Virucidal efficacy of guanidine-free inactivants and rapid test buffers against SARS-CoV-2.

A pathogen inactivation step during collection or processing of clinical samples has the potential to reduce infectious risks associated with diagnostic procedures. It is essential that these inactivation methods are demonstrated to be effective, particularly for non-traditional inactivation reagents or for commercial products where the chemical composition is undisclosed. This study assessed inactivation effectiveness of twenty-four next-generation (guanidine-free) nucleic acid extraction lysis buffers and twelve rapid antigen test buffers against SARS-CoV-2, the causative agent of COVID-19. These data have significant safety implications for SARS-CoV-2 diagnostic testing and support the design and evidence-based risk assessment of these procedures.

Effective in vitro inactivation of SARS-CoV-2 by commercially available mouthwashes.

Infectious SARS-CoV-2 can be recovered from the oral cavities and saliva of COVID-19 patients with potential implications for disease transmission. Reducing viral load in patient saliva using antiviral mouthwashes may therefore have a role as a control measure in limiting virus spread, particularly in dental settings. Here, the efficacy of SARS-CoV-2 inactivation by seven commercially available mouthwashes with a range of active ingredients were evaluated in vitro. We demonstrate ≥4.1 to ≥5.5 log10 reduction in SARS-CoV-2 titre following a 1 min treatment with commercially available mouthwashes containing 0.01-0.02 % stabilised hypochlorous acid or 0.58 % povidone iodine, and non-specialist mouthwashes with both alcohol-based and alcohol-free formulations designed for home use. In contrast, products containing 1.5 % hydrogen peroxide or 0.2 % chlorhexidine gluconate were ineffective against SARS-CoV-2 in these tests. This study contributes to the growing body of evidence surrounding virucidal efficacy of mouthwashes/oral rinses against SARS-CoV-2, and has important applications in reducing risk associated with aerosol generating procedures in dentistry and potentially for infection control more widely.

The effect of heat-treatment on SARS-CoV-2 viability and detection.

The development of safe diagnostic protocols for working with SARS-CoV-2 clinical samples at Biosafety Level 2 (BSL2) requires understanding of the effect of heat-treatment on SARS-CoV-2 viability and downstream RT-PCR sensitivity. In this study heating SARS-CoV-2/England/2/2020 to 56 °C and 60 °C for 15, 30 and 60 min reduced the virus titre by between 2.1 and 4.9 log10 pfu/mL (as determined by plaque assay). Complete inactivation did not occur and there was significant variability between replicates. Viable virus was detected by plaque assay after heat-treatment at 80 °C for 15 or 30 min but not 60 or 90 min. After heat-treatment at 80 °C for 60 min infectious virus was only detected by more sensitive virus culture. No viable virus was detected after heating to 80 °C for 90 min or 95 °C for 1 or 5 min. RT-PCR sensitivity was not compromised by heating to 56 °C and 60 °C. However, RT-PCR sensitivity was reduced (≥3 Ct value increase) after heating the virus to 80 °C for 30 min or longer, or 95 °C for 1 or 5 min. In summary we found that the efficacy of heat-inactivation varies greatly depending on temperature and duration. Local validation of heat-inactivation and its effects downstream is therefore essential for molecular testing.

Effective in-vitro inactivation of SARS-CoV-2 by commercially available mouthwashes

Infectious SARS-CoV-2 can be recovered from the oral cavities and saliva of COVID-19 patients with potential implications for disease transmission. Reducing viral load in patient saliva using antiviral mouthwashes may therefore have a role as a control measure in limiting virus spread, particularly in dental settings. Here, the efficacy of SARS-CoV-2 inactivation by seven commercially available mouthwashes with a range of active ingredients were evaluated in vitro. We demonstrate [≥]4.1 to [≥]5.5 log10 reduction in SARS-CoV-2 titre following a one minute treatment with commercially available mouthwashes containing 0.01-0.02% stabilised hypochlorous acid or 0.58% povidone iodine, and non-specialist mouthwashes with both alcohol-based and alcohol-free formulations designed for home use. In contrast, products containing 1.5% hydrogen peroxide or 0.2% chlorhexidine gluconate were ineffective against SARS-CoV-2 in these tests. This study contributes to the growing body of evidence surrounding virucidal efficacy of mouthwashes/oral rinses against SARS-CoV-2, and has important applications in reducing risk associated with aerosol generating procedures in dentistry and potentially for infection control more widely.

The effect of heat on SARS-CoV-2 viability and RNA integrity as determined by plaque assay, virus culture and real-time RT-PCR

The effect of heat on SARS-CoV-2/England/2/2020 viability was assessed by plaque assay and virus culture. Heating to 56{degrees}C and 60{degrees}C for 15, 30 and 60 minutes led to a reduction in titre of between 2.1 and 4.9 log10 pfu/ml but complete inactivation was not observed. At 80{degrees}C plaques were observed after 15 and 30 minutes of heating, however after 60 minutes viable virus was only detected following virus culture. Heating to 80{degrees}C for 90 minutes and 95{degrees}C for 1 and 5 minutes resulted in no viable virus being detected. At 56{degrees}C and 60{degrees}C significant variability between replicates was observed and the titre often increased with heat-treatment time. Nucleic acids were extracted and tested by RT-PCR. Sensitivity of the RT-PCR was not compromised by heating to 56{degrees}C and 60{degrees}C. Heating to 80{degrees}C for 30 minutes or more and 95{degrees}C for 1 or 5 minutes however, resulted in an increase of at least three Ct values. This increase remained constant when different dilutions of virus underwent heat treatment. This indicates that high temperature heat inactivation of clinical samples prior to nucleic acid extraction could significantly affect the ability to detect virus in clinical samples from patients with lower viral loads by RT-PCR.

Analysis of Inactivation of SARS-CoV-2 by Specimen Transport Media, Nucleic Acid Extraction Reagents, Detergents, and Fixatives.

The COVID-19 pandemic has necessitated a multifaceted rapid response by the scientific community, bringing researchers, health officials, and industry together to address the ongoing public health emergency. To meet this challenge, participants need an informed approach for working safely with the etiological agent, the novel human coronavirus SARS-CoV-2. Work with infectious SARS-CoV-2 is currently restricted to high-containment laboratories, but material can be handled at a lower containment level after inactivation. Given the wide array of inactivation reagents that are being used in laboratories during this pandemic, it is vital that their effectiveness is thoroughly investigated. Here, we evaluated a total of 23 commercial reagents designed for clinical sample transportation, nucleic acid extraction, and virus inactivation for their ability to inactivate SARS-CoV-2, as well as seven other common chemicals, including detergents and fixatives. As part of this study, we have also tested five filtration matrices for their effectiveness at removing the cytotoxic elements of each reagent, permitting accurate determination of levels of infectious virus remaining following treatment. In addition to providing critical data informing inactivation methods and risk assessments for diagnostic and research laboratories working with SARS-CoV-2, these data provide a framework for other laboratories to validate their inactivation processes and to guide similar studies for other pathogens.

Inactivation analysis of SARS-CoV-2 by specimen transport media, nucleic acid extraction reagents, detergents and fixatives

The COVID-19 pandemic has necessitated a rapid multi-faceted response by the scientific community, bringing researchers, health officials and industry together to address the ongoing public health emergency. To meet this challenge, participants need an informed approach for working safely with the etiological agent, the novel human coronavirus SARS-CoV-2. Work with infectious SARS-CoV-2 is currently restricted to high-containment laboratories, but material can be handled at a lower containment level after inactivation. Given the wide array of inactivation reagents that are being used in laboratories during this pandemic, it is vital that their effectiveness is thoroughly investigated. Here, we evaluated a total of 23 commercial reagents designed for clinical sample transportation, nucleic acid extraction and virus inactivation for their ability to inactivate SARS-CoV-2, as well as seven other common chemicals including detergents and fixatives. As part of this study, we have also tested five filtration matrices for their effectiveness at removing the cytotoxic elements of each reagent, permitting accurate determination of levels of infectious virus remaining following treatment. In addition to providing critical data informing inactivation methods and risk assessments for diagnostic and research laboratories working with SARS-CoV-2, these data provide a framework for other laboratories to validate their inactivation processes and to guide similar studies for other pathogens.

Muscle specific kinase protects dystrophic mdx mouse muscles from eccentric contraction-induced loss of force-producing capacity.

KEY POINTS: Adeno-associated viral vector was used to elevate the expression of muscle specific kinase (MuSK) and rapsyn (a cytoplasmic MuSK effector protein) in the tibialis anterior muscle of wild-type and dystrophic (mdx) mice. In mdx mice, enhanced expression of either MuSK or rapsyn ameliorated the acute loss of muscle force associated with strain injury. Increases in sarcolemmal immunolabelling for utrophin and ß-dystroglycan suggest a mechanism for the protective effect of MuSK in mdx muscles. MuSK also caused subtle changes to the structure and function of the neuromuscular junction, suggesting novel roles for MuSK in muscle physiology and pathophysiology. ABSTRACT: Muscle specific kinase (MuSK) has a well-defined role in stabilizing the developing mammalian neuromuscular junction, but MuSK might also be protective in some neuromuscular diseases. In the dystrophin-deficient mdx mouse model of Duchenne muscular dystrophy, limb muscles are especially fragile. We injected the tibialis anterior muscle of 8-week-old mdx and wild-type (C57BL10) mice with adeno-associated viral vectors encoding either MuSK or rapsyn (a cytoplasmic MuSK effector protein) fused to green fluorescent protein (MuSK-GFP and rapsyn-GFP, respectively). Contralateral muscles injected with empty vector served as controls. One month later mice were anaesthetized with isoflurane and isometric force-producing capacity was recorded from the distal tendon. MuSK-GFP caused an unexpected decay in nerve-evoked tetanic force, both in wild-type and mdx muscles, without affecting contraction elicited by direct electrical stimulation of the muscle. Muscle fragility was probed by challenging muscles with a strain injury protocol consisting of a series of four strain-producing eccentric contractions in vivo. When applied to muscles of mdx mice, eccentric contraction produced an acute 27% reduction in directly evoked muscle force output, affirming the susceptibility of mdx muscles to strain injury. mdx muscles overexpressing MuSK-GFP or rapsyn-GFP exhibited significantly milder force deficits after the eccentric contraction challenge (15% and 14%, respectively). The protective effect of MuSK-GFP in muscles of mdx mice was associated with increased immunolabelling for utrophin and ß-dystroglycan in the sarcolemma. Elevating the expression of MuSK or rapsyn revealed several distinct synaptic and extrasynaptic effects, suggesting novel roles for MuSK signalling in muscle physiology and pathophysiology.

The tail of two models: Impact of circularity and biomass non-homogeneity on UV disinfection of wastewater flocs.

The effects of floc structural characteristics, i.e. shape and dense biomass distribution, were evaluated on ultraviolet (UV) disinfection resistance, represented by the tailing level of the UV dose response curve (DRC). Ellipsoid-shaped flocs of similar volume and different projected circularities were constructed in-silico and a mathematical model was developed to compare their UV DRC tailing levels (indicative of UV-resistance). It was found that floc shape can significantly influence tailing level, and rounder flocs (i.e. flocs with higher circularity) were more UV-resistant. This result was confirmed experimentally by obtaining UV DRCs of two 75-90 µm floc populations with different percentages (20% vs. 30%) of flocs with circularities higher than 0.5. The population enriched in less circular flocs (i.e. 20% flocs with circularities >0.5) had a lower tailing level (at least by 1-log) compared to the other population. The second model was developed to describe variations in UV disinfection kinetics observed in flocs with transverse vs. radial biomass non-homogeneity, indicative of biofilm-originated vs. suspended flocs. The varied-density hemispheres model and shell-core model were developed to simulate transverse and radial non-homogeneity, respectively. The UV DRCs were mathematically constructed and biofilm-originated flocs showed higher UV resistance compared to suspended flocs. The calculated UV DRCs agreed well with the experimental data collected from activated sludge and trickling filter flocs (no fitting parameters were used). These findings provide useful information in terms of designing/modifying upstream processes for reducing UV disinfection energy demand.

Enhancing disinfection by advanced oxidation under UV irradiation in polyphosphate-containing wastewater flocs.

In this paper, the role of naturally occurring polyphosphate in enhancing the ultraviolet disinfection of wastewater flocs is examined. It was found that polyphosphate, which accumulates naturally within the wastewater flocs in the enhanced biological phosphorus removal process, is capable of producing hydroxyl radicals under UV irradiation and hence causing the photoreactive disinfection of microorganisms embedded within flocs. This phenomenon is likely responsible for the improved UV disinfection of the biological nutrient removal (BNR) effluent compared to that of conventional activated sludge effluent by as much as 1 log. A mathematical model is developed that combines the chemical disinfection by hydroxyl radical formation within flocs, together with the direct inactivation of microorganisms by UV irradiation. The proposed model is able to quantitatively explain the observed improvement in the UV disinfection of the BNR effluents. This study shows that the chemical composition of wastewater flocs could have a significant positive impact on their UV disinfection by inducing the production of oxidative species.

Hypercoagulability and ACTH-dependent hyperadrenocorticism in dogs.

BACKGROUND: Dogs with hyperadrenocorticism are at risk of thromboembolic disease, which might be caused by an underlying hypercoagulable state. HYPOTHESIS/OBJECTIVES: To assess hemostatic function in dogs with ACTH-dependent hyperadrenocorticism (ADHAC) before and after treatment. ANIMALS: Nineteen dogs with ADHAC and 40 normal dogs. METHODS: Prospective, observational study. Dogs with ADHAC were recruited from the referral hospital patient population; normal dogs were recruited from staff and students at the study's institution. Hemostasis was assessed before and at 3 and 6 months after treatment with trilostane (T0, T3, T6) by kaolin-activated thrombelastography with platelet mapping (TEG-PM), prothrombin time, activated partial thromboplastin time, fibrinogen concentration, and antithrombin activity (AT). RESULTS: Dogs with ADHAC had statistically significantly increased α-angle (P < .01) and maximum amplitude (MA)(thrombin) (P < .01) on TEG-PM, and significantly decreased κ (P < .005) at T0, T3, and T6. Platelet count (P < .001) and fibrinogen concentration (P < .001), but not AT activity, were increased in dogs with ADHAC at T0, T3, and T6. CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with ADHAC have thrombelastographic evidence of hypercoagulability and remained hypercoagulable during treatment. AT deficiency does not appear to be involved in the pathogenesis of hypercoagulability in this population.

UV disinfection of wastewater flocs: the effect of secondary treatment conditions.

Activated sludge flocs that are carried to the final effluent can significantly decrease the effectiveness of ultraviolet (UV) disinfection of wastewater. This effect is detected in a typical UV dose-response curve, where at higher UV doses there is a decrease in the inactivation rate (tailing). In this study, the effect of activated sludge process conditions on the UV inactivation kinetics of flocs was investigated. The conditions compared were nitrifying vs. non-nitrifying vs. an enhanced biological nutrient removal-University of Cape Town (BNR-UCT) system. The results showed that the flocs generated in the BNR-UCT process were easier to disinfect. The final effluent from the BNR-UCT process also showed improved kinetics of inactivation and reached higher levels of disinfection. The nitrifying system's final effluent had a lower number of initial fecal coliforms, which contributed to reaching higher disinfection levels compared to the non-nitrifying system.

Assessment of the protective effect of Imvamune and Acam2000 vaccines against aerosolized monkeypox virus in cynomolgus macaques.

To support the licensure of a new and safer vaccine to protect people against smallpox, a monkeypox model of infection in cynomolgus macaques, which simulates smallpox in humans, was used to evaluate two vaccines, Acam2000 and Imvamune, for protection against disease. Animals vaccinated with a single immunization of Imvamune were not protected completely from severe and/or lethal infection, whereas those receiving either a prime and boost of Imvamune or a single immunization with Acam2000 were protected completely. Additional parameters, including clinical observations, radiographs, viral load in blood, throat swabs, and selected tissues, vaccinia virus-specific antibody responses, immunophenotyping, extracellular cytokine levels, and histopathology were assessed. There was no significant difference (P > 0.05) between the levels of neutralizing antibody in animals vaccinated with a single immunization of Acam2000 (132 U/ml) and the prime-boost Imvamune regime (69 U/ml) prior to challenge with monkeypox virus. After challenge, there was evidence of viral excretion from the throats of 2 of 6 animals in the prime-boost Imvamune group, whereas there was no confirmation of excreted live virus in the Acam2000 group. This evaluation of different human smallpox vaccines in cynomolgus macaques helps to provide information about optimal vaccine strategies in the absence of human challenge studies.

Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements.

BACKGROUND: People with severe challenging behaviour are vulnerable to exclusion from local services and removal to out-of-area placements if locally available supported accommodation is insufficient to meet their needs. There are concerns about the high costs and potentially poorer outcomes of out-of-area placements but relatively little is known about how costs and outcomes compare with provision for a similar population placed locally. METHODS: Costs, quality of care and a wide range of quality of life outcomes for 38 people with intellectual disabilities and challenging behaviour living in-area and 38 similar people living out-of-area were compared. The two groups were matched as far as possible on risk factors for out-of-area placement. The out-of-area group represented two-thirds of the total number of people who originated from the territory served by the largest specialist health service in Wales and were placed in residential settings at least 10 miles beyond its boundaries. RESULTS: There was a mixed pattern of quality of care and quality of outcome advantages between the two types of setting, although in-area placements had a greater number of advantages than out-of-area placements. Unexpectedly, out-of-area placements had lower total costs, accommodation costs and daytime activity costs. CONCLUSIONS: No overall conclusion could be reached about cost-effectiveness. A number of potential reasons for the differences in cost were identified. Although additional resources may be needed to provide in-area services for those currently placed out-of-area, government policy to provide comprehensively for those who want to live locally, irrespective of their needs, appears to be attainable.

Kinetics of UV inactivation of wastewater bioflocs.

Ultraviolet disinfection is a physical method of disinfecting secondary treated wastewaters. Bioflocs formed during secondary treatment harbor and protect microbes from exposure to ultraviolet (UV) light, and significantly decrease the efficiency of disinfection at high UV doses causing the tailing phenomena. However, the exact mechanism of tailing and the role of biofloc properties and treatment conditions are not widely understood. It is hypothesized that sludge bioflocs are composed of an easily disinfectable loose outer shell, and a physically stronger compact core inside that accounts for the tailing phenomena. Hydrodynamic shear stress was applied to the bioflocs to peel off the looser outer shell to isolate the cores. Biofloc and core samples were fractionated into narrow size distributions by sieving and their UV disinfection kinetics were determined and compared. The results showed that for bioflocs, the tailing level elevates as the biofloc size increases, showing greater resistance to disinfection. However, for the cores larger than 45µm, it was found that the UV inactivation curves overlap, and show very close to identical inactivation kinetics. Comparing bioflocs and cores of similar size fraction, it was found that in all cases cores were harder to disinfect with UV light, and showed a higher tailing level. This study suggests that physical structure of bioflocs plays a significant role in the UV inactivation kinetics.

Effect of the length of the superficial plate on bending stiffness, bending strength and strain distribution in stacked 2.0-2.7 veterinary cuttable plate constructs. An in vitro study.

OBJECTIVES: Use of stacked veterinary cuttable plates (VCP) increases the construct stiffness, but it also increases the stress protection and concentrates the stress at the extremities of the implants. We hypothesized that by shortening the superficial plate, it would not reduce the stiffness of the construct, but that it would reduce the stress concentration at the plate ends. METHODS: A 3 mm fracture gap model was created with copolymer acetal rods, stacked 2.0-2.7 VCP and 2.7 screws. The constructs consisted of an 11-hole VCP bottom plate and a 5-, 7-, 9- or 11-hole VCP superficial plate. Five of each construct were randomly tested for failure in four-point bending and axial loading. Stiffness, load at yield, and area under the curve until contact (AUC) were measured. Strains were recorded during elastic deformation for each configuration. RESULTS: During both testing methods, stiffness, load at yield and AUC progressively decreased when decreasing the length of the superficial plate. No statistically significant differences were obtained for load at yield in four-point bending and AUC in axial loading. The strain within the implant over the gap increased as the length of the superficial plate decreased. CLINICAL SIGNIFICANCE: Shortening the superficial plate reduces the stiffness and strength of the construct, and decreases stress concentration at the implants ends. As the cross section of the implant covering the gap remained constant, friction between the plates may play a role in the mechanical properties of stacked VCP.

Interactions between intracellular calcium and phosphate in intact mouse muscle during fatigue.

Fatigue was studied in intact tibialis anterior muscle of anesthetized mice. The distal tendon was detached and connected to a force transducer while blood flow continued normally. The muscle was stimulated with electrodes applied directly to the muscle surface and fatigued by repeated (1 per 4 s), brief (0.4 s), maximal (100-Hz stimulation frequency) tetani. Force declined monotonically to 49 ± 5% of the initial value with a half time of 36 ± 5 s and recovered to 86 ± 4% after 4 min. Intracellular phosphate concentration ([P(i)]) was measured by (31)P-NMR on perchloric acid extracts of muscles. [P(i)] increased during fatigue from 7.6 ± 1.7 to 16.0 ± 1.6 mmol/kg muscle wet wt and returned to control during recovery. Intracellular Ca(2+) was measured with cameleons whose plasmids had been transfected in the muscle 2 wk before the experiment. Yellow cameleon 2 was used to measure myoplasmic Ca(2+), and D1ER was used to measure sarcoplasmic reticulum (SR) Ca(2+). The myoplasmic Ca(2+) during tetani declined steadily during the period of fatigue and showed complete recovery over 4 min. The SR Ca(2+) also declined monotonically during fatigue and showed a partial recovery with rest. These results show that the initial phase of force decline is accompanied by a rise in [P(i)] and a reduction in the tetanic myoplasmic Ca(2+). We suggest that both changes contribute to the fatigue. A likely cause of the decline in tetanic myoplasmic Ca(2+) is precipitation of CaP(i) in the SR.

Effect of calcium on moving-bed biofilm reactor biofilms.

The effect of calcium concentration on the biofilm structure, microbiology, and treatment performance was evaluated in a moving-bed biofilm reactor. Three experiments were conducted in replicate laboratory-scale reactors to determine if wastewater calcium is an important variable for the design and optimization of these reactors. Biofilm structural properties, such as thickness, oxygen microprofiles, and the composition of extracellular polymeric substances (EPS) were affected by increasing calcium concentrations. Above a threshold concentration of calcium between 1 and 50 mg/L, biofilms became thicker and denser, with a shift toward increasingly proteinaceous EPS at higher calcium concentrations up to 200 mgCa2+/L. At 300 mgCa2+/L, biofilms were found to become primarily composed of inorganic calcium precipitates. Microbiology was assessed through microscopy, denaturing grade gel electrophoresis, and enumeration of higher organisms. Higher calcium concentrations were found to change the bacterial community and promote the abundant growth of filamentous organisms and various protazoa and metazoan populations. The chemical oxygen demand removal efficiency was improved for reactors at calcium concentrations of 50 mg/L and above. Reactor effluents for the lowest calcium concentration (1 mgCa2+/L) were found to be turbid (>50 NTU), as a result of the detachment of small and poorly settling planktonic biomass, whereas higher concentrations promoted settling of the suspended phase. In general, calcium was found to be an important variable causing significant changes in biofilm structure and reactor function.

Production and characterization of lignocellulosic biomass-derived activated carbon.

The goal of this work is to establish the technical feasibility of producing activated carbon from pulp mill sludges. KOH chemical activation of four lignocellulosic biomass materials, two sludges from pulp mills, one sludge for a linerboard mill, and cow manure, were investigated experimentally, with a focus on the effects of KOH/biomass ratio (1/1, 1.5/1 and 2/1), activation temperature (400-600 °C) and activation time (1 to 2 h) on the development of porosity. The activation products were characterized for their physical and chemical properties using a surface area analyzer, scanning electron microscopy and Fourier transform infrared spectroscopy. Experiments were carried out to establish the effectiveness of the lignocellulosic biomass-derived activated carbon in removing methylene blue (MB), a surrogate of large organic molecules. The results show that the activated carbon are highly porous with specific surface area greater than 500 m²/g. The yield of activated carbon was greater than the percent of fixed carbon in the dry sludge, suggesting that the activation process was able to capture a substantial amount of carbon from the organic matter in the sludge. While 400 °C was too low, 600 °C was high enough to sustain a substantial rate of activation for linerboard sludge. The KOH/biomass ratio, activation temperature and time all play important roles in pore development and yield control, allowing optimization of the activation process. MB adsorption followed a Langmuir isotherm for all four activated carbon, although the adsorption capacity of NK-primary sludge-derived activated carbon was considerably lower than the rest, consistent with its lower specific surface area.