Data sharing in the age of predictive psychiatry: an adolescent perspective.

BACKGROUND: Advances in genetics and digital phenotyping in psychiatry have given rise to testing services targeting young people, which claim to predict psychiatric outcomes before difficulties emerge. These services raise several ethical challenges surrounding data sharing and information privacy. OBJECTIVES: This study aimed to investigate young people's interest in predictive testing for mental health challenges and their attitudes towards sharing biological, psychosocial and digital data for such purpose. METHODS: Eighty UK adolescents aged 16-18 years took part in a digital role-play where they played the role of clients of a fictional predictive psychiatry company and chose what sources of personal data they wished to provide for a risk assessment. After the role-play, participants reflected on their choices during a peer-led interview. FINDINGS: Participants saw multiple benefits in predictive testing services, but were highly selective with regard to the type of data they were willing to share. Largely due to privacy concerns, digital data sources such as social media or Google search history were less likely to be shared than psychosocial and biological data, including school grades and one's DNA. Participants were particularly reluctant to share social media data with schools (but less so with health systems). CONCLUSIONS: Emerging predictive psychiatric services are valued by young people; however, these services must consider privacy versus utility trade-offs from the perspective of different stakeholders, including adolescents. CLINICAL IMPLICATIONS: Respecting adolescents' need for transparency, privacy and choice in the age of digital phenotyping is critical to the responsible implementation of predictive psychiatric services.

Influenza A virus: sampling of the unique shorebird habitat at Delaware Bay, USA.

Delaware (DE) Bay, in the northeastern USA, has long been recognized as a hotspot for avian influenza A virus (IAV); every spring, this coastal region serves as a brief stopover site for thousands of long-distance migrating shorebirds, en route to breeding grounds in the Arctic. During these stopovers, IAV has been consistently recovered from ruddy turnstones (Arenaria interpres) that are likely to become infected as they feed by probing sand and cobble in search of food. In May 2010-2012, we successfully isolated 19 IAV from environmental samples (sand, n = 18; horseshoe crab eggs, n = 1) obtained from DE Bay sites. Two of these viruses were subjected to laboratory conditions similar to those in the DE Bay spring-time environment, and remained infectious for 7 days. Here, through the recovery of IAV from environmental samples, temperature monitoring at and below the sand surface and simulated laboratory trials, we provide evidence that the beach environment may enable localized transmission and short-term maintenance of IAV in this unique ecosystem.

Antibodies to Influenza A Viruses in Wintering Snow Geese (Chen caerulescens) in Texas.

Wild waterfowl in the order Anseriformes are recognized reservoirs for influenza A viruses (IAVs); however, prevalence of infection can vary greatly by species. Few isolates of IAVs have been reported from snow geese (Chen caerulescens), and generally they have not been regarded as an important component of this reservoir. In February 2013, 151 combined cloacal and oropharangeal swabs and 147 serum samples were collected from snow geese wintering on the Gulf coast of Texas. None of the swab samples tested positive by virus isolation, but antibodies to IAVs were detected in 87 (59%) birds tested by competitive blocking ELISA (bELISA). To further characterize these detected antibodies, positive samples were tested by virus microneutralization (MN) for antibodies to viruses representing 14 hemagglutinin subtypes (HA1-HA12, H14, and H15). By MN, antibodies to H1 (n = 41; 47%), H5 (n = 32; 37%), H6 (n = 49; 56%), H9 (n = 50; 57%), and H12 (n = 24; 28%) were detected. Snow goose populations have increased in North America since the 1960s, and their association with agricultural lands provides a potential indirect source of IAV infection for domestic poultry. This potential, as well as the detection of antibodies to HA subtypes H5, H9, and H12 that are not well represented in other waterfowl species, suggests that further snow geese surveillance is indicated.

Gallstone and Severe Hypertriglyceride-Induced Pancreatitis in Pregnancy.

IMPORTANCE: Patients with biliary disease or underlying dyslipidemias are at risk for pancreatitis in pregnancy. Appropriate treatment can decrease the risk of recurrence and perinatal complications. Prevention of severe lipid elevations can prevent the development of pancreatitis in pregnancy. OBJECTIVE: To review the pathophysiology, diagnosis and treatment of gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy. EVIDENCE ACQUISITION: We performed a literature search regarding pancreatitis, gallstones, hyperlipidemia, and the treatment of both severe hypertriglyceride-induced pancreatitis and gallstone pancreatitis in pregnancy. RESULTS: In the setting of acute pancreatitis, removal of the offending agent, either gallstones or serum lipids, can lead to improved status and decrease recurrence risk. CONCLUSIONS AND RELEVANCE: Patients with acute pancreatitis should be treated with analgesia and fluid resuscitation and maintain a nothing-per-os status. In cases of gallstone pancreatitis, removal of the offending stone through endoscopic retrograde cholangiopancreatography or cholecystectomy can decrease recurrence risk. Severe hypertriglyceride-induced pancreatitis includes similar management. Lipopheresis may be considered in refractory cases. Patients with severe hypercholesterolemia should maintain a low-fat diet and can continue lipid-lowering agents outside the statin class of medications. Preventing severe dyslipidemia in gestation can decrease the risk of pancreatitis and improve maternal and neonatal outcomes.

Isolation of type A influenza viruses from Red-necked Grebes (Podiceps grisegena).

Six type-A low pathogenic influenza viruses from 14 Red-necked Grebes (Podiceps grisegena) from Agassiz National Wildlife Refuge were sequenced. The grebe viruses were closely related to North American duck viruses. The genetic and temporal subtype consistency between the duck and grebe isolates suggest spillover events, potentially enhanced by feather eating.

Are passerine birds reservoirs for influenza A viruses?

Abstract Although peridomestic passerine species have been involved in influenza A virus (IAV) outbreaks in poultry, there is little evidence to indicate they serve as reservoirs for these viruses under natural conditions. Recent molecular-based detections of IAV in terrestrial wild birds have challenged this paradigm, and it has been suggested that additional research is warranted to better define the role of these birds as IAV hosts. To address this need, we reviewed the published literature reporting results from IAV surveillance of passerines. We also conducted prospective virologic and serologic surveillance of North American passerines for IAVs. The literature review included 60 publications from 1975-2013 that reported results from 829 species of passerines and other terrestrial birds. In our prospective study during 2010 and 2011, 3,868 serum samples and 900 swab samples were collected and tested from 102 terrestrial wild bird species from Georgia, New Jersey, Delaware, and Minnesota, USA. Antibodies to the nucleoprotein of IAV were detected with a commercial blocking enzyme-linked immunosorbent assay in 4/3,868 serum samples (0.1%); all positive samples were from Minnesota. No virus was detected in 900 swab samples by virus isolation in embryonated chicken eggs or matrix real-time reverse transcriptase PCR. Our results are consistent with historic literature; although passerines and terrestrial wild birds may have a limited role in the epidemiology of IAV when associated with infected domestic poultry or other aberrant hosts, there is no evidence supporting their involvement as natural reservoirs for IAV.

Evidence for seasonal patterns in the relative abundance of avian influenza virus subtypes in blue-winged teal (Anas discors).

Seasonal dynamics of influenza A viruses (IAVs) are driven by host density and population immunity. Through an analysis of subtypic data for IAVs isolated from Blue-winged Teal (Anas discors), we present evidence for seasonal patterns in the relative abundance of viral subtypes in spring and summer/autumn.

Isolation of influenza A viruses from wild ducks and feathers in Minnesota (2010-2011).

We investigated the feasibility of testing feathers as a complementary approach to detect low pathogenic influenza A viruses (IAVs) in wild duck populations. Feathers on the ground were collected at four duck capture sites during 2010 and 2011, in Minnesota, U. S. A. IAVs were isolated from both feathers and cloacal swabs sampled from ducks at the time of capture. Although virus isolation rates from feather and cloacal swabs were inconsistent between collections, the overall rate of isolation was greatest from the feather samples. Viruses isolated from feathers also reflected the subtype diversity observed in cloacal swab isolates but resulted in many more isolates that contained more than one virus. Our study suggests that testing feathers may represent an alternative noninvasive approach to recover viruses and estimate subtype abundance and diversity.

Antibodies to H5 subtype avian influenza virus and Japanese encephalitis virus in northern pintails (Anas acuta) sampled in Japan.

Blood samples from 105 northern pintails (Anas acuta) captured on Hokkaido, Japan were tested for antibodies to avian influenza virus (AIV), Japanese encephalitis virus (JEV), and West Nile virus (WNV) to assess possible involvement of this species in the spread of economically important and potentially zoonotic pathogens. Antibodies to AIV were detected in 64 of 105 samples (61%). Of the 64 positives, 95% and 81% inhibited agglutination of two different H5 AIV antigens (H5N1 and H5N9), respectively. Antibodies to JEV and WNV were detected in five (5%) and none of the samples, respectively. Results provide evidence for prior exposure of migrating northern pintails to H5 AIV which couldhave implications for viral shedding and disease occurrence. Results also provide evidence for limited involvement of this species in the transmission and spread of flaviviruses during spring migration.

Influenza-A viruses in ducks in northwestern Minnesota: fine scale spatial and temporal variation in prevalence and subtype diversity.

Waterfowl from northwestern Minnesota were sampled by cloacal swabbing for Avian Influenza Virus (AIV) from July-October in 2007 and 2008. AIV was detected in 222 (9.1%) of 2,441 ducks in 2007 and in 438 (17.9%) of 2,452 ducks in 2008. Prevalence of AIV peaked in late summer. We detected 27 AIV subtypes during 2007 and 31 during 2008. Ten hemagglutinin (HA) subtypes were detected each year (i.e., H1, 3-8, and 10-12 during 2007; H1-8, 10 and 11 during 2008). All neuraminidase (NA) subtypes were detected during each year of the study. Subtype diversity varied between years and increased with prevalence into September. Predominant subtypes during 2007 (comprising ≥5% of subtype diversity) included H1N1, H3N6, H3N8, H4N6, H7N3, H10N7, and H11N9. Predominant subtypes during 2008 included H3N6, H3N8, H4N6, H4N8, H6N1, and H10N7. Additionally, within each HA subtype, the same predominant HA/NA subtype combinations were detected each year and included H1N1, H3N8, H4N6, H5N2, H6N1, H7N3, H8N4, H10N7, and H11N9. The H2N3 and H12N5 viruses also predominated within the H2 and H12 subtypes, respectively, but only were detected during a single year (H2 and H12 viruses were not detected during 2007 and 2008, respectively). Mallards were the predominant species sampled (63.7% of the total), and 531 AIV were isolated from this species (80.5% of the total isolates). Mallard data collected during both years adequately described the observed temporal and spatial prevalence from the total sample and also adequately represented subtype diversity. Juvenile mallards also were adequate in describing the temporal and spatial prevalence of AIV as well as subtype diversity.

Influenza A viruses in American White Pelican (Pelecanus erythrorhynchos).

The role of many wild waterbird species in the ecology and epidemiology of avian influenza viruses (AIV) remains unclear. We report the first isolation of AIV from American White Pelicans (Pelecanus erythrorhynchos; Pelecaniformes) in North America. Two H13N9 AIVs were isolated from hatchling birds in breeding colonies in Minnesota, USA, during 2007 and 2008. Based on molecular sequencing of the hemagglutinin and neuraminidase genes, the 2008 virus was genetically related to AIVs previously isolated from gulls and shorebirds in North America. The 2007 isolate was most related to AIVs from Eurasian gulls and North American ducks, reflecting both global movement of these viruses and reassortment between viruses associated with duck and gull reservoirs.

Prevalence of antibodies to type a influenza virus in wild avian species using two serologic assays.

Serologic testing to detect antibodies to avian influenza (AI) virus has been an underused tool for the study of these viruses in wild bird populations, which traditionally has relied on virus isolation and reverse transcriptase-polymerase chain reaction (RT-PCR). In a preliminary study, a recently developed commercial blocking enzyme-linked immunosorbent assay (bELISA) had sensitivity and specificity estimates of 82% and 100%, respectively, for detection of antibodies to AI virus in multiple wild bird species after experimental infection. To further evaluate the efficacy of this commercial bELISA and the agar gel immunodiffusion (AGID) test for AI virus antibody detection in wild birds, we tested 2,249 serum samples collected from 62 wild bird species, representing 10 taxonomic orders. Overall, the bELISA detected 25.4% positive samples, whereas the AGID test detected 14.8%. At the species level, the bELISA detected as many or more positive serum samples than the AGID in all 62 avian species. The majority of positive samples, detected by both assays, were from species that use aquatic habitats, with the highest prevalence from species in the orders Anseriformes and Charadriiformes. Conversely, antibodies to AI virus were rarely detected in the terrestrial species. The serologic data yielded by both assays are consistent with the known epidemiology of AI virus in wild birds and published reports of host range based on virus isolation and RT-PCR. The results of this research are also consistent with the aforementioned study, which evaluated the performance of the bELISA and AGID test on experimental samples. Collectively, the data from these two studies indicate that the bELISA is a more sensitive serologic assay than the AGID test for detecting prior exposure to AI virus in wild birds. Based on these results, the bELISA is a reliable species-independent assay with potentially valuable applications for wild bird AI surveillance.

Canada geese and the epidemiology of avian influenza viruses.

Canada geese (Branta canadensis) are numerous, highly visible, and widely distributed in both migratory and resident populations in North America; as a member of the order Anseriformes, they are often suggested as a potential reservoir and source for avian influenza (AI) viruses. To further examine the role of Canada Geese in the ecology of AI, we re-evaluated existing literature related to AI virus in this species and tested breeding populations of Canada Geese from three states (Georgia, West Virginia, and Minnesota, USA) by virus isolation and serology. The ability of AI virus to persist in goose feces under experimental conditions also was evaluated as an additional measure of the potential for this species to serve as an AI virus reservoir. Virus was not isolated from 1,668 cloacal swabs and type-specific antibody prevalence was low (4/335, 1.2%). Finally, under experimental conditions, AI virus persistence in goose feces and in water contaminated with goose feces was limited as compared to published estimates from duck feces and water. Our results are consistent with historic reports of a low prevalence of AI virus infection in this species, and we suggest that Canada Geese play a minor, if any, role as a reservoir for low pathogenic AI viruses that naturally circulate in wild bird populations.

Avian influenza virus in aquatic habitats: what do we need to learn?

Although aquatic habitats utilized by wild and domestic birds potentially can provide a bridge for avian influenza virus (AIV) transmission among many diverse hosts, the factors controlling environmental persistence and transmission via these habitats are poorly understood. AIV has been detected in water samples collected in the field, and under experimental laboratory conditions, these viruses can remain infective in water for periods of time that would be consistent with an environmental reservoir. However, the application of laboratory results to field realities is complicated by the complexity and scale of these systems. In this brief review, we present a summary of existing research on the environmental tenacity of AIV, provide an example of the challenges associated with the application of laboratory results to the field realities associated with detection of AIV from environmental sources, and identify gaps in our current understanding of the factors potentially affecting AIV infectivity in the environment, specifically from aquatic habitats utilized by wild birds.

Characterization of 'Candidatus Neoehrlichia lotoris' (family Anaplasmataceae) from raccoons (Procyon lotor).

Recently, a novel ehrlichial organism was isolated from a raccoon (Procyon lotor) and the isolate (RAC413) was infectious to two naïve raccoons but not laboratory mice, rats or rabbits. In this study, amplification and sequencing of four gene targets (16S rRNA gene, groESL, gltA and rpoB) confirmed that the novel ehrlichial organism was a member of the family Anaplasmataceae and was most closely related to, but distinct from, 'Candidatus Neoehrlichia mikurensis' TK4456(R) and IS58. RAC413 shared the highest sequence similarity with members of the genus Ehrlichia (94.2-95.1, 80.9-83.1, 67.9-71.9 and 39.9-40.7 % similarity for the 16S rRNA gene, groESL, gltA and rpoB, respectively). No sequence variation in three sequences (16S rRNA gene, groESL and gltA) was observed between the RAC413 isolate and five additional sequences amplified from blood of naturally infected raccoons from several geographically isolated populations in the south-eastern USA. Serum samples from four experimentally infected raccoons did not react to Ehrlichia canis, Ehrlichia chaffeensis, Anaplasma marginale or Anaplasma phagocytophilum antigens in an immunofluorescence assay or an Ehrlichia ewingii peptide in an ELISA format. On the basis of the distinctive molecular and serological characteristics and apparent host specificity of this ehrlichial organism, it is proposed that this organism be designated 'Candidatus Neoehrlichia lotoris' (reference strain RAC413).

Substituted hippurates and hippurate analogs as substrates and inhibitors of peptidylglycine alpha-hydroxylating monooxygenase (PHM).

Peptidyl alpha-hydroxylating monooxygenase (PHM) functions in vivo towards the biosynthesis of alpha-amidated peptide hormones in mammals and insects. PHM is a potential target for the development of inhibitors as drugs for the treatment of human disease and as insecticides for the management of insect pests. We show here that relatively simple ground state analogs of the PHM substrate hippuric acid (C(6)H(5)-CO-NH-CH(2)-COOH) inhibit the enzyme with K(i) values as low as 0.5microM. Substitution of sulfur atom(s) into the hippuric acid analog increases the affinity of PHM for the inhibitor. Replacement of the acetylglycine moiety, -CO-NH-CH(2)-COOH with an S-(thioacetyl)thioglycolic acid moiety, -CS-S-CH(2)-COOH, yields compounds with the highest PHM affinity. Both S-(2-phenylthioacetyl)thioglycolate and S-(4-ethylthiobenzoyl)thioglycolic acid inhibit the proliferation of cultured human prostate cancer cells at concentrations >100-fold excess of their respective K(i) values. Comparison of K(i) values between mammalian PHM and insect PHM shows differences in potency suggesting that a PHM-based insecticide with limited human toxicity can be developed.

Raccoons (Procyon lotor), but not rodents, are natural and experimental hosts for an ehrlichial organism related to "Candidatus Neoehrlichia mikurensis".

"Candidatus Neoehrlichia mikurensis" has been reported from a variety of rodent and Ixodes tick species in Europe and Asia. Recently, an ehrlichial organism closely related to "Candidatus Neoehrlichia mikurensis" was cultured from a raccoon (Procyon lotor) from Georgia, USA. To determine prevalence and distribution, we conducted a molecular survey of free-ranging raccoons (n=197) from 10 populations in 3 states and found that infections were common in tick-infested populations (50-94%). In an effort to determine the host range of this organism, 10 species of rodents (n=137) trapped in 3 areas where positive raccoons had been detected were tested; all were negative. In addition, captive bred raccoons and several common laboratory animals (mice, rats, and rabbits) were inoculated with the raccoon ehrlichial isolate (strain RAC413). Raccoons became infected with the culture isolate but all other hosts were refractory to infection. The 16S rRNA gene sequence (1379bp) of the RAC413 isolate was most similar (98.4-98.8%) to members of the "Candidatus Neoehrlichia mikurensis" group and phylogenetic analysis confirmed this organism was related to, but distinct from, "Candidatus Neoehrlichia mikurensis". Based on the molecular and natural history uniqueness of this organism from raccoons, we propose that this represents a novel species in the "Candidatus Neoehrlichia" group of ehrlichial organisms.

West Nile virus antibody prevalence in American crows (Corvus brachyrhynchos) and fish crows (Corvus ossifragus) in Georgia, USA.

Crows have been the centerpiece of avian West Nile virus (WNV) surveillance and research in North America. This work has demonstrated variation in susceptibility to WNV infection between American (Cor vus brachyrhynchos) andFish Crows (Corvus ossifragus). The higher WNV-associated mortality rate in American Crows compared with Fish Crows suggests that WNV antibody prevalence would be greater in the Fish Crow population. The objectives of this study were to 1) determine whether Fish Crows had higher WNV antibody prevalencethan American Crows, 2 ) determine th e persistence o f antibodies to WNV in naturally infected Fish Crows, and 3) develop a technique to distinguish Fish Crows from American Crows on the basis of sequence analysis and restriction enzyme digestion of a mitochondrial DNA fragment. West Nile virus antibody prevalence was 16.5% (n = 97) in Fish Crows and 5.7% in American Crows (n = 53) collected from Georgia between 2004 and 2006. Antibodies persisted at high titers for 12 mo in Fish Crows. This is the first report of WNV antibody persistence in a crow species. A polymerase chain reaction technique paired with restriction enzyme digestion easily distinguished American Crows from Fish Crows on the basis of a mitochondrial DNA fragment.

West Nile virus antibodies in avian species of Georgia, USA: 2000-2004.

West Nile virus (WNV) was first isolated in the state of Georgia in the summer of 2001. As amplifying hosts of WNV, avian species play an important role in the distribution and epidemiology of the virus. The objective of this study was to identify avian species that are locally involved as potential amplifying hosts of WNV and can serve as indicators of WNV transmission over the physiographic and land use variation present in the southeastern United States. Avian serum samples (n=14,077) from 83 species of birds captured throughout Georgia during the summers of 2000-2004 were tested by a plaque reduction neutralization test for antibodies to WNV and St. Louis encephalitis virus. Over the 5-year period, WNV-neutralizing antibodies were detected in 869 (6.2%) samples. The WNV seroprevalence increased significantly throughout the study and was species dependent. The highest antibody prevalence rates were detected in rock pigeons (Columba livia), northern cardinals (Cardinalis cardinalis), common ground doves (Columbina passerina), grey catbirds (Deumetella carolinensis), and northern mockingbirds (Mimus polyglottos). Northern cardinals, in addition to having high geometric mean antibody titers and seroprevalence rates, were commonly found in all land use types and physiographic regions. Rock pigeons, common ground doves, grey catbirds, and northern mockingbirds, although also having high seroprevalence rates and high antibody titers against WNV, were more restricted in their distribution and therefore may be of more utility when attempting to assess exposure rates in specific habitat types. Of all species tested, northern cardinals represent the best potential avian indicator species for widespread serologic-based studies of WNV throughout Georgia due to their extensive range, ease of capture, and high antibody rates and titers. Due to the large geographic area covered by this species, their utility as a WNV sentinel species may include most of the eastern United States.