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Background: There is an increasing use of assistive technology and interactive therapeutic robots in nursing homes. However, little is known about the possible risks for transmitting infectious diseases through the use of such devices. Methods: Representative surface samples of two multipurpose hygiene chairs and two interactive therapeutic robots were collected on a weekly basis at two nursing homes over a period of two months. Results: We found that both robots and hygiene chairs may contribute to pathogen transmission. [ABSTRACT FROM AUTHOR]

Knowledge of the health status and potential effect of disease outbreaks among Southern Ocean fauna may be decisive for its conservation. We assessed the exposure and infection of Antarctic fur seals (Arctocephalus gazella, AFS) and Southern elephant seals (Mirounga leonine, SES) to parapoxvirus, Phocid alphaherpesvirus-1 (PhHV-1), smooth Brucella spp. and Toxoplasma gondii. AFS (n = 65) serum and swab samples, and SES (n = 13) serum samples from the sub-Antarctic island of Bouvetøya (54°25’S, 03°22’E) were collected during two austral summers (2014/15, 2017/18). Three polymerase chain reaction (PCR) tests amplifying the DNA polymerase, B2L and GIF parapoxvirus genomic regions were performed, investigating DNA from mucosal swab samples. The glycoprotein B gene was targeted to detect PhHV-1 viral DNA. Sera were assayed for T. gondii and smooth Brucella spp. antibodies with indirect enzyme-linked immunosorbent assays. Parapoxvirus PCR amplicons of the expected size were generated in two of the 29 AFS pups (nasal swabs, 2014/15), targeting the B2L (n = 2) and DNA polymerase (n = 1) genes, whereas the GIF PCR did not amplify target sequences. The PCR amplicons were sequenced and blasted in GenBank, revealing highest similarity with a seal parapoxvirus, confirming the presence of the virus in AFS for the first time. No PhHV-1 amplicons were generated, and antibodies against T. gondii or smooth Brucella spp. were not detected. Our data indicate that these seals are host for parapoxvirus but are neither exposed to smooth Brucella spp. nor T. gondii. Evidence of PhHV-1 shedding was not detected. [ABSTRACT FROM AUTHOR]

Abstract This study investigated relationships between organohalogen compound (OHC) exposure, feeding habits, and pathogen exposure in a recovering population of Atlantic walruses (Odobenus rosmarus rosmarus) from the Svalbard Archipelago, Norway. Various samples were collected from 39 free-living, apparently healthy, adult male walruses immobilised at three sampling locations during the summers of 2014 and 2015. Concentrations of lipophilic compounds (polychlorinated biphenyls, organochlorine pesticides and polybrominated diphenyl ethers) were analysed in blubber samples, and concentrations of perfluoroalkylated substances (PFASs) were determined in plasma samples. Stable isotopes of carbon and nitrogen were measured in seven tissue types and surveys for three infectious pathogens were conducted. Despite an overall decline in lipophilic compound concentrations since this population was last studied (2006), the contaminant pattern was similar, including extremely large inter-individual variation. Stable isotope ratios of carbon and nitrogen showed that the variation in OHC concentrations could not be explained by some walruses consuming higher trophic level diets, since all animals were found to feed at a similar trophic level. Antibodies against the bacteria Brucella spp. and the parasite Toxoplasma gondii were detected in 26% and 15% of the walruses, respectively. Given the absence of seal-predation, T. gondii exposure likely took place via the consumption of contaminated bivalves. The source of exposure to Brucella spp. in walruses is still unknown. Parapoxvirus DNA was detected in a single individual, representing the first documented evidence of parapoxvirus in wild walruses. Antibody prevalence was not related to contaminant exposure. Despite this, dynamic relationships between diet composition, contaminant bioaccumulation and pathogen exposure warrant continuing attention given the likelihood of climate change induced habitat and food web changes, and consequently OHC exposure, for Svalbard walruses in the coming decades. Graphical abstract Image 1 Highlights • This study was conducted on 39 male Atlantic walruses from Svalbard, Norway. • Stable isotope values indicated that all individuals fed at a low trophic level. • Total lipophilic POP concentrations in blubber ranged from 43.2 to 41554 ng/g lw. • Seroprevalence of anti- Brucella spp. and anti- Toxoplasma gondii antibodies was ≤26%. • Antibody prevalence was not related to exposure to POPs or PFASs. This study reports levels of pollutants in comparison with diet and pathogen exposure in 39 male Atlantic walruses from Svalbard, Norway. [ABSTRACT FROM AUTHOR]

Background: The government of Ethiopia has envisioned digitalizing primary healthcare units through the electronic community health information system (eCHIS) program as a re-engineering strategy aiming to improve healthcare data quality, use, and service provision. The eCHIS is intended as a community-wide initiative to integrate lower health structure with higher administrative health and service delivery unit with the ultimate goal of improving community health. However, the success or failure of the program depends on the level of identifying enablers and barriers of the implementation. Therefore, this study aimed to explore individual and contextual-level enablers and barriers determining eCHIS implementation., Method: We conducted an exploratory study to determine the enablers and barriers to successfully implementing eCHIS in rural Wogera district, northwest Ethiopia. In-depth interviews and key informant interviews were applied at participants from multiple sites. A thematic content analysis was conducted based on the key themes reported. We applied the five components of consolidated framework for implementation research to interpret the findings., Results: First, based on the intervention's characteristics, implementers valued the eCHIS program. However, its implementation was impacted by the heavy workload, limited or absent network and electricity. Outer-setting challenges were staff turnover, presence of competing projects, and lack of incentive mechanisms. In terms of the inner setting, lack of institutionalization and ownership were mentioned as barriers to the implementation. Resource allocation, community mobilization, leaders' engagement, and availability of help desk need emphasis for a better achievement. With regard to characteristics of the individuals, limited digital literacy, older age, lack of peer-to-peer support, and limited self-expectancy posed challenges to the implementation. Finally, the importance of mentoring and engaging community and religious leaders, volunteers, having defined plan and regular meetings were identified elements of the implementation process and need emphasis., Conclusion: The findings underlined the potential enablers and barriers of eCHIS program for quality health data generation, use, and service provision and highlighted areas that require emphasis for further scale-up. The success and sustainability of the eCHIS require ongoing government commitment, sufficient resource allocation, institutionalization, capacity building, communication, planning, monitoring, and evaluation., (© 2023. The Author(s).)

Polarization-sensitive Fourier-ptychography microscopy (pFPM) allows for high resolution imaging while maintaining a large field of view, and without mechanical movements of optical-setup components. In contrast to ordinary light microscopes, pFPM provides quantitative absorption and phase information, for complex and birefringent specimens, with high resolution across a wide field of view. Using a semi-spherical home-built LED illumination array, a single polarizer, and a 10x /0.28NA objective, we experimentally demonstrate high performance pFPM with a synthesized NA of 1.1. Applying the standard quantitative method, a measured half-pitch resolution of 244 nm is achieved for the 1951 USAF resolution test target. As application examples, the polarimetric properties of a herbaceous flowering plant and the metastatic carcinoma of human liver cells are analyzed and quantitatively imaged.

Introduction: unCoVer-Unravelling data for rapid evidence-based response to COVID-19-is a Horizon 2020-funded network of 29 partners from 18 countries capable of collecting and using real-world data (RWD) derived from the response and provision of care to patients with COVID-19 by health systems across Europe and elsewhere. unCoVer aims to exploit the full potential of this information to rapidly address clinical and epidemiological research questions arising from the evolving pandemic., Methods and Analysis: From the onset of the COVID-19 pandemic, partners are gathering RWD from electronic health records currently including information from over 22 000 hospitalised patients with COVID-19, and national surveillance and screening data, and registries with over 1 900 000 COVID-19 cases across Europe, with continuous updates. These heterogeneous datasets will be described, harmonised and integrated into a multi-user data repository operated through Opal-DataSHIELD, an interoperable open-source server application. Federated data analyses, without sharing or disclosing any individual-level data, will be performed with the objective to reveal patients' baseline characteristics, biomarkers, determinants of COVID-19 prognosis, safety and effectiveness of treatments, and potential strategies against COVID-19, as well as epidemiological patterns. These analyses will complement evidence from efficacy/safety clinical trials, where vulnerable, more complex/heterogeneous populations and those most at risk of severe COVID-19 are often excluded., Ethics and Dissemination: After strict ethical considerations, databases will be available through a federated data analysis platform that allows processing of available COVID-19 RWD without disclosing identification information to analysts and limiting output to data aggregates. Dissemination of unCoVer's activities will be related to the access and use of dissimilar RWD, as well as the results generated by the pooled analyses. Dissemination will include training and educational activities, scientific publications and conference communications., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) led to coronavirus disease 2019 (COVID-19) pandemic affecting nearly 71.2 million humans in more than 191 countries, with more than 1.6 million mortalities as of 12 December, 2020. The spike glycoprotein (S-protein), anchored onto the virus envelope, is the trimer of S-protein comprised of S1 and S2 domains which interacts with host cell receptors and facilitates virus-cell membrane fusion. The S1 domain comprises of a receptor binding domain (RBD) possessing an N-terminal domain and two subdomains (SD1 and SD2). Certain regions of S-protein of SARS-CoV-2 such as S2 domain and fragment of the RBD remain conserved despite the high selection pressure. These conserved regions of the S-protein are extrapolated as the potential target for developing molecular diagnostic techniques. Further, the S-protein acts as an antigenic target for different serological assay platforms for the diagnosis of COVID-19. Virus-specific IgM and IgG antibodies can be used to detect viral proteins in ELISA and lateral flow immunoassays. The S-protein of SARS-CoV-2 has very high sequence similarity to SARS-CoV-1, and the monoclonal antibodies (mAbs) against SARS-CoV-1 cross-react with S-protein of SARS-CoV-2 and neutralize its activity. Furthermore, in vitro studies have demonstrated that polyclonal antibodies targeted against the RBD of S-protein of SARS-CoV-1 can neutralize SARS-CoV-2 thus inhibiting its infectivity in permissive cell lines. Research on coronaviral S-proteins paves the way for the development of vaccines that may prevent SARS-CoV-2 infection and alleviate the current global coronavirus pandemic. However, specific neutralizing mAbs against SARS-CoV-2 are in clinical development. Therefore, neutralizing antibodies targeting SARS-CoV-2 S-protein are promising specific antiviral therapeutics for pre-and post-exposure prophylaxis and treatment of SARS-CoV-2 infection. We hereby review the approaches taken by researchers across the world to use spike gene and S-glycoprotein for the development of effective diagnostics, vaccines and therapeutics against SARA-CoV-2 infection the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Malik, Kumar, Ansari, Hemida, El Zowalaty, Abdel-Moneim, Ganesh, Salajegheh, Natesan, Sircar, Safdar, Vinodhkumar, Duarte, Patel, Klein, Rahimi and Dhama.)

Parapoxviruses cause nodular lesions on the skin and mucosal membranes of pinnipeds and infections by these viruses have been documented worldwide. Seal parapoxvirus is currently classified as a tentative species of the Parapoxvirus genus. Tissue or swab samples were analyzed from 11 pinnipeds of different host species undergoing rehabilitation on the east and west coasts of the United States of America (USA) that were positive for parapoxvirus. The aim of the study was to compare parapoxvirus sequences of fragments of the B2L, DNA polymerase, GIF and viral interleukin-10 ortholog ( vIL-10) genes and to examine the evolutionary relationship between viruses detected in different pinniped species and at different locations with other members of the Parapoxvirus genus, such as Orf virus (ORFV), Bovine papular stomatitis virus (BPSV) and Pseudocowpox virus (PCPV). The sequence analysis showed that the parapoxvirus sequences from the pinnipeds differed significantly from those found in terrestrial hosts and that they formed a separate cluster within the genus. Our results suggest that transmission of the same parapoxvirus strain is possible between different species, including between members of different families (phocids and otariids). Animals belonging to the same species but living in distant geographic locations presented genetically distant parapoxviruses. The findings of this study demonstrate that sealpox lesions in pinnipeds of different species are caused by viruses that belong to the Parapoxvirus genus but have significant genetic differences compared to the established virus species in terrestrial hosts, thus strongly supporting the classification of pinniped parapoxvirus as a new species of the genus., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Costa, Klein, Breines, Nollens, Matassa, Garron, Duignan, Schmitt, Goldstein and Tryland.)

Background: Migrant populations in the European Union (EU) suffer a disproportionate burden of infectious diseases and may be particularly vulnerable due to poor conditions in countries of origin or throughout transit to the host country. Given the rising level of migration into Europe, the vaccination of migrant populations has become a key priority, with European countries committing to equitably extending the benefits of vaccination to all. However, in Norway, little is known about the vaccination of migrant populations., Objective: The aim of this qualitative research study was to explore the process of vaccinating migrant populations in Norway and elucidate any challenges as perceived by healthcare providers. This involved exploring the challenges faced by healthcare providers in delivering vaccinations to migrants as well as potential barriers faced by migrants in accessing vaccinations in Norway, from the perspectives of healthcare providers., Methods: In June 2019, the authors conducted semi-structured interviews with seven healthcare providers who are involved in vaccinating migrants in South-Eastern and Western Norway. This included healthcare providers working in general practice, public health and infectious disease clinics, migrant health clinics, and local public health institutes., Results: An inductive, exploratory analysis identified key themes that were reviewed and analysed in light of existing literature. According to the informants, the Childhood Immunisation Programme is effective in including migrant children within the national vaccination schedule. However, gaps in vaccination appear to exist with regards to adult migrants as well as working migrants. There is currently no consistent or structured approach to vaccinating adult migrants in Norway, including no guidelines from governing bodies on how to organise vaccination to adult migrants in municipalities. Furthermore, reasons why adult vaccination is not prioritised were provided, such as tuberculosis screening and treatment taking precedence and the common assumption among healthcare providers that vaccinations are dealt with in childhood., Conclusion: The development of equitable immunisation programmes requires an understanding of the multifactorial barriers to immunisation, such as those posed by policies, structures and governance bodies, or lack thereof. It also entails understanding the administration of such policies and the perspectives of those who are responsible for the delivery of vaccination, namely healthcare providers. This qualitative research study demonstrated that challenges exist in the vaccination of migrants in Norway and that they are coherent with those experienced throughout the EU, principally the presence of gaps in vaccinating adult migrants, working migrants and internal EU migrants. This research provides direction for future investigations and highlights the need for the inclusion of migrant status in the Norwegian Immunisation Registry., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Supplementary winter feeding of semi-domesticated reindeer ( Rangifer tarandus tarandus ) has become more common in Sweden and Norway due to reindeer pasture fragmentation and climatic conditions. With increased corralling and feeding, often associated with animal stress, increased animal-to-animal contact, and poor hygienic conditions, an altered range of health challenges and diseases may emerge. An outbreak of three different infectious diseases appeared simultaneously in a reindeer herd in Norrbotten County, Sweden. The animals were corralled and fed silage. Several animals in poor body condition stopped eating, with drool and discoloration of the hair coat around the mouth. There were large, black, necrotic lesions on the tongue and gingiva, with holes perforating the chin, indicative of oral necrobacillosis and Fusobacterium spp. infection. Simultaneously, animals were seen with proliferative lesions in the oral mucosa and on the lips, characteristic of contagious ecthyma and Orf virus infection. Furthermore, three animals had keratoconjunctivitis suggesting exposure to cervid herpesvirus 2 (CvHV2) and possibly secondary bacterial infections. DNA specific for Fusobacterium necrophorum and ORFV was detected in relevant tissue samples. Antibodies against CvHV2 were detected in 10 of 13 diseased and in four of 11 apparently healthy reindeer. Nine animals were found dead or were euthanized during the outbreak. Health risk factors associated with feeding and corralling may severely impact animal welfare and the herder's economy, and may represent an underestimated cost when replacing natural grazing with feeding.