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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in wastewater has been used to track community infections of coronavirus disease-2019 (COVID-19), providing critical information for public health interventions. Since levels in wastewater are dependent upon human inputs, we hypothesize that tracking infections can be improved by normalizing wastewater concentrations against indicators of human waste [Pepper Mild Mottle Virus (PMMoV), β-2 Microglobulin (B2M), and fecal coliform]. In this study, we analyzed SARS-CoV-2 and indicators of human waste in wastewater from two sewersheds of different scales: a University campus and a wastewater treatment plant. Wastewater data were combined with complementary COVID-19 case tracking to evaluate the efficiency of wastewater surveillance for forecasting new COVID-19 cases and, for the larger scale, hospitalizations. Results show that the normalization of SARS-CoV-2 levels by PMMoV and B2M resulted in improved correlations with COVID-19 cases for campus data using volcano second generation (V2G)-qPCR chemistry (

Characterizing the microbiology of swelling bentonite clays can help predict the long-term behaviour of deep geological repositories (DGRs), which are proposed as a solution for the management of used nuclear fuel worldwide. Such swelling clays represent an important component of several proposed engineered barrier system designs and, although cultivation-based assessments of bentonite clay are routinely conducted, direct nucleic acid detection from these materials has been difficult due to technical challenges. In this study, we generated direct comparisons of microbial abundance and diversity captured by cultivation and direct nucleic acid analyses using 15 reference bentonite clay samples. Regardless of clay starting material, the corresponding profiles from cultivation-based approaches were consistently associated with phylogenetically similar sulfate-reducing bacteria, denitrifiers, aerobic heterotrophs, and fermenters, demonstrating that any DGR-associated growth may be consistent, regardless of the specific bentonite clay starting material selected for its construction. Furthermore, dominant nucleic acid sequences in the as-received clay microbial profiles did not correspond with the bacteria that were enriched or isolated in culture. Few core taxa were shared among cultivation and direct nucleic acid analysis profiles, yet those in common were primarily affiliated with Streptomyces, Micrococcaceae, Bacillus, and Desulfosporosinus genera. These putative desiccation-resistant bacteria associated with diverse bentonite clay samples can serve as targets for experiments that evaluate microbial viability and growth within DGR-relevant conditions. Our data will be important for global nuclear waste management organizations, demonstrating that identifying appropriate design conditions with suitable clay swelling properties will prevent growth of the same subset of clay-associated bacteria, regardless of clay origin or processing conditions.

Canada is currently implementing a site selection process to identify a location for a deep geological repository (DGR) for the long-term storage of Canada’s used nuclear fuel, wherein used nuclear fuel bundles will be sealed inside copper-coated carbon steel containers, encased in highly compacted bentonite clay buffer boxes, and sealed deep underground in a stable geosphere. Because a DGR must remain functional for a million years, it is important to examine ancient natural systems that serve as analogues for planned DGR components. Specifically, studying the microbiology of natural analogue components of a DGR is important for developing an understanding of the types of microorganisms that may be able to grow and influence the long-term stability of a DGR. This study explored the abundance, viability, and composition of microorganisms in several ancient natural analogues using a combination of cultivation and cultivation-independent approaches. Samples were obtained from the Tsukinuno bentonite deposit (Japan) that formed ∼10 mya, the Opalinus Clay formation (Switzerland) that formed ∼174 mya, and Canadian shield crystalline rock from Northern Ontario that formed ∼2.7 bya. Analysis of 16S rRNA gene amplicons revealed that three of the ten Tsukinuno bentonite samples analyzed were dominated by putative aerobic heterotrophs and fermenting bacteria from the phylum Actinobacteria, whereas five of the Tsukinuno bentonite samples were dominated by sequences associated with putative acidophilic chemolithoautotrophs capable of sulfur reduction. The remaining Tsukinuno bentonite samples, the Northern Ontario rock samples, and the Opalinus Clay samples generated inconsistent replicate 16S rRNA gene profiles and were associated primarily with contaminant sequences, suggesting that the microbial profiles detected were not sample-specific but spurious. Culturable aerobic heterotroph abundances were relatively low for all Tsukinuno bentonite samples, culturable anaerobic heterotrophs were only detected in half of the Tsukinuno samples, and sulfate-reducing bacteria (SRB) were only detected in one Tsukinuno sample by cultivation. Culture-specific 16S rRNA gene profiles from Tsukinuno clay samples demonstrated the presence of phyla Bacteroidetes, Proteobacteria, Actinobacteria, and Firmicutes among aerobic heterotroph cultures and additional bacteria from the phyla Actinobacteria and Firmicutes from anaerobic heterotroph plate incubations. Only one nucleic acid sequence detected from a culture was also associated with its corresponding clay sample profile, suggesting that nucleic acids from culturable bacteria were relatively rare within the clay samples. Sequencing of DNA extracted from the SRB culture revealed that the taxon present in the culture was affiliated with the genus Desulfosporosinus, which has been found in related bentonite clay analyses. Although the crystalline rock and Opalinus Clay samples were associated with inconsistent, likely spurious 16S rRNA gene profiles, we show evidence for viable and detectable microorganisms within several Tsukinuno natural analogue bentonite samples.

Biogeophysical investigations over the last decade have provided evidence documenting that geophysical technique can be used to assess in-situ biogeochemical processes. In this study, we investigated a site contaminated by crude oil at Bemidji, Minnesota where intrinsic bioremediation is known to occur and iron is the dormant electron acceptor process.

A major contribution to debates about the origins of the Civil War, this study of English forests and hunting from the late sixteenth century to the early 1640s explores their significance in the symbolism and effective power of royalty and the nobility in early modern England. Blending social, cultural and political history, Dan Beaver examines the interrelationships among four local communities to explain the violent political conflicts in the forests in the years leading up to the civil war. Adopting a micro-historical approach, the book explores how local politics became bound up with national political and ideological divisions. The author argues that, from the early seventeenth century, a politics of land use in forests and other hunting reserves involved its participants in a sophisticated political discourse, touching on the principles of law and justice, the authority of the crown and the nature of a commonwealth.

The use of pneumatic and explosive cartridge-activated nail guns is common in the construction industry. The ease and speed of nailing these tools afford enhance productivity at the cost of increased potential for traumatic injury. Although extremity injuries are most common, life-threatening injuries to the head, neck, chest, or abdomen and pelvis may occur. During a 20-month period, eight potentially life-threatening nail gun injuries were admitted to a Level I trauma center, including injuries to the brain, eye, neck, heart, lung, and femoral artery. Mechanism of injury included nail ricochet, nail gun misuse due to inadequate training, and successful suicide. Nail guns have significant potential for causing severe debilitating injury and death. These findings indicate a need for improved safety features and user education. The various types of nail guns, their ballistic potential, and techniques for operative management are discussed.

Summary Seventeen new and four reclassified cases of zoonotic filariasis in the United States are reported, and eighteen previously reported cases are reviewed. Worms recovered from the 39 infected persons were of six morphological types: In 11 cases, worms morphologically indistinguishable from Dirofilaria immitis were found in the heart (2 cases) or in infarct-like lesions of the lungs; in 24, worms of the morphological type referred to as Dirofilaria conjunctivae were in subcutaneous nodules or swellings; and Dirofilaria of a different type was found in one case, Brugia-like in one, and Dipetalonema-like in two. All of the infected persons were adult, 31 (80%) were female, and 32 or more acquired the infection in the South, mostly in Florida. The worms in all cases were sexually mature but unmated; more than two-thirds had died in the tissues. In most cases the symptoms or signs of infection were of short duration, with onset apparently coinciding with the worm's loss of vitality.

With the growing popularity and advancements in personal computers, their use in the medical field is becoming increasingly advantageous. Computer assisted learning has provided valuable instruction to physicians, residents, and medical students. Within the last ten years, computer driven artificial intelligence software packages have allowed physicians to save considerable time in formulating differential diagnoses. Medsearch and other programs provide the ability to cross-reference topics quickly and easily.

A worm in the lung of a man in Colombia, whose death was caused by lymphoid leukemia, originally reported as Wuchereria bancrofti with embryos in the uterus, was re-examined and identified as a Dirofilaria sp. and its gravid condition confirmed. A Dirofilaria sp. in the lung of a man in Japan, reported as gravid, was found to be nongravid with sloughed fragments of lining of the uterus mistaken for microfilariae. Noteworthy in the Colombia case is the association of lymphoid leukemia in the host and the gravid condition of the worm.

This article is concerned with the methodological issues of assessing the effects of casemixfunding on hospital utilisation. Time-series analysis and intervention analysis are proposedto ascertain the effects. It was found there had been a decline in average length of stay andnumber of bed-days, an increase in weighted separations for teaching and non-teachinghospitals, and no apparent increase of costliness in terms of a comprehensive casemix index.No evidence of decline in quality of care can be established in terms of readmission rates.The long-term effects of casemix funding, and specific issues in terms of the funding modelused, patients and cost shifting between hospital services and community health services,remain to be studied.

A 9-year-old boy in Teheran, Iran developed severe asthmatic symptoms, productive cough, and moderate eosinophilia. Lung biopsy demonstrated a helminth in a granulomatous lesion with foreign-body type cellular reaction leading to a tentative diagnosis of visceral larva migrans. Diethylcarbamazine, thiabendazole, and steroids were given, rapidly relieving the symptoms. In a subsequent review of the biopsy the helminth was identified as a Capillaria, probably Capillaria (Thominx) aerophila, a nematode parasite of dogs, cats, and other carnivores, apparently the ninth such infection to be reported in man.

We describe a useful technique for removing filaria from the anterior chamber. In the case described, an immature female filaria approximately 15 mm in length was removed from the anterior chamber of a 32-year-old man in western Oregon and identified as a species of Dipetalonema. Features of four cases of filarial infection in the anterior chamber from the same geographic area are described. In three out of four cases, the worms were removed alive without difficulty by means of a simple irrigation aspiration system.

A Necator infection produced by percutaneous exposure of a volunteer to three larvae was followed with periodic egg counts for 4 months beyond 18 years when passage of eggs in the feces ceased permanently. During the 2nd year of infection, there was unintentional exposure to two additional larvae. Egg counts per gram of feces (EPG) were approximately 1,000 during the 1st year, 1,500 over the next 5 years, and less than or equal to 200 over the final 3 years, during which time there were 6 periods of approximately 1 month each when Kato thick-smear examinations revealed no eggs. During 6 of the 1st 14 years, when egg counts were done by the standard direct smear method, up to 37% of the eggs were infertile. Based on the assumption that two female worms were present during the 1st year, three during the next 3 years or more, and only one during the final 3 years, the estimated output per female in this light infection was 500 EPG in the worm's prime of life, and less than 200 EPG in the final year of the 17 or 18 year life span.

Fifty-six cases of human intraocular filariasis have been reported. In 6, the objects interpreted as filariae may have been artifacts. In 8, a motile worm that apparently was not a filaria was observed. In the remainder, a motile filaria or filaria-like worm was observed, but in only 6 cases were the filariae removed from the eye, described, and identified. Three of these were identified as Dipetalonema spp., and one each as Wuchereria, Dirofilaria, and Loaina. In 10 cases, filariae were removed and identified as Loa loa (6) or Wuchereria bancrofti (4) but without a supporting description. A filaria was removed but not satisfactorily described or identified in 8 cases, spontaneously disappeared in 4, died following treatment in 4, and met unreported fates in seven. For 3 the original reports were inaccessible. Records of intraocular filariae that are not supported by morphological description are questionable.

Sarcocystis was identified in biopsy specimens of skeletal muscle from two adults in Singapore and one in Bombay, and in muscle obtained at autopsy from an adult in Uganda, and in the heart of a child in Costa Rica. Review of case reports revealed that in seven reported cases, including three reported by Lindemann, non-parasite objects were misinterpreted as sarcocysts; in four instances organisms of undetermined classification were described, and in 35 cases true sarcocysts were observed. Among the sarcocysts seen in the 40 cases (35 old, 5 new), seven morphological types were recognized, each representing one to several different species, all of which are zoonotic and none of which can be designated Sarcocystis lindemanni. Among the four types of sarcocysts found in skeletal muscle, three closely resembled a corresponding species found commonly in monkeys: one from a man in Uganda corresponding to a species in Ceropithicus talapoin, forms from India resembling one or two species in Macaca mulatta, and forms from Southeast Asia resembling a species in Macaca fascicularis. Among three types of sarcocysts found in the human heart, one resembled a species commonly seen in the heart of cattle. Of the 40 Sarcocystis infections in man, 13 probably were acquired in Southeast Asia, 8 in India, 5 in Central or South America, 4 each in Africa and Europe, 3 in USA, 1 IN China and 2 in unknown localities. Associated conditions include muscle soreness or weakness in 7 cases, subcutaneous swellings in 5, eosinophilia in 2, and periarteritis or polyarteritis nodosa in 2 cases. However, evidence of pathogenicity of the mature sarcocyst is inconclusive.

Two cases of subcutaneous dirofilariasis acquired in Ontario and Vermont are reported. The parasites in these and eight cases previously reported from the northern United States and Canada are classified as resembling Dirofilaria ursi, a primarily subcutaneous parasite of bears, or D. subdermata of porcupines, in the same region. A distinguishing morphological feature of the D. ursi-like group is the presence of distinct longitudinal cuticular ridges regularly and widely spaced on the outer surface, and usually evident even when the worms are necrotic. In the 10 known cases, all patients were women, and the usual location of nodules containing the worms was the scalp or a covered part of the upper body where blackfl.ies, the intermediate hosts of D. ursi, normally feed.

A case of invasion of the brain of a 48-year-old man, a native of Louisiana, by a larval tapeworm is described. Inasmuch as there were no scolices or rostellar hooks present the parasite was identified as a racemose cysticercus which could be either a sterile coenurus of Taenia multiceps (= Multiceps multiceps), Taenia serialis (= Multiceps serialis), or an aberrant cysticercus of Taenia solium or of a different species of Taenia. Most of the parasite was removed surgically with a preoperative diagnosis of brain tumor. After operation the patient improved, and 32 months after onset of his illness he was working and showed no evidence of a recurrence.

Nine new zoonotic Brugia infections, 8 acquired in the United States and 1 in Brazil, are described. In each, a single worm was found in histological sections of lymph nodes or lymphoid tissues. In those from North America, 5 of the 8 worms were females, all were infertile, and only 3 were alive at the time the tissues were excised; all of the patients were male. A dead female worm was collected from a Brazilian male patient. In addition, 3 cases of filarial infections in the U.S., previously identified as Dirofilaria-, Dipetalonema-, or Brugia-like, are reviewed and reclassified as Brugia species on the basis of microscopic morphological features. Morphological features of male and female zoonotic Brugia species as they appear in the host tissues are described. The possible reservoirs of human infections are discussed.

In the reported cases of an infarct-like density caused by a filarial worm in a pulmonary artery the species involved usually was identified as a Dirofilaria. In most instances the worm was presumed to be D. immitis and was dead when discovered. In a recent such case the worm was identified as a sexually mature, infertile female Brugia, probably B. malayi, in a normal artery situated some distance from the lesion, and it apparently was alive when removed in resected lung tissue. In the present case the findings were similar in that the worm was a living, sexually mature, infertile female lying free in a normal artery some distance from an infarct-like pulmonary density, but the morphological features evident in histopathological sections of the worm resembled those seen in Wuchereria bancrofti.

Surgical repair of an inguinal hernia in a 19-year-old man in Honduras revealed massive numbers of small granulomata containing trematode eggs on the omentum and other peritoneal surfaces. The eggs resembled those of Achillurbainia recondita Travassos, 1942, a species found in the maxillary sinuses of the opossum, Didelphis marsupialis. Species of Achillurbainis (syn. Poikilorchis Fain and Vandepitte, 1957) have been reported in retroauricular cysts or abscesses in residents of West Africa and Southeast Asia.

Retinal detachments are usually divided between rhegmatogenous and exudative. Many causes for exudative retinal detachments are described in the literature. Subretinal nematodes are a rare but well-known etiology for severe exudative retinal detachments and endophthalmitis. The case presented represents the first known infestation of human ocular tissue by the nematode Porrocaecum or Hexametra. Described are the presenting symptoms and medical and surgical management, including pars plana vitrectomy, retinotomy, and air-fluid exchange to salvage the eye.

A 4.5-mm filarial worm was removed from the anterior chamber of the left eye of a 56-year-old man who had lost the sight in the right eye due to trauma some years earlier. The worm was removed intact through an upper scleral incision with a corneal based flap. Within 2 months vision was normal. The worm was identified as a sexually mature male of an undescribed species of Loaina Eberhard and Orihel 1984, a genus related to Loa and Dirofilaria.

A mature male filarial worm was found in sections of an enlarged, painful retroauricular lymph node removed from an 18-year-old resident of New Jersey. On the basis of its morphology and location in an obstructed lymph vessel, the worm was identified as probably a species of Brugia, possibly Brugia beaveri, a parasite of the raccoom. The infection in this case resembled one reported earlier from the same general area of the country, New York City. In the absence of demonstrable microfilaremia in this and other cases of zoonotic filariasis acquired in the United States, specific drug treatment after surgical removal of the worm is usually unnecessary.

Summary Twenty-three cases of human sparganosis are reported. Of these, 21 were in residents of the southern United States, principally Louisiana, Texas and Florida. Two infections were in patients from Puerto Rico and British Honduras. Cases of sparganosis have been diagnosed annually since 1953, and except for two that were seen in 1948 and 1949, also reported herein, the infection had not been observed previously in Louisiana. With the addition of these 21 cases, the total number of naturally acquired infections reported for the United States to date is 35, of which 25 occurred in residents of Louisiana and adjoining states.

Summary In the lungs of an adult Indian in Singapore who died after a ten-day illness which was tentatively diagnosed as eosinophilic lung, numerous nematode larvae were found. The larvae have been identified morphologically as Ascaris sp., probably A. lumbricoides. It is believed that the larvae were responsible for the disease observed in this case, and that pulmonary ascariasis and eosinophilic lung are separate but clinically similar disease entities. The observations suggest that this and possibly other species of nematode larvae may cause pulmonary symptoms with hypereosinophilia resembling the condition described as eosinophilic lung, and in life the two conditions may be indistinguishable.