title: The role of apoptosis within the retina of coronavirus-infected mice.

text: PURPOSE To evaluate the possible roles of apoptosis in the murine retinopathy induced by coronavirus. METHODS Mice were inoculated with virus intravitreally. Mouse eyes harvested at varying times after inoculation were evaluated for apoptotic and immunologic events by hematoxylin and eosin staining, immunohistochemical staining, in situ terminal deoxynucleotidyltransferase dUTP nick-end labeling (TUNEL) assay, and electron microscopy. Isolated retinas were analyzed for infectious virus and for expression of apoptosis-associated genes. RESULTS The number of apoptotic events was significantly elevated in infected eyes from BALB/c and CD-1 mouse strains, reaching a maximum at days 6 through 10, and returning to normal levels at day 20. The majority of apoptotic cells were observed in the outer nuclear layer of the infected retina. In contrast, few apoptotic cells were observed in normal or mock-injected mouse eyes. Apoptotic events within the retina were associated with the presence of viral antigen, infiltration of CD8(+) T cells, and clearance of infectious virus. Reverse transcription-polymerase chain reaction (RT-PCR) analysis identified the upregulation of Fas ligand (FasL) and granzyme B mRNAs within the infected retinas. The development of apoptosis, regulative gene expression, and viral clearance were similar in both retinal degeneration-susceptible (BALB/c) and -resistant (CD-1) mice. CONCLUSIONS Retinal apoptosis was associated with retinal inflammation, a decrease in infectious virus, and upregulation of genes associated with CTL killing. These studies indicate that retinal apoptosis may be one of the host mechanisms that contribute to limiting this retinal infection.


title: Distribution of serum measles-neutralizing antibodies according to age in women of childbearing age in France in 2005-2006: impact of routine immunization.

text: Measles antibody titers were measured in 210 French women. Ninety-four percent had protective values (>120 mIU/mL). Geometric mean titers were significantly different (P < 0.001) between women born before and after 1983, when measles vaccination was recommended (731 and 1358 mIU/mL, respectively). geometric mean titers in 4 age cohorts decreased significantly (P < 0.001) with increasing birth year. These data may help identify the appropriate age for infant vaccination.


title: Influenza and SARS: the impact of viral pandemics on maritime health.

text: Global travel and transport play a critical role in the spread of infections. We see this clearly in the first two pandemics of the 21st century: SARS and influenza H1N1-2009. Although air travel contributed to dissemination in these two pandemics, the travel restrictions, quarantines, and heightened vigilance which resulted had an impact on maritime health. Seasonal, pandemic, and avian influenza have some important differences with regards to exposure risks, infectivity, and severity. Most of the data for maritime influenza outbreaks focus on seasonal influenza on cruise ships, but influenza among crew members occurs due to close working conditions and is potentially preventable with staff vaccination programs. To date, avian influenza has low human-to-human transmission; infection typically requires close contact with poultry, but presents with severe disease and a high fatality rate. Pandemic (swine) influenza was readily transmitted between people, including young adults, and caused severe illness in high-risk groups including pregnant women, children, and those with co-morbidities and obesity. In contrast, SARS had lower infectivity compared to influenza, and a longer incubation period. These characteristics slowed its propagation enough that outbreak control measures, such as isolation of infected cases and quarantine of exposed but well persons, were effective in terminating this pandemic. No effective vaccine exists for SARS at this time, whereas countries were able to deploy millions of doses of pandemic influenza vaccine within 7 months after the outbreak was first recognized in Mexico. The lack of a protective vaccine and the higher case fatality rate in SARS will mean that stringent quarantine measures may still be required for outbreak control if SARS ever occurs again. Compliance with international health regulations, and the ability to adapt these to maritime health needs, will be important in the shipping industry.


title: Emerging and re-emerging arboviral diseases in Southeast Asia.

text: Arthropod-borne viruses (arboviruses) have become significant public health problems, with the emergence and re-emergence of arboviral diseases nearly worldwide. The most populated Southeast Asia region is particularly vulnerable. The arboviral diseases such as dengue (DEN), Japanese encephalitis (JE), West Nile virus (WNV), chikungunya fever (CHIK), hemorrhagic fevers such as Crimean-Congo hemorrhagic (CCHF) fever, Kyasanur forest disease virus (KFDV), etc. are on the rise and have spread unprecedentedly, causing considerable burden of disease. The emergence/re-emergence of these diseases is associated with complex factors, such as viral recombination and mutation, leading to more virulent and adaptive strains, urbanization and human activities creating more permissive environment for vector-host interaction, and increased air travel and commerce. Climate is a major factor in determining the geographic and temporal distribution of arthropods, the characteristics of arthropod life cycles, the consequent dispersal patterns of associated arboviruses, the evolution of arboviruses; and the efficiency with which they are transmitted from arthropods to vertebrate hosts. The present and future arboviral threats must be mitigated by priority actions such as improving surveillance and outbreak response, establishing collaboration and communication intersectorally, and strengthening the prevention and control programmes along with improving biosafety aspects with regards to highly infectious nature of these arboviral diseases. Evidence from research needs to be generated and priority areas for research defined.


title: Preliminary evaluation of a multiplex reverse transcription-PCR assay combined with a new DNA chip hybridization assay for detecting respiratory syncytial virus.

text: DNA chips represent a major advance in microbiology laboratories, enabling the detection of a wide range of possible pathogens using a single test. This study compared a multiplex reverse transcription-PCR combined with DNA chip hybridization (ProDect BCS RV chip; bcs Biotech) with the indirect immunofluorescence test commonly used to detect respiratory viruses. A total of 39 respiratory viruses (38 respiratory syncytial viruses [RSVs] and 1 influenza A virus) were detected in samples from 96 patients using the immunofluorescence test, while 36 viruses (34 RSV, 1 influenza A virus, and 1 influenza B virus) were detected by the DNA chip technique. Results showed a good level of agreement between the two tests for RSV detection; the incidence of other viruses was low, since samples were taken from patients with suspected bronchiolitis. DNA chips displayed high sensitivity (94.6%) and specificity (100%).


title: Usefulness of intraoperative monitoring of visual evoked potentials in transsphenoidal surgery.

text: Postoperative visual outcome is a major concern in transsphenoidal surgery (TSS). Intraoperative visual evoked potential (VEP) monitoring has been reported to have little usefulness in predicting postoperative visual outcome. To re-evaluate its usefulness, we adapted a high-power light-stimulating device with electroretinography (ERG) to ascertain retinal light stimulation. Intraoperative VEP monitoring was conducted in TSSs in 33 consecutive patients with sellar and parasellar tumors under total venous anesthesia. The detectability rates of N75, P100, and N135 were 94.0%, 85.0%, and 79.0%, respectively. The mean latencies and amplitudes of N75, P100, and N135 were 76.8 ± 6.4 msec and 4.6 ± 1.8 μV, 98.0 ± 8.6 msec and 5.0 ± 3.4 μV, and 122.1 ± 16.3 msec and 5.7 ± 2.8 μV, respectively. The amplitude was defined as the voltage difference from N75 to P100 or P100 to N135. The criterion for amplitude changes was defined as a > 50% increase or 50% decrease in amplitude compared to the control level. The surgeon was immediately alerted when the VEP changed beyond these thresholds, and the surgical manipulations were stopped until the VEP recovered. Among the 28 cases with evaluable VEP recordings, the VEP amplitudes were stable in 23 cases and transiently decreased in 4 cases. In these 4 cases, no postoperative vision deterioration was observed. One patient, whose VEP amplitude decreased without subsequent recovery, developed vision deterioration. Intraoperative VEP monitoring with ERG to ascertain retinal light stimulation by the new stimulus device was reliable and feasible in preserving visual function in patients undergoing TSS.


Use of mobile phones in hospitals.


Mapping the epitopes of antibodies.


title: Tocotrienols: the emerging face of natural vitamin E.

text: Natural vitamin E includes eight chemically distinct molecules: alpha-, beta-, gamma-, and delta-tocopherols and alpha-, beta-, gamma-, and delta-tocotrienols. More than 95% of all studies on vitamin E are directed toward the specific study of alpha-tocopherol. The other forms of natural vitamin E remain poorly understood. The abundance of alpha-tocopherol in the human body and the comparable efficiency of all vitamin E molecules as antioxidants led biologists to neglect the non-tocopherol vitamin E molecules as topics for basic and clinical research. Recent developments warrant a serious reconsideration of this conventional wisdom. The tocotrienol subfamily of natural vitamin E possesses powerful neuroprotective, anticancer, and cholesterol-lowering properties that are often not exhibited by tocopherols. Current developments in vitamin E research clearly indicate that members of the vitamin E family are not redundant with respect to their biological functions. alpha-Tocotrienol, gamma-tocopherol, and delta-tocotrienol have emerged as vitamin E molecules with functions in health and disease that are clearly distinct from that of alpha-tocopherol. At nanomolar concentration, alpha-tocotrienol, not alpha-tocopherol, prevents neurodegeneration. On a concentration basis, this finding represents the most potent of all biological functions exhibited by any natural vitamin E molecule. Recently, it has been suggested that the safe dose of various tocotrienols for human consumption is 200-1000/day. A rapidly expanding body of evidence supports that members of the vitamin E family are functionally unique. In recognition of this fact, title claims in publications should be limited to the specific form of vitamin E studied. For example, evidence for toxicity of a specific form of tocopherol in excess may not be used to conclude that high-dosage "vitamin E" supplementation may increase all-cause mortality. Such conclusion incorrectly implies that tocotrienols are toxic as well under conditions where tocotrienols were not even considered. The current state of knowledge warrants strategic investment into the lesser known forms of vitamin E. This will enable prudent selection of the appropriate vitamin E molecule for studies addressing a specific health need.


Response to critique of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial by Abou-Chebl and Steinmetz.


US soldiers refuse to fall in line with anthrax vaccination scheme.


title: How Clean Are Hotel Rooms? Part II: Examining the Concept of Cleanliness Standards.

text: Hotel room cleanliness is based on observation and not on microbial assessment even though recent reports suggest that infections may be acquired while staying in hotel rooms. Exploratory research in the first part of the authors' study was conducted to determine if contamination of hotel rooms occurs and whether visual assessments are accurate indicators of hotel room cleanliness. Data suggested the presence of microbial contamination that was not reflective of visual assessments. Unfortunately, no standards exist for interpreting microbiological data and other indicators of cleanliness in hotel rooms. The purpose of the second half of the authors' study was to examine cleanliness standards in other industries to see if they might suggest standards in hotels. Results of the authors' study indicate that standards from other related industries do not provide analogous criteria, but do provide suggestions for further research.


title: HIV/AIDS policy and policy evolution in China.

text: The early cases of HIV/AIDS in China were mostly foreign nationals. The Chinese government's response then was to stop and prevent HIV from entering China. However, the policy was not effective. From the middle 1990s, HIV/ AIDS spread all over China and all modes of transmission have been reported. By the end of 2003, China estimated that there were 840,000 cases of HIV/AIDS. China's HIV/AIDS policy has been changing along with its epidemic change. Based on an extensive document and literature review, I depict China's HIV/AIDS epidemic and policy and illustrate the main factors contributing to its policy evolution.


title: Pathogenicity of porcine respiratory coronavirus isolated in Québec.

text: Porcine respiratory coronavirus (PRCV) is present in many countries, including Canada, but controversy still exists concerning its pathogenicity. Eight-week-old piglets were inoculated intratracheally with a Quebec PRCV isolate (1Q90). Two contact piglets were kept with the inoculated animals. Three animals served as control. Polypnea and dyspnea were the main clinical signs observed. Diffuse bronchioloalveolar damage occurred 24 hours postinoculation. Changes compatible with bronchointerstitial pneumonia were present six days postinoculation. The inoculated virus was recovered from the respiratory tract and mesenteric lymph nodes, but not from the digestive tract, of the inoculated as well as the contact piglets. No virus was isolated from the control piglets. The development of clinical signs and histopathological changes in inoculated as well as in contact piglets and the reisolation of the inoculated virus demonstrated that PRCV can be an important respiratory pathogen.


Healthcare workers baulk at caring for contagious patients.


title: The effects of exercise on the immune system and stress hormones in sportswomen.

text: BACKGROUND Despite the numerous studies controversial results exist in specific immune response to exercise. The aim of this study was to determining the differences in the humoral immune parameters, serum ACTH and cortisol levels existing between sportswomen and sedentary subjects and the effect of acute aerobic and anaerobic exercise on these parameters. MATERIALS/METHODS 40 sportswomen (Groups 1 and 2) and 20 sedentary women (Group 3) were enrolled and Group 1 performed aerobic exercise on a treadmill for 30 minutes while the Group 2 was subjected to the Wingate effort test for 30 seconds. Before exercising (at 8.30 a.m), immediately after the exercise, and 4 hours, days 2 and 5 days after exercising blood samples were obtained and the levels of IgA, IgG, IgM, complement 3 (C3) and complement 4 (C4) were determined turbidometrically. RESULTS Before exercise: the means of IgA and IgG values in the G1 and G2 groups were higher than the Group G3, and the mean cortisol levels in the sedentary group was significantly higher (p<0.05). After Exercise: Whereas the C3 and C4 levels decreased significantly at the end of the exercise in Group 1 and 2 (p<0.05), the IgA, IgG (p<0.05) and IgM levels (p<0.01) at the 4th and 5th determinations were observed to be significantly higher in only the Group 1. The cortisol and ACTH levels were found to have increased significantly (p<0.05) in the Group 1. In Group 2, no changes were observed in the IgA, IgG and IgM levels. CONCLUSIONS We conclude that regular and moderate exercise has favorable effects on the immune system by increasing immunoglobulins which are potent protective factors.


title: [Application of bioactive mutant TNF alpha to a mucosal vaccine adjuvant].

text: A large number of emerging pathogens, such as severe acute respiratory syndrome (SARS), human immunodeficiency virus (HIV), and influenza virus are mucosally transmitted and must cross mucosal barriers to infect the host. Thus, to induce a maximal protective effect, it is desirable to apply vaccines by the mucosal route where virus infections start. Mucosal vaccines administered either orally or nasally have been shown to be effective in inducing antigen-specific immune responses at both systemic and mucosal compartments. However the mucosal antigen-specific immune response is weak because most protein antigens can evoke only a weak immune response when they are applied mucosally. Therefore, one strategy to overcome the weakness of the immune response is a co-administration of mucosal adjuvant with the vaccine antigen. Unfortunately, the development of safe and effective mucosal adjuvant has proved to be challenging. Cytokines are promising adjuvants because they are human-derived safe material and display potent immune-modulating functions. In this regards, we have created a mutant tumor necrosis factor-alpha (TNF-alpha), mTNF-K90R, that exhibits high bioactivity and resistance to proteases. In this report, we examined the potential of mTNF-K90R as a mucosal adjuvant and evaluated its effectiveness and safety.


title: Macrophage infiltration, but not apoptosis, is correlated with immune-mediated demyelination following murine infection with a neurotropic coronavirus.

text: Mice infected with mouse hepatitis virus strain JHM (MHV-JHM) develop a chronic demyelinating encephalomyelitis that is in large part immune mediated. Potential mechanisms of immune activity were assessed using an adoptive transfer system. Mice deficient in recombinase-activating gene function (RAG1(-/-)), defective in B- and T-cell maturation, become persistently infected with MHV but do not develop demyelination. Adoptive transfer of splenocytes from mice immunized to MHV into RAG1(-/-) mice infected with an attenuated strain of the virus results in the rapid and progressive development of demyelination. Most striking, adoptive transfer resulted, within 5 to 6 days, in extensive recruitment of activated macrophages/microglia to sites of demyelination within the spinal cord. Clearance of virus antigen occurred preferentially from the gray matter of the spinal cord. Apoptotic cells were identified in both the gray and white matter of the central nervous system (CNS) from RAG1(-/-) mice before and after adoptive transfer, with a moderate increase in number, but not distribution, of apoptotic cells following the development of demyelination. These results suggest that apoptosis following MHV-JHM infection of the murine CNS is not sufficient to cause demyelination. These results, showing that macrophage recruitment and myelin destruction occur rapidly after immune reconstitution of RAG(-/-) mice, suggest that this will be a useful system for investigating MHV-induced demyelination.


Electron microscopy of coronavirus-like particles characteristic of turkey bluecomb disease.


title: Nurses, smoking, and immunity: a review.

text: Nurses regularly are exposed to a variety of occupational hazards. In addition to documented occupational hazards, exposure to smoking remains a major concern. This article reviews the prevalence of smoking among nurses working in the United States and discusses their reasons for smoking. Researchers conducted a state-of-the-art review on the effects of cigarette smoking and exposure to secondhand smoke (SHS) on the immune system. Smoking prevalence among nurses working in the United States ranged from 796-12%, and high work stress, poor work environment, shift work, and peer influence were suspected major risk factors influencing smoking behavior. A review of the effects of smoking on immunity revealed that both active smoking and exposure to SHS negatively affects immune function. When rehabilitation nurses stop smoking their health improves and nonsmokers are exposed to less SHS. Rehabilitation nurses are encouraged to share knowledge of the immunological benefits of smoking cessation with patients to facilitate nurse-led rehabilitation programs.


title: Human carcinoembryonic antigen and biliary glycoprotein can serve as mouse hepatitis virus receptors.

text: Receptors for murine coronavirus mouse hepatitis virus (MHV) are members of the murine carcinoembryonic antigen (CEA) gene family. Since MHV can also infect primates and cause central nervous system lesions (G. F. Cabirac et al., Microb. Pathog. 16:349-357, 1994; R. S. Murray et al., Virology 188:274-284, 1992), we examined whether human CEA-related molecules can be used by MHV as potential receptors. Transfection of plasmids expressing human carcinoembryonic antigen (hCEA) and human biliary glycoprotein into COS-7 cells, which lack a functional MHV receptor, conferred susceptibility to two MHV strains, A59 and MHV-2. Domain exchange experiments between human and murine CEA-related molecules identified the immunoglobulin-like loop I of hCEA as the region conferring the virus-binding specificity. This finding expands the potential MHV receptors to primate species.


title: Spike glycoprotein cleavage recognition site analysis of infectious bronchitis virus.

text: The spike glycoprotein of infectious bronchitis virus (IBV), a coronavirus, is translated as a precursor protein (So), then cleaved into two subunits (S1 and S2) by host cell serine proteases. In this study, we compared the cleavage recognition site of 55 IBV isolates to determine if the cleavage recognition site sequence, which consists of five basic amino acid residues, correlates with host cell range, serotype, geographic origin, and pathogenicity as it does in orthomyxoviruses and paramyxoviruses. The most common cleavage recognition site observed (33 of 55 viruses) was Arg-Arg-Ser-Arg-Arg, representing at least 11 different serotypes. Thus, cleavage recognition site does not appear to correlate with serotype. We also determined that cleavage recognition site sequence does not correlate with pathogenicity because attenuated and pathogenic isolates (different passages of the same virus) contain identical cleavage recognition site sequences. In addition, nephropathogenic strains had the same cleavage recognition site sequence as many nonnephropathogenic isolates. Cleavage recognition site sequence does correlate with viruses in different geographic regions, which may be an important characteristic to examine in epidemiologic studies. An IBV monoclonal antibody neutralization-resistant mutant (NR 18) had an unusual substitution of Ile for Arg at the fourth position, giving the sequence Arg-Arg-Ser-Ile-Arg, which likely prevents cleavage and, thus, destroys the conformationally dependent monoclonal antibody binding epitope. Six residues on the amino-terminal side of the cleavage recognition site are conserved in 31% of the isolates and consist of only one or two basic amino acids. Thus, the number of basic residues around the cleavage recognition site does not appear to correlate with increased cleavability, host cell range, and increased virulence as it does with envelope glycoproteins in orthomyxoviruses and paramyxoviruses.


title: Crystal structure of severe acute respiratory syndrome coronavirus spike protein fusion core.

text: Severe acute respiratory syndrome coronavirus is a newly emergent virus responsible for a recent outbreak of an atypical pneumonia. The coronavirus spike protein, an enveloped glycoprotein essential for viral entry, belongs to the class I fusion proteins and is characterized by the presence of two heptad repeat (HR) regions, HR1 and HR2. These two regions are understood to form a fusion-active conformation similar to those of other typical viral fusion proteins. This hairpin structure likely juxtaposes the viral and cellular membranes, thus facilitating membrane fusion and subsequent viral entry. The fusion core protein of severe acute respiratory syndrome coronavirus spike protein was crystallized, and the structure was determined at 2.8 A of resolution. The fusion core is a six-helix bundle with three HR2 helices packed against the hydrophobic grooves on the surface of central coiled coil formed by three parallel HR1 helices in an oblique antiparallel manner. This structure shares significant similarity with the fusion core structure of mouse hepatitis virus spike protein and other viral fusion proteins, suggesting a conserved mechanism of membrane fusion. Drug discovery strategies aimed at inhibiting viral entry by blocking hairpin formation, which have been successfully used in human immunodeficiency virus 1 inhibitor development, may be applicable to the inhibition of severe acute respiratory syndrome coronavirus on the basis of structural information provided here. The relatively deep grooves on the surface of the central coiled coil will be a good target site for the design of viral fusion inhibitors.


title: Comparison of cytopathic and noncytopathic isolates of bovine viral diarrhea virus by oligonucleotide fingerprinting.

text: The molecular technique of RNA fingerprinting was used to characterize the genomes of 5 isolates of bovine viral diarrhea virus (BVDV): 2 viral pairs from the same animal, BVD-ILN/BVD-ILC and BVD-TGAN/BVD-TGAC, and the cytopathic viral prototype, BVD-NADL. Oligonucleotide patterns from the viruses were compared, and unique and overlapping oligonucleotides were identified. A comparison of the fingerprints indicated that the genome of each virus was distinguishable by the T1 RNase oligonucleotide fingerprinting technique. The greatest similarity observed was between oligonucleotides from BVD-ILC and BVD-ILN. Eighteen large oligonucleotides were conserved in all 5 BVDV isolates studied. We found that within a pair of BVDV, the cytopathic fingerprint was different from the noncytopathic fingerprint, indicating that cytopathic and noncytopathic BVDV may be distinct viruses.


title: Gastrointestinal neuroendocrine (carcinoid) tumours: current diagnosis and management.

text: Neuroendocrine tumours (NETs) are increasing in both incidence and prevalence and, as a group, are more prevalent than either gastric, pancreatic, oesophageal or hepatobiliary adenocarcinomas, or any two of these cancers combined. Clinical awareness of the protean and intermittent symptoms of NETs (eg, sweating, flushing, diarrhoea, and bronchospasm) is critical for timely diagnosis; however, the classical carcinoid syndrome is relatively uncommon. The most useful diagnostic test for gastrointestinal NETs is measurement of plasma chromogranin A (CgA) levels. Disease extent is assessed by both anatomical imaging, and nuclear imaging with radiolabelled somatostatin analogues. Pathological evaluation comprises tumour-node-metastasis classification, a minimum pathological dataset, CgA and synaptophysin immunostaining, as well as mitotic count or Ki-67 index (a marker of cell proliferation) to define grading. Resection of the primary lesion and as much metastatic disease as possible increases the efficacy of medical therapy. Other management strategies include hepatic embolisation and peptide receptor radionuclide therapy. Patients with tumours expressing somatostatin receptors should be treated with somatostatin analogues. Depending on the tumour grade, other effective agents include cytotoxics, tyrosine kinase inhibitors, and antiangiogenics. The overarching requirement for best management of patients with NETs is to ensure that they have ready access to experienced multidisciplinary clinician groups located within centres of appropriate subspecialty expertise.


title: Initial sequence and comparative analysis of the cat genome.

text: The genome sequence (1.9-fold coverage) of an inbred Abyssinian domestic cat was assembled, mapped, and annotated with a comparative approach that involved cross-reference to annotated genome assemblies of six mammals (human, chimpanzee, mouse, rat, dog, and cow). The results resolved chromosomal positions for 663,480 contigs, 20,285 putative feline gene orthologs, and 133,499 conserved sequence blocks (CSBs). Additional annotated features include repetitive elements, endogenous retroviral sequences, nuclear mitochondrial (numt) sequences, micro-RNAs, and evolutionary breakpoints that suggest historic balancing of translocation and inversion incidences in distinct mammalian lineages. Large numbers of single nucleotide polymorphisms (SNPs), deletion insertion polymorphisms (DIPs), and short tandem repeats (STRs), suitable for linkage or association studies were characterized in the context of long stretches of chromosome homozygosity. In spite of the light coverage capturing approximately 65% of euchromatin sequence from the cat genome, these comparative insights shed new light on the tempo and mode of gene/genome evolution in mammals, promise several research applications for the cat, and also illustrate that a comparative approach using more deeply covered mammals provides an informative, preliminary annotation of a light (1.9-fold) coverage mammal genome sequence.


title: Ii-Key/MHC class II epitope hybrids: a strategy that enhances MHC class II epitope loading to create more potent peptide vaccines.

text: Life-threatening diseases, such as cancer and pandemic influenza, demand new efforts towards effective vaccine design. Peptides represent a simple, safe and adaptable basis for vaccine development; however, the potency of peptide vaccines is insufficient in most cases for significant therapeutic efficacy. Several methods, such as Ligand Epitope Antigen Presentation System and ISCOMATRIX, have been developed to enhance the potency of peptide vaccines. One way of increasing the loading of MHC class II peptides occurs through the use of Ii-Key technology. Ii-Key (LRMK), a portion of the MHC class II-associated invariant chain (Ii), facilitates the direct loading of epitopes to the MHC class II molecule groove. Linking the Ii-Key moiety via a simple polymethylene bridge to an MHC class II epitope, to generate an Ii-Key/MHC class II epitope hybrid, greatly enhances the vaccine potency of the tethered epitope. The combination of such Ii-Key/MHC class II epitope hybrids with MHC class I epitope-containing peptides might generate a potent peptide vaccine for malignancies and infectious diseases. The Ii-Key hybrid technology is compared with other methods that enhance the potency of a peptide vaccine.


title: A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection.

text: The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 (p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible.


title: The Lebanese Society for Infectious Diseases and Clinical Microbiology (LSIDCM) guidelines for adult community-acquired pneumonia (Cap) in Lebanon.

text: Adult community-acquired pneumonia (CAP) is a common cause of morbidity and mortality which is managed by different disciplines in a heterogeneous fashion. Development of consensus guidelines to standardize these wide variations in care has become a prime objective. The Lebanese Society of Infectious Diseases and Clinical Microbiology (LSIDCM) convened to set Lebanese national guidelines for the management of CAP since it is a major and a prevalent disease affecting the Lebanese population. These guidelines, besides being helpful in direct clinical practice, play a major role in establishing stewardship programs in hospitals in an effort to contain antimicrobial resistance on the national level. These guidelines are intended for primary care practitioners and emergency medicine physicians. They constitute an appropriate starting point for specialists' consultation being based on the available local epidemiological and resistance data. This document includes the following: 1/ Rationale and scope of the guidelines; 2/ Microbiology of CAP based on Lebanese data; 3/ Clinical presentation and diagnostic workup of CAP; 4/ Management and prevention strategies based on the IDSA/ATS Consensus Guidelines, 2007, and the ESCMID Guidelines, 2011, and tailored to the microbiological data in Lebanon; 5/ Comparison to regional guidelines. The recommendations made in this document were graded based on the strength of the evidence as in the 2007 IDSA/ATS Consensus Guidelines. Hopefully, these guidelines will be an important step towards standardization of CAP care in Lebanon and set the agenda for further research in this area.


Chronic diarrhea in dogs.


title: Emergent cardiopulmonary bypass for a 180 kilogram patient: support with a single oxygenator.

text: As obesity increases in prevalence, so will cases in which patients present at the boundaries of care. We report the support of a class III obese man, having a body mass index of 60.8 kg/m2 and in acute renal failure, with a single Trillium-coated Affinity NT Hollow Fiber oxygenator in cardiopulmonary bypass for an emergent aortic valve replacement secondary to infective endocarditis. A maximum oxygen delivery of 807.51 mL of oxygen per minute is reported for this oxygenator in this case report.


[Hepatitis C].


title: Preparing for an influenza pandemic in Singapore.

text: The national strategy against pandemic influenza essentially consists of 3 prongs: (i) effective surveillance, (ii) mitigation of the pandemic's impact, and (iii) render the population immune through vaccination. When the pandemic hits Singapore, the response plan aims to achieve the following 3 outcomes: (i) maintenance of essential services to limit social and economic disruption, (ii) reduction of morbidity and mortality through antiviral treatment, and (iii) slow and limit the spread of influenza to reduce the surge on healthcare services. The biggest challenge will come from managing the surge of demand on healthcare services. A high level of preparedness will help healthcare services better cope with the surge.


title: Serologic survey for selected viral pathogens in brown bears from Italy.

text: Blood samples were collected from six captive bears and nine free-ranging Marsican brown bears (Ursus arctos marsicanus) in the Abruzzo National Park, Italy, between 1991 and 1995. Sera were tested for evidence of exposure to canine distemper virus (CDV), canine adenovirus type 2, canine coronavirus, and canine parvovirus type 2 (CPV-2). Serologic evidence of CDV and CPV-2-exposure was found in both captive and free-ranging bears. This may be the first report of CDV exposure in free-ranging bears.


title: [The therapeutic effect of high flow nasal cannula oxygen therapy for the first imported case of Middle East respiratory syndrome to China].

text: OBJECTIVE To investigate the value of high flow nasal cannula (HFNC) in treating a patient with Middle East respiratory syndrome (MERS). METHODS The effect of HFNC applied in the first imported MERS patient with complication of acute respiratory distress syndrome (ARDS) to China was observed. The patient was admitted to Department of Critical Care Medicine of Huizhou Municipal Central Hospital on May 28th, 2015, and the changes in various clinical parameters and their significance were analyzed. RESULTS A 43-year old male was admitted to negative pressure isolation intensive care unit with the complaint of back ache for 7 days and fever for 2 days. Vital signs and saturation of pulse oximetry (SpO2) were monitored continuously. After admission, ribavirin was given orally for 12 days and α-interferon was administered once on the first day. However, after 2-week anti-virus therapy, the virus test was positive. Ceftriaxone was given on the 4th day, and it was changed to meropenem on the 3rd day for 2 weeks. Immune globulin was given on the 4th day and continued for 1 week. Thymosin-α1 was given on the 8th day and continued for 2 weeks. According to his past history, methimazole had been given continuously for hyperthyroidism and other symptomatic treatment. Oxygen inhalation (6 L/min) was given immediately after admission, but the condition of patient worsened with the following symptoms: frequent cough and obvious shortness of breath. Moreover pleural effusion gradually increased as shown by X-ray. SPO2 was maintained only at about 0.91. Oxygenation index (PaO2/FiO2) decreased to 144 mmHg (1 mmHg = 0.133 kPa). So oxygen inhalation via nasal cannula was changed to HFNC after 2 days. The parameters were set as follows: temperature 34 degrees C, flow rate 20 L/min, fraction of inspired oxygen (FiO2) 0.50. The flow was raised 5 L/min every 10 minutes, and was continued till the target value reached 60 L/min. FiO2 was modified according to SpO2 and PaO2/FiO2. FiO2 was set to 0.80 on the 5th day of admission. Shortness of breath of the patient was improved on the 7th day of admission after the application of HFNC. FiO2 was then decreased to 0.58 as PaO2/FiO2 rose. Then the flow was gradually decreased to 30 L/min. HFNC was reduced with continuous improvement in PaO2/FiO2. HFNC was changed to low flow oxygen inhalation nasal cannula (2-3 L/min) on the 20th day. Oxygen treatment was stopped on the 23rd day, and SpO2 was maintained at 0.98-1.00. Activities on bed were gradually increased. The patient was cured and discharged from hospital on June 26th. The patient showed good tolerance and high compliance during the treatment with HFNC. No nosocomial spread occurred during the treatment. CONCLUSIONS HFNC could improve respiratory function of the patient with MERS obviously, and complication ARDS was prevented. HFNC might reduce nosocomial spread.


title: Effects of mitogen-activated protein kinase inhibitors on tumor necrosis factor-alpha gene expression and apoptosis induction in cultured human fetal membrane chorion cells infected with influenza virus.

text: OBJECTIVES We investigated the involvement of p38 mitogen-activated protein (MAP) kinase in tumor necrosis factor (TNF)-alpha gene expression, apoptosis induction and virus replication in cultured human fetal membrane chorion cells infected with influenza virus. METHODS Influenza virus-infected chorion cells were incubated in the absence or presence of inhibitors of p38 MAP kinase, SB203580 and SB202190. TNF-alpha mRNA and hemagglutinin viral RNA (HA vRNA) were amplified with reverse transcriptase-polymerase chain reaction techniques. TNF-alpha protein concentrations were determined by enzyme-liked immunosorbent assay. The extent of apoptosis induction was estimated by DNA agarose gel electrophoresis. Pyrrolidine dithiocarbamate (PDTC) and ribavirin, which have been shown to inhibit apoptosis induction via the inhibition of viral gene replication, were used as positive control reagents. RESULTS PDTC and ribavirin inhibited the accumulation of TNF-alpha mRNA and HA vRNA in the virus-infected chorion cells, resulting in the suppression of TNF-alpha protein secretion. Both SB203580 and SB202190 suppressed TNF-alpha protein secretion, but not the accumulation of TNF-alpha mRNA as well as HA vRNA and the induction of apoptosis. CONCLUSIONS These results suggest that p38 MAP kinase pathway is critical in TNF-alpha gene expression at a post-transcriptional level but not in the apoptosis induction and influenza virus replication in cultured chorion cells.


title: Experimental infection of pigs with a new porcine enteric coronavirus, CV 777.

text: Cesarean-derived colostrum-deprived and conventionally reared pigs were orally inoculated with the coronavirus-like agent, CV 777, isolate from an outbreak of epizootic diarrhea in swine of all ages. Viral particles detected by electron microscopy in the feces and intestinal contents of inoculated pigs had the typical coronavirus morphology. The present studies provided further evidence that this coronavirus-like agent is different from the two known porcine coronaviruses, transmissible gastroenteritis virus and hemagglutinating encephalomyelitis virus. The experimental infection of pigs with this new agent resulted in vomiting, diarrhea, and dehydration. This coronavirus-like agent was shown to replicate in the epithelial cells covering the small intestinal villi but, unlike transmissible gastroenteritis virus, it also replicated in the epithelial cells covering the large intestinal villi.


title: Caring for Nephrology Patients and Staff During the COVID-19 Pandemic: Experiences of the Northwest Kidney Centers.

text: The Northwest Kidney Center (NWC) in Seattle, Washington, has been a leader in nephrology care for almost 60 years, opening the first hemodialysis unit in the United States in 1962. In February 2020, one of their patients was the first reported death from COVID-19 in the United States. On April 6, 2020, as a part of NNJ Extra - the Nephrology Nursing Journal's podcast series, Beth Ulrich, EdD, RN, FACHE, FAONL, FAAN, Editor-in-Chief of the Nephrology Nursing Journal, talked with the leaders of the Northwest Kidney Centers - Suzanne Watnick, MD, the Chief Medical Officer, and Liz McNamara, MN, RN, Vice President of Patient Care Services and the Chief Nursing Officer, who discussed dealing with the onset of COVID-19 at NWC, how their team worked together to provide care for their patients and support for their staff members, and the lessons they learned that can benefit others.


title: Enhancing public health response to respiratory epidemics: are family physicians ready and willing to help?

text: OBJECTIVE To describe Ottawa family physicians' perceptions of their preparedness to respond to outbreaks of infectious diseases or other public health emergencies and to assess their capacity and willingness to assist in the event of such emergencies. DESIGN Cross-sectional self-administered survey conducted between February 11 and March 10, 2004. SETTING The City of Ottawa, Ont, and the Department of Family Medicine at the University of Ottawa. PARTICIPANTS Ottawa family physicians; respondents can be considered a self-selected sample. MAIN OUTCOME MEASURES Self-reported office preparedness and physicians' capacity and willingness to respond to public health emergencies. RESULTS Response rate was 41%. Of 676 physicians contacted, 274 responded, and of those, 246 completed surveys. About 26% of respondents felt prepared for an outbreak of influenza not well covered by vaccine. About 18% felt prepared for serious respiratory epidemics, such as severe acute respiratory syndrome; about 50% felt unprepared. Most respondents (80%) thought they were not ready to respond to an earthquake. About 77% of physicians were willing to be contacted on an urgent basis in case of a public health emergency. Of these, 94% would assist in immunization clinics, 84% in antibiotic clinics, 58% in assessment centres, 52% in treatment centres, 41% with declaration of death, 26% with home care, and 23% with telephone counseling. CONCLUSION Family physicians appear to be unprepared for, but willing to address, serious public health emergencies. It is essential to set up effective partnerships between primary care and public health services to support family physicians' capacity to respond to emergencies. This type of study, along with the creation of a register of available services and of a virtual network for sharing information, is an initial step in assessing primary care response.


title: Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: background.

text: The following principles of appropriate antibiotic use for adults with acute bronchitis apply to immunocompetent adults without complicating comorbid conditions, such as chronic lung or heart disease.1. The evaluation of adults with an acute cough illness or a presumptive diagnosis of uncomplicated acute bronchitis should focus on ruling out serious illness, particularly pneumonia. In healthy, nonelderly adults, pneumonia is uncommon in the absence of vital sign abnormalities or asymmetrical lung sounds, and chest radiography is usually not indicated. In patients with cough lasting 3 weeks or longer, chest radiography may be warranted in the absence of other known causes.2. Routine antibiotic treatment of uncomplicated acute bronchitis is not recommended, regardless of duration of cough. If pertussis infection is suspected (an unusual circumstance), a diagnostic test should be performed and antimicrobial therapy initiated.3. Patient satisfaction with care for acute bronchitis depends most on physician-patient communication rather than on antibiotic treatment.


title: Preparation of armored RNA as a control for multiplex real-time reverse transcription-PCR detection of influenza virus and severe acute respiratory syndrome coronavirus.

text: The common respiratory viruses, including influenza A, influenza B, and newly emerging severe acute respiratory syndrome (SARS) viruses, may cause similar clinical symptoms. Therefore, differential diagnosis of these virus pathogens is frequently required for single clinical samples. In addition, there is an urgent need for noninfectious and stable RNA standards and controls for multivirus detection. In this study, reverse transcription-PCR (RT-PCR) targeting of the RNAs of influenza A and influenza B viruses and SARS coronavirus was performed, and the resulting products were spliced into a fragment which was packaged into armored RNA for use as a noninfectious, quantifiable synthetic substitute. Furthermore, in the present study we developed a multiplex real-time RT-PCR assay in which the armored RNA was used as an external positive control and the three RNA viruses could be detected simultaneously in a single reaction mix. The detection limit of the multiplex real-time PCR was 10 copies/microl of armored RNA.


title: Antiviral activity of the green marine alga Ulva fasciata on the replication of human metapneumovirus.

text: We evaluated the antiviral activity of the marine alga, Ulva fasciata, collected from Rasa beach and Forno beach, Búzios, Rio de Janeiro, Brazil on the replication of human metapneumovirus (HMPV). The algae extracts were prepared using three different methodologies to compare the activity of different groups of chemical composites obtained through these different methodologies. Four out of the six extracts inhibited nearly 100% of viral replication. The results demonstrated that the majority of the extracts (five out of six) possess virucidal activity and therefore have the ability to interact with the extracellular viral particles and prevent the infection. On the other hand, only two extracts (from Forno beach, obtained by maceration and maceration of the decoction) were able to interact with cell receptors, hindering the viral entry. Finally, only the extract of algae collected at Forno beach, obtained by maceration presented intracellular activity. To our knowledge, this is a pioneer study on antiviral activity of marine algae against HMPV. It is also the first on antiviral activity against HMPV ever done in Brazil. The study also shows the effect of different environment factors and different chemical procedures used to obtain the extract on its biological properties.


title: New endotracheal tubes designed to prevent ventilator-associated pneumonia: do they make a difference?

text: Ventilator-associated pneumonia (VAP) is a pervasive and expensive nosocomial infection that is largely related to instrumentation of the airway with an endotracheal tube (ETT), followed by microaspiration of contaminated secretions. VAP prevention will probably be most effective via a multifaceted approach, which includes meticulous attention to basic infection-control methods during patient care, proper patient positioning, oral hygiene, and removal of the ETT as soon as indicated. Modification of the ETT to reduce microaspiration and/or biofilm formation may also play an important role in VAP prevention. However, despite numerous studies of various such interventions, there is insufficient evidence upon which to base strong recommendations, and important safety concerns remain regarding the use of some devices. Most importantly, cost-effectiveness data are lacking for modified ETTs designed to prevent VAP. It is critical that future studies of ETTs designed to prevent VAP be adequately powered to demonstrate efficacy on important patient outcomes and safety, in addition to cost-effectiveness.


title: Regulation of mRNA 1 expression by the 5'-untranslated region (5'-UTR) of the coronavirus infectious bronchitis virus (IBV).

text: In this report, we show that expression of the coronavirus IBV mRNA1 is regulated by its 5'-UTR. Evidence presented demonstrates that the IBV sequence from nucleotide 1 to 1904 directs very inefficient synthesis of a product of approximately 43 kDa. Deletion of either the first 362 bp or the whole part of the 5'-UTR, however, dramatically increased the expression of the 43 kDa protein species. The mechanisms involved were investigated by two different approaches. Firstly, translation of the same construct in the presence of [3H]-leucine ruled out the possibility that initiation of small reading frames from non-AUG codons located in the 5'-UTR may compete with the authentic AUG initiation codon, and therefore inhibit the expression of ORF 1a. Secondly, expression and deletion analyses of a dicistronic construct showed that translation of the 43 kDa protein was initiated by ribosome internal entry mechanism. These studies suggest that a 'weak' ribosome internal entry signal is located in the 5'-UTR and is involved in the regulation of mRNA1 expression.


title: Polysorbates prevent biofilm formation and pathogenesis of Escherichia coli O104:H4.

text: Escherichia coli biotype O104:H4 recently caused the deadliest E. coli outbreak ever reported. Based on prior results, it was hypothesized that compounds inhibiting biofilm formation by O104:H4 would reduce its pathogenesis. The nonionic surfactants polysorbate 80 (PS80) and polysorbate 20 (PS20) were found to reduce biofilms by ≥ 90% at submicromolar concentrations and elicited nearly complete dispersal of preformed biofilms. PS80 did not significantly impact in vivo colonization in a mouse infection model; however, mice treated with PS80 exhibited almost no intestinal inflammation or tissue damage while untreated mice exhibited robust pathology. As PS20 and PS80 are classified as 'Generally Recognized as Safe' (GRAS) compounds by the Food and Drug Administration (FDA), these compounds have clinical potential to treat future O104:H4 outbreaks.


title: A novel coronavirus (SARS-CoV-2) and COVID-19.

text: By the end of 2019 the first cases of severe pneumonia of unknown origin were reported in Wuhan, China. The causative agent was identified as a novel b-coronavirus SARS-CoV-2 and the disease was named COVID-19. Since the beginning of 2020, the infection has spread worldwide, which led the WHO to declare COVID-19 a public health emergency of international concern and to characterize the current situation as a pandemic. The transmission occurs mainly via respiratory droplets and the incubation period ranges from 2 to 14 days. Most cases are mild, but some patients develop severe pneumonia with acute respiratory distress, septic shock and multi-organ failure. The most common symptoms include fever, dry cough, myalgia and shortness of breath. Characteristic laboratory findings are normal white blood cell count or mild leukopenia, marked lymphopenia, in severe cases elevated CRP, procalcitonin, LDH, and D-dimer are commonly found. Typical imaging findings include multifocal peripherally distributed ground-glass opacities or consolidations, interlobular septal thickening, crazy paving appearance and cystic changes. The overall case fatality rate is estimated to range from 1 to 3 %, however, it is dependent on age and underlying medical comorbidities. Current potential treatment options include hydroxychloroquine, remdesivir, lopinavir/ritonavir and convalescent plasma.


title: [Primary analysis of reasons and countermeasures for 19 cases infection of severe acute respiratory syndrome (SARS) in health care workers].

text: OBJECTIVE To analyse the reason and countermeasure for the infection of severe acute respiratory syndrome (SARS) in health care workers, to provide reference for the health care workers to control infection of SARS. METHODS To analyse retrospectively the reason and countermeasure 19 infective cases of SARS among the health care workers in our hospital from 16th March, 2003 to 3rd May, 2003. RESULTS Except for 4 fellow-doctors were infected by close contact in a same dormitory, all others were infected on work-station of close contact with SARS patients, there were no more cross-infection among the health care workers. CONCLUSION It is important to improve the protection even for the health care workers without contact of SARS patients, and it's necessary to wear mask, goggles, and gloves, health care workers with contact with SARS patients must be separated according the extent of contact separately, and draw guideline in advance.


title: Middle East Respiratory Syndrome (MERS) coronavirus seroprevalence in domestic livestock in Saudi Arabia, 2010 to 2013.

text: In Saudi Arabia, including regions of Riyadh and Al Ahsa, pseudoparticle neutralisation (ppNT) and microneutralisation (MNT) tests detected no antibodies to Middle East Respiratory Syndrome coronavirus (MERS-CoV) in sheep (n= 100), goats (n= 45), cattle (n= 50) and chickens (n= 240). Dromedary camels however, had a high prevalence of MERS-CoV antibodies. Bovine coronavirus (BCoV) infected sera from cattle had no cross-reactivity in MERS-CoV ppNT or MNT, while many dromedary camels’ sera reacted to both BCoV and MERS-CoV. Some nevertheless displayed specific serologic reaction profiles to MERS-CoV.


COVID-19 Pandemic - Call for National Preparedness.


title: Programmed translational frameshifting.

text: Errors that alter the reading frame occur extremely rarely during translation, yet some genes have evolved sequences that efficiently induce frameshifting. These sequences, termed programmed frameshift sites, manipulate the translational apparatus to promote non-canonical decoding. Frameshifts are mechanistically diverse. Most cause a -1 shift of frames; the first such site was discovered in a metazoan retrovirus, but they are now known to be dispersed quite widely among evolutionarily diverse species. +1 frameshift sites are much less common, but again dispersed widely. The rarest form are the translational hop sites which program the ribosome to bypass a region of several dozen nucleotides. Each of these types of events are stimulated by distinct mechanisms. All of the events share a common phenomenology in which the programmed frameshift site causes the ribosome to pause during elongation so that the kinetically unfavorable alternative decoding event can occur. During this pause most frameshifts occur because one or more ribosome-bound tRNAs slip between cognate or near-cognate codons. However, even this generalization is not entirely consistent, since some frameshifts occur without slippage. Because of their similarity to rarer translational errors, programmed frameshift sites provide a tool with which to probe the mechanism of frame maintenance.


title: Human biliary glycoproteins function as receptors for interspecies transfer of mouse hepatitis virus.

text: A variant Mouse Hepatitis virus (MHV), designated MHV-H2, was isolated by serial passage in mixed cultures of permissive DBT cells and nonpermissive Syrian Hamster Kidney (BHK) cells. MHV-H2 replicated efficiently in hamster, mouse, primate kidney (Vero, Cos 1, Cos 7), and human adenocarcinoma (HRT) cell lines but failed to replicate in porcine testicular (ST), feline kidney (CRFK), and canine kidney (MDCK) cells. To understand the molecular basis for coronavirus cross-species transfer into human cell lines, the replication of MHV-H2 was studied in hepatocellular carcinoma (HepG2) cells which expressed high levels of the human homologue of the normal murine receptor, biliary glycoprotein (Bgp). MHV-H2 replicated efficiently in human HepG2 cells, at low levels in breast carcinoma (MCF7) cells, and poorly, if at all, in human colon adenocarcinoma (LS 174T) cell lines which expressed high levels of carcinoembryonic antigen (CEA). These data suggested that MHV-H2 may utilize the human Bgp homologue as a receptor for entry into HepG2 cells. To further study MHV-H2 receptor utilization in human cell lines, blockade experiments were performed with a panel of different monoclonal or polyclonal antiserum directed against the human CEA genes. Pretreatment of HepG2 cells with a polyclonal antiserum directed against all CEA family members, or with a monoclonal antibody, Kat4c (cd66abde), directed against Bgp1, CGM6, CGM1a, NCA and CEA, significantly reduced virus replication and the capacity of MHV-H2 to infect HepG2 cells. Using another panel of monoclonals with more restricted cross reactivities among the human CEA's, Col-4 and Col-14, but not B6.2 B1.13, Col-1, Col-6 and Col-12 blocked MHV-H2 infection in HepG2 cells. These antibodies did not block sindbis virus (SB) replication in HepG2 cells, or block SB, MHV-A59 or MHV-H2 replication in DBT cells. Monoclonal antibodies Col-4, Col-14, and Kat4c (cd66abde) all reacted strongly with human Bgp and CEA, but displayed variable binding patterns with other CEA genes. Following expression of human Bgp in normally nonpermissive porcine testicular (ST) and feline kidney (CRFK) cells, the cells became susceptible to MHV-H2 infection. These data suggested that phylogenetic homologues of virus receptors represent natural conduits for virus xenotropism and cross-species transfer.


title: Human metapneumovirus infection in Japanese children.

text: Human metapneumovirus (hMPV) has been recently discovered as an etiological agent of acute respiratory infections. Our purpose was to asses the virological and clinical features of children with respiratory infections caused by hMPV. We examined 658 nasopharyngeal swab samples obtained from 637 children with respiratory infections for hMPV by using reverse transcription-PCR (RT-PCR). A total of 268 samples from 637 children were inoculated onto tertiary monkey kidney cells. A total of 36 serum samples (26 in the acute phase and 10 in the convalescent phase) from the 26 hMPV-positive children were tested for immunoglobulin G (IgG) and IgM antibodies to hMPV by using an indirect immunofluorescence assay. We detected hMPV in 57 (8.9%) of the 637 samples by using RT-PCR and isolated 7 (2.6%) hMPV strains of the 268 samples in cell cultures. A total of 12 (46.2%) of 26 hMPV-positive children were suspected to have primary infection with hMPV as determined by an indirect immunofluorescence assay. The infected children were diagnosed as having wheezy bronchitis (36.8%), upper respiratory tract infection (26.3%), bronchitis (22.8%), and pneumonia (14.0%). We showed that two hMPV groups were circulating in different regions during the same period and that reinfection with hMPV frequently occurs in childhood. The RT-PCR test is the most sensitive test for detection of hMPV, and a serological test may be useful to differentiate between primary infection and reinfection with hMPV.


title: Nocardia otitidiscaviarum (GAM-5) induces parkinsonian-like alterations in mouse.

text: Parkinson's disease, a major neurodegenerative disorder in humans whose etiology is unknown, may be associated with some environmental factors. Nocardia otitidiscaviarum (GAM-5) isolated from a patient with an actinomycetoma produced signs similar to Parkinson's disease following iv injection into NMRI mice. NMRI mice were infected intravenously with a non-lethal dose of 5 x 10(6) colony forming units of N. otitidiscaviarum (GAM-5). Fourteen days after bacterial infection, most of the 60 mice injected exhibited parkinsonian features characterized by vertical head tremor, akinesia/bradykinesia, flexed posture and postural instability. There was a peak of nocardial growth in the brain during the first 24 h followed by a decrease, so that by 14 days nocardiae could no longer be cultured. At 24 h after infection, Gram staining showed nocardiae in neurons in the substantia nigra and occasionally in the brain parenchyma in the frontal and parietal cortex. At 21 days post-infection, tyrosine hydroxylase immunolabeling showed a 58% reduction of tyrosine hydroxylase in the substantia nigra, and a 35% reduction of tyrosine hydroxylase in the ventral tegmental region. Dopamine levels were reduced from 110 +/- 32.5 to 58 +/- 16.5 ng/mg protein (47.2% reduction) in brain from infected mice exhibiting impaired movements, whereas serotonin levels were unchanged (191 +/- 44 protein in control and 175 +/- 39 ng/mg protein in injected mice). At later times, intraneuronal inclusion bodies were observed in the substantia nigra. Our observations emphasize the need for further studies of the potential association between Parkinson's disease or parkinsonism-like disease and exposure to various nocardial species.


On Croup.


title: Viruses in the stools.

text: It has long been possible to isolate viruses from the stools by culture, though the viruses found are rarely implicated in disease of the gut. In contrast, only recently has it been possible to identify viruses in the stools of patients with diarrhoea. Initially, such identifications were made by electron microscopy but the unsuitability of the microscope for large-scale screening has led to the development of other methods. The new methods have concentrated on rotaviruses but other viruses are also implicated and an overall view of the significance of finding a virus in any stool specimen has to take into account the evidence about all viruses, old and new.


title: What is the role of autophagy in HIV-1 infection?

text: HIV-1 infection is characterized by a progressive CD4 T cell depletion. It is now accepted that apoptosis of uninfected bystander CD4 T lymphocytes plays a major role in AIDS development. Viral envelope glycoproteins (Env) are mainly involved in inducing this cell death process, but the mechanisms triggered by HIV-1 leading to immunodeficiency are still poorly understood. Recently, we have demonstrated that autophagy is a prerequisite for Env-mediated apoptosis in uninfected CD4 T cells, underlining its role in HIV-1 infection. However, occurrence of autophagy in HIV-1-infected cells has not yet been described. Several hypotheses are discussed, based on the comparison with data from other viral infections.


title: Isolation and identification of caliciviruses from dogs with enteric infections.

text: Caliciviruses were isolated from 7 dogs and 1 captured coyote with enteritis. There was a high fatality rate in dogs 4 to 16 weeks of age. The occurrence in these dogs of concurrent infection with known enteric pathogens such as Salmonella sp, canine parvovirus, canine coronavirus, and canine rotavirus did not allow making any conclusions regarding the pathogenicity of this newly recognized calicivirus. The caliciviruses were characterized by electron microscopy and were further identified as being closely related to feline calicivirus by immunoelectron microscopy with specific antibody.


title: [Quantitative detection of SARS-CoV RNA in excreta and oropharyngeal washing fluid from convalescence patients with severe acute respiratory syndrome].

text: OBJECTIVE To detect the severe acute respiratory syndrome coronavirus (SARS-CoV) RNA in excreta and oropharyngeal washing fluid (OWF) from the convalescence SARS patients, and to determine whether convalescence patients carry the SARS-CoV, and whether having infectivity. METHODS Totally 531 samples (including urine, stool, and OWF) were collected from 177 convalescence patients with positive SARS antibody which were confirmed by ELISA method. Real-time quantitative PCR was performed to detect the RNA of the SARS-CoV, and results were analyzed by SPSS analysis software. RESULTS There were 49 (27.7%) cases of SARS-CoV RNA detection positive in 177 patients, including 31 (17.5%) cases with one sample positive, 14 (7.9%) cases with two samples positive, and 4 (2.3%) cases with three samples positive. The positive rates of urine, stool, and OWF were 14.7% (26/177), 11.9% (21/177), and 13.6% (24/177), respectively. The quantity of SARS-CoV RNA in samples was 100-47 000 copies/ml. No significant difference was found among urine, stool, and OWF on the difference grade quantity of SARS-CoV RNA quantity. CONCLUSIONS About 10% convalescence SARS patients might still carry the SARS-CoV in hospitalization. The detection of SARS-CoV RNA by real-time quantitative PCR may become a laboratory examination warranty for convalescence SARS patients to discharge hospital and relieve separation.


A clinical prediction rule for the severe acute respiratory syndrome.


title: Is partial thickness excision in TAMIS without defect suture safe for benign rectal lesions?

text: BACKGROUND One of the minimally invasive methods used in the surgical treatment of large-based polypoid lesions located in the rectum is transanal minimally invasive surgery (TAMIS). This method, which relieves patients from the severe morbidities of invasive surgical procedures, is performed in both malign (T1-T2) and benign lesions. Difficulty of suturation after TAMIS emerges as the most important factor to prolong the procedure. We aimed to analyse the efficacy of TAMIS procedure with partial thickness resection without suturation. MATERIALS AND METHODS This was a retrospective study. The study was conducted in a Turkish Education and Research Hospital in 2016. Data of 10 patients who diagnosed with benign rectal masses were included in the study. Patients who were suspected for muscularis propria invasion and lymph node positivity in magnetic resonance imaging preoperatively excluded from the study. All lesions were resected with TAMIS and the mucosal defects were not closed in any patients. Demographic features, lesion's distances to anal verge, excised lesion's size, histopathological report, operation times, duration of hospital stay and complications were recorded RESULTS: Six male and 4 female patients were treated. The mean distance to the anal werge of the lesions was 8.5 (5-12) cm. The longest diameters of the lesions ranged from 1-4 cm in length. All the patients were discharged the day after the surgery. Operation times were found to be 46.1 ± 5 min (30-70). Histopathological examinations of the removed lesions revealed villous adenomas in 3 patients, villous adenoma and Tis adenocarcinoma in 5 patients, villous adenoma and T1 adenocarcinoma in 1 patient and neuroendocrine tumor in 1 patient. There were no early complications such as bleeding, and late complications such as perforation, anal incontinence or anorectal dysfunction in any patient. No evidence of recurrence was found in any of the patients under control rectosigmoidoscopy and pelvic MRI examinations. CONCLUSION Partial thickness resection of rectal benign lesions by TAMIS method is safe. After resection some surgeons suggest to close the defect by suture or stapler. In our study resection without closure of the defect is found safe and feasible with limited patient prejudice. KEY WORDS Rectal benign lesions, Transanal partial thickness excision.


title: Good veterinary governance: definition, measurement and challenges.

text: Good veterinary governance assumes the provision of veterinary services that are sustainably financed, universally available, and provided efficiently without waste or duplication, in a manner that is transparent and free of fraud or corruption. Good veterinary governance is a necessary condition for sustainable economic development insomuch as it promotes the effective delivery of services and improves the overall performance of animal health systems. This article defines governance in Veterinary Services and proposes a framework for its measurement. It also discusses the role of Veterinary Services and analyses the governance dimensions of the performance-assessment tools developed by the World Organisation for Animal Health (OIE). These tools (OIE PVS Tool and PVS Gap Analysis) track the performance of Veterinary Services across countries (a harmonised tool) and over time (the PVS Pathway). The article shows the usefulness of the OIE PVS Tool for measuring governance, but also points to two shortcomings, namely (i) the lack of clear outcome indicators, which is an impediment to a comprehensive assessment of the performance of Veterinary Services, and (ii) the lack of specific measures for assessing the extent of corruption within Veterinary Services and the extent to which demand for better governance is being strengthened within the animal health system. A discussion follows on the drivers of corruption and instruments for perception-based assessments of country governance and corruption. Similarly, the article introduces the concept of social accountability, which is an approach to enhancing government transparency and accountability, and shows how supply-side and demand-side mechanisms complement each other in improving the governance of service delivery. It further elaborates on two instruments--citizen report card surveys and grievance redress mechanisms--because of their wider relevance and their possible applications in many settings, including Veterinary Services. Also, central to improving transparency and accountability is access to information and a discussion on the appropriate level of decentralisation of Veterinary Services. Bringing Veterinary Services into compliance with OIE international standards would contribute to improving governance and providing economic benefits through increased animal productivity, the expansion of trade and improved food security. It would also help to increase public health benefits, through greater food safety and better prevention and control of zoonoses.


title: Diagnosis of human metapneumovirus infection in immunosuppressed lung transplant recipients and children evaluated for pertussis.

text: Human metapneumovirus (hMPV) is a recently discovered paramyxovirus that is known to cause respiratory tract infections in children and immunocompromised individuals. Given the difficulties of identifying hMPV by conventional culture, molecular techniques could improve the detection of this virus in clinical specimens. In this study, we developed a real-time reverse transcription-PCR (RT-PCR) assay designed to detect the four genetic lineages of hMPV. This assay and a commercial real-time nucleic acid sequence-based amplification (NASBA) assay (bioMérieux, Durham, NC) were used to determine the prevalence of hMPV in 114 immunosuppressed asymptomatic and symptomatic lung transplant recipients and 232 pediatric patients who were being evaluated for pertussis. hMPV was detected in 4.3% of the immunosuppressed lung transplant recipients and in 9.9% of children evaluated for pertussis. Both RT-PCR and NASBA assays were efficient in detection of hMPV infection in respiratory specimens. Even though hMPV was detected in a small number of the lung transplant recipients, it was still the most prevalent etiologic agent detected in patients with respiratory symptoms. In both of these diverse patient populations, hMPV infection was the most frequent viral respiratory tract infection identified. Given our findings, infection with hMPV infection should be determined as part of the differential diagnosis of respiratory illnesses.


Evolutionary aspects of recombination in RNA viruses.


The biology of coronaviruses.


title: Investigation of the Actual Causes of Hip Joint Implant Loosening Classified as Aseptic--Analysis of Microbiological Culture Results and Levels of Inflammatory Markers.

text: Loosening of the hip joint prosthesis is considered as one of the most significant postoperative complications in recent years. The laboratory diagnostic procedure used to differentiate periprosthetic infection from aseptic loosening is very difficult because of the biofilm which microorganisms form on the implant surface. The purpose of this research was to evaluate the level of concordance between clinical classification of implant loosening among 50 patients subjected to reimplantation procedure and laboratory investigation of PJI including microbiological culture results and the levels of inflammatory markers assessed in the patients' synovial fluid samples, serum, and full blood. The synovial fluid was collected for leukocyte count, differential cell count, and culture on standard media. The levels of systemic inflammation markers such as the ESR and CRP concentration were determined in serum and full blood. Tissue samples were collected for microbiological studies. Components from endoprostheses were exposed to ultrasound in a process called sonication. Among the parameters measured in serum and full blood the levels of ESR and CRP were higher in the septic group of patients. Cytologic analysis of synovial fluid was in correlation with microbiologic identification. The most frequent isolated bacteria was Staphylococcus epidermidis. Culture results from materials such as synovial fluid, sonicate and tissues are crucial to establish the infectious aetiology of the loosening. Microscopic analysis of synovial fluid represents a simple, rapid and accurate method for differentiating PJI from aseptic failure. Sonication increases detection of the infectious process, and culture results are in correlation with the cytologic analysis of synovial fluid.


title: Tuberculous meningitis in child born in the US to immigrants from a tuberculosis-endemic country.

text: This is a case of a child born in the US to immigrant parents from a tuberculosis (TB)-endemic area of Liberia who was diagnosed with TB meningitis after a greater than 1-month history of unremitting fever. This report aims to highlight the importance of early identification of TB in the pediatric population with risk factors for TB and considering TB as a diagnosis among US born children to immigrants from TB-endemic countries.


Relatedness of virion and intracellular proteins of the murine coronaviruses JHM and A59.


Hirsutism, Amphetamines, COVID-19 Viral Shedding, Hand-Foot-and-Mouth Disease.


title: Endoproteolytic processing of the ebola virus envelope glycoprotein: cleavage is not required for function.

text: Proteolytic processing is required for the activation of numerous viral glycoproteins. Here we show that the envelope glycoprotein from the Zaire strain of Ebola virus (Ebo-GP) is proteolytically processed into two subunits, GP1 and GP2, that are likely covalently associated through a disulfide linkage. Murine leukemia virions pseudotyped with Ebo-GP contain almost exclusively processed glycoprotein, indicating that this is the mature form of Ebo-GP. Mutational analysis identified a dibasic motif, reminiscent of furin-like protease processing sites, as the Ebo-GP cleavage site. However, analysis of Ebo-GP processing in LoVo cells that lack the proprotein convertase furin demonstrated that furin is not required for processing of Ebo-GP. In sharp contrast to other viral systems, we found that an uncleaved mutant of Ebo-GP was able to mediate infection of various cell lines as efficiently as the wild-type, proteolytically cleaved glycoprotein, indicating that cleavage is not required for the activation of Ebo-GP despite the conservation of a dibasic cleavage site in all filoviral envelope glycoproteins.


title: Laparoscopic partial gastrectomy of a huge gastric duplication cyst in an infant.

text: Gastric duplication cyst is a rare anomaly, and most cases are recognized during childhood. Recently, several pediatric cases with small gastric duplication cysts treated by laparoscopic resection have been reported. Here, we describe an infant in whom we successfully performed laparoscopic partial gastrectomy for the treatment of a huge gastric duplication cyst. To the best of our knowledge, this is the largest gastric duplication cyst treated by laparoscopic surgery among infants. We introduce our procedure and some tips.


In vitro assembly of the murine coronavirus membrane protein E1.


Anthrax 2001: observations on the medical and public health response.


title: Receptor-based computational screening of compound databases: the main docking-scoring engines.

text: The processes used by academic and industrial scientists to discover new drugs have recently experienced a true renaissance with many new and exciting techniques. The number of protein structures and/or chemical ligands is constantly growing, through the use of parallel chemistry, X-ray crystallography, NMR or homology modeling methods and so is the theoretical understanding of protein-ligand interactions. As such, structure-based approaches to drug-design and in silico screening are becoming routine part of most modern lead discovery programs. Prioritization of compound libraries is an extremely important task that aims at the rapid identification of tight-binding ligands and ultimately new therapeutic compounds. These in silico approaches combined with other experimental methods facilitate the design of new medicines to treat cardiovascular, degenerative, infectious, and neoplastic diseases, among others. Here, we review key concepts and specific features of several selected ligand-receptor docking/scoring methods while several other topics pertaining to the field of in silico screening are reviewed in the following articles of this special issue of Current Protein and Peptide Science.


title: Predominance of MHC class II-restricted CD4+ cytotoxic T cells against mouse hepatitis virus A59.

text: Coronavirus-induced acute hepatitis is a complex event and the role of different components of the immune system with regard to defined viral proteins and the course of the infection is not yet clear. We have analysed the cytotoxic T-lymphocyte (CTL) response in mouse hepatitis virus (MHV-A59) infection. Surprisingly, we detected only a very clear virus-specific major histocompatibility complex (MHC) class II-restricted cytotoxicity in mice infected with MHV-A59. We found no evidence of activation of the classical CD8+ MHC class I-restricted CTL. The virus-specific CD4+ CTL derived from two different mouse strains having different MHC haplotypes recognized the same immunodominant epitope. This epitope, comprising the amino acid residues 329-343 of the viral S-glycoprotein, was recognized both at the polyclonal level and by virus-specific CTL clones. Transfer studies using a MHV-A59-specific CD4+ CTL clone showed significant protection against a lethal challenge with MHV-A59, implicating that these CD4+ CTL play a pivotal role in the protection against MHV-A59 infections.


[Travel insurance].


title: Recovery of a patient from clinical rabies--California, 2011.

text: In May 2011, a girl aged 8 years from a rural county in California was brought to a local emergency department (ED) with a 1-week history of progressive sore throat, difficulty swallowing, and weakness. After she developed flaccid paralysis and encephalitis, rabies was diagnosed based on 1) detection of rabies virus-specific antibodies in serum and cerebrospinal fluid (CSF), 2) a compatible clinical syndrome in the patient, and 3) absence of a likely alternative diagnosis. The patient received advanced supportive care, including treatment with therapeutic coma. She was successfully extubated after 15 days and discharged from the hospital 37 days later to continue rehabilitation therapy as an outpatient. The public health investigation identified contact with free-roaming, unvaccinated cats at the patient's school as a possible source of infection. Several of these cats were collected from the school and remained healthy while under observation, but at least one was lost to follow-up. A total of 27 persons received rabies postexposure prophylaxis (PEP) for potential exposures to the patient's saliva. No further cases of rabies associated with this case have been identified. Rabies prevention efforts should highlight the importance of domestic animal vaccination, avoidance of wildlife and unvaccinated animals, and prompt PEP after an exposure.


title: A single amino acid change within antigenic domain II of the spike protein of bovine coronavirus confers resistance to virus neutralization.

text: The spike glycoprotein is a major neutralizing antigen of bovine coronavirus (BCV). Conformational neutralizing epitopes of group A and group B monoclonal antibodies (MAbs) have previously been mapped to two domains at amino acids 351 to 403 (domain I) and amino acids 517 to 621 (domain II). To further map antigenic sites, neutralization escape mutants of BCV were selected with a group A MAb which has both in vitro and in vivo virus-neutralizing ability. The escape mutants were demonstrated to be neutralization resistant to the selecting group A MAb and remained sensitive to neutralization by a group B MAb. In radioimmunoprecipitation assays, the spike proteins of neutralization escape mutants were shown to have lost their reactivities with the selecting group A MAb. Sequence analysis of the spike protein genes of the escape mutants identified a single nucleotide substitution of C to T at position 1583, resulting in the change of alanine to valine at amino acid position 528 (A528V). The mutation occurs in domain II and in a location which corresponds to the hypervariable region of the spike protein of the coronavirus mouse hepatitis virus. Experimental introduction of the A528V mutation into the wild-type spike protein resulted in the loss of MAb binding of the mutant protein, confirming that the single point mutation was responsible for the escape of BCV from immunological selective pressure.


title: Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989-1999.

text: CONTEXT Most sore throats are due to viral upper respiratory tract infections. Group A beta-hemolytic streptococci (GABHS), the only common cause of sore throat warranting antibiotics, is cultured in 5% to 17% of adults with sore throat. The frequency of antibiotic use for pharyngitis has greatly exceeded the prevalence of GABHS, but less is known about specific classes of antibiotics used. Only penicillin and erythromycin are recommended as first-line antibiotics against GABHS. OBJECTIVES To measure trends in antibiotic use for adults with sore throat and to determine predictors of antibiotic use and nonrecommended antibiotic use. DESIGN, SETTING, AND SUBJECTS Retrospective analysis of 2244 visits to primary care physicians in office-based practices in the National Ambulatory Medical Care Survey, 1989-1999, by adults with a chief complaint of sore throat. MAIN OUTCOME MEASURES Treatment with antibiotics and treatment with nonrecommended antibiotics, extrapolated to US annual national rates. RESULTS There were an estimated 6.7 million annual visits in the United States by adults with sore throat between 1989 and 1999. Antibiotics were used in 73% (95% confidence interval [CI], 70%-76%) of visits. Patients treated with antibiotics were given nonrecommended antibiotics in 68% (95% CI, 64%-72%) of visits. From 1989 to 1999, there was a significant decrease in use of penicillin and erythromycin and an increase in use of nonrecommended antibiotics, especially extended-spectrum macrolides and extended-spectrum fluoroquinolones (P<.001 for all trends). In multivariable modeling, increasing patient age (odds ratio [OR], 0.86 per decade; 95% CI, 0.79-0.94) and general practice specialty (OR, 1.54 compared with family practice specialty; 95% CI, 1.10-2.14) were independent predictors of antibiotic use. Among patients receiving antibiotics, nonrecommended antibiotic use became more frequent over time (OR, 1.17 per year; 95% CI, 1.11-1.24). CONCLUSIONS More than half of adults are treated with antibiotics for sore throat by community primary care physicians. Use of nonrecommended, more expensive, broader-spectrum antibiotics is frequent.


title: Emergence of a nephropathogenic avian infectious bronchitis virus with a novel genotype in India.

text: We describe the emergence of a nephropathogenic avian infectious bronchitis virus (IBV) with a novel genotype in India. The Indian IBV isolate exhibited a relatively high degree of sequence divergence with reference strains. The highest homology was observed with strain 6/82 (68%) and the least homology with strain Mex/1765/99 (34.3%).


The structure and behavior of coronavirus A59 glycoproteins.


Physician drug prescribing preferences and availability for ventilation of patients with COVID-19.


title: Impact of an antimicrobial dressing in reducing surgical site infections in cardiac surgery patients.

text: UNLABELLED xBxxaxcxkground. In addition to prevention guidelines already in place, the effectiveness of an antimicrobial dressing on the occurrence of surgical site infections (SSIs) among adult patients undergoing cardiac surgery was evaluated. METHODS A house-wide replacement of the plain postoperative gauze dressing with a sterile dressing impregnated with 0.2% polyhexamethylene biguanide directly on the incision after closure in the operation room was performed. From May 2005 to March 2007, 1658 patients were enrolled in this study. Surgical site infections were identified using the Centers for Disease Control and Prevention standard criteria. RESULTS Of the 1658 patients enrolled, 1399 patients were included in the analysis, 692 with the plain dressing and 707 with antimicrobial dressing. The overall and leg site infection rate was significantly higher in the plain dressing group compared to the antimicrobial group but similar in the sternal site. Overall, the antimicrobial dressings significantly reduced infection (OR 0.58 [0.38-0.89]). Obesity was also a strong independent predictor of SSI regardless of the site of surgery. Increasing age at surgery and left ventricular ejection fraction of 30%-49% were also independent predictors of infection. CONCLUSION The antimicrobial dressing had a positive effect by reducing the infection rate, especially for leg incisions using conventional open techniques, and could be a worthwhile addition in conjunction with a strategic program. .


title: Severe acute respiratory syndrome (SARS) prevention in Taiwan.

text: Severe Acute Respiratory Syndrome (SARS) is a newly identified respiratory disease that threatened Taiwan between April 14 and July 5, 2003. Chang Gung University experienced various SARS-related episodes, such as the postponement of classes for 7 days, the reporting of probable SARS cases, and the isolation of students under Level A and B quarantines. Ninety-eight percent of the students at the university live in dormitories; thus the prevention of SARS became an important issue. Preventive strategies are classified into primary, secondary, and tertiary prevention, with a different focus and strategy for each level of prevention. The university emphasized personal hygiene and a healthy lifestyle as the key to SARS prevention. Our experiences as school nurses during this crisis can help other school nurses to prevent the spread of SARS during similar situations.


title: Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy in Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use.

text: COVID-19 has affected the United States leading to a national emergency with health care and economic impact, propelling the country into a recession with disrupted lifestyles not seen in recent history. COVID-19 is a serious illness leading to multiple deaths in various countries including the United States. Several million Americans satisfy the Center for Disease Control and Prevention (CDC) criteria for being high risk. Unfortunately, the available supply of medical beds and equipment for mechanical ventilation are much less than is projected to be needed. The World Health Organization (WHO) and multiple agencies led by the CDC in the United States have attempted to organize intensive outbreak investigation programs utilizing appropriate preventive measures, evaluation, and treatment. The clinical spectrum of COVID-19 varies from asymptomatic forms to conditions encompassing multiorgan and systemic manifestations in terms of septic shock, and multiple organ dysfunction (MOD) syndromes. The presently approved treatments are supportive but not curative for the disease. There are multiple treatments being studied. These include vaccines, medications Remdesivir and hydroxychloroquine and potentially combination therapy. Finally, expanded umbilical cord mesenchymal stem cells or (UC-MSCs) may have a role and are being studied. The cure of COVID-19 is essentially dependent on the patients' own immune system. When the immune system is over activated in an attempt to kill the virus, this can lead to the production of a large number of inflammatory factors, resulting in severe cytokine storm. The cytokine storm may induce organ damage followed by the edema, dysfunction of air exchange, acute respiratory distress syndrome (ARDS), acute cardiac injury, and secondary infection, which may lead to death. Thus, at this point, the avoidance of the cytokine storm may be the key for the treatment of HCOV-19 infected patients.In China, where there was limited availability of effective modalities to manage COVID-19 several patients were treated with expanded UC-MSCs. Additionally, the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care have reported guidelines to treat coronavirus patients with stem cells in the hope of decreasing the number of patients going to the ICU, and, also relatively quickly getting them out of ICU. In this manuscript, we describe the urgent need for various solutions, pathogenesis of coronavirus and the clinical evidence for treatment of COVID-19 with stem cells. The limited but emerging evidence regarding UC MSC in managing COVID-19 suggests that it might be considered for compassionate use in critically ill patients to reduce morbidity and mortality in the United States. The administration and Coronavirus Task Force might wish to approach the potential of expanded UC-MSCs as an evolutionary therapeutic strategy in managing COVID-19 illness with a 3-pronged approach: If proven safe and effective on a specific and limited basis…1. Minimize regulatory burden by all agencies so that critically ill COVID-19 patients will have access regardless of their financial circumstance.2. Institute appropriate safeguards to avoid negative consequences from unscrupulous actors.3. With proper informed consent from patients or proxy when necessary, and subject to accumulation of data in that cohort, allow the procedure to be initiated in critically ill patients who are not responding to conventional therapies.KEY WORDS: Coronavirus, COVID-19, cytokine storm, multiorgan failure, expanded umbilical cord mesenchymal stem cells.


title: An effective training program for chest tube drainage for medical interns in a clinical simulation laboratory.

text: The Department of Respiratory Medicine of Nippon Medical School Hospital and the Working Committee of Clinical Simulation Laboratory have held training sessions for chest tube drainage since 2007. The training program consists of the preparation of a training manual, a small-group session, and a review of the process of chest tube drainage using a checklist of steps after the session. A total of 21 medical interns of Nippon Medical School Hospital participated in training sessions from April 2010 through February 2011. A questionnaire survey at the end of the session revealed that most participants rated highly both the explanations given by the instructors and the descriptions in the manual for comprehensibility. Only 3 interns felt that they had successfully acquired the clinical skill, and the other 18 interns felt that they had somewhat acquired the skill. Research after the interns had completed the program of the department showed that 80% of interns had performed chest tube drainage for patients during the rotation. The interns assessed the training program as useful, and some interns felt they could perform the skill with confidence or without anxiety. Other systematic programs of skill training for medical interns are recommended to ensure definite acquisition of basic skills.


title: The role of the OIE in information exchange and the control of animal diseases, including zoonoses.

text: The growing importance of animal diseases and zoonoses at a time when globalisation has increased movements of people, animals and animal products across the globe, has strengthened the role of the World Organisation for Animal Health (OIE) in animal disease control. The OIE's mandate since its establishment in 1924 has been to facilitate the exchange of public health, animal health and scientific information, and to further the control and eradication of animal diseases. The OIE is recognised by the World Trade Organization Agreement on the Application of Sanitary and Phytosanitary Measures as the international reference organisation for animal diseases and zoonoses, especially for standard setting. The standards adopted by the World Assembly of OIE Delegates on veterinary public health and animal health feature in the OlE Terrestrial Animal Health Code, the Aquatic Animal Health Code, the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals and the Manual of Diagnostic Tests for Aquatic Animals. The OlE is also a reference organisation for the exchange of public and animal health information among Member Countries, through an information, reporting and warning system based on transparent communication between countries. The OIE provides scientific expertise in ascertaining countries' status with regard to notifiable diseases, enabling them to secure official recognition as being free from foot and mouth disease, African horse sickness, contagious bovine pleuropneumonia and bovine spongiform encephalopathy. The OIE also contributes its scientific expertise to stakeholder training on the surveillance and control of animal diseases and zoonoses and to the evaluation of the performance of Veterinary Services, to enhance theirwork asthe cornerstone of their countries' disease control efforts.


title: Racial/ethnic disparities among children with diagnoses of perinatal HIV infection - 34 states, 2004-2007.

text: Early in the epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the United States, racial/ethnic disparities were observed in the diagnoses of AIDS among adults and children. Since the early 1990s, the annual number of diagnoses of perinatally acquired AIDS and HIV infection has declined by approximately 90% in the United States as a result of routine HIV screening of pregnant women and the availability of effective interventions to prevent transmission. To characterize the most recent trends in diagnoses of perinatal HIV infection by race/ethnicity, CDC analyzed national HIV surveillance data for the period 2004-2007 from 34 states. This report summarizes the results of those analyses, which indicated that, during 2004-2007, 85% of diagnoses of perinatal HIV infection were in blacks or African Americans (69%) or Hispanics or Latinos (16%). The average annual rate of diagnoses of perinatal HIV infection during 2004-2007 was 12.3 per 100,000 among blacks, 2.1 per 100,000 among Hispanics, and 0.5 per 100,000 among whites. However, from 2004 to 2007, the racial/ethnic disparity narrowed, as the annual rate of diagnoses of perinatal HIV infection for black children decreased from 14.8 to 10.2 per 100,000, and the rate for Hispanic children decreased from 2.9 to 1.7 per 100,000. To further reduce perinatal HIV transmission and racial/ethnic disparities, HIV-infected pregnant women, and particularly black and Hispanic women, should receive timely prenatal care, early antiretroviral treatment, and other recommended interventions.


title: [The prevalence of the human rhinoviruses and coronaviruses circulating in the Moscow region during 2007-2012].

text: The rhinoviruses and coronaviruses are the most common causative agents of the acute upper respiratory tract infection in humans. They include several species that vary in the pathogenicity, some causing severe respiratory tract diseases. In this work, the species prevalence of rhinoviruses and coronaviruses was studied in 92 virus-positive clinical patients that were collected at the area of the Moscow region during the period from 2007 to 2012. Using the real-time PCR the virus circulation has been established for all species common in humans, including three rhinoviruses, HRV A, HRV B, and HRV C, and four coronaviruses, HCoV-NL63, HCoV-229E, HCoV-OC43, and HCoV-HKU1. For eight patients, the identity of the rhinoviruses, including 4 cases of HRV-C, 3 cases of HRV-A, and a single case of HRV-B, was corroborated using partial sequencing of the 5 non-coding regions and phylogenetic analysis. The viruses of HRV-C, HCoV-NL63, and HCoV-OC43 were prevalent in children with severe respiratory diseases.