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Mark Obrenovich,1–4 Thriveen Sankar Chittoor Mana,5 Herleen Rai,2 Dorjee Shola,4,6 Christopher Sass,2,3 Benjamin McCloskey,4 Bruce S Levison7 1Pathology and Laboratory Medicine Service, 2Research Service, Cleveland Veterans Affairs Medical Center, 3Department of Chemistry, Cleveland State University, 4Gilgamesh Foundation, 5Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, OH, 6Gene Targeting Resource Center, The Rockefeller University, New York, NY, 7Department of Pediatrics, University of Toledo, Toledo, OH, USA Purpose of review: We have established that many metabolic biomes exist within the complex mammalian gut. Substantial metabolism occurs within these biomes and is called co-metabolism of the host and resident microorganisms. This gut–brain–endocrine metabolic interaction emphasizes how bacteria can affect the brain and the hormonal axes in the process of co-metabolism. This review highlights new findings in this regard. Recent findings: In this review, we explore how the gut microbiota affect the development and regulation of the hypothalamic–pituitary–adrenal axis and neurochemistry from mental health and behavioral health to memory, depression, mood, anxiety, obesity, and the development of the blood–brain barrier. Summary: This review describes the implications of the findings for clinical practice or research. Interaction of small molecules within these biomes is now described collectively as a “metabolic interactome”. Metabolites of the gut–brain–endocrine axis and our overall gut health constantly shape the host phenotype in ways previously unimagined, and this niche represents potential targets for treatment and drug design, since the interaction or biochemical interplay results in net metabolite production and/or end products to exercise either positive or negative effects on human health. Keywords: neurotransmitters, gut brain axis, metabolomics, microbiota, microbiome, HPA

Non-aqueous Li-air or Li-O2 cells show considerable promise as a very high energy density battery couple. Such cells, however, show sudden death at capacities far below their theoretical capacity and this, among other problems, limits their practicality. In this paper, we show that this sudden death arises from limited charge transport through the growing Li2O2 film to the Li2O2-electrolyte interface, and this limitation defines a critical film thickness, above which it is not possible to support electrochemistry at the Li2O2-electrolyte interface. We report both electrochemical experiments using a reversible internal redox couple and a first principles metal-insulator-metal charge transport model to probe the electrical conductivity through Li2O2 films produced during Li-O2 discharge. Both experiment and theory show a 'sudden death' in charge transport when film thickness is ∼5 to 10 nm. The theoretical model shows that this occurs when the tunneling current through the film can no longer support the electrochemical current. Thus, engineering charge transport through Li2O2 is a serious challenge if Li-O2 batteries are ever to reach their potential. [ABSTRACT FROM AUTHOR]

Background This study illustrates the potential of using emergency department attendance data, routinely accessed as part of a national syndromic surveillance system, to monitor the impact of thunderstorm asthma. Methods The Emergency Department Syndromic Surveillance System (EDSSS) routinely monitors anonymised attendance data on a daily basis across a sentinel network of 35 emergency departments. Attendance data for asthma, wheeze and difficulty breathing are analysed on a daily basis. Results A statistically significant spike in asthma attendances in two EDSSS emergency departments in London was detected on 23 July 2013, coinciding with a series of large violent thunderstorms across southern England. There was also an increase in the reported severity of these attendances. Conclusions This preliminary report illustrates the potential of the EDSSS to monitor the impact of thunderstorms on emergency department asthma attendances. Further work will focus on how this system can be used to quantify the impact on emergency departments, thus potentially improving resource planning and also adding to the thunderstorm asthma evidence-base. [ABSTRACT FROM AUTHOR]

To investigate whether exposure to tap water contaminated in a major river pollution incident with 2 ethyl 5,5 dimethyl 1,3 dioxane (EDD) and 2 ethyl 4 methyl 1,3 dioxolane (EMD) was associated with an increase of self reported symptoms. To assess the extent of association between noticing the water had an unusual taste or odour and self reported symptoms. Retrospective cohort study. A city and two nearby towns in a semi-rural area of England, UK. A total of 3861 people who replied to a postal questionnaire asking about symptoms and water consumption sent to a sample of 1000 households in each of three areas--one area supplied with contaminated water (study group) and two control areas that were unaffected (control groups). The household response rates were 65% for the study group and 56% and 57% for the two control groups. Self reporting of 10 individual symptoms was significantly increased in the study group compared with controls. Within the study group, reporting of one or more symptoms was significantly higher in subjects who consumed contaminated water but not among subjects who used it to wash or cook. Subjects who drank contaminated water showed a dose-response relationship for self reporting of one or more symptoms and for seven individual symptoms. Within the study group, however, only 62% (867 of 1398 subjects) noticed that the water had an unusual taste or odour. Among subjects who did not notice that the water had an unusual taste or odour, no association was found between drinking contaminated water and reporting one or more symptoms, or between drinking contaminated water and reporting of individual symptoms, although a dose-response relationship was shown between the amount of water consumed and self reporting of nausea. Among subjects who noticed the water had an unusual taste or odour, both an association and a dose-response relationship were found between consumption of contaminated water and the self reporting of six symptoms--diarrhoea, nausea, headache, stomach pains, skin irritation, and itchy eyes. Higher rates of symptom reporting were associated with the water contamination incident. Reported symptoms seemed, however, to be associated with the ability to detect an unusual taste or odour in the water. Because concentrations of the contaminants would be expected to be evenly distributed in the tap water in the affected area, irrespective of taste or odour, and because of the known toxicity of the parent compounds of EMD and EDD, it is concluded that the increase in self reported symptoms in the study group respondents was associated with noticing the unpleasant taste or odour of the tap water and not with the chemical contamination. It is concluded that the observed increase in reporting of nausea with increasing water consumption was due to public anxiety caused by the incident but did not pose a serious risk to the public's health. The increase in self reported symptoms in the area affected by the contamination was an important reminder of the wider health implications of 'health scares'. [ABSTRACT FROM AUTHOR]

Intermittent photic stimulation (IPS) is an activating procedure meant to elicit or accentuate epileptiform discharges during an EEG. There is insufficient clinical data to advocate IPS in the routine EEGs of all adult patients. We therefore sought to address the clinical significance of routine IPS in the adult population. We retrospectively reviewed 100 consecutive abnormal EEGs in adult patients (inpatients and outpatients) who had undergone photic stimulation in our laboratory. Nine patients had abnormalities noted during IPS. The abnormalities consisted of sharp waves in four patients and focal slowing in five patients. Only one patient had abnormalities on IPS that provided information additional to that seen on the baseline record. [ABSTRACT FROM AUTHOR]

Competing Interests: All authors have an academic interest in infectious diseases with pandemic potential and the globalisation of infections from mass gathering events. AZ acknowledges support from the Pan-African Network for Rapid Research, Response, Relief and Preparedness for Emerging and Re-Emerging Infections (PANDORA-ID-NET), funded by the EU-EDCTP2–EU Horizon 2020 Framework Programme. AZ is also a recipient of a UK NIHR Senior Investigator Award. All other authors declare no competing interests.

The COVID-19 pandemic profoundly affected all mass gatherings for sporting and religious events, causing cancellation, postponement, or downsizing. On March 24, 2020, the Japanese Government, the Tokyo Organising Committee of the Olympic and Paralympic Games, and the International Olympic Committee decided to postpone the Tokyo 2020 Olympic and Paralympic Games until the summer of 2021. With the emergence of SARS-CoV-2, the potential creation of a superspreading event that would overwhelm the Tokyo health system was perceived as a risk. Even with a delayed start date, an extensive scale of resources, planning, risk assessment, communication, and SARS-CoV-2 testing were required for the Games to be held during the COVID-19 pandemic. The effectiveness of various mitigation and control measures, including the availability of vaccines and the expansion of effective testing options, allowed event organisers and the Japanese Government to successfully host the rescheduled 2020 Tokyo Olympic Games from July 23 to Aug 8, 2021 with robust safety plans in place. In February and March, 2022, Beijing hosted the 2022 Winter Olympic Games as scheduled, built on the lessons learnt from the Tokyo Games, and developed specific COVID-19 countermeasure plans in the context of China's national framework for the plan called Zero COVID. Results from the testing programmes at both the Tokyo and Beijing Games show that the measures put in place were effective at preventing the spread of COVID-19 within the Games, and ensured that neither event became a COVID-19-spreading event. The extensive experience from the Tokyo and Beijing Olympic Games highlights that it is possible to organise mass gatherings during a pandemic, provided that appropriate risk assessment, risk mitigation, and risk communication arrangements are in place, leaving legacies for future mass gatherings, public health, epidemic preparedness, and wider pandemic response., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The World Health Organization priority zoonotic pathogen Middle East respiratory syndrome (MERS) coronavirus (CoV) has a high case fatality rate in humans and circulates in camels worldwide., Methods: We performed a global analysis of human and camel MERS-CoV infections, epidemiology, genomic sequences, clades, lineages, and geographical origins for the period January 1, 2012 to August 3, 2022. MERS-CoV Surface gene sequences (4061 bp) were extracted from GenBank, and a phylogenetic maximum likelihood tree was constructed., Results: As of August 2022, 2591 human MERS cases from 26 countries were reported to the World Health Organization (Saudi Arabia, 2184 cases, including 813 deaths [case fatality rate: 37.2%]) Although declining in numbers, MERS cases continue to be reported from the Middle East. A total of 728 MERS-CoV genomes were identified (the largest numbers were from Saudi Arabia [222: human = 146, camels = 76] and the United Arab Emirates [176: human = 21, camels = 155]). A total of 501 'S'-gene sequences were used for phylogenetic tree construction (camels [n = 264], humans [n = 226], bats [n = 8], other [n=3]). Three MERS-CoV clades were identified: clade B, which is the largest, followed by clade A and clade C. Of the 462 clade B lineages, lineage 5 was predominant (n = 177)., Conclusion: MERS-CoV remains a threat to global health security. MERS-CoV variants continue circulating in humans and camels. The recombination rates indicate co-infections with different MERS-CoV lineages. Proactive surveillance of MERS-CoV infections and variants of concern in camels and humans worldwide, and development of a MERS vaccine, are essential for epidemic preparedness., Competing Interests: Declaration of competing interests The authors have no competing interests to declare., (Copyright © 2023. Published by Elsevier Ltd.)