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During the water crisis in Flint, Michigan, USA (2014-2015), 2 outbreaks of Legionnaires' disease occurred in Genesee County, Michigan. We compared whole-genome sequences of 10 clinical Legionella pneumophila isolates submitted to a laboratory in Genesee County during the second outbreak with 103 water isolates collected the following year. We documented a genetically diverse range of L. pneumophila strains across clinical and water isolates. Isolates belonging to 1 clade (3 clinical isolates, 3 water isolates from a Flint hospital, 1 water isolate from a Flint residence, and the reference Paris strain) had a high degree of similarity (2-1,062 single-nucleotide polymorphisms), all L. pneumophila sequence type 1, serogroup 1. Serogroup 6 isolates belonging to sequence type 2518 were widespread in Flint hospital water samples but bore no resemblance to available clinical isolates. L. pneumophila strains in Flint tap water after the outbreaks were diverse and similar to some disease-causing strains.

This study, guided by the theory of planned behavior (TPB), aimed to investigate whether attitude, subjective norms, and perceived behavioral control can predict parents' intentions to reduce or stop adding sugar to their child's beverages, such as tea or milk. The research also seeks to determine the predictive power of the TPB on the actual behavior of parents in reducing or halting sugar intake in their children's drinks. A questionnaire was developed to assess sweetening beverage behavior variables by mothers of children aged 3–7 years attending Lebanese public schools, with 184 responses retained with no missing values for analysis. Regression analysis was utilized to examine determinants of self-reported practice and intentions regarding sweetening beverages. Results showed that attitude and perceived behavioral control were significant predictors of intention to reduce or stop adding sugar to a child's beverages. The perception of behavioral control was found to predict the behavior of adding sugar to a child's beverages, even though the intention to reduce or stop did not. The study findings suggest that individuals with low perceived behavioral control and strong habits would be more likely to be actual performers of the adding sugar behavior regardless of their intention level. When adding sugar to a child's beverages is a common parental habit in low-income Lebanese families, our findings offer valuable insights for developing culturally and socially tailored health promotion strategies to reduce or stop adding sugar to children's beverages and raise parental awareness about the health risks associated with excessive sugar consumption in children. [ABSTRACT FROM AUTHOR]

Being a whistleblower can be lonely. The public opposition to authority that it requires often results in assaults on one's reputation. Weathering such assaults is an ordeal--one that the three [...]

PurposeTo develop an assay to quantify serum immunoglobulin (IgG, IgM, IgA) levels using dried blood spots (DBS) obtained on collection cards to be used as a tool for targeted screening for hypogammaglobulinemia.MethodsDBS samples, along with simultaneous serum samples, were collected from 107 healthy individuals (11 months to 57 years of age). After eluting proteins from DBS, IgG, IgM, and IgA were quantified by an enzyme-linked immunosorbent assay (ELISA). The Ig-DBS assay was validated through calibration curve performance, intra- and inter-assay precision, accuracy, specificity, selectivity, and linearity. The ELISA measurements were compared with serum Ig levels obtained using a standard nephelometry assay on serum samples collected simultaneously with the DBS samples and the results of the two assays were correlated. The stability of IgG, IgM, and IgA in the DBS was tested at room temperature, 36° to 38 °C, 2 to 8 °C, and -25 to -40 °C, from 4 to 14 days.ResultsThe Ig-DBS assay demonstrated precision, accuracy, specificity, selectivity, and linearity. Using the identified correlation coefficients of 0.834 for IgG, 0.789 for IgM, and 0.918 for IgA, the standard nephelometry-based normal reference ranges for all 3 serum Ig isotypes could be used with the Ig-DBS assay in individuals ≥16 years of age. The DBS samples were stable for 14 days at room temperature in a closed polyethylene bag.ConclusionsThe Ig-DBS assay is both sensitive and accurate for quantification of serum immunoglobulins. Samples are sufficiently stable at ambient temperature to allow for convenient shipping and analysis at a centralized laboratory. This assay therefore presents a new option for screening patients ≥16 years of age for hypogammaglobulinemia in any setting.