Encephalitis and Death in Wild Mammals at a Rehabilitation Center after Infection with Highly Pathogenic Avian Influenza A(H5N8) Virus, United Kingdom.

We report a disease and mortality event involving swans, seals, and a fox at a wildlife rehabilitation center in the United Kingdom during late 2020. Five swans had onset of highly pathogenic avian influenza virus infection while in captivity. Subsequently, 5 seals and a fox died (or were euthanized) after onset of clinical disease. Avian-origin influenza A virus subtype H5N8 was retrospectively determined as the cause of disease. Infection in the seals manifested as seizures, and immunohistochemical and molecular testing on postmortem samples detected a neurologic distribution of viral products. The fox died overnight after sudden onset of inappetence, and postmortem tissues revealed neurologic and respiratory distribution of viral products. Live virus was isolated from the swans, seals, and the fox, and a single genetic change was detected as a potential adaptive mutation in the mammalian-derived viral sequences. No human influenza-like illness was reported in the weeks after the event.

Regaining A Sense Of Me: a single case study of SCI adjustment, applying the appraisal model and coping effectiveness training.

INTRODUCTION: Sustaining a spinal cord injury (SCI) has been shown to impose a significant physical and psychological challenge with threat to quality of life (QOL). Duff & Kennedy provide a SCI explanation of appraisals and the two-stage process of an individual's primary assessment of their experience, and their secondary appraisal of their perceived coping resource being key facilitators of adjustment and fundamental to longer term adaptation. King & Kennedy designed a group coping effectiveness training (CET) intervention with a framework of coping strategy selection fit to reduce use of threat appraisals/avoidance coping, and to promote development of challenge appraisals with consequent stress reduction and adjustment. CASE PRESENTATION: This CET approach was applied within individual psychological therapy with a 74-year old woman who presented with symptoms of anxiety, reactivated PTSD, mood disturbance and difficulty adjusting after sustaining SCI. Psychological adjustment treatment enabled resolution of post-trauma symptoms, re-evaluation of appraisals and perceived loss of identity, and development of positive coping strategies, and promoted a new conceptualisation of independence. DISCUSSION: Case studies of psychological treatment are rare within the SCI literature. This paper provides a detailed application of primary appraisals and coping strategy selection fit in individual therapy. Attention is drawn to the important impact appraisals have on long-term rehabilitation outcomes and the necessity of a multi-disciplinary team (MDT) approach to achieve optimal psychological and physical adjustment following SCI. Finally, the paper highlights the need for community education to reduce negative perceptions/taboo of disability.

A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a 'now window' of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Spindle Cell Tumor in a Brown Long-eared Bat (Plecotus auritus).

Most reports of neoplasia in bats are in captive Egyptian fruit bats (Rousettus aegyptiacus), a megachiropteran species. Only three reports of neoplasia in microchiropteran species have been reported. We report the detection of a tumor in a wild brown long-eared bat (Plecotus auritus), a microchiropteran species, in England. Histolopathology indicated the mass was a spindle cell tumor, likely of smooth muscle origin, which was confirmed by immunohistochemistry.

20 years of national wildlife disease surveillance.

The need for wildlife surveillance is as great now as it ever has been. Here, members of the APHA's Diseases of Wildlife Scheme explain why their work is important.

RECENT CHANGES IN INFECTIOUS DISEASES IN EUROPEAN WILDLIFE.

Many infectious diseases originating from, or carried by, wildlife affect wildlife conservation and biodiversity, livestock health, or human health. We provide an update on changes in the epidemiology of 25 selected infectious, wildlife-related diseases in Europe (from 2010-16) that had an impact, or may have a future impact, on the health of wildlife, livestock, and humans. These pathogens were selected based on their: 1) identification in recent Europe-wide projects as important surveillance targets, 2) inclusion in European Union legislation as pathogens requiring obligatory surveillance, 3) presence in recent literature on wildlife-related diseases in Europe since 2010, 4) inclusion in key pathogen lists released by the Office International des Epizooties, 5) identification in conference presentations and informal discussions on a group email list by a European network of wildlife disease scientists from the European Wildlife Disease Association, or 6) identification as pathogens with changes in their epidemiology during 2010-16. The wildlife pathogens or diseases included in this review are: avian influenza virus, seal influenza virus, lagoviruses, rabies virus, bat lyssaviruses, filoviruses, canine distemper virus, morbilliviruses in aquatic mammals, bluetongue virus, West Nile virus, hantaviruses, Schmallenberg virus, Crimean-Congo hemorrhagic fever virus, African swine fever virus, amphibian ranavirus, hepatitis E virus, bovine tuberculosis ( Mycobacterium bovis), tularemia ( Francisella tularensis), brucellosis ( Brucella spp.), salmonellosis ( Salmonella spp.), Coxiella burnetii, chytridiomycosis, Echinococcus multilocularis, Leishmania infantum, and chronic wasting disease. Further work is needed to identify all of the key drivers of disease change and emergence, as they appear to be influencing the incidence and spread of these pathogens in Europe. We present a summary of these recent changes during 2010-16 to discuss possible commonalities and drivers of disease change and to identify directions for future work on wildlife-related diseases in Europe. Many of the pathogens are entering Europe from other continents while others are expanding their ranges inside and beyond Europe. Surveillance for these wildlife-related diseases at a continental scale is therefore important for planet-wide assessment, awareness of, and preparedness for the risks they may pose to wildlife, domestic animal, and human health.

Proposed attributes of national wildlife health programmes.

Wildlife health is important for conservation, healthy ecosystems, sustainable development and biosecurity. It presents unique challenges for national programme governance and delivery because wildlife health not only crosses jurisdictional responsibilities and authorities but also inherently spans multiple sectors of expertise. The World Organisation for Animal Health (OIE) encourages its Members to have wildlife disease monitoring and notification systems. Where national wildlife health surveillance programmes do exist, they vary in scope and size. Evidence-based guidance is lacking on the critical functions and roles needed to meet the OIE's recommendations and other expectations of a national programme. A literature review and consultation with national wildlife health programme leaders identified five key attributes of national programmes: 1) being knowledge and science based; 2) fostering cross-nation equivalence and harmonisation; 3) developing partnerships and national coordination; 4) providing leadership and administration of national efforts; and 5) capacity development. Proposed core purposes include: 1) establishment and communication of the national wildlife health status; 2) leading national planning; 3) centralising information and expertise; 4) developing national networks leading to harmonisation and collaborations; 5) developing wildlife health workforces; and 6) centralising administration and management of national programmes. A national wildlife health programme should aim to identify, effectively communicate and manage the risk to or from a country's wildlife populations. It should generate the appropriate knowledge required to improve the effectiveness of wildlife policies and systems, including identifying and assessing emerging priorities, thus facilitating early warning, preparedness and preventive actions.

La santé de la faune sauvage a un impact important sur la préservation des espèces et d'écosystèmes sains, sur le développement durable et sur la biosécurité. Les défis sont nombreux et complexes pour les programmes nationaux de gouvernance et de mise en oeuvre car les responsabilités et les compétences juridictionnelles sont croisées et les secteurs d'expertise sont multiples. L'Organisation mondiale de la santé animale (OIE) encourage ses Membres à mettre en place des systèmes de notification et de surveillance des maladies de la faune sauvage. Les programmes existants sont de tailles et de compétences variables et les orientations prises concernant les fonctions indispensables pour répondre aux recommandations de l'OIE et à ce qui est attendu d'un programme national ne sont pas toujours déterminées sur une base scientifique. Une revue de la littérature et des consultations auprès de responsables des programmes nationaux de santé de la faune sauvage ont permis d'identifier cinq attributs à proposer pour ces programmes nationaux. Ces programmes doivent :1) fonctionner sur la base de données scientifiques ; 2) favoriser l'équivalence et l'harmonisation transnationales ; 3) développer des partenariats et une coordination à l'échelle nationale ; 4) encadrer et administrer les efforts nationaux ; et 5) assurer le renforcement des capacités. Les missions essentielles sont : 1) déterminer et rendre publique la situation sanitaire de la faune sauvage dans le pays ; 2) encadrer le plan national ; 3) centraliser l'information et l'expertise ; 4) développer les réseaux nationaux d'harmonisation et de collaboration ; 5) former des personnels compétents dans le domaine de la faune sauvage ; et 6) centraliser l'administration et la gestion des programmes nationaux. Les objectifs d'un programme national de santé de la faune sauvage sont d'identifier, de rendre publics et de gérer les risques pour les populations d'animaux sauvages ainsi que les risques générés par ces mêmes populations. Ces programmes doivent promouvoir les connaissances nécessaires pour améliorer l'efficacité des politiques et des systèmes applicables à la faune sauvage, en particulier l'identification et l'évaluation des nouvelles priorités afin de faciliter la mise en oeuvre de systèmes d'alerte précoce, de préparation aux urgences et d'action préventive.

La salud de los animales silvestres, tan importante para la conservación del medio, el buen funcionamiento de los ecosistemas, el desarrollo sostenible y la seguridad biológica, presenta singulares dificultades desde el punto de vista de la gobernanza y aplicación de programas nacionales, dado que la fauna silvestre no solo toca a múltiples responsabilidades y atribuciones jurisdiccionales sino que, por su propia naturaleza, convoca a una plétora de especialidades técnicas. La Organización Mundial de Sanidad Animal (OIE) alienta a sus Miembros a que se doten de sistemas de vigilancia y notificación de enfermedades de la fauna silvestre. Allí donde existen, los programas nacionales en la materia son muy variopintos en cuanto a sus dimensiones y alcance. Faltan pautas científicamente sólidas sobre las funciones y atribuciones básicas que se requieren para cumplir las recomendaciones de la OIE y otras expectativas a las que pueda responder un programa nacional. Tras efectuar un estudio bibliográfico y consultar a los directivos de programas nacionales en la materia, los autores determinaron cinco atributos clave que debe reunir todo programa nacional: 1) estar basado en el saber y la ciencia; 2) favorecer la equivalencia y la armonización entre naciones; 3) crear alianzas y mecanismos de coordinación nacional; 4) encabezar y administrar las actividades a escala nacional; y 5) desarrollar los medios de acción del país. Los objetivos básicos propuestos son: 1) determinar y dar a conocer la situación sanitaria de la fauna silvestre del país; 2) dirigir las labores de planificación a escala nacional; 3) centralizar la información y las competencias especializadas; 4) instituir redes nacionales que propicien la armonización y las iniciativas de colaboración; 5) desarrollar los recursos humanos dedicados a la sanidad de la fauna silvestre; y 6) centralizar la gestión y administración de los programas nacionales. Todo programa nacional de sanidad de la fauna silvestre debe responder a la finalidad de detectar, comunicar eficazmente y gestionar los riesgos que amenacen a las poblaciones de animales silvestres del país o que provengan de ellas. A tal efecto debe generar el conocimiento adecuado y necesario para conferir más eficacia a las políticas y sistemas tocantes a la fauna silvestre, lo que supone, entre otras cosas, determinar y evaluar las nuevas prioridades, facilitando con ello la alerta anticipada y las labores de preparación y prevención.

Perioperative, local and systemic warming in surgical site infection: a systematic review and meta-analysis.

OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs. Adult patients undergoing elective or emergency surgery under general anaesthesia, receiving any active or passive warming intervention perioperatively were included. Selection, risk of bias assessment and data extraction were performed by two review authors, independently. Outcomes studied were SSI (primary outcome), inpatient mortality, hospital length of stay and pain (secondary outcomes). RESULTS: We identified four studies, including 769 patients. The risk ratio (RR) for SSI in warming groups was 0.36 [95% confidence interval (CI): 0.23, 0.56; p<0. 001]. Length of hospitalisation was 1.13 days less in warming groups [95% CI: -3.07, 5.33; p=0.600]. The RR for mortality in the warming groups was 0.77 [95% CI: 0.17, 3.43; p=0.730]. A meta-analysis for pain outcome could not be conducted. CONCLUSION: This review provides evidence in favour of active warming to prevent SSI, but insufficient evidence of active warming to reduce length of hospital stay and mortality. Benefits of passive warming remain unclear and warrant further research.

An upgraded interferometer-polarimeter system for broadband fluctuation measurements.

Measuring high-frequency fluctuations (above tearing mode frequencies) is important for diagnosing instabilities and transport phenomena. The Madison Symmetric Torus interferometer-polarimeter system has been upgraded to utilize improved planar-diode mixer technology. The new mixers reduce phase noise and allow more sensitive measurements of fluctuations at high frequency. Typical polarimeter rms phase noise values of 0.05°-0.07° are obtained with 400 kHz bandwidth. The low phase noise enables the resolution of fluctuations up to 250 kHz for polarimetry and 600 kHz for interferometry. The importance of probe beam alignment for polarimetry is also verified; previously reported tolerances of ≤0.1 mm displacement for equilibrium and tearing mode measurements minimize contamination due to spatial misalignment to within acceptable levels for chords near the magnetic axis.

Novel HSPB1 mutation causes both motor neuronopathy and distal myopathy.

OBJECTIVE: To identify the cause of isolated distal weakness in a family with both neuropathic and myopathic features on EMG and muscle histology. METHODS: Case study with exome sequencing in 2 affected individuals, bioinformatic prioritization of genetic variants, and segregation analysis of the likely causal mutation. Functional studies included Western blot analysis of the candidate protein before and after heat shock treatment of primary skin fibroblasts. RESULTS: A novel HSPB1 variant (c.387C>G, p.Asp129Glu) segregated with the phenotype and was predicted to alter the conserved α-crystallin domain common to small heat shock proteins. At baseline, there was no difference in HSPB1 protein levels nor its binding partner αB-crystallin. Heat shock treatment increased HSPB1 protein levels in both patient-derived and control fibroblasts, but the associated increase in αB-crystallin expression was greater in patient-derived than control fibroblasts. CONCLUSIONS: The HSPB1 variant (c.387C>G, p.Asp129Glu) is the likely cause of distal neuromyopathy in this pedigree with pathogenic effects mediated through binding to its partner heat shock protein αB-crystallin. Mutations in HSBP1 classically cause a motor axonopathy, but this family shows that the distal weakness can be both myopathic and neuropathic. The traditional clinical classification of distal weakness into "myopathic" or "neuropathic" forms may be misleading in some instances, and future treatments need to address the pathology in both tissues.

Drowning is an apparent and unexpected recurrent cause of mass mortality of Common starlings (Sturnus vulgaris).

Drowning is infrequently reported as a cause of death of wild birds and such incidents typically involve individual, rather than multiple, birds. Over a 21-year period (1993 to 2013 inclusive), we investigated 12 incidents of mortality of multiple (2 - 80+) Common starlings (Sturnus vulgaris) in Great Britain that appeared to be due to drowning. More than ten birds were affected in ten of these reported incidents. These incidents always occurred during the spring and early summer months and usually involved juvenile birds. In all cases, circumstantial evidence and post-mortem examinations indicated drowning to be the most likely cause of death with no underlying disease found. A behavioural explanation seems likely, possibly related to the gregarious nature of this species combined with juvenile inexperience in identifying water hazards. A review of data from the ringed bird recovery scheme across Great Britain (1909-2013 inclusive) of both starlings and Common blackbirds (Turdus merula), also a common garden visitor, identified additional suspected drowning incidents, which were significantly more common in the former species, supporting a species predisposition to drowning. For each species there was a marked seasonal peak from April to August. Drowning should be included as a differential diagnosis when investigating incidents of multiple starling mortality, especially of juveniles.

Frequency of rare recessive mutations in unexplained late onset cerebellar ataxia.

Sporadic late onset cerebellar ataxia is a well-described clinical presentation with a broad differential diagnosis that adult neurologists should be familiar with. However, despite extensive clinical investigations, an acquired cause is identified in only a minority of cases. Thereafter, an underlying genetic basis is often considered, even in those without a family history. Here we apply whole exome sequencing to a cohort of 12 patients with late onset cerebellar ataxia. We show that 33% of 'idiopathic' cases harbor compound heterozygous mutations in known ataxia genes, including genes not included on multi-gene panels, or primarily associated with an ataxic presentation.

Efficient central nervous system AAVrh10-mediated intrathecal gene transfer in adult and neonate rats.

Intracerebral administration of recombinant adeno-associated vector (AAV) has been performed in several clinical trials. However, delivery into the brain requires multiple injections and is not efficient to target the spinal cord, thus limiting its applications. To assess widespread and less invasive strategies, we tested intravenous (IV) or intrathecal (that is, in the cerebrospinal fluid (CSF)) delivery of a rAAVrh10-egfp vector in adult and neonate rats and studied the effect of the age at injection on neurotropism. IV delivery is more efficient in neonates and targets predominantly Purkinje cells of the cerebellum and sensory neurons of the spinal cord and dorsal root ganglia. A single intra-CSF administration of AAVrh10, single strand or oversized self-complementary, is efficient for the targeting of neurons in the cerebral hemispheres, cerebellum, brainstem and spinal cord. Green fluorescent protein (GFP) expression is more widespread in neonates when compared with adults. More than 50% of motor neurons express GFP in the three segments of the spinal cord in neonates and in the cervical and thoracic regions in adults. Neurons are almost exclusively transduced in neonates, whereas neurons, astrocytes and rare oligodendrocytes are targeted in adults. These results expand the possible routes of delivery of AAVrh10, a serotype that has shown efficacy and safety in clinical trials concerning neurodegenerative diseases.

A novel de novo STXBP1 mutation is associated with mitochondrial complex I deficiency and late-onset juvenile-onset parkinsonism.

Mutations in STXBP1 have recently been identified as a cause of infantile epileptic encephalopathy. The underlying mechanism of the disorder remains unclear and, recently, several case reports have described broad and progressive neurological phenotypes in addition to early-onset epilepsy. Herein, we describe a patient with early-onset epilepsy who subsequently developed a progressive neurological phenotype including parkinsonism in her early teens. A de novo mutation in STXBP1 (c.416C>T, p.(Pro139Leu)) was detected with exome sequencing together with profound impairment of complex I of the mitochondrial respiratory chain on muscle biopsy. These findings implicate a secondary impairment of mitochondrial function in the progressive nature of the disease phenotype.

Electron kinetic effects on interferometry, polarimetry and Thomson scattering measurements in burning plasmas (invited).

At anticipated high electron temperatures in ITER, the effects of electron thermal motion on Thomson scattering (TS), toroidal interferometer/polarimeter (TIP), and poloidal polarimeter (PoPola) diagnostics will be significant and must be accurately treated. The precision of the previous lowest order linear in τ = Te/mec(2) model may be insufficient; we present a more precise model with τ(2)-order corrections to satisfy the high accuracy required for ITER TIP and PoPola diagnostics. The linear model is extended from Maxwellian to a more general class of anisotropic electron distributions that allows us to take into account distortions caused by equilibrium current, ECRH, and RF current drive effects. The classical problem of the degree of polarization of incoherent Thomson scattered radiation is solved analytically exactly without any approximations for the full range of incident polarizations, scattering angles, and electron thermal motion from non-relativistic to ultra-relativistic. The results are discussed in the context of the possible use of the polarization properties of Thomson scattered light as a method of Te measurement relevant to ITER operational scenarios.

High-frequency fluctuation measurements by far-infrared laser Faraday-effect polarimetry-interferometry and forward scattering system on MST.

Magnetic fluctuation-induced transport driven by global tearing modes has been measured by Faraday-effect polarimetry and interferometry (phase measurements) in the MST reversed field pinch. However, the role of small-scale broadband magnetic and density turbulence in transport remains unknown. In order to investigate broadband magnetic turbulence, we plan to upgrade the existing detector system by using planar-diode fundamental waveguide mixers optimized for high sensitivity. Initial tests indicate these mixers have ×10 sensitivity improvement compared to currently employed corner-cube Schottky-diode mixers and ×5 lower noise. Compact mixer design will allow us to resolve the wavenumbers up to k ∼ 1-2 cm(-1) for beam width w = 1.5 cm and 15 cm(-1) for beam width w = 2 mm. The system can also be used to measure the scattered signal (amplitude measurement) induced by both plasma density and magnetic fluctuations.