Exposure of wild Caspian seals (Pusa caspica) to parasites, bacterial and viral pathogens, evaluated via molecular and serological assays

Disease surveillance of marine mammal populations is essential to understand the causes of strandings, identify potential threats to animal health, and to support development of conservation strategies. Here we report the first large multi-pathogen screening of prevalence for viruses, bacteria and parasites in a sample of 177 live, healthy, wild Caspian seals (Pusa caspica), captured and released during satellite telemetry studies 2007-2017. Employing molecular and serological assays we assess prevalence of pathogens known to be of significance for marine mammal health worldwide, and evaluate the results in relation to Caspian seal health and conservation. RT-PCR, and PCR assays find evidence for infection by Canine Distemper Virus (CDV), Phocine herpes virus, phocine adenovirus and Influenza A at prevalences of 5%, 6.4%, 21.7%, and 4% respectively. The genomes of CDV isolates collected in 2008 showed 99.59% identity with the 2000 Caspian seal CDV epizootic strain. A partial coding sequence for the Us2 gene from the Caspian seal herpes virus was identical to PhHV-1 isolate PB84, previously reported from a harbor seal (Phoca vitulina), while amplicon sequences for the adenovirus polymerase gene indicated a novel strain. ELISA assays detected exposure to Influenza A (55% of tested samples), adenovirus (25%), coronavirus (6%), CDV (8%), herpes virus (94%), Toxoplasma gondii (2.6%) and heartworm (1%). Hemagglutination inhibition (HI) tests detected exposure to Influenza B at a prevalence of 20%, and Leptospira microscopic agglutination tests detected suspected exposure to Leptospira serovars in 9% of tested samples. Overall, the risks, profile and prevalence of pathogens in Caspian seals appear comparable to other wild phocid seal populations. Our results suggest Caspian seals have exposure pathways to pathogens with epizootic potential or ability to cause significant morbidity, and that disease impacts could reduce the resilience of the population to other conservation threats. Caspian seals are listed as Endangered by the International Union for Conservation of Nature (IUCN), and we recommend that resources are invested to support further surveillance programs and to understand how anthropogenic pressures may influence future disease risks. A translated version of this is available in Russian and Kazakh in the Supplementary Material (Presentation 1 and Presentation 2)

Scepticism or conspiracy? A discourse analysis of anti-lockdown comments to online newspaper articles

This paper addresses responses to news about the imposing of a local lockdown in a UK city. The opposition to the measure shows it to be controversial as does the associated rejection of the grounds for taking action against covid more generally, which comes alongside the devaluing of expertise, resistance to public health responses, a proliferation of conspiracy theories and misinformation and the harm that can be caused by focussing on non-adherence to covid measure. The research question for this analysis is therefore: how are arguments about the local lockdown discursively formulated in online discussions? Discursive analysis of online discussions following four newspaper articles identified six arguments used that range from scepticism to conspiratorial: scepticism over (1) the prevalence and;(2) severity of covid;(3) lockdowns generally do not work and (4) the specific city lockdown will not work;(5) lockdowns are overly risk averse;and (6) there are hidden political motives for lockdowns. The discussion shows how both the ‘conspiratorial' and non-conspiratorial arguments are potentially harmful from a public health perspective. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Assessing implementation of interventions to recruit & retain the Therapeutic Radiographer workforce

Purpose or Objective Recruitment and retention of key NHS staff has been an ongoing challenge. The Reducing Pre-registration Attrition and Improving Retention (RePAIR) initiative was set up by Health Education England (HEE) in 2015 to explore effective interventions to improve retention across the student journey, from pre-enrolment to two years post qualification. Key objectives: · Map and identify areas of good practice, opportunities, and challenges of the RePAIR recommendations in England · Further embed partnership working across a range of stakeholders · Develop a shared online repository of good practice and understand the impact of COVID-19 on student education and training. Project delivered by Society of Radiographers (SoR), funded by HEE. Materials and Methods Sample: Radiotherapy approved Higher Education Institutions (HEI’s) n=10 and Radiotherapy Healthcare Providers (HCP’s) n=51 in England. A two stage project: · Multi-method survey of HEI’s, HCP’s and therapeutic radiography students on a placement expansion programme in England · Follow-up semi-structured interviews and Dual Moderator focus groups with key stakeholders Results A 100% HEI and 88% HCP survey response Key findings: • 80% of HEIs and 98% of HCPs were in favour of standardising clinical assessment documentation. • HEIs, HCPs and students felt simulation could replace up to 20% of clinical practice. • 70% of HEI’s and 51% of HCP’s surveyed had informal student support mechanisms however only 15% of HCP’s and 20% of HEI’s had extra support for year 2 • Physical and mental health and wrong career choice, were the most common reasons for attrition. • Recruitment initiatives were evident in all HEI’s and in 82% of HCP’s, however, only 27% of HCP’s were involved in retention initiatives. • Formal use of ‘culture of care’ tools was not standard practice. • All HEI’s had a transition to professional practice. 80% of HCP’s had a preceptorship programme with 20% collaborating with local HEI • Only 20% awareness of RePAIR from survey findings Conclusion Priority areas were identified and developed into workstreams: 1. Effective recruitment initiatives (e.g. outreach) 2. Effective retention initiatives, student support toolkit, return to practice 3. Strategies to increase student placement capacity (e.g. simulation and non-traditional placements) 4. Placement allocation and funding support 5. Standardised clinical assessment documentation 6. Preparation for practice (e.g preceptorship) This led to the development of an online toolkit – AHP Support Programme for Implementing Recruitment, Retention and Engagement (ASPIRRE), Standalone projects were identified, requiring separate research and development. • National project exploring requirements of implementing standardised clinical assessment. • Production of a professional body guidance document on simulation within pre-registration Therapeutic Radiography education and training programmes These projects address student and professional workforce growth, placement expansion and transformation requirements.

PATIENT WITH COVID-19 RELATED COLLAPSING GLOMERULOPATHY

We present a case of Collapsing Glomerulopathy (CG) in a patient with Coronavirus disease 2019 (COVID-19). A 53-year-old African American female with history of diabetes mellitus type II and hypertension presented with 7 days of fevers, cough, worsening dyspnea, diarrhea and oliguria. She was found to have severe AKI with serum creatinine of 6.2 mg/dL, up from a baseline of 0.8mg/dL, and nephrotic-range proteinuria (>2000 mg/dL), hematuria, pyuria, hypoalbuminemia, elevated LDH, leukocytosis, metabolic acidosis, and elevated inflammatory markers. COVID-19 PCR was positive;an extensive serologic work up to explain AKI was negative. Renal imaging revealed bilaterally increased echogenicity with normal arterial and venous Doppler flow, nonspecific left perinephric stranding concerning for pyelonephritis, and an obstructing 3 mm calculus with right hydronephrosis. Fluid resuscitation, empiric antibiotics, and dexamethasone were initiated. Scant urine output and worsening creatinine (peak of 9.3 mg/dL) continued, and hemodialysis was started on hospital day 2. Kidney biopsy on hospital day 10 showed podocyte hyperplasia and "collapse" of the underlying capillary lumens, and CG was diagnosed. The patient's symptoms improved after dialysis and steroid treatment. She was discharged requiring dialysis, now twice weekly, and renal function monitoring. Limited data on COVID-19-associated renal dysfunction exist. Hemodynamic instability may cause AKI in patients with COVID-19;however, this does not explain the severe proteinuria and hematuria sometimes observed. Both proteinuria and AKI are associated with increased mortality in these patients. Though electron microscopy did not prove the presence of COVID-19 in podocytes in our patient, possible mechanisms include direct viral toxicity on tubular cells that also harbor angiotensin-converting enzyme 2 or cytokine-mediated tubular damage. Treatment of CG secondary to infections includes antimicrobials and non-immunosuppressive therapy with renin-angiotensin-aldosterone blockers and statins. Steroid use is controversial. Currently, there is no proven treatment for COVID-19 infection, but it is reasonable to initiate steroids in these patients who have AKI and glomerular injury.

Trends in major adverse cardiac events during the covid-19 pandemic in alberta, canada

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has impacted cardiovascular (CV) outcomes and care globally, although to date, limited data exist on the Canadian experience. This study aimed to describe trends in major adverse cardiovascular events (MACE)/procedures during the COVID-19 pandemic in the Province of Alberta, Canada. Methods: A repeated cross-sectional study design compared MACE from inpatient and emergency department visits among Albertan adults between March 15, 2019, and September 14, 2020. The Alberta population was 4.4 million in 2020 and all residents are part of a single payer healthcare system. The percent change between each MACE reported in the control (2019) and COVID-19 restriction periods (2020) were calculated. MACE were defined individually and as a primary composite outcome (CV death, acute coronary syndrome [ACS], ischemic stroke, or coronary revascularization procedures). These preliminary data are part of an ongoing study, measuring outcomes throughout the first year of the pandemic. Results: Compared to March-June 2019, primary MACE during the initial COVID-19 restriction period (March-June 2020) decreased by 15.6% (n=739 patients), and by 7.3% (n=342 patients) during June-September 2020, when COVID-19 restrictions were eased. Most individual MACE followed similar patterns with reduced reported events/procedures during the initial restriction period and an increase towards previous rates thereafter (Figure 1): CV death (17.7% vs 10.2%), ACS (19.1% vs 8.4%), coronary revascularization (17.0% vs 9.2%). The exception was ischemic stroke, which was not notably impacted by pandemic restrictions. Conclusions: Declines in MACE/procedures during the COVID-19 pandemic are suggestive of a substantial gap in patient management and healthcare-seeking behaviour that may have negative downstream implications. Ongoing analyses will further explore reported MACE up to one year after the pandemic began.

Carbon nanotube-paper composite-capacitive sensor for respiratory monitoring

Recent COVID-19 pandemic highlights the importance of monitoring and prediction of acute respiratory illness. Few options are available for convenient respiratory monitoring in both hospital and community settings. This paper presents a novel respiratory monitoring sensor made of carbon nanotube-paper composites (CPC). A CPC capacitive sensor fabricated with tensional fracture consists of numerous cellulose fibers coated with carbon nanotubes (CNTs). The high aspect ratio structure significantly enhances the capacitive sensitivity due to the high electric field. A CPC-wearable sensor is characterized in comparison to a sensor made of aluminum electrodes followed by monitoring of respiratory efforts. © 2020 CBMS-0001

The worldwide clinical trial research response to the COVID-19 pandemic - the first 100 days

Background: Never before have clinical trials drawn as much public attention as those testing interventions for COVID-19. We aimed to describe the worldwide COVID-19 clinical research response and its evolution over the first 100 days of the pandemic. Methods: Descriptive analysis of planned, ongoing or completed trials by April 9, 2020 testing any intervention to treat or prevent COVID-19, systematically identified in trial registries, preprint servers, and literature databases. A survey was conducted of all trials to assess their recruitment status up to July 6, 2020. Results: Most of the 689 trials (overall target sample size 396,366) were small (median sample size 120;interquartile range [IQR] 60-300) but randomized (75.8%;n=522) and were often conducted in China (51.1%;n=352) or the USA (11%;n=76). 525 trials (76.2%) planned to include 155,571 hospitalized patients, and 25 (3.6%) planned to include 96,821 health-care workers. Treatments were evaluated in 607 trials (88.1%), frequently antivirals (n=144) or antimalarials (n=112);78 trials (11.3%) focused on prevention, including 14 vaccine trials. No trial investigated social distancing. Interventions tested in 11 trials with >5,000 participants were also tested in 169 smaller trials (median sample size 273;IQR 90-700). Hydroxychloroquine alone was investigated in 110 trials. While 414 trials (60.0%) expected completion in 2020, only 35 trials (4.1%;3,071 participants) were completed by July 6. Of 112 trials with detailed recruitment information, 55 had recruited <20% of the targeted sample;27 between 20-50%;and 30 over 50% (median 14.8% [IQR 2.0-62.0%]). Conclusions: The size and speed of the COVID-19 clinical trials agenda is unprecedented. However, most trials were small investigating a small fraction of treatment options. The feasibility of this research agenda is questionable, and many trials may end in futility, wasting research resources. Much better coordination is needed to respond to global health threats.