Diverse array of neutralizing antibodies elicited upon Spike Ferritin Nanoparticle vaccination in rhesus macaques

The repeat emergence of SARS-CoV-2 variants of concern (VoC) with decreased susceptibility to vaccine-elicited antibodies highlights the need to develop next-generation vaccine candidates that confer broad protection. Here we describe the antibody response induced by the SARS-CoV-2 Spike Ferritin Nanoparticle (SpFN) vaccine candidate adjuvanted with the Army Liposomal Formulation including QS21 (ALFQ) in non-human primates. By isolating and characterizing several monoclonal antibodies directed against the Spike Receptor Binding Domain (RBD), N-Terminal Domain (NTD), or the S2 Domain, we define the molecular recognition of vaccine-elicited cross-reactive monoclonal antibodies (mAbs) elicited by SpFN. We identify six neutralizing antibodies with broad sarbecovirus cross-reactivity that recapitulate serum polyclonal antibody responses. In particular, RBD mAb WRAIR-5001 binds to the conserved cryptic region with high affinity to sarbecovirus clades 1 and 2, including Omicron variants, while mAb WRAIR-5021 offers complete protection from B.1.617.2 (Delta) in a murine challenge study. Our data further highlight the ability of SpFN vaccination to stimulate cross-reactive B cells targeting conserved regions of the Spike with activity against SARS CoV-1 and SARS-CoV-2 variants.

Role of the NSs protein in the zoonotic capacity of Orthobunyaviruses

The family Bunyaviridae contains over 350 named isolates, classified into five genera: Orthobunyavirus, Hantavirus, Nairovirus, Phlebovirus and Tospovirus. The Orthobunyavirus genus contains some 170 isolates that are mainly transmitted by mosquitoes and are responsible for a range of disease syndromes in humans including self-limiting febrile illness, encephalitis and haemorrhagic fever. The viruses have a tripartite, negative-sense RNA genome. Analyses of viruses in four serogroups (Bunyamwera, California, Group C and Simbu) showed that the smallest (S) RNA segment encodes the nucleocapsid protein (N) and a non-structural protein called (NSs). The NSs protein of Bunyamwera virus (BUNV) has been shown to play a role in shut-off of host cell protein synthesis in mammalian cells, but no protein shut-off is observed in BUNVinfected mosquito cells (Aedes albopictus C6/36 cells). Protein shut-off in infected mammalian cells is achieved by global inhibition of RNA polymerase II-mediated transcription and enables the virus to overcome the host innate immune response. As innate defence mechanisms constitute a significant barrier to virus infection of different hosts, NSs would appear to play a key role in determining the zoonotic capacity of orthobunyaviruses.

Dengue seroepidemiology in Singapore

The resurgence of dengue in Singapore since 1986 had been associated with an adult predominance and a very low incidence in children. No study had been carried out to investigate this finding. Here we report a serological study of 1068 children aged 0 to 15 years. There is a significant rise in seroconversion in children aged 6 years and older coinciding with the start of formal schooling. This suggests that there may be a change in the location where dengue is acquired.

Opening base wedge osteotomy with first metatarsophalangeal joint implantation arthroplasty--a retrospective study

The authors present a retrospective study of the opening base wedge osteotomy with first metatarsophalangeal joint implant arthroplasty, for the correction of long-standing hallux abducto valgus deformity. Twenty cases involving 23 feet were performed, and the results are discussed. The indications and procedure are described, as well as an in-depth discussion.

Diabetic foot amputations. Part III: Midfoot

Recently, the approach in management of diabetic foot disorders has undergone critical re-evaluation. Major foot infections, such as plantar space infections and osteomyelitis do not automatically result in Syme's or below-the-knee amputations. When indicated, midfoot amputations should be attempted because of the functional and psychologic advantages compared with more proximal amputation levels of the lower extremity. In Part III of this series of articles concerning diabetic foot amputations, the authors present case studies along with midfoot amputations and muscle-balancing procedures.

A perspective study using bleomycin sulfate in the treatment of plantar verrucae

The authors present a perspective study using bleomycin sulfate in the treatment of plantar verrucae. Also, they review the literature concerning this modality. Although the effective cure rate obtained in this study was less than that reported previously, the authors found bleomycin to be particularly effective in the treatment of mosaic verrucae.

Changes in limb dynamics during the practice of rapid arm movements

In our study we examined Bernstein's hypothesis that practice alters the motor coordination among the muscular and passive joint moments. In particular, we conducted dynamical analyses of a human multisegmental movement during the practice of a task involving the upper extremity. Seven male human volunteers performed maximal-speed, unrestrained vertical arm movements whose upward and downward trajectories between two target endpoints required the hand to round a barrier, resulting in complex shoulder, elbow, and wrist joint movements. These movements were recorded by high-speed ciné film, and myopotentials from selected upper-extremity muscles were recorded. The arm was modeled as interconnected rigid bodies, so that dynamical interactions among the upper arm, forearm, and hand could be calculated. With practice, subjects achieved significantly shorter movement times. As movement times decreased, all joint-moment components (except gravity) increased, and the moment-time and EMG profiles were changed significantly. Particularly during reversals in movement direction, the changes in moment-time and EMG profiles were consistent with Bernstein's hypothesis relating practice effects and intralimb coordination: with practice, motor coordination was altered so that individuals employed reactive phenomena in such a way as to use muscular moments to counterbalance passive-interactive moments created by segment movements.

Surgical management of the deep plantar abscess in the diabetic patient

The authors report the case of a deep plantar abscess in a diabetic patient. The pathophysiology of diabetic foot lesions as well as classification is discussed. The philosophy of local radical debridement involving ray resection, as well as postdebridement management is discussed in detail.

Diagnosis and treatment of the ruptured Achilles tendon

The authors review the basic principles of tendon healing and repair as they apply to a ruptured Achilles tendon, and discuss its diagnosis and treatment. The treatment, either surgical or conservative, is a controversial subject. Both forms have their problems. The authors conclude that while surgical repair is the treatment of choice in most cases, conservative management should be considered an effective alternative.

Surgical management of plantar von Recklinghausen neurofibroma

Clinical manifestations of von Recklinghausen's disease on the plantar aspect are very rare. Most of the neurofibromas involving the skin are asymptomatic, but when they occupy an unusual position or attain a large size, they lead to significant disability. A case report and the surgical treatment of a 39-year-old female with the pathognomonic clinical characteristics, along with a symptomatic plantar neurofibroma, are presented. The pathogenesis, clinical manifestations, diagnosis, complications, and treatment of this progressive disease are described in this report.

Diabetic osteoarthropathy versus diabetic osteomyelitis

The differentiation between diabetic osteoarthropathy and osteomyelitis is a very difficult one to make, even in the presence of a pedal ulceration. However, considering present medical costs, the incorrect diagnosis of osteomyelitis can be a costly one, not only for the hospital, but also for the patient. In light of a normal white blood cell count, a benign 67Ga-citrate scan, and two noncontiguous areas of bone destruction, the diagnosis of diabetic osteoarthropathy can be made without the necessity of a bone biopsy.

Heterogeneous mechanical response of rat knee menisci to thermomechanical stress

Thermodilatometric, dynamic thermomechanical, and light-microscopic analyses were done on the anterior and posterior regions of the rat knee menisci to correlate regional differences in morphology and extracellular matrix composition with regional mechanical behavior. Following the administration of a general anesthetic, menisci were excised from 12 young female Sprague-Dawley rats. During thermodilatometric and thermomechanical testing, tissue temperature was increased at a constant rate of 3.5 degrees C/min from 30 to 100 degrees C. Light microscopy revealed regional differences in cell density and proteoglycan content. The anterior horn was significantly heavier (greater than 87%) and thicker (greater than 60%) than the posterior region. During thermal analyses, both the anterior and posterior horns decreased in tissue thickness as the temperature increased from 30 to 73 degrees C. After 73 degrees C, however, the posterior horn expanded significantly, whereas the anterior remained in a comparatively contracted state. The rates of linear contraction and expansion of the posterior horn were seven times those of the anterior horn, and the stiffness of the anterior horn was significantly greater than the posterior horn.

Iatrogenic metatarsal coalition: a postoperative complication of adjacent V-osteotomies

The authors present a case report of iatrogenic metatarsal coalition, a postoperative complication of adjacent V-osteotomies. The paper also includes a discussion of surgical considerations of multiple adjacent osteotomies contributing to such a sequela, including adequate irrigation, instrumentation, anatomy, and the use of corticosteroids.