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A large pooled analysis of liver oligometastases, classified accordingly to the ESTRO/EORTC recommendations, treated by stereotactic radiotherapy (SBRT) and Radiosurgery (SRS) was carried out. The clinical and dosimetric data of patients who underwent SBRT/SRS for liver metastases were analysed in terms of efficacy and toxicity profile. In particular, the Local Control (LC), the Distant Metastases Free Survival (DMFS), the Disease-Free Survival (DFS), the Overall Survival (OS), and the Next Systemic Therapy Free Survival (NEST-FS) rates were analysed. 113 patients (M/F: 49/64), accounting for a total of 150 hepatic lesions (March 2006–February 2023) in two Italian radiotherapy Institutions were evaluated. Median age was 67 years old (36–92) and 48 (42.5%) patients had at least one comorbidity. The majority of the lesions were induced (30.7%) or repeated oligoprogressive (12.7%) metastases. 98 lesions were treated with more than one daily fraction (mainly 50 Gy in 5 fractions), while 52 were radiosurgery treatments (mainly 32 Gy). The treatment response at 3–4 months was evaluable in 147 lesions: complete response was 32.0%, partial response 17.0%, and stable disease 32.0%. Actuarial LC, DMFS, DFS, OS, and NEST-FS at 1 year were 75.8%, 37.7%, 34.9%, 78.7%, and 59.4% respectively; while actuarial LC, DMFS, DFS, OS, and NEST-FS at 2 years were 52.1%, 24.9%, 21.9%, 51.3%, and 36.8%, respectively. The achievement of complete response, synchronous oligometastases, and no treatment interruptions correlated with a more favorable outcomes. As per the toxicity profile, we registered only two acute and one late toxicity cases higher than grade 2. Stereotactic treatment for liver metastases seems to be a safe and promising option in terms of local control. The best results in term of outcomes have been obtained in patients with complete response, synchronous oligometastases, favorable histology, and no treatment interruptions. [ABSTRACT FROM AUTHOR]

Usutu virus (USUV) is an emerging flavivirus that is maintained in an enzootic cycle with mosquitoes as vectors and birds as amplifying hosts. In Europe, the virus has caused mass mortality of wild birds, mainly among Common Blackbird (Turdus merula) populations. While mosquitoes are the primary vectors for USUV, Common Blackbirds and other avian species are exposed to other arthropod ectoparasites, such as ticks. It is unknown, however, if ticks can maintain and transmit USUV. We addressed this question using in vitro and in vivo experiments and field collected data. USUV replicated in IRE/CTVM19 Ixodes ricinus tick cells and in injected ticks. Moreover, I. ricinus nymphs acquired the virus via artificial membrane blood-feeding and maintained the virus for at least 70 days. Transstadial transmission of USUV from nymphs to adults was confirmed in 4.9% of the ticks. USUV disseminated from the midgut to the haemocoel, and was transmitted via the saliva of the tick during artificial membrane blood-feeding. We further explored the role of ticks by monitoring USUV in questing ticks and in ticks feeding on wild birds in the Netherlands between 2016 and 2019. In total, 622 wild birds and the Ixodes ticks they carried were tested for USUV RNA. Of these birds, 48 (7.7%) carried USUV-positive ticks. The presence of negative-sense USUV RNA in ticks, as confirmed via small RNA-sequencing, showed active virus replication. In contrast, we did not detect USUV in 15,381 questing ticks collected in 2017 and 2019. We conclude that I. ricinus can be infected with USUV and can transstadially and horizontally transmit USUV. However, in comparison to mosquito-borne transmission, the role of I. ricinus ticks in the epidemiology of USUV is expected to be minor. Author summary: Usutu virus (USUV) is a virus primarily circulating between birds and mosquitoes. Other blood-feeding arthropods, such as ticks, feed on birds. However, it is unknown whether ticks can be infected with USUV and transmit the virus to birds or other animals. Therefore, we infected a tick cell line and ticks collected from the field with USUV. We showed that the virus replicates in tick cells, as well as in field-collected ticks. Moreover, we showed that USUV disseminated through the tick body and was excreted with the saliva of ticks during artificial feeding. We further investigated if ticks are infected with USUV while feeding on wild birds and when searching for a host in the vegetation. We found that 7.7% of tick-infested birds carried USUV positive ticks, while USUV was not detected in questing ticks. Our findings provide evidence that ticks can be infected with USUV and might transmit the virus to another host, but the role of ticks in the transmission of USUV is expected to be minor. [ABSTRACT FROM AUTHOR]

Background: Recently, Europe has seen an emergence of mosquito-borne viruses (MBVs). Understanding citizens' perceptions of and behaviours towards mosquitoes and MBVs is crucial to reduce disease risk. We investigated and compared perceptions, knowledge, and determinants of citizens' behavioural intentions related to mosquitoes and MBVs in the Netherlands and Spain, to help improve public health interventions. Methods: Using the validated MosquitoWise survey, data was collected through participant panels in Spain (N = 475) and the Netherlands (N = 438). Health Belief Model scores measuring behavioural intent, knowledge, and information scores were calculated. Confidence Interval-Based Estimation of Relevance was used, together with potential for change indexes, to identify promising determinants for improving prevention measure use. Results: Spanish participants' responses showed slightly higher intent to use prevention measures compared to those of Dutch participants (29.1 and 28.2, respectively, p 0.03). Most participants in Spain (92.2%) and the Netherlands (91.8%) indicated they used at least one prevention measure, but differences were observed in which types they used. More Spanish participants indicated to have received information on mosquitoes and MBVs compared to Dutch participants. Spanish participants preferred health professional information sources, while Dutch participants favoured government websites. Determinants for intent to use prevention measures included "Knowledge", "Reminders to Use Prevention Measures", and "Information" in the Netherlands and Spain. Determinants for repellent use included "Perceived Benefits" and "Cues to Action", with "Perceived Benefits" having a high potential for behavioural change in both countries. "Self-Efficacy" and "Knowledge" were determinants in both countries for breeding site removal. Conclusion: This study found differences in knowledge between the Netherlands and Spain but similarities in determinants for intent to use prevention measures, intent to use repellents and intent to remove mosquito breeding sites. Identified determinants can be the focus for future public health interventions to reduce MBV risks. [ABSTRACT FROM AUTHOR]

Starting December 2019, a novel coronavirus (SARS-CoV-2) spread among humans across the world. From 2020 onward, farmed mink were found susceptible to the virus. In this paper, we describe the Dutch surveillance system and the added surveillance components for early detection of SARS-CoV-2 outbreaks and their results in Dutch mink farms. In the Netherlands, a surveillance system was in place in which mink farmers could submit carcasses for postmortem evaluation and could contact a telephone helpdesk for veterinary advise. Through this system, the first SARS-CoV-2 outbreak in two mink farms was detected in April 2020. Immediately, the Dutch Ministry of Agriculture commissioned a consortium of statutory and research institutes to intensify the surveillance system. The program consisted of both passive surveillance, i.e., mandatory notifications and active surveillance components, i.e., serological screenings and weekly risk-based sampling of dead mink for early detection of new SARS-CoV-2 infections. When one of the surveillance components indicated a suspicion of a possible SARS-CoV-2 infection, follow-up samplings were conducted and at confirmation, all mink were culled. During 2020, 67 out of 124 mink farms that were under surveillance became infected with SARS-CoV-2 (54%). Of these, 31 were detected based on clinical signs (passive surveillance of clinical signs) and 36 were detected through active surveillance. From the mink farms with a new SARS-CoV-2 outbreak that was detected through the surveillance, in 19% of the farms (n = 7), the mink never showed any clinical signs of SARS-CoV-2 and might have been missed by the passive notification system. This study underlines the added value of a surveillance system that can quickly be intensified. The subsequent combination of both passive and active surveillance has shown to be effective in the early detection of emerging pathogens, which is important to minimize the risk of zoonotic spill-over. [ABSTRACT FROM AUTHOR]

Background: Mosquito-borne diseases are on the rise. While climatic factors have been linked to disease occurrences, they do not explain the non-random spatial distribution in disease outbreaks. Landscape-related factors, such as vegetation structure, likely play a crucial but hitherto unquantified role. Methods: We explored how three critically important factors that are associated with mosquito-borne disease outbreaks: microclimate, mosquito abundance and bird communities, vary at the landscape scale. We compared the co-occurrence of these three factors in two contrasting habitat types (forest versus grassland) across five rural locations in the central part of the Netherlands between June and September 2021. Results: Our results show that forest patches provide a more sheltered microclimate, and a higher overall abundance of birds. When accounting for differences in landscape characteristics, we also observed that the number of mosquitoes was higher in isolated forest patches. Conclusions: Our findings indicate that, at the landscape scale, variation in tree cover coincides with suitable microclimate and high Culex pipiens and bird abundance. Overall, these factors can help understand the non-random spatial distribution of mosquito-borne disease outbreaks. [ABSTRACT FROM AUTHOR]

Background: West Nile virus (WNV) outbreaks in birds, humans, and livestock have occurred in multiple areas in Europe and have had a significant impact on animal and human health. The patterns of emergence and spread of WNV in Europe are very different from those in the US and understanding these are important for guiding preparedness activities. Methods: We mapped the evolution and spread history of WNV in Europe by incorporating viral genome sequences and epidemiological data into phylodynamic models. Spatially explicit phylogeographic models were developed to explore the possible contribution of different drivers to viral dispersal direction and velocity. A "skygrid-GLM" approach was used to identify how changes in environments would predict viral genetic diversity variations over time. Findings: Among the six lineages found in Europe, WNV-2a (a sub-lineage of WNV-2) has been predominant (accounting for 73% of all sequences obtained in Europe that have been shared in the public domain) and has spread to at least 14 countries. In the past two decades, WNV-2a has evolved into two major co-circulating clusters, both originating from Central Europe, but with distinct dynamic history and transmission patterns. WNV-2a spreads at a high dispersal velocity (88km/yr–215 km/yr) which is correlated to bird movements. Notably, amongst multiple drivers that could affect the spread of WNV, factors related to land use were found to strongly influence the spread of WNV. Specifically, the intensity of agricultural activities (defined by factors related to crops and livestock production, such as coverage of cropland, pasture, cultivated and managed vegetation, livestock density) were positively associated with both spread direction and velocity. In addition, WNV spread direction was associated with high coverage of wetlands and migratory bird flyways. Conclusion: Our results suggest that—in addition to ecological conditions favouring bird- and mosquito- presence—agricultural land use may be a significant driver of WNV emergence and spread. Our study also identified significant gaps in data and the need to strengthen virological surveillance in countries of Central Europe from where WNV outbreaks are likely seeded. Enhanced monitoring for early detection of further dispersal could be targeted to areas with high agricultural activities and habitats of migratory birds. Author summary: Evidence for the drivers for West Nile virus (WNV) dispersal has been not clear in Europe. Here, we have comprehensively described the dispersal history of the currently predominant WNV lineage in Europe and estimated the contribution of key drivers of spread between and within countries. By fitting several phylodynamic and phylogeographic models, we found that 1) WNV in Europe has a greater lineage diversity than in other regions of the world. 2) Agricultural intensity had the greatest impact on both WNV spread direction and velocity. 3) WNV spread direction was specifically associated with urbanization and bird habitats. 4) Climate change and bio-diversity changes predicted viral genetic diversity over time. Our study revealed that to enhance preparedness for potential outbreaks, it is important to further define these drivers, and increase sampling for WNV in areas that appear to be a source of WNV in other countries in Europe, as well as in regions with known risk factors but where WNV has not yet been detected. [ABSTRACT FROM AUTHOR]

Due to climate change and the expanding geographical ranges of key mosquito species, several mosquito-borne viruses (MBVs) have recently emerged in Europe. Understanding people's perceptions and behaviours towards these viruses and the mosquitoes capable of transmitting them is crucial for implementing effective prevention measures and targeted communication campaigns. However, there is currently no appropriate validated survey for European populations to assess this. This study developed and validated a standardized survey, based on the Health Belief Model (HBM), to assess perceptions of mosquitoes and MBVs among Europe's residents. The survey was distributed online to United Kingdom (UK), Dutch and Spanish participants through panel providers. Survey validity and reliability were tested using confirmatory factor analysis (CFA) and Cronbach's alpha. The optimised survey was completed by 336 UK, 438 Dutch and 475 Spanish residents, respectively, and the HBM items passed our validity and reliability testing in all three countries. The final survey has 57 questions, including 19 validated HBM items, and questions to assess demographic characteristics, knowledge, prevention measures and behavioural determinants. Our MosquitoWise survey bridges researchers' understandings of European residents' perceptions and knowledge as a first step to improve preventive behaviour towards mosquitoes and MBVs and guide prevention and communication initiatives. [ABSTRACT FROM AUTHOR]

PEERS® for Preschoolers (P4P) is a social skills group program for young autistic children and their caregivers, which provides everyday tools for interacting and communicating with others. Twenty-two caregiver-child dyads participated and completed pre-treatment, post-treatment, and follow-up measures (4–16 weeks after). Using single-subject analyses to examine social skills, 60% demonstrated post-treatment improvement, and 53.85% demonstrated follow-up improvement. Regarding a secondary outcome of behavioral difficulties, 33.33% demonstrated post-treatment reduction, and 7.69% demonstrated follow-up reduction. Using regressions, autistic traits predicted outcomes; fewer social communication difficulties predicted both greater social skills and fewer behavioral difficulties at post-treatment, while fewer repetitive behaviors predicted fewer post-treatment and follow-up behavioral difficulties. These results preliminarily demonstrate the benefits of P4P and how autistic traits may impact P4P outcomes. [ABSTRACT FROM AUTHOR]

Benzyl alcohol is a compound found in many volatile chemical products (VCPs), and is widely used in personal care products and as an industrial solvent. While past work has empirically identified oxidation products, we do not understand explicit branching ratios for first-generation benzyl alcohol oxidation products, particularly over a range of [NO] conditions. Using gas chromatography (GC) in tandem with chemical ionization mass spectrometry (CIMS), we measure the branching ratios of major oxidation products, namely hydroxybenzyl alcohol (HBA) and benzaldehyde. Later-generation oxidation products from both HBA and benzaldehyde pathways are also observed. We find the H-abstraction route leading to benzaldehyde formation unaffected by [NO], with a branching ratio of ~ 19%. The OH addition route, however, which leads to HBA formation, does vary with [NO]. At higher [NO], we report a branching ratio for HBA of ~ 45-47% and as high as ~ 69% at low [NO]. We also find that HBA has a high secondary organic aerosol (SOA) yield and, therefore, likely contributes to the high SOA yield of benzyl alcohol which under some conditions can approach unity. Insights from the present study can help elucidate the chemistry of other atmospherically-relevant aromatic compounds, especially those found in VCPs. [ABSTRACT FROM AUTHOR]

Benzyl alcohol is a compound that is found in many volatile chemical products (VCPs) that are primarily used in personal care products and as industrial solvents. While past work has empirically identified oxidation products, we do not understand explicit branching ratios for first-generation benzyl alcohol oxidation products, particularly over a range of [NO] conditions. Using gas chromatography (GC) in tandem with chemical ionization mass spectrometry (CIMS), we measure the branching ratios of major oxidation products, namely hydroxybenzyl alcohol (HBA) and benzaldehyde. Later-generation oxidation products from both HBA and benzaldehyde pathways are also observed. We find the H-abstraction route leading to benzaldehyde formation unaffected by [NO], with a branching ratio of ~19 %. The OH addition route, however, which leads to HBA formation, does vary with [NO]. At higher [NO], we report a branching ratio for HBA of ~45–47 % and as high as ~69 % at low [NO]. We also find that HBA has a high secondary organic aerosol (SOA) yield, for the reaction times in this study, approaching unity. HBA, therefore, likely contributes to the high SOA yield of benzyl alcohol which under some conditions can also approach unity. Insights from the present study can help elucidate the chemistry of other atmospherically-relevant aromatic compounds, especially those found in VCPs. [ABSTRACT FROM AUTHOR]

Diagnosis of arbovirus infection or exposure by antibody testing is becoming increasingly difficult due to global expansion of arboviruses, which induce antibodies that may (cross-)react in serological assays. We provide a systematic review of the current knowledge and knowledge gaps in differential arbovirus serology. The search included Medline, Embase and Web of Science databases and identified 911 publications which were reduced to 102 after exclusion of studies not providing data on possible cross-reactivity or studies that did not meet the inclusion criteria regarding confirmation of virus exposure of reference population sets. Using a scoring system to further assess quality of studies, we show that the majority of the selected papers (N = 102) provides insufficient detail to support conclusions on specificity of serological outcomes with regards to elucidating antibody cross-reactivity. Along with the lack of standardization of assays, metadata such as time of illness onset, vaccination, infection and travel history, age and specificity of serological methods were most frequently missing. Given the critical role of serology for diagnosis and surveillance of arbovirus infections, better standards for reporting, as well as the development of more (standardized) specific serological assays that allow discrimination between exposures to multiple different arboviruses, are a large global unmet need. Author summary: Arboviruses are notorious for triggering antibodies that may cross-react with (closely) related arboviruses, complicating interpretation of serology-based arbovirus diagnostics and of epidemiological surveys. This is further complicated by the rapid global spread of arboviruses, that may lead to increasing co-circulation of antigenically related arboviruses, and by the lack of detailed background information on the population tested, methods used and background arbovirus exposures such as prior infections or vaccinations. Here, we aim to provide a better understanding of the complex cross-reactivity patterns as well as the current knowledge and knowledge gaps in differential arbovirus serology. We have done a systematic analysis of reported cross-reactivity patterns from published peer-reviewed articles, using a system that allows assessment of the quality of reported cross-reactivity results. We show that using this approach, the majority of studies lack details needed to reliably assess whether reactivity to antigens from different, related arboviruses is caused by antibody cross-reactivity, or if it reflects antibodies from multiple exposures to these different viruses. Furthermore, there is a strong need for standardization of assays and study designs in future serological studies to compare cross-reactivity results from different studies. Tackling this may lead to improved diagnosis and surveillance of (newly) emerging and/or rapidly spreading arboviruses. [ABSTRACT FROM AUTHOR]

Heavy metal (HM) contamination from mining activities poses a health risk to humans who consume mollusks and crustaceans from mine-affected environments. One such example is the Taft River, which receives drainage water and sediments from the Bagacay mines in Samar, Philippines. To assess the accumulation of HM in mollusks and crustaceans and the associated risks to the humans, a comprehensive analysis was conducted on representative specimens, which were gathered from different sections of the river. The concentrations of Cu (97.67 mg kg-1), Ni (29.30 mg kg-1), Pb (0.59 mg kg-1), and Sr (14.67 mg kg-1) in the flesh of "bebe" (Batissa violacea Lamarck) were significantly higher than those in "tangili" (Telescopium telescopium Linn.), "tuway" (Mercenaria mercenaria Linn.), and "sihi" (Nerita albicilla Linn.); whereas for crustaceans, the flesh of mud crabs (Scylla serrata) contained higher concentrations of As (17.67 mg kg-1), Cu (118.67 mg kg-1), Ni (25.79 mg kg-1), Rb (31.33 mg kg-1), Sr (60.67 mg kg-1), and Zn (331.00 mg kg-1) compared with giant freshwater prawns (Macrobrachium rosenbergii). The consumption of T. telescompium, N. albicilla, and B. violacea may result in an estimated daily intake (EDI) that is greater than the provisional tolerable daily intake (PTDI) for As [2.03-4.48 µg kg-1 body weight (BW) d-1], while all mollusks may have an EDI for Cr of between 124.59-136.23 48 µg kg-1 BW d-1. This may subsequently lead to a high target hazard quotient (THQ), high hazard index (HI), and high target cancer risk (TCR) for adults. With respect to crustaceans, the consumption of S. serrata exceeds the PTDI index for As. Both S. serrata and M. rosenbergii exceed the PTDI for Cr by 20-21 times, as well as the elevated health risk values of 22.36 and 28.57 48 µg kg-1 d-1 for M. rosenbergii and S. serrata, respectively. Overall, current results indicate that human consumption of the Taft River mollusks and crustaceans may inadvertently lead to an increased intake of As and Cr that could negatively impact human health. [ABSTRACT FROM AUTHOR]

Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and often worsen. Research indicates including caregivers in social skills groups may increase generalization for child outcomes, while also benefiting caregivers by increasing their self-confidence in ability to coach their child. Further, there may be an impact on the entire family. This pilot study examined benefits to the caregiver–child relationship, caregiver self-efficacy, parenting style, and family functioning in an exploratory study of the PEERS® for Preschoolers (P4P) social skills program. The present pilot study aimed to examine the above variables with 15 children with ASD (11 boys; 66.7% white) without intellectual impairment in four groups, applying this novel intervention, informed by other PEERS® programs. Children ranged from 4 to 7 years (M = 4.87, SD = 1.25). Children and caregivers participated in groups twice weekly (i.e., 8 weeks, 16 sessions). Measures that captured specified variables were completed by caregivers as well as through an observational task. Results showed increases in parenting self-efficacy and positive caregiver–child interaction strategies, specifically in caregiver affect/animation and achievement orientation over intervention and at follow-up. Caregivers also noted improvements in overall parenting styles. Changes in family functioning were not indicated. This pilot intervention may positively impact both the child and caregiver, though more research is needed with larger samples that include a control group and apply conclusions to the larger population. Future research should address why changes to family functioning did not emerge and specific mechanisms that lead to positive caregiver-specific outcomes. Highlights: This pilot study examined caregiver and family outcomes from a social skills intervention for young children with ASD. Fifteen caregivers and children with ASD participated in a 16-session (8-week) social skills program. Caregivers showed increased self-efficacy, more positive interaction, and improvements in overall parenting styles. Changes in family functioning were not indicated. Results suggest potential benefits for caregivers and families following the PEERS® for Preschoolers Program. [ABSTRACT FROM AUTHOR]

Background: Parents of autistic children experience increased levels of caregiver strain and adverse mental health outcomes, even in comparison to parents of children with other neurodevelopmental disabilities. Previous studies have largely attributed these increased levels of mental health concerns to their child behavioral concerns and autism symptomatology, but less attention has been given to other potential child factors, such as child adaptive functioning. Additionally, little is known about potential protective factors, such as parents' emotion regulation (ER) abilities, that may ameliorate the experience of caregiver strain, anxiety, and depression. Objective: The current study examined the impact of child characteristics (restricted and repetitive behaviors, adaptive functioning and behavioral concerns) on parent mental health outcomes (caregiver strain, anxiety, depression and wellbeing). Additionally, we explore parents' ER abilities as a moderator of the impact of child characteristic on parents' mental health outcomes. Results: Results of linear mixed effect models indicated a significant relationship between parents' ER abilities and all four parent outcomes. Additionally, children's adaptive functioning abilities and repetitive behaviors (RRBs) were significant predictors of caregiving strain. Parents' ER abilities were a significant moderator of the effect of children's repetitive behaviors and adaptive functioning challenges on caregiver strain, such that better ER abilities mitigated the impact of child clinical factors on caregiver strain. Finally, a significant difference was detected for mothers' and fathers' mental health, with mothers reporting higher caregiver strain, and more symptoms of anxiety and depression than did fathers. Conclusion: This study leveraged a large sample of autistic children and their biological parents to examine the relationship between children's clinical characteristics and parents' psychological wellbeing. Results indicate that, although parents of autistic children do experience high rates of internalizing mental health concerns that relate to child adaptive functioning and RRBs, parent ER abilities act as a protective factor against parents' adverse mental health outcomes. Further, mothers in our sample reported significantly higher rates of depression, anxiety, and caregiver strain, as compared with fathers. [ABSTRACT FROM AUTHOR]

Background: Healthcare facilities have been challenged by the risk of SARS-CoV-2 transmission between healthcare workers (HCW) and patients. During the first wave of the COVID-19 pandemic, infections among HCW were observed, questioning infection prevention and control (IPC) measures implemented at that time. Aim: This study aimed to identify nosocomial transmission routes of SARS-CoV-2 between HCW and patients in a tertiary care hospital. Methods: All SARS-CoV-2 PCR positive HCW and patients identified between 1 March and 19 May 2020, were included in the analysis. Epidemiological data were collected from patient files and HCW contact tracing interviews. Whole genome sequences of SARS-CoV-2 were generated using Nanopore sequencing (WGS). Epidemiological clusters were identified, whereafter WGS and epidemiological data were combined for re-evaluation of epidemiological clusters and identification of potential transmission clusters. HCW infections were further classified into categories based on the likelihood that the infection was acquired via nosocomial transmission. Secondary cases were defined as COVID-19 cases in our hospital, part of a transmission cluster, of which the index case was either a patient or HCW from our hospital. Findings: The study population consisted of 293 HCW and 245 patients. Epidemiological data revealed 36 potential epidemiological clusters, with an estimated 222 (75.7%) HCW as secondary cases. WGS results were available for 195 HCW (88.2%) and 20 patients (12.8%) who belonged to an epidemiological cluster. Re-evaluation of the epidemiological clusters, with the available WGS data identified 31 transmission clusters with 65 (29.4%) HCW as secondary cases. Transmission clusters were all part of 18 (50.0%) previously determined epidemiological clusters, demonstrating that several larger outbreaks actually consisted, of several smaller transmission clusters. A total of 21 (7.2%) HCW infections were classified as from confirmed nosocomial, of which 18 were acquired from another HCW and 3 from a patient. Conclusion: The majority of SARS-CoV-2 infections among HCW could be attributed to community-acquired infection. Infections among HCW that could be classified as due to nosocomial transmission, were mainly caused by HCW-to-HCW transmission rather than patient-to-HCW transmission. It is important to recognize the uncertainties of cluster analyses based solely on epidemiological data. [ABSTRACT FROM AUTHOR]

Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and often worsen. There is a paucity of evidence-based interventions explicitly targeting social skill development for young children with ASD and few actively integrate caregivers. The PEERS® program, an evidence-based caregiver-assisted social skills program, was extended for young children with ASD (i.e., PEERS® for Preschoolers (P4P)). This pilot study expands upon initial results by examining the feasibility of a briefer intervention period and the effectiveness in improving child social skills among 15 children with ASD. Results suggest P4P recruitment, participant retention, and implementation are feasible across clinicians and sites. Further, P4P appears to improve social skills, maintained post-intervention. Future research might examine mechanisms that lead to results. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 prevention and control measures did not only impact SARS-CoV-2 circulation, but also the timing and prevalence of other seasonal respiratory viruses. Especially in children, information on exposure and infections to seasonal coronaviruses as well as SARS-CoV-2 in the first year of the pandemic is largely lacking. Therefore, we set up a one-year serological survey in a large tertiary hospital in the Netherlands. We show that seasonal coronavirus seroprevalence significantly decreased in 2021 in children less than one year, most likely due to COVID-19 control measures. The SARS-CoV-2 seroprevalence in children and adolescents increased from 0.4% to 11.3%, the highest in adolescents. This implies higher exposure rates in adolescents as compared to the general population (>18 years old). It is clear that there have been significant changes in the circulation and subsequent immunity against most respiratory pathogens as a result of the mitigation measures. The implications on shorter as well as longer term are still largely unknown, but the impact of the SARS-CoV-2 pandemic and subsequent control measures will continue to affect the dynamics of other pathogens. [ABSTRACT FROM AUTHOR]

Rabies virus (RABV) has a broad host range and infects multiple cell types throughout the infection cycle. Next-generation sequencing (NGS) and minor variant analysis are powerful tools for studying virus populations within specific hosts and tissues, leading to novel insights into the mechanisms of host-switching and key factors for infecting specific cell types. In this study we investigated RABV populations and minor variants in both original (non-passaged) samples and in vitro-passaged isolates of various CNS regions (hippocampus, medulla oblongata and spinal cord) of a fatal human rabies case, and of multiple CNS and non-CNS tissues of experimentally infected mice. No differences in virus populations were detected between the human CNS regions, and only one non-synonymous single nucleotide polymorphism (SNP) was detected in the fifth in vitro passage of virus isolated from the spinal cord. However, the appearance of this SNP shows the importance of sequencing newly passaged virus stocks before further use. Similarly, we did not detect apparent differences in virus populations isolated from different CNS and non-CNS tissues of experimentally infected mice. Sequencing of viruses obtained from pharyngeal swab and salivary gland proved difficult, and we propose methods for improving sampling. [ABSTRACT FROM AUTHOR]

Introduction: Social differences characteristic of autism spectrum disorder (ASD) and other developmental disabilities are evident in early childhood and are associated with later difficulties. Unfortunately, there is a paucity of evidence-based interventions explicitly targeting social skills development for young children, few actively integrate parents and caregivers, and even fewer have remote models. The importance of providing accessible, tailored services for families in the wake of the COVID-19 pandemic, prompted the creation of a parent-mediated telehealth version of Program for the Education and Enrichment of Relational Skills (PEERS®) for Preschoolers (P4P), a pre-existing, evidence-based social skills intervention for children 4-6 years focused on making and keeping friends. Method: This methodological paper documents the implementation, feasibility, and satisfaction of a novel telehealth group-based delivery of P4P. Results: Qualitative results indicate acceptable feasibility and satisfaction. Additionally, following completion there was an increase in parental confidence in social coaching and increased use of child social skills. Discussion: Future work will evaluate quantitative outcomes and comparisons between delivery methods (e.g., telehealth vs. in-person). [ABSTRACT FROM AUTHOR]

In the Netherlands, 69 of the 126 (55%) mink farms in total became infected with SARS‐CoV‐2 in 2020. Despite strict biosecurity measures and extensive epidemiological investigations, the main transmission route remained unclear. A better understanding of SARS‐CoV‐2 transmission between mink farms is of relevance for countries where mink farming is still common practice and can be used as a case study to improve future emerging disease preparedness. We assessed whether SARS‐CoV‐2 spilled over from mink to free‐ranging animals, and whether free‐ranging animals may have played a role in farm‐to‐farm transmission in the Netherlands. The study encompassed farm visits, farm questionnaires, expert workshops and SARS‐CoV‐2 RNA and antibody testing of samples from target animal species (bats, birds and free‐ranging carnivores). In this study, we show that the open housing system of mink allowed access to birds, bats and most free‐ranging carnivores, and that direct and indirect contact with mink was likely after entry, especially for free‐ranging carnivores and birds. This allowed SARS‐CoV‐2 exposure to animals entering the mink farm, and subsequent infection or mechanical carriage by the target animal species. Moreover, mink can escape farms in some cases, and two SARS‐CoV‐2‐positive mink were found outside farm premises. No other SARS‐CoV‐2‐RNA‐positive free‐ranging animals were detected, suggesting there was no abundant circulation in the species tested during the study period. To investigate previous SARS‐CoV‐2 infections, SARS‐CoV‐2 antibody detection using lung extracts of carcasses was set up and validated. One tested beech marten did have SARS‐CoV‐2 antibodies, but the closest SARS‐CoV‐2‐infected mink farm was outside of its home range, making infection at a mink farm unlikely. Knowing that virus exchange between different species and the formation of animal reservoirs affects SARS‐CoV‐2 evolution, continued vigilance and monitoring of mink farms and surrounding wildlife remains vital. [ABSTRACT FROM AUTHOR]

Animals like mink, cats and dogs are susceptible to SARS‐CoV‐2 infection. In the Netherlands, 69 out of 127 mink farms were infected with SARS‐CoV‐2 between April and November 2020 and all mink on infected farms were culled after SARS‐CoV‐2 infection to prevent further spread of the virus. On some farms, (feral) cats and dogs were present. This study provides insight into the prevalence of SARS‐CoV‐2‐positive cats and dogs in 10 infected mink farms and their possible role in transmission of the virus. Throat and rectal swabs of 101 cats (12 domestic and 89 feral cats) and 13 dogs of 10 farms were tested for SARS‐CoV‐2 using PCR. Serological assays were performed on serum samples from 62 adult cats and all 13 dogs. Whole Genome Sequencing was performed on one cat sample. Cat‐to‐mink transmission parameters were estimated using data from all 10 farms. This study shows evidence of SARS‐CoV‐2 infection in 12 feral cats and 2 dogs. Eleven cats (18%) and two dogs (15%) tested serologically positive. Three feral cats (3%) and one dog (8%) tested PCR‐positive. The sequence generated from the cat throat swab clustered with mink sequences from the same farm. The calculated rate of mink‐to‐cat transmission showed that cats on average had a chance of 12% (95%CI 10%–18%) of becoming infected by mink, assuming no cat‐to‐cat transmission. As only feral cats were infected it is most likely that infections in cats were initiated by mink, not by humans. Whether both dogs were infected by mink or humans remains inconclusive. This study presents one of the first reports of interspecies transmission of SARS‐CoV‐2 that does not involve humans, namely mink‐to‐cat transmission, which should also be considered as a potential risk for spread of SARS‐CoV‐2. [ABSTRACT FROM AUTHOR]

Background: To understand the dynamics of infectious diseases, genomic epidemiology is increasingly advocated, with a need for rapid generation of genetic sequences during outbreaks for public health decision making. Here, we explore the use of metagenomic sequencing compared to specific amplicon- and capture-based sequencing, both on the Nanopore and the Illumina platform for generation of whole genomes of Usutu virus, Zika virus, West Nile virus, and Yellow Fever virus. Results: We show that amplicon-based Nanopore sequencing can be used to rapidly obtain whole genome sequences in samples with a viral load up to Ct 33 and capture-based Illumina is the most sensitive method for initial virus determination. Conclusions: The choice of sequencing approach and platform is important for laboratories wishing to start whole genome sequencing. Depending on the purpose of genome sequencing the best choice can differ. The insights presented in this work and the shown differences in data characteristics can guide labs to make a well informed choice. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 outbreaks on 69 Dutch mink farms in 2020 were studied to identify risk factors for virus introduction and transmission and to improve surveillance and containment measures. Clinical signs, laboratory test results, and epidemiological aspects were investigated, such as the date and reason of suspicion, housing, farm size and distances, human contact structure, biosecurity measures, and presence of wildlife, pets, pests, and manure management. On seven farms, extensive random sampling was performed, and age, coat color, sex, and clinical signs were recorded. Mild to severe respiratory signs and general diseases such as apathy, reduced feed intake, and increased mortality were detected on 62/69 farms. Throat swabs were more likely to result in virus detection than rectal swabs. Clinical signs differed between virus clusters and were more severe for dark-colored mink, males, and animals infected later during the year. Geographical clustering was found for one virus cluster. Shared personnel could explain some cases, but other transmission routes explaining farm-to-farm spread were not elucidated. An early warning surveillance system, strict biosecurity measures, and a (temporary) ban on mink farming and vaccinating animals and humans can contribute to reducing the risks of the virus spreading and acquisition of potential mutations relevant to human and animal health. [ABSTRACT FROM AUTHOR]

Novel safe, immunogenic, and effective vaccines are needed to control the COVID-19 pandemic, caused by SARS-CoV-2. Here, we describe the safety, robust immunogenicity, and potent efficacy elicited in rhesus macaques by a modified vaccinia virus Ankara (MVA) vector expressing a full-length SARS-CoV-2 spike (S) protein (MVA-S). MVA-S vaccination was well tolerated and induced S and receptor-binding domain (RBD)-binding IgG antibodies and neutralizing antibodies against SARS-CoV-2 and several variants of concern. S-specific IFNγ, but not IL-4, -producing cells were also elicited. After SARS-CoV-2 challenge, vaccinated animals showed a significant strong reduction of virus loads in bronchoalveolar lavages (BAL) and decreased levels in throat and nasal mucosa. Remarkably, MVA-S also protected macaques from fever and infection-induced cytokine storm. Computed tomography and histological examination of the lungs showed reduced lung pathology in MVA-S-vaccinated animals. These findings favor the use of MVA-S as a potential vaccine for SARS-CoV-2 in clinical trials. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the psychometric properties of a 4‐minute assessment designed to identify early autism spectrum disorder (ASD) status through evaluation of early social responsiveness (ESR). Method: This retrospective, preliminary study included children between 13 and 24 months (78 males, 79 females mean age 19.4mo, SD 3.1) from two independent data sets (an experimental/training sample [n=120] and a validation/test sample [n=37]). The ESR assessment examined social behaviors (e.g. eye contact, smiling, ease‐of‐social‐engagement) across five common play activities (e.g. rolling a ball, looking at a book). Data analyses examined reliability and accuracy of the assessment in identifying ESR abilities and in discriminating children with and without ASD. Results: Results indicated adequate internal consistency and test–retest reliability of the ESR assessment. Receiver operator curve analysis identified a cutoff score that discriminated infants with ASD‐risk from peers in the training sample. This score yielded moderate sensitivity and high specificity for best‐estimate ASD diagnosis in the validation sample. Interpretation: Preliminary findings indicated that brief, systematic observation of ESR may assist in discriminating infants with and without ASD, providing concrete evidence to validate or supplement parents', pediatricians', or clinicians' concerns. Future studies could examine the utility of ESR 'growth curves'. [ABSTRACT FROM AUTHOR]

Decamethylcyclopentasiloxane (D5, C10H30O5Si5) is measured at parts per trillion (ppt) levels outdoors and parts per billion (ppb) levels indoors. Primarily used in personal care products, its outdoor concentration is correlated to population density. Since understanding the aerosol formation potential of volatile chemical products is critical to understanding particulate matter in urban areas, the secondary organic aerosol yield of D5 was studied under a wide range of OH concentrations and, correspondingly, OH exposures using both batch-mode chamber and continuously run flow tube experiments. These results were comprehensively analyzed and compared to two other secondary organic aerosol (SOA) yield datasets from literature. It was found that the SOA yield from the oxidation of D5 is extremely dependent on either the OH concentration or exposure. For OH concentrations of ≲ 10 7 molec.cm-3 or OH exposures of ≲ 2 × 10 11 molec.scm-3 , the SOA yield is largely < 5 % and usually ∼ 1 %. This is significantly lower than SOA yields previously reported. Using a two-product absorptive partitioning model for the upper bound SOA yields, the stoichiometric mass fraction and absorptive partitioning coefficients are, for the first product, α1 = 0.056 and KOM,1 = 0.022 m3µg-1 ; for the second product, they are α2 = 7.7 and KOM,2 = 4.3 × 10 -5 m3µg-1. Generally, there are high SOA yields (> 90 %) at OH mixing ratios of 5 × 10 9 molec.cm-3 or OH exposures above 10 12 molec.scm-3. [ABSTRACT FROM AUTHOR]

Autistic individuals often experience anxiety at higher rates than typically developing individuals, which could worsen social impairment. While anxiety is highly linked to social skills, social anxiety symptoms have not often been investigated within the context of social skills interventions. The present study compared changes in social anxiety and social responsiveness in 154 adolescents and young adults on the autism spectrum participating in the Program for the Education and Enrichment of Relational Skills (PEERS®) social skills intervention. Results indicate that social anxiety symptoms significantly improved following treatment for both adolescents and young adults. Although young adults reported higher levels of anxiety overall, age group did not moderate social anxiety outcome, with both groups demonstrating comparable social anxiety improvements following treatment. Further, greater improvements in social responsiveness following PEERS® were associated with greater reductions in social anxiety symptoms. We also examined reporter agreement (e.g., self- and caregiver-reports), which indicated these reports were largely consistent, though correlations between adolescent and caregiver-report increased from pre- to post-treatment. Findings suggest that social skills interventions may play a critical role in the reduction of mental health symptoms, such as anxiety symptoms, for autistic adolescents and young adults. [ABSTRACT FROM AUTHOR]

Objective: Unprecedented SARS-CoV-2 infections in farmed minks raised immediate concerns regarding transmission to humans and initiated intensive environmental investigations to assess occupational and environmental exposure.Methods: Air sampling was performed at infected Dutch mink farms, at farm premises and at nearby residential sites. A range of other environmental samples were collected from minks' housing units, including bedding materials. SARS-CoV-2 RNA was analysed in all samples by quantitative PCR.Results: Inside the farms, considerable levels of SARS-CoV-2 RNA were found in airborne dust, especially in personal inhalable dust samples (approximately 1000-10 000 copies/m3). Most of the settling dust samples tested positive for SARS-CoV-2 RNA (82%, 75 of 92). SARS-CoV-2 RNA was not detected in outdoor air samples, except for those collected near the entrance of the most recently infected farm. Many samples of minks' housing units and surfaces contained SARS-CoV-2 RNA.Conclusions: Infected mink farms can be highly contaminated with SARS-CoV-2 RNA. This warns of occupational exposure, which was substantiated by considerable SARS-CoV-2 RNA concentrations in personal air samples. Dispersion of SARS-CoV-2 to outdoor air was found to be limited and SARS-CoV-2 RNA was not detected in air samples collected beyond farm premises, implying a negligible risk of environmental exposure to nearby communities. Our occupational and environmental risk assessment is in line with whole genome sequencing analyses showing mink-to-human transmission among farm workers, but no indications of direct zoonotic transmission events to nearby communities. [ABSTRACT FROM AUTHOR]

In the first wave of the COVID-19 pandemic (April 2020), SARS-CoV-2 was detected in farmed minks and genomic sequencing was performed on mink farms and farm personnel. Here, we describe the outbreak and use sequence data with Bayesian phylodynamic methods to explore SARS-CoV-2 transmission in minks and humans on farms. High number of farm infections (68/126) in minks and farm workers (>50% of farms) were detected, with limited community spread. Three of five initial introductions of SARS-CoV-2 led to subsequent spread between mink farms until November 2020. Viruses belonging to the largest cluster acquired an amino acid substitution in the receptor binding domain of the Spike protein (position 486), evolved faster and spread longer and more widely. Movement of people and distance between farms were statistically significant predictors of virus dispersal between farms. Our study provides novel insights into SARS-CoV-2 transmission between mink farms and highlights the importance of combining genetic information with epidemiological information when investigating outbreaks at the animal-human interface. SARS-CoV-2 was detected in mink farms in the Netherlands in the first wave of the pandemic with evidence of human-to-mink and mink-to-human transmission. Here, the authors investigate this outbreak using phylodynamic analysis and show that personnel links and spatial proximity are predictors of transmission between farms. [ABSTRACT FROM AUTHOR]

Background Sars-CoV-2 outbreaks resulted in a high case fatality rate in nursing homes (NH) worldwide. It is unknown to which extent presymptomatic residents and staff contribute to the spread of the virus. Aims To assess the contribution of asymptomatic and presymptomatic residents and staff in SARS-CoV-2 transmission during a large outbreak in a Dutch NH. Methods Observational study in a 185-bed NH with two consecutive testing strategies: testing of symptomatic cases only, followed by weekly facility-wide testing of staff and residents regardless of symptoms. Nasopharyngeal and oropharyngeal testing with RT-PCR for SARs-CoV-2, including sequencing of positive samples, was conducted with a standardised symptom assessment. Results 185 residents and 244 staff participated. Sequencing identified one cluster. In the symptom-based test strategy period, 3/39 residents were presymptomatic versus 38/74 residents in the period of weekly facility-wide testing (P -value < 0.001). In total, 51/59 (91.1%) of SARS-CoV-2 positive staff was symptomatic, with no difference between both testing strategies (P -value 0.763). Loss of smell and taste, sore throat, headache or myalga was hardly reported in residents compared to staff (P -value <0.001). Median Ct-value of presymptomatic residents was 21.3, which did not differ from symptomatic (20.8) or asymptomatic (20.5) residents (P -value 0.624). Conclusions Symptoms in residents and staff are insufficiently recognised, reported or attributed to a possible SARS-CoV-2 infection. However, residents without (recognised) symptoms showed the same potential for viral shedding as residents with symptoms. Weekly testing was an effective strategy for early identification of SARS-Cov-2 cases, resulting in fast mitigation of the outbreak. [ABSTRACT FROM AUTHOR]

Background An outbreak of coronavirus disease 2019 (COVID-19) in a nursing home in the Netherlands, following an on-site church service held on 8 March 2020, triggered an investigation to unravel sources and chain(s) of transmission. Methods Epidemiological data were collected from registries and through a questionnaire among church attendees. Symptomatic residents and healthcare workers (HCWs) were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse-transcription polymerase chain reaction and subjected to whole genome sequencing (WGS). Sequences from a selection of people from the same area were included as community reference. Results After the church service, 30 of 39 attendees (77%) developed symptoms; 14 (11 residents and 3 nonresidents) were tested and were positive for COVID-19. In the following 5 weeks, 62 of 300 residents (21%) and 30 of 640 HCWs (5%) tested positive for COVID-19; 21 of 62 residents (34%) died. The outbreak was controlled through a cascade of measures. WGS of samples from residents and HCWs identified a diversity of sequence types, grouped into 8 clusters. Seven resident church attendees all were infected with distinct viruses, 4 of which belonged to 2 larger clusters in the nursing home. Conclusions Although initial investigation suggested the church service as the source of the outbreak, detailed analysis showed a more complex picture, most consistent with widespread regional circulation of the virus in the weeks before the outbreak, and multiple introductions into the nursing home before the visitor ban. The findings underscore the importance of careful outbreak investigations to understand SARS-CoV-2 transmission to develop evidence-based mitigation measures. [ABSTRACT FROM AUTHOR]

Introduction: Non-suicidal self-injury (NSSI) is defined as any deliberate destruction of one's body tissue, engaged in for reasons that are non-suicidal. Online platforms, notably social media, witness a surge in NSSI-related content, amplified by the COVID-19 pandemic. Young individuals increase video and post uploads, prompting scholarly inquiry into the impact on vulnerable demographics in the online environment. Despite potential benefits, concerns surface regarding content reinforcing self-injurious behavior. The Blue Whale phenomenon exemplifies serious consequences in this digital landscape. Objectives: The present study aims at screening the prevalence of NSSIs on SNS among Italian young people. Methods: An observational cross-sectional study was conducted by recruiting 373 Italian young people (aged 18-25). Bergen Social Media Addiction Scale (BSMAS), Fear Of Missing Out Scale (FOMO), Inventory of Statements About Self-Injury (ISAS) were administered to investigate the relationship between NSSIs, social media use and frequency and underpinned motivations. Results: Overall, 99.7 % (n=372) of participants declared to have used at least one social network. Around 92.5 % (n=345) declared to know Blue Whale Challenge and more than half of the sample (51.5%) referred to have looked for NSSI contents on SNS, mostly (28.7 % (n=107)) have sought for curiosity, 17.7 % (n=66) have sought for help/support. 53.4 % (n=199) of the sample was found to have problematic social media use (PSMU) according to BSMAS. 85 % (n=317) have committed self-injurious gestures in the past, 66.2 % (n=247) practice NSSI currently, most subjects practice them to vent 51.7% (n=193), calm themselves 41.6% (n=155), and punish themselves 30% (n=112). The mean age of transgender and nonbinary subjects (30 % n=112)) who sought/saw content pertaining to NSSIs appears to be lower (p=0.033) than cisgender subjects. Those who searched for content inherent to NSSIs scored higher mean scores on the FOMO (p=0.022) and BSMAS (p=0.013) scales. Those who follow social pages inherent to NSSIs scored higher on the FOMO scale (p=0.035). Subjects who practice NSSIs at their present state, on average, have higher scores on the FOMO and BSMAS scales (p=<.001). Linear regression analysis was conducted showing an association between BSMAS and FOMO (R²=0.199, B=0.260; F(1.371)=92.334; p=<.001). Logistic regression analyses were conducted to define the effects of FOMO, PMSU, sex, and NSSI search on the development of self-injurious conduct. The logistic regression model was statistically significant, χ2 (1)=3.909; p=0.048. Conclusions: The study examines NSSI behaviors among young Italian college students on digital platforms, particularly social networks. It stresses the critical need for targeted interventions, addressing concerns like social media addiction, to provide essential mental health support and foster a safer online environment for this population. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Background: The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically.Methods: Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections.Results: Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany.Conclusions: Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19. [ABSTRACT FROM AUTHOR]

Decamethylcyclopentasiloxane (D5, C10H30O5Si5) is measured at ppt levels outdoors and ppb levels indoors. Primarily used in personal care products, its outdoor concentration is correlated to population density. Since understanding the aerosol formation potential of volatile chemical products is critical to understanding particulate matter in urban areas, the secondary organic aerosol yield of D5 was studied under a range of OH concentrations, OH exposures, NOx concentrations, and temperatures. The secondary organic aerosol (SOA) yield from the oxidation of D5 is extremely dependent on the OH concentration, and differing measurements of the SOA yield from the literature are resolved in this study. Here, we compare experimental results from environmental chambers and flow tube reactors. Generally, there are high SOA yields (> 68 %) at OH mixing ratios of 5 × 109 molec cm-3. At atmospherically relevant OH concentrations, the SOA yield is largely < 5 % and usually -1 %. This is significantly lower than SOA yields used in emission and particulate matter inventories and demonstrates the necessity of OH concentrations similar to the ambient environment when extrapolating SOA yield data to the outdoor atmosphere. [ABSTRACT FROM AUTHOR]

Recent inventory-based analysis suggests that emissions of volatile chemical products in urban areas are competitive with those from the transportation sector. Understanding the potential for secondary organic aerosol formation from these volatile chemical products is therefore critical to predicting levels of aerosol and for formulating policy to reduce aerosol exposure. Experimental and computationally simulated environmental chamber data provide an understanding of aerosol yield and chemistry under relevant urban conditions (5–200 ppb NO and 291–312 K) and give insight into the effect of volatile chemical products on the production of secondary organic aerosol. Benzyl alcohol, one of these volatile chemical products, is found to have a large secondary organic aerosol formation potential. At NO concentrations of ∼ 80 ppb and 291 K, secondary organic aerosol mass yields for benzyl alcohol can reach 1. [ABSTRACT FROM AUTHOR]

The Five Minute Speech Sample's (FMSS) measure of parental expressed emotion (EE), defined as criticism (CRIT) and emotional overinvolvement (EOI), has been increasingly used to measure family emotional climate in relation to youth psychopathological development. As CRIT and EOI were defined based on adults, a meta-analysis and systematic review was conducted to analyze the presence and strength of an effect among maternal CRIT and EOI with youth internalizing and externalizing problems. A random effects model was used to analyze the 42 studies on families of youth (aged 1.5 to 19). There was a small, significant relation among maternal CRIT with youth internalizing and externalizing problems and among EOI with youth internalizing problems. EOI was not significantly related to externalizing problems. The current study suggests that the FMSS measure of CRIT is a more robust correlate of youth internalizing and externalizing symptoms than EOI, but EOI does relate to internalizing behaviors. Few moderators emerged, highlighting a continued need to identify factors accounting for heterogeneity. The current results suggest that the FMSS measure of CRIT may be a valuable measure of the family emotional climate in families of youth, but care should be taken when including analyses on EOI. [ABSTRACT FROM AUTHOR]

The first highly pathogenic (HP) influenza A/H7N9 was reported in Guangdong in January 2017. To investigate the emergence and spread of HP A/H7N9 in Guangdong province, we sequenced 297 viruses (58 HP A/H7N9, 19 low pathogenic (LP) A/H7N9, and 220 A/H9N2) during 2016–2017. Our analysis showed that during the fifth wave, three A/H7N9 lineages were co-circulating in Guangdong: the local LP Pearl River Delta (PRD) lineage (13%), the newly imported LP Yangtze River Delta (YRD) lineage (23%), and the HP YRD lineage (64%). Previously circulating YRD-lineage LP during the third wave evolved to the YRD-lineage HP A/H7N9 in Guangdong. All YRD-lineage LP detected during the fifth wave most likely originated from newly imported viruses into Guangdong. Genotype comparison of HP A/H7N9 suggests limited outward spread of HP A/H7N9 to other provinces. The distribution of HP A/H7N9 cleavage site variants on live poultry markets differed from that found in humans, suggesting a V1-type cleavage site may facilitate human infections. [ABSTRACT FROM AUTHOR]

A new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged to cause a human pandemic. Although molecular diagnostic tests were rapidly developed, serologic assays are still lacking, yet urgently needed. Validated serologic assays are needed for contact tracing, identifying the viral reservoir, and epidemiologic studies. We developed serologic assays for detection of SARS-CoV-2 neutralizing, spike protein-specific, and nucleocapsid-specific antibodies. Using serum samples from patients with PCR-confirmed SARS-CoV-2 infections, other coronaviruses, or other respiratory pathogenic infections, we validated and tested various antigens in different in-house and commercial ELISAs. We demonstrated that most PCR-confirmed SARS-CoV-2-infected persons seroconverted by 2 weeks after disease onset. We found that commercial S1 IgG or IgA ELISAs were of lower specificity, and sensitivity varied between the 2 assays; the IgA ELISA showed higher sensitivity. Overall, the validated assays described can be instrumental for detection of SARS-CoV-2-specific antibodies for diagnostic, seroepidemiologic, and vaccine evaluation studies. [ABSTRACT FROM AUTHOR]

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Recent inventory-based analysis suggests that emissions of volatile chemical products in urban areas are now competitive with those from the transportation sector. Understanding the potential for secondary organic aerosol formation from these volatile chemical products is, therefore, critical to predicting levels of aerosol and for formulating policy to reduce aerosol exposure. It is clear that a plethora of oxygenated compounds are either emitted directly into the atmosphere or emitted indoors and later escape into the outdoors. Experimental and computationally simulated environmental chamber data provide an understanding of aerosol yield and chemistry under relevant urban conditions (5-200 ppb NO and 291-312 K) and give insight into the effect of volatile chemical products on the production of secondary organic aerosol. Benzyl alcohol, one of these volatile chemical products, is found to have a large secondary organic aerosol formation potential. At NO concentrations of ~ 80 ppb and 291 K, secondary organic aerosol mass yields for benzyl alcohol can reach 1. [ABSTRACT FROM AUTHOR]