Bioaerosol Exposures and Respiratory Diseases in Cannabis Workers.

PURPOSE OF REVIEW: This review investigates occupational inhalation hazards associated with biologically derived airborne particles (bioaerosols) generated in indoor cannabis cultivation and manufacturing facilities. RECENT FINDINGS: Indoor cannabis production is growing across the US as are recent reports of respiratory diseases among cannabis workers, including occupational asthma morbidity and mortality. More information is needed to understand how bioaerosol exposure in cannabis facilities impacts worker health and occupational disease risk. Preliminary studies demonstrate a significant fraction of airborne particles in cannabis facilities are comprised of fungal spores, bacteria, and plant material, which may also contain hazardous microbial metabolites and allergens. These bioaerosols may pose pathogenic, allergenic, toxigenic, and pro-inflammatory risks to workers. The absence of multi-level, holistic bioaerosol research in cannabis work environments necessitates further characterization of the potential respiratory hazards and effective risk prevention methods to safeguard occupational health as the cannabis industry continues to expand across the US and beyond.

Aerosol fluorescence, airborne hexosaminidase, and quantitative genomics distinguish reductions in airborne fungal loads following major school renovations.

Fluorescent aerosol cytometry (FAC) was compared to concurrent recovery of airborne ß-N-acetylhexosaminidase (NAHA) and quantitative polymerase chain reaction (qPCR) for the respective ability of these methods to detect significant changes in airborne fungal loads in response to building renovations. Composite, site-randomized indoor aerosol samples for airborne fungi measurements were acquired from more than 70 occupied classrooms in 26 different public schools in the Colorado Rocky Mountain Front Range region of the United States. As judged by ANOVA and Pearson's correlation test, statistically significant associations were observed between real-time FAC and airborne NAHA levels, which detected significant reductions in airborne fungal loads immediately following building rehabilitations. With lower confidence, a statistically significant association was also resolved between fluorescing aerosols, NAHA levels, and the recovery of fungal 18S rRNA gene copies by qPCR from simultaneous, collocated aerosol samples. Quantitative differences encountered between the recovery of common genomic markers for airborne fungi and that of optical and biochemical methods are attributed to the variance in 18S rRNA target gene copies that different fungal species can host.

Carbon dioxide and hydrogen sulfide associations with regional bacterial diversity patterns in microbially induced concrete corrosion.

The microbial communities associated with deteriorating concrete corrosion fronts were characterized in 35 samples taken from wastewater collection and treatment systems in ten utilities. Bacterial communities were described using Illumina MiSeq sequencing of the V1V2 region of the small subunit ribosomal ribonucleic acid (SSU-rRNA) gene recovered from fresh corrosion products. Headspace gas concentrations (hydrogen sulfide, carbon dioxide, and methane), pore water pH, moisture content, and select mineralogy were tested for correlation to community outcomes and corrosion extent using pairwise linear regressions and canonical correspondence analysis. Corroding concrete was most commonly characterized by moisture contents greater than 10%, pore water pH below one, and limited richness (<10 taxa). Bacterial community composition was not correlated to geographic location when considered independently from other environmental factors. Corrosion was most severe in sites with high levels of hydrogen sulfide (>100 ppm) and carbon dioxide (>1%) gases, conditions which also were associated with low diversity biofilms dominated by members of the acidophilic sulfur-oxidizer genus Acidithiobacillus.

Perceptions of the determinants of health across income and urbanicity levels in eight countries.

BACKGROUND: A clear understanding of public perceptions of the social determinants of health remains lacking. This paper aimed to describe the relationship between income and urbanicity levels and public views of the determinants of health in eight middle-and high-income countries that varied across multiple characteristics. METHODS: We conducted a cross-sectional online survey in Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States. Respondents were asked to select what they considered to be most important for health out of a list of ten determinants. We stratified the results by income and urbanicity levels and tested significance of differences between groups using two-tailed χ2 tests. Multivariable logistic regression models tested associations between demographic factors and the likelihood of respondents selecting the genetics, healthcare, income and wealth, or social support determinants. RESULTS: Here we show 8753 respondents across eight countries. Rankings of determinants are similar across income groups, except for two determinants. Respondents in the highest income group rank genetics in higher proportions (32.4%, 95%CI: 29.0%,35.8%) compared to other income groups. Conversely, those in lowest income group rank social support more frequently (27.9%, 95%CI: 25.3%,30.7%) than other income groups. Those living in urban settings rank healthcare in higher proportions (61.2%, 95%CI: 59.0%,63.4%) compared to non-urban respondents; meanwhile, higher proportions (26.6%, 95%CI: 24.9%,28.3%) of non-urban respondents rank social support as important for health compared to urban respondents. CONCLUSION: Demographic factors play a role in shaping public views of what affects health. Advancing public understanding about determinants of health requires tailoring public health messaging to account for socioeconomic position within a population.

Various factors determine our health, such as our environment, education, and genetics. Here, we explore how people from different income and urban backgrounds view the factors that affect health. We surveyed participants from Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States. Respondents selected the most important factors for health from a list of ten choices. Overall, people's views on these factors were comparable across income groups, with exceptions. Those with higher incomes tended to emphasize the importance of genetics more, while lower-income individuals valued social support. People in urban areas prioritized healthcare, while those in non-urban areas valued social support. These findings suggest that factors such as income and where people live influence their views about health determinants. These factors should be considered in public health messaging and strategies to promote health amongst different groups.

Tetracycline resistance and Class 1 integron genes associated with indoor and outdoor aerosols.

Genes encoding tetracycline resistance and the integrase of Class 1 integrons were enumerated using quantitative PCR from aerosols collected from indoor and outdoor environments. Concentrated animal feeding operations (CAFOs) and human-occupied indoor environments (two clinics and a homeless shelter) were found to be a source of airborne tet(X) and tet(W) genes. The CAFOs had 10- to 100-times higher concentrations of airborne 16S rRNA, tet(X), and tet(W) genes than other environments sampled, and increased concentrations of aerosolized bacteria correlated with increased concentrations of airborne resistance genes. The two CAFOs studied had statistically similar concentrations of resistance genes in their aerosol samples, even though antibiotic use was markedly different between the two operations. Additionally, tet(W) genes were recovered in outdoor air within 2 km of livestock operations, which suggests that antibiotic resistance genes may be transported via aerosols on local scales. The integrase gene (intI1) from Class 1 integrons, which has been associated with multidrug resistance, was detected in CAFOs but not in human-occupied indoor environments, suggesting that CAFO aerosols could serve as a reservoir of multidrug resistance. In conclusion, our results show that CAFOs and clinics are sources of aerosolized antibiotic resistance genes that can potentially be transported via air movement.

Building Interest in the Primary Care Specialty Through Enhanced Global Health Experience.

Background An overwhelming majority of matriculating medical students in the USA are keen to deliver quality health care to all people, including the socioeconomically disadvantaged populations in remote, resource-scarce regions nationally and worldwide. Here, we describe a protocol developed to evaluate the interest of our medical students in global health activities. We also examined the relationship between students' interest in global health and readiness to pursue a future career in the primary care specialty. Materials and methods We designed a survey in Qualtrics online software and reached all first-year and third-year medical students between 2019 and 2022 enrolled at the Alabama College of Osteopathic Medicine (ACOM). The survey utilized ordinal scale items to explore the medical students' interest in primary care residency programs, their interest in global health and international travel, and their perceptions of how a range of factors might motivate their desire to participate in global health activities. The study was approved by ACOM's Institutional Review Board (IRB). In order to compare findings from this study with data from other medical schools, we developed constructs using the national aggregate data, in percentages, from matriculants and graduates of Doctor of Osteopathic Medicine (DO) degree-granting medical schools according to gender, published by the American Association of Colleges of Osteopathic Medicine (AACOM). Statistical analysis of national aggregate data was performed using the unpaired t-test. Results Both female and male participants had lived or traveled abroad before starting medical school. Female (98%, n=249) and male (95%, n=140) participants in the first-year cohorts considered helping the underserved population as important or very important as it is related to a career in medicine. Females in the third-year cohorts (97%, n=71) also ranked this statement as important or very important compared to male cohorts (89%, n=31). A higher proportion of females (43%, n=108) compared to males (35%, n=52) in first-year cohorts agreed or strongly agreed that they would likely pursue a residency in primary care. More females (59%, n=43) than males (46%, n=16) in the third-year cohorts agreed or strongly agreed with the same statement. Analysis of the aggregate national data (2009-2022) revealed that the percentage (actual count not available) of female students who planned to practice in underserved/shortage area was higher both at the time of matriculation (M=51%, SD=4%) and before graduation (M=40%, SD=4%) compared to males (matriculation: M=40%, SD=5%; graduation: M=33%, SD=4%) presenting a significant difference (matriculation t(24)=6.7, p<0.0001; graduation t(24)=5.4, p<0.0001). Furthermore, a higher percentage of females at the time of matriculation (M=25%, SD=5%) and graduation (M=40%, SD=6%) planned to practice in the primary care specialties compared to males (matriculation: M=17%, SD=4%; graduation: M=29%, SD=6%) presenting a significant difference (matriculation: t(24)=4.6, p = 0.0001; graduation: t(24)=4.8, p<0.0001). Conclusions Interest in global health activities may be associated with interest in pursuing a future career in the primary care specialty. In this study, more female medical students expressed interest in participating in global health experiences, serving the underserved population domestically and abroad, and expressing interest in primary care than males.

Artificial intelligence-based prediction of indoor bioaerosol concentrations from indoor air quality sensor data.

Exposure to bioaerosols in indoor environments, especially public venues that have a high occupancy and poor ventilation, is a serious public health concern. However, it remains challenging to monitor and determine real-time or predict near-future concentrations of airborne biological matter. In this study, we developed artificial intelligence (AI) models using physical and chemical data from indoor air quality sensors and physical data from ultraviolet light-induced fluorescence observations of bioaerosols. This enabled us to effectively estimate the bioaerosol (bacteria-, fungi- and pollen-like particle) and 2.5-µm and 10-µm particulate matter (PM2.5 and PM10) on a real-time and near-future (≤60 min) basis. Seven AI models were developed and evaluated using measured data from an occupied commercial office and a shopping mall. A long short-term memory model required a relatively short training time and gave the highest prediction accuracy of âˆ¼ 60 %-80 % for bioaerosols and âˆ¼ 90 % for PM on the testing and time series datasets from the two venues. This work demonstrates how AI-based methods can leverage bioaerosol monitoring into predictive scenarios that building operators can use for improving indoor environmental quality in near real-time.

Carbohydrate vitrification in aerosolized saliva is associated with the humidity-dependent infectious potential of airborne coronavirus.

An accepted murine analogue for the environmental behavior of human SARS coronaviruses was aerosolized in microdroplets of its culture media and saliva to observe the decay of its airborne infectious potential under relative humidity (RH) conditions relevant to conditioned indoor air. Contained in a dark, 10 m3 chamber maintained at 22°C, murine hepatitis virus (MHV) was entrained in artificial saliva particles that were aerosolized in size distributions that mimic SARS-CoV-2 virus expelled from infected humans' respiration. As judged by quantitative PCR, more than 95% of the airborne MHV aerosolized was recovered from microdroplets with mean aerodynamic diameters between 0.56 and 5.6 µm. As judged by its half-life, calculated from the median tissue culture infectious dose (TCID50), saliva was protective of airborne murine coronavirus through a RH range recommended for conditioned indoor air (60% < RH < 40%; average half-life = 60 minutes). However, its average half-life doubled to 120 minutes when RH was maintained at 25%. Saliva microaerosol was dominated by carbohydrates, which presented hallmarks of vitrification without efflorescence at low RH. These results suggest that dehydrating carbohydrates can affect the infectious potential coronaviruses exhibit while airborne, significantly extending their persistence under the drier humidity conditions encountered indoors.

Identifying the core concepts of pharmacology education: A global initiative.

BACKGROUND AND PURPOSE: In recent decades, a focus on the most critical and fundamental concepts has proven highly advantageous to students and educators in many science disciplines. Pharmacology, unlike microbiology, biochemistry, or physiology, lacks a consensus list of such core concepts. EXPERIMENTAL APPROACH: We sought to develop a research-based, globally relevant list of core concepts that all students completing a foundational pharmacology course should master. This two-part project consisted of exploratory and refinement phases. The exploratory phase involved empirical data mining of the introductory sections of five key textbooks, in parallel with an online survey of over 200 pharmacology educators from 17 countries across six continents. The refinement phase involved three Delphi rounds involving 24 experts from 15 countries across six continents. KEY RESULTS: The exploratory phase resulted in a consolidated list of 74 candidate core concepts. In the refinement phase, the expert group produced a consensus list of 25 core concepts of pharmacology. CONCLUSION AND IMPLICATIONS: This list will allow pharmacology educators everywhere to focus their efforts on the conceptual knowledge perceived to matter most by experts within the discipline. Next steps for this project include defining and unpacking each core concept and developing resources to help pharmacology educators globally teach and assess these concepts within their educational contexts.

Reduction of the background magnetic field inhibits ability of Drosophila melanogaster to survive ionizing radiation.

The effects of exposure to an environment where the background magnetic field (BMF) has been reduced were studied on wild-type Drosophila melanogaster by measuring its ability to survive a single exposure to ionizing radiation (IR) during its larval stage. The experimental design presented shows a timeframe, IR dose, and BMF parameters that will cause a significant and reproducible reduction of survival on this insect model. These results suggest that BMFs may play a fundamental role in the recovery or harm of a biological system that is exposed to single doses of IR.

Effects of classroom cleaning on student health: a longitudinal study.

BACKGROUND: School districts across the world have been grappling with how to keep their schools open, students healthy, and prevent the spread of viruses in their communities. OBJECTIVE: The aims of this study included assessing both (1) the effectiveness of enhanced classroom cleaning and disinfecting protocol on surface biocontamination and (2) the associations between surface biocontamination and student absence due to illnesses. METHODS: Cleaning effectiveness was assessed using quantitative adenosine triphosphate (ATP) measurements during a 10-week study period in a sample of 34 public schools (15,814 students), of a district located in the Western US. The schools were randomly assigned to 17 intervention schools implementing enhanced cleaning and disinfecting protocol and 17 control schools cleaning as usual. General estimating equations (GEEs) were used for modeling associations between ATP levels and weekly aggregates of student absences due to respiratory and gastrointestinal illnesses, which were recorded by the schools according to district wide protocol. RESULTS: The weekly average ATP levels on logarithmic scale were 5.02 (SD 0.53) and 5.26 (SD 0.48) in the intervention and control schools, respectively, where the difference is statistically significant (p < 0.001). The probability of weekly absence due to gastrointestinal illness was significantly associated with ATP levels (parameter estimate 1.16, 95% CI 1.01-1.34, per unit (log) increase of weekly average ATP), where the model accounts for student level, gender, ethnic group, and socioeconomic status as well as for school level attendance, total absence ratio, and ventilation adequacy in classrooms. Associations were not found between ATP levels and weekly probability of any absence, or absence due to respiratory illness. SIGNIFICANCE: Enhanced cleaning resulted in a significantly lower level of biocontamination on desktops in the intervention group. In addition, a statistically significant association was established between ATP levels on classroom desks and probability of absence due to gastrointestinal illness. IMPACT: We found that enhanced cleaning protocol, including bi-weekly cleaning of classroom desks, as well as training of custodians and teachers, monitoring of effectiveness, and feedback, yielded a moderate but statistically significantly lower level of biocontamination on desktops, indicated by quantitative ATP monitoring. Within the range of weekly average desktop ATP levels observed, the probability of reported absence due to gastrointestinal illness is estimated to increase from 0.021 to 0.026. Based on the results, enhanced surface cleaning and monitoring its effectiveness is a possible district, state, or even national level policy to support healthy school environments.

Direct-Read Fluorescence-Based Measurements of Bioaerosol Exposure in Home Healthcare.

Home healthcare workers (HHCWs) are subjected to variable working environments which increase their risk of being exposed to numerous occupational hazards. One of the potential occupational hazards within the industry includes exposure to bioaerosols. This study aimed to characterize concentrations of three types of bioaerosols utilizing a novel fluorescence-based direct-reading instrument during seven activities that HHCWs typically encounter in patients' homes. Bioaerosols were measured in an indoor residence throughout all seasons in Cincinnati, OH, USA. A fluorescence-based direct-reading instrument (InstaScope, DetectionTek, Boulder, CO, USA) was utilized for all data collection. Total particle counts and concentrations for each particle type, including fluorescent and non-fluorescent particles, were utilized to form the response variable, a normalized concentration calculated as a ratio of concentration during activity to the background concentration. Walking experiments produced a median concentration ratio of 52.45 and 2.77 for pollen and fungi, respectively. Fungi and bacteria produced the highest and lowest median concentration ratios of 17.81 and 1.90 for showering, respectively. Lastly, our current study showed that sleeping activity did not increase bioaerosol concentrations. We further conclude that utilizing direct-reading methods may save time and effort in bioaerosol-exposure assessment.

Diet during the COVID-19 pandemic: An analysis of Twitter data.

In this study, we measured the association between county characteristics and changes in healthy-food, fast-food, and alcohol tweets during the COVID-19 pandemic in the United States. Our analytic dataset consisted of 1,282,316 geotagged tweets that referenced food consumption posted before (63.2%) and during (36.8%) the pandemic and included all US states. We found the share of healthy-food tweets increased by 20.5% during the pandemic compared with pre-pandemic, while fast-food and alcohol tweets decreased by 9.4% and 11.4%, respectively. We also observed that time spent at home and more grocery stores per capita were associated with increased odds of healthy-food tweets and decreased odds of fast-food tweets. More liquor stores per capita was associated with increased odds of alcohol tweets. Our results highlight the potential impact of the pandemic on nutrition and alcohol consumption and the association between the built environment and health behaviors.

What matters for health? Public views from eight countries.

INTRODUCTION: Despite growing scholarship on the social determinants of health (SDoH), wider action remains in its early stages. Broad public understanding of SDoH can help catalyse such action. This paper aimed to document public perception of what matters for health from countries with broad geographic, cultural, linguistic, population composition, language and income level variation. METHODS: We conducted an online survey in Brazil, China, Germany, Egypt, India, Indonesia, Nigeria and the USA to assess rankings of what respondents thought matters for health and what they perceived decision makers think matters for health. We analysed the percentages of each determinant rated as the most important for good health using two metrics: the top selection and a composite of the top three selections. We used two-tailed χ2 test for significance testing between groups. RESULTS: Of 8753 respondents, 56.2% (95% CI 55.1% to 57.2%) ranked healthcare as the most important determinant of good health using the composite metric. This ranking was consistent across countries except in China where it appeared second. While genetics was cited as the most important determinant by 22.3% (95% CI 21.5% to 23.2%) of the overall sample with comparable rates in most countries, the percentage increased to 33.3% (95% CI 30.5% to 36.3%) in Germany and 35.9% (95% CI 33.0% to 38.8%) in the USA. Politics was the determinant with the greatest absolute difference (18.5%, 95% CI 17.3% to 19.6%) between what respondents considered matters for health versus what they perceived decision makers think matters for health. CONCLUSION: The majority of people consider healthcare the most important determinant of health, well above other social determinants. This highlights the need for more investment in communication efforts around the importance of SDoH.

The Effect of Short-Term Exposure to Cadmium on the Expression of Vascular Endothelial Barrier Antigen in the Developing Rat Forebrain and Cerebellum: A Computerized Quantitative Immunofluorescent Study.

Clinical and laboratory studies have shown that environmental exposure to cadmium produces damage to several organs, including bones, lungs, and kidneys. The involvement of cadmium in central nervous system (CNS) disorders has also been widely reported, but the precise pathophysiological mechanism is not yet fully understood. Children who were exposed to cadmium during pregnancy are known to suffer from developmental delays, learning difficulties, attention deficit hyperactivity disorder (ADHD), and other cognitive and neurobehavioral deficits. Results from numerous studies suggest that dysfunction of the blood-brain barrier (BBB) structures is an important step in the neurotoxicity of cadmium. A rat-specific BBB marker protein, the endothelial barrier antigen (EBA), has been previously isolated and classified by Sternberger and others. The mouse IgG1 clone, anti-endothelial barrier antigen (anti-EBA), detects a protein triplet (23.5kDa, 25 kDa, and 30kDa) localized to the luminal surface of central and peripheral nervous system (CNS and PNS) vascular endothelial cells with selective permeability barrier functions. This marker has been widely used for characterizing BBB alterations under demyelinating, inflammatory, and other CNS pathologies. Many studies have been published using the rat model system for studying the neurotoxic effect of acute and chronic exposure to cadmium. We applied the indirect immunofluorescent techniques using the anti-EBA antibody in conjunction with the Olympus cellSens computerized image analysis to detect and quantify the surface areas of BBB-competent microvessel profiles in paraformaldehyde-fixed, paraffin-embedded brains of term-delivered young rats after intraperitoneal injection of a single dose of cadmium chloride. We detected a statistically significant reduction in EBA-positive microvessel surface areas in the forebrain (t = 5.86, df = 1789, p-value < 0.001) and cerebellum (t=73.40, df=1337, p < 0.001) of cadmium-treated rats compared to the normal controls. Thus, this study supports the hypothesis that the EBA is a sensitive and measurable indicator for quantitative assessment of the impact of cadmium exposure in the developing rat brain.

Commercial toilets emit energetic and rapidly spreading aerosol plumes.

Aerosols can transmit infectious diseases including SARS-CoV-2, influenza and norovirus. Flushed toilets emit aerosols that spread pathogens contained in feces, but little is known about the spatiotemporal evolution of these plumes or the velocity fields that transport them. Using laser light to illuminate ejected aerosols we quantify the kinematics of plumes emanating from a commercial flushometer-type toilet, and use the motion of aerosol particles to compute velocity fields of the associated flow. The toilet flush produces a strong chaotic jet with velocities exceeding 2 m/s; this jet transports aerosols to heights reaching 1.5 m within 8 seconds of initiating a flush. Quantifying toilet plumes and associated flow velocities provides a foundation for future design strategies to mitigate plume formation or to disinfect pathogens within it.

Investigating transmission of SARS-CoV-2 using novel face mask sampling: a protocol for an observational prospective study of index cases and their contacts in a congregate setting.

INTRODUCTION: This study aims to measure how transmission of SARS-CoV-2 occurs in communities and to identify conditions that lend to increased transmission focusing on congregate situations. We will measure SARS-CoV-2 in exhaled breath of asymptomatic and symptomatic persons using face mask sampling-a non-invasive method for SARS-CoV-2 detection in exhaled air. We aim to detect transmission clusters and identify risk factors for SARS-CoV-2 transmission in presymptomatic, asymptomatic and symptomatic individuals. METHODS AND ANALYSIS: In this observational prospective study with daily follow-up, index cases and their respective contacts are identified at each participating institution. Contact definitions are based on Centers for Disease Control and Prevention and local health department guidelines. Participants will wear masks with polyvinyl alcohol test strips adhered to the inside for 2 hours daily. The strips are applied to all masks used over at least 7 days. In addition, self-administered nasal swabs and (optional) finger prick blood samples are performed by participants. Samples are tested by standard PCR protocols and by novel antigen tests. ETHICS AND DISSEMINATION: This study was approved by the Colorado Multiple Institutional Review Board and the WHO Ethics Review Committee. From the data generated, we will analyse transmission clusters and risk factors for transmission of SARS-CoV-2 in congregate settings. The kinetics of asymptomatic transmission and the evaluation of non-invasive tools for detection of transmissibility are of crucial importance for the development of more targeted control interventions-and ultimately to assist with keeping congregate settings open that are essential for our social fabric. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (#NCT05145803).

Occurrence of respiratory viruses on school desks.

BACKGROUND: Schools represent high occupancy environments and well-documented high-risk locations for the transmission of respiratory viruses. The goal of this study was to report on the area density, occurrence, and type of respiratory viruses on desks in primary school classrooms. METHODS: Quantitative reverse transcription polymerase chain reaction (qPCR) techniques were employed to measure nucleic acid area densities from a broad range of human adenoviruses and rhinoviruses, as well as coronavirus OC43, influenza A, and norovirus GI. Every two weeks, virus monitoring was conducted on the desks of four primary school classrooms in Colorado, USA, during the 2019 respiratory virus season. RESULTS: DNA and RNA from respiratory viruses and norovirus were recovered from more than 20% of the desks sampled; occurrence patterns that indicate a greater than 60% probability of encountering any virus, if more than five desks were occupied in a day. Rhinoviruses and adenoviruses were the most commonly detected viruses as judged by the composite of occurrence and number of gene copies recovered. Desktop adenosine triphosphate monitoring did not predict the recovery of viral genomic materials on desks. School desks can be commonly contaminated with respiratory viruses. CONCLUSIONS: Genomic surveys of the identity, distribution and abundance of human viruses on "high-touch" surfaces, can help inform risk assessments, design cleaning interventions, and may be useful for infection surveillance.

Detecting Pathogen Exposure During the Non-symptomatic Incubation Period Using Physiological Data: Proof of Concept in Non-human Primates.

Background and Objectives: Early warning of bacterial and viral infection, prior to the development of overt clinical symptoms, allows not only for improved patient care and outcomes but also enables faster implementation of public health measures (patient isolation and contact tracing). Our primary objectives in this effort are 3-fold. First, we seek to determine the upper limits of early warning detection through physiological measurements. Second, we investigate whether the detected physiological response is specific to the pathogen. Third, we explore the feasibility of extending early warning detection with wearable devices. Research Methods: For the first objective, we developed a supervised random forest algorithm to detect pathogen exposure in the asymptomatic period prior to overt symptoms (fever). We used high-resolution physiological telemetry data (aortic blood pressure, intrathoracic pressure, electrocardiograms, and core temperature) from non-human primate animal models exposed to two viral pathogens: Ebola and Marburg (N = 20). Second, to determine reusability across different pathogens, we evaluated our algorithm against three independent physiological datasets from non-human primate models (N = 13) exposed to three different pathogens: Lassa and Nipah viruses and Y. pestis. For the third objective, we evaluated performance degradation when the algorithm was restricted to features derived from electrocardiogram (ECG) waveforms to emulate data from a non-invasive wearable device. Results: First, our cross-validated random forest classifier provides a mean early warning of 51 ± 12 h, with an area under the receiver-operating characteristic curve (AUC) of 0.93 ± 0.01. Second, our algorithm achieved comparable performance when applied to datasets from different pathogen exposures - a mean early warning of 51 ± 14 h and AUC of 0.95 ± 0.01. Last, with a degraded feature set derived solely from ECG, we observed minimal degradation - a mean early warning of 46 ± 14 h and AUC of 0.91 ± 0.001. Conclusion: Under controlled experimental conditions, physiological measurements can provide over 2 days of early warning with high AUC. Deviations in physiological signals following exposure to a pathogen are due to the underlying host's immunological response and are not specific to the pathogen. Pre-symptomatic detection is strong even when features are limited to ECG-derivatives, suggesting that this approach may translate to non-invasive wearable devices.

Molecular thermometry.

Conventional temperature measurements rely on material responses to heat, which can be detected visually. When Galileo developed an air expansion based device to detect temperature changes, Santorio, a contemporary physician, added a scale to create the first thermometer. With this instrument, patients' temperatures could be measured, recorded, and related to changing health conditions. Today, advances in materials science and bioengineering provide new ways to report temperature at the molecular level in real time. In this review, the scientific foundations and history of thermometry underpin a discussion of the discoveries emerging from the field of molecular thermometry. Intracellular nanogels and heat sensing biomolecules have been shown to accurately report temperature changes at the nanoscale. Various systems will soon provide the ability to accurately measure temperature changes at the tissue, cellular, and even subcellular level, allowing for detection and monitoring of very small changes in local temperature. In the clinic, this will lead to enhanced detection of tumors and localized infection, and accurate and precise monitoring of hyperthermia-based therapies. Some nanomaterial systems have even demonstrated a theranostic capacity for heat-sensitive, local delivery of chemotherapeutics. Just as early thermometry rapidly moved into the clinic, so too will these molecular thermometers.