Humoral immunity to smallpox vaccines and monkeypox virus challenge: proteomic assessment and clinical correlations.

Despite the eradication of smallpox, orthopoxviruses (OPV) remain public health concerns. Efforts to develop new therapeutics and vaccines for smallpox continue through their evaluation in animal models despite limited understanding of the specific correlates of protective immunity. Recent monkeypox virus challenge studies have established the black-tailed prairie dog (Cynomys ludovicianus) as a model of human systemic OPV infections. In this study, we assess the induction of humoral immunity in humans and prairie dogs receiving Dryvax, Acam2000, or Imvamune vaccine and characterize the proteomic profile of immune recognition using enzyme-linked immunosorbent assays (ELISA), neutralization assays, and protein microarrays. We confirm anticipated similarities of antigenic protein targets of smallpox vaccine-induced responses in humans and prairie dogs and identify several differences. Subsequent monkeypox virus intranasal infection of vaccinated prairie dogs resulted in a significant boost in humoral immunity characterized by a shift in reactivity of increased intensity to a broader range of OPV proteins. This work provides evidence of similarities between the vaccine responses in prairie dogs and humans that enhance the value of the prairie dog model system as an OPV vaccination model and offers novel findings that form a framework for examining the humoral immune response induced by systemic orthopoxvirus infection.

Comparison of the potential for developmental toxicity of prenatal exposure to two dietary chromium supplements, chromium picolinate and [Cr3O(O2CCH2CH3)(6(H2O)3]+, in mice.

BACKGROUND: Chromium(III) is generally thought to be an essential trace element that allows for proper glucose metabolism. However, chromium(III) picolinate, Cr(pic)3, a popular dietary supplement form of chromium, has been shown to be capable of generating hydroxyl radicals and oxidative DNA damage in rats. The cation [Cr3O(O2CCH2CH3)(6(H2O)3]+, Cr3, has been studied as an alternative supplemental source of chromium. It has been shown to increase insulin sensitivity and lower glycated hemoglobin levels in rats, making it attractive as a potential therapeutic treatment for gestational diabetes. To date, no studies have been published regarding the safety of Cr3 supplementation to a developing fetus. METHODS: From gestation days (GD) 6-17, mated CD-1 female mice were fed diets delivering either 25 mg Cr/kg/day as Cr(pic)(3), 3.3 or 26 mg Cr/kg/day as Cr3, or the diet only to determine if Cr3 could cause developmental toxicity. Dams were sacrificed on GD 17, and their litters were examined for adverse effects. RESULTS: No signs of maternal toxicity were observed. No decrease in fetal weight or significantly increased incidence of skeletal defects was observed in the Cr3 or Cr(pic)3 exposed fetuses compared to the controls. CONCLUSION: Maternal exposure to either Cr(pic)3 or Cr3 at the dosages employed did not appear to cause deleterious effects to the developing offspring in mice.

Twenty-four hour care teams.

When faced with staff mix changes, nurse managers must clarify the underlying purpose so that the strategy selected will support the specific objective. Mix change options are reviewed and a two-dimensional philosophy regarding patient care teams is described.

Patient-focused care: is it for your hospital?

Advocates of Patient-Focused Care (PFC) claim that a win-win resolution to the cost/quality dilemma can be achieved by placing the patient's concerns at the center of planning. With the patient as the central focus, a whole new paradigm of care emerges which links all components of systems redesign work with a common, defining purpose. Before embarking on such a change effort, planners should carefully examine PFC assumptions for relevance to their specific environment.

Creating a better work environment. Measuring effectiveness.

Strategies to improve one hospital's work environment have paid off in significantly improved nursing staff satisfaction. Preintervention and postintervention surveys using similar instruments showed gratifying improvements in staff satisfaction with communication with managers, recognition by managers, opportunities for professional growth and development, and support by peers.

A participative approach to administrative reorganization.

A participative approach to nursing reorganization proved very successful in gaining support and acceptance of major structural changes by all affected managers. In this approach, managers developed a new organizational design which better met the Nursing Division's needs while supporting its philosophy and values. Working from the design, the entire management group developed operational descriptions of each new and revised role which have proved invaluable as guidelines for people learning new interrelationships.