Vaccination with the Crimean-Congo hemorrhagic fever virus viral replicon vaccine induces NP-based T-cell activation and antibodies possessing Fc-mediated effector functions.

Crimean-Congo hemorrhagic fever virus (CCHFV; family Nairoviridae) is a tick-borne pathogen that frequently causes lethal disease in humans. CCHFV has a wide geographic distribution, and cases have been reported in Africa, Asia, the Middle East, and Europe. Availability of a safe and efficacious vaccine is critical for restricting outbreaks and preventing disease in endemic countries. We previously developed a virus-like replicon particle (VRP) vaccine that provides complete protection against homologous and heterologous lethal CCHFV challenge in mice after a single dose. However, the immune responses induced by this vaccine are not well characterized, and correlates of protection remain unknown. Here we comprehensively characterized the kinetics of cell-mediated and humoral immune responses in VRP-vaccinated mice, and demonstrate that they predominantly target the nucleoprotein (NP). NP antibodies are not associated with protection through neutralizing activity, but VRP vaccination results in NP antibodies possessing Fc-mediated antibody effector functions, such as complement activation (ADCD) and antibody-mediated cellular phagocytosis (ADCP). This suggests that Fc-mediated effector functions may contribute to this vaccine's efficacy.

A Comprehensive Model for Estimating Heat Vulnerability of Young Athletes.

Current methods for estimating heat vulnerability of young athletes use a heat index (HI) or a wet bulb globe thermometer (WBGT), neither of which fully include the environmental or physiological characteristics that can affect a person's heat budget, particularly where activity occurs on a synthetic surface. This study analyzed and compared the standard methods, HI and WBGT, with a novel and more comprehensive method termed COMFA-Kid (CK) which is based on an energy budget model explicitly designed for youth. The COMFA model was presented at the same time to demonstrate the difference between a child and an adult during activity. Micrometeorological measurements were taken at a synthetic-surfaced football field during mid-day in hot environmental conditions. Standard methods (HI and WBGT) indicated that conditions on the field were relatively safe for youth to engage in activities related to football practice or games, whereas the CK method indicated that conditions were dangerously hot and could lead to exertional heat illness. Estimates using the CK method also indicated that coaches and staff standing on the sidelines, and parents sitting in the stands, would not only be safe from heat but would be thermally comfortable. The difference in thermal comfort experienced by coaches and staff off the field, versus that experienced by young players on the field, could affect decision making regarding the duration and intensity of practices and time in the game. The CK method, which is easy to use and available for modification for specific conditions, would lead to more accurate estimates of heat safety on outdoor synthetic surfaces in particular, and in sports with a high prevalence of heat illness such as football, and should be considered as a complementary or alternative preventive measure against heat.

Increasing Access to Physical Activity Within Low Income and Diverse Communities: A Systematic Review.

OBJECTIVE: The purpose of this review is to uncover some best practices for increasing access to physical activity opportunities by examining efforts used within low income and diverse communities. The theoretical lens used is from the Active Living by Design (ALbD) Community Action Model, with a focus on the 6 essential practices (health equity focus, community engagement, facilitative leadership, sustainable thinking, culture of learning, and strategic communication) describing how partnerships can guide and sustain meaningful change in a community. METHODS: A 2-step process guided the literature search. In step 1, 4 databases (PubMed, Psych INFO, Social Science Citation Index, and Cochrane Library) were searched using Boolean connections and variations in the key terms. Step 2 assessed articles by title, abstract, and full text to determine whether the studies met the inclusion and exclusion criteria guided by Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Additionally, included articles were compared against the 6 essential practices outlined by the ecological framework, ALbD. RESULTS: Of 1775 total articles, 14 studies met inclusion criteria. Most of the studies were case studies located in the United States using several different approaches including, changes in the built environment, implementation of a community-based physical activity program, creating partnerships to leverage resources, and policy change. This review compared the 14 studies against the 6 essential practices of the ALbD model and found 2 studies that met all 6 criteria, and only a few studies meeting more than 2 criteria. CONCLUSIONS: Overall, the conclusions are 2-fold, (1) only 14 cases demonstrate success in increasing access to physical activity opportunities, suggesting that more can be done to address inequalities. (2) Of the existing efforts, few utilize crucial components to create a sustainable change in the community. Future research should take into consideration the ALbD ecological framework, the best existing theory for this type of work, to guide the creation and implementation of a sustainable community access effort.

Building Evidence for Health: Green Buildings, Current Science, and Future Challenges.

Civilizational challenges have questioned the status quo of energy and material consumption by humans. From the built environment perspective, a response to these challenges was the creation of green buildings. Although the revolutionary capacity of the green building movement has elevated the expectations of new commercial construction, its rate of implementation has secluded the majority of the population from its benefits. Beyond reductions in energy usage and increases in market value, the main strength of green buildings may be the procurement of healthier building environments. Further pursuing the right to healthy indoor environments could help the green building movement to attain its full potential as a transformational public health tool. On the basis of 40 years of research on indoor environmental quality, we present a summary of nine environment elements that are foundational to human health. We posit the role of green buildings as a critical research platform within a novel sustainability framework based on social-environmental capital assets.

Prenatal exposure to fine particles and polycyclic aromatic hydrocarbons and birth outcomes: a two-pollutant approach.

BACKGROUND: Previous epidemiologic studies have considered the effects of individual air pollutants on birth outcomes, whereas a multiple-pollutant approach is more relevant to public health policy. OBJECTIVES: The present study compared the observed effect sizes of prenatal fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAH) (a component of PM2.5) exposures on birth outcome deficits, assessed by the single vs. two-pollutant approaches. METHODS: The study sample included 455 term infants born in Krakow to non-smoking mothers, among whom personal exposures to PM2.5 and PAH were monitored in the second trimester of pregnancy. The exposure effect estimates (unstandardized and standardized regression coefficients) on birth outcomes were determined using multivariable linear regression models, accounting for relevant covariates. RESULTS: In the single-pollutant approach, each pollutant was inversely associated with all birth outcomes. The effect size of prenatal PAH exposure on birth weight and length was twice that of PM2.5, in terms of standardized coefficients. In the two-pollutant approach, the negative effect of PM2.5 on birth weight and length, adjusted for PAH exposure, lost its significance. The standardized effect of PAH on birth weight was 10-fold stronger (ß = -0.20, p = 0.004) than that estimated for PM2.5 (ß = -0.02, p = 0.757). CONCLUSION: The results provide evidence that PAH had a greater impact on several measures of fetal development, especially birth weight, than PM2.5. Though in the single-pollutant models PM2.5 had a significant impact on birth outcomes, this effect appears to be mediated by PAH.

Seasonal variability in environmental tobacco smoke exposure in public housing developments.

The risk of tobacco smoking and second-hand smoke (SHS) exposure combined are the leading contributors to disease burden in high-income countries. Recent studies and policies are focusing on reducing exposure to SHS in multiunit housing (MUH), especially public housing. We examined seasonal patterns of SHS levels within indoor common areas located on Boston Housing Authority (BHA) properties. We measured weekly integrated and continuous fine particulate matter (PM2.5) and passive airborne nicotine in six buildings of varying building and occupant characteristics in summer 2012 and winter 2013. The average weekly indoor PM2.5 concentration across all six developments was 9.2 µg/m3, higher during winter monitoring period (10.3 µg/m3) compared with summer (8.0 µg/m3). Airborne nicotine concentrations ranged from no detection to about 5000 ng/m3 (mean 311 ng/m3). Nicotine levels were significantly higher in the winter compared with summer (620 vs. 85 ng/m3; 95% CI: 72-998). Smoking-related exposures within Boston public housing vary by season, building types, and resident smoking policy. Our results represent exposure disparities that may contribute to health disparities in low-income communities and highlight the potential importance of efforts to mitigate SHS exposures during winter when outdoor-indoor exchange rates are low and smokers may tend to stay indoors. Our findings support the use of smoke-free policy as an effective tool to eliminate SHS exposure and protect non-smokers, especially residents of MUH.

[Avulsion of the proximal hamstring origin - report of 6 cases]. / Proximale Ausrissverletzungen der ischiokruralen Muskulatur - Ergebnisse nach 6 Fällen.

Proximal hamstring origin avulsions are rare injuries. A common cause for this kind of injury is a trauma with the hamstring in overextension and simultaneously forced hip flexion and knee extension. We report on 6 cases, 5 with an acute rupture of the hamstring origin and one case with a delayed presentation in our emergency room. In 3 cases the injury was related to sport activity, the other 3 are related to accidents during work. None of these patients took part in competitive sports. One case was reported 8 weeks after trauma with an MRI performed one week before. Due to the low functional deficits conservative treatment was preferred. In all of the acute injuries open refixation was done within the first two weeks after trauma using 2-3 suture anchors. Postoperative mobilisation was done with partial weight bearing. Active knee flexion against gravity was not started until six weeks postoperative. All patients who had surgery achieved good results 3-28 months after surgery. They suffered from only little pain (VAS1-2) and had good movement ability. Sport activities were reduced in 3 cases, 2 patients returned to pre-injury sport levels. All patients were able to perform one-legged squats. In the evaluated LEFS (Lower Extremity Functional Scale) 75.6/80 points were achieved (72-79). There were no severe complications within this case study. It is important to distinguish proximal hamstring origin avulsions from the majority of hamstring muscle injuries. If the avulsion is treated with surgery, refixation should be performed within the first weeks to prevent the sciatic nerve from being bound in scar tissue with a consecutive high risk of injury during mobilisation of the tendon.

Ventilation rates and health: multidisciplinary review of the scientific literature.

UNLABELLED: The scientific literature through 2005 on the effects of ventilation rates on health in indoor environments has been reviewed by a multidisciplinary group. The group judged 27 papers published in peer-reviewed scientific journals as providing sufficient information on both ventilation rates and health effects to inform the relationship. Consistency was found across multiple investigations and different epidemiologic designs for different populations. Multiple health endpoints show similar relationships with ventilation rate. There is biological plausibility for an association of health outcomes with ventilation rates, although the literature does not provide clear evidence on particular agent(s) for the effects. Higher ventilation rates in offices, up to about 25 l/s per person, are associated with reduced prevalence of sick building syndrome (SBS) symptoms. The limited available data suggest that inflammation, respiratory infections, asthma symptoms and short-term sick leave increase with lower ventilation rates. Home ventilation rates above 0.5 air changes per hour (h(-1)) have been associated with a reduced risk of allergic manifestations among children in a Nordic climate. The need remains for more studies of the relationship between ventilation rates and health, especially in diverse climates, in locations with polluted outdoor air and in buildings other than offices. PRACTICAL IMPLICATIONS: Ventilation with outdoor air plays an important role influencing human exposures to indoor pollutants. This review and assessment indicates that increasing ventilation rates above currently adopted standards and guidelines should result in reduced prevalence of negative health outcomes. Building operators and designers should avoid low ventilation rates unless alternative effective measures, such as source control or air cleaning, are employed to limit indoor pollutant levels.

Indoor concentrations of nicotine in low-income, multi-unit housing: associations with smoking behaviours and housing characteristics.

OBJECTIVE: An analysis of airborne nicotine measurements collected in 49 low-income, multi-unit residences across the Greater Boston Area. METHODS: Nicotine concentrations were determined using passive monitors placed in homes over a one-week sampling period and air exchange rates (AER) were sampled using the perfluorocarbon tracer technique. Residents were surveyed through a questionnaire about smoking behaviour and a visual inspection was conducted to collect information on housing characteristics contributing to secondhand smoke (SHS) exposure. Using a mass balance model to account for the air exchange rate, volume of the home and sorption and re-emission of nicotine on indoor surfaces, the effective smoking rate (SR(eff)) was determined for each residence. RESULTS: Nicotine levels ranged from the limit of detection to 26.92 microg/m(3), with a mean of 2.20 microg/m(3) and median of 0.13 microg/m(3). Nicotine measurements were significantly associated with the number of smokers in the household and the number of cigarettes smoked in the home. The results of this study suggest that questionnaire reports can provide a valid estimate of residential exposure to tobacco smoke. In addition, this study found evidence that tobacco smoke contamination in low-income housing developments is not limited to homes with smokers (either residing in the home or visiting). The frequent report of tobacco smoke odour coming from other apartments or hallways resulted in increased levels of nicotine concentrations and SR(eff) in non-smoking homes, suggestive of SHS infiltration from neighbouring units. CONCLUSION: These findings have important implications for smoking regulations in multi-unit homes and highlight the need to reduce involuntary exposure to tobacco smoke among low-income housing residents.

Evaluating building-related symptoms using the US EPA BASE study results.

UNLABELLED: In order to develop baseline data about United States office buildings, the United States Environmental Protection Agency conducted the Building Assessment Survey Evaluation (BASE) study, a systematic survey of 100 randomly selected United States office buildings, in the 1990s. This paper analyzes the self-reported work-related symptoms and job and workplace characteristics of 4326 respondents and compares results to the National Institute for Occupational Safety and Health's (NIOSH) study of 80 'complaint' buildings. Four distinct groups of symptoms, representing 'tiredness', 'mucosal irritation', 'neuropsychological', and 'lower respiratory' conditions emerged from factor analysis of work-related symptoms. The symptom grouping is identical for both surveys. Although the prevalence of each symptom is significantly higher in the NIOSH than in the BASE sample, there is overlap of the symptom distributions. In the BASE survey, 45% of the work force reported at least one work-related health symptom; 20% reported at least three symptoms. These findings imply that it is counterproductive to dichotomize buildings into healthy vs. unhealthy; instead the prevalence of health problems related to buildings span a continuum. PRACTICAL IMPLICATIONS: These results indicate that most office buildings have occupants who report building-related symptoms. This paper provides practical guidance for the comparison of building prevalences to the BASE normative data. Work-related symptom distributions and symptom groups can improve investigators' ability to identify IEQ problems.

[Sonographical diagnosis of pneumoretroperitoneum as a result of retroperitoneal perforation]. / Das sonografische Bild des Pneumoretroperitoneums als Folge einer retroperitonealen Perforation.

A retroperitoneal perforation is a rare incident. It can occur as a complication of ERCP with papillotomy (0.2-0.5%). Leakage of contrast agent during endoscopy raises the suspicion that this complication has occurred but doesn't always give sufficient information about the leakage extent. In the case of extreme gas emission, a plain abdominal X-ray shows classic pneumoretroperitoneum. The abdominal CT scan can display small amounts of free air which is why it is used for diagnosis in such cases. Ultrasonography also provides a reliable diagnosis and is a good method for monitoring the progression of the condition. Alternative causes of pneumoretroperitoneum can be: trauma, inflammation, infection, tumor as well as ERCP and other interventional procedures, especially endoscopies. Presacral retroperitoneal pneumoradiography was used for the diagnosis of retroperitoneal tumors in the 70 s but is no longer used today. Perforations into the retroperitoneal space come from several locations in the gastrointestinal tract. In the different types of lesions the gas can penetrate the compartments and reach as far as the mediastinum, the intraabdominal cavity, subcutaneum (cervical) or the scrotal compartment (compartment shift). Based on 11 cases (7 perforations during ERCP, 2 perforation during colonoscopy, 2 cases with damage of the distal esophagus), we show the most extensive presentation of the sonographical picture of pneumoretroperitoneum. Typical signs on abdominal ultrasound are an increased echogenicity around the right kidney ("overcasted" or "covered" kidney), air dorsal to the gallbladder, around the duodenum and the head of the pancreas and especially ventral to the great abdominal vessel which can lead to the picture of "vanishing" vessels. The extent of free air is easy to assess. Even very small amounts are detectable ventral to the right kidney. In most cases, a conservative approach with no oral intake, antibiotic coverage, and analgesia in close gastroenterological-surgical cooperation is indicated. Especially after ERCP abscess formation is repeatedly described, sometimes even with a lethal outcome. Sonography is a suitable method for detecting free air in the retro-peritoneum. Pneumoretroperitoneum following bowel-perforation can be effectively shown by ultrasound, it is possible to assess the extent of free air, and sonographic monitoring of the treatment is possible and successful.

A longitudinal analysis of the efficacy of environmental interventions on asthma-related quality of life and symptoms among children in urban public housing.

In an environmental intervention study in public housing, we examined monthly Juniper Paediatric Asthma Quality of Life (QOL) Questionnaires for 51 children. Longitudinal analysis and spline models were used to identify time periods with significant improvements in QOL to inform judgments about causality. We found significant improvements in QOL, with moderate improvements before environmental interventions, increased rates of improvement immediately after, and reduced rates more than 5 months post-intervention. Effect modification analyses identified high-risk subpopulations and emphasized the importance of environmental, social, and economic conditions. Our results demonstrate the value of longitudinal techniques in evaluating the benefits of environmental interventions for asthma.

Synthesis of alpha-trifluoromethyl alpha-amino acids with aromatic, heteroaromatic and ferrocenyl subunits in the side chain.

5-Benzyloxy-4-trifluoromethyl-1,3-oxazoles, obtained from 5-fluoro-4-trifluoromethyloxazoles and benzyl alcohols, are capable for rearrangements. A 1,3 shift of a benzyl group is the key step of a new general route toward alpha-trifluoromethyl substituted aromatic and heteroaromatic amino acids, demonstrating that 5-fluoro-4-trifluoromethyl-1,3-oxazole is a synthetic Tfm-Gly equivalent. On reaction with benzpinacol partially fluorinated oxazoles are transformed into bis(trifluoromethyl) substituted 2,5-diamino adipic acid and N-benzoyl-2-benzhydryl-3,3,3-trifluoroalanine.

Domino reactions with fluorinated five-membered heterocycles. alpha-Trifluoromethyl alpha-amino acids with unsaturated side-chains.

Alpha-trifluoromethyl alpha-amino acids with unsaturated side-chains have been prepared from 5-fluoro-4-trifluoromethyloxazole and allyl, propargyl as well as terpene alcohols in a one-pot procedure.

Ventilation in public housing: implications for indoor nitrogen dioxide concentrations.

UNLABELLED: Although elevated nitrogen dioxide (NO2) exposures may exacerbate asthma, few studies have examined indoor NO2 levels in low-income, urban neighborhoods, where asthma prevalence is high. As part of the Healthy Public Housing Initiative, NO2 was measured in 77 homes within three Boston public housing developments, using Palmes tubes placed in the kitchen, living room, and outdoors. Air exchange rates (AERs) were assessed using a perfluorocarbon tracer technique. Overall NO2 levels were [mean (ppb)+/-s.d.]: kitchen (43+/-20, n=100), living room (36+/-17, n=102), outdoor (19+/-6, n=91). Indoor NO2 levels were significantly higher in the heating season (living room: 43 ppb vs. 26 ppb, kitchen: 50 ppb vs. 33 ppb), while AERs were significantly lower in the heating season (medians 0.49/h vs. 0.85/h). Significant univariate predictors of indoor concentrations include: outdoor NO2 levels, AERs, and occupancy. AERs and outdoor NO2 remained significant in multivariate models (P<0.05). A dummy variable for supplemental heating with gas stove was not significant (P=0.14), but had a large, positive coefficient. Indoor NO2 levels in this cohort are higher than those generally reported in residential US settings, associated in part with increased gas stove usage and decreased AERs during the heating season. PRACTICAL IMPLICATIONS: Indoor air quality is mainly a function of outdoor concentrations, indoor sources, ventilation, and residential behavior. Indoor exposures to nitrogen dioxide and other combustion pollutants may be elevated within low-income housing developments due to the presence of multiple sources, poor ventilation, small apartment size, and behavioral responses to apartment conditions (e.g. supplemental heating with gas stove). This information may be used by housing authorities and other landlords to decrease potential environmental stressors, through interventions such as source substitution and improved ventilation, particularly for sensitive sub-populations such as asthmatics.

Abbreviated nomenclature for cyclic and branched homo- and hetero-detic peptides.

Amino acid sequences and linear or head-to-tail cyclopeptides can be represented conveniently in one-line text formulae using the three-letter symbols. However, other - but nonetheless important - topologies of peptides are 'side chain-to-head (or tail)', 'backbone-to-backbone', 'side chain-to-side chain' cyclopeptides, 'side chain-to-side chain' connected peptide strands, and branched peptides (like peptide dendrimers). In general, such structures cannot be described using the three-letter symbols in one-line text: a chemical structure editor is required for symbolic representations according to the IUPAC-IUBMB recommendations. The aim of this contribution is to offer an unambiguous and general nomenclature system that enables researchers to represent all cyclic and branched homo- and hetero-detic peptides in a coherent manner in one-line text - as long as their as constituents can be represented in (three)-letter codes. The application of this new nomenclature would overcome the existing difficulties and provide a way to express complex situations in the shortest way in order to highlight more clearly the salient points in a given scientific communication.

[Jejunal intussusception of an inflammatory fibrinoid polyp]. / Jejunale Invagination eines inflammatorischen fibrinoiden Polypen.

Intussusception of parts of the intestine in adulthood is a rare cause of ileus. In more than 90 % of all cases there is a malignant or benign tumour situated in the parts of the intestine affected. We describe a 55-year-old patient who was admitted to hospital as an emergency because of signs of a proximal intestinal obstruction. Abdominal sonography suggested the diagnosis of a typical jejunal intussusception, whereas gastroscopy yielded no pathological findings. Laparotomy was performed immediately and confirmed the diagnosis. After intraoperative de-invagination 9 cm of jejunum and an inflammatory fibrinoid polyp of 3 cm were resected.

Ozone exposures during trans-continental and trans-Pacific flights.

UNLABELLED: Ozone concentrations were passively monitored in passenger cabins of commercial airliners flying domestic, Pacific, and south-east Asian routes. One-hundred and six flight segments were monitored for either the full duration and/or approximately 3 h during the middle portion of the flight for a total of 145 time-integrated measurements. Over all samples the mean (+/-SD) concentration was 80 p.p.b. (30.1). Twenty percent of the measurements exceeded 100 p.p.b., the FAA-recommended level. Eleven percent of the measurements exceeded 120 p.p.b., the US EPA's short-term National Ambient Air Quality Standard for ozone. Ozone concentrations measured on Pacific flights were substantially higher during mid-flight than over the full flight (95 p.p.b. vs. 56 p.p.b). Ozone concentrations on the northern Pacific routes were higher than concentrations for other Pacific flights. Season comparison showed that ozone levels were higher during the winter and spring than for the summer and fall. Our study shows that even in aircraft with catalytic ozone converters, passengers and flight crew may be exposed to elevated ozone levels on domestic and international flights. Given the frequency of ozone excess, it is recommended that (1) ozone converters should be required equipment on all commercial passenger aircraft for mid and high latitude routes (2) improved maintenance procedures should be required for catalytic converters (e.g., more frequent servicing/replacement), and (3) ozone should be routinely monitored on all mid and high latitude flights. PRACTICAL IMPLICATIONS: The authors have demonstrated elevated ozone concentrations in passenger cabins. They give several practical recommendations to help solve the problem.

[Impact of building and finishing materials and new furniture on the occurrence of respiratory diseases in children]. / Vliianie stroitel'no-otdelochnykh materialov i novoi mebeli na vozniknovenie respiratornykh zabolevanii u detei.

An epidemiological survey was made in 9 cities and towns of Russia to study the influence of emissions from building and finishing materials and new furniture on children's health. About 6,000 questionnaires containing the questions as to their apartment repairs and furniture changes were filled in. The questionnaire pays a particular attention to the types of used building materials, such as synthetic carpet covering, wood-particle boards, linoleum, paints, wall papers, and suspended ceilings. To study the children's health status, a number of questions of the questionnaire were devoted to the presence of some respiratory and allergic diseases (symptoms) reflecting the influence of unfavorable factors within the inhabited place. The logistic regression analysis was used to examine the relationship between the types of building materials used for repairs and the respiratory symptoms. There was a significant relationship of the chemical substances emitted from building materials and new furniture to the incidence of respiratory and allergic diseases in young schoolchildren.