Genomic Analysis and Surveillance of Respiratory Syncytial Virus (RSV) Using Wastewater-Based Epidemiology (WBE).

Respiratory syncytial virus (RSV) causes severe infections in infants, immunocompromised or elderly individuals resulting in annual epidemics of respiratory disease. Currently, limited clinical surveillance and the lack of predictable seasonal dynamics limits the public health response. Wastewater-based epidemiology (WBE) has recently been used globally as a key metric in determining prevalence of SARS-CoV-2 in the community but its application to other respiratory viruses is limited. In this study, we present an integrated genomic WBE approach, applying RT-qPCR and partial G-gene sequencing to track RSV levels and variants in the community. We report increasing detection of RSV in wastewater concomitant with increasing numbers of positive clinical cases. Analysis of wastewater-derived RSV sequences permitted identification of distinct circulating lineages within and between seasons. Altogether, our genomic WBE platform has the potential to complement ongoing global surveillance and aid the management of RSV by informing the timely deployment of pharmaceutical and non-pharmaceutical interventions.

An Ethical Framework for Research Using Genetic Ancestry.

A wide range of research uses patterns of genetic variation to infer genetic similarity between individuals, typically referred to as genetic ancestry. This research includes inference of human demographic history, understanding the genetic architecture of traits, and predicting disease risk. Researchers are not just structuring an intellectual inquiry when using genetic ancestry, they are also creating analytical frameworks with broader societal ramifications. This essay presents an ethics framework in the spirit of virtue ethics for these researchers: rather than focus on rule following, the framework is designed to build researchers' capacities to react to the ethical dimensions of their work. The authors identify one overarching principle of intellectual freedom and responsibility, noting that freedom in all its guises comes with responsibility, and they identify and define four principles that collectively uphold researchers' intellectual responsibility: truthfulness, justice and fairness, anti-racism, and public beneficence. Researchers should bring their practices into alignment with these principles, and to aid this, the authors name three common ways research practices infringe these principles, suggest a step-by-step process for aligning research choices with the principles, provide rules of thumb for achieving alignment, and give a worked case. The essay concludes by identifying support needed by researchers to act in accord with the proposed framework.

Novel insight into ammonium, phosphate, and iron(II) dynamics in the sediment porewater of a constructed wetland under artificial aeration through the diffusive equilibrium in thin films technique.

The analysis of porewater concentrations in constructed wetland sediments could help to understand biogeochemical processes, the sources and sinks of nutrients, and their effect on overlying water quality. In this study, we measured high-resolution porewater concentration profiles of ammonium (NH4+-N), nitrate (NO3N), phosphate (PO43--P), and ferrous iron (Fe(II)) in-situ in the Laratinga constructed wetland in Mount Barker (South Australia) using diffusive equilibration in thin films (DET) techniques. Measurements were taken under light and dark conditions, and non-aerated and aerated conditions to determine the effect on sediment porewater nutrient concentrations. Baseline surface water nutrient concentrations (NH4+-N > 36 mg L-1, PO43--P > 0.43 mg L-1) greatly exceeded water quality guideline criteria. Aeration of the water column alleviated night-time hypoxic conditions (i.e. dissolved oxygen increased from a minimum of 0.7 mg L-1 to a minimum of 4 mg L-1), and increased the redox potential in the sediment. Significant differences were present for NH4+-N, PO43--P, and Fe(II) concentrations with depth in the sediment. Ammonium concentrations in the sediment reduced under aerated conditions, presumably due to enhanced nitrification. However it was observed that PO43--P and Fe(II) concentrations increased significantly with aeration, especially under dark conditions, and were strongly correlated (R2>0.8). This was not what was hypothesised and points to complex interactions between Fe and P in the sediment. Nitrate concentrations in the sediment were below the detection limit (<0.9 mg L-1) which suggests limited nitrification-denitrification is occurring. Overall the results suggest that DET techniques are useful tools for quantifying porewater concentrations of nutrients in constructed wetlands under various environmental conditions.

Improved recovery of SARS-CoV-2 from wastewater through application of RNA and DNA stabilising agents.

Wastewater Based Epidemiology (WBE) has become an integral part of the public health effort to track the levels of SARS-CoV-2 within communities. Detection of SARS-CoV-2 in wastewater can be challenging due to relatively low levels of virus within the sample. The wastewater matrix is also comprised of commercial and domestically derived contaminants, as well as RNases, all of which can adversely affect RT-qPCR analysis. To improve SARS-CoV-2 detection within wastewater samples we investigated both the effect of template dilution (as a means to reduce RT-qPCR inhibition) and sample stabilisation via addition of DNA/RNA Shield™ and/or RNA Later™ (to prevent RNA degradation via RNases) as a means to improve viral fragment detection. Using both methodologies, a significant improvement in SARS-CoV-2 detection from wastewater samples was observed. No adverse effects of stabilising agent addition on downstream Next-Generation Sequencing workflows were detected.

Ancestry: How researchers use it and what they mean by it.

Background: Ancestry is often viewed as a more objective and less objectionable population descriptor than race or ethnicity. Perhaps reflecting this, usage of the term "ancestry" is rapidly growing in genetics research, with ancestry groups referenced in many situations. The appropriate usage of population descriptors in genetics research is an ongoing source of debate. Sound normative guidance should rest on an empirical understanding of current usage; in the case of ancestry, questions about how researchers use the concept, and what they mean by it, remain unanswered. Methods: Systematic literature analysis of 205 articles at least tangentially related to human health from diverse disciplines that use the concept of ancestry, and semi-structured interviews with 44 lead authors of some of those articles. Results: Ancestry is relied on to structure research questions and key methodological approaches. Yet researchers struggle to define it, and/or offer diverse definitions. For some ancestry is a genetic concept, but for many-including geneticists-ancestry is only tangentially related to genetics. For some interviewees, ancestry is explicitly equated to ethnicity; for others it is explicitly distanced from it. Ancestry is operationalized using multiple data types (including genetic variation and self-reported identities), though for a large fraction of articles (26%) it is impossible to tell which data types were used. Across the literature and interviews there is no consistent understanding of how ancestry relates to genetic concepts (including genetic ancestry and population structure), nor how these genetic concepts relate to each other. Beyond this conceptual confusion, practices related to summarizing patterns of genetic variation often rest on uninterrogated conventions. Continental labels are by far the most common type of label applied to ancestry groups. We observed many instances of slippage between reference to ancestry groups and racial groups. Conclusion: Ancestry is in practice a highly ambiguous concept, and far from an objective counterpart to race or ethnicity. It is not uniquely a "biological" construct, and it does not represent a "safe haven" for researchers seeking to avoid evoking race or ethnicity in their work. Distinguishing genetic ancestry from ancestry more broadly will be a necessary part of providing conceptual clarity.

Artificial aeration of an overloaded constructed wetland improves hypoxia but does not ameliorate high nitrogen loads.

High organic loadings to constructed wetlands can result in water quality issues such as low dissolved oxygen and high ammonium concentrations, with artificial aeration a potential mitigation option. This study compared baseline (no aeration - NA), continuous aeration (CA), and intermittent aeration (IA) conditions to improve water quality in a tertiary treatment free water surface constructed wetland (FWS CW) with night time hypoxia/anoxia, and high nutrient concentrations. The response variables included dissolved oxygen (DO), total nitrogen (TN), ammonium nitrogen (NH4+-N), nitrate nitrogen (NO3--N), total phosphorus (TP), phosphate (PO43--P), and dissolved organic carbon (DOC). In situ aeration and monitoring was performed from April to June 2021 in a large, field-scale FWS CW, the Laratinga wetlands Mount Barker, South Australia. The results demonstrated that DO increased by an average 2.11 mg L-1 from NA to CA during the night and 1.26 mg L-1 and 1.84 mg L-1 from NA to IA during the night and day respectively when averaging over the basins. The C/N ratio was very low and there was no significant influence of DO on DOC concentrations. There was no significant difference in TN concentrations with the application of aeration aside from a decrease in the channel at night from NA to IA, and an increase in NH4+-N resulted under IA compared with NA in Basin 1 and 2 during the day. This implies that the N loadings exceeded the wetland's ability to complete nutrient conversions at a rate that aligns with input rate. The concentrations of NO3--N increased at night under CA and IA treatments suggesting that some nitrification was promoted, or there was inhibition of dissimilatory nitrate reduction to ammonium. The concentrations of TP and PO43--P significantly increased with the aeration compared with no aeration, however there was no difference between the aeration treatments. This suggested that increased sediment resuspension during aeration increased P in the water. There was no change in DOC with the application of aeration. Overall, the DO increased with aeration application and may be able to better support the wetland ecology; however, the Laratinga wetland is overloaded and the capacity of the wetland to effectively transform and remove nutrients is inhibited, even with the application of artificial aeration.

Detection of human adenovirus F41 in wastewater and its relationship to clinical cases of acute hepatitis of unknown aetiology.

As of 8 July 2022, the World Health Organization (WHO) have reported 1010 probable cases of acute hepatitis of unknown aetiology in children worldwide, including approximately 250 cases in the United Kingdom (UK). Clinical presentations have often been severe, with liver transplantation a frequent clinical outcome. Human adenovirus F41 (HAdV-F41) has been detected in most children with acute hepatitis, but its role in the pathogenesis of this infection has yet to be established. Wastewater-based epidemiology (WBE) has become a well-established tool for monitoring the community spread of SARS-CoV-2, as well as other pathogens and chemicals. In this study, we adopted a WBE approach to monitoring levels of HAdV-F40/41 in wastewater before and during an acute hepatitis outbreak in Northern Ireland. We report increasing detection of HAdV-F40/41 in wastewater, concomitant with increasing numbers of clinical cases. Amplicon whole genome sequencing further classified the wastewater-derived HAdV as belonging to the F41 genotype which in turn was homologous to clinically derived sequences. We propose that WBE has the potential to inform community surveillance of HAdV-F41 and can further contribute to the ongoing global discussion supporting HAdV-F41 involvement in acute hepatitis cases.

A scoping review of guidelines for the use of race, ethnicity, and ancestry reveals widespread consensus but also points of ongoing disagreement.

The use of population descriptors such as race, ethnicity, and ancestry in science, medicine, and public health has a long, complicated, and at times dark history, particularly for genetics, given the field's perceived importance for understanding between-group differences. The historical and potential harms that come with irresponsible use of these categories suggests a clear need for definitive guidance about when and how they can be used appropriately. However, while many prior authors have provided such guidance, no established consensus exists, and the extant literature has not been examined for implied consensus and sources of disagreement. Here, we present the results of a scoping review of published normative recommendations regarding the use of population categories, particularly in genetics research. Following PRISMA guidelines, we extracted recommendations from n = 121 articles matching inclusion criteria. Articles were published consistently throughout the time period examined and in a broad range of journals, demonstrating an ongoing and interdisciplinary perceived need for guidance. Examined recommendations fall under one of eight themes identified during analysis. Seven are characterized by broad agreement across articles; one, "appropriate definitions of population categories and contexts for use," revealed substantial fundamental disagreement among articles. Additionally, while many articles focus on the inappropriate use of race, none fundamentally problematize ancestry. This work can be a resource to researchers looking for normative guidance on the use of population descriptors and can orient authors of future guidelines to this complex field, thereby contributing to the development of more effective future guidelines for genetics research.

Characterization of Bacteria Using Surface-Enhanced Raman Spectroscopy (SERS): Influence of Microbiological Factors on the SERS Spectra.

SERS is currently being explored as a rapid method for identification of bacteria but variation in the experimental procedures has resulted in considerable variation in the spectra reported for a range of bacterial species. Here, we show that mixing bacteria with a conventional citrate-reduced silver colloid (CRSC) and drying the resulting suspension yield highly reproducible spectra. These signals were due to intracellular components released when the structure of the bacteria was disrupted during sample preparation. This reproducibility allowed us to examine the effects of variables that do not arise in SERS of simple solutions but are relevant in studies of bacteria. These included growth phase and biological variation, which occurred when the same bacterial isolates were cultured under nominally identical conditions on different days. It was found that even under optimal standardized conditions the effect of differences in experimental parameters such as growth phase was very large in some bacterial species but insignificant in others. This suggests that it is important to avoid drawing general conclusions about bacterial SERS based on studies using small numbers of samples. Similarly, discrimination between bacterial species was straightforward when a small number of isolates with distinct spectral features were investigated; however, this became more challenging when more bacterial species were included, as this increased the possibility of finding different species of bacteria with similar spectra. These observations are important because they clearly delineate the challenges that will need to be addressed if SERS is to be used for clinical applications.

Getting genetic ancestry right for science and society.

We must embrace a multidimensional, continuous view of ancestry and move away from continental ancestry categories.

Long-term water quality response to increased hydraulic loadings in a field-scale free water surface constructed wetland treating domestic effluent.

There is limited understanding of how constructed wetland (CW) water quality may change over time in response to increased wastewater nutrient and hydraulic loadings. We evaluated long-term water quality trends and drivers for a full-scale (8.19 ha) free water surface CW that was developed in 2001 for the treatment of increasing amounts of pre-treated domestic wastewater from the township of Mount Barker, South Australia. Water quality parameter concentrations and loads, hydraulic loadings rates, trend direction assessments (TDAs), and water quality parameter removal efficiencies were analysed over the study period. The wetland received an annual average loading rate of 947, 19644, 31039, 18140, 2985, and 807 kg year-1 for BOD5, TN, NH4-N, TKN-N, NOx-N, and TP respectively and removed on average 8%, 72%, 73%, 78%, 12% and -246% of these loadings respectively. The average influent concentrations for the study period were 2.6, 42.3, 40.6, 35.9, 9.0, and 1.9 mg L-1 for BOD5, TN, NH4-N, TKN-N, NOx-N, and TP respectively. Average concentration removal rates over the study period were 50%, 39%, 40%, 15%, -216% and -600.5% for TN, NH4-N, TKN-N, NOx-N, BOD5 and TP respectively, suggesting that nitrogen was only partly assimilated by the wetland and it was a source of organic material and phosphorus. Using seasonally and inflow rate adjusted data, TDAs predicted virtually certain increases in TN, NH4-N, and TKN-N influent concentrations over time, a decline in NOx-N, no trend in BOD5, and a possible decreasing trend in TP. The inflow explained variance accounted for approximately 50% of the variation in TN, NH4-N and TKN-N effluent concentrations. Annual removal efficiencies of N declined with increasing hydraulic loads, and hydraulic loading rates varied with management practices. Seasonal analysis showed that N removal was greater during summer and lower in winter. Due to local population growth and various management practices, hydraulic loading is variable and has often exceeded design targets. Our findings indicate the long-term performance of CWs need to be closely monitored, as water quality can deteriorate due to increased hydraulic loadings.

Just One More.

A nurse gently sets the stage for an impossible goodbye.

Resin Infiltration Therapy: A micro-invasive treatment approach for white spot lesions.

Purpose: The demand for esthetic dentistry has led to the development of new treatments for white spot lesions (WSLs). Microinvasive therapies, such as resin infiltration, have been used to treat demineralized enamel. Recently, resin infiltration using the active ingredient triethylene glycol dimethacrylate (TEGDMA), has been used to restore WSLs. The purpose of this narrative review is to evaluate the evidence on TEGDMA, an innovative resin that has been introduced, as an alternative dental material for treating WSLs.Methods: A review of the literature was conducted using key words pertaining to WSLs and resin infiltration including cosmetic dentistry; dental caries; dental materials; general dentistry; sealants; technology for patient care. Evidence was incorporated from biomedical data bases including PubMed and the Cochrane Library, which formed the framework for the review.Results: Based on the synthesis of the evidence, resin infiltration using TEGDMA is an effective alternative treatment option for WSLs. Studies suggest that the outcomes for micro-invasive procedures using resin infiltration may vary depending on the depth of the lesion.Conclusion: Resin infiltration, using TEGDMA, removes minimal amounts of enamel and preserves the hard tissue surrounding the WSLs. Additionally, TEGDMA restores the natural fluorescence, hardness, and texture of intact enamel. Future studies are needed to assess the long-term clinical effects of resin infiltration using this material on both permanent and primary dentition.

Toward the development of a color visual prosthesis.

Objective. All of the human prosthetic visual systems implanted so far have been achromatic. Schmidtet al(1996Brain119507-22) reported that at low stimulation intensities their subject reported that phosphenes usually had a specific hue, but when the stimulus intensity was increased, they desaturated to white. We speculate here that previous B/W prosthetic systems were unnecessarily over-stimulating the visual cortex to obtain white phosphenes, which may be why unexpected alterations in phosphenes and seizures were not an uncommon occurrence. A color prosthesis would have the advantage of being elicited by lower levels of stimulation, reducing the probability of causing epileptogenic responses.Approach.A 'hybrid' mode of stimulation is suggested, involving a combination of B/W and color stimulation, which could provide color information without reducing spatial resolution.Main results.Colors in the real world are spread along intensity and chromatic gradients.Significance.Software implementation strategies are discussed, as are the advantages and challenges for possible color prosthetic systems.

Paternal diet programs offspring health through sperm- and seminal plasma-specific pathways in mice.

The association between poor paternal diet, perturbed embryonic development, and adult offspring ill health represents a new focus for the Developmental Origins of Health and Disease hypothesis. However, our understanding of the underlying mechanisms remains ill-defined. We have developed a mouse paternal low-protein diet (LPD) model to determine its impact on semen quality, maternal uterine physiology, and adult offspring health. We observed that sperm from LPD-fed male mice displayed global hypomethylation associated with reduced testicular expression of DNA methylation and folate-cycle regulators compared with normal protein diet (NPD) fed males. Furthermore, females mated with LPD males display blunted preimplantation uterine immunological, cell signaling, and vascular remodeling responses compared to controls. These data indicate paternal diet impacts on offspring health through both sperm genomic (epigenetic) and seminal plasma (maternal uterine environment) mechanisms. Extending our model, we defined sperm- and seminal plasma-specific effects on offspring health by combining artificial insemination with vasectomized male mating of dietary-manipulated males. All offspring derived from LPD sperm and/or seminal plasma became heavier with increased adiposity, glucose intolerance, perturbed hepatic gene expression symptomatic of nonalcoholic fatty liver disease, and altered gut bacterial profiles. These data provide insight into programming mechanisms linking poor paternal diet with semen quality and offspring health.

The Squeeze.

Why is the experience of violence a commonality in nursing?

Improving Nurse-Physician Teamwork: A Multidisciplinary Collaboration.

Nurses surveyed on an inpatient gynecology surgical unit suggested communication and teamwork between nurses and physicians could be improved. To enhance teamwork, a multidisciplinary collaboration committee of nurses and physicians was created.

Nurses as Champions for Patient Safety and Interdisciplinary Problem Solving.

Nurses on an inpatient surgical unit were apprehensive in activating the Rapid Response Team (RRT). Nurse-led interdisciplinary solutions addressed perceived barriers and led to open communication and issue resolution with physician colleagues.