Routine testing for blood-borne viruses in prisons: a systematic review

Background: People in prison have a higher burden of blood-borne virus (BBV) infection than the general population, and prisons present an opportunity to test for BBVs in high-risk, underserved groups. Changes to the BBV testing policies in English prisons have recently been piloted. This review will enable existing evidence to inform policy revisions. We describe components of routine HIV, hepatitis B and C virus testing policies in prisons and quantify testing acceptance, coverage, result notification and diagnosis. Methods: We searched five databases for studies of both opt-in (testing offered to all and the individual chooses to have the test or not) and opt-out (the individual is informed the test will be performed unless they actively refuse) prison BBV testing policies. Results: Forty-four studies published between 1989 and 2013 met the inclusion criteria. Of these, 82% were conducted in the USA, 91% included HIV testing and most tested at the time of incarceration. HIV testing acceptance rates ranged from 22 to 98% and testing coverage from 3 to 90%. Mixed results were found for equity in uptake. Six studies reported reasons for declining a test including recent testing and fear. Conclusions: While the quality of evidence is mixed, this review suggests that reasonable rates of uptake can be achieved with opt-in and, even better, with opt-out HIV testing policies. Little evidence was found relating to hepatitis testing. Policies need to specify exclusion criteria and consider consent processes, type of test and timing of the testing offer to balance acceptability, competence and availability of individuals

Regional outbreak of staphylococcal scalded skin syndrome in healthy children

Purpose : Staphylococcal scalded skin syndrome (SSSS) is a relatively uncommon superficial blistering skin disease that is due to Staphylococcus aureus. We had experienced a regional outbreak of SSSS over 3 years in healthy children. Methods : We retrospectively reviewed the medical records of those patients diagnosed as SSSS. Most of neonatal cases were nosocomial infections and excluded from the analysis. The clinical features, laboratory findings, the isolation and antibiotic resistance of S. aureus, the antibiotic management and other supportive treatments were analyzed. Results : Fifty-five patients with SSSS were admitted to our hospital from October 2001 to September 2004. The median age of patients was 3.0 years. Of the 55 patients, 9 were the generalized type, 13 were the intermediate type and 33 were the scarletiniform rash. All the patients were living in neighborhood of the Jinju area. S. aureus were isolated from 9 of the patients and all of the isolated S. aureus were methicillin resistant. All the patients except two were treated with intravenous flocloxacillin or nafcillin and/or cefotaxime. All the patients recovered during the follow-up period of 2 to 3 weeks. Conclusion : We experienced a regional outbreak of SSSS in previous healthy children. Further study for finding the carriers of S. aureus caused SSSS and preventing the spread of this disease is needed. Additionally, guidelines for treating SSSS due to methicillin resistant S. aureus should be established

Using Prescribed Fire and Biosolids Applications as Grassland Management Tools: Do Wildlife Respond?

Prescribed burning is a management tool commonly used in forested ecosystems in the southeastern United States, but the influence of this method on grassland vegetation and wildlife in this geographic region is unknown. During 2009–2015, we conducted a study to determine if the application of prescribed burning and/or long-term biosolid applications alter plant communities and/or wildlife use of grassland areas at Marine Corps Air Station Cherry Point, Havelock, North Carolina. We monitored vegetation growth, measured plant community composition, and documented wildlife activity in four study plots for 3 years after the implementation of annual winter prescribed burns. Prescribed burning reduced the amount of litter, increased bare ground during spring, and altered the plant community composition relative to areas that were not burned. Overall, prescribed burning did not alter (F1,803 = 0.37, p = 0.54) bird use of the airfield grasslands, while the long-term application of biosolids resulted in higher (F1,803 = 17.61, p \u3c 0.01) bird use. Few species-specific differences in avian use of prescribed burned and unburned grasslands were found. In contrast, white-tailed deer (Odocoileus virginianus) use of areas that were burned in winter, as well as the adjacent unburned areas, was drastically reduced. Winter prescribed burning appeared to remove forage plants at the time of year deer would use them the most. Our findings suggest that prescribed burning and biosolid applications, used alone and in combination, might be viable grassland management tools for altering wildlife use of grassland areas, specifically white-tailed deer; however, similar research at additional locations should be conducted

The Ability of Avian Radars to Track Near Miss Bird Strike Events: A Missing Informational Link

The management of problem wildlife within the airfield environment is a difficult job and today’s biologists require as much information as possible. Bird censuses and actual strike events provide a good picture, but there is a valuable data set out there that has been overlooked, until now. Recent advances in commercially available, digital avian tracking radars have for the first time enabled biologists to track and evaluate near-miss events to increase the safety margin for our pilots and crew. As a part of the Department of Defense, Environmental Securities Technology Certification Program (ESTCP) Project: Integration and Validation of Avian Radars, tens of thousands of hours of bird tracks have been recorded. During the evaluation of many of these tracks, it was discovered that the radar software is capable of tracking and reporting near- miss events between birds and aircraft. This capability has motivated a study to characterize near-miss events and their importance for BASH management. This presentation will discuss the importance of near-miss information and how it can be used to enhance aviation safety. The definition of a near-miss event will be discussed, along with how this type of information can be used as a part of a facility bird strike management program. A review of some archived data sets will illustrate the potential for deriving risk assessments from near-miss information

Population trends of resident and migratory Canada geese in relation to strikes with civil aircraft

Canada geese (Branta canadensis) are of particular concern to aviation in the USA because of their large size, flocking behavior, attraction to airports for grazing, and, for the resident population, year-round presence in urban environments. We documented trends in resident and migrant Canada goose populations in North America from 1970 to 2012, and for 1990 to 2012 examined these trends in relation to trends in reported civil aircraft collisions (strikes) with Canada geese. The overall Canada goose population increased 4.5 fold from 1.26 million in 1970 to 5.69 million in 2012. Most of this overall increase was due to a 15.6-fold increase in the population of resident geese (from 0.25 to 3.85 million), especially during the 1990s when the population increased at a mean annual rate of 12.7%. From 2000 to 2012, the resident population has stabilized, fluctuating between 3.36 and 3.85 million birds. The migrant population has remained relatively stable since 1990, with the population in 2012 estimated at 1.84 million. Resident geese comprised 68% of the total Canada goose population in 2012 compared to 41% in 1990 and 20% in 1970. From 1990 to 2012, 1,403 Canada goose strikes with civil aircraft were reported in the USA, of which 704 (50%) caused damage. The strike rate and damaging strike rate for all geese and for resident geese only (strikes in May to September) increased in parallel with the increase in the total Canada goose population (resident and migratory combined) and resident population, respectively, from 1990 to 1999. From 1999 to 2012, the strike rate and especially the damage strike rate exhibited a downward trend, especially for strikes involving resident geese during May to September. We hypothesize that this decline is due to Canada goose management programs implemented at many airports and in other urban areas

Induction of Cell Cycle and NK Cell Responses by Live-Attenuated Oral Vaccines against Typhoid Fever

The mechanisms by which oral, live-attenuated vaccines protect against typhoid fever are poorly understood. Here, we analyze transcriptional responses after vaccination with Ty21a or vaccine candidate, M01ZH09. Alterations in response profiles were related to vaccine-induced immune responses and subsequent outcome after wild-type Salmonella Typhi challenge. Despite broad genetic similarity, we detected differences in transcriptional responses to each vaccine. Seven days after M01ZH09 vaccination, marked cell cycle activation was identified and associated with humoral immunogenicity. By contrast, vaccination with Ty21a was associated with NK cell activity and validated in peripheral blood mononuclear cell stimulation assays confirming superior induction of an NK cell response. Moreover, transcriptional signatures of amino acid metabolism in Ty21a recipients were associated with protection against infection, including increased incubation time and decreased severity. Our data provide detailed insight into molecular immune responses to typhoid vaccines, which could aid the rational design of improved oral, live-attenuated vaccines against enteric pathogens

Wildlife at Airports

Collisions between aircraft and wildlife (wildlife strikes) are common occurrences across the developed world. Wildlife strikes are not only numerous, but also costly. Estimates suggest that wildlife strikes cost the civil aviation industry in the U.S. up to $625 million annually, and nearly 500 people have been killed in wildlife strikes worldwide. Most wildlife strikes occur in the airport environment: 72 percent of all strikes occur when the aircraft is ≤500 ft (152 m) above ground level, and 41 percent of strikes occur when the aircraft is on the ground during landing or takeoff. Thus, management efforts to reduce wildlife hazards are focused at the airport. There are many techniques used to reduce wildlife hazards at airports, and these usually work best when used in an integrative fashion. Here, we discuss the available data on wildlife strikes with aircraft, summarize legal considerations, explain why wildlife are attracted to airports and how to identify important wildlife attractants, describe commonly-used tools and techniques for reducing wildlife hazards at airports, and explain how airports can enlist the help of professional wildlife biologists to manage wildlife hazards. Effective management of wildlife to reduce strikes, like all types of wildlife damage management, is based on principles from wildlife ecology, physiology, and behavior. Airport biologists should consider how these disciplines interact in the airport context, particularly with an understanding of regulatory guidance, non-wildlife related airport safety priorities, and strike data. This “marriage” of wildlife ecology with aspects of airport operations will aid in discerning how and why animals respond to various mitigation methods (at both the individual and population levels), why and under what conditions some management tools and techniques work better than others, and allow airport biologists to more intelligently direct management efforts

Two Vaccines for Staphylococcus aureus Induce a B-Cell- Mediated Immune Response

Staphylococcus aureus causes severe disease in humans for which no licensed vaccine exists. A novel S. aureus vaccine (SA4Ag) is in development, targeting the capsular polysaccharides (CPs) and two virulence-associated surface proteins. Vaccine-elicited antibody responses to CPs are efficacious against serious infection by other encapsulated bacteria. Studies of natural S. aureus infection have also shown a role for TH17 and/or TH1 responses in protection. Single-antigen vaccines, including CPs, have not been effective against S. aureus; a multiantigen vaccine approach is likely required. However, the impact of addition of protein antigens on the immune response to CPs has not been studied. Here, the immune response induced by a bivalent CP conjugate vaccine (to model the established mechanism of action of vaccine-induced protection against Gram-positive pathogens) was compared to the response induced by SA4Ag, which contains both CP conjugates and protein antigens, in cynomolgus macaques. Microengraving, flow cytometry, opsonophagocytic assays, and Luminex technology were used to analyze the B-cell, T-cell, functional antibody, and innate immune responses. Both the bivalent CP vaccine and SA4Ag induced cytokine production from naive cells and antigen-specific memory B-cell and functional antibody responses. Increases in levels of circulating, activated T cells were not apparent following vaccination, nor was a TH17 or TH1 response evident. However, our data are consistent with a vaccine-induced recruitment of T follicular helper (TFH) cells to lymph nodes. Collectively, these data suggest that the response to SA4Ag is primarily mediated by B cells and antibodies that abrogate important S. aureus virulence mechanisms.IMPORTANCEStaphylococcus aureus causes severe disease in humans for which no licensed vaccine exists. A novel vaccine is in development that targets multiple elements of the bacteria since single-component vaccines have not shown efficacy to date. How these multiple components alter the immune response raised by the vaccine is not well studied. We found that the addition of two protein components did not alter substantially the antibody responses raised with respect to function or mobilization of B cells. There was also not a substantial change in the activity of T cells, another part of the adaptive response. This study showed that protection by this vaccine may be mediated primarily by antibody protection.Pfizer Inc.National Cancer Institute (U.S.) (grant P30-CA14051

Recovery of visual function after endarterectomy - series of cases report

Carotid arteriosclerosis is the main cause of the stroke but it can also lead to ophthalmic symptoms. In this article, we aim to present four patients. All of them had hemodynamically significant but asymptomatic unilateral carotid stenosis and underwent internal carotid endarterectomy. Postoperatively, their visual function improved. Mean deviation in perimetry and values of amplitudes in pattern visual evoked potentials increased. Two patients improved visual acuity; in the other two, it remained stable

Adjusting for case under-ascertainment in estimating RSV hospitalisation burden of older adults in high-income countries:a systematic review and modelling study

Abstract Introduction Previous studies suggest diagnostic testing characteristics (i.e. variations in clinical specimens and diagnostic tests) can contribute to underestimation of RSV disease burden. We aimed to improve the understanding of RSV hospitalisation burden in older adults (aged ≥ 65 years) in high-income countries through adjusting for case under-ascertainment. Methods We conducted a systematic review to include data on RSV-associated acute respiratory infection (ARI) hospitalisation burden in older adults in high-income countries. To adjust for case under-ascertainment, we developed a two-step framework that incorporated empirical data on the RSV detection proportion of different clinical specimens and testing approaches as well as their statistical uncertainty. We estimated the unadjusted and adjusted RSV-associated hospitalisation burden through multilevel random-effects meta-analysis. We further explored RSV-associated in-hospital mortality burden. Results We included 12 studies with eligible RSV hospitalisation burden data. We estimated that pooled unadjusted hospitalisation rate was 157 per 100,000 (95% CI 98–252) for adults aged ≥ 65 years; the rate was adjusted to 347 per 100,000 (203–595) after accounting for under-ascertainment. The adjusted rate could be translated into 787,000 (460,000–1,347,000) RSV-associated hospitalisations in high-income countries in 2019, which was about 2.2 times the unadjusted estimate. Stratified analysis by age group showed that the adjusted rate increased with age, from 231 per 100,000 in adults aged 65–74 years to 692 per 100,000 in adults aged > 85 years. The in-hospital case fatality ratio of RSV was 6.1% (3.3–11.0) and the total RSV-associated in-hospital deaths in high-income countries in 2019 could be between 22,000 and 47,000. Conclusion This study improves the understanding of RSV-associated hospitalisation burden in older adults and shows that the true RSV-associated hospitalisation burden could be 2.2 times what was reported in existing studies. This study has implications for calculating the benefit of interventions to treat and prevent RSV-associated disease