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Chambers ST, Withers A, Dawson K, Anderson T, Williman J, Murdoch D, Scott-Thomas A, Slow S. How safe are gloves and masks used for protection against Legionella longbeachae infection when gardening? Lett Appl Microbiol 2021; 73:616-622. [PMID: 34338345 DOI: 10.1111/lam.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
Legionella longbeachae has been frequently identified in composted plant material and can cause Legionnaires' disease (LD). We wanted to determine how frequently L. longbeachae DNA was present on gardeners' gloves, and how long L. longbeachae could persist on inoculated gloves and masks. Volunteers completed a survey of gardening practices and their gardening gloves were tested for L. longbeachae DNA by qPCR. The persistence of viable L. longbeachae was assessed by timed subcultures after inoculation of gardening gloves and masks. Gloves but not masks were used regularly. L. longbeachae was detected on 11 (14%; 95% CI 8-24%) gloves. Viable organisms were recovered from 25-50% of inoculated cotton, leather and PU coated gloves but not rubber gloves after 8 h incubation. There was a difference in dose-response curve slopes by glove material (P = 0·001) and time to 50% sterility (P = 0·036). There were differences in persistence of L. longbeachae between mask types from analysis of the slopes and 50% sterility on the decay curves (P = 0·042, P < 0·001 respectively). Gardening gloves and masks may act as a vector for transmission of L. longbeachae during gardening. Washing gardening gloves and prompt disposal of masks could reduce risk of LD.
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Affiliation(s)
- S T Chambers
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - A Withers
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - K Dawson
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - T Anderson
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - J Williman
- Population Health, University of Otago, Christchurch, New Zealand
| | - D Murdoch
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - A Scott-Thomas
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - S Slow
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
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Burnside M, Lewis D, Crocket H, Wilson R, Williman J, Jefferies C, Paul R, Wheeler BJ, de Bock M. CREATE (Community deRivEd AutomaTEd insulin delivery) trial. Randomised parallel arm open label clinical trial comparing automated insulin delivery using a mobile controller (AnyDANA-loop) with an open-source algorithm with sensor augmented pump therapy in type 1 diabetes. J Diabetes Metab Disord 2020; 19:1615-1629. [PMID: 32837953 PMCID: PMC7261211 DOI: 10.1007/s40200-020-00547-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/16/2020] [Indexed: 01/22/2023]
Abstract
Background Commercialised automated insulin delivery (AID) systems have demonstrated improved outcomes in type 1 diabetes (T1D), however, they have limited capacity for algorithm individualisation, and can be prohibitively expensive if an individual is without access to health insurance or health funding subsidy. Freely available open-source algorithms, which have the ability to individualise algorithm parameters paired with commercial insulin pumps, and continuous glucose monitoring make up the so-called "do it yourself" (DIY) approach to AID. Limited data on the open-source approach have shown promising results, but data from a large randomised control trial are lacking. Methods The CREATE (Community deRivEd AutomaTEd insulin delivery) trial is an open-labelled, randomised, parallel 24-week, multi-site trial comparing sensor augmented pump therapy (SAPT) to our AnyDANA-loop. The three components of AnyDANA-loop are: 1) OpenAPS algorithm implemented in a smartphone (a version of AndroidAPS), 2) DANA-i™ insulin pump and, 3) Dexcom G6R continuous glucose monitor (CGM). The primary outcome measure is the percentage of time in target sensor glucose range (3.9 -10mmol/L). Secondary outcomes include psycho-social factors and platform performance. Analysis of online collective learning, characteristic of the open-source approach, is planned. 100 participants with T1D aged 7 - 70 years (age stratified into children/adolescents 7-15 years and adults 16-70 years), will be recruited from four sites in New Zealand. A 24-week continuation phase follows, to assess long-term safety.
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Affiliation(s)
- M Burnside
- Department of Paediatrics, University of Otago, 2 Riccarton Avenue, Christchurch, 8011 New Zealand.,Paediatric Department, Canterbury District Health Board, Christchurch, New Zealand.,Endocrinology Department, Canterbury District Health Board, Christchurch, New Zealand
| | | | - H Crocket
- Te Huataki Waiora School of Health, Sport & Human Performance, University of Waikato, Hamilton, New Zealand
| | - R Wilson
- Department of Paediatrics, University of Otago, 2 Riccarton Avenue, Christchurch, 8011 New Zealand
| | - J Williman
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - C Jefferies
- Department of Paediatric Endocrinology, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - R Paul
- Waikato Regional Diabetes Service, Waikato District Health Board, Hamilton, New Zealand.,Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - B J Wheeler
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Paediatric Department, Southern District Health Board, Dunedin, New Zealand
| | - Martin de Bock
- Department of Paediatrics, University of Otago, 2 Riccarton Avenue, Christchurch, 8011 New Zealand.,Paediatric Department, Canterbury District Health Board, Christchurch, New Zealand.,Endocrinology Department, Canterbury District Health Board, Christchurch, New Zealand
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DONNELLAN S, Cross N, Williman J, Palmer S. MON-173 DONOR SOURCE OF KIDNEY TRANSPLANTATION IN NEW ZEALAND BY ETHNICITY: A LONGITUDINAL COHORT STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hughes RCE, Williman J, Gullam JE. Universal HbA1c Measurement in Early Pregnancy to Detect Type 2 Diabetes Reduces Ethnic Disparities in Antenatal Diabetes Screening: A Population-Based Observational Study. PLoS One 2016; 11:e0156926. [PMID: 27272760 PMCID: PMC4896429 DOI: 10.1371/journal.pone.0156926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/20/2016] [Indexed: 01/07/2023] Open
Abstract
In response to the type 2 diabetes epidemic, measuring HbA1c with the first-antenatal blood screen was recently recommended in NZ. This would enable prompt treatment of women with unrecognised type 2 diabetes, who may otherwise go undetected until the gestational diabetes (GDM) screen. We compare inter-ethnic antenatal screening practices to examine whether the HbA1c test would be accessed by ethnicities most at risk of diabetes, and we determined the prevalence of unrecognised type 2 diabetes and prediabetes in our pregnant population. This is an observational study of pregnancies in Christchurch NZ during 2008-2010. Utilising electronic databases, we matched maternal characteristics to first-antenatal bloods, HbA1c, and GDM screens (glucose challenge tests and oral glucose tolerance tests). Overall uptake of the first-antenatal bloods versus GDM screening was 83.1% and 53.8% respectively in 11,580 pregnancies. GDM screening was lowest in Māori 39.3%, incidence proportion ratio (IPR) 0.77 (0.71, 0.84) compared with Europeans. By including HbA1c with the first-antenatal bloods, the number screened for diabetes increases by 28.5% in Europeans, 40.0% in Māori, 28.1% in Pacific People, and 26.7% in 'Others' (majority of Asian descent). The combined prevalence of unrecognised type 2 diabetes and prediabetes by NZ criteria, HbA1c ≥5.9% (41mmol/mol), was 2.1% in Europeans, Māori 4.7% IPR 2.59 (1.71, 3.93), Pacific People 9.5% IPR 4.76 (3.10, 7.30), and 'Others' 6.2% IPR 2.99 (2.19, 4.07). Applying these prevalence data to 2013 NZ national births data, routine antenatal HbA1c testing could have identified type 2 diabetes in 0.44% and prediabetes in 3.96% of women. Routine HbA1c measurement in early pregnancy is an ideal screening opportunity, particularly benefitting vulnerable groups, reducing ethnic disparities in antenatal diabetes screening. This approach is likely to have world-wide relevance and applicability. Further research is underway to establish whether, as for type 2 diabetes, prompt treatment of prediabetes improves pregnancy and neonatal outcomes.
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Affiliation(s)
- R. C. E. Hughes
- Department of Obstetrics and Gynaecology, University of Otago, Christchurch Women’s Hospital, Christchurch, New Zealand
- * E-mail:
| | - J. Williman
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch School of Medicine, Christchurch, New Zealand
| | - J. E. Gullam
- Department of Obstetrics and Gynaecology, University of Otago, Christchurch Women’s Hospital, Christchurch, New Zealand
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Williman J, Young S, Buchan G, Slobbe L, Wilson M, Pang P, Austyn J, Preston S, Baird M. DNA fusion vaccines incorporating IL-23 or RANTES for use in immunization against influenza. Vaccine 2008; 26:5153-8. [PMID: 18456374 DOI: 10.1016/j.vaccine.2008.03.084] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The incorporation of RANTES or IL-23 into DNA vaccines may improve their immunogenicity by the recruitment and activation of dendritic cells. This may also select for a TH1 response counteracting the TH2 response which can predominate when a DNA vaccine is delivered by gene gun. We have immunized mice with various DNA constructs encoding APR/8/34 influenza virus hemagglutinin (HA), either fused to or separate from, IL-23 or RANTES using a gene gun. Those immunized with IL-23/HA fusion constructs and challenged with influenza 27 weeks post-vaccination, tended to have cleared more virus than those vaccinated with HA DNA. Mice immunized with the RANTES/HA fusion construct produced a mixed TH1/TH2 response whereas in HA-vaccinated mice, a TH2 response predominated. Immunization with a plasmid in which HA and RANTES were under the control of separate promoters, failed to generate a mixed TH1/TH2 response suggesting that enhanced antigen uptake via RANTES receptors may contribute to the mixed immune response generated to the fusion construct. Overall these findings provide further evidence that Type 1 cytokines or chemokines, fused to antigen in a DNA vaccine, can influence the nature and the longevity of the immune response and ultimately, its protective capacity.
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Affiliation(s)
- J Williman
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
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Baird M, Wilson R, Young L, Williman J, Young S, Wilson M, Slobbe L, Lockhart E, Buchan G. Bystander Help within a Polyepitope DNA Vaccine Improves Immune Responses to Influenza Antigens. Scand J Immunol 2004; 60:363-71. [PMID: 15379861 DOI: 10.1111/j.0300-9475.2004.01487.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A polyepitope DNA vaccine has the potential to generate protective immune responses to a range of antigens in a single construct. We investigated whether it was possible to obtain responses to individual epitopes from different antigens, directly linked in a string, and whether the response to a given epitope was enhanced by adjacent epitopes within the construct. A polyepitope plasmid was created, which included three Th epitopes (influenza haemagglutinin, moth cytochrome c and ovalbumin), a Tc epitope (ovalbumin) and two B cell epitopes (haemagglutinin and ovalbumin). Mice were immunized with DNA by using a gene gun. Responses to the polyepitope DNA vaccine were compared with those to DNA vaccine comprising only the haemagglutinin Th and B epitopes (HAT(h)B) or with responses to the recombinant protein. These experiments showed that the polyepitope DNA vaccine induced greater antigen-specific responses to HAT(h)B peptide than the HAT(h)B DNA vaccine. Antigen-specific in vivo cytotoxic responses following polyepitope DNA vaccination were also clearly demonstrable. We conclude that a 'naked DNA' polyepitope vaccine generates specific responses to constituent epitopes and that adjacent irrelevant epitopes may enhance these responses.
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Affiliation(s)
- M Baird
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand.
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