Measuring SARS-CoV-2 RNA concentrations in neighborhood wastewater

Longitudinal wastewater sampling during the COVID-19 pandemic was an important aspect of disease surveillance, adding to a more complete understanding of infection dynamics and providing important data for community public health monitoring and intervention planning. This was largely accomplished by testing SARS-CoV-2 RNA concentrations in samples from municipal wastewater treatment plants (WWTPs). We evaluated the utility of testing for virus levels upstream from WWTP within the residential neighborhoods that feed into the WWTP. We propose that monitoring virus dynamics across residential neighborhoods could reveal important public health-relevant information about community sub-group heterogeneity in virus concentrations. PRINCIPAL RESULTS: Virus concentration patterns display heterogeneity within neighborhoods and between neighborhoods over time. Sewage SARS-CoV-2 RNA concentrations as measured by RT-qPCR also corresponded closely to verified COVID-19 infection counts within individual neighborhoods. More importantly, our data suggest the loss of disease-relevant public health information when sampling occurs only at the level of WWTP instead of upstream in neighborhoods. Spikes in SARS-CoV-2 RNA concentrations in neighborhoods are often masked by dilution from other neighborhoods in the WWTP samples. MAJOR CONCLUSIONS: Wastewater-based epidemiology (WBE) employed at WWTP reliably detects SARS-CoV-2 in a city-sized population but provides less actionable public health information about neighborhoods experiencing greater viral infection and disease. Neighborhood sewershed sampling reveals important population-based information about local virus dynamics and improves opportunities for public health intervention. Longitudinally employed, neighborhood sewershed surveillance may provide a 3-6 day early warning of SARS-CoV-2 infection spikes and, importantly, highly specific information on subpopulations in a community particularly at higher risk at different points in time. Sampling in neighborhoods may thus provide timely and cost-saving information for targeted interventions within communities.

The ideal environment for the development of postcardiac surgery atrial fibrillation: evidence for endothelial activation and poor cell-cell interaction

Introduction

The development of post-operative atrial fibrillation (POAF) after cardiac surgeryis associated with pre-existing endothelial activation and systemic inflammation due to adhesion and transmigration of leukocytes into the interstitium. The electrical remodelling associated with AF causes changes in connexins, resulting in ineffective electrical coupling between cells and thus ineffective cell-cell communication.There is also an association between the inflammatory state, and the presence of cardiac fibrosis, oxidative stress and myocyte apoptosis.

Purpose

Our aim was to investigate the pathophysiologicaland regulatory mechanisms of AF through endothelial activation and inflammatory status, as well as cell-cell interactions (connexins) in relation to POAF amongst a cohort of patients undergoing cardiac surgery.

Methods

We studied prospective patients who underwent CABG (52.9%) or cardiac valve (47.1%) surgery without previous documented AF. Patients with permanent AF who underwent CABG or cardiac valve surgery were also included as positive controls. Plasma samples were collected at baseline and 24 hours after surgery, to assess the impact of surgery. To detect endothelial activation, vascular cell adhesion protein-1 (VCAM-1 (CD106)) was evaluated by ELISA assay in plasma samples. Expression of connexin 40 and 43 were measured by inmunohistochemistry in atrial tissue samples.

Results

We included 117 patients (75.2% males, median age 67 [IQR 59.5–73.0] years), of whom17 (14.5%) patients had permanent AF; 27 (23.1%) developed POAF and 73 (62.4%) had no AF detected.

We found higher baseline VCAM-1 levels versus 24-hour samples overall (p=0.001). When comparing groups, baseline VCAM-1 levels were higher in patients with permanent AF compared to non-AF (p=0.035); and in permanent AF compared to POAF (p=0.049). VCAM-1 levels at 24h followed the same trends between permanent AF and non-AF (p=0.001), and permanent AF versus POAF (p=0.013) (Table 1). VCAM-1 levels over the third tertile (i.e.>49.77 ng/ml) increased the risk of AF almost 3-fold (OR 2.85, 95% CI 1.06–7.70; p=0.039). There was a significant decrease in the expression of connexion 40 in patients with AF (ie. patients with permanent AF or POAF) compared to non-AF patients (1.00 [0.50–2.31] vs. 2.48 [1.94–3.00], p=0.044), while connexin 43 was non-significantly different (1.07 [0.41–1.75] vs. 2.00 [0.63–2.25], p=0.289) (Table 2).

Conclusions

VCAM-1 levels were upregulated in patients with permanent AF and POAF compared to patients without AF, and remained higher even after surgery, thus demonstrating a relevantendothelial activation. The pro-inflammatory state presented in these patients with AF, along with decreased connexin 40 expression impacting cell-to-cell conduction, suggests a potential combination for atrial remodelling and incident AF.

Funding Acknowledgement

Type of funding sources: None.

A CURE for a Major Challenge in Phenomics: A Practical Guide to Implementing a Quantitative Specimen-Based Undergraduate Research Experience

The measurement and analysis of phenotypes is often a rate-limiting step for many integrative organismal studies but engaging undergraduate researchers can help overcome this challenge. We present a practical guide to implementing a quantitative specimen-based Course-based Undergraduate Research Experience (CURE), which trains students to collect phenotypic data and mentors them through the entire scientific process using the data they help to collect. Direct access to specimens is not necessary to implement this undergraduate research experience, as recent efforts to digitize museum collections along with online image archives allow data extraction to take place in any classroom. We focus in particular on hypothesis development and quantitative skills, as they are essential for modern biological discovery but are rarely emphasized in traditional lecture-based classes. We have implemented this experience, focusing on collecting and analyzing body shape data across fishes, at two institutions with a total of 39 students. It has so far resulted in 14 talks and 4 posters presented by students at local symposia and 2 scientific papers in preparation with undergraduate co-authors. Moreover, the students had a positive experience that, according to their own assessment, improved their critical thinking and analytical skills as well as their knowledge of science and the scientific process.

Building a Body Shape Morphospace of Teleostean Fishes

We present a dataset that quantifies body shape in three dimensions across the teleost phylogeny. Built by a team of researchers measuring easy-to-identify, functionally relevant traits on specimens at the Smithsonian National Museum of Natural History it contains data on 16,609 specimens from 6144 species across 394 families. Using phylogenetic comparative methods to analyze the dataset we describe the teleostean body shape morphospace and identify families with extraordinary rates of morphological evolution. Using log shape ratios, our preferred method of body-size correction, revealed that fish width is the primary axis of morphological evolution across teleosts, describing a continuum from narrow-bodied laterally compressed flatfishes to wide-bodied dorsoventrally flattened anglerfishes. Elongation is the secondary axis of morphological variation and occurs within the more narrow-bodied forms. This result highlights the importance of collecting shape on three dimensions when working across teleosts. Our analyses also uncovered the fastest rates of shape evolution within a clade formed by notothenioids and scorpaeniforms, which primarily thrive in cold waters and/or have benthic habits, along with freshwater elephantfishes, which as their name suggests, have a novel head and body shape. This unprecedented dataset of teleostean body shapes will enable the investigation of the factors that regulate shape diversification. Biomechanical principles, which relate body shape to performance and ecology, are one promising avenue for future research.

Pectoral Dimorphism Is a Pervasive Feature of Skate Diversity and Offers Insight into their Evolution

Mature skates (Batoidea: Rajoidei) display a unique form of sexual dimorphism in which males develop a concave anterior pectoral fin, giving them a bell-shaped appearance. Recent work has linked the male-specific transformation to differential skeletal development that is coincident with the rapid elongation of claspers, cartilage-supported intromittent organs. Still, little is known about the prevalence of pectoral dimorphism across skates or of interspecific variation in its expression. Here, we use various morphological approaches to broadly explore pectoral dimorphism in skates, with the goal of understanding its significance in their evolutionary history. We find that pectoral fin sexual dimorphism exists across skate diversity, positively identifying its presence in at least 131 species spanning 33 genera, approximately 40% of valid species. Further, we show that the nature of male–female shape change is largely consistent across species, but that it differs in its magnitude at a biologically meaningful scale. Finally, we use the pygmy skate Fenestraja plutonia as a case study to illustrate ontogenetic patterns in the development of pectoral fin dimorphism, additionally identifying sex-based differences in the pelvic girdle and jaw. Our work suggests that the diversity of pectoral dimorphism in skates is linked to comparative growth and maturation, and potentially to processes underlying reproductive and life history diversification within the group.

Extending the Geometric Approach for Studying Biomechanical Motions

Whether it is swimming, walking, eating, or jumping, motions are a fundamental way in which organisms interact with their environment. Understanding how morphology contributes to motion is a primary focus of kinematic research and is necessary for gaining insights into the evolution of functional systems. However, an element that is largely missing from traditional analyses of motion is the spatial context in which they occur. We explore an application of geometric morphometrics (GM) for analyzing and comparing motions to evaluate the outputs of biomechanical linkage models. We focus on a common model for oral jaw mechanics of perciform fishes, the fourbar linkage, using GM to summarize motion as a trajectory of shape change. Two traits derived from trajectories capture the total kinesis generated by a linkage (trajectory length) and the kinematic asynchrony (KA) of its mobile components (trajectory nonlinearity). Oral jaw fourbar data from two subfamilies of Malagasy cichlids were used to generate form–function landscapes, describing broad features of kinematic diversity. Our results suggest that kinesis and KA have complex relationships with fourbar morphology, each displaying a pattern in which different shapes possess equivalent kinematic trait values, known as many-to-one mapping of form-to-function. Additionally, we highlight the observation that KA captures temporal differences in the activation of motion components, a feature of kinesis that has long been appreciated but was difficult to measure. The methods used here to study fourbar linkages can also be applied to more complex biomechanical models and broadly to motions of live organisms. We suggest that they provide a suitable alternative to traditional approaches for evaluating linkage function and kinematics.

Can an eel be a flatfish? Observations on enigmatic asymmetrical heterenchelyids from the Guinea coast of West Africa

Morphological asymmetry is described in the heterenchelyid mud eel Pythonichthys cf. macrurus from inshore coastal waters of Guinea, West Africa. The intensity of asymmetry differs between two examined specimens, with the more extreme case exhibiting strong asymmetry in both external and internal features, including unilateral depigmentation, reductive degeneration and embedding of a blind-side eye, skewed jaws with reduced dentition and tooth loss. The extent and nature of asymmetry suggests that this individual probably lived primarily on its left lateral side, not unlike sinistral pleuronectiform flatfishes.

Immunohistochemical Characterization and Evaluation of Prognostic Factors in Canine Oral Melanomas with Osteocartilaginous Differentiation

Melanomas are the most common malignant oral neoplasm in dogs. Osteocartilaginous differentiation in oral melanomas is a rare feature described both in veterinary and human medicine. Here, 10 cases of this type of neoplasm were used to study their immunohistochemical, biological, and clinical characteristics. Reactivity for S100 and melan A antigen was evaluated, and 4 prognosis factors (mitotic index, invasiveness of epithelium, nuclear atypia, and proliferation index) were analyzed and correlated with the clinical course of the neoplasms after diagnosis. Immunohistochemical analysis of the studied neoplasms, including the osteocartilaginous areas, showed positive immunoreaction for S100 and melan A, except in one dog, which was negative for melan A. Analysis of the results showed that oral melamonas with osteocartilaginous differentiation have a clinical course similar to that of other melanomas in the oral cavity. Analysis of the mitotic index and the expression of proliferation marker Ki-67 could be useful tools for predicting the biological behavior of these neoplasms.

Effects of rumen-protected choline and dry propylene glycol on feed intake and blood parameters for Holstein dairy cows in early lactation

A 6 x 6 Latin square design was used to test 3 sets of comparisons simultaneously to study response in dry matter intake, milk yield, and blood parameters to propylene glycol (PG) supplementation delivered by 2 methods [incorporating PG into the total mixed ration (TMR) vs. top dressing; comparison I]; individual or combined dietary choline and PG supplementation as a 2 x 2 factorial (comparison II); or increasing amounts of dietary choline (comparison III). Six multiparous (lactation number = 1.5 +/- 0.8 SD) Holstein dairy cows were at 41 d in milk (+/- 9 SD) at the start of the experiment. Propylene glycol used was a dry product containing 65% PG, and choline was a rumen-protected choline product (RPC; estimated to be 50% rumen-protected) containing 50% choline chloride. In comparison I, treatments compared were 1) control: no PG; 2) PG-TMR: 250 g/d of dry PG (corresponding to 162.5 g/d of PG) incorporated into the TMR; and 3) PG-top dress: 250 g/d of dry PG top-dressed onto the TMR. In comparison II, treatments compared were 1) control: no PG and no RPC; 2) PG: 250 g/d of dry PG incorporated into the TMR; 3) RPC: 50 g/d of RPC top-dressed onto the TMR; and 4) PG+RPC: combination of treatments 2 and 3. In comparison III, treatments compared were 0, 25, and 50 g/d of RPC top-dressed onto the TMR. Each experimental period lasted 10 d with 9 d of adaptation followed by 1 d of serial blood sampling. Dry matter intake and milk yield were recorded daily. During the serial blood sampling, jugular blood was sampled every 20 min for the first 4 h and at 8 and 12 h after treatment administration. Results obtained from comparison I showed that feeding 250 g/d of PG as a dry product decreased plasma beta-hydroxybutyrate (BHBA) concentration (mean +/- SEM) from 701 +/- 81 (control) to 564 +/- 76 micromol/L without affecting serum insulin, plasma glucose, or plasma nonesterified fatty acid concentrations. Top-dressing PG decreased plasma BHBA concentrations more than by incorporating it into the TMR [527 vs. 601 micromol/L (+/- 81 pooled SEM)]. Results obtained from comparison II showed that supplementing choline as RPC, PG, or both had no effect on dry matter intake, milk yield, or any of the blood parameters measured. Results obtained from comparison III showed that milk yield tended to increase linearly with increasing amounts of dietary choline as RPC. We concluded that feeding PG as a dry product reduced plasma BHBA concentration but top-dressing PG was more efficient at reducing plasma BHBA level than incorporating PG into the TMR. Dietary choline as RPC tended to increase milk yield linearly. However, a combined effect of dietary PG and choline was not evident and therefore not beneficial.

Immunohistochemical characterization of a pulmonary large-cell carcinoma in a dog

Primary pulmonary tumors are less common in dogs than secondary (metastatic) tumors. Most primary tumors are malignant and of epithelial origin. Pulmonary large-cell carcinoma is considered extremely rare in domestic animals, and some of the few reported cases actually may have been cases of malignant pulmonary histiocytosis. An 8-year-old female Wire Fox Terrier with diffuse alveolar pattern radiographically was euthanatized when it failed to respond to antibiotic therapy. Histologically, pulmonary alveolar spaces contained clusters of large round anaplastic cells with ample eosinophilic cytoplasm and large irregularly shaped nuclei with prominent nucleoli. Immunohistochemistry was used to distinguish large-cell carcinoma from malignant pulmonary histiocytosis. Tumor cells had strong immunoreactivity for cytokeratin, consistent with epithelial origin. However, a substantial percentage of the neoplastic cells co-expressed vimentin and MHC-II. The type II alveolar epithelial cell was considered the cell of origin of the neoplasm based on the presence of lamellar bodies in some neoplastic cells and immunoreactivity for surfactant protein A and thyroid transcription factor-1.

Characterization of a murine model of intranasal infection suitable for testing vaccines against C. abortus

Mouse models have been widely used to test candidate vaccines against Chlamydophila abortus infection in mice. Although the induction of a systemic infection by endogenous or intraperitoneal inoculation is a useful tool for understanding the immune mechanism involved in the protection conferred by the vaccination, a different approach is necessary to understand other factors of the infection, such as mucosal immunity or the colonization of target organs. To test whether C. abortus intranasal model of infection in mice is a useful tool for testing vaccines in a first group of experiments mice, were infected intranasally with C. abortus to characterize the model of infection. When this model was used to test vaccines, two inactivated experimental vaccines, one of them adjuvated with QS-21 and another with aluminium hydroxide, and a live attenuated vaccine (strain 1B) were used. Non-vaccinated control mice died within the first 8 days, after displaying substantial loss of weight. Histologically, the mice showed lobar fibrinopurulent bronchointerstitial pneumonia. Prior immunization with QS-21 adjuvated vaccine or 1B vaccine presented mortality and the recipients showed a greater number of T cells in the lesions, especially CD8(+) T cells, than the control mice and mice immunized with vaccine adjuvated with aluminium hydroxide. The results confirm that the C. abortus intranasal model of infection in mice is a useful tool for testing vaccines.

Atrial fibrillation and anabolic steroids

A young male bodybuilder, consuming large doses of anabolic steroids (AS), presented to the Emergency Department (ED) with symptomatic rapid atrial fibrillation (AF). Echocardiogram revealed significant septal hypokinesis, and posterior and septal wall thickness at the upper limit of normal for highly trained athletes. The atrial fibrillation had not recurred at 10 weeks after discontinuation of AS use. Consumption of these agents in athletes has been associated with hypertension, ischemic heart disease, hypertrophic cardiomyopathy, and sudden death.

Sordarins: in vitro activities of new antifungal derivatives against pathogenic yeasts, Pneumocystis carinii, and filamentous fungi

GM 193663, GM 211676, GM 222712, and GM 237354 are new semisynthetic derivatives of the sordarin class. The in vitro antifungal activities of GM 193663, GM 211676, GM 222712, and GM 237354 against 111 clinical yeast isolates of Candida albicans, Candida kefyr, Candida glabrata, Candida parapsilosis, Candida krusei, and Cryptococcus neoformans were compared. The in vitro activities of some of these compounds against Pneumocystis carinii, 20 isolates each of Aspergillus fumigatus and Aspergillus flavus, and 30 isolates of emerging less-common mold pathogens and dermatophytes were also compared. The MICs of GM 193663, GM 211676, GM 222712, and GM 237354 at which 90% of the isolates were inhibited (MIC90s) were 0.03, 0.03, 0.004, and 0.015 microg/ml, respectively, for C. albicans, including strains with decreased susceptibility to fluconazole; 0.5, 0.5, 0.06, and 0.12 microg/ml, respectively, for C. tropicalis; and 0.004, 0.015, 0.008, and 0.03 microg/ml, respectively, for C. kefyr. GM 222712 and GM 237354 were the most active compounds against C. glabrata, C. parapsilosis, and Cryptococcus neoformans. Against C. glabrata and C. parapsilosis, the MIC90s of GM 222712 and GM 237354 were 0.5 and 4 microg/ml and 1 and 16 microg/ml, respectively. The MIC90s of GM 222712 and GM 237354 against Cryptococcus neoformans were 0.5 and 0.25 microg/ml, respectively. GM 193663, GM 211676, GM 222712, and GM 237354 were extremely active against P. carinii. The efficacies of sordarin derivatives against this organism were determined by measuring the inhibition of the uptake and incorporation of radiolabelled methionine into newly synthesized proteins. All compounds tested showed 50% inhibitory concentrations of <0.008 microg/ml. Against A. flavus and A. fumigatus, the MIC90s of GM 222712 and GM 237354 were 1 and 32 microg/ml and 32 and >64 microg/ml, respectively. In addition, GM 237354 was tested against the most important emerging fungal pathogens which affect immunocompromised patients. Cladosporium carrioni, Pseudallescheria boydii, and the yeast-like fungi Blastoschizomyces capitatus and Geotrichum clavatum were the most susceptible of the fungi to GM 237354, with MICs ranging from </=0.25 to 2 microg/ml. The MICs of GM 237354 against Trichosporon beigelii and the zygomycetes Absidia corymbifera, Cunninghamella bertholletiae, and Rhizopus arrhizus ranged from </=0.25 to 8 microg/ml. Against dermatophytes, GM 237354 MICs were >/=2 microg/ml. In summary, we concluded that some sordarin derivatives, such as GM 222712 and GM 237354, showed excellent in vitro activities against a wide range of pathogenic fungi, including Candida spp., Cryptococcus neoformans, P. carinii, and some filamentous fungi and emerging invasive fungal pathogens.

The cardiac toxicity of anabolic steroids

Anabolic steroids are synthetic derivatives of testosterone that were developed as adjunct therapy for a variety of medical conditions. Today they are most commonly used to enhance athletic performance and muscular development. Both illicit and medically indicated anabolic steroid use have been temporally associated with many subsequent defects within each of the body systems. Testosterone is the preferred ligand of the human androgen receptor in the myocardium and directly modulates transcription, translation, and enzyme function. Consequent alterations of cellular pathology and organ physiology are similar to those seen with heart failure and cardiomyopathy. Hypertension, ventricular remodeling, myocardial ischemia, and sudden cardiac death have each been temporally and causally associated with anabolic steroid use in humans. These effects persist long after use has been discontinued and have significant impact on subsequent morbidity and mortality. The mechanisms of cardiac disease as a result of anabolic steroid use are discussed in this review.

Cidofovir use in acyclovir-resistant herpes infection

Herpes infections continue to be prevalent, especially in immunocompromised patients. Some of these patients will develop resistant HSV infections. Therefore, it is important to explore new treatment options. Animal studies have shown cidofovir to be effective in the treatment and prevention of HSV infections. Human data are limited, with only one randomized, double-blind, placebo-controlled trial performed to date. The results from this study look promising; however, due to the small sample size, a larger clinical trial is warranted. The human data available as case reports are suboptimal in the quality of reporting time frames for resolution of lesions/symptoms and outcomes of therapy. Another problem with the case report data is that the TK status of the herpes simplex isolates was not reported. This would have helped substantiate the acyclovir resistance seen in these patients. It was evident in these case reports that acyclovir resistance can be overcome, as acyclovir-resistant strains became sensitive following cidofovir therapy. This may be because TK(+) viruses have been shown to establish latency more readily than do TK(-) viruses. This pattern suggests that alternating between acyclovir and cidofovir therapies may provide a strategy to manage the emergence of alternatively acyclovir-sensitive and -resistant infections. At present, only the intravenous formulation of cidofovir is commercially available. Advantages of the intravenous formulation include weekly dosing and efficacy. Disadvantages are the complexity of administration and the adverse effect profile. The most common adverse effects with this formulation include nephrotoxicity manifested as proteinuria (12%), and increased creatinine (5%) and neutropenia (15%). Administration of probenecid and NaCl 0.9% hydration are used to reduce the incidence and severity of nephrotoxicity in patients who are receiving cidofovir. Probenecid also has toxicities, including nausea, vomiting, headache, fever, and flushing. The topical formulation of cidofovir looks promising for mucocutaneous HSV infection because it is usually undetectable in the blood following topical administration. Therefore, systemic adverse effects should be minimized. A cidofovir gel product (Forvade, Gilead Sciences) is currently being reviewed by the Food and Drug Administration for the treatment of refractory HSV. Ultimately, more controlled clinical studies are necessary to determine whether routine cidofovir use can be justified in patients with acyclovir-resistant HSV infection.

Use of automated reminders for tuberculin skin test return

INTRODUCTION

This study assessed the impact of automated telephone reminders on tuberculin skin test returns.

METHODS

A total of 701 English-speaking and Spanish-speaking patients of a public health immunization program were randomly assigned to an intervention or a control group. Those in the intervention group received an automated telephone reminder to return for the reading of their skin test.

RESULTS

Automated telephone reminders significantly reduced return failures 53% (from 14% to 7%) when the scheduled interval between test administration and reading was three days, but had no impact for a two-day interval. Effectiveness of reminders did not differ significantly by patient age, gender, or language (English versus Spanish).

CONCLUSIONS

Results suggest the value of automated reminder calls for intra-appointment intervals as short as three days.

Comparative study of toxic lead effect on gill and haemoglobin of tilapia fish

This study was designed to determine the 72-h LC50 of lead for tilapia fish (Oreochromis hornorum), as well as the effect of exposure to sublethal lead concentrations (15, 23, 31, 39 and 47% of the LC50) on gill tissue lysosomal membranes of the fish and thaemoglobin concentration in blood. The LC50 value was found to be 202 mg Pb2+ l-1. Exposure to sublethal lead concentrations for 72 h showed significant increases in the lability of gill lysosomal membranes, measured by the release of acid phosphatase. Changes in membrane lability and in haemoglobin concentration were dependent on the amount of lead used during the exposure. We considered that the membrane lability is an adequate parameter to assay for monitoring lead contamination in water, because it is more sensitive than the haemoglobin concentration in blood.

Pneumomediastinum following a surgical renal biopsy

A case of pneumomediastinum, which appeared after a biopsy of the right kidney by minimal lumbotomy, is reported. The anatomicopathological condition of the renal fragment obtained was judged to be focal and segmental hyalinosis. We wish to emphasize the rarity of such a complication, the type of electrocardiographic changes observed, and the rapid and spontaneous recuperation of the patient without further repercussions.