of sputum smear-positive TB cases in Kenya. DESIGN: A national-level retrospective TB inventory study was conducted. All sputum smear-positive TB cases diagnosed by public or private laboratories during 1 April-30 June 2013 were extracted from laboratory registers in 73 randomly sampled subcounties and matched to TB cases in the national TB surveillance system (TIBU). Bivariate and multivariate analyses were conducted. RESULTS: In the subcounties sampled, 715 of 3409 smear-positive TB cases in laboratory registers were not found in TIBU. The estimated level of under-reporting of smear-positive TB cases in Kenya was 20.7% (95%CI 18.4-23.0). Under-reporting was greatest in subcounties with a high TB burden. Unreported cases were more likely to be patients aged ≥55 years, have scanty smear results, and be diagnosed at large facilities, private facilities, and facilities in high TB burden regions. CONCLUSION: In Kenya, one fifth of smear-positive TB cases diagnosed during the study period went unreported, suggesting that the true TB burden is higher than reported. TB surveillance in Kenya should be strengthened to ensure all diagnosed TB cases are reported. © 2016 The Union. |
Positive bacteriological results among contacts of patients with active tuberculosis
Frieden TR . Int J Tuberc Lung Dis 2016 20 (10) 1416 In a recent issue of the Journal, an article by Balcells | et al. provides interesting data on positive Mycobacterium tuberculosis bacteriological results among | contacts of patients with active tuberculosis.1 | There is relevant historical evidence on the | pathophysiology of tuberculosis infection and disease. People newly infected with M. tuberculosis, | whether or not they progress to active tuberculosis, | are, when monitored intensively, often culture-positive.2 This was shown elegantly in a series of studies | conducted on US Navy personnel in the 1960s.3 |
Erectile dysfunction medication prescription and condomless intercourse in HIV-infected men who have sex with men in the United States
Lin X , Mattson CL , Freedman M , Skarbinski J . AIDS Behav 2016 21 (4) 1129-1137 Using nationally representative data, we assessed the prevalence of erectile dysfunction medication (EDM) prescription, and its association with insertive condomless anal intercourse (CAI) with an HIV-serodiscordant partner among sexually-active HIV-infected men who have sex with men (MSM) receiving medical care in the United States. Overall, 14 % (95 % CI 12-16) were prescribed EDM and 21 % (95 % CI 19-23) engaged in serodiscordant CAI. MSM who were prescribed EDM were more likely to engage in insertive CAI with a serodiscordant casual partner than those not prescribed EDM after adjusting for illicit drug use before or during sex (adjusted prevalence ratio = 1.38; 95 % CI 1.01-1.88). We found no association with main partners. Only 40 % (95 % CI 36-44) of MSM prescribed EDM received risk-reduction counseling from healthcare professionals. Risk-reduction counseling should be provided at least annually to all HIV-infected persons as recommended, especially at the time of EDM prescription. |
Design and weighting methods for a nationally representative sample of HIV-infected adults receiving medical care in the United States - Medical Monitoring Project
Iachan R , Johnson C H , Harding R L , Kyle T , Saavedra P , Frazier E L , Beer L , Mattson C L , Skarbinski J . Open AIDS J 2016 10 164-81 BACKGROUND: Health surveys of the general US population are inadequate for monitoring human immunodeficiency virus (HIV) infection because the relatively low prevalence of the disease (<0.5%) leads to small subpopulation sample sizes. OBJECTIVE: To collect a nationally and locally representative probability sample of HIV-infected adults receiving medical care to monitor clinical and behavioral outcomes, supplementing the data in the National HIV Surveillance System. This paper describes the sample design and weighting methods for the Medical Monitoring Project (MMP) and provides estimates of the size and characteristics of this population. METHODS: To develop a method for obtaining valid, representative estimates of the in-care population, we implemented a cross-sectional, three-stage design that sampled 23 jurisdictions, then 691 facilities, then 9,344 HIV patients receiving medical care, using probability-proportional-to-size methods. The data weighting process followed standard methods, accounting for the probabilities of selection at each stage and adjusting for nonresponse and multiplicity. Nonresponse adjustments accounted for differing response at both facility and patient levels. Multiplicity adjustments accounted for visits to more than one HIV care facility. RESULTS: MMP used a multistage stratified probability sampling design that was approximately self-weighting in each of the 23 project areas and nationally. The probability sample represents the estimated 421,186 HIV-infected adults receiving medical care during January through April 2009. Methods were efficient (i.e., induced small, unequal weighting effects and small standard errors for a range of weighted estimates). CONCLUSION: The information collected through MMP allows monitoring trends in clinical and behavioral outcomes and informs resource allocation for treatment and prevention activities. |
Distribution of disease phase, treatment prescription and severe liver disease among 1598 patients with chronic hepatitis B in the Chronic Hepatitis Cohort Study, 2006-2013
Spradling PR , Xing J , Rupp LB , Moorman AC , Gordon SC , Teshale ET , Lu M , Boscarino JA , Schmidt MA , Trinacty CM , Holmberg SD . Aliment Pharmacol Ther 2016 44 (10) 1080-1089 BACKGROUND: Limited information exists regarding the distribution of disease phases, treatment prescription and severe liver disease among patients with chronic hepatitis B (CHB) in US general healthcare settings. AIM: To determine the distribution of disease phases, treatment prescription and severe liver disease among patients with CHB in general US healthcare settings. METHODS: We analysed demographic and clinical data collected during 2006-2013 from patients with confirmed CHB in the Chronic Hepatitis Cohort Study, an observational cohort study involving patients from healthcare organisations in Michigan, Pennsylvania, Oregon and Hawaii. CHB phases were classified according to American Association for the Study of Liver Disease guidelines. RESULTS: Of 1598 CHB patients with ≥12 months of follow-up (median 6.3 years), 457 (29%) were immune active during follow-up [11% hepatitis B e antigen (HBeAg)-positive, 16% HBeAg-negative, and 2% HBeAg status unknown], 10 (0.6%) were immune tolerant, 112 (7%) were inactive through the duration of follow-up and 886 (55%) were phase indeterminate. Patients with cirrhosis were identified within each group (among 21% of immune active, 3% of inactive and 9% of indeterminate phase patients) except among those with immune-tolerant CHB. Prescription of treatment was 59% among immune active patients and 84% among patients with cirrhosis and hepatitis B virus (HBV) DNA >2000 IU/mL. CONCLUSIONS: Approximately, one-third of the cohort had active disease during follow-up; 60% of eligible patients were prescribed treatment. Our findings underscore the importance of ascertainment of fibrosis status in addition to regular assessment of ALT and HBV DNA levels. |
Impact of anthropogenic disturbance on native and invasive trypanosomes of rodents in forested Uganda
Salzer JS , Pinto CM , Grippi DC , Williams-Newkirk AJ , Peterhans JK , Rwego IB , Carroll DS , Gillespie TR . Ecohealth 2016 13 (4) 698-707 Habitat disturbance and anthropogenic change are globally associated with extinctions and invasive species introductions. Less understood is the impact of environmental change on the parasites harbored by endangered, extinct, and introduced species. To improve our understanding of the impacts of anthropogenic disturbance on such host-parasite interactions, we investigated an invasive trypanosome (Trypanosoma lewisi). We screened 348 individual small mammals, representing 26 species, from both forested and non-forested habitats in rural Uganda. Using microscopy and PCR, we identified 18% of individuals (order Rodentia) as positive for trypanosomes. Further phylogenetic analyses revealed two trypanosomes circulating-T. lewisi and T. varani. T. lewisi was found in seven species both native and invasive, while T. varani was identified in only three native forest species. The lack of T. varani in non-forested habitats suggests that it is a natural parasite of forest-dwelling rodents. Our findings suggest that anthropogenic disturbance may lead to spillover of an invasive parasite (T. lewisi) from non-native to native species, and lead to local co-extinction of a native parasite (T. varani) and native forest-dwelling hosts. |
Estimating national trends in inpatient antibiotic use among US hospitals from 2006 to 2012
Baggs J , Fridkin SK , Pollack LA , Srinivasan A , Jernigan JA . JAMA Intern Med 2016 176 (11) 1639-1648 Importance: The rising threat of antibiotic resistance and other adverse consequences resulting from the misuse of antibiotics requires a better understanding of antibiotic use in hospitals in the United States. Objective: To use proprietary administrative data to estimate patterns of US inpatient antibiotic use in recent years. Design, Setting, and Participants: For this retrospective analysis, adult and pediatric in-patient antibiotic use data was obtained from the Truven Health MarketScan Hospital Drug Database (HDD) from January 1, 2006, to December 31, 2012. Data from adult and pediatric patients admitted to 1 of approximately 300 participating acute care hospitals provided antibiotic use data for over 34 million discharges representing 166 million patient-days. Main Outcomes and Measures: We retrospectively estimated the days of therapy (DOT) per 1000 patient-days and the proportion of hospital discharges in which a patient received at least 1 dose of an antibiotic during the hospital stay. We calculated measures of antibiotic usage stratified by antibiotic class, year, and other patient and facility characteristics. We used data submitted to the Centers for Medicare and Medicaid Services Healthcare Cost Report Information System to generate estimated weights to apply to the HDD data to create national estimates of antibiotic usage. A multivariate general estimating equation model to account for interhospital covariance was used to assess potential trends in antibiotic DOT over time. Results: During the years 2006 to 2012, 300 to 383 hospitals per year contributed antibiotic data to the HDD. Across all years, 55.1% of patients received at least 1 dose of antibiotics during their hospital visit. The overall national DOT was 755 per 1000 patient-days. Overall antibiotic use did not change significantly over time. The multivariable trend analysis of data from participating hospitals did not show a statistically significant change in overall use (total DOT increase, 5.6; 95% CI, -18.9 to 30.1; P = .65). However, the mean change (95% CI) for the following antibiotic classes increased significantly: third- and fourth-generation cephalosporins, 10.3 (3.1-17.5); macrolides, 4.8 (2.0-7.6); glycopeptides, 22.4 (17.5-27.3); beta-lactam/beta-lactamase inhibitor combinations, 18.0 (13.3-22.6); carbapenems, 7.4 (4.6-10.2); and tetracyclines, 3.3 (2.0-4.7). Conclusions and Relevance: Overall DOT of all antibiotics among hospitalized patients in US hospitals has not changed significantly in recent years. Use of some antibiotics, especially broad spectrum agents, however, has increased significantly. This trend is worrisome in light of the rising challenge of antibiotic resistance. Our findings can help inform national efforts to improve antibiotic use by suggesting key targets for improvement interventions. |
Concomitant opioid and laxative use in older adults in hospice care in the United States: 2007
Lau DT , Dwyer LL , Shega JW . J Am Geriatr Soc 2016 64 (11) e160-e165 OBJECTIVES: To examine laxative use by individuals in hospice who were taking opioids during the last week of life. DESIGN: Retrospective cross-sectional. SETTING: 2007 National Home and Hospice Care Survey. PARTICIPANTS: Individuals in hospice aged 65 and older who were taking opioids during the last week of life (N = 2,825). MEASUREMENTS: Hospice staff were asked the names of all medications and drugs that participants were taking 7 days before and on the day of death while in hospice, including any standing, routine, or as-needed medications." Medications "used" included medications taken and as-needed medications provided in case a symptom developed. Opioids included all opioid-combination drugs. Laxatives included fibers, lubricants, stimulants, and suppositories. RESULTS: Forty-one percent of participants had cancer as the primary hospice diagnosis, 13% heart disease, 12% debility, 11% dementia, 8% lung disease, and 15% other. Overall, 52% of opioid users used a laxative in the last week of life; the proportions of opioid and laxative users did not differ according to diagnosis. Racial minorities taking opioids had lower odds than white participants (odds ratio (OR) = 0.57, 95% confidence interval (CI) = 0.33-0.99) of using laxatives. Participants taking opioids enrolled in hospice for 7 days or less had lower odds of using laxatives than those enrolled for more than 7 days (OR = 0.65, 95% CI = 0.37-0.95), as did those in hospice inpatient, hospital, or other settings (OR = 0.45, 95% CI = 0.43-0.93) than those in long-term care settings. Participants using five or fewer medications had lower odds of using laxatives than those using six to 10 (OR = 6.01, 95% CI = 3.88-9.32) or 11 to 25 medications (OR = 13.80, 95% CI = 8.74-21.80). CONCLUSION: In 2007, slightly more than half of older adults in hospice who were taking opioids used laxatives during the last week of life. Recent quality indicators from the Centers for Medicare and Medicaid Services recommend laxative treatment when opioid therapy is initiated to prevent opioid-induced constipation and are intended to improve laxative use in individuals in hospice treated with opioids. |
The relationship of high PM2.5 days and subsequent asthma-related hospital encounters during the fireplace season in Phoenix, AZ, 2008–2012
Pope R , Stanley KM , Domsky I , Yip F , Nohre L , Mirabelli MC . Air Qual Atmos Health 2016 10 (2) 161–169 Exposure to particulate matter less than 2.5 μm in diameter (PM2.5) exacerbates asthma and increases mortality. In Phoenix, AZ, the highest PM2.5 values frequently occur during the winter fireplace season and air quality health standards are often exceeded during the Christmas and New Year’s holidays. It was clear that enhanced messaging was needed by air quality and public health authorities to discourage biomass fires (BMF) on days when unhealthful levels of pollution were likely to be caused by that activity. Demonstrating adverse health outcomes would bolster this effort. We conducted this study to evaluate associations between elevated PM2.5 exposures during the fireplace season and asthma-related hospital admissions in Phoenix; days with average PM2.5 > 35 μg/m3 were categorized as elevated PM2.5 exposure. We used hospital discharge data to identify patients with an asthma-related hospital encounter and who lived within an 8-km radius of a PM2.5 monitor. To estimate the risk of a hospital encounter following an elevated PM2.5 event, we used generalized estimating equations, specified with a Poisson distribution, and exposure lags of 0–3 days. Controlling for influenza, temperature, humidity, rain, and year, these analyses generated elevated estimates of emergency department visit risk among adults on lag days 2 (relative risk [RR] 1.19; 95 % CI 1.06, 1.34) and 3 (RR 1.20, 95 % CI 1.05, 1.37). Elevated PM2.5 was not associated with hospital encounters among children. Our findings suggest that adults may be at elevated risk of asthma-related hospital encounters during the fireplace season. © 2016 Springer Science+Business Media Dordrecht |
A state-by-state assessment of food service regulations for prevention of norovirus outbreaks
Kambhampati A , Shioda K , Gould LH , Sharp D , Brown LG , Parashar UD , Hall AJ . J Food Prot 2016 79 (9) 1527-1536 Noroviruses are the leading cause of foodborne disease in the United States. Foodborne transmission of norovirus is often associated with contamination of food during preparation by an infected food worker. The U.S. Food and Drug Administration's Food Code provides model food safety regulations for preventing transmission of foodborne disease in restaurants; however, adoption of specific provisions is at the discretion of state and local governments. We analyzed the food service regulations of all 50 states and the District of Columbia (i.e., 51 states) to describe differences in adoption of norovirus-related Food Code provisions into state food service regulations. We then assessed potential correlations between adoption of these regulations and characteristics of foodborne norovirus outbreaks reported to the National Outbreak Reporting System from 2009 through 2014. Of the 51 states assessed, all (100%) required food workers to wash their hands, and 39 (76%) prohibited bare-hand contact with ready-to-eat food. Thirty states (59%) required exclusion of staff with vomiting and diarrhea until 24 h after cessation of symptoms. Provisions requiring a certified food protection manager (CFPM) and a response plan for contamination events (i.e., vomiting) were least commonly adopted; 26 states (51%) required a CFPM, and 8 (16%) required a response plan. Although not statistically significant, states that adopted the provisions prohibiting bare-hand contact (0.45 versus 0.74, P = 0.07), requiring a CFPM (0.38 versus 0.75, P = 0.09), and excluding ill staff for ≥24 h after symptom resolution (0.44 versus 0.73, P = 0.24) each reported fewer foodborne norovirus outbreaks per million person-years than did those states without these provisions. Adoption and compliance with federal recommended food service regulations may decrease the incidence of foodborne norovirus outbreaks. |
Food allergy knowledge and attitudes of restaurant managers and staff: An EHS-Net study
Radke TJ , Brown LG , Hoover ER , Faw BV , Reimann D , Wong MR , Nicholas D , Barkley J , Ripley D . J Food Prot 2016 79 (9) 1588-1598 Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers' food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant's ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction. © 2016, International Association for Food Protection. All rights reserved. |
Future challenges for tracking foodborne diseases: PulseNet, a 20-year-old US surveillance system for foodborne diseases, is expanding both globally and technologically
Ribot EM , Hise KB . EMBO Rep 2016 17 (11) 1499-1505 After 20 years of successfully tracking and preventing outbreaks of foodborne diseases, PulseNet, a US surveillance program, is implementing new diagnostic technologies and expanding its international cooperation with public health agencies. [Image: see text] |
Development and Characterization of Reference Materials for Genetic Testing: Focus on Public Partnerships.
Kalman LV , Datta V , Williams M , Zook JM , Salit ML , Han JY . Ann Lab Med 2016 36 (6) 513-20 Characterized reference materials (RMs) are needed for clinical laboratory test development and validation, quality control procedures, and proficiency testing to assure their quality. In this article, we review the development and characterization of RMs for clinical molecular genetic tests. We describe various types of RMs and how to access and utilize them, especially focusing on the Genetic Testing Reference Materials Coordination Program (Get-RM) and the Genome in a Bottle (GIAB) Consortium. This review also reinforces the need for collaborative efforts in the clinical genetic testing community to develop additional RMs. |
Genomic epidemiology of gonococcal resistance to extended spectrum cephalosporins, macrolides, and fluoroquinolones in the US, 2000-2013.
Grad YH , Harris SR , Kirkcaldy RD , Green AG , Marks DS , Bentley SD , Trees D , Lipsitch M . J Infect Dis 2016 214 (10) 1579-1587 BACKGROUND: Treatment of Neisseria gonorrhoeae infection is empiric and based on population-wide susceptibilities. Increasing antimicrobial resistance underscores the potential importance of rapid diagnostics, including sequence-based tests, to guide therapy. However, the utility of sequence-based diagnostics depends on the prevalence and dynamics of the resistance mechanisms. METHODS: We define the prevalence and dynamics of resistance markers to extended spectrum cephalosporins (ESC), macrolides, and fluoroquinolones in 1102 resistant and susceptible clinical N. gonorrhoeae isolates collected from 2000-2013 via the CDC's Gonococcal Isolate Surveillance Project (GISP). RESULTS: Reduced ESC susceptibility (ESCRS) is predominantly clonal and associated with the mosaic penA XXXIV allele and derivatives (sensitivity 98% for cefixime, 91% for ceftriaxone), but alternative resistance mechanisms have sporadically emerged. Reduced azithromycin susceptibility (AziRS) has arisen through multiple mechanisms and shows limited clonal spread; the basis for resistance in 36% of AziRS isolates is unclear. Quinolone resistant N. gonorrhoeae (QRNG) have arisen multiple times, with extensive clonal spread. CONCLUSION: QRNG and reduced cefixime susceptibility appear amenable to development of sequence-based diagnostics, whereas the undefined mechanisms of resistance to ceftriaxone and azithromycin underscore the importance of phenotypic surveillance. The identification of multidrug-resistant isolates highlights the need for additional measures to respond to the threat of untreatable gonorrhea. |
Development of a multilocus sequence typing tool for high-resolution subtyping and genetic structure characterization of Cryptosporidium ubiquitum.
Tang Y , Li N , Song M , Roellig DM , Feng Y , Xiao L . Infect Genet Evol 2016 45 256-261 Cryptosporidium ubiquitum is an emerging zoonotic pathogen in humans. Recently, a subtyping tool targeting the 60-kDa glycoprotein (gp60) gene was developed for C. ubiquitum, and identified six subtype families (XIIa-XIIf). In this study, we selected five genetic loci known to be polymorphic in C. hominis and C. parvum for the development of a multilocus subtyping tool for C. ubiquitum, including CP47 (cgd6_1590), MSC6-5 (cgd6_4290), cgd6_60, cgd2_3690, and cgd4_370. PCR primers for these targets were designed based on whole genome sequence data from C. ubiquitum. DNA sequence analyses of 24 C. ubiquitum specimens showed the presence of 18, 1, 5, 4, and 5 subtypes at the CP47, MSC6-5, cgd6_60, cgd2_3690, and cgd4_370 loci, respectively. Altogether, 18 multilocus sequence typing (MLST) subtypes were detected among the 19 specimens successfully sequenced at all polymorphic loci. Phylogenetic analyses of the MLST data indicated that the rodent subtype families of XIIe and XIIf were highly divergent from others, and the ruminant XIIa subtype family formed a monophyletic group genetically distant from other rodent subtype families XIIb, XIIc, and XIId. The latter showed no consistent grouping of specimens and formed one large cluster in phylogenetic analysis of concatenated multilocus sequences. This was supported by results of STRUCTURE and FST analyses, which further suggested that XIIa originated from one common ancestor whereas XIIb, XIIc, and XIId contained mixed ancestral types, reflecting a close relatedness of the three subtype families and the likely occurrence of genetic recombination among them. Thus, an MLST tool was developed for high-resolution subtyping of C. ubiquitum and results of preliminary characterizations of specimens from humans and animals supported the conclusion on the existence of ruminant and rodent-adapted C. ubiquitum groups. |
Dynamics of genome change among Legionella species.
Joseph SJ , Cox D , Wolff B , Morrison SS , Kozak-Muiznieks NA , Frace M , Didelot X , Castillo-Ramirez S , Winchell J , Read TD , Dean D . Sci Rep 2016 6 33442 Legionella species inhabit freshwater and soil ecosystems where they parasitize protozoa. L. pneumonphila (LP) serogroup-1 (Lp1) is the major cause of Legionnaires' Disease (LD), a life-threatening pulmonary infection that can spread systemically. The increased global frequency of LD caused by Lp and non-Lp species underscores the need to expand our knowledge of evolutionary forces underlying disease pathogenesis. Whole genome analyses of 43 strains, including all known Lp serogroups 1-17 and 17 emergent LD-causing Legionella species (of which 33 were sequenced in this study) in addition to 10 publicly available genomes, resolved the strains into four phylogenetic clades along host virulence demarcations. Clade-specific genes were distinct for genetic exchange and signal-transduction, indicating adaptation to specific cellular and/or environmental niches. CRISPR spacer comparisons hinted at larger pools of accessory DNA sequences in Lp than predicted by the pan-genome analyses. While recombination within Lp was frequent and has been reported previously, population structure analysis identified surprisingly few DNA admixture events between species. In summary, diverse Legionella LD-causing species share a conserved core-genome, are genetically isolated from each other, and selectively acquire genes with potential for enhanced virulence. |
Complete Genome Sequences of Bordetella pertussis Vaccine Reference Strains 134 and 10536.
Weigand MR , Peng Y , Loparev V , Batra D , Burroughs M , Johnson T , Juieng P , Rowe L , Tondella ML , Williams MM . Genome Announc 2016 4 (5) Vaccine formulations and vaccination programs against whooping cough (pertussis) vary worldwide. Here, we report the complete genome sequences of two divergent Bordetella pertussis reference strains used in the production of pertussis vaccines. |
Effect of cigarette prices on smoking initiation and cessation in China: a duration analysis
Kostova D , Husain MJ , Chaloupka FJ . Tob Control 2016 26 (5) 569-574 BACKGROUND: China is the world's largest producer and consumer of cigarettes. The status of tobacco as both a contributor to China's economy and a liability for the health of its population may complicate the use of taxes for addressing smoking in the country. Understanding how cigarette prices affect transitions in smoking behaviour in China can increase understanding of how China's high smoking rates can be influenced by tax policy. METHODS: In order to estimate the effect of cigarette prices on smoking initiation and cessation in China, we construct pseudo-longitudinal samples for duration analysis using data from the Global Adult Tobacco Survey China 2010. We use the historical variation in prices representative of 4 China regions over a 20-year period to identify the average price effect on the hazards of initiation and cessation while controlling for unobserved fixed and time-varying region characteristics. FINDINGS: We find that initiation rates fall in response to higher prices (with a price elasticity of initiation estimated at -0.95 for men and -1.07 overall). CONCLUSIONS: The effect of prices on smoking in China is likely to occur through averting initiation over time. At the population level, cessation behaviour may be less responsive to price increases as the wide range of cigarette prices in China may provide relatively high opportunity for switching to lower priced brands. |
The impact of chronic conditions on the economic burden of cancer survivorship: a systematic review
Rim SH , Guy GP Jr , Yabroff KR , McGraw KA , Ekwueme DU . Expert Rev Pharmacoecon Outcomes Res 2016 16 (5) 579-589 INTRODUCTION: This systematic review examines the excess cost of chronic conditions on the economic burden of cancer survivorship among adults in the US. AREAS COVERED: Twelve published studies were identified. Although studies varied substantially in populations, comorbidities examined, methods, and types of cost reported, costs for cancer survivors with comorbidities generally increased with greater numbers of comorbidities or an increase in comorbidity index score. Survivors with comorbidities incurred significantly more in total medical costs, out-of-pocket costs, and costs by service type compared to cancer survivors without additional comorbidities. Expert Commentary: Cancer survivors with comorbidities bear significant excess out-of-pocket costs and their care is also more expensive to the healthcare system. On-going evaluation of different payment models, care coordination, and disease management programs for cancer survivors with comorbidities will be important in monitoring impact on healthcare costs. |
The epidemiology and outcomes of invasive Candida infections among organ transplant recipients in the United States: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)
Andes DR , Safdar N , Baddley JW , Alexander B , Brumble L , Freifeld A , Hadley S , Herwaldt L , Kauffman C , Lyon GM , Morrison V , Patterson T , Perl T , Walker R , Hess T , Chiller T , Pappas PG . Transpl Infect Dis 2016 18 (6) 921-931 BACKGROUND: Invasive candidiasis (IC) is a common cause of mortality in solid organ transplant recipients (OTRs), but knowledge of epidemiology in this population is limited. METHOD: The present analysis describes data from 15 US centers that prospectively identified IC from nearly 17,000 OTRs. Analyses were undertaken to determine predictors of infection and mortality. RESULTS: A total of 639 cases of IC were identified. The most common species was Candida albicans (46.3%), followed by Candida glabrata (24.4%) and Candida parapsilosis (8.1%). In 68 cases >1 species was identified. The most common infection site was bloodstream (44%), followed by intra-abdominal (14%). The most frequently affected allograft groups were liver (41.1%) and kidney (35.3%). All-cause mortality at 90 days was 26.5% for all species and was highest for Candida tropicalis (44%) and C. parapsilosis (35.2%). Non-white race and female gender were more commonly associated with non-albicans species. A high rate of breakthrough IC was seen in patients receiving antifungal prophylaxis (39%). Factors associated with mortality include organ dysfunction, lung transplant, and treatment with a polyene antifungal. The only modifiable factor identified was choice of antifungal drug class based upon infecting Candida species. CONCLUSION: These data highlight the common and distinct features of IC in OTRs. This article is protected by copyright. All rights reserved. |
Subacute sclerosing panencephalitis: The foothold in undervaccination
Holt RL , Kann D , Rassbach CE , Schwenk HT , Ritter JM , Rota PA , Elbers J . J Pediatr 2016 179 259-262 Subacute sclerosing panencephalitis (SSPE) is a fatal complication of measles infection. We present a case of a fully vaccinated 3-year-old boy who was diagnosed with and treated for autoimmune encephalitis before arriving at a diagnosis of SSPE. We discuss the challenges of diagnosing SSPE in developed countries. |
Vaccine receipt and vaccine card availability among children of the apostolic faith: analysis from the 2010-2011 Zimbabwe demographic and health survey
Kriss JL , Goodson J , Machekanyanga Z , Shibeshi ME , Daniel F , Masresha B , Kaiser R . Pan Afr Med J 2016 24 47 INTRODUCTION: Vaccine hesitancy and refusal continue to be a global challenge to reaching immunization targets, especially among those in traditional or fundamentalist religions. The apostolic faith in Zimbabwe has been historically associated with objection to most medical interventions, including immunization. METHODS: We conducted a descriptive analysis of socio-demographic characteristics and vaccine coverage among apostolic and non-apostolic adults aged 15-49 years and children aged 12-23 months using the Demographic and Health Survey conducted in Zimbabwe during 2010-2011. We used logistic regression models to estimate associations between the apostolic religion and receipt of all four basic childhood vaccinations in the Expanded Program on Immunization, receipt of no vaccinations, and availability of child vaccination card. RESULTS: Among children aged 12-23 months, 64% had received all doses of the four basic vaccinations, and 12% had received none of the recommended vaccines. A vaccination card was available for 68% of children. There was no significant association between Apostolic faith and completion of all basic vaccinations (aOR = 0.90, 95% CI: 0.69-1.17), but apostolic children were almost twice as likely to have received no basic vaccinations (aOR = 1.83, 95% CI: 1.22-2.77) than non-Apostolic children, and they were 32% less likely to have a vaccination card that was available and seen by the interviewer (aOR = 0.68, 95% CI: 0.52-0.89). CONCLUSION: Disparities in childhood vaccination coverage and availability of vaccination cards persist for apostolic in Zimbabwe. Continued collaboration with apostolic leaders and additional research to better understand vaccine hesitancy and refine interventions and messaging strategies are needed. |
Vaccine-induced mucosal immunity to poliovirus: analysis of cohorts from an open-label, randomised controlled trial in Latin American infants
Wright PF , Connor RI , Wieland-Alter WF , Hoen AG , Boesch AW , Ackerman ME , Oberste MS , Gast C , Brickley EB , Asturias EJ , Ruttimann R , Bandyopadhyay AS . Lancet Infect Dis 2016 16 (12) 1377-1384 BACKGROUND: Identification of mechanisms that limit poliovirus replication is crucial for informing decisions aimed at global polio eradication. Studies of mucosal immunity induced by oral poliovirus (OPV) or inactivated poliovirus (IPV) vaccines and mixed schedules thereof will determine the effectiveness of different vaccine strategies to block virus shedding. We used samples from a clinical trial of different vaccination schedules to measure intestinal immunity as judged by neutralisation of virus and virus-specific IgA in stools. METHODS: In the FIDEC trial, Latin American infants were randomly assigned to nine groups to assess the efficacy of two schedules of bivalent OPV (bOPV) and IPV and challenge with monovalent type 2 OPV, and stools samples were collected. We selected three groups of particular interest-the bOPV control group (serotypes 1 and 3 at 6, 10, and 14 weeks), the trivalent attenuated OPV (tOPV) control group (tOPV at 6, 10, and 14 weeks), and the bOPV-IPV group (bOPV at 6, 10, and 14 weeks plus IPV at 14 weeks). Neutralising activity and poliovirus type-specific IgA were measured in stool after a monovalent OPV type 2 challenge at 18 weeks of age. Mucosal immunity was measured by in-vitro neutralisation of a type 2 polio pseudovirus (PV2). Neutralisation titres and total and poliovirus-type-specific IgG and IgA concentrations in stools were assessed in samples collected before challenge and 2 weeks after challenge from all participants. FINDINGS: 210 infants from Guatemala and Dominican Republic were included in this analysis. Of 38 infants tested for mucosal antibody in the tOPV group, two were shedding virus 1 week after challenge, compared with 59 of 85 infants receiving bOPV (p<0.0001) and 53 of 87 infants receiving bOPV-IPV (p<0.0001). Mucosal type 2 neutralisation and type-specific IgA were noted primarily in response to tOPV. An inverse correlation was noted between virus shedding and both serum type 2 neutralisation at challenge (p<0.0001) and mucosal type 2 neutralisation at challenge (p<0.0001). INTERPRETATION: Mucosal type-2-specific antibodies can be measured in stool and develop in response to receipt of OPV type 2 either in the primary vaccine series or at challenge. These mucosal antibodies influence the amount of virus that is shed in an established infection. FUNDING: Bill & Melinda Gates Foundation. |
Use of immunization information systems in primary care
Kempe A , Hurley LP , Cardemil CV , Allison MA , Crane LA , Brtnikova M , Beaty BL , Pabst LJ , Lindley MC . Am J Prev Med 2016 52 (2) 173-182 INTRODUCTION: Immunization information systems (IISs) are highly effective for increasing vaccination rates but information about how primary care physicians use them is limited. METHODS: Pediatricians, family physicians (FPs), and general internists (GIMs) were surveyed by e-mail and mail from January 2015 to April 2015 from all states with an existing IIS. Providers were recruited to be representative of national provider organization memberships. Multivariable log binomial regression examined factors associated with IIS use (October 2015-April 2016). RESULTS: Response rates among pediatricians, FPs, and GIMs, respectively, were 75% (325/435), 68% (310/459), and 63% (272/431). A proportion of pediatricians (5%), FPs (14%), and GIMs (48%) did not know there was a state/local IIS; 81%, 72%, and 27% reported using an IIS (p<0.0001). Among those who used IISs, 64% of pediatricians, 61% of FPs, and 22% of GIMs thought the IIS could tell them a patient's immunization needs; 22%, 29%, and 51% did not know. The most frequently reported major barriers to use included the IIS not updating the electronic medical record (29%, 28%, 35%) and lack of ability to submit data electronically (22%, 27%, 31%). Factors associated with lower IIS use included FP (adjusted risk ratio=0.85; 95% CI=0.75, 0.97) or GIM (adjusted risk ratio=0.33; 95% CI=0.25, 0.42) versus pediatric specialty and older versus younger provider age (adjusted risk ratio=0.96; 95 CI%=0.94, 0.98). CONCLUSIONS: There are substantial gaps in knowledge of IIS capabilities, especially among GIMs; barriers to interoperability between IISs and electronic medical records affect all specialties. Closing these gaps may increase use of proven IIS functions including decision support and reminder/recall. |
THRIVES: Using the best evidence to prevent violence against children
Hillis S , Mercy J , Saul J , Gleckel J , Abad N , Kress H . J Public Health Policy 2016 37 Suppl 1 51-65 More than 1 billion children - half the children in the world - are victims of violence every year. As part of the Post-2015 sustainable development agenda, the UN has issued a global call-to-action: to eliminate violence against children. Essential to preventing violence against children is guidance to countries on using the best available evidence to address this problem. THRIVES provides this evidence. It represents a framework of complementary strategies that, taken together, have potential to achieve and sustain efforts to prevent violence against children. These strategies, which span health, social services, education, and justice sectors, include Training in parenting, Household economic strengthening, Reduced violence through legislative protection, Improved services, Values and norms that protect children, Education and life skills, and Surveillance and evaluation. For each THRIVES area, we review evidence for effectiveness and identify programmatic or policy examples. This framework will facilitate commitments to effective, sustainable, and scalable action. |
Injury-related fatalities in selected governorates of Iraq from 2010 to 2013: Prospective surveillance
Bilukha OO , Sultan AS , Hassan A , Hussain SJ , Leidman E . Am J Disaster Med 2016 11 (1) 49-58 OBJECTIVE: After several years of relative stability in Iraq, the emergence of the Islamic State militant group has spurred a resurgence of violence. This study explores the impact of the conflict on the overall injury profile to estimate the proportion of injury fatalities related to conflict and better understand how violence has affected nonconflict-related injuries. DESIGN: Routine prospective injury surveillance operated by the Iraqi Ministry of Health. SETTING: Surveillance data were collected from coroner offices in eight pilot governorates: Al-Anbar, Baghdad, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. PARTICIPANTS: We analyzed all fatalities from external injury causes recorded between January 1, 2010 and December 31, 2013. Analysis included 32,664 fatal injuries. RESULTS: Of all injury fatalities reported, 27.1 percent were conflict-related fatalities, approximately the same proportion as road traffic-related fatalities (24.4 percent) and other unintentional injuries (27.5 percent). The proportion of fatalities from conflict was approximately three times higher among males than females (33.0 percent and 10.3 percent, respectively) and four times higher among adults than children (29.8 percent and 7.3 percent, respectively). The total number of injury fatalities remained stable between 2010 and 2012; an increase in injury fatalities in 2013 was driven primarily by increases in fatalities from both interpersonal violence and conflict. CONCLUSIONS: From 2010 to 2013, nearly one in four injury fatalities in Iraq was attributable to conflict, a notably higher proportion than other conflict-affected countries in the region. The overall profile of nonconflict injuries in Iraq is also distinct from other countries of similar socioeconomic level that have not experienced violence. |
Xpert MTB/RIF - why the lack of morbidity and mortality impact in intervention trials?
Auld AF , Fielding KL , Gupta-Wright A , Lawn SD . Trans R Soc Trop Med Hyg 2016 110 (8) 432-44 Compared with smear microscopy, the Xpert MTB/RIF assay (Xpert), with superior accuracy and capacity to diagnose rifampicin resistance, has advanced tuberculosis (TB) diagnostic capability. However, recent trials of Xpert impact have not demonstrated reductions in patient morbidity and mortality. We conducted a narrative review of Xpert impact trials to summarize which patient-relevant outcomes Xpert has improved and explore reasons for no observed morbidity or mortality reductions. We searched PubMed, Google Scholar, Cochrane Library and Embase and identified eight trials meeting inclusion criteria: three individually randomized, three cluster-randomized, and two pre-post trials. In six trials Xpert increased diagnostic yield of bacteriologically-confirmed TB from sputa and in four trials Xpert shortened time to TB treatment. However, all-cause mortality was similar between arms in all six trials reporting this outcome, and the only trial to assess Xpert impact on morbidity reported no impact. Trial characteristics that might explain lack of observed impact on morbidity and mortality include: higher rates of empiric TB treatment in microscopy compared with Xpert arms, enrollment of study populations not comprised exclusively of populations most likely to benefit from Xpert, and health system weaknesses. So far as equipoise exists, future trials that address past limitations are needed to inform Xpert use in resource-limited settings. |
Genetic Characterisation of Plasmodium falciparum Isolates with Deletion of the pfhrp2 and/or pfhrp3 Genes in Colombia: The Amazon Region, a Challenge for Malaria Diagnosis and Control.
Dorado EJ , Okoth SA , Montenegro LM , Diaz G , Barnwell JW , Udhayakumar V , Murillo Solano C . PLoS One 2016 11 (9) e0163137 Most Plasmodium falciparum-detecting rapid diagnostic tests (RDTs) target histidine-rich protein 2 (PfHRP2). However, P. falciparum isolates with deletion of the pfhrp2 gene and its homolog gene, pfhrp3, have been detected. We carried out an extensive investigation on 365 P. falciparum dried blood samples collected from seven P. falciparum endemic sites in Colombia between 2003 and 2012 to genetically characterise and geographically map pfhrp2- and/or pfhrp3-negative P. falciparum parasites in the country. We found a high proportion of pfhrp2-negative parasites only in Amazonas (15/39; 38.5%), and these parasites were also pfhrp3-negative. These parasites were collected between 2008 and 2009 in Amazonas, while pfhrp3-negative parasites (157/365, 43%) were found in all the sites and from each of the sample collection years evaluated (2003 to 2012). We also found that all pfhrp2- and/or pfhrp3-negative parasites were also negative for one or both flanking genes. Six sub-population clusters were established with 93.3% (14/15) of the pfhrp2-negative parasites grouped in the same cluster and sharing the same haplotype. This haplotype corresponded with the genetic lineage BV1, a multidrug resistant strain that caused two outbreaks reported in Peru between 2010 and 2013. We found this BV1 lineage in the Colombian Amazon as early as 2006. Two new clonal lineages were identified in these parasites from Colombia: the genetic lineages EV1 and F. PfHRP2 sequence analysis revealed high genetic diversity at the amino acid level, with 17 unique sequences identified among 53 PfHRP2 sequences analysed. The use of PfHRP2-based RDTs is not recommended in Amazonas because of the high proportion of parasites with pfhrp2 deletion (38.5%), and implementation of new strategies for malaria diagnosis and control in Amazonas must be prioritised. Moreover, studies to monitor and genetically characterise pfhrp2-negative P. falciparum parasites in the Americas are warranted, given the extensive human migration occurring in the region. |
Role of mesothelin in carbon nanotube-induced carcinogenic transformation of human bronchial epithelial cells
He X , Despeaux E , Stueckle TA , Chi A , Castranova V , Dinu CZ , Wang L , Rojanasakul Y . Am J Physiol Lung Cell Mol Physiol 2016 311 (3) L538-49 Carbon nanotubes (CNTs) have been likened to asbestos in terms of morphology and toxicity. CNT exposure can lead to pulmonary fibrosis and promotion of tumorigenesis. However, the mechanisms underlying CNT-induced carcinogenesis are not well defined. Mesothelin (MSLN) is overexpressed in many human tumors, including mesotheliomas and pancreatic and ovarian carcinomas. In this study, the role of MSLN in the carcinogenic transformation of human bronchial epithelial cells chronically exposed to single-walled CNT (BSW) was investigated. MSLN overexpression was found in human lung tumors, lung cancer cell lines, and BSW cells. The functional role of MSLN in the BSW cells was then investigated by using stably transfected MSLN knockdown (BSW shMSLN) cells. MSLN knockdown resulted in significantly decreased invasion, migration, colonies on soft agar, and tumor sphere formation. In vivo, BSW shMSLN cells formed smaller primary tumors and less metastases. The mechanism by which MSLN contributes to these more aggressive behaviors was investigated by using ingenuity pathway analysis, which predicted that increased MSLN could induce cyclin E expression. We found that BSW shMSLN cells had decreased cyclin E, and their proliferation rate was reverted to nearly that of untransformed cells. Cell cycle analysis showed that the BSW shMSLN cells had an increased G2 population and a decreased S phase population, which is consistent with the decreased rate of proliferation. Together, our results indicate a novel role of MSLN in the malignant transformation of bronchial epithelial cells following CNT exposure, suggesting its utility as a potential biomarker and drug target for CNT-induced malignancies. |
Manual for maintenance of multi-host ixodid ticks in the laboratory
Levin ML , Schumacher LB . Exp Appl Acarol 2016 70 (3) 343-367 Use of laboratory animals as hosts for blood-sucking arthropods remains a time-proven and the most efficient method for establishment and propagation of slowly feeding ixodid ticks, despite introduction of techniques involving artificial feeding on either animal skins or synthetic membranes. New Zealand White rabbits are usually the most accessible and most suitable hosts routinely used for establishment and maintenance of a large variety of multi-host tick species. Here we describe standard procedures for maintaining colonies of multi-host ixodid ticks by feeding all developmental stages (larvae, nymphs, and adults) upon New Zealand White rabbits. When needed, the same procedures can be easily adapted to other species of laboratory or domestic animals from mice to dogs and goats. A summary of our experience in maintaining laboratory colonies of Ixodes scapularis, Ixodes pacificus, Amblyomma americanum, Dermacentor variabilis, Dermacentor occidentalis, Haemaphysalis leporispalustris, and Rhipicephalus sanguineus with descriptions of the complete laboratory life cycles and reliable production of uninfected ticks under standardized conditions has been published by Troughton and Levin (J Med Entomol 44:732-740, 2007). Here we provide step-by-step recommendations for various procedures used in the maintenance of ixodid tick colonies based on over 20 years of experience. |
MicroRNA reduction of neuronal West Nile virus replication attenuates and affords a protective immune response in mice
Brostoff T , Pesavento PA , Barker CM , Kenney JL , Dietrich EA , Duggal NK , Bosco-Lauth AM , Brault AC . Vaccine 2016 34 (44) 5366-5375 West Nile virus (WNV) is an important agent of human encephalitis that has quickly become endemic across much of the United States since its identification in North America in 1999. While the majority ( approximately 75%) of infections are subclinical, neurologic disease can occur in a subset of cases, with outcomes including permanent neurologic damage and death. Currently, there are no WNV vaccines approved for use in humans. This study introduces a novel vaccine platform for WNV to reduce viral replication in the central nervous system while maintaining peripheral replication to elicit strong neutralizing antibody titers. Vaccine candidates were engineered to incorporate microRNA (miRNA) target sequences for a cognate miRNA expressed only in neurons, allowing the host miRNAs to target viral transcription through endogenous RNA silencing. To maintain stability, these targets were incorporated in multiple locations within the 3'-untranslated region, flanking sequences essential for viral replication without affecting the viral open reading frame. All candidates replicated comparably to wild type WNV in vitro within cells that did not express the cognate miRNA. Insertional control viruses were also capable of neuroinvasion and neurovirulence in vivo in CD-1 mice. Vaccine viruses were safe at all doses tested and did not demonstrate mutations associated with a reversion to virulence when serially passaged in mice. All vaccine constructs were protective from lethal challenge in mice, producing 93-100% protection at the highest dose tested. Overall, this is a safe and effective attenuation strategy with broad potential application for vaccine development. |
A multi-laboratory, multi-country study to determine bedaquiline minimal inhibitory concentration quality control ranges for phenotypic drug-susceptibility testing
Kaniga K , Cirillo DM , Hoffner S , Ismail NA , Kaur D , Lounis N , Metchock B , Pfyffer GE , Venter A . J Clin Microbiol 2016 54 (12) 2956-2962 OBJECTIVES: To establish standardized drug susceptibility testing (DST) methodologies and reference minimal inhibitory concentration (MIC) quality control (QC) ranges for bedaquiline, a diarylquinoline antimycobacterial, used in the treatment of adults with multidrug-resistant tuberculosis. METHODS: Two tier-2 QC reproducibility studies of bedaquiline DST were conducted in eight laboratories using Clinical Laboratory and Standards Institute (CLSI) guidelines. Agar dilution and broth microdilution methods were evaluated. Mycobacterium tuberculosis H37Rv was used as the QC reference strain. Bedaquiline MIC frequency, mode, and geometric mean were calculated. When resulting data occurred outside predefined CLSI criteria, the entire laboratory dataset was excluded. RESULTS: For the agar dilution MIC, a 4-dilution QC range (0.015-0.12 mug/ml) centered around the geometric mean included 95.8% (7H10 agar dilution; 204/213 observations with one dataset excluded) or 95.9% (7H11 agar dilution; 232/242) of bedaquiline MICs. For the 7H9 broth microdilution MIC, a 3-dilution QC range (0.015-0.06 mug/ml) centered around the mode included 98.1% (207/211 with one dataset excluded) of bedaquiline MICs. Microbiological equivalence was demonstrated for bedaquiline MICs determined using 7H10 agar and 7H11 agar, but not for bedaquiline MICs determined using 7H9 broth and 7H10 agar or 7H9 broth and 7H11 agar. CONCLUSIONS: Bedaquiline DST methodologies and MIC QC ranges against H37Rv M. tuberculosis reference strain have been established: 0.015-0.12 mug/ml for 7H10 and 7H11 agar dilution MICs, and 0.015-0.06 mug/ml for the 7H9 broth microdilution MIC. These methodologies and QC ranges will be submitted to CLSI and EUCAST to inform future research and provide guidance for routine clinical bedaquiline DST in laboratories worldwide. |
A Multilaboratory, Multicountry Study To Determine MIC Quality Control Ranges for Phenotypic Drug Susceptibility Testing of Selected First-Line Antituberculosis Drugs, Second-Line Injectables, Fluoroquinolones, Clofazimine, and Linezolid
Kaniga K , Cirillo DM , Hoffner S , Ismail NA , Kaur D , Lounis N , Metchock B , Pfyffer GE , Venter A . J Clin Microbiol 2016 OBJECTIVES: To establish reference minimal inhibitory concentration (MIC) quality control (QC) ranges for drug susceptibility testing of antimycobacterials, including first-line agents, second-line injectables, fluoroquinolones and World Health Organization Category 5 drugs for multidrug-resistant tuberculosis, using a 7H9 broth microdilution MIC method. METHODS: A Tier-2 reproducibility study was conducted in eight participating laboratories using Clinical Laboratory and Standards Institute (CLSI) guidelines. Three lots of custom-made frozen 96-well polystyrene micro titer plates were used and pre-prepared with 2X pre-diluted drugs in 7H9 broth/oleic acid albumin dextrose catalase. The QC reference strain was Mycobacterium tuberculosis (MTB) H37Rv. MIC frequency, mode and geometric mean were calculated for each drug. QC ranges were derived, based on predefined, strict CLSI criteria. Any data lying outside CLSI criteria resulted in exclusion of the entire laboratory dataset. RESULTS: Data from one laboratory were excluded due to higher MIC values than for other laboratories. QC ranges were established for eleven drugs: isoniazid (0.03-0.12 mug/ml), rifampin (0.03-0.25 mug/ml), ethambutol (0.25-2 mug/ml), levofloxacin (0.12-1 mug/ml), moxifloxacin (0.06-0.5 mug/ml), ofloxacin (0.25-2 mug/ml), amikacin (0.25-2 mug/ml), kanamycin (0.25-2 mug/ml), capreomycin (0.5-4 mug/ml), linezolid (0.25-2 mug/ml) and clofazimine (0.03-0.25 mug/ml). QC ranges could not be established for nicotinamide (pyrazinamide surrogate), prothionamide or ethionamide, which were assay non-performers. CONCLUSIONS: Using strict CLSI criteria, QC ranges against the MTB H37Rv reference strain were established for the majority of commonly used antituberculosis drugs, with a convenient 7H9 broth microdilution MIC method suitable for use in resource-limited settings. |
Near real-time measurement of carbonaceous aerosol using microplasma spectroscopy: Application to measurement of carbon nanomaterials
Zheng L , Kulkarni P , Birch ME , Deye G , Dionysiou DD . Aerosol Sci Technol 2016 50 (11) 1155-1166 A sensitive, field-portable microplasma spectroscopy method has been developed for real-time measurement of carbon nanomaterials. The method involves microconcentration of aerosol on a microelectrode tip for subsequent analysis for atomic carbon using spark emission spectroscopy (SES). The spark-induced microplasma was characterized by measuring the excitation temperature (15,000-35,000 K), electron density (1.0 × 1017−2.2 × 1017 cm−3), and spectral responses as functions of time and interelectrode distance. The system was calibrated and detection limits were determined for total atomic carbon (TAC) using a carbon emission line at 247.856 nm (C I) for various carbonaceous materials including sucrose, EDTA, caffeine, sodium carbonate, carbon black, and carbon nanotubes. The limit of detection for total atomic carbon was 1.61 ng, equivalent to 238 ng m−3 when sampling at 1.5 L min−1 for 5 min. To improve the selectivity for carbon nanomaterials, which mainly consist of elemental carbon (EC), the cathode was heated to 300°C to reduce the contribution of organic carbon to the total atomic carbon. Measurements of carbon nanotube aerosol at elevated electrode temperature showed improved selectivity to elemental carbon and compared well with the measurements from the thermal optical method (NIOSH Method 5040). The study shows the SES method to be an excellent candidate for development of low-cost, hand-portable, real-time instrument for measurement of carbonaceous aerosols and nanomaterials. |
New approaches to wipe sampling methods for antineoplastic and other hazardous drugs in healthcare settings
Connor T H , Smith J P . Pharm Technol Hosp Pharm 2016 1 (3) 107-114 Purpose: At the present time, the method of choice to determine surface contamination of the workplace with antineoplastic and other hazardous drugs is surface wipe sampling and subsequent sample analysis with various analytical techniques. The purpose of this article is to review current methodology for determining the level of surface contamination with hazardous drugs in healthcare settings and to discuss recent advances in this area. In addition it will provide some guidance for conducting surface wipe sampling and sample analysis for these drugs in healthcare settings. Methods: Published studies on the use of wipe sampling to measure hazardous chemicals, including antineoplastic drugs on surfaces were reviewed. These studies include the use of well-documented chromatographic techniques for sample analysis in addition to newly evolving technology that provides rapid analysis of specific antineoplastic drugs. Results: Methodology for the analysis of surface wipe samples for hazardous drugs are reviewed, including the purposes, technical factors, sampling strategy, materials required, and limitations. The use of lateral flow immunoassay (LFIA) and fluorescence covalent microbead immunosorbent assay (FCMIA) for surface wipe sample evaluation is also discussed. Conclusions: Current recommendations are that all healthcare settings where antineoplastic and other hazardous drugs are handled include surface wipe sampling as part of a comprehensive hazardous drug-safe handling program. Surface wipe sampling may be used as a method to characterize potential occupational dermal exposure risk and to evaluate the effectiveness of implemented controls and the overall safety program. New technology, although currently limited in scope, may make wipe sampling for hazardous drugs more routine, less costly, and provide a shorter response time than classical analytical techniques now in use. |
A polyvalent inactivated rhinovirus vaccine is broadly immunogenic in rhesus macaques
Lee S , Nguyen MT , Currier MG , Jenkins JB , Strobert EA , Kajon AE , Madan-Lala R , Bochkov YA , Gern JE , Roy K , Lu X , Erdman DD , Spearman P , Moore ML . Nat Commun 2016 7 12838 As the predominant aetiological agent of the common cold, human rhinovirus (HRV) is the leading cause of human infectious disease. Early studies showed that a monovalent formalin-inactivated HRV vaccine can be protective, and virus-neutralizing antibodies (nAb) correlated with protection. However, co-circulation of many HRV types discouraged further vaccine efforts. Here, we test the hypothesis that increasing virus input titres in polyvalent inactivated HRV vaccine may result in broad nAb responses. We show that serum nAb against many rhinovirus types can be induced by polyvalent, inactivated HRVs plus alhydrogel (alum) adjuvant. Using formulations up to 25-valent in mice and 50-valent in rhesus macaques, HRV vaccine immunogenicity was related to sufficient quantity of input antigens, and valency was not a major factor for potency or breadth of the response. Thus, we have generated a vaccine capable of inducing nAb responses to numerous and diverse HRV types. |
Implementation of the World Health Organization regional office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation
Ndihokubwayo JB , Maruta T , Ndlovu N , Moyo S , Yahaya AA , Coulibaly SO , Kasolo F , Turgeon D , Abrol AP . Afr J Lab Med 2016 5 (1) 280 Background: The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program. SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1-5 stars were issued. Preliminary results: By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62-77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%. Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process. Copyright © 2016. The Authors. Licensee: AOSIS. |
Increases in endogenous or exogenous progestins promote virus-target cell interactions within the non-human primate female reproductive tract
Carias AM , Allen SA , Fought AJ , Kotnik Halavaty K , Anderson MR , Jimenez ML , McRaven MD , Gioia CJ , Henning TR , Kersh EN , Smith JM , Pereira LE , Butler K , McNicholl SJ , Hendry RM , Kiser PF , Veazey RS , Hope TJ . PLoS Pathog 2016 12 (9) e1005885 Currently, there are mounting data suggesting that HIV-1 acquisition in women can be affected by the use of certain hormonal contraceptives. However, in non-human primate models, endogenous or exogenous progestin-dominant states are shown to increase acquisition. To gain mechanistic insights into this increased acquisition, we studied how mucosal barrier function and CD4+ T-cell and CD68+ macrophage density and localization changed in the presence of natural progestins or after injection with high-dose DMPA. The presence of natural or injected progestins increased virus penetration of the columnar epithelium and the infiltration of susceptible cells into a thinned squamous epithelium of the vaginal vault, increasing the likelihood of potential virus interactions with target cells. These data suggest that increasing either endogenous or exogenous progestin can alter female reproductive tract barrier properties and provide plausible mechanisms for increased HIV-1 acquisition risk in the presence of increased progestin levels. |
Infectivity of attenuated poxvirus vaccine vectors and immunogenicity of a raccoonpox vectored rabies vaccine in the Brazilian Free-tailed bat (Tadarida brasiliensis)
Stading BR , Osorio JE , Velasco-Villa A , Smotherman M , Kingstad-Bakke B , Rocke TE . Vaccine 2016 34 (44) 5352-5358 Bats (Order Chiroptera) are an abundant group of mammals with tremendous ecological value as insectivores and plant dispersers, but their role as reservoirs of zoonotic diseases has received more attention in the last decade. With the goal of managing disease in free-ranging bats, we tested modified vaccinia Ankara (MVA) and raccoon poxvirus (RCN) as potential vaccine vectors in the Brazilian Free-tailed bat (Tadarida brasiliensis), using biophotonic in vivo imaging and immunogenicity studies. Animals were administered recombinant poxviral vectors expressing the luciferase gene (MVA-luc, RCN-luc) through oronasal (ON) or intramuscular (IM) routes and subsequently monitored for bioluminescent signal indicative of viral infection. No clinical illness was noted after exposure to any of the vectors, and limited luciferase expression was observed. Higher and longer levels of expression were observed with the RCN-luc construct. When given IM, luciferase expression was limited to the site of injection, while ON exposure led to initial expression in the oral cavity, often followed by secondary replication at another location, likely the gastric mucosa or gastric associated lymphatic tissue. Viral DNA was detected in oral swabs up to 7 and 9 days post infection (dpi) for MVA and RCN, respectively. While no live virus was detected in oral swabs from MVA-infected bats, titers up to 3.88 x 104 PFU/ml were recovered from oral swabs of RCN-infected bats. Viral DNA was also detected in fecal samples from two bats inoculated IM with RCN, but no live virus was recovered. Finally, we examined the immunogenicity of a RCN based rabies vaccine (RCN-G) following ON administration. Significant rabies neutralizing antibody titers were detected in the serum of immunized bats using the rapid fluorescence focus inhibition test (RFFIT). These studies highlight the safety and immunogenicity of attenuated poxviruses and their potential use as vaccine vectors in bats. |
Accumulation of ubiquitin and sequestosome-1 implicate protein damage in diacetyl-induced cytotoxicity
Hubbs AF , Fluharty KL , Edwards RJ , Barnabei JL , Grantham JT , Palmer SM , Kelly F , Sargent LM , Reynolds SH , Mercer RR , Goravanahally MP , Kashon ML , Honaker JC , Jackson MC , Cumpston AM , Goldsmith WT , McKinney W , Fedan JS , Battelli LA , Munro T , Bucklew-Moyers W , McKinstry K , Schwegler-Berry D , Friend S , Knepp AK , Smith SL , Sriram K . Am J Pathol 2016 186 (11) 2887-2908 Inhaled diacetyl vapors are associated with flavorings-related lung disease, a potentially fatal airway disease. The reactive alpha-dicarbonyl group in diacetyl causes protein damage in vitro. Dicarbonyl/l-xylulose reductase (DCXR) metabolizes diacetyl into acetoin, which lacks this alpha-dicarbonyl group. To investigate the hypothesis that flavorings-related lung disease is caused by in vivo protein damage, we correlated diacetyl-induced airway damage in mice with immunofluorescence for markers of protein turnover and autophagy. Western immunoblots identified shifts in ubiquitin pools. Diacetyl inhalation caused dose-dependent increases in bronchial epithelial cells with puncta of both total ubiquitin and K63-ubiquitin, central mediators of protein turnover. This response was greater in Dcxr-knockout mice than in wild-type controls inhaling 200 ppm diacetyl, further implicating the alpha-dicarbonyl group in the protein damage. Western immunoblots demonstrated decreased free ubiquitin in airway-enriched fractions. Transmission electron microscopy and colocalization of ubiquitin-positive puncta with lysosomal markers lysosomal-associated membrane protein 1 and 2 and with the multifunctional scaffolding protein sequestosome-1 (SQSTM1/p62) confirmed autophagy. Surprisingly, immunoreactive SQSTM1 also accumulated in the olfactory bulb of the brain. Olfactory bulb SQSTM1 often congregated in activated microglial cells that also contained olfactory marker protein, indicating neuronophagia within the olfactory bulb. This suggests the possibility that SQSTM1 or damaged proteins may be transported from the nose to the brain. Together, these findings strongly implicate widespread protein damage in the etiology of flavorings-related lung disease. |
Characterization of silver particles in the stratum corneum of healthy subjects and atopic dermatitis patients dermally exposed to a silver-containing garment
Bianco C , Visser MJ , Pluut OA , Svetlicic V , Pletikapic G , Jakasa I , Riethmuller C , Adami G , Larese Filon F , Schwegler-Berry D , Stefaniak AB , Kezic S . Nanotoxicology 2016 10 (10) 1-32 Silver is increasingly being used in garments to exploit its antibacterial properties. Information on the presence of silver nanoparticles (AgNPs) in garments and their in vivo penetration across healthy and impaired skin from use is limited. We investigated the presence of AgNPs in a silver containing garment and in the stratum corneum (SC) of healthy subjects (CTRLs) and individuals with atopic dermatitis (AD). Seven CTRLs and seven AD patients wore a silver sleeve (13% Ag w/w) 8 hours/day for 5 days on a forearm and a placebo sleeve on the other forearm. After 5 days the layers of the SC were collected by adhesive tapes. The silver particles in the garment and SC were characterized by scanning electron microscopy (SEM-EDX) and atomic force microscopy (AFM). AFM and SEM revealed the presence of sub-micrometre particles having a broad range of sizes (30-500 nm) on the surface of the garment that were identified as silver. On the SC tapes collected from different depths, aggregates with a wide range of sizes (150 nm - 2 microm) and morphologies were found. Most aggregates contained primarily silver, although some also contained chlorine and sulphur. There was no clear difference in the number or size of the aggregates observed in SC between healthy and AD subjects. After use, AgNPs and their aggregates were present in the SC at different depths of both healthy subjects and AD patients. Their micrometre size suggests that aggregation likely occurred in the SC. |
Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): An extension of the strobe statement for neonatal infection research
Fitchett EJ , Seale AC , Vergnano S , Sharland M , Heath PT , Saha SK , Agarwal R , Ayede AI , Bhutta ZA , Black R , Bojang K , Campbell H , Cousens S , Darmstadt GL , Madhi SA , Meulen AS , Modi N , Patterson J , Qazi S , Schrag SJ , Stoll BJ , Wall SN , Wammanda RD , Lawn JE . Lancet Infect Dis 2016 16 (10) e202-e213 Neonatal infections are estimated to account for a quarter of the 2.8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines. |
Direct-on-filter alpha-quartz estimation in respirable coal mine dust using transmission fourier transform infrared spectrometry and partial least squares regression
Miller AL , Weakley AT , Griffiths PR , Cauda EG , Bayman S . Appl Spectrosc 2016 71 (5) 1014-1024 In order to help reduce silicosis in miners, the National Institute for Occupational Health and Safety (NIOSH) is developing field-portable methods for measuring airborne respirable crystalline silica (RCS), specifically the polymorph alpha-quartz, in mine dusts. In this study we demonstrate the feasibility of end-of-shift measurement of alpha-quartz using a direct-on-filter (DoF) method to analyze coal mine dust samples deposited onto polyvinyl chloride filters. The DoF method is potentially amenable for on-site analyses, but deviates from the current regulatory determination of RCS for coal mines by eliminating two sample preparation steps: ashing the sampling filter and redepositing the ash prior to quantification by Fourier transform infrared (FT-IR) spectrometry. In this study, the FT-IR spectra of 66 coal dust samples from active mines were used, and the RCS was quantified by using: (1) an ordinary least squares (OLS) calibration approach that utilizes standard silica material as done in the Mine Safety and Health Administration's P7 method; and (2) a partial least squares (PLS) regression approach. Both were capable of accounting for kaolinite, which can confound the IR analysis of silica. The OLS method utilized analytical standards for silica calibration and kaolin correction, resulting in a good linear correlation with P7 results and minimal bias but with the accuracy limited by the presence of kaolinite. The PLS approach also produced predictions well-correlated to the P7 method, as well as better accuracy in RCS prediction, and no bias due to variable kaolinite mass. Besides decreased sensitivity to mineral or substrate confounders, PLS has the advantage that the analyst is not required to correct for the presence of kaolinite or background interferences related to the substrate, making the method potentially viable for automated RCS prediction in the field. This study demonstrated the efficacy of FT-IR transmission spectrometry for silica determination in coal mine dusts, using both OLS and PLS analyses, when kaolinite was present. |
Comparative genomics reveals adaptive evolution of Asian tapeworm in switching to a new intermediate host.
Wang S , Wang S , Luo Y , Xiao L , Luo X , Gao S , Dou Y , Zhang H , Guo A , Meng Q , Hou J , Zhang B , Zhang S , Yang M , Meng X , Mei H , Li H , He Z , Zhu X , Tan X , Zhu XQ , Yu J , Cai J , Zhu G , Hu S , Cai X . Nat Commun 2016 7 12845 Taenia saginata, Taenia solium and Taenia asiatica (beef, pork and Asian tapeworms, respectively) are parasitic flatworms of major public health and food safety importance. Among them, T. asiatica is a newly recognized species that split from T. saginata via an intermediate host switch approximately 1.14 Myr ago. Here we report the 169- and 168-Mb draft genomes of T. saginata and T. asiatica. Comparative analysis reveals that high rates of gene duplications and functional diversifications might have partially driven the divergence between T. asiatica and T. saginata. We observe accelerated evolutionary rates, adaptive evolutions in homeostasis regulation, tegument maintenance and lipid uptakes, and differential/specialized gene family expansions in T. asiatica that may favour its hepatotropism in the new intermediate host. We also identify potential targets for developing diagnostic or intervention tools against human tapeworms. These data provide new insights into the evolution of Taenia parasites, particularly the recent speciation of T. asiatica. |
Opportunities for integrated control of neglected tropical diseases that affect the skin
Engelman D , Fuller LC , Solomon AW , McCarthy JS , Hay RJ , Lammie PJ , Steer AC . Trends Parasitol 2016 32 (11) 843-854 Many neglected tropical diseases (NTDs) affect the skin, causing considerable disability, stigma, and exacerbation of poverty. However, there has been relatively little investment into laboratory research, epidemiology, diagnostic tools or management strategies to control tropical skin disease. Integration may advance the control of skin disease across a range of domains, including mapping, diagnosis, clinical management, and community control measures such as mass drug administration. Examples of successful integration strategies include programs targeting scabies, impetigo, yaws, and diseases causing lymphoedema. Future strategies should build on these experiences and the experience of integration of other NTDs, strengthen existing health systems, and contribute toward the attainment of Universal Health Coverage. Strong partnerships and political support and will be necessary to achieve these goals. |
Perceptions of emerging tobacco products and nicotine replacement therapy among pregnant women and women planning a pregnancy
England LJ , Tong VT , Koblitz A , Kish-Doto J , Lynch MM , Southwell BG . Prev Med Rep 2016 4 481-5 The increasing availability of emerging non-combusted tobacco products (snus, dissolvables, and electronic nicotine delivery systems or ENDS) may have implications for pregnant women and women of reproductive age. We conducted 15 focus groups to explore how women perceive emerging non-combusted tobacco products and nicotine replacement therapy (NRT) in general, and during pregnancy. Sessions were held in 2013 in four U.S. cities. Participants were 18-40 years old and were pregnant smokers, pregnant quitters, or smokers planning a pregnancy. Responses were coded and analyzed to identify key themes using NVivo 10.0 qualitative software (QSR). Several themes emerged from focus groups. Participants generally found snus unappealing, but viewed dissolvables as a discreet and stigma-free way to use tobacco during pregnancy. Participants perceived NRT as ineffective and having undesired side effects. ENDS were thought to offer advantages over cigarettes, including use in smoke-free areas, lower cost, appealing flavors, and fewer health effects, and were seen by some as a potential quit aid. Some participants, however, worried that the lack of natural stopping point could lead to excessive use. Many participants felt that the use of any tobacco or NRT product is harmful during pregnancy. Women seeking to reduce health risks or stigma related to smoking during pregnancy may perceive advantages of using some emerging products over cigarettes. These findings can inform future public health efforts to reduce risks associated with tobacco product use among women of reproductive age. |
Ever-use and curiosity about cigarettes, cigars, smokeless tobacco, and electronic cigarettes among US middle and high school students, 2012-2014
Persoskie A , Donaldson EA , King BA . Prev Chronic Dis 2016 13 E134 INTRODUCTION: Among young people, curiosity about tobacco products is a primary reason for tobacco experimentation and is a risk factor for future use. We examined whether curiosity about and ever-use of tobacco products among US middle and high school students changed from 2012 to 2014. METHODS: Data came from the 2012 and 2014 National Youth Tobacco Surveys, nationally representative surveys of US students in grades 6 through 12. For cigarettes, cigars, smokeless tobacco, and e-cigarettes (2014 only), students were classified as ever-users or never-users of each product. Among never-users, curiosity about using each product was assessed by asking participants if they had "definitely," "probably," "probably not," or "definitely not" been curious about using the product. RESULTS: From 2012 to 2014, there were declines in ever-use of cigarettes (26% to 22%; P = .005) and cigars (21% to 18%; P = .003) overall and among students who were Hispanic (cigarettes, P = .001; cigars, P = .001) or black (cigarettes, P = .004; cigars, P = .01). The proportion of never-users reporting they were "definitely not" curious increased for cigarettes (51% to 54%; P = .01) and cigars (60% to 63%; P = .03). Ever-use and curiosity about smokeless tobacco did not change significantly from 2012 to 2014. In 2014, the proportion of young people who were "definitely" or "probably" curious never-users of each product was as follows: cigarettes, 11.4%; e-cigarettes, 10.8%; cigars, 10.3%; and smokeless tobacco, 4.4%. CONCLUSION: The proportion of US students who are never users and are not curious about cigarettes and cigars increased. However, many young people remain curious about tobacco products, including e-cigarettes. Understanding factors driving curiosity can inform tobacco use prevention for youth. |
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