Integrated Genomic and Social Network Analyses of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in the Healthcare Setting

BACKGROUND

Infection prevention (IP) measures are designed to mitigate the transmission of pathogens in healthcare. Using large-scale viral genomic and social network analyses, we determined if IP measures used during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic were adequate in protecting healthcare workers (HCWs) and patients from acquiring SARS-CoV-2.

METHODS

We performed retrospective cross-sectional analyses of viral genomics from all available SARS-CoV-2 viral samples collected at UC San Diego Health and social network analysis using the electronic medical record to derive temporospatial overlap of infections among related viromes and supplemented with contact tracing data. The outcome measure was any instance of healthcare transmission, defined as cases with closely related viral genomes and epidemiological connection within the healthcare setting during the infection window. Between November 2020 through January 2022, 12 933 viral genomes were obtained from 35 666 patients and HCWs.

RESULTS

Among 5112 SARS-CoV-2 viral samples sequenced from the second and third waves of SARS-CoV-2 (pre-Omicron), 291 pairs were derived from persons with a plausible healthcare overlap. Of these, 34 pairs (12%) were phylogenetically linked: 19 attributable to household and 14 to healthcare transmission. During the Omicron wave, 2106 contact pairs among 7821 sequences resulted in 120 (6%) related pairs among 32 clusters, of which 10 were consistent with healthcare transmission. Transmission was more likely to occur in shared spaces in the older hospital compared with the newer hospital (2.54 vs 0.63 transmission events per 1000 admissions, P < .001).

CONCLUSIONS

IP strategies were effective at identifying and preventing healthcare SARS-CoV-2 transmission.

No disruption of rhizobial symbiosis during early stages of cowpea domestication

Modern agriculture intensely selects aboveground plant structures, while often neglecting belowground features, and evolutionary tradeoffs between these traits are predicted to disrupt host control over microbiota. Moreover, drift, inbreeding, and relaxed selection for symbiosis in crops might degrade plant mechanisms that support beneficial microbes. We studied the impact of domestication on the nitrogen fixing symbiosis between cowpea and root-nodulating Bradyrhizobium. We combined genome-wide analyses with a greenhouse inoculation study to investigate genomic diversity, heritability, and symbiosis trait variation among wild and early-domesticated cowpea genotypes. Cowpeas experienced modest decreases in genome-wide diversity during early domestication. Nonetheless, domesticated cowpeas responded efficiently to variation in symbiotic effectiveness, by forming more root nodules with nitrogen-fixing rhizobia and sanctioning non-fixing strains. Domesticated populations invested a larger proportion of host tissues into root nodules than wild cowpeas. Unlike soybean and wheat, cowpea showed no compelling evidence for degradation of symbiosis during domestication. Domesticated cowpeas experienced a less severe bottleneck than these crops and the low nutrient conditions in Africa where cowpea landraces were developed likely favored plant genotypes that gain substantial benefits from symbiosis. Breeders have largely neglected symbiosis traits, but artificial selection for improved plant responses to microbiota could increase plant performance and sustainability. This article is protected by copyright. All rights reserved.

Perceptions of mission-critical organizational resources: a survey of substance prevention and treatment agencies in the southwest

This article explores administrator and staff perceptions of mission-critical agency capacity in a predominantly Hispanic region that has a high degree of acculturation and elevated use of alcohol, tobacco, and other drugs. The domains explored are financial resources, proposal development, agency policies, organizational structure, communication, leadership, planning, and networking capabilities. Although significant differences were found among all eight domains, both staff and administrators concurred regarding the two areas of least capacity--financial resources and proposal development--and the two areas of greatest capacity--planning and networking capabilities. The authors suggest that agreement about the ranking of the domains is the most important finding rather than the differences between administrators and staff. A discussion of the practice and educational implications concludes the article.

Modulation by nitric oxide of gastric acid secretion in toads

Nitric oxide (NO) is a novel chemical messenger that mediates a variety of biological actions. This study was undertaken to investigate the effects of NO on parietal cell function. The rate of [3H]arginine conversion to [3H]citrulline, a parameter of NO synthase activity, and NO formation (as NO2-), were inhibited by the NO synthase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME), in a concentration-dependent manner in the non-stimulated toad gastric mucosa. This range of concentrations of L-NAME provoked stimulation of H+ secretion in a similar fashion, which was blocked by L-arginine but not by D-arginine. Pre-treatment with carbachol plus ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetra-acetic acid (EGTA) prevented the effect of L-NAME on H+ secretion and drastically reduced NO synthase activity. L-arginine had an inhibitory effect on H+ secretion in non-stimulated and carbachol-stimulated gastric mucosa, which was reversed by L-NAME. Carbachol and pentagastrin, but not histamine, significantly increased NO formation in the toad gastric mucosa. The results suggest that changes in NO synthesis in the gastric mucosa may modulate parietal cell function and that a calcium-dependent mechanism may be involved.

Periventricular heterotopia: an X-linked dominant epilepsy locus causing aberrant cerebral cortical development

Periventricular heterotopia (PH) involves dramatic malformations of the human cerebral cortex. Here we show that PH is closely linked to markers in distal Xq28 (maximal two-point lod score = 4.77 for F8C at theta = 0; maximal multipoint lod score = 5.37), so that affected females are obligatory mosaics for the mutation; that PH is lethal to at least some affected males; that PH malformations consist of well-differentiated cortical neurons filling the adult subependymal zone; and that individuals with PH are at high risk for epilepsy, though they have no other neurological or external stigmata. The PH gene may represent an important epilepsy susceptibility locus in addition to playing a key role in normal cortical development.

A clinical trial evaluating the 24-hour effects of bisoprolol/hydrochlorothiazide 5 mg/6.25 mg combination in patients with mild to moderate hypertension

This study used 24-h ambulatory blood pressure (BP) monitoring to investigate the effectiveness of a novel low-dose combination of bisoprolol/hydrochlorothiazide in adult patients with mild to moderate essential hypertension. Thirty-six patients with stable mild to moderate hypertension (sitting diastolic BP 95-114 mmHg) after a placebo run-in phase received oral bisoprolol/hydrochlorothiazide 5 mg/6.25 mg once daily for 4 weeks in a single-blind regimen. At office visits, BP and pulse were measured with statistically significant reductions (p < 0.01) recorded after 2 and 4 weeks of treatment. Twenty-four-h ambulatory BP monitoring at the completion of therapy revealed significant reductions (p < 0.01) in both systolic and diastolic 24-h, daytime, and nighttime BP, compared with the end of the placebo treatment phase. Systolic and diastolic load were also reduced (p < 0.01). The combination was well tolerated, and overall quality-of-life questionnaire scores indicated an improvement after bisoprolol/hydrochlorothiazide therapy (p = 0.02). No clinically significant changes from baseline in laboratory parameters were observed; in particular, serum potassium was unchanged. This is the first study to demonstrate the 24-h effectiveness of the bisoprolol/hydrochlorothiazide 5 mg/6.25 mg combination, using 24-h ambulatory BP monitoring. In addition, antihypertensive therapy with low doses of bisoprolol/hydrochlorothiazide in combination may improve tolerability.

Hormonal effects on gluconeogenesis from (U-14C)glutamate in rainbow trout (Salmo gairdneri)

Blood glucose was significantly decreased by insulin (4 I.U./kg). Glucagon (1 mg/kg) and Cortisol (5 mg/kg) administration produced a significant hyperglycaemia. Insulin administration did not modify liver glycogen levels. Glucagon showed a marked liver glycogen mobilization. Cortisol stimulated liver glycogen deposition. Insulin and Glucagon showed a significant inverse effect on gluconeogenesis from (U-14C)glutamate, decreasing and increasing 14C-glucose formation respectively. Hormonal treatments did not influence the very low levels of incorporation of (U-14C)glutamate into liver and muscle glycogen.

Influence of dietary composition on gluconeogenesis from L-(U-14C)glutamate in rainbow trout (Salmo gairdneri)

The effect of dietary composition (high-protein, high-carbohydrate and high-fat diets) and starvation on in totum gluconeogenesis from L-(U-14C)glutamate was studied in the rainbow trout. High-fat and high-carbohydrate diets produced a significant hyperglycaemia. Lower blood glucose values were obtained in trout fed on a high-protein diet. Liver glycogen levels were significantly lower in trout fed on carbohydrate-free diets (high-protein and high-fat diets) and in starved fish. Gluconeogenesis from L-(U-14C)glutamate was markedly reduced in fish given the high-carbohydrate diet and significantly enhanced in starved fish. Radioactive liver glycogen was higher in starved fish, although the amount of radioactivity incorporated into glycogen was very low.