SARS-CoV-2 genome quantification in wastewaters at regional and city scale allows precise monitoring of the whole outbreaks dynamics and variants spreading in the population.

SARS-CoV-2 is a coronavirus causing a globalized outbreak called COVID-19. SARS-CoV-2 transmission is associated with inhalation of contaminated respiratory droplets and could causes severe complications. Until today several "waves" of infections have been observed despite implementation of strict health policies. Decisions for such sanitary measures are based on population health monitoring. Unfortunately, for COVID-19, a significant proportion of individuals are asymptomatic but play a role in the virus transmission. To overcome these limitations, several strategies were developed including genome quantification in wastewater that could allow monitoring of the health status of population, since shedding of SARS-CoV-2 in patient stool is frequent. Wastewater-based epidemiology (WBE) was established and several countries implemented this approach to allow COVID-19 outbreak monitoring. In France, the OBEPINE project performed a quantitative analysis of SARS-CoV-2 in raw wastewater samples collected from major wastewater treatment plants (WWTP) since March 2020. In the greater Paris area 1101 samples (507 for five WWTP and 594 for sewer) were collected. This 16 months monitoring allows us to observe the outbreak dynamics. Comparison of WBE indicators with health data lead to several important observation; the good level of correlation with incidence rates, the average 3 days lead time, and the sensitivity (WBE change when incidence is > to 7/100000 inhabitants). We also compared the local monitoring (city level) with the regional monitoring, to help cluster identification. Moreover, variants of concern (VOC) emerged due to the selection pressure. We developed a specific RT-qPCR method targeting the deletion H69-V70 in the spike protein, using this deletion as a proxy of the B.1.1.7 presence in the wastewater. With this data we demonstrate the predominant role played by this strain in the third wave. All these results allow a better description and understanding of the pandemic and highlight the role of such WBE indicators.

Several forms of SARS-CoV-2 RNA can be detected in wastewaters: Implication for wastewater-based epidemiology and risk assessment.

The ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a public health emergency of international concern. Although SARS-CoV-2 is considered to be mainly transmitted by inhalation of contaminated droplets and aerosols, SARS-CoV-2 is also detected in human feces and to a less extent in urine, and in raw wastewaters (to date viral RNA only) suggesting that other routes of infection may exist. Monitoring SARS-CoV-2 genomes in wastewaters has been proposed as a complementary approach for tracing the dynamics of virus transmission within human population connected to wastewater network. The understanding on SARS-CoV-2 transmission through wastewater surveillance, the development of epidemic modeling and the evaluation of SARS-CoV-2 transmission from contaminated wastewater are largely limited by our knowledge on viral RNA genome persistence and virus infectivity preservation in such an environment. Using an integrity based RT-qPCR assay this study led to the discovery that SARS-CoV-2 RNA can persist under several forms in wastewaters, which provides important information on the presence of SARS-CoV-2 in raw wastewaters and associated risk assessment.

Hydrophobic Organic Matter Promotes Coxsackievirus B5 Stabilization and Protection from Heat.

In urban rivers, many of which are used for drinking water production, viruses encounter a range of particulate, colloidal, and dissolved organic and inorganic compounds. To date, the impact of environmental organic matter on virus persistence in the environment has received little attention. In the present study, fresh water was fractioned to separate particulate natural organic matter from dissolved forms. Each fraction was tested for its ability to promote coxsackievirus B5 resistance to heat inactivation. Our results demonstrate that, at natural concentrations, environmental waters contain particulate or dissolved compounds that are able to protect viruses from heat. We also show that hydrophobic compounds promote an efficient protection against heat inactivation. This study suggests that local conditions encountered by viruses in the environment could greatly impact their persistence.

Osteopathy--an aid to the healing process.

1. Osteopaths deal primarily with the dysfunction of joints and the resulting effects. 2. Osteopaths believe that the body is able to heal itself and that their role is to aid this process. 3. Spinal dysfunction has wide-ranging effects on all bodily systems. 4. Osteopaths use a wide variety of techniques, not just supposedly painful manipulations, and treat both spinal and non-spinal problems.

Employment prospects in dentistry.

While the employment projections by the Department of Labor do not identify specific changes in delivery patterns for dental care (e.g., independent dental hygiene practice), they do suggest models with some modifications to traditional practice arrangements (e.g., retail dentistry). But if we may assume that the dramatic changes in the last ten years in the delivery of dental services are any indication of the developments in the next decade, then the resultant system will bear little resemblance to the world of dentistry to which many older practitioners nostalgically cling. But from the perspective of dental employees, the combination of 1) the Department of Labor projections for increases in the number of job opportunities for auxiliaries through the next decade, and 2) a decrease in the production of the number of dental hygienist and dental auxiliary graduates, portends a favorable employment market.

Pancreatic injury associated with interposed abdominal compressions in pediatric cardiopulmonary resuscitation.

A case in which conventional CPR was augmented with interposed abdominal compressions on a child is reported. Animal studies and electrical models of this new form of CPR have demonstrated improved hemodynamics without instance of intra-abdominal injury. In this case, intraperitoneal visceral injury was noticed in the form of blood within the stomach and small intestine and parenchymal hemorrhage within the pancreas. Similar pancreatic injury has not been reported with conventional pediatric CPR, and caution may have to be exercised if this form of CPR with interposed abdominal compressions is to be used on children.

The rehabilitation of disabled people: towards a framework for future developments.

Structural changes in the economic and social climate require rehabilitation and other social provisions to review their values, goals and strategies in order to maintain relevance and effectiveness and improve "productivity". This raises the need for conceptual and operational frameworks of rehabilitation policies and practices to take account of foreseeable social and economic trends, needs and opportunities in society. The study set out to outline frameworks for future developments and to assess the feasibility of their implementation in a specific rehabilitation system in a Member State of the European Economic Community. It examined national and european assessments of short term economic, demographic and technological trends and their implications for the disabled and their rehabilitation towards economic and social integration. A limited survey of the existing system identified strengths and potentials which were used as a basis for an operational framework and a plan of action for changes and extensions to the system. The study revealed that the system has the capacity to change in the direction indicated by the framework which is expected to improve quality and "productivity" of the provision.

A new technique for evaluating bath oil in the treatment of dry skin.

Patients with moderate-to severe dry skin of the lower legs bathed daily for 17 days using either an emulsified lanolin and mineral oil bath additive (Treatment Group) or their usual bath soap (Control Group). The affected sites were evaluated and photographed before and at selected times following treatment, using a standardized technique. The severity of the dry skin as it appeared in projected color transparencies was evaluated on a 10-point grading scale by a second investigator under blinded conditions. The differential response between treatment and control groups increased with time and was found statistically significant (p less than 0.05), demonstrating the sensitivity of the method as well as the apparent therapeutic effects of the bath additive.