Characterization of Neutropenia in Preterm Neonates Following Administration of Darbepoetin Alfa.

OBJECTIVE: This study is to evaluate the effects of darbepoetin alfa (darbe) on neutrophil count in preterm neonates treated for anemia of prematurity. METHODS: This was a retrospective chart review comparing the absolute neutrophil counts (ANCs) of neonates administered 2 doses of subcutaneous darbe 10 mcg/kg to that of a randomly selected comparator group of neonates not administered the drug. Neonates <34 weeks gestational age, gestational age between 23w1d and 33w4d, born between July 2016 and June 2019, were included in the study. RESULTS: The ANCs of 45 darbe-treated neonates compared with those of 45 randomly selected comparator control neonates revealed no difference in the rate of occurrence of neutropenia (ANC ≤1000/µL) between the darbe-treated neonates (26.7%) and comparator neonates (24.4%) (p > 0.99). There was also no difference in the rate of occurrence of severe neutropenia (ANC ≤500/µL) between the darbe-treated neonates (11.1%) and comparator neonates (6.7%) (p = 0.70). Darbepoetin alfa did not lead to differences in rates of resolution of neutropenia or severe neutropenia. CONCLUSIONS: Short-term administration of darbe did not affect the ANCs of preterm neonates treated for anemia of prematurity. There was no difference in the rates of occurrence of neutropenia, severe neutropenia, or resolution of either between the darbe-treated neonates and comparator neonates.

Scrambling For Safety In The Eye Of Dorian: Mental Health Consequences Of Exposure To A Climate-Driven Hurricane.

As climate change alters the behavior of Atlantic hurricanes, these storms are trending stronger, wetter, and slower moving over coastal and island populations. Hurricane Dorian exemplified all three attributes. Dorian's destructive passage over the Abaco Islands, Bahamas, on September 1, 2019, exposed residents of its capital, Marsh Harbour, to a prolonged encounter with the storm's core. After Dorian's fierce front eyewall and towering storm surge tore apart shanty town habitats and eviscerated concrete homesites, residents desperately sought refuge during the brief respite when Dorian's eye passed directly overhead. The category 5 winds then resumed abruptly and Dorian continued its relentless destruction. This article focuses on the storm's mental health consequences, drawing on observations of on-site clinicians as well as findings from previous research on the mental health effects of Atlantic hurricanes and the transformation of hurricane hazards resulting from climate change. To protect island and coastal populations against climate-driven storms, disaster planning policy should emphasize resilience-focused prevention and mitigation strategies. In the aftermath of these events, health system response should include community outreach, case finding, and evidence-based interventions that optimize the use of mental health professionals.

Quantifying stream periphyton assemblage responses to nutrient amendments with a molecular approach.

Nutrient (nitrogen [N] and phosphorus [P]) pollution is a pervasive water quality issue in the USA for small streams and rivers. The effect of nutrients on the biotic condition of streams is often evaluated with biological indicators such as macroinvertebrate assemblages or periphyton assemblages, particularly diatoms. Molecular approaches facilitate the use of periphyton assemblages as bioindicators because periphyton is diverse and its composition as a whole, rather than just diatoms, soft-bodied algae, or any single group, may convey additional information about responses to nutrients. To further develop the concept that a taxonomically-broad evaluation of periphyton assemblages could be useful for developing stream bioindicators, we examined microbial assemblage composition with both 16S and 18S rRNA genes, enabling us to evaluate composition in 3 domains. We measured otherwise unknown nutrient responses of different periphyton groups in situ with experiments that used glass fiber filters to allow diffusion of amended nutrients into a stream. We deployed these experimental setups in 2 streams that differ in the extent of agricultural land-use in their catchments in the southeastern USA. Experiments consisted of controls, N amendments, P amendments, and both N and P amendments. Periphyton assemblages that grew on the filters differed significantly by stream, date or season, and nutrient treatment. Assemblage differences across treatments were more consistent among Bacteria and Archaea than among eukaryotes. Effects of nutrient amendments were more pronounced in the stream with less agricultural land use and, therefore, lower nutrient loading than in the stream with more agricultural land use and higher nutrient loading. Combined N and P amendments decreased species richness and evenness for Bacteria and Archaea by ∼36 and ∼9%, respectively, compared with controls. Indicator species analysis revealed that specific clades varied in their response to treatments. Indicators based on the responses of these indicator clades were related to nutrient treatments across sites and seasons. Analyses that included all the taxa in a domain did not resolve differences in responses to N vs P. Instead, better resolution was achieved with an analysis focused on diatoms, which responded more strongly to P than N. Overall, our results showed that in situ nutrient-diffusing substrate experiments are a useful approach for describing assemblage responses to nutrients in streams. This type of molecular approach may be useful to environmental agencies and stakeholders responsible for assessing and managing stream water quality and biotic condition.

Linking Water Quality to Aedes aegypti and Zika in Flood-Prone Neighborhoods.

The ability of ecosystems to regulate water quality and flood events has been linked to health outcomes, including mosquito-borne illnesses. In the San Juan Bay Estuary watershed of Puerto Rico, habitat alterations and land-use development have disrupted watershed hydrology, exacerbating wastewater discharges and subjecting some neighborhoods to frequent flooding events. In 2016, the mosquito-borne illness Zika became a new cause for concern. We hypothesized that nutrient-enriched flood water could provide pulses of supplemental nutrients to local mosquito populations. We conducted a field study in six neighborhoods adjacent to the estuary to assess whether environmental variability of nutrient inputs could be linked to breeding habitat containers, Aedes aegypti larvae and adults, and the acquisition of Zika virus by adult mosquitoes. The most frequently flooded neighborhood had consistently higher levels of nitrogen in estuary water, leaf detritus, containers, and adult mosquitoes compared to other neighborhoods. Adult body nitrogen was significantly related to both nitrogen content of containers and leaf detritus from the local trapping area. Disseminated Zika concentration in adult Ae. aegypti tended to decrease as body carbon and nitrogen increased. Our study provides preliminary evidence that environmental variability in nutrient inputs can influence viral acquisition by mosquito vectors. This suggests that management actions to reduce flooding and improve water quality should go hand-in-hand with more traditional vector control methods, such as aerial spraying, to help control spread of vector-borne diseases.

Genomic sequences of two novel levivirus single-stranded RNA coliphages (family Leviviridae): evidence for recombinationin environmental strains.

Bacteriophages are likely the most abundant entities in the aquatic environment, yet knowledge of their ecology is limited. During a fecal source-tracking study, two genetically novel Leviviridae strains were discovered. Although the novel strains were isolated from coastal waters 1130 km apart (North Carolina and Rhode Island, USA), these strains shared 97% nucleotide similarity and 97-100% amino acid similarity. When the novel strains were compared to nine Levivirus genogroup I strains, they shared 95-100% similarity among the maturation, capsid and lysis proteins, but only 84-85% in the RNA-dependent RNA polymerase gene. Further bioinformatic analyses suggested a recombination event occurred. To the best of our knowledge, this is the first description of viral recombinants in environmental Leviviridae ssRNA bacteriophages.

Design and assessment of a real time reverse transcription-PCR method to genotype single-stranded RNA male-specific coliphages (Family Leviviridae).

A real-time, reverse transcription-PCR (RT-qPCR) assay was developed to differentiate the four genogroups of male-specific ssRNA coliphages (FRNA) (family Leviviridae). As FRNA display a trend of source-specificity (human sewage or animal waste) at the genogroup level, this assay provides a tool to help identify the origin of fecal contamination. Primers and probes were designed using complete genomic sequences from 29 FRNA phages. The final selection of primer/probe sets were based on (i) ability to amplify a single, specific product, (ii) genogroup specificity, (iii) lack of cross-reactivity, and (iv) experimental reproducibility and sensitivity over a range of target concentrations. Assay time was reduced by using heat-released viral RNA rather than purified RNA. For quality assurance, a custom RNA molecule was employed as an internal, non-competitive control. The usefulness of this method to identify sources of fecal contamination was tested on a total of 49 FRNA phages isolated from various warm-blooded animals, sewage and combined sewage overflow. FRNA phages from animal wastes were genotyped as 86% I, 4% III Q-like and 9% IV. Two sewage isolates typed to genogroup I and combined sewage overflow isolates genotyped as 40% II and 52% III. Primer specificity designed from this comprehensive sequence database may better discriminate FRNA from different sources.

Gene mapping and phylogenetic analysis of the complete genome from 30 single-stranded RNA male-specific coliphages (family Leviviridae).

Male-specific single-stranded RNA (FRNA) coliphages belong to the family Leviviridae. They are classified into two genera (Levivirus and Allolevivirus), which can be subdivided into four genogroups (genogroups I and II in Levivirus and genogroups III and IV in Allolevivirus). Relatively few strains have been completely characterized, and hence, a detailed knowledge of this virus family is lacking. In this study, we sequenced and characterized the complete genomes of 19 FRNA strains (10 Levivirus strains and 9 Allolevivirus strains) and compared them to the 11 complete genome sequences available in GenBank. Nucleotide similarities among strains of Levivirus genogroups I and II were 75% to 99% and 83 to 94%, respectively, whereas similarities among strains of Allolevivirus genogroups III and IV ranged from 70 to 96% and 75 to 95%, respectively. Although genogroup I strain fr and genogroup III strains MX1 and M11 share only 70 to 78% sequence identity with strains in their respective genogroups, phylogenetic analyses of the complete genome and the individual genes suggest that strain fr should be grouped in Levivirus genogroup I and that the MX1 and M11 strains belong in Allolevivirus genogroup III. Strains within each genus share >50% sequence identity, whereas between the two genera, strains have <40% nucleotide sequence identity. Overall, amino acid composition, nucleotide similarities, and replicase catalytic domain location contributed to phylogenetic assignments. A conserved eight-nucleotide signature at the 3' end of the genome distinguishes leviviruses (5' ACCACCCA 3') from alloleviviruses (5' TCCTCCCA 3').

A reverse transcription-PCR assay to distinguish the four genogroups of male-specific (F+) RNA coliphages.

Goals of reducing fecal contamination in recreational, drinking, shellfishing and other waters and accurately assessing risk from exposure can best be attained if tools to distinguish between sources of pollution are available. The male-specific RNA coliphage (FRNA) genogroups display a trend of source specificity. Reverse transcription-PCR (RT-PCR) can be effectively used for genotyping if specific primer sets are designed to be capable of identifying all members within each genogroup. In this study genogroup-specific primer sets were designed using a minimum of 5 to a maximum of 10 complete phage genome sequences from strains in each genogroup. With these primers and employing a heat-release procedure that eliminated the need for RNA purification an RT-PCR method for genotype identification of FRNA phages was developed. The four genogroup-specific primer sets generated discrete PCR amplicon sizes from a variety of environmental FRNA phage strains. Limits of detection, cross-reactivity and/or non-specific binding to strains from other genogroups were evaluated.

Use of composite data sets for source-tracking enterococci in the water column and shoreline interstitial waters on Pensacola Beach, Florida.

Sources of Enterococcus faecalis isolates from Pensacola Beach, FL. were identified using a library-based approach by applying the statistical method of average similarity to single and composite data sets generated from separate analyses. Data sets included antibiotic resistance analysis (ARA), rep-fingerprints, and fatty acid methyl ester (FAME) profiles. Use of a composite data set composed of ARA and rep-fingerprints, added to the confidence of the identifications. The addition of FAME data to composite data sets did not add to the confidence of identifications. Source identification was performed to better understand risk associated with higher densities of enterococci found in swash zone interstitial water (SZIW) as compared to adjacent bathing water on Pensacola Beach, FL. The "swash zone" is that area of the beach continually washed over by waves. As the potential sources of enterococci were limited in this environment, only two library units, sea gull and human, were constructed. Identification of the beach isolates using a composite data set indicated a sea gull origin. The clonality of the beach isolates suggested that the beach environment selects certain subspecies of E. faecalis.

Inhibition of airway remodeling in IL-5-deficient mice.

To determine the role of IL-5 in airway remodeling, IL-5-deficient and WT mice were sensitized to OVA and challenged by repetitive administration of OVA for 3 months. IL-5-deficient mice had significantly less peribronchial fibrosis (total lung collagen content, peribronchial collagens III and V) and significantly less peribronchial smooth muscle (thickness of peribronchial smooth muscle layer, alpha-smooth muscle actin immunostaining) compared with WT mice challenged with OVA. WT mice had a significant increase in the number of peribronchial cells staining positive for major basic protein and TGF-beta. In contrast, IL-5-deficient mice had a significant reduction in the number of peribronchial cells staining positive for major basic protein, which was paralleled by a similar reduction in the number of cells staining positive for TGF-beta, suggesting that eosinophils are a significant source of TGF-beta in the remodeled airway. OVA challenge induced significantly higher levels of airway epithelial alphaVbeta6 integrin expression, as well as significantly higher levels of bioactive lung TGF-beta in WT compared with IL-5-deficient mice. Increased airway epithelial expression of alphaVbeta6 integrin may contribute to the increased activation of latent TGF-beta. These results suggest an important role for IL-5, eosinophils, alphaVbeta6, and TGF-beta in airway remodeling.

A New Look at Performance on Theory-of-Mind Tasks by Adolescents With Autism Spectrum Disorder.

PURPOSE: A hallmark of autistic spectrum disorder (ASD) is disruption in theory-of-mind development, including the understanding of false beliefs. Previous studies have typically assessed the development of first- and second-order false belief concepts in ASD, with tasks primarily emphasizing physical causality and logical inferencing. The present study investigated how preadolescents and adolescents with ASD performed on false belief tasks that included social inferencing of psychological states as well as logical inferencing of physical states. METHOD: Two categories of tasks were administered: four traditional logical inferencing tasks and four social inferencing tasks specifically developed for this study. In addition, a prompt hierarchy was included to ascertain if performance on both task types improved. Participants were 45 children and adolescents primarily selected from three urban school districts: 15 adolescents with a previous diagnosis of ASD (ASD group); 15 typically developing children matched for age, gender, and ethnicity (CA group); and 15 typically developing children matched for language age, gender, and ethnicity (LA group). RESULTS: Three findings were pertinent. First, the CA group performed at higher levels than did the LA group and the ASD group on both task sets. Second, although the CA and the LA groups performed equally well on both the logical and the social inferencing tasks, the ASD group performed better on the social inferencing tasks. Finally, the prompt hierarchy significantly improved overall task performance for the ASD and LA groups. CLINICAL IMPLICATIONS: These findings indicate that task type, variations in vocabulary ability, and the provision of support influenced performance on the false belief tasks.

Vitellogenin mRNA regulation and plasma clearance in male sheepshead minnows, (Cyprinodon variegatus) after cessation of exposure to 17 beta-estradiol and p-nonylphenol.

Research was conducted to determine the kinetics of hepatic vitellogenin (VTG) mRNA regulation and plasma VTG accumulation and clearance in male sheepshead minnows (Cyprinodon variegatus) during and after cessation of exposure to either 17 beta-estradiol (E2) or para-nonylphenol (NP). Adult fish were continuously exposed to aqueous measured concentrations of 0.089 and 0.71 microg E2 per l, and 5.6 and 59.6 microg NP per l for 16 days using an intermittent flow-through dosing apparatus. Fish were sampled on days 8 and 16 of exposure followed by sampling at discrete intervals for up to 96 days post-exposure. At each interval five fish were randomly sampled from each concentration and hepatic VTG mRNA and serum VTG levels for individual fish determined by slot blot and direct enzyme-linked immunosorbent assay (ELISA), respectively. Exposure to E2 and NP resulted in a dose dependent increase in hepatic VTG mRNA and plasma VTG over the course of the 16-day exposure period. Mean plasma VTG levels at day 16 were >100 mg/ml for both high doses of E2 and NP, and >20 mg/ml for the low exposure treatments. Within 8 days post-exposure, hepatic VTG mRNA levels returned to baseline in both high and low E2 treatments but remained elevated 2-4 fold in the NP treatments. Due to a shortened sampling period, a clearance rate for plasma VTG in the 5.6 microg NP per l treatment could not determined. In the 0.089, 0.71 microg E2 per l, and 59.6 microg NP per l treatments, VTG levels began decreasing within 4 days after exposure cessation and exhibited an exponential rate of elimination from plasma. Clearance rates for 0.71 microg E2 per l and 59.6 microg NP per l were not significantly different (P=0.47), however, both demonstrated significantly higher rates of clearance (P<0.02) than observed in the 0.089 microg E2 per l treatment. Our results indicate that hepatic VTG mRNA rapidly diminishes after cessation of estrogenic exposure in sheepshead minnows, but plasma VTG clearance is concentration and time dependent and may be detected at measurable levels for months after initial exposure to an estrogenic compound.