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1.
Trials ; 25(1): 256, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38610038

RESUMO

BACKGROUND: Teleaudiology can potentially improve access to hearing healthcare services. Remote hearing aid fittings offer a new mode of service delivery that removes barriers of geography and access to an audiologist. Real-ear measurements (REMs) are the gold standard for hearing aid output verification but require in-clinic appointments. This study will investigate whether remote hearing aid fittings can provide clinically equivalent outcomes when compared to current, in-clinic, best practice guidelines. RESEARCH DESIGN: A repeated measure, double-blinded crossover design will be used. Participants will be randomly allocated to one of two groups to determine order of intervention, balanced for degree of hearing loss. STUDY SAMPLE: Sixty adults with mild to moderate hearing loss and at least 1 year of experience with hearing aids will be recruited. DATA COLLECTION AND ANALYSIS: Participants will complete two hearing aid fitting protocols, one using an in-clinic fitting process and the other using a remote (at-home) fitting process. In-clinic fittings will include REMs with adjustments to standard (NAL-NL2) prescription targets. The two fitting protocols will then be randomly assigned to participants in a crossover design, so participants and researchers will be blinded to the order of the two fitting protocols. Participants will then have a 4-week period with follow-up appointments for participant-directed gain adjustment. For each fitting protocol, participants will complete objective measurements of final hearing aid output with REMs, speech-in-noise testing, subjective measurements of hearing aid performance, and quality of life measurements. They will then begin an identical period of living with, adjusting, and objective assessment with the other fitting protocol. Data will be analysed as repeated measures with statistical control for potential confounding variables. RESULTS: Data will compare the four-frequency average real-ear aided response (4FREAR) for hearing aids programmed in-clinic and hearing aids programmed remotely, after participant-directed gain adjustments. Secondary measures will assess clinically significant differences in estimated speech intelligibility, hearing-related quality of life, hearing aid benefit, sound quality and preference, and speech-in-noise ability. CONCLUSIONS: This study will inform the development of best practice guidelines for remote hearing aid fittings. If no clinically significant differences are found between in-clinic and remote fit hearing aids, it has the potential to expand teleaudiology initiatives. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry, ACTRN12623000028606p . Date of registration: 12 January 2023.


Assuntos
Auxiliares de Audição , Perda Auditiva Neurossensorial , Perda Auditiva , Adulto , Humanos , Qualidade de Vida , Austrália , Instituições de Assistência Ambulatorial , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Sci Rep ; 14(1): 6722, 2024 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509265

RESUMO

An emerging intervention for control of airborne-mediated pandemics and epidemics is whole-room far-UVC (200-235 nm). Laboratory studies have shown that 222-nm light inactivates airborne pathogens, potentially without harm to exposed occupants. While encouraging results have been reported in benchtop studies and in room-sized bioaerosol chambers, there is a need for quantitative studies of airborne pathogen reduction in occupied rooms. We quantified far-UVC mediated reduction of aerosolized murine norovirus (MNV) in an occupied mouse-cage cleaning room within an animal-care facility. Benchtop studies suggest that MNV is a conservative surrogate for airborne viruses such as influenza and coronavirus. Using four 222-nm fixtures installed in the ceiling, and staying well within current recommended regulatory limits, far-UVC reduced airborne infectious MNV by 99.8% (95% CI: 98.2-99.9%). Similar to previous room-sized bioaerosol chamber studies on far-UVC efficacy, these results suggest that aerosolized virus susceptibility is significantly higher in room-scale tests than in bench-scale laboratory studies. That said, as opposed to controlled laboratory studies, uncertainties in this study related to airflow patterns, virus residence time, and dose to the collected virus introduce uncertainty into the inactivation estimates. This study is the first to directly demonstrate far-UVC anti-microbial efficacy against airborne pathogens in an occupied indoor location.


Assuntos
Doenças Transmissíveis , Infecções por Coronavirus , Norovirus , Vírus , Animais , Camundongos , Raios Ultravioleta , Ambiente Controlado , Desinfecção/métodos
3.
Healthcare (Basel) ; 11(23)2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38063622

RESUMO

BACKGROUND: In New Zealand, as in many places, a significant proportion of the population lives outside the main urban centres. People living in regional areas have similar needs for audiological services as those living in urban centres; however, economic and geographical barriers can be a barrier to accessible services. The objective of this research was to explore factors that influence equitable audiological service provision and user uptake of services in regional areas of New Zealand. METHODS: Fifteen participants who represented either audiological service users living in rural or non-urban areas (regional) or audiological service providers in these areas were recruited. Semi-structured interviews were conducted virtually and on average took forty minutes to complete. The interviews were transcribed and analysed using thematic analysis to identify themes and subthemes related to audiological service delivery and uptake. RESULTS: Seven themes were identified. These are related to service provision, geographical barriers, and cultural appropriateness. CONCLUSIONS: This study provides a basis for understanding the challenges of delivering and accessing audiological services in non-urban areas in New Zealand, and in principle elsewhere. There is scope for future research to further understand policy directions needed to achieve equitable audiological service provision in regional areas.

4.
Photochem Photobiol ; 2023 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-37929787

RESUMO

The COVID-19 pandemic underscored the crucial importance of enhanced indoor air quality control measures to mitigate the spread of respiratory pathogens. Far-UVC is a type of germicidal ultraviolet technology, with wavelengths between 200 and 235 nm, that has emerged as a highly promising approach for indoor air disinfection. Due to its enhanced safety compared to conventional 254 nm upper-room germicidal systems, far-UVC allows for whole-room direct exposure of occupied spaces, potentially offering greater efficacy, since the total room air is constantly treated. While current evidence supports using far-UVC systems within existing guidelines, understanding the upper safety limit is critical to maximizing its effectiveness, particularly for the acute phase of a pandemic or epidemic when greater protection may be needed. This review article summarizes the substantial present knowledge on far-UVC safety regarding skin and eye exposure and highlights research priorities to discern the maximum exposure levels that avoid adverse effects. We advocate for comprehensive safety studies that explore potential mechanisms of harm, generate action spectra for crucial biological effects and conduct high-dose, long-term exposure trials. Such rigorous scientific investigation will be key to determining safe and effective levels for far-UVC deployment in indoor environments, contributing significantly to future pandemic preparedness and response.

5.
Heliyon ; 9(6): e17399, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37408891

RESUMO

Purpose: The mortality in patients with MYCN-amplified high-risk neuroblastoma remains greater than 50% despite advances in multimodal therapy. Novel therapies are urgently needed that requires preclinical evaluation in appropriate mice models. Combinatorial treatment with high-dose radiotherapy (HDRT) and immunotherapy has emerged as an effective treatment option in a variety of cancers. Current models of neuroblastoma do not recapitulate the anatomic and immune environment in which multimodal therapies can be effectively tested, and there is a need for an appropriate syngeneic neuroblastoma mice model to study interaction of immunotherapy with host immune cells. Here, we develop a novel syngeneic mouse model of MYCN-amplified neuroblastoma and report the relevance and opportunities of this model to study radiotherapy and immunotherapy. Materials and methods: A syngeneic allograft tumor model was developed using the murine neuroblastoma cell line 9464D derived a tumor from TH-MYCN transgenic mouse. Tumors were generated by transplanting 1 mm3 portions of 9464D flank tumors into the left kidney of C57Bl/6 mice. We investigated the effect of combining HDRT with anti-PD1 antibody on tumor growth and tumor microenvironment. HDRT (8 Gy x 3) was delivered by the small animal radiation research platform (SARRP). Tumor growth was monitored by ultrasound. To assess the effect on immune cells tumors sections were co-imuunostained for six biomarkers using the Vectra multispectral imaging platform. Results: Tumor growth was uniform and confined to the kidney in 100% of transplanted tumors. HDRT was largely restricted to the tumor region with minimal scattered out-of-field dose. Combinatorial treatment with HDRT and PD-1 blockade significantly inhibited tumor growth and prolonged mice survival. We observed augmented T-lymphocyte infiltration, especially CD3+CD8+ lymphocytes, in tumors of mice which received combination treatment. Conclusion: We have developed a novel syngeneic mouse model of MYCN amplified high-risk neuroblastoma. We have utilized this model to show that combining immunotherapy with HDRT inhibits tumor growth and prolongs mice survival.

6.
PLoS Biol ; 21(7): e3001888, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37478130

RESUMO

Rotifers have been studied in the laboratory and field for over 100 years in investigations of microevolution, ecological dynamics, and ecotoxicology. In recent years, rotifers have emerged as a model system for modern studies of the molecular mechanisms of genome evolution, development, DNA repair, aging, life history strategy, and desiccation tolerance. However, a lack of gene editing tools and transgenic strains has limited the ability to link genotype to phenotype and dissect molecular mechanisms. To facilitate genetic manipulation and the creation of reporter lines in rotifers, we developed a protocol for highly efficient, transgenerational, CRISPR-mediated gene editing in the monogonont rotifer Brachionus manjavacas by microinjection of Cas9 protein and synthetic single-guide RNA into the vitellaria of young amictic (asexual) females. To demonstrate the efficacy of the method, we created knockout mutants of the developmental gene vasa and the DNA mismatch repair gene mlh3. More than half of mothers survived injection and produced offspring. Genotyping these offspring and successive generations revealed that most carried at least 1 CRISPR-induced mutation, with many apparently mutated at both alleles. In addition, we achieved precise CRISPR-mediated knock-in of a stop codon cassette in the mlh3 locus, with half of injected mothers producing F2 offspring with an insertion of the cassette. Thus, this protocol produces knockout and knock-in CRISPR/Cas9 editing with high efficiency, to further advance rotifers as a model system for biological discovery.


Assuntos
Edição de Genes , Rotíferos , Animais , Feminino , Edição de Genes/métodos , Sistemas CRISPR-Cas/genética , Proteína 9 Associada à CRISPR , Rotíferos/genética , Reparo do DNA
7.
Codas ; 35(2): e20210201, 2023.
Artigo em Português, Inglês | MEDLINE | ID: mdl-37132696

RESUMO

PURPOSE: The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA). METHODS: The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam. RESULTS: The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency. CONCLUSION: This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).


OBJETIVO: O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). MÉTODO: O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. RESULTADOS: os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. CONCLUSÃO: Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).


Assuntos
Comparação Transcultural , Traduções , Humanos , Brasil , Inquéritos e Questionários , Audição , Reprodutibilidade dos Testes
8.
Microbiologyopen ; 12(2): e1348, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37186229

RESUMO

The dental clinic air microbiome incorporates microbes from the oral cavity and upper respiratory tract (URT). This study aimed to establish a reliable methodology for air sampling in a dental clinic setting and quantify the abundance of culturable mesophilic aerobic bacteria present in these samples using regression modeling. Staphylococcus hominis, a potentially pathogenic bacterium typically found in the human oropharynx and URT, was consistently isolated. S. hominis was the most abundant species of aerobic bacteria (22%-24%) and comprised 60%-80% of all Staphylococcus spp. The study also assessed the susceptibility of S. hominis to 222 nm-far-UVC light in laboratory experiments, which showed an exponential surface inactivation constant of k = 0.475 cm2 /mJ. This constant is a critical parameter for future on-site use of far-UVC light as a technique for reducing pathogenic bacterial load in dental clinics.


Assuntos
Staphylococcus hominis , Raios Ultravioleta , Humanos , Clínicas Odontológicas , Staphylococcus
9.
Photochem Photobiol ; 99(1): 168-175, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35614842

RESUMO

Far-UVC radiation, typically defined as 200-235 nm, has similar or greater anti-microbial efficacy compared with conventional 254-nm germicidal radiation. In addition, biophysical considerations of the interaction of far-UVC with tissue, as well as multiple short-term safety studies in animal models and humans, suggest that far-UVC exposure may be safe for skin and eye tissue. Nevertheless, the potential for skin cancer after chronic long-term exposure to far-UVC has not been studied. Here, we assessed far-UVC induced carcinogenic skin changes and other pathological dermal abnormalities in 96 SKH-1 hairless mice of both sexes that were exposed to average daily dorsal skin doses of 400, 130 or 55 mJ cm-2 of 222 nm far-UVC radiation for 66 weeks, 5 days per week, 8 h per day, as well as similarly-treated unexposed controls. No evidence for increased skin cancer, abnormal skin growths or incidental skin pathology findings was observed in the far-UVC-exposed mice. In addition, there were no significant changes in morbidity or mortality. The findings from this study support the long-term safety of long-term chronic exposure to far-UVC radiation, and therefore its potential suitability as a practical anti-microbial approach to reduce airborne viral and bacterial loads in occupied indoor settings.


Assuntos
Anormalidades da Pele , Neoplasias Cutâneas , Humanos , Masculino , Feminino , Animais , Camundongos , Pele/microbiologia , Raios Ultravioleta/efeitos adversos , Neoplasias Cutâneas/etiologia , Camundongos Pelados
10.
Photochem Photobiol ; 99(1): 160-167, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35818780

RESUMO

Far-UVC radiation, defined in this paper as ultraviolet (UV) radiation with wavelengths from 200 to 235 nm, is a promising tool to help prevent the spread of disease. The unique advantage of far-UVC technology over traditional UV germicidal irradiation lies in the potential for direct application of far-UVC into occupied spaces since antimicrobial doses of far-UVC are significantly below the recommended daily safe exposure limits. This study used a ceiling-mounted far-UVC fixture emitting at 222 nm to directly irradiate an indoor space and then evaluated the doses received upon a manikin. Radiation-sensitive film was affixed to the head, nose, lip and eyes of the manikin, and the 8-h equivalent exposure dose was determined. Variables examined included manikin height (sitting or standing position), manikin offset from directly below the fixture, tilt of the manikin, the addition of glasses, the addition of hair and different anatomical feature sizes. Importantly, at the manikin position with the highest dose to eyes, the average eye dose was only 5.8% of the maximum directly measured dose. These results provide the first experimental analysis of possible exposure doses a human would experience from an indoor far-UVC installation.


Assuntos
Desinfecção , Raios Ultravioleta , Humanos , Desinfecção/métodos
11.
J Deaf Stud Deaf Educ ; 28(2): 162-170, 2023 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-36416417

RESUMO

Early detection of hearing loss leads to early intervention-related decisions. Most children with cochlear implants (CIs) are born to hearing parents. Prior evidence suggests that this increased access to oral communication and the "hearing" world means oral communication is prioritized by hearing parents. Language plays a key role within culture and these communication decisions are likely to be associated with children's level of d/Deaf acculturation. This study was based on qualitative interviews. Thirty-two people associated with 14 children were interviewed; these were parents of children with CIs, four children over age 11 years, and teachers of 13 of the children. The study aimed to investigate parental communication decisions on child/family d/Deaf acculturation and the role of access to resources on children's d/Deaf acculturation development. Findings indicate two profiles of family acculturation-oral and bicultural and point to a possible relationship between access to resources and parents' decision-making process.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Criança , Humanos , Aculturação , Atitude , Surdez/cirurgia , Pais , Conhecimentos, Atitudes e Prática em Saúde
12.
CoDAS ; 35(2): e20210201, 2023. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1439934

RESUMO

RESUMO Objetivo O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). Método O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. Resultados os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. Conclusão Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).


ABSTRACT Purpose The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA). Methods The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam. Results The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency. Conclusion This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

13.
Nat Commun ; 13(1): 6484, 2022 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-36309507

RESUMO

In the second quarter of 2022, there was a global surge of emergent SARS-CoV-2 lineages that had a distinct growth advantage over then-dominant Omicron BA.1 and BA.2 lineages. By generating 10,403 Omicron genomes, we show that Aotearoa New Zealand observed an influx of these immune-evasive variants (BA.2.12.1, BA.4, and BA.5) through the border. This is explained by the return to significant levels of international travel following the border's reopening in March 2022. We estimate one Omicron transmission event from the border to the community for every ~5,000 passenger arrivals at the current levels of travel and restriction. Although most of these introductions did not instigate any detected onward transmission, a small minority triggered large outbreaks. Genomic surveillance at the border provides a lens on the rate at which new variants might gain a foothold and trigger new waves of infection.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Nova Zelândia/epidemiologia , SARS-CoV-2/genética , COVID-19/epidemiologia , Surtos de Doenças
14.
Noise Health ; 24(114): 158-165, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36124525

RESUMO

Background: Noise sensitivity moderates the association between environmental noise exposure and annoyance and health outcomes. Methods: In normally hearing adults, we measured noise sensitivity in three ways: using the noise sensitivity questionnaire, a 3-point self-rating, and the loudness discomfort level (LDL; mean reported discomfort level for tone bursts). We then presented recordings of a 15-second 80 dBLAeq aeroplane overflight and participants rated the annoyance and loudness they experienced. Results: The three measures of noise sensitivity were not well correlated with each other, and only the overall LDL was associated with the ratings of loudness and annoyance in response to the aeroplane sounds. Conclusions: This implies that our current measures of noise sensitivity may only capture parts of the underlying construct, and therefore underestimate effects due to it on the association between environmental noise and annoyance and health outcomes. We developed a theoretical model to describe the set of factors that may influence a person's sensitivity to noise and propose that interaction between the systems described is the basis for noise sensitivity. This paradigm alters the focus of noise research from the annoyance caused by the sound, to the sensitization to noise that may occur as a result of the interplay of many factors. We hope that our model will allow research to explore the sensitizing factors for noise more easily and systematically.


Assuntos
Ruído , Som , Adulto , Exposição Ambiental/efeitos adversos , Humanos , Ruído/efeitos adversos , Inquéritos e Questionários
15.
Front Integr Neurosci ; 16: 909972, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910338

RESUMO

Introduction: Noise-induced hearing loss can be avoided by taking preventive measures. Objective: To assess the effectiveness of the Brazilian version of the Dangerous Decibels® program for noise-exposed workers, using the ecological model as an educational intervention plan. Method: Non-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups-the first one (n = 132, divided into 6 subgroups) received the Dangerous Decibels® Brazil educational intervention (DDBEI) adapted to workers while the second group (n = 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student's t-test for paired data (<0.05). Results: After both the DDBEI and CEI training, workers improved significantly in barriers, supports, knowledge, attitudes, and behavior around noise. By chance, the CEI group scored lower in all measures than the DDBEI group before training, and though both groups improved, the difference was maintained after training. Conclusion: The Brazilian version of the Dangerous Decibels® program for noise-exposed workers was effective, influencing positively the factors at different levels of the ecological model. Though the DDBEI was no more effective than the CEI, the CEI participants began at much lower levels, so the effectiveness of the DDBEI may have been underestimated.

16.
Nat Commun ; 13(1): 4035, 2022 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-35821124

RESUMO

New Zealand's COVID-19 elimination strategy heavily relied on the use of genomics to inform contact tracing, linking cases to the border and to clusters during community outbreaks. In August 2021, New Zealand entered its second nationwide lockdown after the detection of a single community case with no immediately apparent epidemiological link to the border. This incursion resulted in the largest outbreak seen in New Zealand caused by the Delta Variant of Concern. Here we generated 3806 high quality SARS-CoV-2 genomes from cases reported in New Zealand between 17 August and 1 December 2021, representing 43% of reported cases. We detected wide geographical spread coupled with undetected community transmission, characterised by the apparent extinction and reappearance of genomically linked clusters. We also identified the emergence, and near replacement, of genomes possessing a 10-nucleotide frameshift deletion that caused the likely truncation of accessory protein ORF7a. By early October, New Zealand moved from an elimination strategy to a suppression strategy and the role of genomics changed markedly from being used to track and trace, towards population-level surveillance.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Genômica , Humanos , Nova Zelândia/epidemiologia , SARS-CoV-2/genética
17.
Mol Biol Evol ; 39(8)2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35733333

RESUMO

Single-cell sequencing provides a new way to explore the evolutionary history of cells. Compared to traditional bulk sequencing, where a population of heterogeneous cells is pooled to form a single observation, single-cell sequencing isolates and amplifies genetic material from individual cells, thereby preserving the information about the origin of the sequences. However, single-cell data are more error-prone than bulk sequencing data due to the limited genomic material available per cell. Here, we present error and mutation models for evolutionary inference of single-cell data within a mature and extensible Bayesian framework, BEAST2. Our framework enables integration with biologically informative models such as relaxed molecular clocks and population dynamic models. Our simulations show that modeling errors increase the accuracy of relative divergence times and substitution parameters. We reconstruct the phylogenetic history of a colorectal cancer patient and a healthy patient from single-cell DNA sequencing data. We find that the estimated times of terminal splitting events are shifted forward in time compared to models which ignore errors. We observed that not accounting for errors can overestimate the phylogenetic diversity in single-cell DNA sequencing data. We estimate that 30-50% of the apparent diversity can be attributed to error. Our work enables a full Bayesian approach capable of accounting for errors in the data within the integrative Bayesian software framework BEAST2.


Assuntos
Neoplasias , Software , Teorema de Bayes , Evolução Molecular , Genômica , Humanos , Modelos Genéticos , Filogenia
18.
N Z Med J ; 135(1549): 26-42, 2022 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-35728138

RESUMO

There are two models used in the literature to describe those who are d/Deaf: the medical and the cultural models. The medical model describes deafness as an unwanted disability that needs to be treated through the use of medical devices like cochlear implants (CIs). The cultural model describes the word "Deaf" (written with a capital) as a culture and membership of the Deaf community as a privilege. It also places emphasis on the importance of sign language in Deaf culture. Historically, the Deaf community has been opposed to cochlear implantation in children, but little is known about current attitudes, or the attitudes of the Deaf community in New Zealand. This research used an online questionnaire to ask deaf, hard-of-hearing (HoH) and culturally Deaf people in New Zealand about their views on paediatric cochlear implants. Culturally Deaf respondents were compared to those who were not. The study's findings were mixed, suggesting that there are still reservations about the benefits of CIs for children born deaf. It identified key areas for consideration: a bilingual/bicultural approach to CI habilitation in children, and the need to fully inform parents of all of their options. The study also highlighted the multitude of cultural and non-cultural factors that need to be considered in both the decision-making and habilitation processes for treatment of a deaf child. An understanding of how the Deaf community's perspective differs from that of health professions in New Zealand is important in considering what is best for deaf children.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Criança , Surdez/cirurgia , Humanos , Nova Zelândia , Língua de Sinais
19.
Viruses ; 14(4)2022 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-35458414

RESUMO

Recent research using UV radiation with wavelengths in the 200-235 nm range, often referred to as far-UVC, suggests that the minimal health hazard associated with these wavelengths will allow direct use of far-UVC radiation within occupied indoor spaces to provide continuous disinfection. Earlier experimental studies estimated the susceptibility of airborne human coronavirus OC43 exposed to 222-nm radiation based on fitting an exponential dose-response curve to the data. The current study extends the results to a wider range of doses of 222 nm far-UVC radiation and uses a computational model coupling radiation transport and computational fluid dynamics to improve dosimetry estimates. The new results suggest that the inactivation of human coronavirus OC43 within our exposure system is better described using a bi-exponential dose-response relation, and the estimated susceptibility constant at low doses-the relevant parameter for realistic low dose rate exposures-was 12.4 ± 0.4 cm2/mJ, which described the behavior of 99.7% ± 0.05% of the virus population. This new estimate is more than double the earlier susceptibility constant estimates that were based on a single-exponential dose response. These new results offer further evidence as to the efficacy of far-UVC to inactivate airborne pathogens.


Assuntos
COVID-19 , Coronavirus Humano OC43 , Desinfecção/métodos , Humanos , SARS-CoV-2 , Raios Ultravioleta , Inativação de Vírus
20.
Sci Rep ; 12(1): 4373, 2022 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-35322064

RESUMO

Many infectious diseases, including COVID-19, are transmitted by airborne pathogens. There is a need for effective environmental control measures which, ideally, are not reliant on human behaviour. One potential solution is Krypton Chloride (KrCl) excimer lamps (often referred to as Far-UVC), which can efficiently inactivate pathogens, such as coronaviruses and influenza, in air. Research demonstrates that when KrCl lamps are filtered to remove longer-wavelength ultraviolet emissions they do not induce acute reactions in the skin or eyes, nor delayed effects such as skin cancer. While there is laboratory evidence for Far-UVC efficacy, there is limited evidence in full-sized rooms. For the first time, we show that Far-UVC deployed in a room-sized chamber effectively inactivates aerosolised Staphylococcus aureus. At a room ventilation rate of 3 air-changes-per-hour (ACH), with 5 filtered-sources the steady-state pathogen load was reduced by 98.4% providing an additional 184 equivalent air changes (eACH). This reduction was achieved using Far-UVC irradiances consistent with current American Conference of Governmental Industrial Hygienists threshold limit values for skin for a continuous 8-h exposure. Our data indicate that Far-UVC is likely to be more effective against common airborne viruses, including SARS-CoV-2, than bacteria and should thus be an effective and "hands-off" technology to reduce airborne disease transmission. The findings provide room-scale data to support the design and development of effective Far-UVC systems.


Assuntos
COVID-19 , Infecções Estafilocócicas , Desinfecção , Humanos , SARS-CoV-2 , Raios Ultravioleta
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