West Nile virus in Tunisia, 2014: First isolation from mosquitoes.

Several outbreaks of human West Nile virus (WNV) infections were reported in Tunisia during the last two decades. Serological studies on humans as well as on equine showed intensive circulation of WNV in Tunisia. However, no virus screening of mosquitoes for WNV has been performed in Tunisia. In the present study, we collected mosquito samples from Central Tunisia to be examined for the presence of flaviviruses. A total of 102 Culex pipiens mosquitoes were collected in September 2014 from Central Tunisia. Mosquitoes were pooled according to the collection site, date and sex with a maximum of 5 specimens per pool and tested for the presence of flaviviruses by conventional reverse transcription heminested PCR and by a specific West Nile virus real time reverse transcription PCR. Of a total of 21 pools tested, 7 were positive for WNV and no other flavivirus could be evidenced in mosquito pools. In addition, WNV was isolated on Vero cells. Phylogenetic analysis showed that recent Tunisian WNV strains belong to lineage 1 WNV and are closely related to the Tunisian strain 1997 (PAH 001). This is the first detection and isolation of WNV from mosquitoes in Tunisia. Some areas of Tunisia are at high risk for human WNV infections. WNV is likely to cause future sporadic and foreseeable outbreaks. Therefore, it is of major epidemiological importance to set up an entomological surveillance as an early alert system. Timely detection of WNV should prompt vector control to prevent future outbreaks. In addition, education of people to protect themselves from mosquito bites is of major epidemiological importance as preventive measure against WNV infection.

Serologic evidence of exposure to Rift Valley fever virus detected in Tunisia.

Rift Valley fever virus (RVFv) is capable of causing dramatic outbreaks amongst economically important animal species and is capable of causing severe symptoms and mortality in humans. RVFv is known to circulate widely throughout East Africa; serologic evidence of exposure has also been found in some northern African countries, including Mauritania. This study aimed to ascertain whether RVFv is circulating in regions beyond its known geographic range. Samples from febrile patients (n = 181) and nonfebrile healthy agricultural and slaughterhouse workers (n = 38) were collected during the summer of 2014 and surveyed for exposure to RVFv by both serologic tests and PCR. Of the 219 samples tested, 7.8% of nonfebrile participants showed immunoglobulin G reactivity to RVFv nucleoprotein and 8.3% of febrile patients showed immunoglobulin M reactivity, with the latter samples indicating recent exposure to the virus. Our results suggest an active circulation of RVFv and evidence of human exposure in the population of Tunisia.

Patients' and carers' views and expectations about intensive management for moderate rheumatoid arthritis: a qualitative study.

Intensive management for rheumatoid arthritis (RA) involves frequent hospital visits and adjusted doses or combinations of medication. Research is currently underway to test whether or not intensive management strategies are valuable in moderately active disease, however, patient views on intensive management in this disease group are unknown. The objectives of this study were to explore the views and expectations of patients with moderately active RA and of carers of patients with moderately active RA. We conducted focus groups and one-to-one interviews in 2014 with 14 participants (9 patients, 5 carers) from 4 rheumatology clinics across 3 London Hospital NHS Trusts. Non-English-speaking patients were included with the assistance of a professional translator. Focus groups and interviews were audio recorded and transcribed and transcripts analysed using a framework analysis approach. Four main themes were identified: 'Hopes and Expectations of Intensive Management', 'Acceptability of Intensive Management', 'Patient Education' and 'The Importance of Continuity of Care'. Our main findings were that attendance at frequent clinic appointments was largely acceptable to patients and carers. Views on taking higher doses of medication depended on how stable patients were on their current treatment regime. Continuity of care from the rheumatologist and the provision of written/verbal information about intensive management were important to patients and carers.

Provisional guidelines for applying the Department of Health (England) 18-week-patient pathway to specialist rheumatology care.

OBJECTIVES: The Government Department of Health (England) has set a target that by 2008 patients on pathways that do or may involve medical or surgical consultant-led care should wait no longer than 18 weeks from referral to start of definitive treatment. Department of Health guidance must be interpreted and applied to patients with rheumatological problems. METHODS: Provisional guidelines have been prepared in collaboration between the British Society for Rheumatology, British Pain Society, Department of Health (England) and other key stakeholders. RESULTS: Definitive rheumatological treatment comprises a package of care rather than a single action. The care package usually requires input from a multidisciplinary team using several modalities in parallel. Actions within the care package that must be taken before treatment can be said to have started, are definitive actions. Definitive actions should be based on evidence of cost-effectiveness, tailored to the individual patient and offered irrespective of local availability or accessibility. They should be agreed between partners in the patient's care. This requires face-to-face consultation between the patient and a health care professional with appropriate expertise and knowledge. All definitive actions specified at the outset of management within specialist care must be initiated or removed by agreement from the patient's care package before the clock can be stopped in the 18-week-patient pathway. CONCLUSIONS: Service redesign may be necessary in order to achieve an 18-week-patient pathway for all patients. A consistent and appropriate definition of clock-stops should ensure that patients will benefit from excellent rheumatology specialist care without unnecessary delay.

Chorionic morphology of eggs of the Psorophora confinnis complex in the United States. II. Pre- and postdeposition studies of Psorophora Columbiae (Dyar and Knab) eggs.

Scanning and transmission electron microscopic techniques were used to determine the morphology of the exochorion and endochorion of Psorophora columbiae eggs as found in the ovary and after deposition. In the ovary, the outer chorionic reticulations and tubercles of the eggs are ornately developed below the follicular epithelium. Expansion of the eggs after deposition causes the outer chorionic reticuli and sculpturing (i.e., minor and major tubercles) to form the characteristic spinose appearance of Psorophora eggs. Transmission electron microscopic micrographs of cross and sagittal sections of the chorionic layers of Ps. columbiae eggs indicate that the major outer chorionic tubercles have 3 distinct regions. The 3rd region was found only on the dorsum of the tubercle. Elevation of major tubercles appears to be regulated, at least in part, by ambient moisture conditions, and one function of these tubercles seems to be adhesion of the egg to an oviposition surface.

Inoculation with Sinorhizobium meliloti RMBPC-2 Increases Alfalfa Yield Compared with Inoculation with a Nonengineered Wild-Type Strain.

Inoculation of alfalfa seeds with any of three recombinant strains of Sinorhizobium meliloti significantly increased overall plant biomass compared with inoculation with the wild-type strains over a 3-year period at three locations. A high proportion of nodules were occupied by the inoculum strains throughout the 3-year period.

Alfalfa yield response to inoculation with recombinant strains of Rhizobium meliloti with an extra copy of dctABD and/or modified nifA expression.

The construction of rhizobial strains which increase plant biomass under controlled conditions has been previously reported. However, there is no evidence that these newly constructed strains increase legume yield under agricultural conditions. This work tested the hypothesis that carefully manipulating expression of additional copies of nifA and dctABD in strains of Rhizobium meliloti would increase alfalfa yield in the field. The rationale for this hypothesis is based on the positive regulatory role that nifA plays in the expression of the nif regulon and the fact that a supply of dicarboxylic acids from the plant is required as a carbon and energy source for nitrogen fixation by the Rhizobium bacteroids in the nodule. These recombinant strains, as well as the wild-type strains from which they were derived, are ideal tools to examine the effects of modifying or increasing the expression of these genes on alfalfa biomass. The experimental design comprised seven recombinant strains, two wild-type strains, and an uninoculated control. Each treatment was replicated eight times and was conducted at four field sites in Wisconsin. Recombinant strain RMBPC-2, which has an additional copy of both nifA and dctABD, increased alfalfa biomass by 12.9% compared with the yield with the wild-type strain RMBPC and 17.9% over that in the uninoculated control plot at the site where soil nitrogen and organic matter content was lowest. These increases were statistically significant at the 5% confidence interval for each of the three harvests made during the growing season. Strain RMBPC-2 did increase alfalfa biomass at the Hancock site; however, no other significant increases or decreases in alfalfa biomass were observed with the seven other recombinant strains at that site. At three sites where this experiment was conducted, either native rhizobial populations or soil nitrogen concentrations were high. At these sites, none of the recombinant strains affected yield. We conclude that RMBPC -2 can increase alfalfa yields under field conditions of nitrogen limitation, low endogenous rhizobial competitors, and sufficient moisture.

The influence of humidity on the residual action of benzene hexachloride

Em câmaras de umidade controlada foi observada diferença na velocidade de absorçäo do BHC relacionada ao substrato borrifado. Embora näo seja mais utilizado o BHC pelo Controle da Doença de Chagas no Brasil, estes dados podem ser relevantes para outros inseticidas usados em programas de controle

The influence of humidity on the residual action of benzene hexachloride (BHC).

In controlled humidity chambers in the laboratory differences in the absorption velocity of BHC were observed depending on the substrate sprayed. While BHC is no longer used in Chagas' disease control this data could have relevance to spraying houses in a control programme with other insecticides.

The influence of building materials on the residual action of BHC

A atividade residual dos vapores do inseticida BHC de vários materiais de construçäo em câmaras com controle de umidade, no laboratório, foram significativamente diferentes entre si. Ninfas do primeiro estágio de Dipetalogaster maximus, criados em laboratório, foram expostas a vapores de BHC liberados da superfície tratada dos materiais de construçäo trazidos de Mambaí, Goiás

The influence of building materials on the residual action of BHC.

Residual insecticide activity of BHC vapors from various building materials in controlled humidity chambers in the laboratory were significantly different. Laboratory-reared, first instar nymphs of Dipetalogaster maximus were exposed to vapors of BHC which were being released from the treated surfaces of building materials taken from Mambaí, Goiás.