Elucidating the molecular physiopathology of acute respiratory distress syndrome in severe acute respiratory syndrome patients

Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury. It is a response to various diseases of variable etiology, including SARS-CoV infection. To date, a comprehensive study of the genomic physiopathology of ARDS (and SARS) is lacking, primarily due to the difficulty of finding suitable materials to study the disease process at a tissue level (instead of blood, sputa or swaps). Hereby we attempt to provide such study by analyzing autopsy lung samples from patient who died of SARS and showed different degrees of severity of the pulmonary involvement. We performed real-time quantitative PCR analysis of 107 genes with functional roles in inflammation, coagulation, fibrosis and apoptosis: some key genes were confirmed at a protein expression level by immunohistochemistry and correlated to the degree of morphological severity present in the individual samples analyzed. Significant expression levels were identified for ANPEP (a receptor for CoV), as well as inhibition of the STAT1 pathway, IFNs production and CXCL10 (a T-cell recruiter). Other genes unassociated to date with ARDS/SARS include C1Qb, C5R1, CASP3, CASP9, CD14, CD68, FGF7, HLA-DRA, ICF1, IRF3, MALAT-1, MSR1, NFIL3, SLPI, USP33, CLC, GBP1 and TACI. As a result, we proposed to therapeutically target some of these genes with compounds such as ANPEP inhibitors, SLPI and dexamethasone. Ultimately, this study may serve as a model for future, tissue-based analyses of fibroinflammatory conditions affecting the lung. (C) 2009 Elsevier B.V. All rights reserved.

Morbillivirus cross-species infection:is there a risk for humans?

The World Health Organisation (WHO) has set regional elimination goals for Measles (MV) eradication to be achieved by 2020 or earlier. A major question is whether an opportunity for veterinary virus infection of humans may arise when MV is eradicated and if vaccination is discontinued. Lessons have been learned from animal to human virus transmission i.e. human immunodeficiency virus (HIV) and more recently from severe acute respiratory syndrome (SARS) and avian influenza virus infections. We are therefore alerted to the risk of zoonosis from the veterinary morbilliviruses. In this review the evidence from viral genomics, animal studies and cell culture experiments will be explored to evaluate the possibility of cross infection of humans with these viruses.

Slopes of Avian Species-Area Relationships, Human Population Density, and Environmental Factors

There is increasing interest in how humans influence spatial patterns in biodiversity. One of the most frequently noted and marked of these patterns is the increase in species richness with area, the species-area relationship (SAR). SARs are used for a number of conservation purposes, including predicting extinction rates, setting conservation targets, and identifying biodiversity hotspots. Such applications can be improved by a detailed understanding of the factors promoting spatial variation in the slope of SARs, which is currently the subject of a vigorous debate. Moreover, very few studies have considered the anthropogenic influences on the slopes of SARs; this is particularly surprising given that in much of the world areas with high human population density are typically those with a high number of species, which generates conservation conflicts. Here we determine correlates of spatial variation in the slopes of species-area relationships, using the British avifauna as a case study. Whilst we focus on human population density, a widely used index of human activities, we also take into account (1) the rate of increase in habitat heterogeneity with increasing area, which is frequently proposed to drive SARs, (2) environmental energy availability, which may influence SARs by affecting species occupancy patterns, and (3) species richness. We consider environmental variables measured at both local (10 km x 10 km) and regional (290 km x 290 km) spatial grains, but find that the former consistently provides a better fit to the data. In our case study, the effect of species richness on the slope SARs appears to be scale dependent, being negative at local scales but positive at regional scales. In univariate tests, the slope of the SAR correlates negatively with human population density and environmental energy availability, and positively with the rate of increase in habitat heterogeneity. We conducted two sets of multiple regression analyses, with and without species richness as a predictor. When species richness is included it exerts a dominant effect, but when it is excluded temperature has the dominant effect on the slope of the SAR, and the effects of other predictors are marginal.

Tonnacypris glacialis (Ostracoda, Cyprididae):taxonomic position, (palaeo)ecology, and zoogeography

The freshwater ostracod Tonnacypris glaciallis (Sars, 1890) is reported from the European Pleistocene for the first time. The historical allocation of the species is discussed, and the species composition and characteristics of Tonnacypris is Diebel & Pietrzeniuk (1975) and its phylozoogeography are considered. The significance of T. glacialis is reviewed, particularly from the viewpoint of the possible implications of parthenogenesis (and occasional-male production) for the Quaternary history of the genus, and for the use of the species in palaeoenvironmental reconstruction. It is suggested that the Pleistocene fossil occurrence of I: glacialis in modern temperate latitudes is a robust indicator of mean summer temperatures of 6 degrees C.

A spatio-temporal contrast of the predatory impact of an invasive freshwater crustacean

Aim: Impacts of invasive species may vary across invasion gradients, owing to trait-based sorting of individuals through dispersal: those aggregating at invasion fronts may be more aggressive and voracious. We examine, in the field and laboratory, variation in the predatory impacts of an invasive Ponto-Caspian crustacean Hemimysis anomala G.O. Sars, 1907 at two sites along a spatio-temporal gradient of invasion.

Location: Republic of Ireland.

Methods: We used reciprocal transplant field-deployed mesocosms to compare predation rates of invasion front and well-established H. anomala on natural zooplankton assemblages. In the laboratory, we measured the functional response (relationship between predation rate and prey supply) of H. anomala from both sites, for a per capita mechanistic comparison of predation efficiency. We also assessed prey selectivity of H. anomala in the mesocosm experiments to further compare feeding behaviour. Finally, we used a correlative approach to assess the community impact of H. anomala across sites, including a nearby uninvaded site, by comparing zooplankton diversities and densities.

Results: Invasion front H. anomala had higher predation rates than well-established H. anomala at high in situ zooplankton densities. Invasion front H. anomala also had higher functional responses - in particular showing higher 'attack rates' - indicating a heightened ability to locate and capture prey. Prey selectivity was consistent across the spatio-temporal contrast, with positive selection for cladocerans. Zooplankton diversity and density declined with time since H. anomala invasion, both being maximal at the uninvaded site.

Main conclusions: Our study, for the first time, (1) reveals differences in predatory per capita effects and associated behavioural traits between two sites along a spatio-temporal invasion gradient and (2) shows a negative community-level impact of the invasive H. anomala in natural water bodies. Further spatio-temporal comparisons of predatory per capita effects of invaders are needed to assess the generality of these results.

Antioxidant properties of hydroxycinnamic acids: a review of structure- activity relationships

Hydroxycinnamic acids (HCAs) are important phytochemicals possessing significant biological properties. Several investigators have studied in vitro antioxidant activity of HCAs in detail. In this review, we have gathered the studies focused on the structure-activity relationships (SARs) of these compounds that have used medicinal chemistry to generate more potent antioxidant molecules. Most of the reports indicated that the presence of an unsaturated bond on the side chain of HCAs is vital to their activity. The structural features that were reported to be of importance to the antioxidant activity were categorized as follows: modifications of the aromatic ring, which include alterations in the number and position of hydroxy groups and insertion of electron donating or withdrawing moieties as well as modifications of the carboxylic function that include esterification and amidation process. Furthermore, reports that have addressed the influence of physicochemical properties including redox potential, lipid solubility and dissociation constant on the antioxidant activity were also summarized. Finally, the pro-oxidant effect of HCAs in some test systems was addressed. Most of the investigations concluded that the presence of ortho-dihydroxy phenyl group (catechol moiety) is of significant importance to the antioxidant activity, while, the presence of three hydroxy groups does not necessarily improve the activity. Optimization of the structure of molecular leads is an important task of modern medicinal chemistry and its accomplishment relies on the careful assessment of SARs. SAR studies on HCAs can identify the most successful antioxidants that could be useful for management of oxidative stress-related diseases.

L’allocation d’antiviraux dans un contexte de pandémie : vérification de critères auprès des professionnels de la santé pour le développement d’un cadre éthique

Cette étude a pour objectif d’évaluer la stratégie d’utilisation de critères de base, d’un point de vue éthique, dans l’allocation d’une quantité limitée d’antiviraux pour une utilisation préventive, lors d’une pandémie. Il est entendu qu’une réserve publique pour la prévention n’est pas présentement en vue. Ainsi un des objectifs de cette recherche est de servir de guide aux personnes ressources en positions décisionnelles, à savoir si l’acquisition d’une telle réserve est justifiée, et dans l’affirmatif, à qui elle serait destinée. La perspective spécifique de deux groupes de professionnels de la santé œuvrant en première ligne est considérée. Le premier groupe est constitué de professionnels provenant des hôpitaux de la région de Toronto qui ont vécu l’expérience du SRAS en 2003. Le second groupe est composé de travailleurs en santé de la région de Montréal qui n’auront pas vécu cette crise sanitaire. Les deux groupes sont analysés ensemble sur leur discours verbal et sur leurs réponses à un questionnaire bâti afin d’évaluer quel poids les participants donnent aux critères proposés.

Analyse critique de la culture de sécurité face aux risques biologiques et pandémiques pour les infirmières

Une préoccupation grandissante face aux risques biologiques reliés aux maladies infectieuses est palpable tant au niveau international que national ou provincial. Des maladies émergentes telles que le SRAS ou la grippe A/H1N1 ont amené une prise en charge des risques pandémiques et à l’élaboration de mesures d’urgence pour maîtriser ces risques : développer une culture de sécurité est devenu une priorité de recherche de l’OMS. Malgré tout, peu d’écrits existent face à cette volonté de sécuriser la santé et le bien-être par toute une série de dispositifs au sein desquels les discours occupent une place importante en matière de culture de sécurité face aux risques biologiques. Une réflexion sociopolitique était nécessaire pour les infirmières qui sont aux premières loges en dispensant des soins à la population dans une perspective de prévention et de contrôle des infections (PCI) dans laquelle elles se spécialisent. Dès lors, ce projet avait pour buts d’explorer la perception du risque et de la sécurité face aux maladies infectieuses auprès des infirmières cliniciennes et gestionnaires québécoises; d’explorer plus spécifiquement l'existence ou l'absence de culture de sécurité dans un centre de santé et de services sociaux québécois (CSSS); et d’explorer les discours en présence dans le CSSS en matière de sécurité et de risques biologiques face aux maladies infectieuses et comment ces discours de sécurité face aux risques biologiques se traduisent dans le quotidien des infirmières. Les risques biologiques sont perçus comme identifiables, mesurables et évitables dans la mesure où les infirmières appliquent les mesures de préventions et contrôle des infections, ce qui s’inscrit dans une perspective positiviste du risque (Lupton, 1999). La gestion de ces risques se décline au travers de rituels de purification et de protection afin de se protéger de toute maladie infectieuse. Face à ces risques, une culture de sécurité unique est en émergence dans le CSSS dans une perspective de prévention de la maladie. Toutefois, cette culture de sécurité désirée est confrontée à une mosaïque de cultures qui couvrent différentes façons d’appliquer ou non les mesures de PCI selon les participants. La contribution de cette recherche est pertinente dans ce nouveau domaine de spécialité que constituent la prévention et le contrôle des infections pour les infirmières québécoises. Une analyse critique des relations de pouvoir tel qu’entendu par Foucault a permis de soulever les questions de surveillance infirmière, de politique de l’aveu valorisée, de punition de tout écart à l’application rigoureuse des normes de PCI, de contrôle de la part des cadres infirmiers et d’assujettissement des corps relevant des mécanismes disciplinaires. Elle a permis également de documenter la présence de dispositifs de sécurité en lien avec la tenue de statistiques sur les patients qui sont répertoriés en tant que cas infectieux, mais également en termes de circulation des personnes au sein de l’établissement. La présence d’un pouvoir pastoral est perceptible dans la traduction du rôle d’infirmière gestionnaire qui doit s’assurer que ses équipes agissent de la bonne façon et appliquent les normes de PCI privilégiées au sein du CSSS afin de réguler les taux d’infections nosocomiales présents dans l’établissement. En cas de non-respect des mesures de PCI touchant à l’hygiène des mains ou à la vaccination, l’infirmière s’expose à des mesures disciplinaires passant de l’avertissement, la relocalisation, l’exclusion ou la suspension de l’emploi. Une culture du blâme a été décrite par la recherche d’un coupable au sein de l’institution, particulièrement en temps de pandémie. Au CSSS, l’Autre est perçu comme étant à l’origine de la contamination, tandis que le Soi est perçu comme à l’abri de tout risque à partir du moment où l’infirmière respecte les normes d’hygiène de vie en termes de saines habitudes alimentaires et d’activité physique. Par ailleurs, les infirmières se doivent de respecter des normes de PCI qu’elles connaissent peu, puisque les participantes à la recherche ont souligné le manque de formation académique et continue quant aux maladies infectieuses, aux risques biologiques et à la culture de sécurité qu’elles considèrent pourtant comme des sujets priorisés par leur établissement de santé. Le pouvoir produit des effets sur les corps en les modifiant. Cette étude ethnographique critique a permis de soulever les enjeux sociopolitiques reliés aux discours en présence et de mettre en lumière ce que Foucault a appelé le gouvernement des corps et ses effets qui se capillarisent dans le quotidien des infirmières. Des recherches ultérieures sont nécessaires afin d’approfondir ce champ de spécialité de notre discipline infirmière et de mieux arrimer la formation académique et continue aux réalités infectieuses cliniques.

Two new clam shrimp species (Crustacea: Branchiopoda: Spinicaudata) from Kerala, India

Two new clam shrimp species belonging to the genera Eulimnadia Packard, 1874 and Leptestheria Sars 1898 from Kerala, India are described. Spinicaudatan clam shrimp are among the least studied groups in India, with only 30 species reported. Eulimnadia azisi sp. nov. was collected from rain fed, temporary, rocky depressions at Vettilapara, in Western Ghats, Kerala. No males were observed and the population may be hermaphroditic. Leptestheria dumonti sp. nov. was collected from the paddy fields at Parapukara, Kerala. Altogether two species of Leptestheria and nine species of Eulimnadia have been reported from India, and this is the first report of the genus Leptestheria from Kerala.

Caracterización de los pacientes críticos ventilados en la Fundación Santa Fe de Bogotá 2009 a 2013

Objetivo: Caracterizar a los pacientes que recibieron ventilación mecánica en las unidades de cuidado intensivo (UCI) de la Fundación Santa Fe de Bogotá entre los años 2009 y 2013. Metodología: Se analizó una cohorte retrospectiva de los pacientes en UCI que requirieron soporte ventilatorio mecánico al ingreso a la unidad independientemente de la causa. Resultados: La media de edad de los pacientes fue 63,83 años; el diagnóstico más frecuente de ingreso fue revascularización miocárdica, seguido por neumonía y recambio valvular aórtico; en el 43% de los casos la causa de la falla fue el estado postoperatorio. Los modos ventilatorios más frecuentemente utilizados fueron SIMV (27,5%) y ventilación asistida controlada (26,12%). El 50% de los pacientes fueron ventilados con PEEP < 6 cmH2O. La mortalidad bruta fue del 15%. 22% de los pacientes tuvieron estancia prolongada en UCI. Se aplicó protocolo de retiro de ventilación mecánica en el 77% de los pacientes. La duración de la ventilación mecánica es mayor a medida que aumenta la edad del paciente entre los 60 y los 80 años. La mortalidad es cercana al 50% alrededor de los 50 años y mayor a 80% después de los 80 años. El soporte ventilatorio por cinco o más días aumentó la mortalidad a 80% o más. Discusión y Conclusiones: Estos resultados son comparables a los encontrados en estudios previos. Este estudio puede ser considerado como el primer paso para generar un registro adecuado de la ventilación de la mecánica de las unidades de cuidado intensivo del país.

La cooperación en América del Norte : de las seguridades económica y militar a la bioseguridad (2001-2009)

El nuevo orden internacional derivado de la Guerra Fría se caracterizó por la multiplicación de nuevas amenazas a la seguridad y la construcción de bloques regionales con el propósito de enfrentarlas. Esta investigación plantea que bajo tales circunstancias, en América del Norte, fue adoptada una agenda ampliada y profundizada en materia de seguridad que permitió articular las seguridades económica, militar y la bioseguridad. En este sentido, la configuración de dicha agenda fue posible gracias a la adopción de una retórica neoliberal de seguridad económica desde la puesta en marcha del Tratado de Libre Comercio en 1994, la cual luego del 11 de septiembre de 2001 fue articulada con la agenda de seguridad militar propuesta por el gobierno estadounidense en materia de lucha antiterrorista, que a su turno permitió la adopción de una retórica y unas medidas extraordinarias en materia de bioseguridad, motivada por los ataques bioterroristas con ántrax en EE.UU., el brote de SARS en Canadá y la pandemia de AH1N1 en México.

Collaboration between infection control and occupational health in three continents: a success story with international impact

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.

All Hands on Deck: Transdisciplinary Approaches to Emerging Infectious Disease

The increasing burden of emerging infectious diseases worldwide confronts us with numerous challenges, including the imperative to design research and responses that are commensurate to understanding the complex social and ecological contexts in which infectious diseases occur. A diverse group of scientists met in Hawaii in March 2005 to discuss the linked social and ecological contexts in which infectious diseases emerge. A subset of the meeting was a group that focused on ‘‘transdisciplinary approaches’’ to integrating knowledge across and beyond academic disciplines in order to improve prevention and control of emerging infections. This article is based on the discussions of that group. Here, we outline the epidemiological legacy that has dominated infectious disease research and control up until now, and introduce the role of new, transdisciplinary and systems-based approaches to emerging infectious diseases.Wedescribe four cases of transboundary health issues and use them to discuss the potential benefits, as well as the inherent difficulties, in understanding the social–ecological contexts in which infectious diseases occur and of using transdisciplinary approaches to deal with them.

Slopes of Avian Species-Area Relationships, Human Population Density, and Environmental Factors

There is increasing interest in how humans influence spatial patterns in biodiversity. One of the most frequently noted and marked of these patterns is the increase in species richness with area, the species–area relationship (SAR). SARs are used for a number of conservation purposes, including predicting extinction rates, setting conservation targets, and identifying biodiversity hotspots. Such applications can be improved by a detailed understanding of the factors promoting spatial variation in the slope of SARs, which is currently the subject of a vigorous debate. Moreover, very few studies have considered the anthropogenic influences on the slopes of SARs; this is particularly surprising given that in much of the world areas with high human population density are typically those with a high number of species, which generates conservation conflicts. Here we determine correlates of spatial variation in the slopes of species–area relationships, using the British avifauna as a case study. Whilst we focus on human population density, a widely used index of human activities, we also take into account (1) the rate of increase in habitat heterogeneity with increasing area, which is frequently proposed to drive SARs, (2) environmental energy availability, which may influence SARs by affecting species occupancy patterns, and (3) species richness. We consider environmental variables measured at both local (10 km × 10 km) and regional (290 km × 290 km) spatial grains, but find that the former consistently provides a better fit to the data. In our case study, the effect of species richness on the slope SARs appears to be scale dependent, being negative at local scales but positive at regional scales. In univariate tests, the slope of the SAR correlates negatively with human population density and environmental energy availability, and positively with the rate of increase in habitat heterogeneity. We conducted two sets of multiple regression analyses, with and without species richness as a predictor. When species richness is included it exerts a dominant effect, but when it is excluded temperature has the dominant effect on the slope of the SAR, and the effects of other predictors are marginal.

Nuclear magnetic resonance structure shows that the severe acute respiratory syndrome coronavirus-unique domain contains a macrodomain fold

The nuclear magnetic resonance (NMR) structure of a central segment of the previously annotated severe acute respiratory syndrome (SARS)-unique domain (SUD-M, for "middle of the SARS-unique domain") in SARS coronavirus (SARS-CoV) nonstructural protein 3 (nsp3) has been determined. SUD-M(513-651) exhibits a macrodomain fold containing the nsp3 residues 528 to 648, and there is a flexibly extended N-terminal tail with the residues 513 to 527 and a C-terminal flexible tail of residues 649 to 651. As a follow-up to this initial result, we also solved the structure of a construct representing only the globular domain of residues 527 to 651 [SUD-M(527-651)]. NMR chemical shift perturbation experiments showed that SUD-M(527-651) binds single-stranded poly(A) and identified the contact area with this RNA on the protein surface, and electrophoretic mobility shift assays then confirmed that SUD-M has higher affinity for purine bases than for pyrimidine bases. In a further search for clues to the function, we found that SUD-M(527-651) has the closest three-dimensional structure homology with another domain of nsp3, the ADP-ribose-1 ''-phosphatase nsp3b, although the two proteins share only 5% sequence identity in the homologous sequence regions. SUD-M(527-651) also shows three-dimensional structure homology with several helicases and nucleoside triphosphate-binding proteins, but it does not contain the motifs of catalytic residues found in these structural homologues. The combined results from NMR screening of potential substrates and the structure-based homology studies now form a basis for more focused investigations on the role of the SARS-unique domain in viral infection.