Examination of mercury concentration in the feathers of 18 species of birds in southwest Iran

This paper presents the levels of mercury (Hg) in tail feathers from different species of birds, in southwest Iran (Khuzestan to Persian Gulf). Between April and October 2005, we collected tail feathers from 77 birds belonging to 18 species, mostly raptor birds. The birds were collected for the Museum Natural History, Faculty of Natural Resources and Marine Sciences of Tarbiat Modares University. Hg concentrations were evaluated in relation to taxonomic affiliation and trophic level. Feather Hg concentrations ranged from 0.09 to 2.01 mg/kg dry wt. We found a significant difference in feather Hg concentrations across taxonomic groups (p<0.001) with highest concentrations in common kestrel and saker falcon (Falconidae) (1.87 mg/kg) followed by greater spotted eagle, sparrowhawk, goshawk, griffon vulture, buzzards, marsh harrier (Accipiteridae) and owls (Strigidae). Blue-cheeked bee-eater (Meropidae) had intermediate values, followed by European roller (Coraciidae), and lapwing (Charadiidae), whereas black francolin, see-see patridge and chukar (Phasianidae) (0.18 mg/kg) contained the least amount of Hg. There was a significant difference in feather Hg concentrations in relation to trophic levels, at confidence level of 99% (p<0.001). There was an increased pattern in the amount of mercury from herbivorous birds up to vertebrate predators, so that the amount of mercury in vertebrate predators (1.30 mg/kg) was more than 1.5 times as much of the invertebrate predators (0.7 mg/kg) and more than 6 times as much of the herbivorous birds (0.18 mg/kg). We also measured Hg levels in secondary feathers of raptor birds. Paired samples t-test showed that the concentrations of mercury were significantly higher (p<0.001) in the tail feathers (1.2mg/kg) than secondary (0.71 mg/kg). However, Hg levels are below the range found by other authors to cause behavioral change or reduce reproduction (5mg/kg). It seems that exposure of some birds with mercury for a long time causes their high concentration of mercury.     

Sedentary nestlings of Wood Stork as monitors of mercury contamination in the gold mining region of the Brazilian Pantanal

Sedentary organisms that are at top trophic levels allow inference about the level of local mercury contamination. We evaluated mercury contamination in feather tissue of nestling Wood Storks (Mycteria americana), sampled in different parts of the Brazilian Pantanal that were variably polluted by mercury releases from gold mining activities. Levels of mercury in feathers sampled in seven breeding colonies were determined by atomic absorption spectroscopy, and the mean value of mercury concentration was 0.557 μg/g, dry weight (n=124), range 0.024–4.423 μg/g. From this total sample, 21 feathers that represent 30% of nestlings collected in Porto da Fazenda and Tucum colonies, in the northern region, ranged from 1.0 to 4.43 μg/g, dry weight (median value=1.87 μg/g). We found significant differences among regions (H=57.342; p=0<0.05). Results suggest that permanently flooded areas, or along mainstream rivers are more contaminated by mercury than dry areas, regardless of the distance from the gold mining center, which is located in the northern Pantanal. Highest values found in nestlings feathers were similar to those found in feathers of adult birds and in tissues of adult mammals that are less sedentary and were captured in the same region of Pantanal. These findings indicate that mercury released has been biomagnified and it is present in high concentrations in tissues of top consumers. We suggest a program to monitor mercury availability in this ecosystem using sedentary life forms of top predators like Wood Storks or other piscivorous birds.     

Ecophysiological determinations of antioxidant enzymes and lipoperoxidation in the blood of White Stork Ciconia ciconia from Poland

The aim of this study was to investigate the activity of antioxidant enzymes in the blood of White Stork Ciconia ciconia chicks (aged 19-54 days) in Poland in 2006. We took under consideration superoxide dismutase (SOD), catalase (CAT), ceruloplasmine (CP), glutathione peroxidase (GPx), glutathione reductase (GR) and the content of thiobarbituric acid-reactive substances (malondialdehyde) in polluted (copper manufacture), suburban areas, at the Odra meadows, and at swamps near Baltic Sea in the Pomeranian region. We examined the levels of Na, K, Ca, Mg, Fe, Zn, Cu, Mn, Co, Cd, and Pb and compared ecophysiological determinations for developing storks.Blood samples of wing venous were collected from 91 chicks from 33 nests. The degree of activity of antioxidant enzymes studied has been different in White Stork chicks’ blood from Poland regions, as a rule. We have stated a relatively high level of CAT, GPx, SOD, and GR activity and malondialdehyde (MDA) content in chicks from polluted areas. However, relative value for GR in storks from Odra meadows was considerably higher (about 112 nmol NADPH₂/min ml) than those in chicks from other environments (56-84 nmol on average). Relatively high levels of CAT, CP, and GPx (2.7 mkM/min l, 22.2 mg/l, and 3.8 nmol GSH/min ml, respectively) were also stated in chicks nested in swamps near Baltic Sea. Simultaneously, we have stated differences (p<0.02-p<0.001) in the level of elements (besides Ca) in blood of young storks from the studied areas. We found a high level of toxic metals, e.g. Cd, either from swamps near Baltic Sea (2.7 mg/kg) or from G?ogów smelter (2.2 mg/kg), whilst Pb concentration was high in chicks from G?ogów (7.2 mg/kg). Cd and Pb levels in blood of chicks were different in individuals from each region (p<0.001). Birds from a smelter have the highest level of these elements, whereas the lowest one was stated in chicks from Odra meadows (Cd: 1.45, Pb: 0.84 mg/kg). Thus, Cd could be a useful marker of response for polluted stress. We also observed a relatively high level of Mg in chicks from both Pomeranian (7000 mg/kg) and polluted (about 6000 mg/kg) areas. Potassium, zinc, and cobalt levels were highest in chicks from suburbs (4.65, 10.1, and 2.7 mg/kg, respectively) and polluted regions (3.8, 9.7, and 5.6 mg/kg, respectively), whilst Cu and Mn were highest in those from polluted (10.9 and 47.6 mg/kg, respectively) and Pomeranian regions (11 and 42.2 mg/kg, respectively).Concentrations of Na, K, and Ca in chicks from G?ogów smelter (143.2, 3.8, and 115.9 mg/kg, respectively) were often similar to those from Odra meadows (147.8, 3.6, and 112.5 mg/kg, respectively). This was probably due to a similar degree of homeostatic regulations of an organism. The levels of Mg, Fe, Zn, and Cu were often different (p<0.02-p<0.001) in the blood of White Stork chicks from the studied areas. Co, Pb, and Cd levels were higher (p<0.001) in chicks from G?ogów smelter than in those from Odra meadows. It is evidence for importance of anthropopression, which influenced the course of biogeochemical processes and the bioaccumulation of toxic metals locally. This takes place also in chicks from swamps near Baltic Sea, in which the level of Cd was high (2.7 mg/kg); so we can state the high intensity of intoxication in this region. We can conclude that the use of hematological research assesses the condition of birds and might give a positive association with miscellaneous environmental loads. The high concentration of toxic heavy metals involved greater intensity of antioxidant enzymes’ activity. Environmental intoxication causes an increase of lipoperoxidation intensity in growing chicks and changes the response of their immunological system.     

Using feathers to assess risk of mercury and selenium to bald eagle reproduction in the Great Lakes region

Mercury (Hg) and selenium (Se) concentrations were determined in feathers of nestling and adult bald eagles (Haliaeetus leucocephalus) in the Great Lakes region, 1985–1989. Relationships between concentrations and two measures of reproduction, productivity and nesting success, were examined. Hg and Se were detected in all feathers analyzed. A maximum concentration of 66 mg/kg Hg was found in adult feathers in the upper peninsula of Michigan. The geometric means of Hg in adult feathers for sample areas were: interior lower peninsula of Michigan, 21 mg/kg; interior upper peninsula of Michigan, 21 mg/kg; Lake Superior, 22 mg/kg; Lakes Michigan and Huron, 20 mg/kg; and Lake Erie, 13 mg/kg. The geometric means of Hg in nestling feathers for sample areas were: interior lower peninsula of Michigan, 8.8 mg/kg; interior upper peninsula of Michigan, 8.1 mg/kg; Lake Superior, 8.7 mg/kg; Lakes Michigan and Huron, 8.0 mg/kg; Lake Erie, 3.7 mg/kg; and Voyageurs National Park, 20 mg/kg. Se concentrations were not significantly different across regions or between adult and nestling feathers, and Se concentrations ranged from 0.8 to 3.2 mg/kg.No significant relationships between adult or nestling feather concentrations and either measure of reproduction, productivity or nesting success, was found for either Hg or Se. It was concluded that neither Hg nor Se concentrations are currently affecting bald eagle reproduction in the Great Lakes region.     

Organochlorine Pesticide and Polychlorinated Biphenyl in Feathers of Resident and Migratory Birds of South-West Iran

Persistent organochlorine pesticides (OCPs), such as dichlorodiphenyltrichloroethane (DDT) and its metabolites, hexachlorobenzene (HCB), α-, β-, and γ-hexachlorocyclohexane (HCH) isomers, together with polychlorinated biphenyl (PCB) congeners (IUPAC Nos. 28, 52, 101, 138, 153, and 180) were determined in tail feathers from 35 birds belonging to 15 species, all originating from the southwest of Iran (Khuzestan, coast of the Persian Gulf) and kept in museum collections. The patterns of organochlorine contaminants (OCs) in birds varied depending on their migratory behavior. Resident birds contained higher median PCB concentrations (<LOQ-151 ng/g feather) than HCHs, DDTs, and HCB. Locally migrating birds had higher median concentrations of HCHs (19–83 ng/g feather). In contrast, long-distance migrants had lower concentrations of HCB and HCHs. A positive correlation was observed among OCs in these birds, suggesting that trophic level, feeding strategy, and taxonomic group are influencing factors for the OC concentrations in bird feathers. An estimate of the risk associated suggests that levels of OCPs and PCBs were lower or close to the threshold reported to affect reproduction in 1990s.     

Mercury in Different Feather Types from Great Cormorants (<Emphasis Type="Italic">Phalacrocorax carbo</Emphasis> L.) Inhabiting the Vistula Lagoon Ecosystem in Poland

Total mercury levels in different feather types (down, contour, tail and flight) in Great Cormorants (Phalacrocorax carbo L.) were determined using CV-AAS. Feathers from Great Cormorants inhabiting the Vistula Lagoon ecosystem have an average Hg level of 7.14 ± 3.99 (μg/g w.w.). Age-dependent concentrations of Hg were statistically significant (ANOVA Kruskal–Wallis, p < 0.0001). There were also significant differences in Hg levels in different parts of feathers from adults and immature birds (ANOVA Kruskal–Wallis, p < 0.0001). Cormorant chick feathers appear to be a potential biomonitor of Hg pollution in the Vistula Lagoon ecosystem, but this subject requires further research.     

Mercury Concentrations in Nestling Wading Birds Relative to Diet in the Southeastern United States: A Stable Isotope Analysis

Mercury (Hg) is a ubiquitous environmental contaminant that is transferred trophically through aquatic and terrestrial food webs. To better understand the routes of Hg uptake in organisms that rely on both aquatic and terrestrial food resources, we analyzed feather and down samples from nestling wading birds of varying trophic positions in both inland and coastal colonies. We used stable nitrogen and carbon isotope analyses to evaluate trophic positions of individual species (δ(15)N) and differences in foraging habitat use (δ(13)C). Inland, aquatic species had higher trophic status than the single terrestrial species examined, and the expected positive relationship between δ(15)N and Hg content of feathers was observed. However, the same was not true for all species from coastal colonies. Feathers from species that primarily consumed saltwater prey were relatively high in δ(15)N value and low in Hg content, which is opposite of the trend expected due to Hg biomagnification in food chains. In contrast, coastal species foraging in freshwater or a combination of freshwater and saltwater habitats displayed greater Hg contents in feathers. The apparent differential use of the two aquatic systems (freshwater and saltwater) in coastal environments by wading bird species results in variations in δ(15)N values and Hg contents in nestling feathers not found in species associated with only freshwater systems.     

Feather growth influences blood mercury level of young songbirds

Dynamics of mercury in feathers and blood of free-living songbirds is poorly understood. Nestling eastern bluebirds (Sialia sialis) living along the mercury-contaminated South River (Virginia, USA) had blood mercury levels an order of magnitude lower than their parents (nestling: 0.09 +/- 0.06 mg/kg [mean +/- standard deviation], n = 156; adult: 1.21 +/- 0.57 mg/kg, n = 86). To test whether this low blood mercury was the result of mercury sequestration in rapidly growing feathers, we repeatedly sampled free-living juveniles throughout the period of feather growth and molt. Mean blood mercury concentrations increased to 0.52 +/- 0.36 mg/kg (n = 44) after the completion of feather growth. Some individuals had reached adult blood mercury levels within three months of leaving the nest, but levels dropped to 0.20 +/- 0.09 mg/kg (n = 11) once the autumn molt had begun. Most studies of mercury contamination in juvenile birds have focused on recently hatched young with thousands of rapidly growing feathers. However, the highest risk period for mercury intoxication in young birds may be during the vulnerable period after fledging, when feathers no longer serve as a buffer against dietary mercury. We found that nestling blood mercury levels were not indicative of the extent of contamination because a large portion of the ingested mercury ended up in feathers. The present study demonstrates unequivocally that in songbirds blood mercury level is influenced strongly by the growth and molt of feathers.     

Community,parental and adolescent awareness and knowledge of meningococcal disease

Objective

To assess knowledge of invasive meningococcal disease (IMD) and concern about the disease in the South Australian Community including adolescents, adults, parents and non-parents.

Methods

This cross-sectional study was conducted by face to face interviews in South Australia in 2012. Participants were scored on their knowledge and concern about IMD. Univariate and multivariate regression analyses were performed with the survey data weighted by age and gender in accordance with 2011 Census data.

Results

Of 5200 households randomly selected and stratified by metropolitan or rural location, 3055 participants were interviewed with a response rate of 60.3%. The majority were Australian born (74.2%, n = 2267) with 31.8% (n = 972) of those interviewed being parents, and 15.9% (n = 487) adolescents (15–24 years). Almost a quarter of participants (23.5%, n = 717) do not know what meningococcal disease is, with 9.1% (n = 278) believing incorrectly that IMD is a viral infection. 36.6% (n = 1114) had low overall knowledge of IMD. Adolescents (p < 0.050), non-Australian born (p < 0.001), low educational attainment (p = 0.019), low household income (p = 0.011), low/medium socio-economic status (p < 0.050) or living in a metropolitan area (p = 0.006) were more likely to have lower overall knowledge of IMD. Participants who were not parents (p < 0.001), male gender (p < 0.001), single (p < 0.001), highly educated (p = 0.022) or had high household income (p = 0.015), had lower concern about IMD.

Conclusion

Large community knowledge gaps for IMD were observed, particularly amongst adolescents and adults with low educational attainment and low socio-economic status. Improving community knowledge of IMD could help ensure optimal uptake of a new meningococcal vaccine. Our study results can help guide development of community tailored immunisation education programs.     

Knowledge differences between male and female university students about human papillomavirus (HPV) and cervical cancer: Implications for health strategies and vaccination

Knowledge about HPV and cervical cancer (CC) depends on several factors such as gender and education, which brings implications for health strategies and vaccination. A survey was conducted in Portugal with a representative sample of 1706 university students. Only 55.4% (n = 945) had already heard of HPV, although 88.3% (n = 834) from that know that is a risk factor for CC. 89% students (n = 841) wants to be vaccinated against it, but only 13.8% stated as main reason to be vaccinated “prevention of the disease”. Mean scores of knowledge were calculated. Statistical differences were found, regarding “CC knowledge”, in gender (p < 0.001) and between health sciences schools and non-health sciences schools (p < 0.001). Differences regarding the study area in “knowledge and beliefs of HPV” (p < 0.001) and in “relation between HPV and CC” (p < 0.001) were found. Therefore, these differences may help to develop effective strategies that lead to decline CC incidence and mortality.     

Early immunocastration of male pigs with Improvac(®) - effect on boar taint, hormones and reproductive organs

The aim of this study was to investigate the effect of a vaccine against gonadotropin-releasing hormone (GnRH), Improvac^® (Pfizer Ltd), administered at a pre- or early pubertal stage on boar taint, hormonal status and reproductive organs. Crossbred male pigs (Swedish Yorkshire dams × Swedish Landrace sires or Swedish Yorkshire sires, n = 192) were at birth randomly allocated to four groups: one group of pigs surgically castrated without anaesthesia before age 1 week, a second group of early vaccinated pigs given Improvac at ages 10 and 14 weeks, a third group of standard vaccinated pigs given Improvac at ages 16 and 20 weeks, and a fourth group of entire male pigs. Following the second vaccine injection, antibody titres increased rapidly, accompanied by a rapid decrease in testosterone and a slower decrease of skatole in plasma to the same low levels as for surgically castrated pigs. At slaughter, the levels of androstenone and skatole in adipose tissue were low in surgically castrated and vaccinated pigs, whereas entire male pigs had elevated levels (p < 0.001). Similarly, oestradiol was at low levels for surgically castrated and vaccinated pigs, whereas entire male pigs had elevated levels (p < 0.001). IGF-1 was lowest for surgically castrated pigs and highest for entire male pigs, with vaccinated pigs at an intermediate level (p < 0.001). At slaughter, reproductive organs were small in pigs vaccinated with Improvac, and smaller in pigs vaccinated early (p < 0.001). Under our experimental conditions, early vaccination with Improvac can be used as an alternative to the recommended schedule with maintained control of boar taint and testicular secretory activity.     

Acceptance of the 2009 A(H1N1) influenza vaccine among hospital workers in two French cancer centers

The aim of the study was to determine predictive factors influencing the acceptance of the 2009 A(H1N1) influenza vaccination among hospital workers (HW) in two French cancer centers. A standardized, anonymous, self-administered questionnaire was sent to HW of two cancer centers. The survey response rate was 26.2% (n = 506). Main reasons for A(H1N1) vaccination acceptance were “to protect my relatives” (30.3%), “to protect myself” (30.3%). Main reasons for A(H1N1) vaccination refusal were the fear of side effects (43.1%), doubt about the vaccine's efficacy (25.8%). Vaccinated HW were more influenced by the institutional campaign (p < 0.001) or colleagues’ advice (p < 0.001) whereas non-vaccinated HW were influenced by their family physician's advice (p = 0.03), personal conviction (p < 0.001) or the media (p < 0.001). A multivariate analysis revealed age (>35 vs ≤35), prior seasonal influenza vaccination, professional category and source of information to be predictive factors of vaccination. Future vaccination campaigns will need to focus on young HW (≤35-year old), with no prior influenza vaccination and HW who are in contact with patients and who reported low seasonal influenza vaccination rates.     

Home-based exercise for middle-aged Chinese at diabetic risk: a randomized controlled trial

Objective

To evaluate short- (3 months) and long-term (9 months) effects of home-based exercise on adiponectin, exercise behavior and metabolic risk factors in middle-aged adults at diabetic risk.

Methods

One hundred and thirty-five middle-aged adults (38 men, 97 women) with at least one diabetic risk factor were randomly assigned to either a home-based exercise group (Ex-group) or a usual care group (C-group). Outcome measures included plasma adiponectin, exercise self-efficacy, physical activity, and metabolic risk factors, as follows: insulin levels, insulin resistance by homeostasis model assessment (HOMA-IR), physical fitness, and components of metabolic syndrome. This study was conducted in metropolitan Taipei from 2004 to 2005.

Results

The Ex-group had improvements in exercise self-efficacy (+ 2.5, p = 0.01), body mass index (BMI) (− 0.6 kg/m², p < 0.001) and flexibility (+ 2.4 cm, p < 0.001) at 3-month follow-up and maintained BMI and flexibility at 9-month follow-up. The Ex-group exhibited significantly increased physical activity while the C-group exhibited decreased physical activity at 9-month follow-up (p < 0.001). No intervention effect was found on adiponectin (p = 0.64) or other outcome measures over time.

Conclusions

Home-based exercise did not improve adiponectin levels, but significantly improved exercise behavior, and certain metabolic risk factors, with the effects maintained for 9-months in subjects with type 2 diabetic risk.     

Protection of red-legged partridges (Alectoris rufa) against West Nile virus (WNV) infection after immunization with WNV recombinant envelope protein E (rE)

West Nile virus (WNV) is maintained in nature in an enzootic transmission cycle between birds and mosquitoes, although it occasionally infects other vertebrates, including humans, in which it may result fatal. To date, no licensed vaccines against WNV infection are available for birds, but its availability would certainly benefit certain populations, as birds grown for restocking, hunting activities, or alimentary purposes, and those confined to wildlife reservations and recreation installations. We have tested the protective capability of WNV envelope recombinant (rE) protein in red-legged partridges (Alectoris rufa). Birds (n = 28) were intramuscularly immunized three times at 2-weeks interval with rE and a control group (n = 29) was sham-immunized. Except for 5 sham-immunized birds that were not infected and housed as contact controls, partridges were subcutaneously challenged with WNV. Oropharyngeal and cloacal swabs and feather pulps were collected at several days after infection and blood samples were taken during vaccination and after infection. All rE-vaccinated partridges elicited anti-WNV antibodies before challenge and survived to the infection, while 33.3% of the sham-immunized birds succumbed, as did 25% of the contact animals. Most (84%) unvaccinated birds showed viremia 3 d.p.i., but virus was only detected in 14% of the rE vaccinated birds. WNV-RNA was detected in feathers and swabs from sham-immunized partridges from 3 to 7 d.p.i., mainly in birds that succumbed to the infection, but not in rE vaccinated birds. Thus, rE vaccination fully protected partridges against WND and reduced the risk of virus spread.     

Participation and cardiovascular risk reduction in a voluntary worksite nutrition and physical activity program

Objective

In a cohort of employees participating in a worksite nutrition and physical activity program, we compared program completion and changes in cardiovascular risk factors by baseline body mass index.

Methods

In 2007, 774 employees enrolled in a 10 week program at a hospital in Boston, Massachusetts. Program completion and change in weight, cholesterol, and blood pressure were compared between obese (body mass index ≥ 30), overweight (body mass index = 25-29.9), and normal weight (body mass index < 25) participants.

Results

At baseline, 63% were obese or overweight and had higher blood pressure and cholesterol compared to normal weight participants. Program completion was 82% and did not differ by body mass index. Mean weight loss was 1.9 kg at end of program (p < 0.001) and 0.4 kg at 1 year (p = 0.002). At end of program, participants with body mass index ≥ 30 lost 3.0% body weight vs. 2.7% for body mass index = 25-29.9 and 1.7% for body mass index < 25 (p < 0.001), but weight loss at 1 year did not differ by body mass index. Mean cholesterol and blood pressure were lower at end of program and 1 year (all, p < 0.005) but did not differ by body mass index.

Conclusions

Worksite programs can successfully initiate cardiovascular risk reduction among employees, but more intensive interventions are needed to make significant improvements in the health of higher risk obese employees.     

Natural and vaccine-induced immunity to Neisseria meningitidis serogroup C in asplenic patients with β-thalassemia

Natural and vaccine-induced immunity to meningococcus C (MenC) was evaluated in asplenic adolescents and adults with β-thalassemia. At baseline 19.3% of patients and 22.8% age-matched controls had positive (>2 μg/ml) naturally acquired Men C- specific IgG antibodies; patients had a lower probability of having protective SBA compared to controls (OR = 21, p = 0.012). MenC conjugate vaccine (MCC) induced protective IgG concentrations in 63% of patients and 90.1% of controls. SBA increased significantly post vaccination and there were no differences between patients and controls; however patients had significantly lower IgG concentrations post vaccination compared to controls (4.52 vs 10.94 μg/ml, p < 0.001, respectively). A second dose of MCC given to 11 patients who had received MCC in the past induced higher IgG compared to primary response (p = 0.001). Naturally- and vaccine-induced immunity to MenC is impaired in asplenic β-thalassemics; a second dose of MCC improves vaccine immunogenicity and is essential for their optimal protection.     

Serum anti-toxin B antibody correlates with protection from recurrent Clostridium difficile infection (CDI)

Background

Previous studies have demonstrated a correlation between Clostridium difficile anti-toxin A serum antibodies and protection against symptomatic disease and recurrence.

Methods

A neutralizing monoclonal antibody to C. difficile toxin A (CDA1) developed by MBL and Medarex, Inc. was studied in a phase II, randomized, double-blind, placebo-controlled trial in patients receiving standard of care treatment for C. difficile infection (CDI). Twenty-nine subjects received a single intravenous infusion of 10 mg/kg CDA1 and 17 subjects received placebo and were evaluated for recurrence of CDI during the 56-day study period. Serum antibodies against C. difficile toxin A and B were measured by ELISA and cytotoxicity assay at various time points before and after infusion.

Findings

CDI recurrence occurred in 5 of 29 (17%) in the CDA1 group and 3 of 17 (18%) (p = NS) in the placebo group with a trend toward delay in time to recurrence in the group treated with CDA1. The geometric mean concentration of antibody to an epitope of the receptor-binding domain of toxin B (0.300 and 1.20 μg/ml, respectively; p = 0.02) and geometric mean titer of neutralizing B antibody (8.00 and 100, respectively; p = 0.02) at study day 28 were lower for those subjects with recurrence compared to those who did not recur. In addition, a significantly greater proportion of subjects who recurred were infected with the epidemic BI/NAP1/027 strain compared with those that did not recur (88% vs. 22%; p = 0.002). Finally, in a multiple logistic regression analysis neutralizing anti-toxin B at day 14 (p < 0.001), anti-toxin A at day 28 (p < 0.001) and infection with the BI/NAP1/027 strain at enrollment (p = 0.002) were all predictive of CDI recurrence.

Interpretation

In this prospective study, lower concentrations of neutralizing anti-toxin B and anti-toxin A antibody and infection with the BI/NAP1/027 strain of C. difficile were significantly associated with recurrence of CDI.     

Hospital-based surveillance of rotavirus gastroenteritis in the era of limited vaccine uptake through the private sector

To investigate possible impact of limited vaccine uptake by the private sector since 2007, a prospective observational study included all children <5 years hospitalized for acute gastroenteritis (AGE) in a Tertiary Care Hospital between 09/2006 and 08/2010. Rotavirus (RV) antigen was detected in stools by a rapid immunochromatographic test and genotype analysis was performed on positive samples by RT-PCR. Compared to 2006-2008, the likelihood of rotavirus infection was significantly reduced among children hospitalized for AGE in 2008-2010 (OR 0.64; 95%CI: 0.49-0.84, p < 0.001). This was mainly due to the reduction of RVGE cases in infants 0-11 months (p = 0.035). Moreover, RVGE cases as well as the rate of RVGE/10,000 hospitalized children significantly decreased (p = 0.009 and p = 0.010 respectively). No children with rotavirus gastroenteritis (RVGE) had received any vaccine dose. G4P [8] was the most common genotype (64/90). In conclusion, this study indicates that even low RV vaccination coverage may have significant effect.     

Human co-exposure to mercury vapor and methylmercury in artisanal mercury mining areas, Guizhou, China

Mercury (Hg) concentrations were determined in human urine and hair samples from Gouxi (GX, n=25) and Laowuchang (LWC, n=18), Tongren, Guizhou, China, to evaluate human exposure from artisanal Hg mining. Geometric means of urinary Hg (U-Hg) were 216 and 560 μg g⁻¹ Creatinine (μg g⁻¹ Cr) for artisanal mining workers from GX and LWC, respectively, and clinical symptoms (finger tremor) were observed in three workers. The means of hair Me-Hg concentrations were 4.26 μg g⁻¹ (1.87-10.6 μg g⁻¹) and 4.55 μg g⁻¹ (2.29-9.55 μg g⁻¹) for the population in GX and LWC, respectively. Significant relationship was found between estimated rice Me-Hg intake and hair Me-Hg levels (r=0.73, p<0.001). Co-exposure to Hg vapor and Me-Hg may pose health risks for the study population.     

Is working in culturally diverse working environment associated with physicians’ work-related well-being? A cross-sectional survey study among Finnish physicians

International mobility of health care professionals is increasing, though little is known about how working in a culturally diverse team affects the native physicians’ psychosocial work environment. We examined Finnish physicians’ perceptions of work-related wellbeing according to whether they had foreign-born colleagues (FBCs) in their work unit. We also examined whether work-related resources moderate the potential association between work-related wellbeing and working alongside FBCs. A cross-sectional survey was conducted for a random sample of physicians in Finland in 2010 (3826 respondents, response rate 55%). Analyses were restricted to native Finnish physicians working in public health care. The results were analyzed by ANCOVA. In unadjusted analyses, having FBCs was related to poor team climate (p < 0.001) and poor job satisfaction (p = 0.001). Those physicians who reported high procedural justice and high job control perceived also higher job satisfaction even if they had many FBCs in the work unit (p = 0.007 for interaction between FBCs and procedural justice and p < 0.001 for interaction between FBCs and job control). These associations were robust to adjustments for age, sex, health care sector, specialization, on-call duty, employment contract, full-time employment and leadership position. The results indicate that culturally diverse work units face challenges related to team climate and job satisfaction. The results also show that leadership plays an important role in culturally diverse work units. The potential challenges of culturally diverse teams for native physicians may be reduced by fair decision-making and by increasing physicians’ job control.