EMS Paramedics and Law Enforcement Officers' Experiences with Joint-Response Efforts on Suspected Opioid Overdose Calls: A Qualitative Study.

In the United States, the opioid crisis remains a nationwide public health emergency. Narcan laws have increased medical collaboration between emergency medical services (EMS) paramedics and law enforcement officers (LEOs), yet research on joint opioid-response efforts with these first responders remains underexplored. Using a phenomenological approach, this study explores EMS paramedics and LEOs' experiences with joint-response efforts on suspected opioid overdose calls amidst the ongoing opioid crisis. Researchers conducted semi-structured interviews with 14 first responders (n = 8 EMS paramedics; n = 6 LEOs) from a large Central Florida emergency services district covering urban, suburban, and rural areas. Four major themes emerged: (1) facilitators to joint-response efforts; (2) barriers to joint-response efforts; (3) concerns for patient co-occurring behavioral health conditions; and (4) perceived solutions. Overall, participants described mutual respect, reliance, and communication as key facilitators, while barriers included conflicting on-scene priorities and differences in Narcan protocols. Concerns for co-occurring behavioral health (i.e., addiction and mental health) conditions among overdose patients included difficulties in assessing mental health and the availability of wraparound services, yet these concerns remained secondary to medical treatment during an opioid-related emergency. Key solutions included enhanced Narcan training for LEOs and increased availability of behavioral health services for long-term patient care. This research contributes to existing literature on opioid overdose response by specifically examining joint-response efforts between EMS paramedics and LEOs. These findings may be applicable to other partnering agencies such as mental health crisis teams and should be explored across behavioral health collaborations.

Methylome Analysis in Chickens Immunized with Infectious Laryngotracheitis Vaccine.

In this study we investigated the methylome of chickens immunized with Infectious laryngotracheitis (ILT) vaccine derived from chicken embryos. Methyl-CpG binding domain protein-enriched genome sequencing (MBD-Seq) method was employed in the detection of the 1,155 differentially methylated regions (DMRs) across the entire genome. After validation, we ascertained the genomic DMRs distribution and annotated them regarding genes, transcription start sites (TSS) and CpG islands. We found that global DNA methylation decreased in vaccinated birds, presenting 704 hypomethylated and 451 hypermethylated DMRs, respectively. Additionally, we performed an enrichment analysis detecting gene networks, in which cancer and RNA post-transcriptional modification appeared in the first place, followed by humoral immune response, immunological disease and inflammatory disease. The top four identified canonical pathways were EIF2 signaling, regulation of EIF4 and p70S6K signaling, axonal guidance signaling and mTOR signaling, providing new insight regarding the mechanisms of ILT etiology. Lastly, the association between DNA methylation and differentially expressed genes was examined, and detected negative correlation in seventeen of the eighteen genes.

Transcriptome analysis reveals an activation of major histocompatibility complex 1 and 2 pathways in chicken trachea immunized with infectious laryngotracheitis virus vaccine.

Infectious laryngotracheitis is an acute, contagious, upper respiratory disease of chickens caused by gallid herpes virus 1. Due to mortality rates that can reach up to 70% depending on the virulence of the virus, the disease is of great economic importance to the poultry industry. In this study, 15-d-old specific pathogen-free White Leghorn chickens were used to perform transcriptome analysis of chicken trachea immunized with infectious laryngotracheitis virus vaccine. Myosin and several collagen-related genes were downregulated in the immunized group, suggesting that normal function and structure may be compromised. In addition, we identified some cytokine receptors and several immune genes, such as Granzyme A (GZMA), CD4 molecule (CD4), CD8a molecule (CD8A), and CD8b molecule (CD8B), that were upregulated upon vaccination. The gene ontology analysis shows that genes included in the biological process cluster were related to antigen processing and presentation, positive regulation of immune system processes, T cell selection, and positive regulation of T cell activation. In conclusion, chicken embryo origin vaccine activation of the major histocompatibility complex 1 and 2 pathways provides insight for evaluation and design of infectious laryngotracheitis vaccines.

Molecular epidemiology of infectious laryngotracheitis: a review.

Infectious laryngotracheitis (ILT) is an economically important respiratory disease of poultry that affects the poultry industry worldwide. The disease is caused by gallid herpesvirus I (GaHV-1), a member of the genus Iltovirus, family Herpesviridae, subfamily Alphaherpesvirinae. The current incidence of the disease is heavily influenced by live attenuated vaccines, which have been used extensively since their introduction in the mid-twentieth century. The capability of current live attenuated vaccine viruses to revert to virulence and spread from bird to bird has shaped the molecular epidemiology of ILT. Because of the antigenic homogeneity among GaHV-1 strains, differentiation of strains has been achieved by targeting genomic differences between outbreak-related isolates and vaccine strains. Numerous genes and genomic regions have been utilized in the development of DNA-based diagnostic assays to differentiate outbreak-related isolates from vaccine strains in countries where ILT outbreaks have occurred. More recently, full genome sequences have allowed determination of the origin of some of the outbreak-related isolates circulating in some poultry production countries. Overall, molecular typing data collected worldwide have identified live attenuated vaccine-related isolates as the primary source for outbreaks of the disease.