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Background: In industrialised countries diphtheria is a rare but still life-threatening disease with a recent increase in cases due to migration and zoonotic aspects. Due to the rarity of the disease, laboratory diagnosis of diphtheria is often carried out in central reference laboratories and involves the use of sophisticated equipment and specially trained personnel. The result of the diphtheria agent detection can usually be obtained after 5-6 days or more. Authors suggest a Lateral Flow Immunoassay (LFIA)-based laboratory algorithm for the diagnosis of diphtheria, which may render less time in issuing a result and could promote the testing be performed in laboratories closer to the patient. Methods: LFIA for diphtheria toxin (DT) detection was designed using a pair of monoclonal antibodies to receptor-binding subunit B of the DT, and validated with 322 corynebacterial cultures as well as 360 simulated diphtheria specimens. Simulated diphtheria specimens were obtained by spiking of human pharyngeal samples with test strains of corynebacteria. The simulated specimens were plated on selective tellurite agar and after 18-24 hours of incubation, grey/black colonies characteristic of the diphtheria corynebacteria were examined for the DT using LFIA. Results: The diagnostic sensitivity of the LFIA for DT detection on bacterial cultures was 99.35%, and the specificity was 100%. Also, the LFIA was positive for all pharyngeal samples with toxigenic strains and negative for all samples with non-toxigenic strains. For setting LFIA, a 6-hour culture on Elek broth was used; thus, under routine conditions, the causative agent of diphtheria could be detected within two working days after plating of the clinical specimen on the tellurite medium of primary inoculation. Conclusions: The availability of such a simple and reliable methodology will speed up and increase the accuracy of diphtheria diagnosis globally

Response conflicts occur when the correct goal-congruent response is weaker than an alternative but incorrect response. To overcome response conflicts, the stronger response has to be inhibited, making the study of response conflicts an important research topic in higher order cognition. Response conflicts often result in conflict interference-an increase in error rates and response times. Here, we ask whether an invertebrate-the ant, Lasius niger-can solve such response conflicts and, if so, whether it suffers from conflict interference. We also ask whether ants show congruency sequence effects, where subjects show transiently reduced conflict inference when conflicts repeat. We developed task-mimicking aspects of the Stroop color-word test, in which ants must learn to follow a neutral cue (a scent) on a Y maze but ignore a dominant and innately meaningful signal (a pheromone trail). The pheromone can be congruent with the scent cue (lead to the same maze arm) or be incongruent. Both accuracy and task-solving latency suffered when the information sources were incongruent. There was no evidence of congruency sequence effects. Because of limitations of the experimental design, we cannot rule out that insects would also show a congruency sequence effect under a different experimental paradigm. Although the methodology is not directly comparable to human studies, the presence of clear conflict interference suggests parallels between insect and human information processing, in spite of completely different brains. This powerful and straightforward methodology opens the possibility of exploring conflict interference in the presence of prepotent response tendencies in an invertebrate model. We hope this work encourages the field of response competition to use the vast literature on response competition in animal behavior studies. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

From July 2022, cases of imported diphtheria with toxigenic

Corynebacterium (C.) diphtheriae is one of the two etiological pathogens for human diphtheria with significant morbidity and mortality. Recently, members of its biovar Belfanti have been described as two novel species, C. belfantii and C. rouxii. The most important virulence factor and also the premise to cause diphtheria is the isolate’s capacity to encode and express the diphtheria toxin (DT). In contrast to C. ulcerans, which represents a potentially zoonotic pathogen, C. diphtheriae (incl. the novel deduced species) has almost exclusively been found to comprise a human pathogen. We here report three rare cases of C. rouxii isolation from dogs suffering from disseminated poly-bacterial exsudative to purulent dermatitis and a traumatic labial defect, respectively. The isolates were identified as C. diphtheriae based on commercial biochemistry and matrix-assisted laser desorption/ionisation–time of flight mass spectrometry (MALDI-TOF MS) analysis. However, recently described specific spectral peaks were highly similar to spectra of C. rouxii, which was confirmed by whole genome sequencing. Further investigations of the dog isolates for the presence of DT by tox gene qPCR revealed negative results. The findings from this study point out that skin infections in companion animals can be colonized by uncommon and so believed human specific pathogens, thereby resembling the clinical signs of cutaneous diphtheria.

The flexible adjustment to changing demands is an astonishing human ability. One related phenomenon is the context-specific proportion congruency (CSPC) effect. Regarding response conflict, the CSPC refers to reduced response interference in contexts with a high conflict proportion as opposed to contexts with a low conflict proportion. Derived from previous research showing CSPCs in the visual domain, we here aim to investigate whether human voices (male vs. female) as auditory contexts trigger control adjustments. To this end, we used a numerical judgement task with number words spoken by a male or female voice. We created response conflict by presenting the words either to the left or right ear (Experiment 1), and we created different levels of processing fluency by presenting them clearly or with background noise (Experiment 2). For a given participant, either the female or the male voice was associated with a high proportion of incongruent/disfluent trials and a low proportion of congruent/fluent trials, respectively. Extending previous findings from the visual modality, we found that the frequency of challenging information within one auditory context (i.e., the voice) can lead to typical CSPC patterns. In two further experiments, using frequency biased and unbiased items, we found evidence for the contribution of associative learning. Limitations of context control associations will be discussed.

A total of 34 Corynebacterium sp. strains were isolated from caseous lymph node abscesses of wild boar and roe deer in different regions of Germany. They showed slow growth on Columbia sheep blood agar and sparse growth on Hoyle’s tellurite agar. Cellular fatty acid analysis allocated them in the C. diphtheriae group of genus Corynebacterium . MALDI-TOF MS using specific database extensions and rpoB sequencing resulted in classification as C. ulcerans . Their quinone system is similar to C. ulcerans , with major menaquinone MK-8(H2). Their complex polar lipid profile includes major lipids phosphatidylinositol, phosphatidylinositol-mannoside, diphosphatidylglycerol, but also unidentified glycolipids, distinguishing them clearly from C. ulcerans . They ferment glucose, ribose and maltose (like C. ulcerans ), but do not utilise d-xylose, mannitol, lactose, sucrose and glycogen (like C. pseudotuberculosis ). They showed activity of catalase, urease and phospholipase D, but variable results for alkaline phosphatase and alpha-glucosidase. All were non-toxigenic, tox gene bearing and susceptible to clindamycin, penicillin and erythromycin. In 16SrRNA gene and RpoB protein phylogenies the strains formed distinct brancheswith C. ulcerans as nearest relative.Whole genome sequencing revealed the unique sequence type 578, a distinctbranch in pangenomic core genome MLST, average nucleotide identities Corynebactriumsilvaticum sp. nov., based on their first isolation from forest-dwellinggame animals. The type strain isKL0182T (= CVUAS 4292T = DSM 109166T = LMG 31313T= CIP 111 672T).

Sexual scripts serve as cognitive representations of typical elements of sexual interactions that guide sexual behavior. To the extent that cognitive scripts for consensual sex comprise elements associated with a risk of experiencing nonconsensual sex, they may be indirectly linked to sexual victimization via risky sexual behavior. A longitudinal study with 2,425 college students in Germany (58% female) examined pathways from sexual scripts for consensual sex, sexual behavior, and sexual victimization over three data waves separated by 12-month intervals. Sexual scripts and behavior were defined as risky to the extent that they include known vulnerability factors for sexual victimization (casual sex, alcohol consumption, ambiguous communication of sexual intentions). Path analyses confirmed that more risky sexual scripts prospectively predicted more risky sexual behavior, which predicted higher odds of sexual victimization. The findings held for men and women and participants with exclusively opposite-sex and both same- and opposite-sex contacts. Moreover, reciprocal influences between risky scripts and risky sexual behavior were found over time, confirming the proposed mutual reinforcement of scripts and behavior. The findings have implications for conceptualizing the role of scripts for consensual sex as vulnerability factors for sexual victimization among women and men and may inform intervention efforts.

According to the conflict monitoring theory (CMT), one of the most prominent theories of cognitive control, the exertion of cognitive control is triggered by the detection of conflicting response tendencies in the anterior cingulate cortex (ACC). Recent research has challenged this emphasis of response conflicts and has debated whether in addition to shielding after incongruent trials the relaxation after congruent trials also contributes to the sequential adaptation of control. To investigate the functionality of facilitative congruent trials in sequential adaptation of control, we conducted two experiments using a visual (Experiment 1) and an auditory (Experiment 2, preregistered) Simon task with stimuli presented laterally to the left or right (creating response congruent and incongruent trials) or without any particular spatial information (creating neutral trials). Both experiments showed converging results: in the error and reaction time data, the Simon effect was smaller following incongruent trials, larger following congruent trials, and the Simon effect following neutral trials was in-between. Results thus suggest that sequential control adaptations can originate from two processes: Increased shielding in response to incongruent trials and relaxation in response to congruent trials. Argumentations for a functional role of congruent and incongruent trials in the sequential adaptation of control suggest a more general theory of fluency monitoring instead of mere conflict monitoring. In addition, such extensions of the CMT provide theoretical explanations of how control is ever relaxed in response conflict tasks after being enhanced by conflict in the first place. Last but not least, the results may also be taken as a further hint that congruent stimuli may provide a positive affective signal for control relaxation just it has already been shown for incongruent stimuli as aversive signals for the up-regulation of control (shielding).

The turbulent dissipation rate ε is a key parameter to many oceanographic processes. Recently, gliders have been increasingly used as a carrier for microstructure sensors. Compared to conventional ship-based methods, glider-based microstructure observations allow for long-duration measurements under adverse weather conditions and at lower costs. The incident water velocity U is an input parameter for the calculation of the dissipation rate. Since U cannot be measured using the standard glider sensor setup, the parameter is normally computed from a steady-state glider flight model. As ε scales with U2 or U4, depending on whether it is computed from temperature or shear microstructure, respectively, flight model errors can introduce a significant bias. This study is the first to use measurements of in situ glider flight, obtained with a profiling Doppler velocity log and an electromagnetic current meter, to test and calibrate a flight model, extended to include inertial terms. Compared to a previously suggested flight model, the calibrated model removes a bias of approximately 1 cm s−1 in the incident water velocity, which translates to roughly a factor of 1.2 in estimates of the dissipation rate. The results further indicate that 90% of the estimates of the dissipation rate from the calibrated model are within a factor of 1.1 and 1.2 for measurements derived from microstructure temperature sensors and shear probes, respectively. We further outline the range of applicability of the flight model.

Background Diphtheria toxin (DT) is produced by toxigenic strains of the human pathogen Corynebacterium diphtheriae as well as zoonotic C. ulcerans and C. pseudotuberculosis. Toxigenic strains may cause severe respiratory diphtheria, myocarditis, neurological damage or cutaneous diphtheria. The DT encoding tox gene is located in a mobile genomic region and tox variability between C. diphtheriae and C. ulcerans has been postulated based on sequences of a few isolates. In contrast, species-specific sequence analysis of the diphtheria toxin repressor gene (dtxR), occurring both in toxigenic and non-toxigenic Corynebacterium species, has not been done yet. We used whole genome sequencing data from 91 toxigenic and 46 non-toxigenic isolates of different pathogenic Corynebacterium species of animal or human origin to elucidate differences in extracted DT, DtxR and tox-surrounding genetic elements by a phylogenetic analysis in a large sample set. Results Sequences of both DT and DtxR, extracted from whole genome sequencing data, could be classified in four distinct, nearly species-specific clades, corresponding to C. diphtheriae, C. pseudotuberculosis, C. ulcerans and atypical C. ulcerans from a non-toxigenic toxin gene-bearing wildlife cluster. Average amino acid similarities were above 99% for DT and DtxR within the four groups, but lower between them. For DT, subgroups below species level could be identified, correlating with different tox-comprising mobile genetic elements. In most C. diphtheriae, tox genes were located within known prophages. In contrast, in C. ulcerans diverse tox-including mobile elements could be identified: either prophages differing from C. diphtheriae prophages or an alternative pathogenicity island (PAI) described previously. One isolate showed a different, shorter tox-comprising putative PAI. Beyond the tox-overlapping elements, most isolates harbored a variety of additional prophages. Conclusion Our NGS data from 137 isolates indicate the existence of different genetic backgrounds of DT-mediated pathogenicity in different Corynebacterium species and evolution of once acquired pathogenicity features with the strains. Different groups of pathogenicity-related elements within C. ulcerans imply that tox transmission pathways between isolates may differ in the zoonotic species and contribute to their emerging pathogenic potential. Electronic supplementary material The online version of this article (10.1186/s12866-019-1402-1) contains supplementary material, which is available to authorized users.

Toxigenic Corynebacterium ulcerans may cause both respiratory and cutaneous diphtheria in humans. As a zoonotic emerging pathogen it has been isolated from a wide variety of animals living in captivity, such as livestock, pet, zoo and research animals and additionally in a large number of different wild animals. Here we report the isolation of tox-positive C. ulcerans in four hedgehogs with cutaneous diphtheria and pneumonia, respectively.

Toxin-producing Corynebacterium ulcerans, causing diphtheria in humans, were isolated from 53 diseased hedgehogs during spring 2020 in Belgium. Isolates showed low levels of acquired antimicrobial resistance. Pronounced strain diversity suggests emergence from an endemic situation. These findings stress the need for raising public awareness and improved wildlife disease surveillance.

Summary Background In December, 2019, the newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, causing COVID-19, a respiratory disease presenting with fever, cough, and often pneumonia. WHO has set the strategic objective to interrupt spread of SARS-CoV-2 worldwide. An outbreak in Bavaria, Germany, starting at the end of January, 2020, provided the opportunity to study transmission events, incubation period, and secondary attack rates. Methods A case was defined as a person with SARS-CoV-2 infection confirmed by RT-PCR. Case interviews were done to describe timing of onset and nature of symptoms and to identify and classify contacts as high risk (had cumulative face-to-face contact with a confirmed case for ≥15 min, direct contact with secretions or body fluids of a patient with confirmed COVID-19, or, in the case of health-care workers, had worked within 2 m of a patient with confirmed COVID-19 without personal protective equipment) or low risk (all other contacts). High-risk contacts were ordered to stay at home in quarantine for 14 days and were actively followed up and monitored for symptoms, and low-risk contacts were tested upon self-reporting of symptoms. We defined fever and cough as specific symptoms, and defined a prodromal phase as the presence of non-specific symptoms for at least 1 day before the onset of specific symptoms. Whole genome sequencing was used to confirm epidemiological links and clarify transmission events where contact histories were ambiguous; integration with epidemiological data enabled precise reconstruction of exposure events and incubation periods. Secondary attack rates were calculated as the number of cases divided by the number of contacts, using Fisher's exact test for the 95% CIs. Findings Patient 0 was a Chinese resident who visited Germany for professional reasons. 16 subsequent cases, often with mild and non-specific symptoms, emerged in four transmission generations. Signature mutations in the viral genome occurred upon foundation of generation 2, as well as in one case pertaining to generation 4. The median incubation period was 4·0 days (IQR 2·3–4·3) and the median serial interval was 4·0 days (3·0–5·0). Transmission events were likely to have occurred presymptomatically for one case (possibly five more), at the day of symptom onset for four cases (possibly five more), and the remainder after the day of symptom onset or unknown. One or two cases resulted from contact with a case during the prodromal phase. Secondary attack rates were 75·0% (95% CI 19·0–99·0; three of four people) among members of a household cluster in common isolation, 10·0% (1·2–32·0; two of 20) among household contacts only together until isolation of the patient, and 5·1% (2·6–8·9; 11 of 217) among non-household, high-risk contacts. Interpretation Although patients in our study presented with predominately mild, non-specific symptoms, infectiousness before or on the day of symptom onset was substantial. Additionally, the incubation period was often very short and false-negative tests occurred. These results suggest that although the outbreak was controlled, successful long-term and global containment of COVID-19 could be difficult to achieve. Funding All authors are employed and all expenses covered by governmental, federal state, or other publicly funded institutions.

Background Diphtheria is mainly caused by diphtheria-toxin-producing strains of Corynebacterium diphtheriae and Corynebacterium ulcerans. The recommended first-line antibiotic is penicillin or erythromycin, but reliable susceptibility data are scarce. Objectives To define WT MIC distributions of 12 antimicrobial agents and provide data for the determination of tentative epidemiological cut-off values (TECOFFs) for potentially toxigenic corynebacteria and to evaluate the potential usefulness of a gradient test (Etest) for susceptibility testing of penicillin, erythromycin and clindamycin. Methods For the 421 human or veterinary isolates from the period 2011–17, MICs of 12 antimicrobial agents were determined. Etest performance was evaluated for penicillin, erythromycin and clindamycin. Results MIC distributions were characterized and TECOFFs could be set for 11 out of 24 antibiotic/species combinations. The current EUCAST clinical breakpoints, predominantly determined for Corynebacterium species other than C. diphtheriae and C. ulcerans, divide the WT MIC distributions of penicillin and clindamycin, thereby making reproducible susceptibility testing of C. diphtheriae and C. ulcerans difficult. For erythromycin, 4% of C. diphtheriae and 2% of C. ulcerans had MICs higher than those for WT isolates. Phenotypically detectable resistance to other antibiotics was rare. Etest underestimated MICs of penicillin and lower concentrations needed to be included for erythromycin, while for clindamycin the Etest was not a good surrogate method. Conclusions MIC distributions based on reference broth microdilution for potentially toxigenic Corynebacterium spp. were developed. For five and six agents, TECOFFs were suggested for C. diphtheriae and C. ulcerans, respectively, but for Corynebacterium pseudotuberculosis the number of isolates was too low.

Cognitive control is the ability to monitor, evaluate, and adapt behavior in the service of long‐term goals. Recent theories have proposed that the integral negative emotions elicited by conflict are critical for the adaptive adjustment of cognitive control. However, evidence for the negative valence of conflict in cognitive control tasks mainly comes from behavioral studies that interrupted trial sequences, making it difficult to directly test the link between conflict‐induced affect and subsequent increases in cognitive control. In the present study, we therefore use online measures of valence‐sensitive electromyography (EMG) of the facial corrugator (frowning) and zygomaticus (smiling) muscles while measuring the adaptive cognitive control in a Stroop‐like task. In line with the prediction that conflict is aversive, results showed that conflict relative to non‐conflict trials led to increased activity of the corrugator muscles after correct responses, both in a flanker task (Experiment 1) and in a prime‐probe task (Experiment 2). This conflict‐induced corrugator activity effect correlated marginally with conflict‐driven increases in cognitive control in the next trial in the confound‐minimalized task used in Experiment 2. However, in the absence of performance feedback (Experiment 3), no reliable effect of conflict was observed in the facial muscle activity despite robust behavioral conflict adaptation. Taken together, our results show that facial EMG can be used as an indirect index of the temporal dynamics of conflict‐induced aversive signals and/or effortful processes in particular when performance feedback is presented, providing important new insights into the dynamic affective nature of cognitive control., Cognitive control plays a pivotal role in goal‐directed behavior. Nevertheless, it still remains elusive what mechanisms determine how cognitive control is recruited. Recent theories have proposed that negative emotions elicited by conflict help to adaptively increase the cognitive control. Although there is indeed accumulating evidence for the negative valence of conflict, no study has yet linked this directly to increased adaptive control. Using valence‐sensitive EMG measures, we here show that conflict is associated with increased activation of the corrugator (frowning) muscle and that the size of this effect predicts the size of conflict‐driven control adjustment in the next trial.

Background: In December 2019, a newly identified coronavirus (SARS-CoV-2) emerged in Wuhan, China, causing respiratory disease (COVID-19) presenting with fever

This study aimed to examine the pathways from child sexual abuse to sexual assault victimization and perpetration in adolescence and early adulthood, considering risky sexual behavior and lowered sexual self-esteem as mediator variables. In a two-wave longitudinal study with 2251 college students in Germany, male and female participants provided reports of sexual aggression victimization and perpetration since age 14 (T1) and again a year later (T2), covering the last 12 months. In addition, child sexual abuse (CSA; before the age of 14), risky sexual behavior, and sexual self-esteem were assessed at T1, and risky sexual behavior and sexual-self-esteem were assessed again at T2. Experience of CSA was significantly associated with greater likelihood of sexual aggression victimization and perpetration, lower sexual self-esteem, and more risky sexual behavior in both gender groups at T1 and was directly related to victimization at T2 among male participants. In both gender groups, CSA indirectly contributed to a higher probability of sexual victimization at T2 via its impact on victimization T1. In males, the indirect path from CSA to T2 perpetration via T1 perpetration was also significant. Through its negative impact on sexual self-esteem, CSA indirectly increased the probability of sexual victimization among women and the probability of sexual aggression perpetration among men. Risky sexual behavior mediated the pathway from CSA to sexual victimization at T2 for men and women and the pathway from CSA to sexual aggression perpetration for women. The findings contribute to the understanding of gendered effects of CSA on revictimization and the victim-to-perpetrator cycle.

According to feedback control models, errors are monitored and inform subsequent control adaptations. Despite these cognitive consequences, errors also have affective consequences. It has been suggested that errors elicit negative affect which might be functional for control adaptations. The present research is concerned with the temporal dynamics of error-related affect. Therefore, we ask how affective responses to errors change over time. Two experiments assessed performance in a Stroop-like task in combination with online measures of facial electromyography that index affective responses specific for muscles that are associated with the expression of negative (corrugator supercilii) and positive affect (zygomaticus major). After errors, corrugator activity first increased relative to correct trials but then decreased (below correct trials) for later time bins. Zygomaticus activity showed a concomitant inverse pattern following errors, such that an initial decrease was followed by a later increase relative to correct trials. Together, this biphasic response in both facial muscles suggests that early negative responses to errors turn into increasingly more positive ones over time. Error-triggered electromyography did marginally predict behavioral adjustments following errors at the inter-individual, but not at the intra-individual level, providing only limited evidence for a functional role of error-related affect for immediate changes in behavior. However, the dynamics of error-related electromyography points to the role of implicit emotion regulation during task performance. We propose that this process helps to maintain homeostasis of positive and negative affect which in the long term could facilitate adaptive behavior.

Clostridium (Clostridioides) difficile is a major cause of nosocomial diarrhoea. A first inter-laboratory ring trial was performed in four European countries to evaluate the genotyping and antibiotic susceptibility testing (AST) accuracy. Six C. difficile isolates representing the epidemiologic important ribotypes (RT), RT001, RT002, RT010, RT014, RT027, and RT078 were blinded and send to 21 participating laboratories. Participants tested the samples with their genotyping and AST methods in use for concordance with reference. A total of 21 genotyping- and 14 antimicrobial susceptibility data sets were obtained. Ribotyping (11 participants) correctly identified most RTs (median 91% concordance rate) except for RT002, which was misidentified in 4/11 reports. However, this isolate was correctly asserted to RT002 after an update of a publicly available ribotyping database. Multilocus sequence typing, surface layer sequence typing, DNA microarray based genotyping, and whole genome sequencing, which were used by 1–3 participants, identified all six isolates correctly. AST was done by epsilometry by the participants and compared to agar dilution data determined by the coordinating reference centre. Susceptibilities against metronidazole, moxifloxacin, and vancomycin were correctly identified in 235 of 237 cases and in accordance to agar dilution as the gold standard. Genotyping of the C. difficile test strains revealed a remarkable high concordance on the level of ribotypes with a wide variety of methods. Epsilometry appears to be a reliable method for AST of C. difficile isolates in routine clinical microbiology laboratories.

Background In 2017, a food-borne Salmonella Agona outbreak caused by infant milk products from a French supplier occurred in Europe. Simultaneously, S. Agona was detected in animal feed samples in Bavaria. Aim Using next generation sequencing (NGS) and three data analysis methods, this study’s objectives were to verify clonality of the Bavarian feed strains, rule out their connection to the outbreak, explore the genetic diversity of Bavarian S. Agona isolates from 1993 to 2018 and compare the analysis approaches employed, for practicality and ability to delineate outbreaks caused by the genetically monomorphic Agona serovar. Methods In this observational retrospective study, three 2017 Bavarian feed isolates were compared to a French outbreak isolate and 48 S. Agona isolates from our strain collections. The later included human, food, feed, veterinary and environmental isolates, of which 28 were epidemiologically outbreak related. All isolates were subjected to NGS and analysed by: (i) a publicly available species-specific core genome multilocus sequence typing (cgMLST) scheme, (ii) single nucleotide polymorphism phylogeny and (iii) an in-house serovar-specific cgMLST scheme. Using additional international S. Agona outbreak NGS data, the cluster resolution capacity of the two cgMLST schemes was assessed. Results We could prove clonality of the feed isolates and exclude their relation to the French outbreak. All approaches confirmed former Bavarian epidemiological clusters. Conclusion Even for S. Agona, species-level cgMLST can produce reasonable resolution, being standardisable by public health laboratories. For single samples or homogeneous sample sets, higher resolution by serovar-specific cgMLST or SNP genotyping can facilitate outbreak investigations.

In September 2018, a child who had returned from Somalia to Germany presented with cutaneous diphtheria by toxigenic Corynebacterium diphtheriae biovar mitis. The child’s sibling had superinfected insect bites harbouring also toxigenic C. diphtheriae. Next generation sequencing (NGS) revealed the same strain in both patients suggesting very recent human-to-human transmission. Epidemiological and NGS data suggest that the two cutaneous diphtheria cases constitute the first outbreak by toxigenic C. diphtheriae in Germany since the 1980s.

One prominent feature of adaptive cognition in humans is the ability to flexibly adjust to changing task demands. In this respect, context-specific proportion congruency (CSPC) effects describe the phenomenon that participants learn to adapt to contexts of frequently occurring conflicts even when the upcoming context cannot be anticipated. Here, we aim to provide evidence that such CSPC effects strongly depend on the affective valence of the context. Participants had to categorize pictures as animals versus humans (Experiment 1), words as male versus female (Experiment 2), and food pictures as depicting cold or hot dishes/beverages (Experiment 3). Stimuli were laterally presented to the left or right, creating Simon-like response interference. Half of the stimuli were of positive valence, half of negative valence with valence always being task-irrelevant. Positive or negative stimuli were associated with a high proportion of incongruent trials and a low proportion of congruent trials, respectively. In all three experiments, a CSPC effect was only significant when the high proportion of incongruent trials was associated with positive stimuli but reduced or even absent when the high proportion of incongruent trials was associated with negative stimuli. The findings further speak to the idea that it is the aversive nature of conflict stimuli that functions as a trigger for control adaptation. And such an unexpected aversive conflict signal looms larger when presented in a positive context than in a negative context. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

From 2016 through the middle of 2017, the German Consiliary Laboratory on Diphtheria noted an increase in nontoxigenic Corynebacterium diphtheriae isolates submitted from cities in northern Germany. Many patients for whom epidemiologic data were available were homeless, alcohol or drug abusers, or both. After performing routine diagnostics and multilocus sequence typing (MLST), we analyzed isolates of sequence type (ST) 8 and previously submitted isolates by whole-genome sequencing. Results were analyzed for phylogenetic relationship by core genome MLST (cg-MLST) and whole-genome single-nucleotide polymorphism profiles. Next-generation sequencing-based cg-MLST revealed several outbreak clusters caused by ST8; the geographic focus was in the metropolitan areas of Hamburg and Berlin. To achieve enhanced analytical depth, we used additional cg-MLST target genes and genome-wide single-nucleotide polymorphisms. We identified patient characteristics and detected transmission events, providing evidence that nontoxigenic C. diphtheriae infection is a potential public health threat in industrialized countries.

Background and aim As a consequence of socioeconomic and political crises in many parts of the world, many European Union/European Economic Area (EU/EEA) countries have faced an increasing number of migrants. In the German federal state of Bavaria, a mandatory health screening approach is implemented, where individuals applying for asylum have to undergo a medical examination that includes serological testing for HIV and hepatitis B, screening for tuberculosis, and until September 2015, stool examination for Salmonella spp. and Shigella spp.. Methods: Data from mandatory screening of all first-time asylum seekers in Bavaria in 2015 was extracted from the mandatory notification and laboratory information system and evaluated. Results: The HIV positivity and hepatitis B surface antigen (HBsAg) positivity rate of tested samples from asylum seekers were 0.3% and 3.3%, respectively, while detection rate of active tuberculosis was between 0.22% and 0.38%. The rates for HIV, hepatitis B, and tuberculosis among asylum seekers were similar to the corresponding prevalence rates in most of their respective countries of birth. Only 47 Salmonella spp. (0.1%) were isolated from stool samples: 45 enteric and two typhoid serovars. Beyond mandatory screening, louse-borne relapsing fever was found in 40 individuals. Conclusions: These results show that mandatory screening during 2015 in Bavaria yielded overall low positivity rates for all tested infectious diseases in asylum seekers. A focus of mandatory screening on specific diseases in asylum seekers originating from countries with higher prevalence of those diseases could facilitate early diagnosis and provision of treatment to affected individuals while saving resources.

The prevalence of protective anti-diphtheria toxin antibodies decreases with age. Therefore, the elderly might serve as reservoir for potentially toxigenic Corynebacterium (C.) species (C. diphtheriae, C. ulcerans, and C. pseudotuberculosis). This study aimed to examine the colonization rate of the nasopharynx with corynebacteria of individuals aged 65 years and older. In the period from October 2012 to June 2013, nasal and throat swabs were taken from 714 asymptomatic subjects aged 65–106 years (average age 77.2) at three regions in Germany and investigated for Corynebacterium species. A total of 402 strains of Corynebacterium species were isolated from 388 out of 714 asymptomatic subjects (carriage rate 54.3%). The carriage rate was significantly higher in study participants living in retirement homes (68.4%) compared to those living autonomously at home (51.1%). Strains were isolated mostly from the nose (99%). Corynebacterium accolens was the most often isolated species (39.8%), followed by C. propinquum (24.1%), C. pseudodiphtheriticum (19.4%), and C. tuberculostearicum (10.2%). No C. diphtheriae, C. ulcerans, and C. pseudotuberculosis strains were isolated. A subsample of 74 subjects was tested serologically for anti-diphtheria antibodies. Protective anti-diphtheria toxin antibodies were found in 29.7% of the subjects; 70.3% showed no protective immunity. These results suggest that carriage of potentially toxigenic corynebacteria is very rare among people aged 65 and older in Germany. However, the low prevalence of protective anti-diphtheria toxin antibodies might pose a risk for acquiring diphtheria especially for the elderly.

Mutated BRAF represents a critical oncogene in melanoma, and selective inhibitors have been approved for melanoma therapy. However, the molecular consequences of RAF inhibition in melanoma cells remained largely elusive. Here, we investigated the effects of the pan-RAF inhibitor L-779,450, which inhibited cell proliferation both in BRAF-mutated and wild-type melanoma cell lines. It furthermore enhanced apoptosis in combination with the death ligand tumor necrosis factor–related apoptosis-inducing ligand (TRAIL) and overcame TRAIL resistance in melanoma cells. Enhanced apoptosis coincided with activation of mitochondrial pathways, seen by loss of mitochondrial membrane potential and release of cytochrome c , Smac (second mitochondria–derived activator of caspases), and apoptosis-inducing factor (AIF). Subsequently, caspase-9 and -3 were activated. Apoptosis induction by L-779,450/TRAIL was prevented by Bcl-2 overexpression and was dependent on Bax. Thus, activation of Bax by L-779,450 alone was demonstrated by Bax conformational changes, whereas Bak was not activated. Furthermore, the BH3-only protein Bim was upregulated in response to L-779,450. The significant roles of Smac, Bax, and Bim in this setting were proven by small interfering RNA (siRNA)-mediated knockdown experiments. L-779,450 also resulted in morphological changes indicating autophagy confirmed by the autophagy marker light chain 3-II (LC3-II). The pro-apoptotic effects of L-779,450 may explain the antitumor effects of RAF inhibition and may be considered when evaluating RAF inhibitors for melanoma therapy.