Interactions of waterborne and dietary cadmium on the expression of calcium transporters in the gills of rainbow trout: influence of dietary calcium supplementation.

Recent studies have shown that dietary Ca(2+) supplementation strongly inhibits uptake of Ca(2+) and Cd at the fish gill. To better understand the influence of dietary Ca(2+) on branchial Ca(2+) transport, we examined the expression of two trout gill calcium transporters during waterborne and dietary Cd exposure, at two different levels of dietary Ca(2+). Quantitative polymerase chain reaction (PCR) was used to monitor epithelial calcium channel (ECaC) and sodium-calcium exchange (NCX) mRNA levels following 7-28 days of exposure to these treatments. In brief, juvenile rainbow trout (Oncorhynchus mykiss) were exposed to control, 3 microg/L waterborne Cd, 500 mg/kg dietary Cd, or a combined 3 microg/L waterborne plus 500 mg/kg dietary Cd exposure, supplemented with either 20 mg/g or 60 mg/g dietary calcium (Ca(2+)). Two-way analysis of variance was used to discern the main effects of Cd exposure and dietary Ca(2+) supplementation on ECaC and NCX mRNA levels. We found that dietary Ca(2+) supplementation decreased significantly ECaC mRNA expression on days 14 and 21. In comparison, NCX mRNA levels were not influenced by dietary Ca(2+) supplementation, but rather were significantly inhibited in the combined waterborne and dietary Cd exposure on day 7 alone. Statistical analysis found no interactive effects between Cd exposure and dietary Ca(2+) exposure at any time point, except for day 28. This study provides evidence of the importance of nutritional status on the transcriptional regulation of ion transport at the fish gill. We discuss the importance of diet and nutritional status to the development of new regulatory approaches, such as the biotic ligand model, which currently do not account for the significance of diet on metal bioavailability in aquatic organisms.

Communicating vaccine safety to the media and general public.

Vaccines are among the most effective measures to control and prevent infectious diseases. Yet, the topic of vaccination is difficult to communicate, as it bears upon individual versus common good. The efficacy and safety of vaccines can only be shown by the absence of undesired events, such as vaccine-preventable diseases or adverse events following immunization. The authors of this paper view accurate, transparent and timely vaccine-safety communication to the media and general public as a core responsibility of healthcare providers. The authors wish to explore potential difficulties faced by immunization specialists when talking to the media, and suggest how to successfully convey vaccination messages to the general public.

Evaluation of novel second-generation RSV and influenza rapid tests at the point of care.

Acute respiratory infections represent common pediatric emergencies. Infection control warrants immediate and accurate diagnoses. In the past, first-generation respiratory syncytial virus (RSV) rapid tests (strip tests) have shown suboptimal sensitivities. In 2013, the Food and Drug Administration licensed a second-generation RSV rapid test providing user-independent readouts (SOFIA™-RSV) using automated fluorescence assay technology known to yield superior results with influenza rapid testing. We are reporting the first point-of-care evaluation of the SOFIA™-RSV rapid test. In the Charité Influenza-Like Disease Cohort, 686 nasopharyngeal samples were tested in parallel with SOFIA™-RSV and SOFIA™-Influenza A+B. Compared to real-time PCR, SOFIA™-RSV sensitivities/specificities were 78.6%/93.9%, respectively (SOFIA™-Influenza A: 80.6%/99.3%). Performance was greatest in patients below 2 years of age with a test sensitivity of 81.8%. RSV sensitivities were highest (85%) in the first 2 days of illness and with nasopharyngeal compared to nasal swabs (P=0.055, McNemar's test). Second-generation RSV and influenza rapid testing provides highly accurate results facilitating timely patient cohortation and management.