Non-avian theropod phalanges from the marine Fox Hills Formation (Maastrichtian), western South Dakota, USA.

We report here the first dinosaur skeletal material described from the marine Fox Hills Formation (Maastrichtian) of western South Dakota. The find consists of two theropod pedal phalanges: one recovered from the middle part of the Fairpoint Member in Meade County, South Dakota; and the other from the Iron Lightning Member in Ziebach County, South Dakota. Comparison with pedal phalanges of other theropods suggests strongly that the Fairpoint specimen is a right pedal phalanx, possibly III-2, from a large ornithomimid. The Iron Lightning specimen we cautiously identify as an ornithomimid left pedal phalanx II-2. The Fairpoint bone comes from thinly bedded and cross-bedded marine sandstones containing large hematitic concretions and concretionary horizons. Associated fossils include osteichthyan teeth, fin spines and otoliths, and abundant teeth of common Cretaceous nearshore and pelagic chondrichthyans. Leaf impressions and other plant debris, blocks of fossilized wood, and Ophiomorpha burrows are also common. The Iron Lightning bone comes from a channel deposit composed of fine to coarse sandstone beds, some of which contain bivalves, and a disseminated assemblage of mammal teeth, chondrichthyan teeth, and fragmentary dinosaur teeth and claws. We interpret the depositional environment of the two specimens as marginal marine. The Fairpoint bone derives from a nearshore foreset setting, above wave base subject to tidal flux and storm activity. The Iron Lightning specimen comes from a topset channel infill probably related to deposition on a tidal flat or associated coastal setting. The taphonomic history and ages of the two bones differ. Orthogonal cracks in the cortical bone of the Fairpoint specimen suggest post-mortem desiccation in a dryland coastal setting prior to transport and preservation in the nearby nearshore setting described above. The pristine surface of the Iron Lightning specimen indicates little transport before incorporation into the channel deposit in which it was found. The Fairpoint bone bed most probably lies within the Hoploscaphites nicolletii Ammonite Zone of the early late Maastrichtian, and would therefore have an approximate age of 69 Ma. The Iron Lightning bone is from the overlying H. nebrascensis Ammonite Zone, and is thus about one million years younger.

2020 taxonomic update for phylum Negarnaviricota (Riboviria: Orthornavirae), including the large orders Bunyavirales and Mononegavirales.

In March 2020, following the annual International Committee on Taxonomy of Viruses (ICTV) ratification vote on newly proposed taxa, the phylum Negarnaviricota was amended and emended. At the genus rank, 20 new genera were added, two were deleted, one was moved, and three were renamed. At the species rank, 160 species were added, four were deleted, ten were moved and renamed, and 30 species were renamed. This article presents the updated taxonomy of Negarnaviricota as now accepted by the ICTV.

Characterization and applications of a Crimean-Congo hemorrhagic fever virus nucleoprotein-specific Affimer: Inhibitory effects in viral replication and development of colorimetric diagnostic tests.

Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV) is one of the most widespread medically important arboviruses, causing human infections that result in mortality rates of up to 60%. We describe the selection of a high-affinity small protein (Affimer-NP) that binds specifically to the nucleoprotein (NP) of CCHFV. We demonstrate the interference of Affimer-NP in the RNA-binding function of CCHFV NP using fluorescence anisotropy, and its inhibitory effects on CCHFV gene expression in mammalian cells using a mini-genome system. Solution of the crystallographic structure of the complex formed by these two molecules at 2.84 Å resolution revealed the structural basis for this interference, with the Affimer-NP binding site positioned at the critical NP oligomerization interface. Finally, we validate the in vitro application of Affimer-NP for the development of enzyme-linked immunosorbent and lateral flow assays, presenting the first published point-of-care format test able to detect recombinant CCHFV NP in spiked human and animal sera.

Detection of new endemic focus of tick-borne encephalitis virus (TBEV), Hampshire/Dorset border, England, September 2019.

The presence of tick-borne encephalitis virus (TBEV) was detected in a questing tick pool in southern England in September 2019. Hitherto, TBEV had only been detected in a limited area in eastern England. This southern English viral genome sequence is distinct from TBEV-UK, being most similar to TBEV-NL. The new location of TBEV presence highlights that the diagnosis of tick-borne encephalitis should be considered in encephalitic patients in areas of the United Kingdom outside eastern England.

Hyalomma rufipes on an untraveled horse: Is this the first evidence of Hyalomma nymphs successfully moulting in the United Kingdom?

During September 2018, a tick was submitted to Public Health England's Tick Surveillance Scheme for identification. The tick was sent from a veterinarian who removed it from a horse in Dorset, England, with no history of overseas travel. The tick was identified as a male Hyalomma rufipes using morphological and molecular methods and then tested for a range of tick-borne pathogens including; Alkhurma virus, Anaplasma, Babesia, Bhanja virus, Crimean-Congo Haemorrhagic fever virus, Rickettsia and Theileria. The tick tested positive for Rickettsia aeschlimannii, a spotted fever group rickettsia linked to a number of human cases in Africa and Europe. This is the first time H. rufipes has been reported in the United Kingdom (UK), and the lack of travel by the horse (or any in-contact horses) suggests that this could also be the first evidence of successful moulting of a Hyalomma nymph in the UK. It is postulated that the tick was imported into the UK on a migratory bird as an engorged nymph which was able to complete its moult to the adult stage and find a host. This highlights that passive tick surveillance remains an important method for the detection of unusual species that may present a threat to public health in the UK. Horses are important hosts of Hyalomma sp. adults in their native range, therefore, further surveillance studies should be conducted to check horses for ticks in the months following spring bird migration; when imported nymphs may have had time to drop off their avian host and moult to adults. The potential human and animal health risks of such events occurring more regularly are discussed.

Xapuri virus, a novel mammarenavirus: natural reassortment and increased diversity between New World viruses.

Mammarenavirus RNA was detected in Musser's bristly mouse (Neacomys musseri) from the Amazon region, and this detection indicated that rodents were infected with a novel mammarenavirus, with the proposed name Xapuri virus (XAPV), which is phylogenetically related to New World Clade B and Clade C viruses. XAPV may represent the first natural reassortment of the Arenaviridae family and a new unrecognized clade within the Tacaribe serocomplex group.

The Development of a Novel Diagnostic Assay That Utilizes a Pseudotyped Vesicular Stomatitis Virus for the Detection of Neutralizing Activity against Crimean-Congo Hemorrhagic Fever Virus.

Crimean-Congo hemorrhagic fever virus is a risk group 4 pathogen, which mandates the use of maximum containment facilities, often termed biosafety level 4 or containment level 4 when working with infectious materials. Diagnostic and research work involving live viruses in such laboratories is time-consuming and inconvenient, resulting in delays. Herein, we show that serum neutralizing activity against the virus can be measured in low-containment laboratories using a pseudotyped virus.

Treatment of a Mandibular Glandular Odontogenic Cyst with Peripheral Ostectomy, Bone Allograft, and Implant Reconstruction: A Case Report.

This article reports on a case of a glandular odontogenic cyst (GOC) in the posterior mandible of a 25-year-old male treated with peripheral ostectomy, bone allograft, and an implant-supported fixed dental prosthesis. During a routine 3-month postoperative visit, a radiograph suggested vertical bone loss on the implant in the location of the mandibular right first molar. The three-walled defect was surgically treated with debridement, bone allograft, and a membrane. Healing of this site has been uneventful. This case report demonstrates that implants can be successfully placed and restored in previously affected GOC sites.

Malpractice, Criminality, and Medical Regulation: Reforming the Role of the GMC in Fitness to Practise Panels.

A recent Law Commission Review emphasised that medical fitness to practise panels (also called medical practitioners tribunals) are an important legal mechanism for ensuring that public trust in medical regulation is maintained when a complaint is made against a doctor. This article examines trends over time in panel outcomes to identify their effectiveness in ensuring public protection. Although a rise in complaints, and a change from the criminal to civil standard of proof, has not led to more doctors being struck off the medical register, increasingly action is being taken to provide advice, issue warnings, and agree rehabilitative forms of action with doctors. It is argued that these trends are congruent with the broader adoption of a risk-based approach to professional regulation. Legal reforms to maintain public trust must ensure that the shift towards risk-averse forms of professional accountability do not sacrifice public safety and due process for the sake of political pragmatic exigency.

Function of calcium phosphate renal concrements in extant Nautilus: a paradigm for Cambrian-relict short-term mineral reserve equivalent to vertebrate bone.

Renal uroliths (concrements) of calcium phosphate have long been known to exist in both growing and mature (non-growing) Nautilus specimens, but to date no evidence-based explanation for their existence has been available. The currently favored speculation is that they function as a calcium reserve for shell and septal calcification. Here we present new observational and experimental data that are consistent with the hypothesis that they serve as a mineral/ion reserve, allowing short-term (<1 day) addition of ionized calcium and phosphorus to blood and other body fluids, in a way analogous to that of vertebrate bone. In both in-ocean experiments and during long-term observation of captive nautiluses, concrements disappear during two different, energy-intensive activities involving removal of anions and cations from newly secreted cameral liquid in the chamber formation cycle, and during dives to depths requiring high osmotic pressures within the canaliculi of the siphuncular epithelium to keep previously emptied chambers from flooding due to suddenly increased ambient hydrostatic pressure. New concrements reappear at other points in the chamber formation cycle and when normal living depth is restored. The use of concrements as an ion reserve and the Cambrian ancestry of nautiloids indicate that Nautilus may exemplify a solution to the problem of energy supply in newly evolved swimmers of the Cambrian radiation independent of that seen in fish.

Rapid molecular detection of Lujo virus RNA.

Lujo virus is an emerging arenavirus circulating in Southern Africa. Although to date there has only been a single outbreak of the novel haemorrhagic disease resulting from human infection with this virus, the case-fatality rate of exposed individuals, including nosocomial transmission, was 80%. The ability to identify viral haemorrhagic fevers accurately, especially those capable of nosocomial transmission, is of critical importance. Timely identification of these diseases allow medical professionals to isolate patients and implement barrier nursing techniques in order to prevent onward transmission of the virus. While rapid diagnostic methods are published for most viral haemorrhagic fevers, at present there are no such virus specific protocols for Lujo haemorrhagic fever. This report details the first set of diagnostic molecular assays designed to identify Lujo viral RNA rapidly, and demonstrates the potential functionality of these assays for use in the clinical setting. Although these assays have been designed and validated against a solitary isolate of Lujo virus, this represents the entirety of strains detected to date, and offer quick, cheap and easy methods for use in diagnostic laboratories.

Identification and analysis of Crimean-Congo hemorrhagic fever virus from human sera in Tajikistan.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is a virulent tick-borne disease reported in more than 30 countries across Europe, Africa, and Asia. The disease is considered endemic in several Central Asian countries, including Tajikistan; however reports of human cases from these regions rarely reach the West. METHODS: We analyzed all historical confirmed cases of CCHF in Tajikistan, mapping these reports against geographic data to assess risk areas. In addition, comprehensive analysis was undertaken on the 2010 human CCHF cohort to demonstrate effective methodologies for diagnosing this disease in-country. RESULTS: These data show that CCHF is endemic in Tajikistan, and several large clusters have been recorded. Endemic foci of disease are localized to the southern region, with geographical factors such as altitude, monthly mean temperature, and monthly mean precipitation levels limiting establishment of tick vectors in other areas. Genomic analysis of viral RNA from a 2010 human case revealed high nucleotide homology (99%) to a strain isolated in Tajikistan in 1990. CONCLUSIONS: CCHF is an important vector-borne and nosocomial pathogen in Tajikistan. The ability to rapidly detect cases using real-time RT-PCR shortly after admission in the hospital setting allows prompt implementation of barrier nursing techniques, therefore reducing onward transmission of the virus.

Genome Sequence of Ex-Afghanistan Crimean-Congo Hemorrhagic Fever Virus SCT Strain, from an Imported United Kingdom Case in October 2012.

Crimean-Congo hemorrhagic fever (CCHF) virus is a serious human pathogen causing severe hemorrhagic disease with a fatality rate of up to approximately 30%. We have determined the viral genomic sequence from an isolate that caused a fatal case of imported CCHF in the United Kingdom in October 2012.

Development of a real-time RT-PCR assay for the detection of Crimean-Congo hemorrhagic fever virus.

Crimean-Congo hemorrhagic fever (CCHF) is a virulent tick-borne disease with a case fatality rate ranging from 10-50% for tick-borne transmission, and up to 80% for nosocomial transmission. Human cases have been reported in over 30 countries across Europe, Asia, and Africa. It appears to be spreading to new areas with several countries reporting their first human cases of CCHF disease within the past 10 years. We report a novel real-time RT-PCR assay designed to amplify a conserved region of the CCHF virus S segment. It is capable of detecting strains from all 7 groups of CCHF, including the AP92 strain that until recently represented a lineage of strains that were not associated with human disease. The limit of detection of the assay is 5 copies of target RNA, and the assay shows no cross-reactivity with other viruses from within the same genus, or with viruses causing similar human disease.

Hazara virus infection is lethal for adult type I interferon receptor-knockout mice and may act as a surrogate for infection with the human-pathogenic Crimean-Congo hemorrhagic fever virus.

Hazara virus (HAZV) is closely related to the Crimean-Congo hemorrhagic fever virus (CCHFV). HAZV has not been reported to cause human disease; work with infectious material can be carried out at containment level (CL)-2. By contrast, CCHFV causes a haemorrhagic fever in humans and requires CL-4 facilities. A disease model of HAZV infection in mice deficient in the type I interferon receptor is reported in this study. Dose-response effects were seen with higher doses, resulting in a shorter time to death and earlier detection of viral loads in organs. The lowest dose of 10 p.f.u. was still lethal in over 50 % of the mice. Histopathological findings were identified in the liver, spleen and lymph nodes, with changes similar to a recent mouse model of CCHFV infection. The findings demonstrate that inoculation of mice with HAZV may act as a useful surrogate model for the testing of antiviral agents against CCHFV.

Correlates and trends in training satisfaction on completion of internal medicine-pediatrics residency: a 5-year study.

OBJECTIVE: To examine trends in training satisfaction in graduates of combined internal medicine-pediatrics (Med-Peds) training programs and whether curricular elements designed to enhance the integration of the two disciplines have been successful. STUDY DESIGN: We conducted a cross-sectional survey of all graduating Med-Peds residents (years 2003-2007). Responses across survey years were analyzed to identify trends. Data for all survey years was analyzed for correlations among curricular elements, perceived adequacy of training, and preparation for future activities. RESULTS: Overall, residents rated training time as just right for all areas except neonatal intensive care unit training, outpatient procedures, career planning, and office management. There was a significant upward trend in availability of board examination reviews, Med-Peds noon conferences, and mentoring. Residents' ratings of their preparation for most activities increased across the years. More residents reported being satisfied with preparation for internal medicine than pediatric primary care practice (86% versus 83%). Career planning seminars, mentoring, and board reviews correlated with the greatest increase in satisfaction. CONCLUSIONS: Med-Peds graduates report a high and increasing level of satisfaction with their preparation in multiple educational domains. Curricular elements designed to enhance integration of the two disciplines have a broad positive impact. Perceived pediatric practice preparation lags behind that of internal medicine.

Graduating med-peds residents' interest in part-time employment.

OBJECTIVE: As part-time work is becoming more popular among the primary care specialties, we examined the demographic descriptors of med-peds residents seeking and finding part-time employment upon completion of residency training. METHODS: As part of the 2006 annual American Academy of Pediatrics (AAP) Graduating Med-Peds Residents Survey, we surveyed the graduating residents of all med-peds programs about their interest in and plans for part-time employment. A total of 199 (60%) of the residents responded. RESULTS: Of the resident respondents applying for nonfellowship jobs, 19% sought part-time positions and 10% actually accepted a part-time position. Female residents were significantly more likely than male residents to apply for part-time jobs (26% vs. 7%, P = .034). Sixty percent of female residents immediately seeking work and 58% of those going on to fellowship reported an interest in arranging a part-time or reduced-hours position at some point in the next 5 years. CONCLUSIONS: Part-time employment among med-peds residents applying for nonfellowship positions after graduation is similar to the current incidence of part-time employment in other fields of primary care. A much higher percentage of med-peds residents are interested in arranging part-time work within 5 years after graduation. This strong interest in part-time work has many implications for the primary care workforce.